创伤性寰椎横韧带断裂

目的：探讨创伤性寰椎横韧带断裂的诊断和治疗。方法：回顾性分析２３例创伤性寰椎横韧带断裂，其中急性损伤９例，陈旧性损伤１４例。所有患者均有颈部症状。１７例有神经损害。Ｘ线检查显示寰齿间距（ＡＤＩ）为６￣１４ｍｍ。本组有５例行非手术治疗，其余１８例行枕颈融合术或寰枢椎融合术。结果：随访１￣１７年（平均７年），５例接受保守治疗患者中有４例出现寰枢椎不稳及迟发性脊髓损害，１８例手术治疗患者中４例完全恢复正

Traumatic Disruption of the Transverse Atlantal Ligament

Objective: To delineate diagnosis and treatment of traumatic transverse atlantal ligament disruption.Methods: Twenty three patients with traumatic disruption of the transverse atlantal ligament, 9 acute and 14 old injuries, were treated. All the patients had the neck symptoms and 17 had neurological deficits. Radiographic examinations demonstrated that the atlanto dental interval (ADI) in these patients was between 6 to 14 mm. Five patients were treated conservatively, and 18 underwent occipitocervical or atlantoaxial fusion. Results: All were followed up for 7 (1 to 17) years. Of 5 patients treated nonoperatively, 4 developed an atlantoaxial instability with delayed myelopathy and 1 with an avulsion injury had no complaints. Of 18 patients treated operatively, 4 recovered completely, 7 had some local symptoms, 2 had their preoperative neurological deficits decreased in severity but 5 showed no improvement in neurological status. Conclusion: The transverse atlantal ligament is of the greatest importance to maintaining atlantoaxial stability. Once this ligament is ruptured, anterior dislocation of atlas will be induced. The severity of clinical symptoms mostly depends upon the degree of atlantal displacement and cord compression. Diagnosis should be made relying upon clinical presentation as well as the change of ADI. Atlantoaxial fusion is indicated in acute phase but for old injury with unreducible atlantoaxial subluxation occipitocervical fusion is usually performed.