后路枕颈固定复位减压术治疗颅底凹陷症的疗效分析

目的 探讨后路枕颈固定复位减压术治疗颅底凹陷症的效果。方法 回顾性分析2015年6月至2020年1月采用单一后路枕颈固定复位减压术治疗的70例颅底凹陷的临床资料。记录病人报告的日本骨科学会（PRO-JOA）评分，用ΔPRO-JOA判断恢复程度，ΔPRO-JOA=（术后PRO-JOA评分-术前PRO-JOA评分）/（17-术前PRO-JOA评分）×100%，其中≥60%为手术效果较好，<60%为手术效果一般。结果 70例中，A型颅底凹陷有寰枢椎脱位，寰椎齿状突间距（ADI）≥3 mm]28例，B型颅底凹陷症（无寰枢椎脱位，ADI<3 mm）42例。70例顺利完成手术，无手术死亡病例。70例术后随访12～60个月，平均（36.2±10.3）个月。A型末次随访，24例（85.71%）手术效果较好，4例手术效果一般。B型末次随访，33例（78.57%）手术效果较好，9例手术效果一般。结论 后路固定复位减压术治疗颅底凹陷症，A型和B型都可获得良好的疗效。

Clinical efficacy of posterior occipitocervical fixation and decompression for patients with basilar invagination

Objective To investigate the clinical efficay of posterior occipitocervical fixation and decompression (PCFD) for the patients with basilar invagination (BI). Methods The clinical data of 70 patients with BI who underwent PCFD from June 2015 to January 2020 were retrospectively analyzed. The patient-reported Japanese Orthopaedic Association (PRO-JOA) score was recorded and the ΔPRO-JOA was calculated, with a ΔPRO-JOA ≥60% as good outcome. Results Of 70 patients with BI, 28 patients were classified as type A atlantoaxial dislocation, atlantodental interval (ADI)≥ 3 mm] and 42 as type B (no atlantoaxial dislocation, ADI<3 mm). All the operations were completed successfully without surgical death. The follow up ranged from 12 months to 60 months with a mean time of (36.2±10.3) months. At last follow up, 24 patients (85.71%) of type A had good outcomes and 33 patient (78.57%) of type B had good outcomes. Conclusions PCFD can achieve good outcomes in the treatment of patients with BI including types A and B.