一种新型枕颈内固定技术在创伤性枕颈区失稳手术中的应用

目的初步评价颅骨板障螺钉联合颈椎椎弓根螺钉技术在创伤性枕颈区失稳手术中的应用价值及安全性。方法对5例枕寰枢骨折脱位采用颅骨板障螺钉联合颈椎椎弓根螺钉内固定技术实施枕颈融合。结果所有病例均未出现脊髓及颅脑、椎动脉损伤,平均手术时间128min,术中平均失血360ml;随访6~24个月,全部达到骨性融合,无内置物松动、脱落或断裂。2例颅神经损伤3个月后均恢复了发声和吞咽功能;6个月后所有患者恢复工作。结论应用颅骨板障螺钉联合颈椎椎弓根螺钉内固定技术实施枕颈融合能够提供坚强的即刻稳定,是治疗创伤性枕颈区失稳安全有效的方法。

A New Surgical Technique of Internal Fixation for Posterior Occipital-cervical Fusion

Objective To assess the value and the security of the technique of the skull plat-barrier screw combined with cervical pedicle screw in the posterior occipital-cervical fusion for the occipital-cervical instability due to trauma.Methods Five patients with occipital-cervical instability underwent occipital-cervical fusion using the technique of the skull plat-barrier screw combined with cervical pedicle screw for treatment of instability due to trauma. Results Injuries of spinal cord, brain and vertebral artery occurred in no patients.The average surgical time was 128 min.The average blood loss was 360 ml.The follow-up ranged form 6 to 24 months.All patients got solid fusion.There were no instances of plate or rod breakage and loosening of screws.Two patients with associated injury of cranial nerve recovered in 3 months.All patients returned to work in 6 months.Conclusion The immediate stability can be achieved in the occipital-cervical fusion with the technique of the skull plat-barrier screw combined with cervical pedicle screw.This technique is a safer and more effective way to treat the instability of occipital-cervical area due to trauma.