使用颗粒状自体松质骨植骨的寰枢椎后路融合术

介绍一种在头环背心保护下用颗粒状自体松质骨植骨的寰枢椎后路融合术。对３４例寰枢椎不稳的病人施行了寰枢椎后路融合术。用头环背心维持寰椎的复位，将颗粒状的自体松质骨植于寰椎后弓和枢椎椎板的背面，不用内固定，直至植骨融合。３１例病人获得了随访，平均随访时间３０个月，其中２９例融合成功，术后头不背心固定时间平均为１３周，有３例出现了寰椎再移位。颗粒状自体松质骨比块状的全层骨更有利于融合。用头环背心的外固定

Atlantoaxial Arthrodesis Using Granulated Autogenous Cancellous Bone Graft with Halo Vest Immobilization

A new technique of C 1-C 2 posterior fusing with autogenous granulated cancellous bone graft and halo vest immobilization was presented. 34 patients with instability of C 1 and C 2 were treated by this technique. The technique consists of reducing the dislocation of C 1 and C 2 by posture and traction, and maintaining the alignment of C 1 and C 2 by the halo vest immobilization. A limited incision was made to expose the posterior aspect of the arch of C 1 and C 2 and autogenous granulated cancellous bone grafted onlay. 31 of 34 cases was followed up for an average of 30 months. 29 cases achieved solid bony union of C 1 and C 2, 3 cases had redisplacement of C 1 and C 2 . It is suggested that granulated autogenous cancellous bone graft may be more advantageous for bone union than using the cortical bone graft. The halo vest immobilization may be competent for this technique without internal fixation.