寰枢椎不稳的后路内固定治疗

目的　介绍寰枢椎不稳的后路内固定治疗的新方法。方法　 18例寰枢椎不稳患者经后路治疗 ,其中Apofix9例 ,Apofix +C1,2 经关节螺钉 9例。结果　共放置经关节螺钉 17枚 ,1例因放置过程中引起大出血 ,仅进行了单侧放置。术后并发感染 2例 ,经清创后愈合 ,无内固定失败和椎动脉及脊髓损伤等并发症。随访 5～ 16月 ,植骨全部融合。结论　Apofix和C1,2 经关节螺钉技术是治疗寰枢椎不稳的有效方法 ,可提供有效的固定和提高植骨融合率。

Posterior surgical approach for atlantoaxial instability

Objective To introduce the new methods of posterior approach for the atlantoaxial instability. Methods Nighteen patients with atlantoaxial instability were treated by using new technique that nine of them were using the Apofix system, and nine others were combining use of the Apofix and the posterior atlantoaxial transarticular screw insertion;only one was using the individual fixation of the C 1 lateral mass and C 2 pedicle with Axis system.Results There was neither vertebral artery injury nor spinal cord injury being experienced clinically, despite one case of neurological complication postoperatively related to the procedure; two patients were experienced a deep wound infection responding to the surgical debridement and intravenous antibiotics. On follow up from five months to 16 months, there was no case of implant failure and the radiological study indicated evidence of solid fusion in all patients at their last follow-up visit. Conclusion It is strongly suggesting to use the transarticular screw fixation combined with other techniques in order to get maximum stability and improved fusion rate.