寰椎椎弓根螺钉技术和侧块螺钉技术的临床疗效比较

目的：探讨寰椎椎弓根螺钉和侧块螺钉固定技术的临床疗效。方法：2006年1月至2010年1月，行寰椎椎弓根螺钉固定技术32例（A组），行寰椎侧块螺钉固定技术28例（B组）。通过术中失血量、手术时间、颈枕区疼痛缓解（VAS评分）、JOA评分和术后植骨融合情况评定疗效。结果：两组患者在JOA评分，颈枕区疼痛缓解，和植骨融合率方面无明显差异。A组术中失血量和手术时间明显低于B组，有统计学意义（P〈0．05）。A组中2例出现寰椎后弓骨折。B组中有3例术后出现颈枕区疼痛加重，且伴有麻木。结论：寰椎椎弓根螺钉固定技术显露范围小，简化了操作程序，减少了术中、术后的并发症。在设计手术方案时，应优先考虑椎弓根螺钉技术，而侧块螺钉技术可以作为一种补充。

Curative Effects Comparison Between C1 Pedicle Screw and C1 Lateral Mass Screw

Objective：To compare the clinical outcomes of C1 pedicle screw and C1 lateral mass screw. Methods： From Jan. 2006 to Jan. 2010, 32 cases （group A） underwent posterior C1 pediele screw fixation technique and 28 cases （group B） underwent posterior C1 lateral mass screw fixation technique. Amount of blood loss, time of operation, JOA score, VAS score and the bone fusion rate of all Patients were followed up at regular intervals. Results：There was no difference in JOA score, VAS score and the bone fusion rate between two groups. There was a significant difference in amount of blood loss and the time of operation （P〈0.05）. Fracture of posterior arch was noted in 2 cases of group A, pain and numbness of cervic-oecipital region after operation were noted in 3 cases of group B. Conclusion：For C1 pedicle screw fixation technique, the explored range is smaller than C1 lateral mass screw fixation technique and complications is less. C1 pedicle screw fixation should be considered firstly when designing the operation plan.