前后路一期减压内固定治疗陈旧性寰枢椎脱位

总结和介绍前后路一期减压、内固定手术治疗陈旧性寰枢椎脱位的临床效果。采用同次进行经口咽前路减压松解和后路减压枕颈内固定植骨融合治疗12例难复性寰枢椎脱位伴高位颈髓压迫症。平均随访20个月，参照Symon和Lavender标准评价临床疗效；测量并比较手术前后颈椎管造影或MRI扫描椎管矢径的变化。结果显示，临床总有效率为91.6%，显效率为50％；椎管减压改善率平均达73.6%。提示前后路一期减压内固定融合术是适应于陈旧性难复性和不可复性寰枢椎脱位伴颈髓压迫症的一种临床效果较好的治疗方法。

DECOMPRESSION AND INTERNAL FIXATION WITH TRANSORAL APPROACH AND POSTERIOR APPROACH FOR THE TREATMENT OF OLD ATLANTOAXIAL DISLOCATION WITH SPINAL CORD COMPRESSION

To summarize the clinical results of combined transoral anterior decompression and posterior decompression and internal fixation of irreducible atlantoaxial dislocation with spinal cord compression. 12 cases of irreducible atlantoaxial dislocation with spinal cord compression were operated on with transoral anterior decompression combined with posterior decompression and occipitocervical internal fixation with occipitocervical CD rod or Cervifix. With an average of 20 month follow up, clinical cure rate was evaluated according to Symon and Lavender . Vertebral canal vector diameters in MR were measured. The results showed that the total clinical effective rate was 91.6%, and the remarkable effective rate was 50%. The average improvement rate of vertebral canal decompression was 73.6 %. These results suggest that transoral anterior decompression combined with posterior decompression and internal fixation is more suitable for irreducible atlantoaxial dislocation with spinal cord compression.