经口咽前路枢椎体次全切除椎管减压术

目的：探讨经口咽前路枢椎体次全切除椎管扩大减压治疗寰枢椎脱位伴以C2后方脊髓受压为主的患者的疗效。方法：对12例先天畸形或外伤(10例先天畸形，2例外伤)引起的寰枢椎脱位伴高位脊髓压迫症患者，采用经口咽前路C2椎体次全切除术，11例仅行C2椎体次全切除，1例行C2椎体次全切除同时切除C1前结节和齿突。结果：无术中脊髓损伤、血管损伤及术后感染等并发症，术后平均随访18个月，按Symon和Lavender临床评定标准和影像学评定标准评定疗效，临床总有效率100％，显效率42％，术后影像学椎管减压改善率平均为75％。结论：该术式减压充分，是治疗以C2后方受压为主的脊髓压迫症较好的术式。

Subtotal axial vertebrectomy for spinal cord decompression by transoral anterior approach

Objective:To evaluate the climical result of subtotal axial vertebrectomy for spinal canal decom-pression by transoral anterior approach in the tractment of atlanto-axial dislocation with spinal cord compres-sion.Method:12cases of atlanto-axial dislocation with spinal cord compression caused by segmental deformity and trauma were operated on with transoral anterior approach decompression by subtotal axial vertebrectomy.Result:With an average of18months follow-up,clinical cure rate was evaluated according to Symon and Lavender.Vertebral canal vector diameters in MRI were measured.The result showed that the total climical ef-fective rate was100%,and the remarkable effective rate was42%.The average improvement rate of vertebral canal decompression was75%.No spinal cord and arteries injury and postoperative infection.Conclusion:Subtotal axial vertebrectomy by transoral anterior approach is a perfect method to treat cervical spinal cord compression on C2level.