板-棒-多轴螺钉系统后路枕颈固定疗效评价

目的]报道板-棒-多轴螺钉系统后路枕颈固定的初步疗效，探讨与其它内固定比较的优势。方法]14例接受颈枕Summit板-棒-多轴螺钉系统固定治疗，男9例，女5例。齿突发育不良并C1,2脱位3例，椎管肿瘤4例，C1,2转移癌并病理骨折、类风湿性关节炎并枕颈不稳与颅底凹陷症各2例，寰椎爆裂骨折并寰枢寰枕不稳1例。12例颈痛，13例有不同程度的脊髓损害表现，JOA评分平均12．4分。结果]所有螺钉位置良好，无螺钉植入相关并发症。所有颈痛缓解。13例获随访，平均14个月。1例颈枕未融合，枕骨螺钉拔出，其它固定满意并坚固融合。神经功能均有不同程度恢复，JOA评分改善率为63．0％。结论]板-棒-多轴螺钉系统后路枕颈固定安全可靠，取得了满意的临床疗效。与目前常用的固定方法比较具有一定优势。

Posterior occipitocervical fixation using plate-rod-polyaxial screw system

Objective]To report the initial outcomes of occipitocervical fixation using plate-rod-polyaxial screw system and investigate whether this new system offers any advantage over other existing methods of fixation.Method]Fourteen cases(male 9,female 5)accepted cervicooccipital fixation with plate-rod-polyaxial screw system.There were 3 cases of odontoid dysplasia with dislocation;spinal canal tumor in 3;2 cases of metastatic carcinoma with pathologic fracture of C_1 and C_2,rheumatoid arthritis with cervicooccipital instability,and fasilar impression;burst fracture of C_1 with oecipital-atlantal-axial instability in 1.Twelve cases had neck pain.Thirteen cases had neurological deficits in different degrees.JOA score was 12.4 on average.Result]The positions of all screws were good.There was no complication related to inserting screws.All neck pain released.Fourteen-months follow-up was obtained on average in 13 patients.Cervicooccipital nonunion was in one case and its occipital screws were pulled out.Twelve patients had satisfactory fixation and got firm fusion.Ameliotate rate of JOA score of the neurological function was 63.0%.Conclusion]These initial data indicate that posterior occipitocervical fixation using plate-rod-polyaxial screw system is safe and reliable,and satisfactory clinical outcome can be obtained.The system appears to offer some advantages over other existing methods of fixation.