寰椎后弓椎板钩联合枢椎椎弓根螺钉固定治疗Ⅱ型齿突骨折

目的评估寰椎后弓椎板钩联合枢椎椎弓根螺钉固定植骨融合治疗Ⅱ型齿突骨折的疗效。方法2004年3月-2007年3月对13例Ⅱ型齿突骨折患者以寰椎后弓椎板钩联合枢椎椎弓根螺钉固定自体髂骨植骨融合术进行治疗，其中6例伴脊髓受损症状。结果术中未发生椎动脉和脊髓损伤；平均随访时间为18个月（6—32个月）；未发生内固定物松动、断裂。所有患者寰枢椎均融合。6例脊髓受损患者术前JOA评分为10．1分（9．2～11．8分），术后2周JOA评分为15．6分（15．2～16．8分）。结论寰椎后弓椎板钩联合枢椎椎弓根螺钉固定植骨融合术治疗Ⅱ型齿突骨折是一种安全有效的方法。

Laminar hooks of C1 posterior arch combined with C2 pedicle screws in the treatment of type Ⅱ odontoid fracture

Objective To evaluate the effects of fixation and fusion and with laminar hooks of C1 posterior arch combined with C2 pedicle screws in the treatment of type Ⅱ odontoid fracture. Methods From march 2004 to march 2007, 13 cases of type Ⅱ odontoid fracture were treated with laminar hooks of C1 posterior arch combined with C2 pedide screws and autogenous iliac bone graft, of which 6 cases were complicated with spinal cord injury. Results There was no vertebral artery injury and spinal cord injury during operation. All patients were followed up for average 18 months （from 6 to 32 months）. No postoperative internal fixation loose and breakage were observed and aflantoaxial fusion was seen in all the cases. The mean JOA score of six cases with spinal cord injury was 10. 1 （from 9.2 to 11.8） pre-operatively and 15.6 （from 15.2 to 16.8） after 2 postoperative weeks. Conclusion The fixation and fusion with laminar hooks of C1 posterior arch and C2 pedide screws in the treatment of type Ⅱ odontoid fracture is a safe and effective method.