前路松解复位后路内固定治疗难复性寰枢关节脱位

目的：探讨难复性寰枢关节脱位的手术治疗方法。方法：对3例难复性寰椎前脱位的病例经口咽入路切断颈长肌、头长肌、前纵韧带和寰枢侧块关节囊，施行松解复位术，同期行后方固定植骨融合术。后方固定方法包括：经寰枢侧块关节螺钉固定、寰枢侧块钉板固定和借助于枢椎椎弓根螺钉的枕颈固定。结果：3例均获得了解剖复位和植骨融合。结论：经口咽入路的寰枢关节松解复位术可使难复性脱位的寰枢关节获得充分复位，松解复位术是一种安全、有效的治疗方法。

Treatment of irreducible atlantoaxial dislocation with surgical lysis through transoral approach and internal fixation by means of posterior approach

Objective:To explore a new method to treat the irreducible atlantoaxial dislocation.Method:3 cas-es of irreducible atlantoaxial dislocation were treated surgically by the o pen reduction of transoral approach.During the surgery the longus collies muscle ,longus capitis muscle,anterior longitudinal ligament and atlantoax-ial articul ar capsules were cut.And arthrodesis were obtained through the posterior approac h.Posterior internal fixation included C1-2transarticular screw fixation,occipit ocervical fixation using cervical pedicle screws of xis and fixation of atantoax ial joint using plate and screws in the lateral masses of the atlas and axis.Res ult:All of the3cases obtained full reduction and arthrodesis.Conclusion:The open reduction by transoral pproach can get anatomic reduction and is a safe,effecti ve and simple method to treat irreducible atlantoaxial dislocation.