孙中仪;林浩;郑勇;胡茂华;汪海滨;孙宏芝;田纪伟;

• 1:南通大学附属南京江北人民医院骨科中心

摘要(Abstract)：

[目的]评估C_(1/2)后路椎弓根螺钉骨折复位非融合内固定术对新鲜Ⅱ型齿状突骨折的疗效。[方法]回顾性分析2015年6月~2017年6月颈后路寰枢椎椎弓根螺钉复位固定非融合术+Ⅱ期去除内固定术治疗的齿状突骨折患者62例,其中男性39例,女性23例,年龄17~78岁。采用疼痛视觉模拟评分(VAS)、颈椎日本骨科协会评分(JOA)和影像检查评估临床疗效。[结果]本组62例患者均顺利完成手术,术中无脊髓、神经根和椎动脉损伤。手术时间75~160 min,平均(95.32±18.46) min;出血量90~400 ml,平均(150.47±50.92) ml。术后脑脊液漏2例,其中1例保守治疗后愈合,另1保守治疗失败后行二次手术修复硬膜治愈。切口浅表感染3例,经非手术治疗痊愈。随访时间24~36个月,平均(26.46±1.32)个月。术后12个月取出内固定物。末次随访时,VAS评分由术前(7.62±0.91)分降低至(2.91±1.23)分,差异有统计学意义(P<0.05);JOA评分由术前(7.21±2.11)分上升至末次随访时(13.22±2.41)分,差异有统计学意义(P<0.05)。所有患者C_(1/2)活动度得到保留。影像方面:术中所有患者C型臂X线机透视下显示寰枢椎完全复位,术后12个月所有患者骨折均达到骨性愈合,无内固定松动、移位;末次随访时,所有患者内固定物已取出,齿状突愈合良好,无畸形,C_(1/2)间隙正常。[结论]后路寰枢椎椎弓根螺钉复位固定非融合术+Ⅱ期去除内固定术治疗新鲜Ⅱ型齿状突骨折可保留C_(1/2)活动度,并取得满意的临床效果。

关键词(KeyWords)： 齿状突骨折;后路椎弓根螺钉内固定;非融合术

Abstract:

Keywords:

基金项目(Foundation): 南通大学临床医学专项重点项目（编号：2019LZ010）;; 江北人民医院省级科研培育项目（编号：JKK201901）

作者(Author): 孙中仪;林浩;郑勇;胡茂华;汪海滨;孙宏芝;田纪伟;

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