后路椎弓根螺钉内固定融合术治疗创伤性寰枢椎不稳Treatment of traumatic atlantoaxial instability via posterior internal fixation and fusion plus atlantoaxial pedicle screw
王守国;徐用亿;谢跃;费昊东;季峰;赵庆华;田纪伟;
摘要(Abstract):
[目的]探讨经后路椎弓根螺钉系统内固定融合术治疗创伤性寰枢椎不稳的临床疗效。[方法]回顾2008年3月~2010年10月,采用后路椎弓根钉系统固定融合治疗创伤性寰枢椎不稳20例,男14例,女6例;平均年龄39.6岁;Jefferson骨折4例,Ⅱ型齿状突骨折5例,齿状突骨折合并寰枢椎脱位3例,Jefferson骨折合并齿状突骨折1例,寰枢椎脱位7例。采用JOA(Japanese Orthopaedic Association,JOA)颈椎评分标准和VAS(visual analoguescale,VAS)评分标准评价治疗效果。[结果]手术时间(138.75±20.06)min,术中出血量(338.80±100.10)ml,术后随访12~25个月,平均随访15.56个月,所有患者均取得了骨性融合,无内固定松动断裂;VAS评分从术前(7.25±1.52)分降至末次随访(2.13±1.75)分,差异有统计学意义(P<0.01);JOA评分从术前(8.65±3.49)分提高至(13.05±4.88)分,差异有统计学意义(P<0.01),改善率为(58.01±20.15)%。[结论]后路椎弓根螺钉棒系统内固定融合术治疗创伤性寰枢椎不稳具有操作相对简便、固定牢固、融合率高等优势,是一种安全有效的治疗方法。
关键词(KeyWords): 寰枢椎不稳;椎弓根螺钉;内固定;融合
基金项目(Foundation):
作者(Author): 王守国;徐用亿;谢跃;费昊东;季峰;赵庆华;田纪伟;
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