单纯后路与前后联合入路手术治疗成年型齿突游离小骨并寰枢关节脱位Posterior alone versus combined anterior and posterior approaches for treatment of os odontoideum and atlantoaxial dislocation in adults
吴星火;杨操;郜勇;刘玮;李帅;王琨;张宇坤;宋雨;邵增务;杨述华;
摘要(Abstract):
[目的]探讨成年型齿突游离小骨继发寰枢关节脱位手术方式及其疗效。[方法]回顾性分析2010年9月~2014年9月收治的13例成年齿突游离小骨继发寰枢椎脱位患者,其中9例可复性脱位患者行单纯后路复位+寰枢椎短节段固定融合术,4例难复性脱位者行前路经口咽减压联合后路寰枢椎融合术,随访术后临床表现及影像学改变。[结果]所有患者均获随访,随访时间1~5年,平均(2.5±1.1)年;术后影像学检查示患者均达到骨性融合,愈合时间3~9个月,平均(4.5±1.6)个月;无内固定松动、断裂等并发症,2例患者术后出现颈椎不适,但颈椎屈伸旋转功能无明显受限,对日常生活无明显影响。术后神经功能均得到明显改善,末次随访,JOA评分由术前平均(9.5±1.65)分提高到(14.2±1.6)分(P<0.05)。[结论]后路短节段寰枢椎融合术是治疗成年型游离齿突伴寰枢关节脱位安全有效的治疗方法,可解除脊髓压迫,重建寰枢椎的稳定性,术后对枕颈部活动影响较小;难复性脱位患者,建议采用前路经口咽减压联合后路复位固定植骨融合术。
关键词(KeyWords): 齿突游离小骨;寰枢椎脱位;内固定;融合;成年
基金项目(Foundation):
作者(Author): 吴星火;杨操;郜勇;刘玮;李帅;王琨;张宇坤;宋雨;邵增务;杨述华;
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DOI:
参考文献(References):
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