儿童陈旧性寰枢椎脱位的诊断与治疗
王鹏波;王丙超;徐韬;甫拉提·买买提;曹锐;梁卫东;盛伟斌;
摘要(Abstract)：
[目的]探讨儿童陈旧性寰枢椎脱位的治疗方法并对其疗效进行分析。[方法]回顾性分析2009年1月～2016年10月收治的21例陈旧性寰枢椎脱位患儿资料,男15例,女6例;年龄1.6～12岁。所有患儿均为前脱位,入院后均予枕颌带牵引。均采用Ⅰ期前路松解后路寰枢椎植骨融合内固定术。术后随访观察患儿临床症状和神经功能改善情况,影像学检查复位和植骨融合情况。[结果]患儿均顺利完成手术,术中均未发生椎动脉损伤和脊髓损伤、脑脊液漏等并发症。术后颈椎CT及MRI显示寰枢椎均复位满意,脊髓无压迫。所有患儿均获得随访,随访时间13～48个月,平均(21.52±7.66)个月。术后6个月随访时除3例患儿ASIA分级无明显改变外,其余患儿神经功能均明显改善,ASIA分级由术前B级1级,C级9例,D级11例改进至C级3例,D级7例,E级11例,平均改善率90%;JOA评分由术前(9.73±0.07)分提高到(15.81±1.22)分。术后植骨均融合,融合时间3～6个月,平均(4.19±1.15)个月。末次随访期间未发现螺钉松动、移位及再移位,2例患儿于术后2年拆除内固定。[结论]儿童陈旧性寰枢椎脱位牵引复位困难,复位后再脱位的发生率高,采用一期前路松解后路植骨融合内固定术治疗可取得较满意的临床效果。
关键词(KeyWords)： 陈旧性寰枢椎脱位;儿童;固定融合术
基金项目(Foundation):
作者(Author): 王鹏波;王丙超;徐韬;甫拉提·买买提;曹锐;梁卫东;盛伟斌;
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参考文献(References)：
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