摘要
目的总结侧块螺钉与椎弓根螺钉技术治疗寰枢椎不稳的效果,探讨寰枢椎不稳的固定方法。方法采用寰椎侧块螺钉与枢椎椎弓根螺钉技术对15例寰枢椎不稳的患者进行固定。男9例,女6例;平均年龄39.5岁。术前行颅骨牵引。寰椎侧块螺钉进钉点选择在寰椎后结节中点旁开18～20mm,与后弓下缘以上2mm的交点,钉道方向在冠状面垂直,矢状面上螺钉头端向头侧倾斜约5°。枢椎进钉点为枢椎下关节突根部中点,钉道与矢状面夹角约15°,横断面夹角约30°。螺钉直径3.5mm,寰椎侧块螺钉长28～32mm,枢椎椎弓根螺钉长22～26mm。结果本组平均随访14个月。所有患者症状消失,植骨块全部融合。无内固定断裂、松动。结论侧块螺钉与椎弓根螺钉技术稳定性良好,具有三维固定的优点。
Objective To summary the results of fixation and fusion with lateral mass screw of atlas combined with vertebra dentata pedicle screw for treatment of atlantoaxial instability and discuss the corresponding therapy methods. Methods A total of 15 cases were fixed and fused with lateral mass screw of atlas and vertebra dentata pedicle screw. There were nine males and six females, with a mean age of 39.5 years. Skull traction was performed before operation. Screws were placed at lateral mass of at- las beside the posterior arch of atlas about 18-20 mm and at the point of intersection above 2 mm inferior boarder of posterior arch. Vertical to coronal plane, the tip of the screw made 5°of lateriversion towards the head in sagittal plane. The screws for verebra dentate were placed at the inferior articular process of axis, with 15° to sagittal plane and 30° to cross section. The diameter of the screw was 3.5 mm, the length of lateral mass of atlas 28-32 mm and the length of vertebra dentate pedicle screw 22-26 mm, Resuits The follow up for average 14 months showed that all cases obtained bony union, without internal fixation breakage or loosening. ConclusionThe lateral mass screw of atlas combined with vertebra dentata pedicle screw is characterized by good stability and three-dimensional fixation.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2005年第10期764-767,共4页
Chinese Journal of Trauma
