摘要
目的介绍后路内固定治疗严重寰、枢椎不稳的手术方式。方法12例寰、枢椎不稳患者中单纯Ⅱ型陈旧性齿状突骨折6例，寰、枢椎前脱位5例（其中习惯性脱位2例，伴齿状突骨折2例，伴横韧带断裂1例），寰、枢椎旋转脱位伴横韧带断裂1例。采用后路C1.2经关节螺钉联合Brooks融合术治疗。结果12例寰、枢椎不稳患者中11例共放置经关节螺钉22枚，1例陈旧性齿状突骨折患者因C2单侧椎板上缘劈裂仅行Brooks融合术。本组患者术中无椎动脉、硬脊膜破裂和脊髓损伤等并发症，随访3～32个月，植骨全部融合。结论Magerl联合Brooks融合术是治疗严重寰、枢椎不稳的有效方法，可提供有效的固定和提高植骨融合率。
Objective To introduce a surgical method of posterior fixation for atlantoaxial instability. Methods Twelve cases of atlantoaxial instability were treated by the combined use of Brooks system and posterior atlantoaxial transarticular screw insertion. In the 12 cases, there were 6 purely type Ⅱ old odontoid fractures, 5 anterior atlantoaxial dislocations （2 habitual dislocations, 2 combined odontoid fractures and 1 combined ligamentum transversum disruption）, and 1 atlantoaxial rotation and dislocation combined with ligamentum transversum disruption. Results Twenty-two transarticular screws were totally placed in 11 cases. One case of old odontoid fracture with single axial vertebral plate burst was treated only by the use of Brooks system. There was no complication such as vertebral artery injury or spinal cord injury. All the cases underwent a follow-up for 3-32 months and had bone graft fusion by radiographs. Conclusion To maximize spinal stability and improve fusion rate, the combined use of Magerl and Brooks techniques is an effective method for the treatment of atlantoaxial instability.
出处
《脊柱外科杂志》
2006年第4期212-214,218,共4页
Journal of Spinal Surgery
关键词
寰椎
枢椎
脊柱骨折
内固定器
atlas
axis
spinal fractures
internal fixators
