摘要
目的：2008年3月~2010年3月2年间共收治的寰枢关节不稳患者57例,结合临床对影像学诊断治疗进行了研究,对X线、CT和MRI检查在该病诊断的应用价值治疗提供基础参考意见。方法：对有颈部外伤史的病人常规行X线检查,然后根据寰齿间距（ADl）和齿突侧块间隙（LADS）的结果,行下一步CT检查或者MR/检查,指导临床治疗方法的选择。X线侧位片观察寰齿前间隙（为寰椎前弓后缘与齿突前缘距离）,齿状突后倾角（齿突纵轴与枢椎体纵轴的夹角）;开口正位片上测定齿突侧块间隙。结果：对ADI增宽（大于3mm）和LADS增大（大于6.9mm）的病例CT扫描,无骨性结构损伤和韧带断裂可行颈围固定等非手术治疗。骨性结构损伤和韧带断裂或脱位者,考虑行寰枢椎融合手术或者枕颈融合术,具体根据损伤程度和类型制定手术方案。结论：X线检查是颈部外伤的常规检查手段,结合CT（尤其是三维重建）和MRI,可以了解寰枢关节周围联系结构的损伤情况,以便制定合理的治疗方案。
Objectives： It was studied 57 atlanto-axial instability cases associating clinic and imageology in two years from 2008.3 to 2010.3.The X-ray,CT and MRI inspection provided the basic reference opinions about value of diagonosis treatment of atlanto-axial instability cases.Methods： Injured patients of cervical spine was carried on X-ray inspection,according to the result of ADI and LADS,next to CT or MRI inspection,and that was to guide clinical diagonosis and treatment.To observe atlanto-dental interval（anterior arch of atlas posterior border to odontoid process anterior border） and odontoid process caster（included angle between axis of ordinate of odontoid process and axis of ordinate of odontoid vertebra） on the X-ray lateral projection.Results： To the cases of ADI widen（was bigger than 3mm） and LADS widen（was bigger than 6.9mm） carried on CT scanning,feasible neck surroundings nothing bone structure injure and ligament fracture waiting to be not operation treat.Otherwise considered the axis and atlas fusion surgery or the pulvinar neck fusion technical according to extent of damage and type formulating surgery plan.Conlusions： X-ray inspection was routine method of the cervical part injure.Integrating CT（especially three diamensions reconstitution） and MRI can work out the reasonable therapeutic program.It could understand the circumstance of the atlanto-axial joint surroundings ligment structure,in order to draw up reasonable of treatment project.
出处
《中国伤残医学》
2011年第3期6-8,共3页
Chinese Journal of Trauma and Disability Medicine
关键词
寰枢关节
不稳
影像学
寰齿间隙
齿突侧块间隙
Atlanioaxial joint
Instability
Imageology
Atlanto-dental interval
The Lateral Atlanto-Dental Space
