摘要
目的:评价寰枢椎后路侧块和椎弓根螺钉徒手置入技术(无须术中影像技术引导)的安全性和可靠性。方法:应用AXIS和VERTEX内固定系统(美国枢法模公司)对17例寰枢椎不稳患者进行后路侧块(椎弓根)螺钉内固定,共置入螺钉68枚。其中男11例,女6例,年龄17～71岁,平均43.5岁。AndersonⅡ型11例(陈旧性骨折4例,新鲜骨折7例),Ⅲ型5例(陈旧性骨折1例,新鲜骨折4例);上颈椎肿瘤1例。AXIS治疗15例,VERTEX治疗2例。结果:术后X线片及CT显示寰枢椎侧块和椎弓根螺钉位置良好,2枚螺钉螺纹轻微穿破寰枢椎侧块(椎弓根)外侧皮质,3枚螺钉螺纹轻微穿破寰椎后弓上侧皮质,但不影响固定强度,也未发现与螺钉相关的神经血管并发症。结论:对寰枢椎X线和CT解剖结构了解的情况下,徒手置入寰枢椎侧块(椎弓根)螺钉行内固定手术是安全可行的。
Objective： To evaluate safety and reliability with freehand technique of posterior lateral mass screw implantation in the treatment of atlantoaxial instability. Methods：Seventeen patients with atlantoaxial instability were treated with internal fixation of AXIS（ 15 cases）and VERTEX （2 cases）system through posterior lateral mass screw implantation. Sixty-eight screws were inserted in the 17 cases. 11 male and 6 female were included in this group with the mean age of 43.5 years（range 17 -71 ）. One case was cervical tumor and the other 16 cases were odontoid fractures. Among the odontoid fractures, 11 cases were Anderson type Ⅱ（4 old and 7 fresh fracture）and 5 case were Anderaon typeⅢ（1 old and 4 fresh fracture）. Results：The X-ray and CT image showed the location of screws were good. Screws in 2 cases perforated the external cortex of lateral mass （pedicle） ,screws in another 3 cases perforated the superior cortex of posterior arch,but no effect to fixation strength. No other screw complication was found in the patients. Conclusion：If the anatiomic structure of C1-2 in X-ray and CT image is well understood,freehand technique of posterior lateral screw implantation for the treatment of atlantoaxial instability is safe and feasible.
出处
《中国骨伤》
CAS
2007年第4期253-255,共3页
China Journal of Orthopaedics and Traumatology
关键词
寰枢椎不稳
椎弓根
螺钉
内固定
Atlantoaxial instability
Pedicle of vertebral arch
Screw
Internal fixation
