CAJ | 학술논문

目的探讨经后路寰枢椎椎弓根钉棒系统内固定融合术治疗寰椎骨折伴齿状突骨折的可行性、方法、疗效和适应证.方法 2008年6月至2010年5月,采用寰枢椎椎弓根螺钉技术治疗寰椎骨折伴齿状突骨折26例,回顾性分析临床疗效和并发症防治,26例均采用美国强生Depuy公司生产的后路Summit钉棒系统.万向螺钉直径3.5 mm,寰椎螺钉长26～30 mm,平均28 mm,枢椎螺钉长24～28 mm,平均26 mm.术后颈托外固定保护3个月.结果患者寰枢椎椎间稳定性得到恢复,术后无一例患者发生脊髓和椎动脉损伤,所有患者均获随访,随访时间6～28个月,平均14个月,手术时间(126±26)min,出血量(350±107)ml.临床症状得到不同程度的改善.内固定断裂、变形、松动.结论经后路寰枢椎椎弓根钉棒系统内固定融合术治疗寰椎骨折伴齿状突骨折具有可行性,操作简便,固定牢固,疗效可靠.
목적 탐토경후로환추추추궁근정봉계통내고정융합술치료환추골절반치상돌골절적가행성、방법、료효화괄응증.방법 2008년6월지2010년5월,채용환추추추궁근라정기술치료환추골절반치상돌골절26례,회고성분석림상료효화병발증방치,26례균채용미국강생Depuy공사생산적후로Summit정봉계통.만향라정직경3.5 mm,환추라정장26～30 mm,평균28 mm,추추라정장24～28 mm,평균26 mm.술후경탁외고정보호3개월.결과 환자환추추추간은정성득도회복,술후무일례환자발생척수화추동맥손상,소유환자균획수방,수방시간6～28개월,평균14개월,수술시간(126±26)min,출혈량(350±107)ml.림상증상득도불동정도적개선.내고정단렬、변형、송동.결론 경후로환추추추궁근정봉계통내고정융합술치료환추골절반치상돌골절구유가행성,조작간편,고정뢰고,료효가고.
Objective To explore the clinical feasibility, approach, efficacy and indications of posterior fusion plus pedicle screw fixation in the treatment of combination atlantoaxial fractures. Methods A retrospective analysis was conducted for 26 cases of Jefferson and dens fracture treated with atlantoaxial pedicle screw from June 2008 to May 2010. Results The postoperative radiographs verified an excellent position of all screws with a satisfactory atlantoaxial reduction. Operative time was (126 ± 26) min, and blood loss was (350 ± 107) ml. During an average follow-up period of 14 months (range:6 -28), it showed no spine cord and vertebral artery injury or interfixation failure. Atlantoaxial alignment and stability were restored without any instrumentation-related complication. Conclusion Posterior atlantoaxial pedicle screw and rod fixation may provide immediate three-dimensional rigid fixation of atlantoaxial joint. This technique is more effective than other previously reported approaches.