CAJ | 학술논문

目的探讨和评估后路寰枢椎椎弓根钉棒固定融合治疗寰枢关节失稳的临床疗效。方法对2008年8月—2012年3月收治的9例寰枢椎失稳患者(其中先天性齿突发育不良3例，创伤性陈旧性寰枢关节脱位6例)施行后路寰枢椎椎弓根钉棒固定融合并行自体髂骨植骨融合，其中5例难复性脱位者先行前路松解术。结果全组病例未发生与置钉相关的并发症；所有病例术后随访6—24个月，临床症状得到不同程度的改善，复查x线片、CT见上颈椎融合良好，螺钉位置良好，无松动、断钉，术后随访效果满意。结论寰枢椎椎弓根钉棒固定治疗寰枢关节失稳效果良好，是寰枢椎后路固定较好的手术方式。
목적탐토화평고후로환추추추궁근정봉고정융합치료환추관절실은적림상료효。방법대2008년8월—2012년3월수치적9례환추추실은환자(기중선천성치돌발육불량3례，창상성진구성환추관절탈위6례)시행후로환추추추궁근정봉고정융합병행자체가골식골융합，기중5례난복성탈위자선행전로송해술。결과전조병례미발생여치정상관적병발증；소유병례술후수방6—24개월，림상증상득도불동정도적개선，복사x선편、CT견상경추융합량호，라정위치량호，무송동、단정，술후수방효과만의。결론환추추추궁근정봉고정치료환추관절실은효과량호，시환추추후로고정교호적수술방식。
Objective To evaluate the clinical effect of C1,2 pedicle screw-rods/plates internal fixation for atlantoaxial instability. Methods Nine patients with atlantoaxial instability (including 3 cases of congenital dysplasia of odontoid process, 6 cases of old traumatic atlanto-axial joint dislocation) were treated by C1,2 pedicle screw-rods/plates internal fixation and bone graft fusion from August 2008 to March 2012. 5 patients with irreducible atlantoaxial dislocation among them underwent anterior release first. Results There were no complications related with the padicle screw insertion. All patients were followed by 6-24 months, the clinical symptom was improved in some extent after operation. There was no upper cervical instability or reduction lose according to X rays and CT. No losseness or breakage of screw occured and bony fusion was achieved in all cases. Conclusions C1, C2 pedicle screw-rods/plates internal fixation and bone graft fusion technique is a reliable method for atlantoaxial instability which can well reestabilish the upper cevical vertebral stability.