医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2013年
36期
19-20
,共2页
郑佳状%蒋电明%张亨闰%张智%陈宇%汪凡栋%张娜
鄭佳狀%蔣電明%張亨閏%張智%陳宇%汪凡棟%張娜
정가상%장전명%장형윤%장지%진우%왕범동%장나
寰枢关节%寰椎%枢椎%重建
寰樞關節%寰椎%樞椎%重建
환추관절%환추%추추%중건
Atlantoaxial joint atlas dentata%Reconstruction
目的：总结后路经寰枢椎椎弓根固定重建寰枢关节稳定性的临床疗效。方法：2006年9月-2012年6月，共收治寰枢关节稳定性丧失患者47例，男32例，女15例，年龄21～71岁，平均40.30±5.65岁。其中新鲜齿状突骨折伴稳定性丧失15例，横韧带断裂5例，陈旧性齿状突骨折17例，先天性游离齿状突3例，先天性短小齿状突3例，类风湿性关节炎4例，寰枢关节不稳28例，寰枢关节脱位19例。神经功能根据JOA脊髓功能评分法评定，9-17分，平均11.50±1.37分。所有寰枢关节脱位患者在麻醉状态下颅骨牵引均已复位，所有患均采用后路经寰枢椎椎弓根固定行稳定性重建。结果：所有患者平稳渡过围手术期，并获得18-69个月随访，平均38.52±5.66个月。所有患者均获得解剖复位和植骨融合，末次随访时神经功能J O A评分12-17分，平均14.50±1.50分。结论：后路经寰枢椎椎弓根固定重建寰枢关节稳定性，具有操作简单、复位充分、固定坚强、融合率高等优点，是重建寰枢关节稳定性安全有效方法。
目的：總結後路經寰樞椎椎弓根固定重建寰樞關節穩定性的臨床療效。方法：2006年9月-2012年6月，共收治寰樞關節穩定性喪失患者47例，男32例，女15例，年齡21～71歲，平均40.30±5.65歲。其中新鮮齒狀突骨摺伴穩定性喪失15例，橫韌帶斷裂5例，陳舊性齒狀突骨摺17例，先天性遊離齒狀突3例，先天性短小齒狀突3例，類風濕性關節炎4例，寰樞關節不穩28例，寰樞關節脫位19例。神經功能根據JOA脊髓功能評分法評定，9-17分，平均11.50±1.37分。所有寰樞關節脫位患者在痳醉狀態下顱骨牽引均已複位，所有患均採用後路經寰樞椎椎弓根固定行穩定性重建。結果：所有患者平穩渡過圍手術期，併穫得18-69箇月隨訪，平均38.52±5.66箇月。所有患者均穫得解剖複位和植骨融閤，末次隨訪時神經功能J O A評分12-17分，平均14.50±1.50分。結論：後路經寰樞椎椎弓根固定重建寰樞關節穩定性，具有操作簡單、複位充分、固定堅彊、融閤率高等優點，是重建寰樞關節穩定性安全有效方法。
목적：총결후로경환추추추궁근고정중건환추관절은정성적림상료효。방법：2006년9월-2012년6월，공수치환추관절은정성상실환자47례，남32례，녀15례，년령21～71세，평균40.30±5.65세。기중신선치상돌골절반은정성상실15례，횡인대단렬5례，진구성치상돌골절17례，선천성유리치상돌3례，선천성단소치상돌3례，류풍습성관절염4례，환추관절불은28례，환추관절탈위19례。신경공능근거JOA척수공능평분법평정，9-17분，평균11.50±1.37분。소유환추관절탈위환자재마취상태하로골견인균이복위，소유환균채용후로경환추추추궁근고정행은정성중건。결과：소유환자평은도과위수술기，병획득18-69개월수방，평균38.52±5.66개월。소유환자균획득해부복위화식골융합，말차수방시신경공능J O A평분12-17분，평균14.50±1.50분。결론：후로경환추추추궁근고정중건환추관절은정성，구유조작간단、복위충분、고정견강、융합솔고등우점，시중건환추관절은정성안전유효방법。
Objective: To summarize the therapeutic effect of surgical treatment of atlantoaxial stability reconstruction through pedicle fixation Methods: 47cases of atlantoaxial instability were treated in our hospital from Sep.2006 to Jun .2012 , among the total , 32 males and 15females,with the age from21years to 71 years , the average 40.30±5.65years ,including 15 patients with fresh odontoid process fracture, 5 patients with ligamentum transversum broken,17patients with obsolete odontoid process fracture, 3 patients with inborn dissociation odontoid process, 3 patients with inborn short and smal odontoid process, 4 patients with rheumarthritis , 28 patients with atlantoaxial instability , 19patients with atlantoaxial dislocation . the Japanese Orthopaedic Association (JOA) score was from 9 to 17, the average 11.50±1.37.Al dislocation could be reduced through skul traction under drugged state, Al patients were performed with posterior fixation through atlantoaxial pedicle . Results: Al patients pul ed through the period time of operation securely. Al patients were fol owed up from 18to 69 months , the average 38.52±5.66 months.Al gained anatomic reduction and bone fusion.By the latest time fol owed up ,the JOA score was from 12to 17, the average 14.50±1.50.Conclusion: Surgical treatment of atlantoaxial instability reconstruction through pedicle fixation have the merits of simple operation , sufficient reduction, firm fixation ,high rate of fusion , which is a safe and effective technique for the treatment of atlantoaxial instability .
