四川医学
四川醫學
사천의학
SICHUAN MEDICAL JOURNAL
2014年
9期
1128-1130
,共3页
张映波%张伟%付能高%谭东%蒋成%蔚芃
張映波%張偉%付能高%譚東%蔣成%蔚芃
장영파%장위%부능고%담동%장성%위봉
椎弓根螺钉系统%齿状突骨折%寰枢椎不稳
椎弓根螺釘繫統%齒狀突骨摺%寰樞椎不穩
추궁근라정계통%치상돌골절%환추추불은
pedicle screw system%odontoid fractures%atlantoaxial instability
目的:探讨经颈椎后路椎弓根螺钉治疗齿状突骨折合并寰枢椎不稳的临床疗效及手术可行性分析。方法回顾性分析2009年8月至2013年2月我院采用后路椎弓根螺钉治疗齿状突骨折合并寰枢椎不稳28例患者资料,Ⅱ型齿状突骨折伴寰枢椎不稳定19例,Ⅲ型齿状突骨折伴寰枢椎脱位9例,随访患者临床症状缓解程度、复位及植骨融合情况。结果所有螺钉位置良好,骨折与复位及固定满意。28例患者均获得随访,平均随访18个月,X线片、CT显示寰枢椎达到骨性融合,内固定物未松动及断裂。临床症状改善优良率89.3%。结论后路椎弓根螺钉治疗齿状突骨折合并寰枢椎不稳具有生物力学稳定性好,复位满意,固定可靠,植骨融合率高,最大限度地保留颈椎活动度,临床症状改善满意。
目的:探討經頸椎後路椎弓根螺釘治療齒狀突骨摺閤併寰樞椎不穩的臨床療效及手術可行性分析。方法迴顧性分析2009年8月至2013年2月我院採用後路椎弓根螺釘治療齒狀突骨摺閤併寰樞椎不穩28例患者資料,Ⅱ型齒狀突骨摺伴寰樞椎不穩定19例,Ⅲ型齒狀突骨摺伴寰樞椎脫位9例,隨訪患者臨床癥狀緩解程度、複位及植骨融閤情況。結果所有螺釘位置良好,骨摺與複位及固定滿意。28例患者均穫得隨訪,平均隨訪18箇月,X線片、CT顯示寰樞椎達到骨性融閤,內固定物未鬆動及斷裂。臨床癥狀改善優良率89.3%。結論後路椎弓根螺釘治療齒狀突骨摺閤併寰樞椎不穩具有生物力學穩定性好,複位滿意,固定可靠,植骨融閤率高,最大限度地保留頸椎活動度,臨床癥狀改善滿意。
목적:탐토경경추후로추궁근라정치료치상돌골절합병환추추불은적림상료효급수술가행성분석。방법회고성분석2009년8월지2013년2월아원채용후로추궁근라정치료치상돌골절합병환추추불은28례환자자료,Ⅱ형치상돌골절반환추추불은정19례,Ⅲ형치상돌골절반환추추탈위9례,수방환자림상증상완해정도、복위급식골융합정황。결과소유라정위치량호,골절여복위급고정만의。28례환자균획득수방,평균수방18개월,X선편、CT현시환추추체도골성융합,내고정물미송동급단렬。림상증상개선우량솔89.3%。결론후로추궁근라정치료치상돌골절합병환추추불은구유생물역학은정성호,복위만의,고정가고,식골융합솔고,최대한도지보류경추활동도,림상증상개선만의。
Objective To investigate by posterior cervical pedicle screw for the treatment of odontoid fracture combined atlantoaxial instability of clinical efficacy and surgical feasibility analysis. Methods Retrospective case analysis, from august 2009 to February 2013, with posterior pedicle screw for treatment of odontoid fracture with atlantoaxial instability in 28 patients, II type dentate process fracture with atlantoaxial instability in 19 cases type III odontoid process fractures with atlantoaxial dislocation nine cases patients were followed up for clinical symptoms of the degree of reduction and interbody fusion. Results All good screw position, fracture reduction and fixation of satisfaction. 28 patients were followed up for a mean follow-up of 18 months,X-ray, CT display atlantoaxial achieve bone fusion and internal fixation is not loose and broken. Clinical symptoms improved excellent rate of 89. 3%. Conclusion Posterior pedicle screws in the treatment of odontoid fracture with atlantoaxial instability biomechanical stability is good, satisfactory reduction, reliable fixation, interbody fusion rate, maximize the retention of cervical activity, clinical symptoms improved satisfaction .