临床骨科杂志
臨床骨科雜誌
림상골과잡지
Journal of Clinical Orthopaedics
2015年
5期
513-516,517
,共5页
林斌%陆成武%林达生%张文彬%俞辉%杨文清%黎秋生
林斌%陸成武%林達生%張文彬%俞輝%楊文清%黎鞦生
림빈%륙성무%림체생%장문빈%유휘%양문청%려추생
强直性脊柱炎%寰枢椎脱位%椎弓根螺钉%内固定%融合
彊直性脊柱炎%寰樞椎脫位%椎弓根螺釘%內固定%融閤
강직성척주염%환추추탈위%추궁근라정%내고정%융합
ankylosing spondylitis%atlantoaxial dislocation%pedicle screw%internal fixation%fusion
目的:探讨经后路椎弓根螺钉系统内固定融合术治疗强直性脊柱炎( AS)并寰枢椎脱位的临床疗效。方法采用后路椎弓根螺钉系统固定融合治疗6例强AS并寰枢椎脱位患者。应用JOA颈椎评分标准和VAS评分标准评价治疗效果。结果手术时间(98.17±9.85) min,术中出血量(301.67±34.30) ml。患者均获随访,时间3~6年。6例均骨性融合,无内固定松动断裂;2例表现为枕大神经刺激症状者,术后即消失;3例伴有四肢不同程度运动及感觉障碍者,术后6个月~1年完全恢复。 VAS从术前(7.0±1.0)分降至末次随访时(2.2±1.2)分,差异有统计学意义(P<0.01);JOA从术前(7.17±2.48)分提高至(13.67±2.42)分,差异有统计学意义(P<0.01)。结论寰枢椎脱位是AS常见并发症。后路椎弓根螺钉系统内固定融合术是治疗AS并寰枢椎脱位不稳的有效治疗方法。
目的:探討經後路椎弓根螺釘繫統內固定融閤術治療彊直性脊柱炎( AS)併寰樞椎脫位的臨床療效。方法採用後路椎弓根螺釘繫統固定融閤治療6例彊AS併寰樞椎脫位患者。應用JOA頸椎評分標準和VAS評分標準評價治療效果。結果手術時間(98.17±9.85) min,術中齣血量(301.67±34.30) ml。患者均穫隨訪,時間3~6年。6例均骨性融閤,無內固定鬆動斷裂;2例錶現為枕大神經刺激癥狀者,術後即消失;3例伴有四肢不同程度運動及感覺障礙者,術後6箇月~1年完全恢複。 VAS從術前(7.0±1.0)分降至末次隨訪時(2.2±1.2)分,差異有統計學意義(P<0.01);JOA從術前(7.17±2.48)分提高至(13.67±2.42)分,差異有統計學意義(P<0.01)。結論寰樞椎脫位是AS常見併髮癥。後路椎弓根螺釘繫統內固定融閤術是治療AS併寰樞椎脫位不穩的有效治療方法。
목적:탐토경후로추궁근라정계통내고정융합술치료강직성척주염( AS)병환추추탈위적림상료효。방법채용후로추궁근라정계통고정융합치료6례강AS병환추추탈위환자。응용JOA경추평분표준화VAS평분표준평개치료효과。결과수술시간(98.17±9.85) min,술중출혈량(301.67±34.30) ml。환자균획수방,시간3~6년。6례균골성융합,무내고정송동단렬;2례표현위침대신경자격증상자,술후즉소실;3례반유사지불동정도운동급감각장애자,술후6개월~1년완전회복。 VAS종술전(7.0±1.0)분강지말차수방시(2.2±1.2)분,차이유통계학의의(P<0.01);JOA종술전(7.17±2.48)분제고지(13.67±2.42)분,차이유통계학의의(P<0.01)。결론환추추탈위시AS상견병발증。후로추궁근라정계통내고정융합술시치료AS병환추추탈위불은적유효치료방법。
Objective To investigate the therapeutic effect of posterior internal fixation and fusion plus pedicle screw in treatment of ankylosing spondylitis( AS) patients with atlantoaxial dislocation. Methods 6 patients who diagnosed with AS with atlantoaxial dislocation were performed posterior internal fixation and fusion plus atlantoaxial pedicle screw. Preoperative and postoperative JOA scores and VAS were measured to evaluate the curative effect. Results The operation time was (98. 17 ± 9. 85)min and blood loss were (301. 67 ± 34. 30)ml. All cases were followed up for 3 ~6 years. All atlantoaxial joint got bony fusion by the last follow-up without complication due to instrumentation failure. Two patients complained peripheral nerve stimulation of the occipital nerves, the symptoms relieved postoper-ation. Three cases with limbs motor and sensory disabilities, however, the symptoms relieved spontaneously within 6~12 months. There was significant difference on VAS scores between preoperation 7. 0 ± 1. 0 and postoperation 2. 2 ± 1. 2 (P<0. 01). There was significant difference on JOA scores between preoperation 7. 17 ± 2. 48 and postop-eration 13. 67 ± 2. 42 (P<0. 01). Conclusions Atlantoaxial dislocation is a common complication of AS. Posterior internal fixation and fusion plus pedicle screw is a safe and effective technique for AS patients with atlantoaxial dislo-cation.