摘要
目的探讨寰枢椎椎弓根螺钉固定非融合治疗新鲜齿状突Ⅱ型骨折的疗效。方法2007年1月至2010年2月，共28例小于50岁的新鲜齿状突Ⅱ型骨折患者，其中男17例，女11例。均采用寰枢椎椎弓根螺钉固定，未植骨融合，骨折愈合后取出内固定观察颈椎旋转功能恢复情况。结果28例患者均获随访，随访时间6～24个月，平均14个月，齿状突骨折均维持解剖复位。随访时均行CT三维重建以了解骨折愈合情况。术后3～6个月骨折愈合，平均5个月。骨折愈合后取出内固定，行颈椎功能位检查，所有患者稳定性良好。初期颈椎旋转功能明显降低，经指导功能锻炼及理疗3个月后，所有旋转功能改善接近正常。结论后路寰枢椎椎弓根螺钉固定具有稳定的三维固定效果，能满足年轻患耆新鲜齿状突Ⅱ型骨折愈合需要，而不需寰枢椎融合，骨折愈合后取出内固定有利于恢复上颈椎旋转功能。
Objective To explore the efficacy of C1-C2 pedicle screw fixation and non-fusion for fresh odontoid fractures. Methods 28 patients （ 17 males and 11 females, aged less than 50 years ） with fresh type ？odontoid fractures who had been hospitalized during the period of January 2007 to February 2010 received C1- C2 pedicle screw fixation and non-fusion. The screws were removed after fractures were cured to observe the rotation function of the cervical spine. Resuhs All the patients were followed up for 6 to 24 months, with an average of 14 months. CT scans showed fracture healing occurred from 3 to 6 months after surgery in all the patients, with an average of 5 months. Cervical function was assessed after the screws were removed. The rotation function of the cervical spine was significantly reduced after surgery, but it returned to near normal 3 months after functional exercises and physical therapy. Conclusions Atlantoaxial posterior pedicle screw fixation without atlantoaxial fusion has a stable three-dimensional fixing effects and meets the need of healing in younger patients with type Ⅱ fresh odontoid fi＇actures. Screw removal after fracture healing is beneficial for the recovery of upper cervical spine rotation.
出处
《国际医药卫生导报》
2011年第15期1817-1820,共4页
International Medicine and Health Guidance News
