摘要
目的 评价在自行设计的瞄准器辅助下椎弓根螺钉技术治疗下颈椎骨折合并强直性脊柱炎（AS）的疗效.方法 回顾性分析自2006年1月至2012年12月收治的8例下颈椎骨折合并AS患者资料,男7例,女1例;年龄35 ～ 66岁,平均39.0岁;骨折部位：经C5-6椎间隙2例,经C6-7椎间隙3例,经C6椎体1例,经C7椎体2例.患者术前行Halo-vest外固定支架固定,术中在自行设计的瞄准器辅助下行颈椎弓根螺钉内固定术.术后影像学资料提示骨折愈合后拆除Halo-vest外固定支架. 结果 8例患者均获随访,时间12 ～ 87个月（平均45个月）;术中无脊髓、椎动脉、神经根损伤等并发症发生.术后1周内影像学资料显示内固定物位置满意;术后3～6个月及末次随访均无椎弓根螺钉松动、脱出、断裂等情况发生,骨折端愈合及植骨融合良好.参照Macnab法和Otani法评定疗效：优4例,良3例,差1例. 结论 瞄准器辅助下椎弓根螺钉技术治疗下椎骨折合并AS患者,置钉安全性高、固定可靠、疗效确切.
Objective To evaluate the clinical efficacy of a self-designed aiming device used in posterior pedicle screwing for cervical spine fractures associated with ankylosing spondylitis.Methods A retrospective analysis was performed of 8 patients with cervical spine fracture associated with ankylosing spondylitis who had received cervical posterior surgery between January 2006 and December 2012 in our department.They were 7 men and one woman,from 35 to 66 years of age （mean,39.0 years）.The fracture affected C5-6 in 2 cases,C6-7 in 3,C6 in one,and C7 in 2.Preoperatively Halo-vest external fixation was installed to ensure the cervical sequence.During the operation,all the 8 patients were fixated with short cervical posterior segmental pedicle screws with the help of the self-designed aiming device.The Halo-vest external fixation was removed after postoperative radiographic data revealed fracture healing.Results The 8 cases were followed up for 12 to 87 months （mean,45 months）.No such complications as injuries to spinal cord,vertebral artery or nerve root happened.Imaging data showed satisfactory position of internal fixation by one week after operation.At 3 and 6 months and the last follow-up postoperatively,imaging information showed the fractures healed and bone grafts were fused with no pedicle screw loosening,emergence or fracture.Conclusion Treatment of cervical spine fractures associated with ankylosing spondylitis can be effectively and safely treated using posterior pedicle screws with the help of our self-designed aiming device.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2014年第9期755-759,共5页
Chinese Journal of Orthopaedic Trauma
关键词
颈椎
骨折
脊柱炎
强直性
骨折固定术
内
Cervical vertebrae
Fractures,bone
Spondylitis,ankylosing
Fracture fixation,internal
