摘要
目的观察自行研发的寰枢椎脱位后路复位钳在辅助单纯后路钉棒系统复位固定治疗难复性寰枢椎脱位中的初步应用效果。方法在寰枢椎后路钉棒系统的基础上,研制寰枢椎脱位后路复位钳辅助单纯后路钉棒系统治疗难复性寰枢椎脱位。回顾性研究2021年1月至2022年10月中国人民解放军南部战区总医院脊柱外科应用此技术治疗的5例难复性寰枢椎脱位患者资料。男2例,女3例;年龄分别为53、62、45、32、48岁;诊断:游离齿状突并寰枢椎脱位1例,寰枢椎脱位2例,陈旧性齿状突骨折并寰枢椎脱位2例。术前日本骨科协会(JOA)评分分别为9、11、12、13、10分,寰齿前间隙(ADI)分别为9.8、7.4、6.6、6.4、8.5 mm。术后行X线、CT及MRI检查评价寰枢椎复位及脊髓压迫情况,行X线、CT检查评价内固定、寰枢椎序列及植骨融合情况。术后1周采用JOA评分评估患者神经功能状态,测量术后1周ADI以评估寰枢椎复位情况。结果5例患者手术成功实施,术中均未出现脊髓神经及血管损伤等并发症。术后寰枢椎复位满意,内固定位置良好,脊髓压迫解除,术后临床症状明显缓解。术后1周JOA评分分别为13、14、14、15、13分,术后1周ADI分别为2.6、2.1、1.8、1.5、2.2 mm,随访时间分别为3、6、12、9、6个月,骨性融合时间分别为3、3、6、6、3个月。随访期间无内固定松动或断裂,寰枢椎序列良好,无复发脱位。结论自行研发的寰枢椎脱位后路复位钳可辅助单纯后路钉棒系统治疗难复性寰枢椎脱位,初步疗效满意。
Objective To evaluate the preliminary clinical application of our self-designed posterior reduction forceps for atlantoaxial dislocation in the reduction and fixation of irreducible atlantoaxial dislocation with simple posterior screw-rod system.Methods Our posterior reduction forceps was self-designed and developed to assist simple posterior screw-rod system in the treatment of irreducible atlantoaxial dislocation based on the posterior atlantoaxial screw-rod system.A retrospective study was conducted to analyze the clinical data of 5 patients with irreducible atlantoaxial dislocation who had been treated from January 2021 to October 2022 at Department of Spine Surgery,General Hospital of Southern Theatre Command of PLA with our self-designed posterior reduction forceps.There were 2 males and 3 females,aged 53,62,45,32 and 48 years,respectively.Diagnosis:1 case of free odontoid process combined with atlantoaxial dislocation,2 cases of atlantoaxial dislocation,and 2 cases of old odontoid process fracture combined with atlantoaxial dislocation.Respectively,their preoperative Japanese Orthopaedic Association(JOA)scores were 9,11,12,13 and 10 points and their atlanto-dental intervals(ADI)9.8,7.4,6.6,6.4 and 8.5 mm.Postoperatively,atlantoaxial reduction and spinal cord compression were evaluated by X-ray,CT,and MRI examinations,and internal fixation,atlanto-axial sequence,and bone graft fusion by X-ray and CT examinations.One week after surgery,the JOA scores were used to evaluate the patients'neurological function and the ADI was measured to evaluate the atlantoaxial reduction.Results The surgery was successfully performed in the 5 patients,with no intraoperative complications like neurovascular injuries to the spinal cord.The postoperative atlantoaxial reduction was satisfactory,the position of internal fixation was good,the compression to the spinal cord was relieved,and the clinical symptoms were significantly improved.At 1 week after surgery,respectively,the JOA score:13,14,14,15 and 13;the ADI:2.6,2.1,1.8,1.5 a
作者
马向阳
邹小宝
杨浩志
张双
邓琛府
马仁财
陈钧麟
夏虹
Ma Xiangyang;Zou Xiaobao;Yang Haozhi;Zhang Shuang;Deng Chenfu;Ma Rencai;Chen Junlin;Xia Hong(Department of Spine Surgery,General Hospital of Southern Theatre Command of PLA,Guangzhou 510010,China;Military Orthopedic Trauma Research Institute,Guangzhou 510010,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2023年第10期853-858,共6页
Chinese Journal of Orthopaedic Trauma
基金
国家自然科学基金(82272582)
广州市科技计划项目(201803010046)。
关键词
寰枢关节
脱位
关节融合术
难复性寰枢椎脱位
后路钉棒系统
后路复位钳
Atlanto-axial joint
Dislocation
Arthrodesis
Irreducible atlantoaxial dislocation
Posterior screw-rod system
Posterior reduction forceps
