摘要
目的:初步报告后路寰枢椎侧块钉板固定植骨融合术治疗寰枢椎不稳定的近期疗效。方法:用特制螺钉经寰椎后弓根部沿寰椎侧块纵轴置入,固定枢椎的螺钉沿枢椎椎弓峡部进入椎弓根,用连接板将寰枢椎固定螺钉的尾端相连接,用螺母锁定,使寰枢椎得到稳定。在寰枢椎后弓间植入松质骨颗粒。结果:治疗10例因齿状突不连而寰枢不稳的患者,平均随访19.4个月,1例固定失败而改用枕颈固定,其余9例均获得了骨性融合。1例术后8个月出现了连接板断裂。6例脊髓功能明显改善,3例略有改善,1例无变化。结论:利用寰椎侧块螺钉和枢椎椎弓根螺钉通过连接板锁定可以使寰枢椎得到坚强的三维固定。此方法更适用于因鹅颈畸形而难以施行Magerl术的病例。
Objective:To report the primary result of a newly-designed screw-plate system for the treatment of atlantoaxial instability.Method:Two screws were screwed into the lateral mass of atlas and another two were inserted into lateral mass of the axis through the pedicles.Two plates were applied to connect the screws of each side and locked by nuts to stabilize the atlas and axis.Then the autogenous granulated cancellous bone was placed on the surface of the posterior arches of both atlas and axis.Result:10 patients of atlantoaxial instability caused by deformity were treated by the methods described above and were followed up for the mean period of 19.4 months.1 failed to achieve atlantoaxial arthrodesis but undergone occipito-cervical arthrodesis instead,all of the other 9 patients achieved atlantoaxial arthrodesis.The connecting plate was broken in 1 patient 8 months after the operation.The myelopathy recovered remarkably in 6 patients;slightly in 3 and unchanged in 1.Conclution:Screws in the lateral mass of atlas and the transpedicular screws of axis with the connecting plate can make the atlantoaxial joint stable.This method is especially useful for the patients who can not be treated by the Magerl′s operation due to swan-neck deformity.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2003年第1期7-10,共4页
Chinese Journal of Spine and Spinal Cord
