后路经寰枢椎椎弓根固定重建寰枢关节稳定性.docVIP

精品论文 参考文献 后路经寰枢椎椎弓根固定重建寰枢关节稳定性 郑佳状1 蒋电明2 张亨闰1 张智1 陈宇1 汪凡栋1 张娜1 　　（1四川省遂宁市中心医院脊柱外科 629000） 　　（2重庆医科大学附属第一医院骨科 400016） 　　【摘要】目的：总结后路经寰枢椎椎弓根固定重建寰枢关节稳定性的临床疗效。方法：2006年9月-2012年6月，共收治寰枢关节稳定性丧失患者47例，男32例，女15例，年龄21～71岁，平均40.30plusmn;5.65岁。其中新鲜齿状突骨折伴稳定性丧失15例，横韧带断裂5例，陈旧性齿状突骨折17例，先天性游离齿状突3例，先天性短小齿状突3例，类风湿性关节炎4例，寰枢关节不稳28例，寰枢关节脱位19例。神经功能根据JOA脊髓功能评分法评定，9－17分，平均11.50plusmn;1.37分。所有寰枢关节脱位患者在麻醉状态下颅骨牵引均已复位，所有患均采用后路经寰枢椎椎弓根固定行稳定性重建。结果：所有患者平稳渡过围手术期，并获得18-69个月随访，平均38.52plusmn;5.66个月。所有患者均获得解剖复位和植骨融合，末次随访时神经功能JOA评分12-17分，平均14.50plusmn;1.50分。结论：后路经寰枢椎椎弓根固定重建寰枢关节稳定性，具有操作简单、复位充分、固定坚强、融合率高等优点，是重建寰枢关节稳定性安全有效方法。 　　【关键词】寰枢关节 寰椎 枢椎 重建 　　【中图分类号】R681 【文献标识码】A 【文章编号】2095-1752（2013）36-0019-02 　　【Abstract】Objective: To summarize the therapeutic effect of surgical treatment of atlantoaxial stability reconstruction through pedicle fixation Methods: 47cases of atlantoaxial instability were treated in our hospital from Sep.2006 to Jun .2012 , among the total , 32 males and 15females，with the age from21years to 71 years , the average 40.30plusmn;5.65years ,including 15 patients with fresh odontoid process fracture, 5 patients with ligamentum transversum broken,17patients with obsolete odontoid process fracture, 3 patients with inborn dissociation odontoid process, 3 patients with inborn short and small odontoid process, 4 patients with rheumarthritis , 28 patients with atlantoaxial instability , 19patients with atlantoaxial dislocation . the Japanese Orthopaedic Association (JOA) score was from 9 to 17, the average 11.50plusmn;1.37.All dislocation could be reduced through skull traction under drugged state, All patients were performed with posterior fixation through atlantoaxial pedicle . Results: All patients pulled through the period time of operation securely. All patients were followed up from 18to 69 months , the average 38.52plusmn;5.66 months.All gained anatomic reduction and bone fusion.By the latest time followed up ,the JOA score