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后路侧块和椎弓根螺钉技术治疗寰枢椎不稳
Hits: 2069   Download times: 1476   Received:July 11, 2006    
作者Author单位UnitE-Mail
王庆 WANG Qing 宁波市第六医院骨科,浙江宁波315040 Department of Orthopaedics,the Sixth Hospital of Ningbo,Ningbo 315040,Zhejiang,China  
徐荣明 XU Rong-ming 宁波市第六医院骨科,浙江宁波315040 Department of Orthopaedics,the Sixth Hospital of Ningbo,Ningbo 315040,Zhejiang,China  
马维虎 MA Wei-hu 宁波市第六医院骨科,浙江宁波315040 Department of Orthopaedics,the Sixth Hospital of Ningbo,Ningbo 315040,Zhejiang,China  
期刊信息:《中国骨伤》2007年20卷,第4期,第253-255页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:评价寰枢椎后路侧块和椎弓根螺钉徒手置入技术(无须术中影像技术引导)的安全性和可靠性。

方法:应用AXIS和VERTEX内固定系统(美国枢法模公司)对17例寰枢椎不稳患者进行后路侧块(椎弓根)螺钉内固定,共置入螺钉68枚。其中男11例,女6例,年龄17~71岁,平均43.5岁。AndersonⅡ型11例(陈旧性骨折4例,新鲜骨折7例),Ⅲ型5例(陈旧性骨折1例,新鲜骨折4例);上颈椎肿瘤1例。AXIS治疗15例,VERTEX治疗2例。

结果:术后X线片及CT显示寰枢椎侧块和椎弓根螺钉位置良好,2枚螺钉螺纹轻微穿破寰枢椎侧块(椎弓根)外侧皮质,3枚螺钉螺纹轻微穿破寰椎后弓上侧皮质,但不影响固定强度,也未发现与螺钉相关的神经血管并发症。

结论:对寰枢椎X线和CT解剖结构了解的情况下,徒手置入寰枢椎侧块(椎弓根)螺钉行内固定手术是安全可行的。
 
Treatment of atlantoaxial instability with posterior lateral mass screw technlque
Abstract:

Objective:To evaluate safety and reliability with freehand technique of posterior lateral mass screw implantation in the treatment of atlantoaxial instability.

Methods:Seventeen patients with atlantoaxial instability were treated with internal fixation of AXIS(15 cases)and VERTEX(2 cases)system through posterior lateral mass screw implantation.Sixty-eight screws were inserted in the 17 cases.11 male and 6 female were included in this group with the mean age of 43.5 years(range 17-71).One case was cervical tumor and the other 16 cases were odontoid fractures.Among the odontoid fractures,11 cases were Anderson type Ⅱ(4 old and 7 fresh fracture)and 5 case were Anderaon typeⅢ(1 old and 4 fresh fracture).

Results:The X-ray and CT image showed the location of screws were good.Screws in 2 cases perforated the external cortex of lateral mass(pedicle),screws in another 3 cases perforated the superior cortex of posterior arch,but no effect to fixation strength.No other screw complication was found in the patients.

Conclusion:If the anatiomic structure of C1-2 in X-ray and CT image is well understood,freehand technique of posterior lateral screw implantation for the treatment of atlantoaxial instability is safe and feasible.
KEYWORDS:Atlantoaxial instability  Pedicle of vertebral arch  Screw  Internal fixation
 
引用本文,请按以下格式著录参考文献:
中文格式:王庆,徐荣明,马维虎.后路侧块和椎弓根螺钉技术治疗寰枢椎不稳[J].中国骨伤,2007,20(4):253~255
英文格式:WANG Qing,XU Rong-ming,MA Wei-hu.Treatment of atlantoaxial instability with posterior lateral mass screw technlque[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(4):253~255
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