劳立峰 钟贵彬 李谦益 李新锋 陈滨 刘祖德

    (上海交通大学医学院附属仁济医院骨科，上海 200127 )

    寰椎后弓椎板钩联合枢椎椎弓根螺钉固定治疗游离齿状突并可复性寰枢椎脱位*

    劳立峰 钟贵彬 李谦益 李新锋 陈滨 刘祖德**

    (上海交通大学医学院附属仁济医院骨科，上海 200127 )

    临床论著?

    背景：游离齿状突并可复性寰枢椎脱位常需要手术治疗，但目前缺乏操作简单且安全有效的寰枢椎内固定方式。

    目的：评估寰椎后弓椎板钩联合枢椎椎弓根螺钉固定植骨融合治疗游离齿状突并可复性寰枢椎脱位的疗效。

    结果：11例术中均未发生椎动脉和脊髓损伤。术后均获得随访，随访时间为12～37个月，平均25个月，均未发生内固定物松动、断裂，术后疼痛和神经症状均得到缓解，术后JOA 评分较术前明显改善(P<0.01)，寰枢椎均融合。

    结论：寰椎后弓椎板钩联合枢椎椎弓根螺钉固定植骨融合术治疗游离齿状突并可复性寰枢椎脱位是一种安全有效的方法。

    游离齿状突；寰枢椎脱位；椎板钩；椎弓根螺钉

    Background:Surgical treatment is essential for os odontoideum combined with reducible atlantoaxial dislocation,but a simple,safe and effective atlantoaxial internal fixation has not been developed.

    Objective:To evaluate the curative effect of internal fixation and fusion with laminar hooks of C1 posterior arch and C2 pedicle screws for os odontoideum combined with reducible atlantoaxial dislocation.

    Methods:From July 2005 to June 2012,11 patients with os odontoideum and reducible atlantoaxial dislocation were treated by internal fixation with laminar hooks of Cl posterior arch combined with C2 pedicle screws and autogenous iliac bone graft.The dislocation reduction,bone fusion rate,JOA functional score,radiological feature and postoperative complications were retrospectively analyzed. ......