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胡勇,马维虎,顾勇杰,徐荣明,赵红勇.经口咽入路内固定治疗孤立性寰椎骨折临床疗效分析[J].脊柱外科杂志,2011,9(3):131-134.
经口咽入路内固定治疗孤立性寰椎骨折临床疗效分析     点此下载全文 (Fulltext)
胡勇  马维虎  顾勇杰  徐荣明  赵红勇
315040 浙江, 宁波市第六医院脊柱外科;315040 浙江, 宁波市第六医院脊柱外科;315040 浙江, 宁波市第六医院脊柱外科;315040 浙江, 宁波市第六医院脊柱外科;315040 浙江, 宁波市第六医院脊柱外科
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DOI:10.3969/j.issn.1672-2957.2011.03.002
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摘要:
      目的 评价应用经口咽入路内固定治疗孤立性寰椎骨折的临床疗效及安全性。方法 2008年7月~2010年12月,应用经口咽入路钢板内固定治疗10例孤立性寰椎骨折患者,其中3例双侧寰椎前弓骨折(前1/2 Jefferson骨折,Landells type Ⅰ)、5例单侧寰椎前后弓双骨折(半环Jefferson骨折,Landells typeⅡ)、2例寰椎前弓骨折合并寰椎后弓发育不良。结果 所有病例术后随访10~24个月,平均15个月。患者的临床症状均得到不同程度的改善。平均手术时间为100 min(80~120 min);平均出血量为200 mL(100~300 mL);平均透视时间60 s;10例患者术均未发生神经、椎动脉和其他手术相关并发症。随访复查X线片和CT,未发现患者上颈椎失稳或复位丢失,螺钉位置良好,无松动、断钉。结论 经口咽入路采用C1侧块螺钉固定钢板重建寰椎前环是治疗不稳定性寰椎骨折的一种新的技术方法。它既保持了C1/C2关节的旋转运动功能,同时又恢复了寰枕关节和寰枢关节的协调运动。
关键词:寰椎  脊柱骨折  内固定器
Transoral osteosynthesis C1 for treatment of isolated atlas fracture:an analysis of clinical effect    Fulltext
HU Yong  MA Wei-hu  GU Yong-jie  XU Rong-ming  ZHAO Hong-yong
Department of Orthopaedics, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China;Department of Orthopaedics, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China;Department of Orthopaedics, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China;Department of Orthopaedics, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China;Department of Orthopaedics, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China
Fund Project:
Abstract:
      Objective To evaluate the efficacy and safety of transoral osteosynthesis C1 in the treatment of isolated atlas fractures. Methods A retrospective study was performed in ten patients with isolated atlas fractures, who were treated by a transoral osteosynthesis C1 from July 2008 to December 2010. Three patients had bilateral fractures of the anterior arch(pre-half Jefferson fractures, Landells type Ⅰ), 5 had anterior arc fracture associated with posterior arc fracture(Half-ring Jefferson fractures, Landells typeⅡ), and 2 had anterior arc fracture associated with aplasia of the posterior arc. Results The patients were followed up for 10-24 months after operation (average 15 months), and all the patients had their clinical symptoms improved to some extent. The operation time ranged from 80-120 min (average l00 min); the intra-operative blood loss was 100-300 mL(average 200 mL); and the average fluoroscopic time was 60 s. No patients developed neurological deficits, vertebral artery-related complications or other complications after operation. The follow-up roentgenograph and CT manifested osseous fusion in all the 10 patients, with no loosening or breakage of the screws. Conclusion Transoral osteosynthesis of the anterior ring and the lateral masses of C1 is a new technique that allows maintenance of rotatory mobility in the C1,2 joint and restoration of congruency in the atlanto-occipital and atlantoaxial joints.
Keywords:Atlas  Spinal fractures  Internal fixators
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