| 马维虎,许楠健,徐荣明,赵刘军,蒋伟宇,孙韶华,胡勇,刘观燚,顾勇杰.经后路单纯寰椎椎弓根螺钉内固定治疗不稳定性寰椎骨折[J].脊柱外科杂志,2011,9(3):140-143. |
经后路单纯寰椎椎弓根螺钉内固定治疗不稳定性寰椎骨折  点此下载全文 (Fulltext) |
| 马维虎 许楠健 徐荣明 赵刘军 蒋伟宇 孙韶华 胡勇 刘观燚 顾勇杰 |
| 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;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 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2011.03.004 |
| 摘要点击次数: 1004 |
| 全文下载次数: 784 |
| 摘要： |
| 目的 探讨经后路单纯寰椎椎弓根螺钉内固定治疗不稳定性寰椎骨折的临床疗效。方法 2007年3月~2010年4月，采用经后路寰椎椎弓根螺钉内固定治疗不稳定性寰椎骨折患者23例，其中8例为后3/4 Jefferson骨折；12例患者为半环Jefferson骨折；3例患者为后1/2 Jefferson骨折。患者均有不同程度的颈枕区疼痛，活动受限；日本骨科协会（Japanese Orthopaedic Association，JOA）评分为7~12分，平均9.5分。结果 所有患者随访12~39个月，平均18.8个月。手术时间为30~60 min，出血量为50~200 mL。术后X 线片及CT 示1例一侧寰椎椎弓根螺钉部分进入椎动脉孔，1例螺钉一侧偏内致椎弓根内侧皮质破裂，但均无神经症状，其余螺钉位置良好。术后JOA评分13~17分，平均14.7分。未发生与螺钉相关的神经血管并发症，无内固定松动或断钉现象，所有患者术后随访时均已达到骨性融合，寰枢关节旋转功能良好。结论 寰椎后路椎弓根螺钉技术是治疗不稳定性寰椎骨折的有效方法。 |
| 关键词：寰椎 脊柱骨折 内固定器 |
| Transpedicular screw fixation system for treatment of unstable fractures of atlas vertebra Fulltext |
| MA Wei-hu XU Nan-jian XU Rong-ming ZHAO Liu-jun JIANG Wei-yu SUN Shao-hua HU Yong LIU Guan-yi GU Yong-jie |
| Department of Orthopedics, Ningbo No.6 Hospital, Ningbo 315040, Zhenjiang, China;Department of Orthopedics, Ningbo No.6 Hospital, Ningbo 315040, Zhenjiang, China;Department of Orthopedics, Ningbo No.6 Hospital, Ningbo 315040, Zhenjiang, China;Department of Orthopedics, Ningbo No.6 Hospital, Ningbo 315040, Zhenjiang, China;Department of Orthopedics, Ningbo No.6 Hospital, Ningbo 315040, Zhenjiang, China;Department of Orthopedics, Ningbo No.6 Hospital, Ningbo 315040, Zhenjiang, China;Department of Orthopedics, Ningbo No.6 Hospital, Ningbo 315040, Zhenjiang, China;Department of Orthopedics, Ningbo No.6 Hospital, Ningbo 315040, Zhenjiang, China;Department of Orthopedics, Ningbo No.6 Hospital, Ningbo 315040, Zhenjiang, China |
| Fund Project: |
| Abstract: |
| Objective To study the clinical outcomes of transpedicular screw fixation system for treatment of unstable fractures of the atlas vertebra. Methods From March 2007 to April 2010, transpedicular fixation was employed to treat 23 patients with unstable fractures of the atlas vertebra; the patients included 15 males and 8 females. Eight patients had posterior 3/4 Jefferson fracture, 12 had 1/2 ring Jefferson fracture and 3 had posterior 1/2 Jefferson fracture. The preoperative Japanese Orthopaedic Association(JOA)score was 7-12, with an average of 9.5. All patients were treated by single transpedicular fixation via the posterior approach. Results The patients were followed up for 12-39 months, with a mean of 18.8 months. The operative time ranged 30-60 min. Intraoperative blood loss ranged from 50-200 mL. Postoperative roentgenoghaph and CT scan showed that 1 screw was inserted so medially and penetrated the spinal canal, and 1 screw was directly inserted into the lateral mass of the atlas due to posterior atlas arch breakage caused by repeated drilling, but with no nervous system symptom. The postoperative JOA scores were 13-17, with an average of 14.7. There were no spinal cord injuries, and no loosening or breakage of screw after surgery. Bony fusion was achieved in all patients and the atlantoaxial rotational function was satisfactorily restored. Conclusion The transpedicular fixation technique is an effective method for the treatment of unstable fractures of the atlas vertebra. |
| Keywords:Atlas Spinal fractures Internal fixators |
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