| 谭明生,唐向盛,移平,杨峰.寰椎椎弓根显露置钉法的临床应用[J].脊柱外科杂志,2011,9(3):148-152. |
寰椎椎弓根显露置钉法的临床应用  点此下载全文 (Fulltext) |
| 谭明生 唐向盛 移平 杨峰 |
| 100029 北京, 卫生部中日友好医院脊柱外科;100029 北京, 卫生部中日友好医院脊柱外科;100029 北京, 卫生部中日友好医院脊柱外科;100029 北京, 卫生部中日友好医院脊柱外科 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2011.03.006 |
| 摘要点击次数: 1845 |
| 全文下载次数: 965 |
| 摘要： |
| 目的 探讨寰椎椎弓根显露置钉法（pedicle exposure method，PEM）的手术可操作性和临床疗效。方法 对46例寰枢椎脱位患者应用经寰椎椎弓根螺钉内固定技术治疗。患者术前均行X线、CT和MRI等影像学检查，寰椎后弓（椎弓根）高度为2.5~4.0 mm，平均3.1 mm；术中在直视下行C1，2置钉，复位固定，椎板后弓植骨。结果 46例患者的92枚螺钉均成功置入，复位固定满意。其中36例术后获3~42个月随访，平均18.6个月，患者均在3~6个月寰枢椎骨性融合，未发现螺钉松动、断钉和寰枢椎再移位现象；其中2枚螺钉穿入椎动脉孔内缘1 mm，但无椎动脉损伤的临床表现。31例患者脊髓功能明显改善，5例好转。结论 椎弓根显露置钉法可操作性强，置钉准确性与安全性高，适用于C1后方高度<4 mm的患者，尤其适用于儿童。 |
| 关键词：寰椎 枢椎 寰枢关节 内固定器 骨移植 |
| Clinical application of pedicle screw in atlas using pedicle exposure method Fulltext |
| TAN Ming-sheng TANG Xiang-sheng YI Ping YANG Feng |
| Department of Spine Surgery, China-Japan Friendship Hospital, Beijing 100029, China;Department of Spine Surgery, China-Japan Friendship Hospital, Beijing 100029, China;Department of Spine Surgery, China-Japan Friendship Hospital, Beijing 100029, China;Department of Spine Surgery, China-Japan Friendship Hospital, Beijing 100029, China |
| Fund Project: |
| Abstract: |
| Objective To explore the surgical feasibility and clinical outcome of pedicle screw in atlas by pedicle exposure method (PEM). Methods Forty-six patients with atlas dislocation were treated surgically with pedicle screw by a revised technique. The patients received preoperative CT, MRI and radiograph examination. The heights of posterior arch were 2.5-4.0 mm, with an average of 3.1 mm. Results All the 92 screws were successfully placed in the atlas of 46 patients and obtained satisfactory fixation. Thirty-six patients were followed up for 3-42 months, with an average of 18.6 months. Bony fusion was observed in all the 36 cases within 3-6 months; there were no complications such as internal fixation failure or redislocation of atlas. Two screws penetrated into the medial rim of the vertebral artery foramen, but caused no vertebral artery injury. Neurological function was greatly improved in 31 cases, and became better in 5 cases. Conclusion Application of pedicle screw in atlas by pedicle exposure method is surgically feasible, with highly accurate and safe insertion of the screw; the method is suitable for patients with the height of posterior arch <4 mm, especially for children. |
| Keywords:Atlas Axis Atlanto-axial joint Internal fixators Bone transplantation |
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