| 前路松解后路固定融合术治疗难复性寰枢关节脱位 |
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| 引用本文： | 郑铁钢,贾卫斗,高彬,许英杰,云得才,孙华,王建华.前路松解后路固定融合术治疗难复性寰枢关节脱位[J].河北北方学院学报(医学版),2008,25(6). |
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| 作者姓名： | 郑铁钢 贾卫斗 高彬 许英杰 云得才 孙华 王建华 |
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| 作者单位： | 中国人民解放军第251医院骨科,河北,张家口,075000 |
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| 摘 要： | 目的:探讨经口咽松解同时后路内固定植骨融合术治疗难复性寰枢关节脱位手术效果。方法:12例难复性寰枢关节脱位患者,其中齿突陈旧性骨折畸形愈合7例,横韧带断裂3例,枕颈畸形2例。10例有脊髓损伤的症状、体征。先行经口咽入路的寰枢关节松解或切除术,同期行后路寰枢或枕颈固定植骨融合术,后路固定方法包括寰枢侧块钉板固定10例和枕颈固定2例。术后不用外固定。结果:10例获得解剖复位,2例基本复位,其中2例行齿突切除。12例随访9~26个月,平均11个月,全部病例均获骨性融合。术前有脊髓症状的10例术后功能评价(JOA标准)为优7例,良2例,可1例。术中出现硬膜破裂1例。结论:前路松解后路固定融合对治疗难复性寰枢关节脱位有良好的治疗效果。
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| 关 键 词： | 寰枢关节 脱位 内固定器 |
The Surgical Treatment for Irreducible Atlantoaxial Dislocation with Release of Transoropharyngeal Approach Combined with Arthrodeses of Posterior Methods |
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| ZHENG Tie-gang,JIA Wei-dou,GAO Bin,et al.The Surgical Treatment for Irreducible Atlantoaxial Dislocation with Release of Transoropharyngeal Approach Combined with Arthrodeses of Posterior Methods[J].Journal of Hebei North University:Medical Edition,2008,25(6). |
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| Authors: | ZHENG Tie-gang JIA Wei-dou GAO Bin |
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| Institution: | ZHENG Tie-gang,JIA Wei-dou,GAO Bin,et al Department of Orthopaedics,The 251st Hospital of PLA,Zhangjiakou,075000,Hebei,China |
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| Abstract: | Objective:To investigate the treatment for irreducible atlantoaxial dislocation.Methods:Twelve patients,were diagnosed with irreducible atlantoaxial dislocation,including 7 patients malunion of odontoid fracture,3 rupture of atlas transverse ligament and 2 Occipitalization of the Atlas.Ten patients presented signs and symptoms of myelopathy injury.All of the patients underwent the operation with release of anterior transoropharyngeal approach,and followed by arthrodesis via posterior approach in one stage.Different methods of posterior arthrodesis were conducted as followed:C1,2 joint fixation with plates and screws in the pedicle of the atlas and axis in 10 cases,occipitocervical fixation using pedicle screws of axis and occipitocervical plate in 2 cases.Results:A complete reduction was achieved in 10 cases,and the other 2 patients obtained partial reduction.Twelve patients were followed up from 9 to 26months,11 months for average.All of them achieved solid arthrodesis.According to JOA's scoring system,among the 10 patients with preoperative upper cervical myelopathy,7 patients were assessed as excellent,2 good and 1 fair.During the operation,cerebral spinal fluid leakage occurred in 1 case.Conclusion:Transoropharyngeal surgical release and posterior arthrodeses can achieve satisfactory outcomes in patients with irreducible atlantoaxial dislocation. |
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| Keywords: | Atlanto-axial Joint Dislocations Internal Fixators |
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