Liu H, Yang Z, Chen T
Department of Orthopedic Surgery, 1st University Hospital, West China University of Medical Sciences, Chengdu, P.R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 1998 Sep;12(5):269-71.
To cure patients suffering from atlanto-axial instability following old fracture of odontoid process concomitant with stenosis of lower end of cervical spinal canal, a new operative method was designed. It included atlanto-axial fusion by Gallie technique and resection of right half of the laminae of C3-C7 spine at one stage. A female of 63 years old was treated. She was admitted with neck pain and numbness of the upper and lower limbs. A history of neck injury was noted in enquiry. In physical examination showed the sensation of pain of the upper limbs was decreased and the muscle power of the upper and lower limbs ranged from III degree to IV degree. The X-ray film and MRI suggested that there was instability of the atlanto-axial joint with stenosis of 4th-6th cervical spinal canal. The operation was satisfactory. After operation, the patient was followed up for 11 months. The physical examination indicated that sensation of the upper limbs had recovered to normal and the muscle power of the upper limbs reached IV degree and that the lower limbs reached V degree and X-ray showed bony fusion of the atlanto-axial joint. The conclusions were: 1. The stability of atlanto-axial joint was reconstructed with expanding of the spinal canal at the same time. 2. The duration, risk and cost of the therapy were reduced, and maintenance of the stability of the cervical spine throughout whole period of treatment was recommended.
为治疗陈旧性齿状突骨折合并颈椎管下端狭窄所致的寰枢椎不稳患者，设计了一种新的手术方法。该方法包括一期采用Gallie技术进行寰枢椎融合及切除C3 - C7椎板右半侧。治疗了一名63岁女性患者。她因颈部疼痛及上下肢麻木入院。询问病史时有颈部受伤史。体格检查显示上肢痛觉减退，上下肢肌力为Ⅲ级至Ⅳ级。X线片和磁共振成像（MRI）提示寰枢关节不稳，第4 - 6颈椎管狭窄。手术效果满意。术后对患者随访11个月。体格检查表明上肢感觉恢复正常，上肢肌力达到Ⅳ级，下肢肌力达到Ⅴ级，X线显示寰枢关节骨性融合。结论为：1. 重建了寰枢关节稳定性，同时扩大了椎管。2. 缩短了治疗时间、降低了风险和费用，建议在整个治疗期间维持颈椎稳定性。
