Di Lorenzo N
Department of Neurological Sciences, Neurosurgery, University of Rome La Sapienza, Italy.
Acta Neurochir (Wien). 1992;118(3-4):112-6. doi: 10.1007/BF01401296.
An experience with 25 consecutive cases of craniocervical junction (CCJ) malformations operated upon via the transoral route is reported. Twenty-two patients also underwent posterior occipito-cervical stabilization with alloplastic material and in only one patient was transoral odontoidectomy and fusion with bone autograph performed. Indication for the transoral route consisted of an irreducible ventral compression of the cervicobulbar junction by the abnormal bone complex. Two patients died during the early postoperative period and the remaining 23 survivors were followed for an average of 3.5 years: 17 of these showed marked improvement and 5 a stabilization of the neurological disturbances. A further patient, who refused posterior stabilization, eventually died because of progressive cranial settling. Long-term results have shown this approach to be decisive in the surgical management of well-selected CCJ anomalies.
报告了经口入路手术治疗25例连续颅颈交界区（CCJ）畸形的经验。22例患者还接受了异体材料枕颈后路固定，仅1例患者进行了经口齿状突切除术及自体骨融合。经口入路的指征为异常骨复合体导致颈髓延髓交界处腹侧压迫无法复位。2例患者在术后早期死亡，其余23例幸存者平均随访3.5年：其中17例有明显改善，5例神经功能障碍稳定。另1例拒绝后路固定的患者最终因进行性颅骨沉降死亡。长期结果表明，这种方法在精心选择的CCJ畸形手术治疗中具有决定性作用。
