Wang Chao, Yin Shao-Meng, Yan Ming, Zhou Hai-Tao, Dang Geng-Ting
Department of Orthopaedics, Peking University Third Hospital, Beijing 100083, China.
Zhonghua Wai Ke Za Zhi. 2004 Jun 22;42(12):707-11.
To observe the clinical effect of a occipitocervical fixation systems using C(2) pedicle screws and plates.
An occipitocervical fixation system was designed. Since June 2001 to March 2003, 38 patients with instability of atlantoaxial joint underwent reconstructive surgery using this systems. Twenty-four patients were associated with congenital occipitalization. The pedicle screws were inserted into C(2) pedicles in the direction as its axis. The occipitocervical plate was slightly bent to fit the occipital contour and fixed onto the occiput. Hyperflexion alignment of the occipitoatlantoaxial complex was corrected by application of extensional force created by tightening of the nut on the pedicle screws. The autogenous cancellous bones were grafted between the occiput and the axis.
In this series, neither vertebral artery nor spinal cord was injured. 36 of 38 cases were followed up for an average of 18 months, all cases achieved solid bony fusion. No implant failure was found.
Occipitocervical reconstruction by the combination of C(2) pedicle screws and occipitocervical plate systems can provide sufficient correction of malalignment in the occipitoatlantoaxial region and achieve high fusion rate.
观察使用C2椎弓根螺钉和钢板的枕颈固定系统的临床效果。
设计一种枕颈固定系统。自2001年6月至2003年3月，38例寰枢关节不稳患者使用该系统进行了重建手术。24例患者合并先天性枕骨化。将椎弓根螺钉沿其轴线方向插入C2椎弓根。枕颈钢板轻微弯曲以适应枕骨轮廓并固定于枕骨。通过拧紧椎弓根螺钉上的螺母产生的伸展力来矫正枕寰枢复合体的过屈对线。在枕骨和枢椎之间植入自体松质骨。
本系列中，椎动脉和脊髓均未受损。38例患者中的36例平均随访18个月，所有病例均实现了牢固的骨融合。未发现植入物失败。
C2椎弓根螺钉和枕颈钢板系统联合进行枕颈重建可充分矫正枕寰枢区域的对线不良并实现高融合率。
