Li Kanghua, Li Qiang, Deng Zhansheng
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha Hunan, 410008, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2005 May;19(5):354-7.
To study operative methods of treating upper cervical spine instability without injury.
Twenty-three cases were treated by internal fixation with autologous bone grafts. Atlantoaxial arthrodesis were performed in 10 cases with interlaminar clamp (5 cases), Atlas cable system (3 cases) and Brooks (2 cases). Occipitocervical fusion were performed in the other 13 cases by using of CD-cervical (3 cases), Cervifix (8 cases) and U-stick fixation (2 cases).
All the 23 cases were followed up for 2. 5 years in average (ranged from 6 months to 5 years). Solid arthrodesis was obtained in all 23 cases. Six months after operation, of the 20 cases with pre-operation nervous lesion, improvement was achieved in 16 cases. According to JOA standard and Hirabashi formula, the rate of improvement was 27.1%.
Posterior fusion is recommended for upper cervical instability.
探讨治疗上颈椎不稳且无损伤的手术方法。
23例患者采用自体骨移植内固定治疗。10例行寰枢椎融合术，其中采用椎板夹（5例）、寰椎线缆系统（3例）及布鲁克斯法（2例）。另外13例行枕颈融合术，采用CD颈椎内固定（3例）、Cervifix（8例）及U形棒固定（2例）。
23例患者均获平均2.5年（6个月至5年）随访。23例均获牢固融合。术前有神经损伤的20例患者术后6个月，16例病情改善。根据JOA标准及平桥公式，改善率为27.1%。
上颈椎不稳建议行后路融合术。
