Anderson A J, Towns G M, Chiverton N
Department of Spinal Surgery, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
J Bone Joint Surg Br. 2006 Nov;88(11):1464-8. doi: 10.1302/0301-620X.88B11.18082.
Traumatic atlanto-occipital dislocation in adults is usually fatal and survival without neurological deficit is rare. The surgical management of those who do survive is difficult and controversial. Most authorities recommend posterior occipitoaxial fusion, but this compromises cervical rotation. We describe a case in which a patient with a traumatic atlanto-occipital disruption but no neurological deficit was treated by atlanto-occipital fusion using a new technique consisting of cancellous bone autografting supported by an occipital plate linked by rods to lateral mass screws in the atlas. The technique is described in detail. At one year the neck was stable, radiological fusion had been achieved, and atlantoaxial rotation preserved. The rationale behind this approach is discussed and the relevant literature reviewed. We recommend the technique for injuries of this type.
成人创伤性寰枕关节脱位通常是致命的，无神经功能缺损而存活者罕见。对存活患者的手术治疗困难且存在争议。大多数权威人士推荐枕颈后路融合术，但这会影响颈椎的旋转功能。我们报告一例创伤性寰枕关节脱位但无神经功能缺损的患者，采用一种新技术进行寰枕融合术，该技术包括自体松质骨移植，由枕骨板支撑，通过棒与寰椎侧块螺钉相连。详细描述了该技术。术后一年颈部稳定，实现了影像学融合，保留了寰枢椎旋转功能。讨论了该方法的理论依据并回顾了相关文献。我们推荐该技术用于此类损伤。
