Department of Orthopaedics, Changhai Hospital, Second Military Medical University, No. 168, Changhai Road, Shanghai 200433, China.
J Clin Neurosci. 2009 Dec;16(12):1592-4. doi: 10.1016/j.jocn.2009.03.026. Epub 2009 Sep 30.
From January 1999 to May 2005, 25 patients (15 males and 10 females; age range, 18-70 years; mean, 42 years) who demonstrated clinical and radiographic evidence of atlantoaxial instability underwent C1 lateral mass and C2 pedicle screw internal fixation with or without fusion at our Orthopedic Unit. The cause of instability was: 13 patients, traumatic fracture; three patients, rheumatoid arthritis; two patients, rotatory subluxation; two patients, congenital malformation; five patients, failed previous surgery. A mean follow-up of 16 months was obtained (range, 4-48 months). Mean operative time was 107 minutes (range, 80-141 minutes). No patient received a blood transfusion. No patient experienced worsening neurological function related to the procedure postoperatively or at follow-up. No other postoperative complication was observed. All patients were relieved from axial pain. Screw placement and reduction were achieved satisfactorily in all patients. Each patient showed evidence of solid fusion after 12 months by plain radiography and dynamic films. During follow-up, no complications were observed related to the bone graft or the screw rod. We suggest that C1 lateral mass and C2 pedicle screw internal fixation is a reliable method to repair atlantoaxial instability.
从 1999 年 1 月至 2005 年 5 月，我们骨科病房共收治了 25 例有寰枢椎不稳的临床和影像学证据的患者（15 例男性，10 例女性；年龄 18-70 岁；平均年龄 42 岁）。这些患者接受了 C1 侧块和 C2 椎弓根螺钉内固定术，其中有些患者同时进行了融合术。寰枢椎不稳定的病因包括：创伤性骨折 13 例，类风湿关节炎 3 例，旋转性半脱位 2 例，先天性畸形 2 例，先前手术失败 5 例。所有患者平均随访 16 个月（4-48 个月）。手术时间平均为 107 分钟（80-141 分钟）。所有患者均未输血。术后或随访过程中，无患者出现与手术相关的神经功能恶化。无其他术后并发症。所有患者的轴向疼痛均得到缓解。所有患者的螺钉位置和复位均满意。所有患者在术后 12 个月的 X 线平片和动力片上均显示出了稳定的融合证据。在随访期间，未观察到与植骨或螺钉棒相关的并发症。我们认为 C1 侧块和 C2 椎弓根螺钉内固定是一种可靠的修复寰枢椎不稳的方法。
