Department of Neurosurgery, University of South Florida, Tampa, Florida 33606, USA.
Neurosurgery. 2009 Dec;65(6):E1216-7; discussion E1217. doi: 10.1227/01.NEU.0000349207.98394.FA.
Presentation of a successful case of craniocervical stabilization involving a novel surgical technique using the occipital condyles as the sole cranial fixation points.
A 22-year-old man presented in a delayed fashion with neck pain after a motor vehicle accident. Evaluation revealed a type 2 odontoid fracture with pseudarthrosis and displacement of the dens superiorly and cranial settling of the dens.
The patient underwent posterior occipitocervical fixation with a polyaxial screw rod construct using the occipital condyle, C1 lateral mass, and C2 pars articularis for fixation. The patient had no immediate postoperative deficits. At the time of the 12-month follow-up examination, the patient was neurologically intact with a solid occipitocervical fusion.
Craniocervical stabilization using occipital condyle screws as the sole cephalad fixation points is a feasible option and can be used safely without neurovascular complication in the treatment of craniocervical instability.
介绍一种成功的颅颈固定病例,该病例采用了一种新的手术技术,仅使用枕骨髁作为唯一的颅部固定点。
一名 22 岁男性,因车祸后出现颈部疼痛而延迟就诊。评估发现存在 2 型齿状突骨折,伴有假关节形成和齿状突向上移位以及齿状突颅底沉降。
患者接受后路枕颈固定,使用多轴螺钉棒结构,固定点包括枕骨髁、C1 侧块和 C2 关节突。患者术后即刻无神经功能缺损。在 12 个月的随访检查时,患者神经功能完整,枕颈融合牢固。
使用枕骨髁螺钉作为唯一的颅侧固定点进行颅颈固定是一种可行的选择,可以安全使用,不会发生神经血管并发症,可用于治疗颅颈不稳定。