Yerramneni Vamsi Krishna, Chandra P Sarat, Kale Shashank S, Lythalling Rajender K, Mahapatra Ashok Kumar
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Pediatr Neurosurg. 2011;47(1):45-50. doi: 10.1159/000329623. Epub 2011 Aug 22.
The authors studied 100 consecutive cases of pediatric bony craniovertebral junction abnormalities operated between 2001 and 2006. The pathologies were developmental (n = 86), traumatic (n = 10) and tuberculous (n = 4). Surgical procedures included transoral decompression (n = 59), occipitocervical fusion (OCF, n = 69), C(1)-C(2) fusion (n = 22), occiput-C(2) wiring (n = 5), and posterior fossa decompression (n = 5). Implants for OCF included contoured stainless steel rods (n = 47), titanium lateral mass screws and plates (n = 16) and steel wires (n = 5). Adequate bone fusion was observed in all patients with OCF at a mean follow-up of 16.5 months, irrespective of the type of implant used for posterior fixation. Good neurological outcome was observed even in poor-grade patients. No significant effect on the curvature or growth of the spine was observed at follow-up.
作者研究了2001年至2006年间连续接受手术治疗的100例小儿颅骨与颈椎交界处骨质异常病例。病变类型包括发育性(n = 86)、创伤性(n = 10)和结核性(n = 4)。手术方式包括经口减压(n = 59)、枕颈融合术(OCF,n = 69)、C1-C2融合术(n = 22)、枕骨-C2钢丝固定术(n = 5)和后颅窝减压术(n = 5)。OCF的植入物包括塑形不锈钢棒(n = 47)、钛质侧块螺钉和钢板(n = 16)以及钢丝(n = 5)。所有接受OCF的患者在平均随访16.5个月时均观察到充分的骨融合,无论用于后路固定的植入物类型如何。即使是病情较差的患者也观察到良好的神经功能结局。随访时未观察到对脊柱曲度或生长有显著影响。