Department of Spine, General Hospital of Southern Theatre Command, 111 Liuhua Road, Guangzhou, 510010, People's Republic of China.
The First School of Clinical Medicine, Southern Medical University, No. 1838 North of Guangzhou Road, Guangzhou, 510515, People's Republic of China.
Eur Spine J. 2024 Aug;33(8):3043-3048. doi: 10.1007/s00586-024-08298-3. Epub 2024 May 15.
To develop posterior reduction forceps for atlantoaxial dislocation and evaluate the preliminary clinical application of this forceps in assisting simple posterior screw-rod system reduction and fixation in the treatment of irreducible atlantoaxial dislocation.
Based on the posterior atlantoaxial screw-rod system, posterior reduction forceps was developed to assist simple posterior screw-rod system for the treatment of irreducible atlantoaxial dislocation. From January 2021 to October 2022, 10 cases with irreducible atlantoaxial dislocation were treated with this technique. The Japanese Orthopaedic Association (JOA) score was applied before and after surgery to evaluate the neurological status of the patient, and the Atlanto-dental interval (ADI) was measured before and after surgery to evaluate the atlantoaxial reduction. X-ray and CT were performed to evaluate internal fixation, atlantoaxial sequence and bone graft fusion during regular follow-up. MRI was performed to evaluate the status of atlantoaxial reduction and spinal cord compression after surgery.
All 10 patients were successfully operated, and there were no complications such as spinal nerve and vascular injury. Postoperative clinical symptoms were significantly relieved in all patients, and postoperative JOA score and ADI were significantly improved compared with those before surgery (P < 0.05).
The developed posterior reduction forceps for atlantoaxial dislocation can assist the simple posterior screw-rod system in the treatment of irreducible atlantoaxial dislocation to avoid the release in anterior or posterior approach and reduce the difficulty of surgery. The preliminary results of this technique are satisfactory and it has a good application prospect.
研制寰枢椎脱位后路复位钳，并评估该复位钳辅助单纯后路钉棒系统复位固定治疗难复性寰枢椎脱位的初步临床应用效果。
基于后路寰枢椎钉棒系统，研制寰枢椎后路复位钳，辅助单纯后路钉棒系统治疗难复性寰枢椎脱位。2021 年 1 月至 2022 年 10 月，采用该技术治疗难复性寰枢椎脱位 10 例。采用日本骨科协会（JOA）评分评估患者神经功能，测量寰齿间距（ADI）评估寰枢椎复位情况。术后定期随访行 X 线、CT 检查，评估内固定、寰枢序列及植骨融合情况，MRI 评估寰枢椎复位及脊髓压迫情况。
10 例患者均顺利完成手术，无脊髓、血管损伤等并发症。所有患者术后临床症状均明显缓解，术后 JOA 评分和 ADI 均较术前明显改善（P < 0.05）。
研制的寰枢椎脱位后路复位钳可辅助单纯后路钉棒系统治疗难复性寰枢椎脱位，避免前路或后路松解，降低手术难度。该技术初步应用效果满意，具有良好的应用前景。
