Cai Mandi, Yang Haozhi, Zhang Shuang, Deng Chenfu, Chen Junlin, Ma Rencai, Zou Xiaobao, Ma Xiangyang
The First School of Clinical Medicine, Southern Medical University, No.1838 North of Guangzhou Road, Guangzhou, 510515, People's Republic of China.
Department of Orthopedics, General Hospital of Southern Theatre Command of PLA, 111 Liuhua Road, Guangzhou, 510010, People's Republic of China.
J Orthop Surg Res. 2024 Dec 23;19(1):863. doi: 10.1186/s13018-024-05330-6.
This study is aimed to compare the differences in clinical outcomes between the crossed rod configuration and the parallel rod configuration applied in posterior occipitocervical and atlantoaxial fixations, and to assess the clinical applicability of crossed rods.
From January 2015 to December 2021, 21 patients with craniocervical junction disorders were treated surgically with the crossed rod technique (CR group). Meanwhile, 27 corresponding patients treated with the conventional parallel rod technique were included as control (PR group). Clinical data, internal fixation type, neurological status, clinical symptoms relief, image parameter, complications and bone fusion conditions were retrospectively analyzed and evaluated.
No statistically significant differences were found in baseline characteristics, fixation type and postoperative complications between the two groups. Although the postoperative ADI was significantly reduced in both groups, the ADI was significantly greater in the CR group than that in the PR group after surgery and at the final follow-up (P < 0.05). All patients achieved bone fusion at 1-year postoperative follow-up except for one case in the PR group. However, patients in the CR group had a significantly higher fusion rate than those in the PR group at 3 months postoperatively (P < 0.05).
The application of a crossed rod configuration in posterior occipitocervical and atlantoaxial fixations provides good clinical applicability. Although this technique has a relatively weaker reduction force, it has greater fixation stability and a higher rate of early bone fusion. This technique could be an easy and viable alternative to the current parallel rod configuration for upper cervical surgery.
本研究旨在比较交叉棒构型与平行棒构型应用于枕颈后路及寰枢椎固定时临床疗效的差异，并评估交叉棒的临床适用性。
2015年1月至2021年12月，21例颅颈交界区疾病患者采用交叉棒技术进行手术治疗（CR组）。同时，纳入27例采用传统平行棒技术治疗的相应患者作为对照组（PR组）。对临床资料、内固定类型、神经功能状态、临床症状缓解情况、影像学参数、并发症及骨融合情况进行回顾性分析和评估。
两组患者的基线特征、固定类型及术后并发症差异均无统计学意义。虽然两组术后寰齿间距（ADI）均显著减小，但术后及末次随访时CR组的ADI均显著大于PR组（P<0.05）。除PR组1例患者外，所有患者术后1年随访时均实现了骨融合。然而，CR组患者术后3个月时的融合率显著高于PR组（P<0.05）。
交叉棒构型应用于枕颈后路及寰枢椎固定具有良好的临床适用性。虽然该技术的复位力相对较弱，但具有更大的固定稳定性和更高的早期骨融合率。对于上颈椎手术，该技术可能是目前平行棒构型的一种简便可行的替代方法。
