Apostolides P J, Dickman C A, Golfinos J G, Papadopoulos S M, Sonntag V K
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Spine (Phila Pa 1976). 1996 Jul 15;21(14):1630-7. doi: 10.1097/00007632-199607150-00004.
In a clinical retrospective study, the authors review long-term results of occipitocervical fusion using a wide diameter, contoured, threaded Steinmann pin.
To evaluate the clinical and radiographic results of occipitocervical fusion using this technique in a variety of abnormalities including rheumatoid arthritis. SUMMARY OF BACKGROUND DATA. The various surgical techniques and hardware developed for occipitocervical fusion have been associated with mixed results, particularly in patients with rheumatoid arthritis or basilar invagination.
Thirty-nine patients with occipitocervical instability were internally fixed with a wide diameter, contoured, threaded Steinmann pin wired to the occiput and cervical laminae or facets. Fusion was facilitated using autologous iliac crest bone graft and a cervical orthosis. Instability resulted from rheumatoid arthritis (n = 12), congenital anomalies (n = 12), trauma (n = 10), tumor (n = 4), or osteogenesis imperfecta (n = 1). Fifteen patients had radiographic evidence of basilar invagination. Long-term outcome (mean follow-up period, 38.9 months; range, 12-78 months) was based on clinical and radiographic review.
Thirty-seven patients (97%) had a stable postoperative occipitocervical construct: there were 35 osseous unions, two fibrous unions, and one nonunion. There was on postoperative death from pulmonary complications. No patient developed evidence of new, recurrent, or progressive basilar invagination.
The authors concluded that rigid segmental fixation of the craniovertebral junction using a wide diameter, contoured, threaded Steinmann pin and supplemental autograft creates excellent fusion with minimal complications. This technique is appropriate for a variety of abnormalities including rheumatoid arthritis.
在一项临床回顾性研究中，作者回顾了使用大直径、塑形、带螺纹的斯氏针进行枕颈融合术的长期结果。
评估使用该技术对包括类风湿性关节炎在内的各种异常情况进行枕颈融合术的临床和影像学结果。背景数据总结。为枕颈融合术开发的各种手术技术和硬件产生的结果不一，尤其是在类风湿性关节炎或基底凹陷患者中。
39例枕颈不稳患者采用大直径、塑形、带螺纹的斯氏针固定于枕骨和颈椎板或小关节面，并进行内固定。使用自体髂骨植骨和颈椎矫形器促进融合。不稳的病因包括类风湿性关节炎（n = 12）、先天性畸形（n = 12）、创伤（n = 10）、肿瘤（n = 4）或成骨不全（n = 1）。15例患者有基底凹陷的影像学证据。长期结果（平均随访期38.9个月；范围12 - 78个月）基于临床和影像学检查。
37例患者（97%）术后枕颈结构稳定：35例为骨性融合，2例为纤维性融合，1例未融合。无术后因肺部并发症死亡的病例。没有患者出现新的、复发性或进行性基底凹陷的证据。
作者得出结论，使用大直径、塑形、带螺纹的斯氏针和补充自体骨移植对颅颈交界进行刚性节段固定可实现良好的融合，并发症最少。该技术适用于包括类风湿性关节炎在内的各种异常情况。
