Hart R A, Weinstein J N, Menezes A H
Department of Neurological Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Iowa Orthop J. 1996;16:157-60.
Surgical approaches to atlanto-axial lesions are generally accomplished by either anterior (transoral) or posterior approaches as dictated by the location of the lesion. In certain patients, these approaches are combined, either in a single or staged procedure. Mechanical stabilization is much more readily accomplished posteriorly, as this allows easy incorporation of the occiput. While the transoral approach allows excellent exposure of the bodies of C1 and C2, it entails substantial surgical trauma. We describe the case of a woman with destruction of the anterior portions of the C1 and C2 vertebrae by metastatic breast cancer addressed by simultaneous anterior tumor debulking and posterior instrumentation through a posterolateral approach to the upper cervical spine.
针对寰枢椎病变的手术方法通常根据病变位置采用前路（经口）或后路。在某些患者中，这些方法可在单次手术或分期手术中联合使用。机械稳定更容易通过后路实现，因为这样便于将枕骨纳入。虽然经口入路能很好地暴露C1和C2椎体，但会带来较大的手术创伤。我们描述了一名患有转移性乳腺癌导致C1和C2椎体前部破坏的女性病例，通过对上颈椎采用后外侧入路同时进行前路肿瘤减瘤和后路内固定来治疗。
