Nakagawa T, Yone K, Sakou T, Yanase M
Department of Orthopaedic Surgery, Faculty of Medicine, Kagoshima University, Japan.
Spine (Phila Pa 1976). 1997 Jun 1;22(11):1209-14. doi: 10.1097/00007632-199706010-00006.
Eight children in whom atlantoaxial dislocation had developed underwent occipitocervical fusion using a rectangular rod. The postoperative results are presented, and the postoperative growth and deformation of the cervical spine were determined radiographically.
To investigate in a relatively long-term follow-up study whether occipitocervical fusion affects the growth of the cervical spine and induces spinal deformation.
It has been reported that children who have undergone C1-C2 posterior fusion are likely to develop abnormal curvature or deformation of the cervical spine as a result of a disturbance of growth of the fused vertebrae. There have been no studies, however, to confirm that these changes occur after occipitocervical fusion in children.
The subjects were one boy and seven girls who had undergone occipitocervical posterior fusion during childhood. The average age at the time of surgery was 8.3 years, and the average follow-up period was 5.9 years. The following were assessed radiographically: redislocation of the atlas, bone union, changes in the curvature of the cervical spine, the height and width of the vertebral bodies, and the anteroposterior diameter of the spinal canal.
Solid bone union was achieved in all patients with maintenance of the reduced position at the time of surgery. None of the patients exhibited abnormal curvature of the cervical spine. The rate of increase in height of the C2 vertebral body was significantly less than that of vertebral bodies below C3. The rate of increase in width of the vertebral body and the anteroposterior diameter of the spinal canal of the C2 vertebral body and vertebral bodies below C3 did not differ significantly.
Occipitocervical fusion with a rectangular rod is useful for treating atlantoaxial dislocation in children and yields excellent results because of the firm internal fixation it achieves. This surgery induced no apparent postoperative spinal deformations.
8例发生寰枢椎脱位的儿童接受了使用矩形棒的枕颈融合术。报告了术后结果，并通过影像学检查确定了颈椎的术后生长和变形情况。
在一项相对长期的随访研究中，调查枕颈融合术是否会影响颈椎生长并导致脊柱变形。
据报道，接受C1-C2后路融合术的儿童由于融合椎体生长紊乱，可能会出现颈椎异常弯曲或变形。然而，尚无研究证实这些变化会在儿童枕颈融合术后发生。
研究对象为1名男孩和7名女孩，他们在儿童期接受了枕颈后路融合术。手术时的平均年龄为8.3岁，平均随访期为5.9年。通过影像学检查评估以下内容：寰椎再脱位、骨融合、颈椎曲度变化、椎体高度和宽度以及椎管前后径。
所有患者均实现了牢固的骨融合，手术时复位位置得以维持。所有患者均未出现颈椎异常弯曲。C2椎体高度的增加率明显低于C3以下椎体。C2椎体以及C3以下椎体的椎体宽度增加率和椎管前后径增加率无显著差异。
使用矩形棒进行枕颈融合术对治疗儿童寰枢椎脱位有效，并且由于实现了牢固的内固定，效果极佳。该手术未引起明显的术后脊柱变形。
