知识与财富的链接
目的探讨用微创理念行后路椎弓根钉板内固定植骨融合术治疗寰枢椎不稳的方法及临床效果。方法采用后路椎弓根螺钉技术对23例寰枢椎不稳定的患者进行内固定。手术前均行颅骨牵引复位，术前先在X线片及CT上测定好进钉点以及角度、方向，选择螺钉、连接板的长度。寰椎进钉点选择在寰椎后结节中点旁开18～20mm与后弓下缘以上2mm的交点，螺钉内斜角度为0°，上斜角度为5°。枢椎进钉点为枢椎下关节突根部中点，螺钉角度上斜30°，内斜约10°，螺钉直径3．5mm，寰椎螺钉长28—32mm，枢椎螺钉长22—26mm。结果均达到解剖复位、术中未损伤脊髓和椎动脉，术中出血量82（68～96）ml，2例齿状突骨折出现过度复位，术中经重新调整后解剖复位。本组平均随访15（10—25）个月，所有患者均症状消失，植骨融合，无内固定松动、断裂。结论用微创的理念行后路椎弓根钉板内固定植骨融合术治疗寰枢椎不稳可提高手术的精确度并将手术创伤降到最低。
Objective To explore the best posterior fixation method of atlantoaxial instability by micro-injury method.Methods A total of 23 cases were fixed by using with lateral pedicle screws and plates.Skull traction was performed before operation.According to the imaging of X-ray films and CT,the best entrance point,angle and direction were determined,and the types of the screws and the plates were chosen.The entry point of atlas pedicle screws was placed at 18~20 mm beside the midpoint of atlas tubercle and at th...
