目的 观察经后路复位椎弓根钉内固定术治疗强直性脊柱炎合并寰枢椎脱位的临床疗效。方法 某院2009-04至2013-06共收治10例强直性脊柱炎合并寰枢椎脱位患者,均采用经颈后路复位椎弓根钉内固定术治疗,采用JOA法和Frankel分级对治疗效果进行评估。结果 本组病例获(21.0±11.1)个月随访。所有患者症状均明显改善,术前JOA评分(12.7±1.7)分,术后JOA评分(15.4±4.0)分,手术前后对比差异有统计学意义(P<0.05)。5例脊髓损伤患者Frankel分级从术前D级恢复至E级。所有病例术中未出现椎动脉、静脉窦及脊髓损伤,术后未出现内固定松动、断裂,随访期间寰枢椎无再移位、失稳,植骨融合满意。结论 经后路复位椎弓根钉内固定术是治疗强直性脊柱炎合并寰枢椎脱位的安全有效的方法。
Abstract
Objective To study the surgical therapeutics and efficacy of posterior restoration pedicle screw internal fixation technique in treating ankylosing spondylitis patients with atlantoaxial dislocation. Methods From April 2009 to June 2013,10 patients with ankylosing spondylitis with atlantoaxial dislocation were recruited. All patients underwent the posterior reduction and pedicle screw fixation treatment. The therapeutic efficacy was evaluated by the JOA method and Frankel scale. Results All patients were followed up (21.0±11.1) for months. Original symptoms in all patients were significantly improved, with preoperative JOA score (12.7±1.7) points, postoperatie JOA score (15.4±4.0) points (P<0.05). Five patients with spinal cord injury recovered from a preoperative D to E by Frankel classification. All patients did not present vertebral artery, venous sinus and spinal cord injury intraoperatively, nor presented fixation loosening and fracture postoperatively. In postoperative follow-up period, no translocation and instability of atlantoaxial vertebra were detected. The bone graft fusion rate was satisfactory. Conclusions Posterior restoration pedicle screw technique is a safe and effective method for treating ankylosing spondylitis patients with atlantoaxial dislocation.
关键词
强直性脊柱炎 /
寰枢椎脱位 /
椎弓根钉 /
颈后路
Key words
ankylosing spondylitis /
atlantoaxial dislocation /
pedicle screw /
posterior cervical fusion
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