【作者单位】Department of Orthopedics, Shanghai First People''s Hospital, Shanghai Jiaotong University, Shanghai 200080, China.
【出处】Zhonghua Yi Xue Za Zhi
【年份】2009
【卷号】Vol.89 No.3
【页码】191-194
【ISSN】0578-1337
【分类号】610
【摘要】OBJECTIVE: To study the clinical and radiographic characteristics of axial fracture with adjacent section instability and the diagnosis and surgical treatment thereof. METHODS: Seventeen patients of axial fracture with adjacent section instability, 11 males and 7 females, aged 34 (23-56) underwent different treatment patterns depending on the fracture type and stability of the atlanto-axial joint and C2-3: resection of C2-3 intervertebral disk and bone grafting, anterior interbody fusion and plate internal fixation, odontoid screw fixation, posterior C2 pedicle screw fixation, odontoid screw fixation combined with bilateral C-2 pedicle screw fixation. Follow-up was conducted for 12 (6-36) months. RESULTS: Postoperatively all patients were immobilized in a hard collar for 3 months. Bony fusion was obtained in all patients in 3 months. There were no operation-related complications, such as spinal cord injury, cerebrospinal fluid leakage, vertebral artery injury, etc. No re-dislocation was found. Neurological recovery was observed in the 3 patients who presented neurological deficits. CONCLUSION: The type of atlas fracture with adjacent section instability and the impact thereof on the stability of the atlanto-axial joint and C2/3 neck joint should be identified early. Surgical treatment results in better outcome.
