显微镜下经口腔复位内固定术治疗颅底凹陷合并寰枢椎脱位
目的探讨经口腔入路松解、复位内固定术在颅底凹陷合并寰枢椎脱位治疗中的应用价值，并评价其有效性及安全性。方法对3例不可复性寰枢椎脱位患者实施显微镜辅助下经El腔入路松解、复位内固定术，术中以经口腔复位内固定钛板作为前方固定，自体颗粒骨植骨。采用Et本骨科协会（JOA）17分评分系统进行手术前后颈脊髓神经功能评价，MRI及x线判断术后寰枢间距及延髓颈髓角改善程度。结果3例患者手术平均时间为130min（110、130和150min）；平均出血量为150ml（100、200和150m1）。术后CT检查显示，3例患者内固定钛板及12枚椎弓根钛钉固定理想、无松动迹象，颅底凹陷及寰枢关节脱位得到不同程度纠...
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| Published in | 中国现代神经疾病杂志 Vol. 12; no. 4; pp. 430 - 436 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
济南军区总医院神经外科,250031
2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1672-6731 |
| DOI | 10.3969/j.issn.1672-6731.2012.04.011 |
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| Abstract | 目的探讨经口腔入路松解、复位内固定术在颅底凹陷合并寰枢椎脱位治疗中的应用价值，并评价其有效性及安全性。方法对3例不可复性寰枢椎脱位患者实施显微镜辅助下经El腔入路松解、复位内固定术，术中以经口腔复位内固定钛板作为前方固定，自体颗粒骨植骨。采用Et本骨科协会（JOA）17分评分系统进行手术前后颈脊髓神经功能评价，MRI及x线判断术后寰枢间距及延髓颈髓角改善程度。结果3例患者手术平均时间为130min（110、130和150min）；平均出血量为150ml（100、200和150m1）。术后CT检查显示，3例患者内固定钛板及12枚椎弓根钛钉固定理想、无松动迹象，颅底凹陷及寰枢关节脱位得到不同程度纠正；颈脊髓神经功能明显改善，JOA评分改善率分别为75．00％、40．00％和56．25％，平均改善率为57．08％，平均JOA评分改善率评级为良好。其中1例患者术后并发颅内感染，经对症治疗痊愈。结论显微镜辅助下经口腔入路松解、复位内固定术治疗颅底凹陷合并寰枢椎脱位具有一定临床应用价值。 |
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| AbstractList | R4; 目的 探讨经口腔入路松解、复位内固定术在颅底凹陷合并寰枢椎脱位治疗中的应用价值,并评价其有效性及安全性.方法 对3 例不可复性寰枢椎脱位患者实施显微镜辅助下经口腔入路松解、复位内固定术,术中以经口腔复位内固定钛板作为前方固定,自体颗粒骨植骨.采用日本骨科协会(JOA)17 分评分系统进行手术前后颈脊髓神经功能评价,MRI 及X 线判断术后寰枢间距及延髓颈髓角改善程度.结果 3 例患者手术平均时间为130 min(110、130 和150 min);平均出血量为150 ml(100、200 和150 ml).术后CT 检查显示,3 例患者内固定钛板及12 枚椎弓根钛钉固定理想、无松动迹象,颅底凹陷及寰枢关节脱位得到不同程度纠正;颈脊髓神经功能明显改善,JOA评分改善率分别为75.00%、40.00%和56.25%,平均改善率为57.08%,平均JOA 评分改善率评级为良好.其中1 例患者术后并发颅内感染,经对症治疗痊愈.结论 显微镜辅助下经口腔入路松解、复位内固定术治疗颅底凹陷合并寰枢椎脱位具有一定临床应用价值. 目的探讨经口腔入路松解、复位内固定术在颅底凹陷合并寰枢椎脱位治疗中的应用价值，并评价其有效性及安全性。方法对3例不可复性寰枢椎脱位患者实施显微镜辅助下经El腔入路松解、复位内固定术，术中以经口腔复位内固定钛板作为前方固定，自体颗粒骨植骨。采用Et本骨科协会（JOA）17分评分系统进行手术前后颈脊髓神经功能评价，MRI及x线判断术后寰枢间距及延髓颈髓角改善程度。结果3例患者手术平均时间为130min（110、130和150min）；平均出血量为150ml（100、200和150m1）。术后CT检查显示，3例患者内固定钛板及12枚椎弓根钛钉固定理想、无松动迹象，颅底凹陷及寰枢关节脱位得到不同程度纠正；颈脊髓神经功能明显改善，JOA评分改善率分别为75．00％、40．00％和56．25％，平均改善率为57．08％，平均JOA评分改善率评级为良好。其中1例患者术后并发颅内感染，经对症治疗痊愈。结论显微镜辅助下经口腔入路松解、复位内固定术治疗颅底凹陷合并寰枢椎脱位具有一定临床应用价值。 |
| Author | 朱伟杰 袁绍纪 卢培刚 张荣伟 王同力 |
| AuthorAffiliation | 济南军区总医院神经外科,250031 |
| AuthorAffiliation_xml | – name: 济南军区总医院神经外科,250031 |
| Author_FL | ZHU Wei-jie LU Pei-gang ZHANG Rong-wei YUAN Shao-ji WANG Tong-li |
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| DOI | 10.3969/j.issn.1672-6731.2012.04.011 |
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| DocumentTitleAlternate | Microscope-assisted transoral-transpharyngeal reduction and fixation of basilar invagination and atlantoaxial dislocation |
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| EndPage | 436 |
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| Keywords | 扁颅底 脱位 寰枢关节 内固定术(非MeSH词) |
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| Notes | ZHU Wei-jie, YUAN Shao-ji, LU Pei-gang, ZHANG Rong-wei, WANG Tong-li Department of Neurosurgery, Ji ＇nan Military General Hospital, Ji ＇nan 250031, Shandong, China Objective To study the outcome of the transoral reduction and fixation of basilar invagination and atlantoaxial dislocation, to evaluate this novel technique involving a microscope-assisted anterior release and reduction and fixation through a transoral-transpharyngeal approach and describe the safety and efficacy of a new minimal invasive technique for the irreducible atlantoaxial dislocation （IADD）. Methods A prospective clinical study was performed. Three consecutive irreducible atlantoaxial dislocation patients underwent a microscope-assisted anterior release and reduction and fixation through transoral-transpharyngeal approach. Transoral atlantoaxial reduction plate （TARP） for anterior fixation and autologous morselized bone grafting were used during the operation. The Japanese Orthopaedic Association （JOA） scoring system was used to evaluate e |
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| PublicationTitle | 中国现代神经疾病杂志 |
| PublicationTitleAlternate | Chinese Journal of Contemporary Neurology and Neurosurgery |
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| PublicationYear | 2012 |
| Publisher | 济南军区总医院神经外科,250031 |
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| Snippet | 目的探讨经口腔入路松解、复位内固定术在颅底凹陷合并寰枢椎脱位治疗中的应用价值，并评价其有效性及安全性。方法对3例不可复性寰枢椎脱位患者实施显微镜辅助下经El腔入路松... R4; 目的 探讨经口腔入路松解、复位内固定术在颅底凹陷合并寰枢椎脱位治疗中的应用价值,并评价其有效性及安全性.方法 对3 例不可复性寰枢椎脱位患者实施显微镜辅助下经口腔... |
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| SubjectTerms | 内固定术（非MeSH词） 寰枢关节 扁颅底 脱位 |
| Title | 显微镜下经口腔复位内固定术治疗颅底凹陷合并寰枢椎脱位 |
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