【摘要】：背景:后路植骨融合釘棒內(nèi)固定是治療寰樞椎脫位的常用手術(shù)方法,寰樞椎間的骨性融合是手術(shù)治療的最終目的。目前,臨床中寰樞椎后路手術(shù)可應(yīng)用多種植骨材料及置釘方式,而術(shù)后患者獲得植骨融合的時(shí)間也多有不同。目的:分析寰樞椎脫位后路不同植骨材料及釘棒內(nèi)固定方式對(duì)植骨后融合時(shí)間的影響。方法:回顧性分析2009年8月至2015年12月286例采用寰樞椎后路植骨融合釘棒內(nèi)固定并獲得寰樞椎間植骨融合的可復(fù)性寰樞椎脫位患者。寰椎固定采用完全經(jīng)椎弓根螺釘,樞椎固定采用椎弓根螺釘或椎板螺釘,后路植骨材料采用自體骨松質(zhì)骨�；虍愺w骨松質(zhì)骨粒。結(jié)果與結(jié)論:術(shù)后獲得植骨融合時(shí)間3-24個(gè)月,C_1雙側(cè)椎弓根螺釘+C_2雙側(cè)椎弓根螺釘、C_1雙側(cè)椎弓根螺釘+C_2雙側(cè)椎板螺釘、C1雙側(cè)椎弓螺釘+C_2一側(cè)椎弓根螺釘+C_2對(duì)側(cè)椎板螺釘3種內(nèi)固定方式對(duì)術(shù)后植骨融合時(shí)間的影響差異無顯著性意義(F=2.134,P=0.120),自體骨松質(zhì)骨粒和異體骨松質(zhì)骨粒2種植骨材料術(shù)后植骨融合時(shí)間差異有顯著性意義(F=83.611,P=0.000),內(nèi)固定方式和植骨材料間無交互作用(F=1.036,P=0.356)。說明不同寰樞椎后路釘棒內(nèi)固定方式均可提供穩(wěn)定可靠的植骨融合環(huán)境,自體骨材料植骨更加有利于術(shù)后獲得植骨融合,縮短融合時(shí)間。
[Abstract]:Background: posterior fusion screw fixation is a common operative method in the treatment of atlantoaxial dislocation, and bone fusion between atlantoaxial vertebrae is the ultimate goal of surgical treatment. At present, the posterior approach of atlantoaxial surgery can use a variety of bone graft materials and nail placement, and the time of bone graft fusion is different. Objective: to analyze the effect of different bone graft materials and screw rod fixation on the fusion time after atlantoaxial dislocation. Methods: from August 2009 to December 2015, 286 cases of atlantoaxial dislocation were treated with posterior atlantoaxial fusion screw rod fixation and fusion of atlantoaxial bone graft. Transpedicular screw was used for atlas fixation, pedicle screw or laminar screw was used for axial fixation, and autologous cancellous bone or allogeneic cancellous bone was used for posterior bone graft. Results and conclusion: the time of bone graft fusion was 3 to 24 months after operation. The pedicle screw of C _ 1 bilateral pedicle screw C _ 2 bilateral pedicle screw, C _ 1 bilateral pedicle screw C _ 2 bilateral laminar screw were obtained after operation, and C _ (1) bilateral pedicle screw, C _ (2) bilateral pedicle screw. C1 bilateral pedicle screw C2 contralateral laminar screw had no significant effect on the time of bone graft fusion (FF2.134PU 0.120). There was significant difference in the time of bone graft fusion between autologous cancellous bone grafts and allogeneic cancellous bone granulocytes 2 implants (FN 83.611P0. 000), but there was no interaction between internal fixation and bone graft materials (FN 1.036 P0. 356). The results showed that different posterior fixation methods of atlantoaxial screw and rod could provide a stable and reliable fusion environment, and autogenous bone graft was more beneficial to achieve bone graft fusion and shorten the fusion time after operation.
【作者單位】： 南方醫(yī)科大學(xué)研究生學(xué)院;解放軍廣州總醫(yī)院骨科醫(yī)院脊柱外科;
【基金】：廣東省省級(jí)科技計(jì)劃項(xiàng)目(2015B020233013)~~
【分類號(hào)】：R687.3

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