临床骨科杂志2017，Vol.20Issue(3)：272-275,4.DOI:10.3969/j.issn.1008-0287.2017.03.004
后路寰枢椎钉棒固定融合与非融合治疗Ⅱ型齿状突骨折的疗效比较
Comparison of clinical outcomes of posterior C1~C2 temporary screw-rod fixation without fusion and C1~C2 fusion for type Ⅱ odontoid fractures
莫挺挺 1张文斌 1李宏杰 1方春养1
作者信息
- 1. 温岭市第一人民医院骨三科,浙江 温岭 317500
- 折叠
摘要
Abstract
Objective To compare the clinical outcomes between the posterior C1~C2 temporary screw-rod fixation technique and the posterior C1~C2 fusion technique in the treatment of typeⅡodontoid fracture.Methods Seventeen patients with type Ⅱodontoid fractures were enrolled,and were randomly divided into non-fusion group (9 cases) and fusion group(8 cases).Non-fusion group was treated by using temporary C1~C2 pedicle screw-rod fixation and without fusion,and fusion group was treated by using C1~C2 pedicle screw fixation with fusion.The differences between the two groups in the visual analogue scale (VAS) for neck pain,degree of cervical rotation,neck disability index (NDI)and fracture healing time were analyzed.Results All pedicle screws were successfully placed and satisfactory fracture reduction was achieved and maintained by internal fixation in all of the 17 patients,and no neurovascular injury was noted.All cases were followed up for 12~20(16.1±2.1) months.The fracture healing time in non-fusion group was 6~14(10.1±2.4)months,and was 7~16(10.3±3.2) months in fusion group.There was no significant difference between two groups(P>0.05).The neck pain was released significantly after operation.The neck pain VAS in non-fusion group at 3 months after removal of internal fixation was (1.3±0.7),and was (2.2±0.7) in fusion group at 3 months after fracture healing.There was statistically significant difference between two groups(P<0.05).The cervical rotation was 142.5°±10.3° in non-fusion group at 3 months after removal of internal fixation,and was 80.0°±7.5° in fusion group at 3 months after fracture healing.There was statistically significant difference between two groups(P<0.01).NDI was 2.3%±1.2% in non-fusion group at 3 months after removal of internal fixation,and was 17.2%±2.8% in fusion group at 3 months after fracture healing.There was statistically significant difference between two groups (P<0.01).Conclusions The clinical outcomes of posterior C1~C2 temporary screw-rod fixation without fusion in the treatment of typeⅡodontoid fractures are good.Patients can retain the maximum cervical rotation range,and reduce cervical dysfunction.关键词
齿状突骨折/钉棒固定/非融合/寰枢融合术Key words
odontoid fractures/screw-rod fixation/nonfusion/atlantoaxial fusion分类
医药卫生引用本文复制引用
莫挺挺,张文斌,李宏杰,方春养..后路寰枢椎钉棒固定融合与非融合治疗Ⅱ型齿状突骨折的疗效比较[J].临床骨科杂志,2017,20(3):272-275,4.
