摘要
目的分析复杂寰枢椎脱位的复杂因素并探讨其解决方案。方法回顾性分析68例复杂寰枢椎脱位的临床特点、复杂因素,分别采取Ⅲ型经口咽寰枢椎复位钢板(TARP-Ⅲ)内固定术、深部磨削减压技术、计算机辅助设计与快速成型(CAD-RP)技术个性化手术及经口扩大入路技术等相应的特殊治疗措施。结果随访平均28个月,60例获解剖复位,8例接近解剖复位,受压颈髓获充分减压,脊髓减压改善率87.2%,神经功能改善率76.6%。发生颅内感染3例。结论针对性地分别采用以上4项技术能使一些复杂的寰枢椎脱位得到有效治疗。
Objective To explore clinic characteristic and treatment of complicated atlantoaxial dislocation.Methods Characteristic and complicated factors of 68 patients with complicated atlantoaxial dislocation that failed in treatment with conventional therapy in the last 4 years were reviewed.According to the complicated factors different treatments mainly including transoralpharyngeal atlantoaxial reduction plate-Ⅲ（TARP-Ⅲ） operation,decompression procedure by grinding at deep part,individualized computer aided design-rapid prototyping（CAD-RP） operation or improve the approach were used.Results The average follow-up was 28 months long.In 68 cases,atlanto-axial joint achieved completely anatomical immediate reduction in 60 cases,nearly anatomical immediate reduction in 8 cases.All cases spinal cords were sufficiently decompressed with 87.2% average decompression rate and 76.6% average improvement rate of nerve function.Two cases suffered intracranial infection.Conclusion Some complicated atlantoaxial dislocation can be effectively treated by knowing the complicated factors and mastering above four technologies.
出处
《山东医药》
CAS
北大核心
2010年第28期12-16,共5页
Shandong Medical Journal
基金
2007年度卫生部公益性行业科研专项(2-18)
广东省科技计划项目(2006A36001003-04
2007B060101003)
关键词
寰枢关节
脱位
经口咽入路
内固定
计算机辅助设计与快速成型
经口咽寰枢椎复位钢板
atlanto-axial joint
dislocations
anterior transoral approach
internal fixation
computer aided design-rapid prototyping
transoralpharyngeal atlantoaxial reduction plate
作者简介
尹庆水，男，主任医师，博士生导师，将军级技术专家。现任全军创伤骨科中心主任、广州军区广州总医院骨科医院院长。具有30多年骨科和脊柱外科的科研和临床工作经验，先后主持国家自然科学基金、全军十一五课题、广东省自然科学基金团队项目等10余项课题。研制发明了经口咽襄枢椎钢板复位内固定（TARP）系统，为世界领先水平。担任全军脊柱学会副主任委员、广东省脊柱外科学会主任委员、广州军区骨科专业委员会主任委员、《中国骨科临床与基础研究杂志》主编。主编专著4部，发表论文60余篇，获军队医疗成果和广东省科技进步一等奖各1项，二等奖共6项，获国家专利6项。曾获军队优秀人才岗位津贴和国务院特殊津贴，被评为全军“爱军精武标兵”、“杰出专业技术人才”、广州军区“三学标兵”、“名医名刀”、广东省医学会“突出贡献专家”。E-mail：gz_yqs@126．com
