|
|
|
| Posterior restoration pedicle screw technique in treating ankylosing spondylitis patients with atlantoaxial dislocation |
| CHEN Guo1, CHEN Jianmei2, ZHANG Yongguang2 |
1. Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350025, China;
2.Department of Orthopedics, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, China |
|
|
|
|
Abstract Objective To study the surgical therapeutics and efficacy of posterior restoration pedicle screw internal fixation technique in treating ankylosing spondylitis patients with atlantoaxial dislocation. Methods From April 2009 to June 2013,10 patients with ankylosing spondylitis with atlantoaxial dislocation were recruited. All patients underwent the posterior reduction and pedicle screw fixation treatment. The therapeutic efficacy was evaluated by the JOA method and Frankel scale. Results All patients were followed up (21.0±11.1) for months. Original symptoms in all patients were significantly improved, with preoperative JOA score (12.7±1.7) points, postoperatie JOA score (15.4±4.0) points (P<0.05). Five patients with spinal cord injury recovered from a preoperative D to E by Frankel classification. All patients did not present vertebral artery, venous sinus and spinal cord injury intraoperatively, nor presented fixation loosening and fracture postoperatively. In postoperative follow-up period, no translocation and instability of atlantoaxial vertebra were detected. The bone graft fusion rate was satisfactory. Conclusions Posterior restoration pedicle screw technique is a safe and effective method for treating ankylosing spondylitis patients with atlantoaxial dislocation.
|
|
Received: 05 December 2014
|
|
|
|
|
|
| [7] |
Yanni D S, Perin N I. Fixation of the axis [J]. Neurosurgery, 2010, 66(3 Suppl):147-152.
|
| [8] |
Finn M A, Apfelbaum R I. Atlantoaxial transarticular screw fixation: update on technique and outcome in 269 patients [J]. Neurosurgery, 2010, 66(3 Suppl): 184-192.
|
| [1] |
Chen W S, Lee H T, Tsai C Y, et al. Severe atlantoaxial subluxation in early ankylosing spondylitis [J]. J Clin Rheumatol, 2010, 16(7): 353-355.
|
| [2] |
Hayashi T, Kawano O, Sakai H, et al. The potential for functional recovery of upper extremity function following cervical spinal cord injury without major bone injury [J]. Spinal Cord, 2013, 51(11): 819-822.
|
| [9] |
丁昌伟. 强直性脊柱炎诊断与治疗进展[J]. 现代医药卫生, 2013, 29(17): 2628-2647.
|
| [10] |
杨 峰,移 平,唐向盛, 等. 后路寰枢椎椎弓根钉固定治疗寰枢椎脱位[J]. 中国中医骨伤科杂志, 2014, 22(2): 36-39.
|
| [3] |
Fukui M, Chiba K, Kawakami M, et al. Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ): Part 2. Endorsement of the alternative item [J]. J Orthop Sci, 2007, 12(3): 241-248.
|
| [4] |
Debarge R, Demey G, Roussouly P. Sagittal balance analysis after pedicle subtraction osteotomy in ankylosing spondylitis [J]. Eur Spine J, 2011, 20(Suppl 5): 619-625.
|
| [11] |
Haid R W, Subach B R, McLaughlin M R, et al. C1-C2 transarticular screw fixation for atlantoaxial instability: a six-year experience [J]. Neurosurg, 2001,49:65-70.
|
| [12] |
Riew K D. Commentary: Anterior atlantoaxial transarticular screws: should this be the preferred atlantoaxial fixation technique? [J]. Spine J, 2012,12(8):663-664.
|
| [13] |
Elliott R E, Tanweer O, Boah A, et al. Outcome comparison of atlantoaxial fusion with transarticular screws and screw-rodconstructs: meta-analysis and review of literature[J]. J Spinal Disord Tech, 2014,27(1):11-28.
|
| [5] |
马 原,余光宇,王 鑫,等.椎板V型截骨矫正强直性脊柱后凸畸形的临床效果分析[J]. 中国矫形外科杂志, 2011, 19(23): 1941-1943.
|
| [6] |
De Iure F, Donthineni R, Boriani S. Outcomes of C1 and C2 posterior screw fixation for upper cervical spine fusion[J]. Eur Spine J, 2009, 18(Suppl 1): 2-6.
|
| [14] |
Guo X, Ni B, Zhao W, et al. Biomechanical assessment of bilateral C1 laminar hook and C1-2 transarticular screws and bone graft for atlantoaxial instability [J]. J Spinal Disord Tech, 2009,22(8):578-585.
|
| [7] |
Yanni D S, Perin N I. Fixation of the axis [J]. Neurosurgery, 2010, 66(3 Suppl):147-152.
|
| [15] |
张 东,何 秦, 黄焱星. 后路寰椎侧块结合枢椎椎弓根螺钉固定治疗上颈椎不稳的临床研究[J]. 南方医科大学报, 2010, 30(2): 359-361.
|
| [8] |
Finn M A, Apfelbaum R I. Atlantoaxial transarticular screw fixation: update on technique and outcome in 269 patients [J]. Neurosurgery, 2010, 66(3 Suppl): 184-192.
|
| [16] |
西永明, 张国庆, 陈伯华, 等. 经后路寰枢椎椎弓根螺钉侧块固定治疗寰枢不稳或脱位疗效观察[J]. 中华外科杂志, 2009, 47(22): 1722-1724.
|
| [9] |
丁昌伟. 强直性脊柱炎诊断与治疗进展[J]. 现代医药卫生, 2013, 29(17): 2628-2647.
|
| [17] |
解京明, 王迎松, 刘路平, 等. 寰枢椎经后路椎弓根钉板/棒系统固定融合治疗上颈椎不稳[J]. 脊柱外科杂志, 2008, 6(5): 257-260.
|
| [10] |
杨 峰,移 平,唐向盛, 等. 后路寰枢椎椎弓根钉固定治疗寰枢椎脱位[J]. 中国中医骨伤科杂志, 2014, 22(2): 36-39.
|
| [18] |
吴李勇, 彭锦芸, 曾碧凤. 双侧经寰枢椎关节螺钉联合寰椎椎板挂钩固定术治疗寰枢椎不稳[J]. 颈腰痛杂志, 2009, 30(6): 511-513.
|
| [11] |
Haid R W, Subach B R, McLaughlin M R, et al. C1-C2 transarticular screw fixation for atlantoaxial instability: a six-year experience [J]. Neurosurg, 2001,49:65-70.
|
| [12] |
Riew K D. Commentary: Anterior atlantoaxial transarticular screws: should this be the preferred atlantoaxial fixation technique? [J]. Spine J, 2012,12(8):663-664.
|
| [19] |
马维虎, 徐荣明, 孙韶华. 枕颈固定技术在上颈椎不稳的应用[J]. 中华创伤杂志, 2005, 21(5): 383-385.
|
| [13] |
Elliott R E, Tanweer O, Boah A, et al. Outcome comparison of atlantoaxial fusion with transarticular screws and screw-rodconstructs: meta-analysis and review of literature[J]. J Spinal Disord Tech, 2014,27(1):11-28.
|
| [14] |
Guo X, Ni B, Zhao W, et al. Biomechanical assessment of bilateral C1 laminar hook and C1-2 transarticular screws and bone graft for atlantoaxial instability [J]. J Spinal Disord Tech, 2009,22(8):578-585.
|
| [20] |
杨述华, 杜靖远, 邵增务, 等. 枕颈融合治疗创伤性上颈椎不稳疗效观察[J]. 实用骨科杂志, 2007, 13(1): 6-8.
|
| [15] |
张 东,何 秦, 黄焱星. 后路寰椎侧块结合枢椎椎弓根螺钉固定治疗上颈椎不稳的临床研究[J]. 南方医科大学报, 2010, 30(2): 359-361.
|
| [21] |
Wang B, Lü G H, Deng Y W, et al. Anterior endoscopically assisted transcervical reconstruction of the upper cervical spine [J]. Eur Spine J, 2011, 20(9): 1526-1532.
|
| [22] |
李金泉, 龚冰南, 徐 皓, 等. 寰枢椎融合与颈枕融合治疗上颈椎疾患的临床疗效比较[J]. 中华临床医师杂志(电子版), 2013,7(4):104-107.
|
| [16] |
西永明, 张国庆, 陈伯华, 等. 经后路寰枢椎椎弓根螺钉侧块固定治疗寰枢不稳或脱位疗效观察[J]. 中华外科杂志, 2009, 47(22): 1722-1724.
|
| [17] |
解京明, 王迎松, 刘路平, 等. 寰枢椎经后路椎弓根钉板/棒系统固定融合治疗上颈椎不稳[J]. 脊柱外科杂志, 2008, 6(5): 257-260.
|
| [18] |
吴李勇, 彭锦芸, 曾碧凤. 双侧经寰枢椎关节螺钉联合寰椎椎板挂钩固定术治疗寰枢椎不稳[J]. 颈腰痛杂志, 2009, 30(6): 511-513.
|
| [19] |
马维虎, 徐荣明, 孙韶华. 枕颈固定技术在上颈椎不稳的应用[J]. 中华创伤杂志, 2005, 21(5): 383-385.
|
| [20] |
杨述华, 杜靖远, 邵增务, 等. 枕颈融合治疗创伤性上颈椎不稳疗效观察[J]. 实用骨科杂志, 2007, 13(1): 6-8.
|
| [21] |
Wang B, Lü G H, Deng Y W, et al. Anterior endoscopically assisted transcervical reconstruction of the upper cervical spine [J]. Eur Spine J, 2011, 20(9): 1526-1532.
|
| [22] |
李金泉, 龚冰南, 徐 皓, 等. 寰枢椎融合与颈枕融合治疗上颈椎疾患的临床疗效比较[J]. 中华临床医师杂志(电子版), 2013,7(4):104-107.
|
|
|
|
2015, Vol. 26 
