C2 Pedicle Screws Combined With C1 Laminar Hooks for Reducible Atlantoaxial Dislocation: An Ideal Salvage Technique for C1-C2 Pedicle Screws
C2 Pedicle Screws Combined With C1 Laminar Hooks for Reducible Atlantoaxial Dislocation: An Ideal Salvage Technique for C1-C2 Pedicle Screws
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C2 椎弓根螺钉结合 C1 板层钩实现可复位的寰枢椎脱位：C1-C2 椎弓根螺钉的理想抢救技术
DOI：
10.1093/ons/opz332
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发表时间：
2019
影响因子：
2.3
通讯作者：
Qunfeng Guo
中科院分区：
文献类型：
--
作者：
Zhao Han;Jun Yang;Qunxiang Chen;Xuhua Lu;Fei Chen;Xiang Guo;Bin Ni;Qunfeng Guo
背景C1椎板钩理论上可以避免椎动脉损伤，并且技术要求较低。然而，只有少数小样本研究分析了C2椎弓根螺钉联合C1椎板钩（C2 PS-C1 LH）技术治疗寰枢椎脱位的短期结局。此外，目前尚不清楚C1-C2椎弓根钉棒结构（PSRC）是否可以获得类似的临床结果。目的评价C2 PS-C1 LH和C1-C2 PSRC固定技术治疗寰枢关节脱位的结果。方法回顾性分析了52例采用C1-C2 PSRC或C2 PS-C1 LH固定治疗寰枢关节脱位的患者的数据。通过颈部疼痛视觉模拟量表评分（VASSNP）、颈部残疾指数（NDI）、寰齿间距（ADI）以及围手术期参数（包括失血量和手术时间）对两种技术的结局进行分析和比较。最后随访时的患者满意度也进行了调查。结果两组均未发生与手术入路和器械相关的并发症。C2 PS-C1 LH组平均骨融合时间为5.06±1.65 mo，C1-C2 PSRC组为3.93±0.99 mo（P> 0.05）。05）。术后12个月，两组均达到100%的融合率。两组治疗后的ADI、VAS评分、NDI评分、乔亚评分均较治疗前明显改善（P<0. 05）。结论C2 PS-C1 LH内固定技术治疗可复性寰枢椎脱位与C1-C2 PSRC内固定技术疗效相当。C2 PS-C1 LH固定是C1-C2 PSRC固定的理想替代策略。
BACKGROUNDA C1 laminar hook can theoretically avoid vertebral artery injury and is less technically demanding. However, only few studies with small samples analyzed the short-term outcomes of C2 pedicle screws combined with C1 laminar hooks (C2PS-C1LH) technique in the treatment of atlantoaxial dislocation. Furthermore, it is not confirmed whether similar clinical outcomes can be achieved with C1-C2 pedicle screw and rod construct (PSRC).OBJECTIVETo evaluate the outcomes of C2PS-C1LH and C1-C2 PSRC fixation techniques for treating atlantoaxial dislocation.METHODSData of 52 patients with atlantoaxial dislocation treated by C1-C2 PSRC or C2PS-C1LH fixation were retrospectively reviewed. Outcomes evaluated by visual analog scale score for neck pain (VASSNP), Neck Disability Index (NDI), atlantodental interval (ADI), and the perioperative parameters including blood loss and operation time were analyzed and compared between 2 techniques. Patient satisfaction at final follow-up was also investigated.RESULTSThere were no complications related to the surgical approach and instrumentation in either group. The mean bone fusion time was 5.06±1.65 mo for the C2PS-C1LH group and 3.93±0.99 mo for the C1-C2 PSRC group (P>. 05). Hundred percent of fusion rates were achieved in both groups at month 12 after operation. The ADI, VAS scores, the NDI scores, and the JOA scores were greatly improved in both the groups (P<. 05), but there were no significant differences between the 2 groups.CONCLUSIONC2PS-C1LH fixation technique was comparable to C1-C2 PSRC in the treatment of reducible atlantoaxial dislocation. C2PS-C1LH fixation was an ideal alternative strategy to C1-C2 PSRC fixation.