C1—C2 Intra-articular Screw Fixation for Atlantoaxial Posterior Stabilization
C1—C2 Intra-articular Screw Fixation for Atlantoaxial Posterior Stabilization
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C1—C2 关节内螺钉固定寰枢椎后路稳定
DOI：
10.1097/00007632-200002010-00013
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发表时间：
2000
期刊：
影响因子：
3
通讯作者：
T. Tateishi
中科院分区：
文献类型：
--
作者：
Y. Tokuhashi;H. Matsuzaki;Y. Shirasaki;T. Tateishi
研究设计。针对寰枢椎不稳定性的新后路稳定技术的试验和初步结果报告。目标。描述一种新的寰枢椎不稳定性后路稳定技术。背景数据摘要。 Magerl 的经关节螺钉固定是一种公认的寰枢椎刚性稳定技术，据报道已经取得了许多良好的临床效果。然而，该技术技术要求较高，并且存在神经和静脉受伤的风险。方法。观察了 11 名接受关节内螺钉固定结合 Halifax 椎板间夹（OSTEONICS，Allendale，NJ）治疗寰枢椎不稳定的患者。他们使用颈椎模型的树脂骨进行临床检查和生物力学研究的结果进行了审查。结果。所有患者的枕部疼痛、颈部疼痛和神经缺陷均得到改善，X 线检查显示骨融合且无矫正损失。迄今为止，尚未发现血管或神经并发症，也没有发生仪器故障。在生物力学研究中，经关节螺钉固定的Halifax的屈曲刚度显着大于仅Halifax或关节内螺钉固定的Halifax，但关节内螺钉固定的Halifax的扭转刚度显着大于其他Halifax组合。结论。初步结果表明，该技术可有效增强寰枢椎固定的旋转稳定性，并被认为有助于寰枢椎后路稳定。
Study Design. A trial of a new posterior stabilization technique for atlantoaxial instability and a report of preliminary results. Objectives. To describe a new posterior stabilization technique for atlantoaxial instability. Summary of Background Data. Magerl’s transarticular screw fixation is an accepted technique for rigid atlantoaxial stabilization, which reportedly has yielded many good clinical results. However, the technique is technically demanding and poses a risk of injury to the nerves and veins. Methods. Eleven patients who had been treated with intra-articular screw fixation in combination with Halifax interlaminar clamp (OSTEONICS, Allendale, NJ) for atlantoaxial instability were observed. Results of their clinical examinations and biomechanical studies using resinous bones of a cervical spine model were reviewed. Results. In all patients, occipital pain, neck pain, and neural deficit improved, and bony fusion with no correction loss was shown on radiography. To date, no vascular or neural complications have been found, and no instrumentation failures have occurred. In the biomechanical study, the Halifax with transarticular screw fixation had significantly greater flexion stiffness than the Halifax only or the Halifax with intra-articular screw fixation, but the torsion stiffness of the Halifax with intra-articular screw fixation was significantly greater than that of the other Halifax combinations. Conclusion. The preliminary results showed that this technique was effective in strengthening the rotational stability of the atlantoaxial fixation and was considered useful for atlantoaxial posterior stabilization.