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首页> 外文期刊>Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia >Combination of skull traction with posterior C1-2 fusion for old C1-2 dislocations.
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Combination of skull traction with posterior C1-2 fusion for old C1-2 dislocations.

机译：颅骨牵引结合后路C1-2融合治疗老年C1-2脱位。

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摘要

Between January 2003 and December 2009, 23 patients who had suffered old C1-2 dislocations, were surgically treated in our orthopedics department. Fifteen patients underwent direct posterior C1-2 fusion following pre-operative reduction by skull traction. In eight patients, reduction was achieved only by skull traction under general anesthesia, facilitated by manual hyperextension of the cervical spine and maintained by simultaneous posterior C1-2 fusion. Intra-operative traction was monitored using C-arm fluoroscopy and cortical somatosensory-evoked potentials. Posterior C1-2 fixation was achieved in nine patients using C1-2 laminar hooks and in 14 patients using C1 laminar hooks with C2 pedicle screws. During the follow-up of 5 to 72 months (mean: 42.8 months), solid bony fusion was accomplished in all patients. Using Di Lorenzo's grades and Japanese Orthopedics Association scores, there was significant improvement (p<0.05). The cervical medullary angle exhibited a significant improvement of 31.7 degrees , from 121.6 degrees to 153.3 degrees (p<0.05). There were no complications, including dural tears, spinal cord damage, vertebral artery damage, or breakage or loosening of implants.
机译：在2003年1月至2009年12月之间，我们的骨科接受了23例C1-2脱位的老年患者的手术治疗。 15例患者在术前通过颅骨牵引复位后进行了直接后路C1-2融合。在八名患者中，仅通过全身麻醉下的颅骨牵引，通过颈椎的人工超伸促进和同时进行后路C1-2融合来维持，即可实现复位。术中牵引力通过C型臂透视检查和皮层体感诱发电位进行监测。使用C1-2层板钩在9例患者中实现了C1-2后路固定，使用带有C2椎弓根螺钉的C1层板钩在14例患者中实现了后路C1-2固定。在5到72个月的随访中（平均42.8个月），所有患者均完成了牢固的骨融合。使用Di Lorenzo的成绩和日本骨科学会的分数，有显着​​改善（p <0.05）。颈髓角从121.6度到153.3度显示31.7度的显着改善（p <0.05）。没有并发症，包括硬脑膜撕裂，脊髓损伤，椎动脉损伤或植入物破裂或松弛。

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