[1]丁崇学　范雁东　潘红利　李彦东　罗　坤.直接后路加压器械撑开复位枕颈融合术治疗颅底凹陷症合并寰枢椎脱位的疗效[J].中国临床神经外科杂志,2020,(06):348-351.[doi:10.13798/j.issn.1009-153X.2020.06.004]
　DING Chong-xue,FAN Yan-dong,PAN Hong-li,et al.Treatment of basilar invagination associated with atlantoaxial dislocation with direct posterior decompression and occipito-cervical fusion[J].,2020,(06):348-351.[doi:10.13798/j.issn.1009-153X.2020.06.004]
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直接后路加压器械撑开复位枕颈融合术治疗颅底凹陷症合并寰枢椎脱位的疗效()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年06期
页码:
348-351
栏目:
论著
出版日期:
2020-06-15

文章信息/Info

Title:
Treatment of basilar invagination associated with atlantoaxial dislocation with direct posterior decompression and occipito-cervical fusion
文章编号:
1009-153X（2020）06-0348-04
作者:
丁崇学　范雁东　潘红利　李彦东　罗　坤
830054 乌鲁木齐，新疆医科大学第一附属医院神经外科（丁崇学、范雁东、潘红利、李彦东、罗　坤）
Author(s):
DING Chong-xue;  FAN Yan-dong;  PAN Hong-li;  LI Yan-dong;  LUO Kun.
Departemnt of Neurosurgery, First Affiliated Hospital,Xinjiang Medical University, Urumqi 830054, China
关键词:
颅底凹陷症; 寰枢椎脱位; 枕颈融合术; 疗效
Keywords:
Basilar invagination;  Atlantoaxial dislocation;  direct posterior decompression and occipito-cervical fusion;  Efficacy
分类号:
R 744.9; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2020.06.004
文献标志码:
A
摘要:
目的 探讨直接后路加压器械撑开复位枕颈融合术治疗颅底凹陷症伴寰枢椎脱位的安全性和有效性。方法 回顾性分析2017年1月至2018年1月采用枕颈融合术治疗的19例颅底凹陷症伴寰枢椎脱位的临床资料。采用日本骨科协会（JOA）评分和Ranawat分级评估神经功能恢复情况，测量齿状突至钱氏线（CL）、颅底斜坡切线（WL）、枕孔线（ML）评估垂直脱位情况，测量寰齿间距（ADI）距离评估水平脱位情况，测量颈髓角（CMA）评估脊髓受压情况。19例平均随访（17.47±6.65）个月。结果 末次随访时，症状明显改善17例，有改善但不明显2例。至末次随访JOA评分[（15.63±1.12）分]明显高于术前[（11.00±2.40）分；P<0.05]。神经功能改善率平均76%，其中优14例（73.68%），良5例（26.32%）。术前Ranawat分级为Ⅱ级7例、ⅢA级11例、ⅢB级1例；末次随访时Ⅰ级14例，Ⅱ级5例。19例末次随访时均获得50%以上的复位，其中18例CL完全复位，16例WL完全复位，15例ML完全复位，17例ADI完全复位，17例CMA恢复正常。结论 直接后路加压器械撑开复位枕颈融合术治疗颅底凹陷症伴寰枢椎脱位，不仅能够显著改善脊髓受压情况，而且能够达到良好复位
Abstract:
Objective To investigate the safety and efficacy of direct posterior decompression and occipito-cervical fusion (DCP-OCF) for the patients with basilar invagination (BI) associated with atlantoaxial dislocation (AAD). Methods The clinical data of 19 patients with BI associated with AAD who underwent DCP-OCF from January 2017 to January 2018 were analyzed retrospectively. Japanese Orthopaedic Association (JOA) score and Ranawat grade were used to evaluate the recovery of neurological function.Chamberlain line (CL), Wackenheim line (WL) and McGae (ML) of dentate process were used to evaluate vertical dislocation. Atlantodental interval (ADI) and cervico-medullary angle (CMA) were used to evaluate the horizontal displacement and spinal cord compression, respectively. The average follow-up time was (17.47±6.65) months. Results The symptoms were significantly improved in 17 patients and no-changed in 2 at the last follow-up. The JOA score [(15.63±1.12) points] at the last follow-up were significantly higher than that [(11.00±2.40) points] before the operative (P<0.05). The Ranawat grade Ⅰ was achieved in 14 patients and grade Ⅱ in 5 at the last follow-up. The imaging indexes of CL, WL, ML, ADI and CMA were significantly improved at the last follow-up (P<0.05). Conclusions The DCP-OCF, which can significantly improve the compression of spinal cord and achieve a good reduction, is a safe and effective treatment method for the patients with BI associated with AAD

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备注/Memo

备注/Memo:
（2019-11-23收稿，2020-03-19修回）基金项目：国家自然科学基金（81660471）通讯作者：罗　坤，E-mail：luokun_2822@sohu.com
更新日期/Last Update: 2020-06-15