经口咽前路减压术治疗寰枢椎脱位

Treatment of atlanto - axial dislocation by anterior decompression via oral approach

关键词:  寰枢椎脱位  显微外科  前路减压

Key words:  atlanto-axial dislocation  microsurgery anterior  decompression

摘要:

总结寰枢椎脱位经口咽入路减压的显微外科治疗体会。方法：分析11例寰枢椎脱位经口咽前路减压术的术前准备、手术适应证、手术方法、术后并发症的处理及手术结果。结果：本组11例寰枢椎脱位病人中，先天性寰枢椎脱位6例，齿状突骨折伴脱位3例，齿状突发育不全合并局部结缔组织增生2例。随访0.5～9.0年，临床症状有明显改善者10例，其中恢复轻体力劳动者7例，生活自理3例；1例临床症状无变化，无死亡。结论：寰枢椎脱位经口咽入路行显微外科减压可有效的改善临床症状，降低术后并发症和死亡率。严格掌握手术适应证和时机、重视围手术期的处理、预防脑脊液漏和感染是手术成功的关键。

Abstract:

summarize microsurgery treatment experience of atlan to-axial dislocation by anterior decompression via oral approach. Methods: Analysis eleven patients of atlanto-axial dislocation by anterior decompression via oral approach about preoperative consideration, operative indication and operative technique and management of postoperative complications.Results: Six cases of eleven patients of atlanto-axial dislocation are congenital bony malformations, 3 odon toid fracture and dislocation, other 2 with granuloma in the ventral part of the medulla oblongata. Follow-up for 0.5～9 years showed that 10 patients had evidence improve, one case no change and non-died. Conclusions: Microsurgery treatment of atlanto-axial dislocation by anterior decompression via oral approach is an effective way and can reduce postoperative morbidity and complications. Perioper ative treatment can prevent incision infection. Prevention of intraoperative CSF leakage mast be emphasized.