摘要
目的 :探讨经口咽入路治疗枕颈部病变致瘫痪的疗效。方法 :自 1984年 1月～ 1998年 6月共收治 43例瘫痪病人 ,其中 42例为各种原因引起的寰枢关节陈旧性难复性脱位 ,均采用经口咽行寰椎前弓、齿状突切除减压寰枢侧关节融合术 ,其中 5例同期加行后路融合术。另 1例C2 .3 椎间盘突出症采用经口咽环锯法切除椎间盘治疗。结果 :经平均5年 1个月 (4个月～ 14年 )随访 ,33例恢复正常 ,无病理征 ;8例明显改善 ,生活自理 ;2例因融合固定不良 ,再发移位出现症状 ,再次予以经后路融合治疗。结论 :采用经口咽途径治疗 ,具有显露容易 ,直接解除致压物的特点 ,并可同时融合稳定枕颈部 ,为枕颈部病变手术治疗的理想术式。
Objective: To analyse the clinic efficacy of surgical treatment of occipito atlanto axial lesions with paralysis by oral approach.Method:From 1984 to 1998.6,43 patients were admitted to our hospital,42 of them were difficult and old atlantoaxial dislocation,were treated with anterior densectomy decompression and reduction and fusion,5 of 42 cases were given posterior internal fixation and fusion in the mean time.One patient with C 2.3 disc herniation was treated with trepanation discoidectomy by oral approach.Result:Followed up for average 61 months,all patients no one death or infection.33 cases were healing without any signs,8 cases can live by himself with some symptoms,and 2 cases were given another operation because of unfusion.Conclusion:Transoral operative treatment can directly remove the main factors which affect paralysis,and high cervical spinal cord will be decompressed;after fusion,the occipito atlanto axial joints were stable.It show the transoral anterior decompression and fusion may be the first selection for treatment of occipito atlanto axial lesion with paralysis.
出处
《中国矫形外科杂志》
CAS
CSCD
2000年第11期1071-1073,共3页
Orthopedic Journal of China
关键词
枕颈部
经口入路
外科治疗
瘫痪
Occipito-atlanto-axial joint
Transoral
Surgical treatment Paralysis
