王翀，覃建朴，张朋云，曹广如，蔡玉强贵州省遵义医学院附属医院脊柱外科，贵州遵义　563000

Apofix内固定系统、椎弓根螺钉技术两种不同手术方法治疗创伤性寰枢椎不稳的疗效比较

王翀，覃建朴，张朋云，曹广如，蔡玉强
贵州省遵义医学院附属医院脊柱外科，贵州遵义563000

目的 观察Apofix和椎弓根螺钉技术治疗创伤性寰枢椎不稳的效果。方法 对创伤性寰枢椎不稳的患者进行Apofix与椎弓根螺钉技术治疗。回顾性分析该院2004年11月—2010年5月期间收治的72例创伤性寰枢椎不稳的患者，根据患者临床诊断分为Apofix组26例和椎弓根螺钉组46例，分析手术效果。结果 两组患者完全复位经椎弓根螺钉组45例明显优于Apofix组的9例，未完全复位发生率，椎弓根螺钉术组2.17%远低于Apofix组的65.38%，差异有统计学意义；Apofix内固定术组术后发生并发症发生率15.3%；椎弓根螺钉术组发生率7.3%。结论 该研究中术后复位、稳定性和并发症等发面，椎弓根螺钉技术明显优于Apofix内固定系。对于不能使用椎弓根钉的患者，Apofix内固定系统也不失为一种相对理想的手术方法。

Apofix；椎弓根螺钉；寰枢椎不稳；寰椎；枢椎

［Abstract］Objective Observation Apofix pedicle screw and treatment of traumatic atlantoaxial instability results. Methods Patients with traumatic atlantoaxial instability were Apofix pedicle screw technique for treatment.A retrospective analysis of 72 patients with traumatic atlantoaxial instability of the patients in our hospital November 2011 to May 2010 period，according to the clinical diagnosis of 26 patients were divided into Apofix pedicle screw group and 46 cases analyzed the effect of surgery.Results Two Two groups of patients was significantly better than the full reset nine cases Apofix group is not completely reset the incidence of intraoperative pedicle screw group far below 2.17% 65.38%Apofix group，the difference was statistically significant after 45 cases of the pedicle screw group；Apofix internal fixation group postoperative complication rate was 15.3%；the incidence rate of pedicle screw operation group was 7.3%.Conclusion Reduction，stability and complications after operation from the aspects of this research，Shiumi Ne screw technique is better than that of Apofix internal fixation system.For patients who can not use pedicle screw fixation，Apofix internal fixation system is a relatively ideal surgical method.

［Key words］Apofix；Atlantoaxial instability；Pedicle screw；Atlas；Atlantoaxial

表1　Apofix组与椎弓根螺钉组患者基本信息比较

创伤性寰枢椎不稳是因外伤导致的寰椎与枢椎即第一、第二颈椎的骨关节面对合关系发生错位，造成关节功能障碍以及神经压迫等病理现象［1］。而当患者进行屈颈活动时其寰椎前移、伸颈时则寰椎复位或持续后移，因此，脊髓在寰枢椎之间反复受到刺激，引发脊髓病等［2］。治疗的主要目的是缓解脊髓压迫，稳定颈椎关节，防止再脱位。……