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The Clinical Application of Hook Plate Lateral Mass Screw Fixation in Atlantoaxial Dislocation

Author: ChenYi
Tutor: LiMu
School: Shandong University
Course: Orthopedic Surgery
Keywords: Atlantoaxial Atlantoaxial joint Measuring Internal fixation
CLC: R687.3
Type: Master's thesis
Year: 2009
Downloads: 32
Quote: 0
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Abstract


Objective: Surgical treatment of atlantoaxial dislocation has been in spine surgery is a major problem in recent years, numerous studies atlantoaxial dislocation surgery fixed ways and means in which the the Magerl screws composite wire fixed stability, intraoperative after bony fusion highest rate. But the Magerl surgical technical requirements are quite high, the operation is relatively difficult, there is a higher risk of spinal cord and vertebral artery injury. This article by atlantoaxial structure measurements and atlantoaxial dislocation (instability) underwent posterior hook plate lateral mass screw fixation introduction and postoperative follow-up, explore the lateral mass screw hook plate fixed to the posterior atlantoaxial dislocation fixation mode of operation, attention problems, and clinical efficacy. Method: 1. Use of vernier calipers and a protractor to measure the complete drying of Chinese adults atlantoaxial specimens part of the structure of the relevant parameters, including the posterior arch of the atlas medial half distance, the outer half of the posterior arch of the atlas from the thickness of the posterior arch of the atlas, axis pedicle height, pedicle width, pedicle inclination, inclination within the pedicle, the transverse diameter of the articular surface, atlantoaxial atlantoaxial articular surface of the radius vector of the joint surface and camber atlantoaxial articular surface the vertebral artery indentation. Measuring the above parameters to guide the surgery operation, to avoid the vertebral artery and spinal cord injury. 2 through April 2001 -2008 in August were nine cases of atlantoaxial dislocation patients (including the atlantoaxial instability patients and atlantoaxial dislocation skull traction satisfactory reduction) line posterior hook plate side block screw fixation, postoperative follow-up ranging from 7-95 months, improvement of symptoms, patients with bone fusion analysis to confirm the feasibility and clinical effect of the surgical approach. Results: 1. Measured atlas bow medial half distance (11.5 ± 2.6) mm, the outer half of the posterior arch of the atlas distance (19.6 ± 4.4) mm, (6.4 ± 1.8) mm of the thickness of the posterior arch of the atlas, atlantoaxial pedicle height (8.5 ± 0.7) mm, the width of the pedicle (7.5 ± 1.2) mm, pedicle angle (42.3 ± 5.4) °, pedicle inclination angle (9.0 ± 6.5) ° atlantoaxial articular surface transverse diameter (17.8 ± 0.8) mm, the vertebral articular surface of the radius vector (19.2 ± 1.3) mm, atlantoaxial articular surface angle (24.5 ± 3.1) °, atlantoaxial articular surface of the vertebral artery indentation (5.7 ± 1.6) mm. 2.9 cases of posterior hook plate lateral mass screw fixation for the treatment of patients, follow-up time of 7-95 months. All patients during surgery goes well, did not occur in spinal cord and nerve roots, vertebral artery injury of important anatomical structures. Posterior operative blood loss was 100-200ml, average blood loss was 140ml; operative time was 170min-220min. Patients after spinal cord function improved, numbness, inability to alleviate the symptoms. 9 patients does not appear within loosening the off nails and redislocation of, all patients with bone fusion. Does not appear after dizziness, headache and other symptoms of cerebral ischemia and the surgical procedure can cause other symptoms. Conclusion: 1. Atlas posterior arch inside the safe operation range for midline open 9mm within the lateral posterior arch of the safe operation of the range of less than 15mm midline. Reusable atlantoaxial dislocation (unstable) and anterior release surgery of irreducible atlantoaxial dislocation with posterior hook plate lateral mass screw fixation for the treatment is feasible, safe and effective. 3 posterior hook plate lateral mass screw fixation has its advantages and limitations of clinical applications must strictly control the surgical indications and contraindications.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Bone surgery
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