Xue Xingsen,Chu Weihua,He Guangjian,et al.Clinical features and surgical results of atlantoaxial dislocation in children[J].Journal of Clinical Pediatric Surgery,,18():728-732.[doi:10.3969/j.issn.1671-6353.2019.09.004]
Clinical features and surgical results of atlantoaxial dislocation in children
- CLC:
- R726;R651.1+1;R681.5+4
- Abstract:
- Objective To explore the clinical features and surgical efficacies of posterior reduction and internal fixation for atlantoaxial dislocation in children.Methods Between September 2010 and December 2017,18 children with a definite diagnosis of atlantoaxial dislocation (2 cases of odontoid fracture) were admitted successively.There were 9 boys and 9 girls with a mean age of 13.17 (6-17) years.Posterior reduction was applied with screw-titanium rod (plate) internal fixation.Computed tomography (CT) thin layer scanning and three-dimensional reconstruction measurements were performed pre-and postoperatively.Atlantodens interval (ADI),Chamberlain’s line (CL),McRae’s line (ML),cervicomedullary angle (CMA) were measured for evaluating the degree of spine cord compression.And Japanese Orthopedic Association Scores (JOA) scores were used for evaluating function curing and nerve electrophysiology for monitoring nerve conduction.Results Fifteen children were followed up for an average period of 45.83 (18-100) months.Three cases were lost to follow-ups.Lateral mass of atlas and axial pedicle of children may accommodate 3.5mm titanium screws.No vertebral arterial injury or bone fracture occurred intraoperatively.Postoperative recovery was decent and there was only limited activity of cervical spine.And with preoperative ADI (3.86±2.71) mm,CL (10.05±6.55) mm),ML (2.17±4.48) mm,CMA (122.84±18.02) °,JOA (11.5±3.26),postoperative ADI(1.96±2.041) mm,CL (6.42±4.85) mm,ML (0.56±3.78) mm,CMA (128.29±17.8) °,JOA (15.44±1.46).The postoperative improvement was significantly better than that before surgery (P<0.05).Conclusion Posterior reduction and internal fixation are efficacious for atlantoaxial dislocation in children and the long-term outcome is excellent.
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Memo
收稿日期:2019-06-15。
基金项目:重庆市技术创新与应用示范项目（编号：cstc2018jscx-msybX0092）；西南医院临床新技术重点项目（编号：SWH2016JSTSZD-04，SWH2017ZDCX2010）
通讯作者:林江凯,Email:jklin@tmmu.edu.cn