P20。单轴侧块螺钉-棒系统后路植骨治疗不稳定寰椎骨折

IF 2.5 Q3 Medicine

North American Spine Society Journal Pub Date : 2025-07-01 DOI:10.1016/j.xnsj.2025.100644

Hao-Hsiang Hsu MD, Yu-Ning Chen MD, E-Jian Lee MD, PhD, Shih-Huang Tai PhD

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引用次数: 0

摘要

背景：寰椎骨折由于其对颅椎稳定性的影响和对保持颈椎活动能力的需要，给临床带来了挑战。传统的固定方法，如C1-C2融合，限制了活动，导致长期发病率。目的评价单轴侧块螺钉-棒系统c1环内固定稳定不稳定寰椎骨折并保持颈椎活动的疗效。研究设计/环境：单中心医院环境中的回顾性病例系列。患者样本3例（年龄70-72岁，2男1女）寰椎不稳定骨折采用Jefferson分类。结果测量：疼痛、寰牙间隙（ADI）、C1悬垂和颈椎活动度（ROM）的视觉模拟量表（VAS）。方法所有患者采用单轴侧块螺钉-棒系统行c1环骨固定术。术前和术后评估包括疼痛评分、x线对准和ROM分析。随访观察临床结果及并发症。结果术后疼痛评分明显改善，VAS评分由5分降至0分。x线分析证实复位成功且稳定，ADI和C1悬垂恢复在正常范围内。ROM评估显示保留了颈椎活动能力。无重大并发症及再手术。结论sc1环内固定术与单轴侧块螺钉棒系统是C1-C2融合的可行选择，在保持颈椎运动的同时提供有效的稳定和疼痛缓解。该技术为治疗不稳定寰椎骨折提供了一种有希望的手术选择，具有良好的临床效果。FDA器械/药物状态本摘要不讨论或包括任何适用的器械或药物。

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P20. Posterior osteosynthesis with monoaxial lateral mass screw-rod system for unstable atlas fractures

BACKGROUND CONTEXT

Atlas fractures pose a clinical challenge due to their impact on craniovertebral stability and the need to preserve cervical mobility. Traditional fixation methods, such as C1-C2 fusion, restrict motion, leading to long-term morbidity.

PURPOSE

To evaluate the efficacy of C1-ring osteosynthesis using a monoaxial lateral mass screw-rod system in stabilizing unstable atlas fractures while preserving cervical motion.

STUDY DESIGN/SETTING

Retrospective case series in a single-center hospital setting.

PATIENT SAMPLE

Three patients (ages 70-72, two males, one female) with unstable atlas fractures classified using the Jefferson classification.

OUTCOME MEASURES

Visual Analog Scale (VAS) for pain, atlanto-dental interval (ADI), C1 overhang, and cervical range of motion (ROM).

METHODS

All patients underwent C1-ring osteosynthesis with a monoaxial lateral mass screw-rod system. Pre- and postoperative assessments included pain scores, radiographic alignment, and ROM analysis. Follow-up was conducted to evaluate clinical outcomes and complications.

RESULTS

Postoperative pain scores improved significantly, with VAS decreasing from 5 to 0. Radiographic analysis confirmed successful reduction and stability, with ADI and C1 overhang restored within normal limits. ROM assessments indicated preserved cervical mobility. No major complications or reoperations were observed.

CONCLUSIONS

C1-ring osteosynthesis with a monoaxial lateral mass screw-rod system is a viable alternative to C1-C2 fusion, providing effective stabilization and pain relief while preserving cervical motion. This technique offers a promising surgical option for managing unstable atlas fractures with favorable clinical outcomes.