Abstract:
Odontoid fractures, frequently observed in patients over the age of 70, often involve the base of the axis (Anderson-D\'Alonzo type 2). For surgical treatment, posterior C1-C2 fixation is the traditional method, whose fusion rates range between 93 and 100%. However, morbidity and mortality rates are high. In addition, cervical motion, especially axial rotation, is postoperatively reduced. Nakanishi and Bohler introduced the anterior screw fixation approach for the surgical treatment of odontoid fracture type II. This procedure preserves the atlantoaxial complex motion, provides immediate stability and high fracture healing rates, and, most importantly, has a low incidence of complications with good fusion rates. The surgical strategy must take into account the patient\'s anatomy, the morphological characteristics of the fracture, the quality of the bone, and any concomitant injuries. In this chapter, we describe a C2 type II fracture treated via a neuronavigated anterior retropharyngeal approach.
摘要:
齿状突骨折,经常在70岁以上的患者中观察到,通常涉及轴的底部(Anderson-D\'Alonzo2型)。对于手术治疗,后路C1-C2固定是传统的固定方法,融合率在93%到100%之间。然而,发病率和死亡率都很高。此外,颈椎运动,尤其是轴向旋转,术后减少。Nakanishi和Bohler介绍了前路螺钉固定方法,用于II型齿状突骨折的手术治疗。这个程序保留了寰枢椎复杂的运动,提供即时稳定性和高骨折愈合率,and,最重要的是,并发症发生率低,融合率良好。手术策略必须考虑患者的解剖结构,断裂的形态特征,骨头的质量,和任何伴随的伤害。在这一章中,我们描述了通过神经导航前咽后入路治疗的C2II型骨折。