经后路超声骨刀双侧切除齿状突治疗颅底凹陷症合并不可复性寰枢关节脱位一例

发布时间：2018-07-18 15:19

【摘要】：目的总结采用1例经后路超声骨刀双侧切除齿状突治疗的颅底凹陷症合并不可复性寰枢关节脱位患者临床资料。方法 2017年10月25日,采用经后路超声骨刀双侧切除齿状突治疗1例颅底凹陷症合并不可复性寰枢关节脱位40岁女性患者。患者因"四肢麻木2年,加重伴四肢感觉、运动障碍6个月"入院,查体见C2平面以下感觉减退,右侧上下肢肌力1~2级,结合影像学检查提示颅底凹陷症合并寰枢关节脱位,寰枢椎自发融合。结果术后患者右侧肢体麻木乏力明显缓解,肌力较术前改善;术后CT示齿状突完整切除,MRI示脊髓受压解除。结论采用经后路超声骨刀双侧切除齿状突可行,可作为颅底凹陷症合并不可复性寰枢关节脱位的治疗方法之一。
[Abstract]:Objective to summarize the clinical data of a case of skull base depression with irreducible atlantoaxial dislocation treated by bilateral resection of odontoid process with posterior ultrasound bone knife. Methods on October 25, 2017, a female patient with cranial base depression and irreducible atlantoaxial dislocation was treated by bilateral resection of odontoid process with posterior ultrasound bone knife. The patient was admitted to hospital because of "numbness of extremities for 2 years, aggravation with sensation of extremities, dyskinesia for 6 months". Body examination showed that the sensation was decreased below C2 level, and the muscle strength of the right upper and lower extremities was 1 ~ 2 grade. Combined with imaging examination, it was suggested that skull base depression complicated with atlantoaxial dislocation. Atlantoaxial spontaneous fusion. Results the numbness and weakness of the right extremity were relieved and the muscle strength was improved after operation. Ct showed complete excision of odontoid process and MRI showed decompression of spinal cord. Conclusion bilateral resection of odontoid process with posterior ultrasonic bone knife is feasible and can be used as one of the treatment methods for cranial base depression with irreducible atlantoaxial dislocation.
【作者单位】：四川大学华西医院骨科;
【分类号】：R687.3

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