背景:齿状突骨折是老年人群中最常见的颈椎骨折,目前,对于齿状突骨折尤其是Ⅱ型齿状突骨折的治疗仍存在较大争议,骨折愈合率及并发症差异较大.目的:探讨术中计算机三维导航辅助下前路螺钉内固定术对Ⅱ型齿状突骨折的治疗效果、安全性及准确性.方法:回顾性分析2010年1月至2017年8月收治的32例Ⅱ型齿状突骨折患者的临床资料,男21例,女11例,年龄21~65岁,平均(39.1±12.4)岁.车祸伤18例,坠落伤10例,击打伤4例,所有螺钉均在术中三维导航下置入.评估其有效性和安全性.结果:32例患者共置入螺钉32枚,未发生与螺钉植入相关的并发症,所有患者均获得随访,随访时间为3~16个月,平均(9.6±3.2)个月.29例患者获得骨性愈合,愈合率达90.6%,3例患者获得纤维愈合,无临床症状.结论:术中计算机三维导航辅助下前路螺钉内固定术治疗Ⅱ型齿状突骨折具有较高的安全性和准确性,骨折愈合良好,临床效果良好.%Background: The odontoid fracture is the most common cervical fracture in the elderly population. At present, there is still controverse regarding the treatment of odontoid fractures, especially type Ⅱ odontoid fractures. The healing rate and complications of this fracture are quite different. Objective: To summarize the clinical results of anterior cannulated odontoid screw fixation for the type Ⅱ odontoid fracture assisted by navigation system. Methods: From January 2010 to Au-gust 2017, clinical data of 32 patients with type Ⅱ odontoid fracture treated surgically in our hospital were reviewed. Among them there were 21 males and 11 females, aged from 21 to 56 years old, mean age (39.1±12.4) years old. All patients com-plained of neck pain and limited cervical movement due to traffic accident (18 patients), falling (10 patients) and hit (4 pa-tients). All patients received the cannulated odontoid screw fixation assisted by the real-time navigation system. Results: No intraoperative vertebral artery injury or spinal cord injury were noted. All 32 patients followed up for an average of (9.6± 3.2) months (range, 3-16 months). 29 patients got bony union and 3 patients obtained fibrous healing. Cervical movement of patients recovered to normal function. Conclusions: The application of computer assisted navigation in anterior odontoid screw fixation improves the accuracy and safety of the operation, with good bone union and clinical effect.
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