Objective To summarize the surgical experiences of internal Fixation for complicated occipito-cervical malformation. Method The clinical data of 48 patients with complicated occipito-cervical malformation were analyzed retrospectively. 14 cases were fixed with bone grafts simply, 10 cases with mental plates and bone scraps, 9 cases with AXIS and YTQ grafts and bone scraps. 11 cases were firstly decompressed posteriorly and fixed internally, and removed odontoid process secondly. In 15 cases the odontoid processes were removed at first, 10 cases were secondly decompressed posteriorly and fixed with mental plates and bone scraps. Results 29 cases gained apparently curative effects, 15 got worse, 3 improved scarcely, and 1 case died. Conclusions The reconstruction of the occipito-cervical stability with proper operative approaches and internal fixation grafts can improve the curative effect of complicated occipito-cervical malformations.%目的 总结复杂性颅颈畸形的外科治疗经验.方法 回顾性分析48例复杂性颅颈畸形治疗方法及疗效.14例单纯植骨块融合,10例可塑性金属钢板加骨屑植骨内固定,9例颈椎后路系统内固定加骨屑植骨融合,11例一期枕下减压加内固定,二期经口咽齿状突切除;15例一期经口咽齿状突切除后,其中10例二期行后路钢板加骨屑植骨内固定.结果 显效29例,15例症状加重,3例无改善,1例死亡.结论 选择合适的术式及内固定材料和方法重建枕颈部稳定性,能够提高颅颈畸形的临床疗效.
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