目的 探讨经寰枢椎侧块关节螺钉(Magerl)技术结合单椎板夹固定术治疗对寰枢椎脱位患者并发症和生活质量的影响.方法 选取2013年12月至2016年12月期间确诊治疗的寰枢椎脱位患者120例进行回顾性研究,依据随机数表法随机分为Magerl板夹组和单纯Magerl组,每组60例.单纯Magerl组患者给予单纯Magerl技术固定术治疗,Magerl板夹组患者在此基础上结合单椎板夹固定术治疗.采用日本骨科协会(JOA)颈椎评分法评估治疗疗效,采用日常生活能力量表(ADL)评估生活质量.随访6个月,统计分析所有患者术中出血量、术后引流量、住院、骨性融合、颈椎功能锻炼时间、并发症和治疗前后寰枢椎稳定性[左和右侧颈椎旋转活动度、脊髓有效空间(SAC)及寰齿前间隙(ADI)、寰枢椎不稳定指数(APAII)];观察治疗后3、6个月的治疗疗效,治疗前、治疗后1、3、6个月的生活质量情况.结果 Magerl板夹组患者手术时间、术中出血量、术后引流量、住院时间高于单纯Magerl组,但差异无统计学意义(P>0.05),但前者骨性融合、颈椎功能锻炼时间明显低于后者,差异有统计学意义(P0.05),但前者治疗后6个月的优良率和JOA得分明显高于后者,差异有统计学意义(P0.05);Magerl板夹组和单纯Magerl组患者治疗后1、3个月的ADL得分基本相同,差异无统计学意义(P>0.05),但前者治疗后6个月的ADL得分明显高于后者,差异有统计学意义(P 0. 05). The bony fusion,cervical functional exer-cise time of the former were significantly lower than those of the latter. There were statistically significant differences (P 0. 05),but excellence rates and JOA scores 6 months after treat-ment of the former were significantly higher than those of the latter. There were statistically significant differences (P 0. 05). The ADL scores 1,3 months after treatment of the Magerl powder group and pure Magerl group were basically the same,there was no statistically significant difference (P > 0. 05). The ADL scores 6 months after treatment of the former were significantly higher than those of the latter. There was statistically significant difference (P < 0. 05). Conclusion Magerl technology combined with single vertebral powder fixation treatment has no significant improvement of vertebral recent efficacy and quality of life in patients with atlantoaxial dislocation,but it can effectively promote the stability of atlanto - axial vertebral atlanto - axial dislocation patients with vertebral recovery and shorten the time,cervical osseous fusion. It is propitious to increase long curative effect in patients and the quality of life,and it has no increase of surgical trauma,compli-cations,and postoperative recovery. It's worthy of further clinical promotion.
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