寰枕的

The atlanto-axial joint disorder is a idiopathy that the micro-transposition from atlanto-axial joint to atlanto-occipital joint and the injury , strain and anaplasia of the peripheral issue leads to stoke, diziness, vomiting,etc. The old people happen frequantly, eapecially the workers hung the head do.

寰枢关节紊乱是以寰枢关节为中心，以寰枢关节及寰枕关节的微小错位及其周围组织的损伤、劳损、退行性改变等病变所产生以头痛、眩晕、恶心为主症的特发性病症，多发生于中老年人，尤其以低头位工作者为多。

Objective:To investigate the surgical treatment of complicated occipitocervical malformation.

目的：探讨复杂寰枕畸形的外科手术方法。

The stability provided by 3 occipitoatlantal fixation techniques (occiput –C1 transarticular screws, occipital keel screws rigidly interconnected with C-1 lateral mass screws, and suboccipital/sublaminar wired contoured rod) were compared.

对象对3种寰枕固定技术（经寰枕关节螺丝固定，枕骨螺钉坚强联接C 1侧块螺钉的固定，枕骨下/椎板下钢丝将轮廓棒固定）所提供的稳定性进行比较。

Results: The atlanto-occipital transarticular screw trajectory was cephalad tilting in sagittal plane and medially tilting in coronal plane; the ideal angle of the trajectory was (53.3±3.4)° upper tilting in sagittal plane and (20.0±2.6)° midline tilting in coronary plane.

结果：寰枕关节经关节螺钉固定的钉道理想角度为：螺钉方向在矢状面的上倾角为(53.3±3.4)°，在冠状面的内倾角为(20.0±2.6)°。

Methods: Posterior atlanto-occipital transarticular Kirschner wire implantation was performed under visual control on 30 dried bony specimens that contained complete atlanto-occipital articulation ,and cephalocaudal and lateral X-rays were taken, on which the angle and the length of the screw trajectory were measured.

30例含完整寰枕关节干燥骨性标本，直视下行后路寰枕关节经关节克氏针植入后行X线摄片，在X线片上测量寰枕关节经关节螺钉固定的钉道角度和长度。

Objective to observe the therapeutic effects of acupotomolgy loosening operation therapy on the cervical spondylopathy of the contracted fascia around the occipital and the affection of vertebal artery hemadynamometer.

目的：探讨针刀松解术对寰枕筋膜挛缩型颈椎病的治疗效果及对椎动脉血液动力学的影响。

Objective: To clarify the technical parameters in posterior atlanto-occipital transarticular screw fixation and discuss the clinical significance of occipitocervical junction fixation with transarticular screws.

目的：明确后路寰枕关节经关节螺钉固定的技术参数；探讨枕颈部经关节螺钉内固定技术的临床意义。

Direction and length of trajectory are the key of posterior atlano-occipital transarticular fixation, if combined with C1-C2 transarticular fixation, it will be an ideal fixation method for occipitocervical fusion.

寰枕关节后路经关节螺钉植入存在一定的方向性和钉道长度，结合后路C1-C2经关节螺钉内固定后可视为能满足当前临床需要的一种相对理想的枕颈融合内固定术式。

［Objective］ To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion ［Method］ From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score ［Result］ All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found ［Conclusion］ Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory

分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。［方法］2005年12月至2007年6月间，对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间（12~16 d，平均135 d）后采用枕骨大孔后缘扩大，寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术，手术后采用日本骨科学会神经功能评分分析临床疗效。［结果］8例患者随访6个月~2年，平均为15个月。8例患者无一例出现术后并发症，术前寰齿前间隙为5~9 mm，经颅骨牵引后为5~7 mm，寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复，影像学检查示枕颈区减压充分植骨区获得骨性融合，无一例出现内固定松动或断裂。［结论］合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变，采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的，且临床效果满意。

The new idea, such as the"rotation"of atlas in 3 direction in some of AADs with intact axis, vertebrated odontoid, complete dislocation of AADs with detached odontoid, and differentiation of"dislocation of atlantoaxial joint"and"stenosis of canal"in atlantoaxial subluxation with detached odontoid, are established in this report.

1、本研究提出了一些新的概念，如枢椎完整型AADs时其寰椎在三个方向上的&旋转&脱位、椎体化齿突畸形、齿突不连型AADs的完全脱位、齿突不连的寰枢半脱位时&脱位&和&狭窄&的区分、枕大孔不规则狭窄等为本研究的新的发现或提出的新概念。

But we don't care about Battlegrounds.

但我们并不在乎沙场中的显露。

Ah! don't mention it, the butcher's shop is a horror.

啊！不用提了。提到肉，真是糟透了。