寰枢的

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。

Posterior atlantoaxial transarticular screw fixation combined with wiring has been widely used for patients with reducible atlantoaxial subluxation.

经后路寰枢椎经关节螺钉联合钢丝固定已经广泛应用于可复位的寰枢椎半脱位患者。

Objective:To report the primary result of a newly-designed screw-plate system for the treatment of atlantoaxial instability.

目的：初步报告后路寰枢椎侧块钉板固定植骨融合术治疗寰枢椎不稳定的近期疗效。

Results Seven cases were basilar impression,nine cases were dearticulation of atlantoepistrophic articulation,and five caces were Chiari abnormity.In the X-ray pictures,it showed the abnormal form of the atlas and axis,it also showed the Chamberlain line, according to which we could diagnose the basilar impression.

结果 21例中，颅底凹陷为7例，寰枢椎脱位9例，Chiari畸形5例。X线平片主要表现为寰椎、枢椎形态构异常，并且能显示Chamberlain线，借此可作出颅底凹陷的诊断。

Methods A total of 15 cases were fixed and fused with lateral mass screw of atlas and vertebra dentata pedicle screw.

方法采用寰椎侧块螺钉与枢椎椎弓根螺钉技术对15例寰枢椎不稳的患者进行固定。

Objective To summary the results of fixation and fusion with lateral mass screw of atlas combined with vertebra dentata pedicle screw for treatment of atlantoaxial instability and discuss the corresponding therapy methods.

目的总结侧块螺钉与椎弓根螺钉技术治疗寰枢椎不稳的效果，探讨寰枢椎不稳的固定方法。

［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。

Fusion can provide stabilization for atlanto-axial joint, but it restricts the movement between atlas and axis and induces degeneration and instablility of unfused cervical spine.

本研究旨在开发一种人工寰齿关节，临床应用它来治疗寰枢椎脱位与不稳，以达到既恢复寰枢关节的稳定性又保留其运动功能的目的。

It is an effective method to make three-dimensional diagnosis of atlantoaxial subluxation with X-ray photograph and thereafter adopt therapies of acupotomy and spinal manipulation technique.

通过X线片对寰枢椎半脱位作出三维诊断并依此选择针刀和相应的手法整脊治疗，是寰枢椎半脱位诊疗的有效方法。

Screws and plates in the pedicles of atlas and axis can make the atlantoaxial joint stable in three - dimension immediately.

结论采用寰枢椎椎弓根钉板固定可以使寰枢椎即刻得到坚强的三维稳定，是一种值得推广应用的手术方法。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。