SU1263237A1 - Method of fixing head in posterior atlanto-axial dislocation - Google Patents

Method of fixing head in posterior atlanto-axial dislocation Download PDF

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Publication number
SU1263237A1
SU1263237A1 SU833653392A SU3653392A SU1263237A1 SU 1263237 A1 SU1263237 A1 SU 1263237A1 SU 833653392 A SU833653392 A SU 833653392A SU 3653392 A SU3653392 A SU 3653392A SU 1263237 A1 SU1263237 A1 SU 1263237A1
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USSR - Soviet Union
Prior art keywords
fixation
simplify
order
implant
posterior
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SU833653392A
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Russian (ru)
Inventor
Григорий Никитич Байбус
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Ленинградский Ордена Трудового Красного Знамени Научно-Исследовательский Нейрохирургический Институт Им.Проф.А.Л.Поленова
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Priority to SU833653392A priority Critical patent/SU1263237A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7055—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant connected to sacrum, pelvis or skull
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Neurosurgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

СПОСОБ ФИКСАЦИИ ГОЛОВЫ ПРИ ЗАДНЕМ АТЛАНТОАКСИАЛЬНОМ ВЫВИХЕ путем вправлени  шейных позвонков , фиксации их с помощью имплантата , укрепленного к остистым отросткам и к чешуе затылочной кости, отличающийс  тем, что, с целью упрощени  способа фиксации и снижени  травматичности, имплантат подвод т до упора под чешую затылочной кости. (Л N5 а оо N5 ОО The method of fixation of the head in the posterior Atlantic-axial dislocation by reducing the cervical vertebrae, fixing them with an implant, strengthened to the spinous processes and to the scales of the occipital bone, characterized in that, in order to simplify the method of fixation and reduce trauma, the implant body will be repaired by the body, in order to simplify the method of fixation and reduce trauma, the implant body will be repaired by the body, in order to simplify the method of fixation and reduce trauma, the implant body will be repaired by the body, in order to simplify the method of fixation and reduce trauma to the occipital bone. bones. (L N5 a oo N5 OO

Description

Изобретение относитс  к медицине, а именно к нейрохирургии, и может быть использовано при вывихах и переломовывихах в Ci-г позвонках.The invention relates to medicine, namely to neurosurgery, and can be used for dislocations and fractures in the Ci-g vertebrae.

Целью изобретени   вл етс  снижение травматичности, упрош.ение способа фиксации .The aim of the invention is to reduce the morbidity, simplify the method of fixation.

На чертеже представлена схема реализации способа.The drawing shows a diagram of the implementation of the method.

На схеме изображены большой затылочный бугор 1, остистый отросток 2, позвонки Ci-5 3, металлическа  пластинка 4, болт 5.The diagram shows a large occipital tubercle 1, a spinous process 2, vertebrae Ci-5 3, a metal plate 4, a bolt 5.

Предлагаемый способ фиксации при задних атлантоаксиальных вывихах осуществл етс  следующим образом.The proposed fixation method for posterior atlantoaxial dislocations is carried out as follows.

Больного с задним атлантоаксиальным вь1вихом укладывают на операционный стол в положении на боку с грузом до 10-15 кг на щейный отдел позвоночника через петлю Глисона. Под общим наркозом осуществл ют разрез м гких тканей от больщого затылочного бугра 1 до остистого отростка 2 позвонка С43. Затем скелетируют остистые отростки 2 позвонков Ci-5, дужки и нижние отделы чещуи затылочной кости. После этого производ т открытое вправление вывиха Ci или €2 позвонков 3 и по бокам остистых отростков 2 €2-3 позвонков 3 укладывают стандартную изогнутую по ребру металлическую пластинку 4 с таким расчетом, чтобы краниальные концы ее упирались в чещую затылочной кости сразу же под затылочным бугром. Металлическую пластинку 4 фиксируют к остистым отросткам 2 С2-3 позвонков с помощью болтов 5, проведенных через отростки 2. Рана зашиваетс  наглухо. Производитс  внешн   фиксаци  с помощью головодержател  из поливика на 10 мес.A patient with a posterior atlantoaxial type is placed on the operating table in a position on the side with a load of up to 10–15 kg per spinal section of the spine through a Gleason loop. Under general anesthesia, soft tissues are cut from the large occipital protuberance 1 to the spinous process 2 of vertebra C43. Then the spinous processes of the 2 vertebrae Ci-5, the arms and the lower sections of the occipital bone gum are skeletonized. After that, open displacement of Ci or € 2 vertebrae 3 is performed and 2 € 2-3 vertebrae 3 are placed on the sides of the spinous processes 3 vertebrae 3 are placed on a standard metal plate 4 along an edge so that its cranial ends abut against the occipital bone immediately under the occipital knoll. The metal plate 4 is fixed to the spinous processes of the 2 C2-3 vertebrae with the help of bolts 5 through the processes of the wound 2. The wound is sutured tightly. External fixation is made with the help of a head holder made of polyvic for 10 months.

Пример.. Больной В., 22 лет, истори  болезни № 707/73, при падении с велосипеда через руль ударилс  головой. Кратковременно тер л сознание. Сразу же развилась тетраплеги , регрессировавша  в течение 3 мин. В течение мес ца проводилось выт жение шейного отдела позвоночника петлей Глисона, после чего выписан с воротником Шанца. Однако через 10 дн по вились чувство онемени  в верхних конечност х и боль в шейнозатылочной области при открывании рта, по поводу чего госпитализирован. При поступлении в неврологическом статусе отмечаютс  умеренно выраженный синдром Горнера справа, горизонтальный нистагм, расстройство по «луковичному типу на лице справа, девиаци   зыка влево, речь с носовым оттенком и плохо модулирована, опущение левой половины м гкого неба, снижены глоточный рефлекс, правосторонн   пирамидна  недостаточность. РасстройствExample .. Patient V., 22 years old, case history No. 707/73, when falling from a bicycle over the steering wheel, hit his head. He briefly lost consciousness. Tetraplegs developed immediately, regressing for 3 minutes. During the month, the cervical spine was stretched with Gleason loops, after which it was discharged with a Schanz collar. However, after 10 days, there was a feeling of numbness in the upper extremities and pain in the cervical occipital region when opening the mouth, about which it was hospitalized. When admitted, neurological status shows moderate Horner syndrome on the right, horizontal nystagmus, onion-type disorder on the right side, deviation of the tongue to the left, nasal speech and poorly modulated, omission of the left half of the soft palate, decreased pharyngeal reflex, right-sided pyramid insufficiency . Frustration

чувствительности не отмечалось. На спондилограммах установлен косой перелом зубовидного отростка аксиса с резким смещением его вместе с атлантом и черепом назад , с сужением позвоночного канала наполовину . Повреждение развилось на фоне sensitivity was noted. On the spondylograms, an oblique fracture of the toothlike process of the axis is established, with its sharp displacement along with the atlas and the skull back, with a narrowing of the spinal canal by half. Damage developed against

0 конкресценции тел €2-3 позвонков, что способствовало степени смещени  позвонков. На функциональных спондилогра.ммах вы влена нестабильность атланта и зубовидного отростка аксиса. Больному в течение 35 дн проводилось скелетное выт жение0 concretions of bodies of 2-3 vertebrae, which contributed to the degree of displacement of the vertebrae. On the functional spondylograms. Mamma the instability of the atlas and the toothlike process of the axis was revealed. The patient was subjected to skeletal traction for 35 days.

5 за теменные бугры с грузом 15 кг с т гой кверху по оси позвонка и кпереди при положении больного на спине. За врем  выт жени  неврологическа  симптоматика регрессировала, при сн тии груза5 for the parietal cusps with a load of 15 kg with a traction upward along the axis of the vertebra and anteriorly when the patient is placed on the back. During the stretching, neurological symptoms regressed, when the load was removed

д указанна  неврологическа  симптоматика возвращалась вновь. На контрольных спондилограммах без динамики.The indicated neurological symptoms returned again. On control spondylograms without dynamics.

Произведен задний окципитоспондилодез предлагаемым способом. Через 22 дн выписан на амбулаторное лечение. Неврологическа  симптоматика регрессиловала полностью . На контрольных спондилограммах через 2 года нарастани  заднего вывиха Ci позвонка нет. Концы пластинок, упирающихс  в затылочную кость, обволокненыProduced posterior occipital spondylodesis with the proposed method. After 22 days, was discharged for outpatient treatment. Neurological symptoms regressed completely. On control spondylograms after 2 years of increase of posterior dislocation Ci vertebra is not. The ends of the plates that abut the occipital bone are encased

костной тканью. Через 9 лет после операции больной жалоб не предъ вл ет. Здоров, работает главным инженером завода.bone tissue. 9 years after the operation, the patient has no complaints. Healthy, works as a chief engineer of the plant.

Claims (1)

СПОСОБ ФИКСАЦИИ ГОЛОВЫ ПРИ ЗАДНЕМ АТЛАНТОАКСИАЛЬНОМ ВЫВИХЕ путем вправления шейных позвонков, фиксации их с помощью имплантата, укрепленного к остистым отросткам и к чешуе затылочной кости, отличающийся тем, что, с целью упрощения способа фиксации и снижения травматичности, имплантат подводят до упора под чешую затылочной кости.METHOD OF FIXING THE HEAD IN THE BACK ATLANTOAXIAL DISLOCATION by repositioning the cervical vertebrae, fixing them with an implant, attached to the spinous processes and the scales of the occipital bone, characterized in that, in order to simplify the method of fixation and reduce trauma, the implant is brought down to the back of the cervical bone under . I сьI smiling СО ЬЭSO bE ОО мOO m
SU833653392A 1983-10-12 1983-10-12 Method of fixing head in posterior atlanto-axial dislocation SU1263237A1 (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2463013C2 (en) * 2006-08-02 2012-10-10 Ворсо Ортопедик, Инк. System of fixing occipital plates

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
The Journal of Bone and Joint Surgery, 1957, 39A, 6, 1289-1301. *

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2463013C2 (en) * 2006-08-02 2012-10-10 Ворсо Ортопедик, Инк. System of fixing occipital plates

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