颅底凹陷合并难复性寰枢椎脱位术后齿状突下移程度对神经功能影响的临床研究

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Abstract Objective To evaluate the relationship between odontoid descent and postoperative neurological function.Methods 19 patients who underwent foramen magnum decompression for basilar invagination with irreducible atlantoaxial dislocation were included.Anterior atlantodental interval(AADI)，clivoaxial angle(CXA)and the distance of the tip of dens to McRae Line(McRL)were measured preoperatively and at the last follow-up.The Japanese Orthopaedic Association(JOA)scoring system were used to characterize neurological function.Pearson correlation analysis was applied to analyse the relationship between JOA improvement rate and odontoid descent rate(ODR)，change of AADI(△AADI)and CXA(△CXA).Results The average follow-up was (20.42±8.24)months.The preoperative JOA was (11.21±2.62)，and JOA at follow-up was (14.53±2.19).The improvement rate of JOA was (58.75±24.43)%.Significant relationship between JOA improvement rate and ODR was found(R＝0.88，P＜0.05).No significant relationship was found between JOA improvement rate and △AADI(R＝0.07，P＝0.77)and △CXA(R＝－0.04，P＝0.98).Conclusion The surgical efficacy of foramen magnum decompression in basilar invagination with irreducible atlantoaxial dislocationis mainly depended on odontoid descent rate.When odonotoid decended to some degree，the surgical efficacy of foramen magnum decompression is optimum.

Key words： atlantoaxial dislocation basilar invagination posterior decompression odontoid descent

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