机器人辅助经椎弓根固定治疗类风湿性寰枢椎脱位合并椎动脉高跨一例报告
Robot-assisted transpedicular screw fixation for rheumatoid atlantoaxial dislocation with high-riding vertebral artery:a case report
谭黎鑫 1余照宇 2鲁尧 2李勇2
作者信息
- 1. 517000 广东省,河源市中医院骨伤科二区
- 2. 519000 珠海,广东省中医院珠海医院骨三科
- 折叠
Abstract
Objective To explore the etiology,incidence,and selection of surgical strategy for rheumatoid atlantoaxial subluxation combined with high-riding vertebral artery(HRVA).Methods A case of robot-assisted transpedicular screw fixation for rheumatoid atlantoaxial dislocation(AAD)combined with high-riding vertebral artery was reported.Relevant literature was reviewed.Results The patient was a 56-year-old female with rheumatoid atlantoaxial dislocation,and the examination revealed high-riding left vertebral artery(V3 segment).The risk of unarmed transpedicular screw fixation was high.Guiding by robot could avoid the high-riding vertebral artery,which greatly enhanced the accuracy and stability,and reduced the risk of surgery.After the operation,symptoms were relieved and the atlantoaxial spine was repositioned.Good atlantoaxial internal fixation,clear atlantodental interval and gradually fused posterior atlantoaxial vertebrae were observed 5 months after operation.The patient returned to normal life.Conclusions Rheumatoid AAD has a higher chance of complicating with HRVA,while atlantoaxial transpedicular screw fixation assisted by robot navigation can enhance the safety and accuracy of nail placement.It significantly shortens the time of nail placement and fluoroscopy,and reduces complications of surgery such as IVAI.But the complications and long-term prognosis of robot-assisted surgery need to be reported in the literature and in more studies.In addition,problems related to the adaptation of instruments such as upper cervical hollow screws should be noted in the robot-assisted surgery.
关键词
脱位/颈椎/关节炎,类风湿/外科手术,计算机辅助/椎动脉高跨Key words
Dislocations/Cervical vertebrae/Arthritis,rheumatoid/Surgery,computer-assisted/High-riding vertebral artery引用本文复制引用
出版年
2024
NETL
NSTL
万方数据