寰枢椎脱位的临床诊疗进展

Progress in the clinical diagnosis and treatment of atlantoaxial dislocation

摘要:

寰枢椎脱位（atlantoaxial dislocation, AAD） 是脊柱脊髓常见疾病之一，影像学一般以颈椎过伸或过屈位X 线片显示ADI 间隙增宽或SAC 间隙变窄为特征。随着上颈椎手术研究的不断深入，AAD 的临床诊疗已取得可观进步。但寰枢椎解剖结构复杂，存在神经、血管及骨性结构变异的可能，充分了解患者的病情及影像学特点，有助于为患者制定个性化诊疗方案。本文对AAD 的发病机理、诊断及治疗方法的研究进展进行综述，为临床AAD 诊治提供参考。

Abstract:

Atlantoaxial dislocation (AAD) is one of special disorders in the spine and spinal cord. Radiographs are characterized bycervical hyper-extension or hyper-flexion positions in which X-rays reveal widening of the atlantodental interval (ADI) or narrowing of thespace available for the cord (SAC). With the deepening of research on upper cervical surgery, the clinical diagnosis and treatment of AADhave made considerable progress. However, the anatomical structure of atlantoaxial vertebrae is complex, with the possibility of neurologi-cal, vascular and bone structural variation. A full understanding of the patient's condition and imaging characteristics is helpful to developpersonalized diagnosis and treatment plans for patients. In this paper, the pathogenesis, diagnosis, non-surgical treatment and surgical treat-ment of AAD were reviewed to provide a reference for clinical diagnosis and treatment of AAD.