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目的 探索枕寰区畸形的外科治疗途径.方法 在详细研究枕颈部解剖结构后,采用经枕颈后外侧入路先行枕骨大孔扩大及寰椎后弓切除减压, 然后经枕颈区硬脊膜侧方显露齿突及C2 椎体的后方, 用高速磨钻切除畸形的齿突.作者于1997 年1 月~1998 年1 月采用此术式治疗枕寰区畸形8 例, 其中5 例合并寰枢椎脱位者行一期枕颈植骨融合.结果 全组患者无手术死亡及术后感染.术后随访6~18 个月, 发现8 例患者躯体感觉恢复接近正常, 四肢肌张力明显降低, 肌力均有一级以上恢复.结论 经枕颈后外侧入路切除齿突, 手术视野开阔, 病变显露清楚, 前、后方减压及枕颈融合可同时完成.经枕颈后外侧入路是处理枕寰区腹侧病变又一新的, 较为理想的手术入路.“,”Objective To explore a new approach to dens axis. Methods Occipital foramen magnum was enlarged and posterior arch of atlas was excised through transoccipitocervical posterolateral approach. Then translateral aspect of dura mater of spinal cord, dens axis and posterior aspect of axis were exposed, and then deformed dens axis was excised with high speed drill. From January 1997 to January 1998, 8 cases were treated for occipitocervical anomalies with this approach and the occipitocervical fusion were performed in 5 cases at the same setting. Results There were no mortality nor infection. The follow up period ranged from 6-18 months. The sensory function in all cases was restored nearly to normal and muscular tone was decreased after surgery. Muscular strength was increased more than one degree in all cases. Conclusion Process of axis was exposed very clearly and the operation field was widened with this new approch. Posteroanterior decompression and occipitocervical fusion can be performed at the same time. It may be a ideal approach to treat disorders of the ventral aspect of spinal cord in the occipitocervical region.