應用路其桿（Luque Rod）做後方枕骨及上頸椎之固定

Posterior Fixation by Luque Rodding for Occipito-Cervical Instability

陳博光(Po-Quang Chen) ； 楊榮森(Jun-Sen Yang) ； 王榮彬(Jun-Ping Wang)

《Journal of Orthopaedic Surgery Taiwan》 4卷4期 (1987/12) Pp. 223-229

摘要

近年來，應用路其桿（Luque Rod）做脊椎畸形之矯正或胸腰椎骨析之固定，均有良好之效果。用此法做枕骨及上頸椎病變之固定，亦效果亦佳，故特為介紹。
病例一，係28歲女性乳癌患者，因第二頸椎之癌轉移致頸部疼痛及上肢無力。經手術以兩支L型路其桿固定枕骨及第三頸椎間，並行補骨，術後病人不再訴頸痛。
病例二，係29歲男性患下肢肉瘤，來住院時訴頸痛，四肢無力，且因第二、三頸椎間病理性第三度脫位，而僅能臥床。先做頭部牽引以整復脫位處，再以一支L型路其桿固定枕骨及第四頸椎間，並行補骨。術後五天，病已可下床行走，並繼續化學療法。
使用時必需弄彎路其桿，以符合正常枕骨及頸椎之彎度，術後不需做外固定。對需要立即且穩定固定之病人有確切之價值。故實為採用路其桿之新領域。

並列摘要

Luque rodding and fusion procedure is a well accepted method to treat scoliosis and spinal fracture in the thoracic to upper sacral level. However, its application in the occipitocervical level is new.
Case 1. A 28 years old female patient with breast cancer. She had C2 metastasis resulting in severe neck pain and weakness of the upper extremities. Two Luque rods were fixed between occiput and C3 along with bone graft. She had no more pain after this operation.
Case 2. A 29 years old male patient with alveolar type sarcoma of the leg. He complained of severe neck pain and weak-ness of the legs. He was also confined to bed.
Roentgenograms showed metastasis to C2 and C3 bodies, and grade 3 slippage of the same level. He had received radio-threrapy, chemotherapy and failed laminec-tomy in another hospital. After this ad-mission, halo-traction for 2 weeks followed by Luque rodding and bone grafting be-tween occiput and C4 were done. One week after operation, patient was able to rise and walk.
From this 2 experiences, we consider Luque rodding can achieve immediate rigid fixation for selected pathological instability at occipito-atlanto and upper cervical spine.

並列關鍵字

Luque rod ； occipito-cervical fixation