中文摘要：

目的：评价经口咽前路寰枢椎复位钢板（transoral atlantoaxial reduction plate,TARP）内固定植骨融合治疗上颈椎疾患的临床效果.方法：应用TARP内固定植骨融合手术治疗上颈椎疾患11例,包括寰枢椎脱位8例,Jefferson骨折2例,先天性寰枕融合伴颅底凹陷症后路减压术后1例.神经功能按美国脊髓损伤学会（ASIA）分级：D级8例,E级3例;ASIA运动评分58～100分（87.0±13.4分）.结果：1例术后曾出现声嘶,左侧声带麻痹,经对症治疗后治愈.11例患者颈部疼痛和肢体麻木无力症状均不同程度改善,8例D级患者中2例改善为E级,其余6例分级无变化,运动评分改善为89～100分（96.5±4.0分）,8例D级的患者术后评分增加4～33分（13.1±9.4分）.平均随访8.3个月,1例不慎跌倒头部着地导致枢椎体螺钉拔出,寰枢椎再次脱位,二次用同样手术方法采用较短型号钢板固定治愈,其余患者效果满意.结论：TARP固定操作简便可行,对寰枢椎前部结构包括寰椎侧块和C2椎体完整的各种上颈椎疾患引起的难复性寰枢椎脱位可获得较好的治疗效果.

英文摘要：

Objective：To evaluate the clinical effect of transoral atlantoaxial reduction plate（TARP） system for the treatment of upper cervical disease.Method：Eleven patients with upper cervical disease were treated with TARP internal fixation.The diseases included eight atlantoaxial dislocation,two Jefferson＇s fracture and one congenital atlanto-occipital fusion acomplied by basilar invagination after posterior decompression procedure.Eight cases were in D grade and three were in E grade according to the international standard revised by American Spinal Cord Injury Association（ASIA）. The preoperational ASIA motor score was 58-100（87.0±13.4）.Result：One case of trachyphonia due to left vocal cord paralysis was cured by symptomatic treatment. The symptoms of neck pain and extremity anesthesia or asthenia of all cases decreased postoperationally in different degree.At a mean follow-up of 8.3 months,the degree of two cases improved from D to E,the other six cases with D grade didn＇t change postoperationally.Their motor scores increased to 89-100 （96.5±4.0）.The motor scores of all the eight patients with D grade increased by 4-33（13.1±9.4）. The complications included screws loosening due to a fall and trachyphonia.The patient with such complication was handled with reoperation with TARP adjustment.Conclusion：TARP procedure is simple which is suitable for irreducible atlantoaxial dislocation resulting from upper cervical disease on the condition that lateral masses of C1 and the vertebrae body of C2 must be kept intact.