前景和展望

综上所述，在过去的30年中，随着对颅脊交界区病理解剖认识的加深，经口入路技术同显微外科一同发展起来，并越来越完善，许多外科医师使用经口入路治疗上颈椎疾病，取得了很大的成功。但目前有关经口寰枢椎钢板的研究报道甚少，主要集中在生物力学的刚度、三维运动范围 （range of motion, ROM）以及钢板固定螺钉进钉点和进钉方向的选择上，且钢板种类不多，虽已出现了SAALP，但仅限于生物力学实验，未见应用于临床。除笔者医院应用于治疗包括颅底陷入症在内的各种难复性寰枢椎脱位患者外，其他单位临床病例资料均较少。

TARP技术在必需行经口手术腹侧减压的前提下，通过一个经口入路完成手术，避免了分期或一期的后路手术，无需切除齿突和（或）斜坡以获得直接减压，术中通过TARP系统联合应用寰枢椎复位器将脱位的寰枢关节即时复位，达到延脊髓无创减压的目的，然后采用坚强的内固定方式，通过符合生理的关节间隙植骨达到最终的融合，因此，TARP手术从根本上简化了手术方法，保证了手术疗效，是手术理念和方式的彻底变革，具有良好的应用前景。

（艾福志　尹庆水　章　莹　刘　晖）

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