КЛИНИКО-РАДИОЛОГИЧЕСКИЕ ОСОБЕННОСТИ АТЛАНТОАКСИАЛЬНЫХ ДИСЛОКАЦИЙ НА ФОНЕ ВРОЖДЕННЫХ АНОМАЛИЙ РАЗВИТИЯ КРАНИОВЕРТЕБРАЛЬНОГО ПЕРЕХОДА

Цель исследования. Анализ клинико-радиологических особенностей атлантоаксиальных дислокаций (ААД) при врожденной патологии краниовертебрального перехода.

Материал и методы. Проанализированы данные 26 пациентов с ААД на фоне врожденной патологии краниовертебрального перехода, обратившихся в Центр Илизарова в 2012–2017 гг.

Результаты. Пациентов разделили на три группы: с несиндромальными ААД – 6 (23,1 %), с ААД на фоне синдрома Клиппеля – Фейля – 11 (42,3 %), с синдромальными ААД – 9 (34,6 %). Аномалии развития зуба встретились у 15 (57,7 %) пациентов, величину смещения у них можно было оценить по расположению фасеток С₁ относительно С₂ в различных плоскостях. У пациентов с несиндромальными ААД отмечены локальный болевой синдром (4,20 ± 2,64 балла по ВАШ), сопровождавшийся кривошеей и ограничением движений головы, и миелопатия. У пациентов с ААД на фоне синдрома Клиппеля – Фейля преобладали локальные симптомы: ограничение движений в шее, кривошея, боли в шее (2,40 ± 2,01 балла по ВАШ), миелопатия. У пациентов с синдромальными ААД ведущими были симптомы миелопатии и невыраженный болевой синдром (2,30 ± 1,94 балла по ВАШ).

Заключение. У пациентов с синдромальными ААД чаще возникает миелопатия, тогда как ААД на фоне синдрома Клиппеля – Фейля и несиндромальные ААД зачастую проявляются локальными симптомами.

врожденные атлантоаксиальные дислокации, нестабильные аномалии, краниовертебральный переход, нестабильные аномалии С1–С2

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