摘要
[目的]介绍颈椎后路钉棒固定非融合治疗新鲜Ⅱ型和ⅡA型Hangman骨折的手术技术和临床初步疗效。[方法] 2010年6月~2017年6月手术治疗10例新鲜Hangman骨折患者,其中Ⅱ型6例,ⅡA型4例。在气管插管全麻下施行一期后路C1~C3钉棒固定,而不进行后路植骨;术后随访CT复查显示椎弓骨折骨性愈合后,二期后路手术取出内固定,并观察颈椎运动功能的恢复情况。[结果]所有10例患者均成功进行后路钉棒固定,术中椎弓骨折复位满意,未发生椎动脉、脊髓损伤。患者一期术后随访6~12个月,CT复查显示10例患者Hangman骨折均获得骨性愈合。二期后路钉棒内固定取出术后6~12个月颈椎运动功能基本恢复正常。[结论]对于新鲜Ⅱ型和ⅡA型Hangman骨折,一期后路钉棒固定二期取出内固定的方法不仅可获得满意的骨折复位,而且不残留内置物,同时还可保留颈椎节段的运动功能,是前路和后路固定融合术的有益补充。
[Objective] To introduce the surgical technique and primary clinical result of posterior screw-rod fixation without fusion for fresh type Ⅱ and ⅡA Hangman’s fractures. [Method] From June 2010 to June 2017, 10 patients underwent surgical treatment for fresh Hangman’s fracture, including 6 cases of type Ⅱ fracture and 4 cases of type ⅡA fracture. Under the general anesthesia, all the 10 cases received C1-C3 screw-rods fixation but no bone grafting. As solid bone union of the Hangman’s fracture was confirmed by CT scan, the second stage operation was conducted to remove the instruments. The recovery of cervical movement function was assessed. [Results] All the 10 patients had the Hangman’s fracture reduced and fixated with posterior C1-C3 screw-rods system successfully without neural or vascular injuries in anyone of them. The patients were followed up for 6-12 months after the first stage operation, and all of them had a solid bone union of the fracture revealed by CT scans. After instruments remove out, the cervical spine movement function almost restored to normal in all patients within 6-12 months follow up. [Conclusion] For fresh type Ⅱ and ⅡA Hangman’s fracture, the first stage posterior screw-rods fixation combined with the second stage instruments removing can not only achieve satisfactory fracture reduction and healing, but also reserve movement function of the cervical spine with no residuary instruments, which maybe an alternative for anterior or posterior fixation and fusion techniques.
作者
马向阳
邹小宝
王宾宾
杨浩志
葛苏
陈育岳
夏虹
吴增晖
章凯
王建华
艾福志
MA Xiang-yang;ZOU Xiao-bao;WANG Bin-bin;YANG Hao-zhi;GE Su;CHEN Yu-yue;XIA Hong;WU Zeng-hui;ZHANG Kai;WANG Jian-hua;AI Fu-zhi(Department of Spine Surgery,General Hospital of Southern Theatre Command of PLA,Guangzhou 510010,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第22期2080-2083,共4页
Orthopedic Journal of China
基金
广州市民生科技攻关计划项目(编号：201803010046)
