合并椎间盘损伤Hangman骨折的外科治疗

Surgical management of Hangman＇ s fracture combined with intervertebral disc injury

目的探讨合并椎间盘损伤Hangman骨折的外科治疗方法及机制。方法39例Hangman骨折伴C2.3椎间盘损伤，行颈椎前路C2．3椎间隙融合、Zephir颈前路钛板固定术，其中8例植入SynCage。结果随访2～6年，平均3年7个月，35例颈痛症状消失，4例残留轻度颈痛症状，未出现神经症状加重、植骨块移位、吸收和切口感染等并发症，术后3～6个月C：，获得骨性融合。结论合并椎间盘损伤的Hangman骨折是一种特殊的骨折类型，颈椎前路融合术符合其病理生理特点。

Objective To explore the outcome and mechanism of surgical treatment for Hangman＇ s fracture combined with intervertebral disc injury. Methods A total of 39 cases of Hangman＇ s fracture combined with C2.3 intervertebral disc injury were treated with C2.3 interbody fusion and titanium plate fixation by cervical anterior approach. SynCage implant was applied in 8 cases of them. Results The patients were followed up for 2-6 years （ average 3.6 years）. Neck pain disappeared in 35 cases but 4 still had slight neck pain, with no aggravated neurological symptom, displacement and absorption of bone graft or infection of incisional wound. C2.3 fusion was achieved at 3-6 months after operation. Conclusion Hangman＇ s fracture combined with intervertebral disc injury is a special kind of fracture and anterior cervical fusion is consistent with its pathophysiological characteristics.