C2椎弓根C3侧块螺钉固定治疗不稳定性Hangman骨折

C2 Pedicle Screw C3 Lateral Mass Screw Fixation for Treatment of Unstable Hangman Fracture

目的探讨C2椎弓根C3侧块螺钉固定治疗不稳定Hangmag骨折的临床疗效。方法2003年7月-2011年7月我院共收治不稳定性Hangmag骨折32例，根据Levine-Edwards分型法：Ⅱ型14例，ⅡA型15例，Ⅲ型3例，均行C2椎弓根C3侧块螺钉固定治疗。结果术中未出现椎动脉脊髓损伤及其他并发症，术后随访3-24个月，平均13.7个月，所有患者均为获得骨牲融合。 术前C2-3椎体间移位（5.7±1.6）mm，术后6个月C2-3椎体间移位（2.3±1.7）mm,P〈0.05；术前C2-3椎体间成角（12.6±1.4）°，术后6个月C2-3椎体成角（7.3±1.7）°，P〈0.05；JOA17分法脊髓功能评判标准术前评分（6.3±0.3）分，术后6个月评分（13.5±1.1）分，术后恢复率为67%。

Objective To evaluate the clinical effect of unstable Hangman fracture treated with C2 pedicle screw C3 lateral mass screw fixation. Methods From July 2003 to July 2011,32 eases of patients with unstable Hangman fracture were treated in our hospital. Based on Levine-Edwards classification,type Ⅱ-14 cases,type Ⅱ A 15 eases,type Ⅲ - 3 cases. All the eases were treated with C2 pedicle serew C3 lateral mass screw fixation. Results There Was no spinal eord and vertebral arlery injury or other complications during the opera; tion. All the patients were followed up from 3 th to 24th months, average of 13.7 months and got bony fusion. The preoperative displaeement of C2 - 3 vertebral bodies was （ 5.7 ± 1.3 ） mm,/he postoperative displacement of C2 -3 vertebral bodies followed up for 6 months was （ 2.3 ± 1.7.） ram, P 〈 O. 05; The preoperative angulation of C2- 3 vertebral bodies was 12.6° ± 1.4°, the postoperative angulation .of C2-3. yertebral bodies followed up for 6. months was 7.3° ± 1.7°,P 〈 O. 05 ;based on JOA 17 scores for assessment of spinal cord function,the preoperative score was 6.3 ±0.3 ,the postoperative score followed up for 6 months was 13.5 ± 1.1 ,the recoveo＂ rate of nervous function was 67%.Conclusion For treatment of unstable Hangman fracture, C2 pedicle screw C3 lateral mass screw fixation is an effective method.