颈后路短节段固定融合治疗Ⅱ型Hangman骨折

Posterior short-segment fusion treatment of type Ⅱ Hangman fracture

目的探讨Ⅱ型Hangman骨折经后路短节段内固定椎旁植骨融合的方法和效果。方法 18例Ⅱ型Hangman骨折患者实施C2-3颈椎椎弓根-侧块钉棒内固定和椎旁植骨融合术。结果术后随访0.5-38个月。C2椎弓根骨折愈合,椎旁植骨融合,椎体无滑移,内固定无松动,无上颈椎失稳、鹅颈畸形和轴性疼痛等,颈部功能满意。结论Ⅱ型Hangman骨折经后路C2-3短节段钉棒系统内固定植骨融合能获得满意的稳定效果,术式可靠,C3给予侧块螺钉固定,为C2-3结构稳定性丧失节段提供了良好的重建。

Objective To investigate the method and effect of posterior short-segment internal fixation and paravertebral bone graft fusion for type Ⅱ Hangman fracture. Method The 18 cases of type Ⅱ Hangman fracture were subjected to C2-3pedicle of vertebral arch-lateral mass fixation with screw and rod system and paravertebral bone graft fusion. Results The postoperative follow-up of 0.5-38 mouthes was taken C_2 pedicle fracture were healing well and no vertebral slipping was found. All patients satisfied with their neck functional activity never complained about loosening of internal fixation, instability of upper cervical spine, goose neck deformity,spinal cord injury, intractable neck or shoulder pain during postoperative follow-up. Conclusion Posterior C2-3short-segment fixation with screw and rod system and paravertebral bone graft fusion obtain patient ＇s satisfactory with cervical spine stabilization effect. The lateral mass screw fixation of C3 can provide a good reconstruction for the loss of C2-3structural stability.