颈前路植骨融合内固定手术治疗不稳定的Hangman骨折

Anterior Fusion with the Internal Fixation System in the Treatment for Unstable Hangman Fracture

目的探讨采用颈前路C_2~C_3椎间Cage植入融合＋钛板内固定治疗不稳定型Hangman骨折的临床疗效。方法收集行颈前路C_2~C_3椎间Cage植入融合＋钛板内固定术的不稳定Hangman骨折患者19例,并回顾性研究其临床治疗效果。结果术后随访37月（10~66月）,围手术期无椎动脉损伤及脑脊液漏等并发症,无内植物断裂。椎弓骨折处骨性愈合15例,骨折线仍可见4例;无迟发性脊髓损伤症状,5例颈髓损伤评级提高1~2级。结论颈前路C_2~C_3融合内固定方法可用于Ⅱ型及ⅡA型Hangman骨折患者。

Objective To observe the clinical efficacy of anterior fusion with the internal fixation system in the treatment for unstable Hangman fractures. Methods 19 cases with unstable Hangman fracture were involved in this study, who all underwent anterior cervical discectomy and fusion. Results All patients were followed up for 10-66 months, average 37 months. No spinal cord injury,vertebral artery injury or cerebrospinal fluid leakage occurred, complications such as plate-screw internal fixation of fracture failure did not occur. 15 patients were cured with bony union and restoration of cervical curvature, fracture line in 4 cases could be seen but no delayed symptoms of spinal cord injury. 5 cases which have cervical spinal cord injury spinal cord function was improved from 1-2 grade in 4 cases. Conclusions Anterior cervical fusion with internal plate fixation could be used for treating unstable Hangman fracture patients with type Ⅱor type Ⅱ A