Hangman骨折的颈后路CerviFix系统固定治疗  

Posterior fixation of C_(2～3) with CerviFix system in the treatment for indicated Hangman's fracture

作　　者：徐瑞生[1] 王立邦[1] 丁涛[1] 王刊石[1] 吴洁石[1] 王雪松[1] 包聚良[2] 

机构地区：[1]江苏省无锡市第三人民医院骨科,214041 [2]上海长征医院骨科

出　　处：《中国矫形外科杂志》2005年第4期255-257,共3页Orthopedic Journal of China

摘　　要：目的:探讨颈后路CerviFix系统固定C2～3治疗Hangman骨折的适应证及疗效.方法:2002年6月～2004年1月在新鲜的Hangman骨折患者中选择6例C2～3不稳(MRI示C2～3椎间盘形状和信号无明显改变、前纵韧带连续)行颈后路C2椎弓根螺钉、C3侧块螺钉的CerviFix系统固定术.6例患者中Levine-Edwards Ⅰ型2例,Ⅱa型3例,Ⅱb型1例;脊髓损伤Frankel分级:D级1例,E级5例.结果:手术均顺利完成,未发生手术并发症,术前脊髓损伤Frankel D级的1例术后恢复至E级,骨折于术后6～12周愈合;颈椎无畸形、活动无明显受限,颈部无明显不适,未出现内固定物松动、断裂方面的并发症;2例于术后1年骨折愈合后取出内固定物并且C2～3仍保持稳定.结论:颈后路CerviFix系统固定C2～3选择性治疗部分Hangman骨折,术后可以获得骨折端良好的复位固定和C2～3间稳定性的即刻重建,为骨折愈合和C2～3间韧带修复创造条件,疗效满意.其适应证为:C2～3椎间盘和韧带解剖结构完整但不稳定的Hangman骨折.Objective: To explore the indications and the result of C_~2~3 posterior fixation with CerviFix system in treatment of traumatic spondylolisthesis of axis (Hangman's fracture).Method: From Jun.2002 to Jan.2004,six acute traumatic spondylolisthesis of axis patients with instability of C_~2~3 ,whose MRI showed no significant change of C_~2~3 disc and the continuation of anterior longitudinal ligament,received the operation of posterior C_~2~3 fixation with CerviFix system.According to Levine-Edwards classification,two cases belonged to type I,three cases belonged to II a and one case II b respectively,as well,SCI degree was grade D 1 case and grade E 5 cases evaluated with Frankle score.Result: All operation were successfully finished without any operative complications.One case of grade D SCI improved to grade E,without complications of cervical spine malformation,significantly cervical move restriction or cervical uncomfort.Conclusion:The operations of posterior C_~2~3 fixation with CerviFix system for some Hangman's fracture with instability of C_~2~3 can get good reduction of fracture and C_~2~3 immediately stability reconstruction,which applys an ideal condition for fracture cure and ligaments rehabilitation,then get a satisfactory result.The indication is Hangman's fracture with disc and ligaments unbroken but instability of C_(2～3) .

关 键 词：枢椎 创伤 固定 内 

分 类 号：R687.3[医药卫生—骨科学]