Apofix联合枢椎椎弓根螺钉内固定治疗Hangman骨折并寰枢椎不稳  

Treatment of Hangman fracture complicating atlantoaxial instability by Apofix interlaminar clamps combined with dentata pedicle screw

作　　者：高俊[1] 丁真奇[1] 洪加源[1] 施建东[1] 庄泽民[1] 黄哲元[1] 

机构地区：[1]解放军第175医院南京军区骨科研究所,福建漳州363000

出　　处：《中国骨伤》2006年第5期264-265,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨Apofix联合枢椎椎弓根螺钉治疗Hangman骨折合并寰枢椎不稳的临床疗效并初步评价其安全性。方法:Hangman骨折合并寰枢椎不稳患者12例,男7例,女5例;年龄27～67岁;依据Levine Edwards对Hangman骨折分型:Ⅰ型2例,Ⅱ型6例,ⅡA型3例,Ⅲ型1例。脊髓功能依据ASIA标准:C级1例,D级3例,E级8例。经颈后路联合使用Apofix和枢椎椎弓根螺钉内固定,术中未行寰枢椎融合。术后3个月骨折达骨性愈合后取出Apofix固定器。结果:12例均获随访,随访时间24～36个月,平均29个月。所有患者均获骨性稳定,10例颈部活动度基本恢复正常,2例活动度较正常减少20%～30%,无神经损伤等并发症。结论:应用Apofix联合枢椎椎弓根螺钉治疗Hangman骨折合并寰枢椎不稳是一种有效、安全并能最大程度保留颈部功能的较好方法。Objective：To evaluate the clinical effect and salty of Apofix interlaminar clamps combined with dentata pedicle screw internal fixation in treating the Hangman fracture complicating atlantoaxial instability. Methods：Twelve patients （7 male and 5 female;The age ranging from 27 to 67 years）suffered from the Hangman fracture complicating atlantoaxial instability. According to Levine-Edwards classification, the patients included 2 cases of type Ⅰ ,6 of type Ⅱ ,3 of type ⅡA,1 of type Ⅲ. Evaluated by ASIA standard of spinal cord function,1 case was in grade C,3 in grade D,8 in grade E. All patients were treated by Apofix interlaminar clamps combined with dentata pedicle screw through posterior approach and no bone graft. The Apofix interlaminar clamp were taken out while bone healing of postoperative three months. Results ： All patients were followed up for from 24 to 36 months（ mean 29 months）. All patients were obtained bone stability. The cervical activity of 10 patients recovered to normal. The cervical activity of 2 patients reduced 20% to 30% than that of the normal. No nerve injury or other complications occurred. Conclusion：It is an effective and simple methods to treat the Hangman fracture complicating atlantoaxial instability by Apofix interlaminar clamps combined with dentata pedicle screw and it can ultimately preserve the cervical function.

关 键 词：Hangmann骨折 寰枢关节 骨折固定术 内 

分 类 号：R683.2[医药卫生—骨科学] R681.5[医药卫生—外科学]