颈椎后路椎弓根螺钉系统C_(2,3)短节段固定材料置入治疗Hangman骨折  

C_(2,3) pedicle screw fixation through cervical posterior approach in treatment of Hangman's fracture

作　　者：万仑[1] 张斌[1] 刘仲前[1] 王跃[1] 

机构地区：[1]四川省人民医院骨科,四川省成都市610072

出　　处：《中国组织工程研究与临床康复》2008年第9期1643-1645,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:分析椎弓根螺钉系统短节段内固定材料置入治疗枢椎椎弓根骨折(Hangman骨折)的临床疗效,评价其应用价值。方法:回顾性分析四川省人民医院骨科自2004年以来收治的枢椎椎弓根骨折17例患者,按Levine-Edwards分型,其中Ⅱ型4例,ⅡA型6例,Ⅲ型7例,脊髓功能按Frankel分级,12例E级,5例D级;行颅骨牵引复位病情稳定后用椎弓根螺钉系统(美敦力枢法模产品)短节段置入材料固定C2,C3椎弓根。结果:术中无椎动脉损伤及脊髓损伤,术后摄片及CT检查显示1例两侧椎弓根骨折未复位,其余均复位良好;1例出现脑脊液漏,经常规治疗痊愈。所有病例随访12～24个月,平均14.5个月,骨折均在6个月内愈合,颈椎活动无明显受限,神经功能4例D级恢复至E级。术中所用材料均为钛合金体内置入物,与人体组织的生物相容性好,到随访结束时,无血液、免疫、组织等反应;亦无钛合金腐蚀、磨损等材料反应的发生。结论:椎弓根螺钉系统短节段固定材料置入治疗Hangman骨折,复位固定及骨折愈合良好,对颈椎功能影响小,神经功能恢复满意。AIM： To evaluate the clinical outcomes and evaluate the application value of pedicle screw system internal fixation in short segment for the treatment of Hangman＇s fracture. METHODS： A retrospectively analysis was conducted in 17 cases of Hangman＇s fracture who were treated in Department of Orthopaedics, Sichuan Provincial People＇s Hospital since 2004. According to Levine-Edwards classification, 4 of them belonged to type Ⅱ, 6 type ⅡA, 7 type Ⅲ According to Frankel classification in function of spinal cord, 12 cases of them belonged to Grade E and 5 cases D. All cases were fixed with C2.3 pedicle screw system short segment implantation materials （product of Medtronic Sofamor） after skull traction and reduction. RESULTS： No vertebra artery injury or spinal injury was found during operation. Postoperational photograph and CT detection revealed bilateral fracture had no reduction in 1 case and cerebrospinal fluid leaking occurred in 1 case who was cured after conventional therapy. All cases were followed up for 12-24 months （average 14.5 moths）. All fractures healed within 6 months, and activities of cervical vertebra were not obviously limited. As for nerve function, 4 cases of Grade D recovered up to Grade E. Ti-alloy implant materials used in this study were well biocompatible to the human body. There were no blood, immune, histology reactions, or the corrosion and abrasion of Ti-alloy appeared. CONCLUSION： Pedicle screw fixation in short segment for the treatment of Hangman＇s fracture is satisfactory in fracture reduction, fixation and healing. There are little lose in function of cervical vertebrae and it promotes functional recovery of spinal cord.

关 键 词：椎弓根螺钉系统 内固定 枢椎椎弓根骨折(Hangman骨折) 

分 类 号：R318[医药卫生—生物医学工程]