应用多聚醚酮椎间融合器修复Ⅱ型及Ⅱa型Hangman骨折:6个月随访评价(英文)  

Polyetheretherketone cage for treating type Ⅱ and type Ⅱa Hangman's fractures: 6-month follow-up

作　　者：黄阳亮[1] 钟祎[2] 刘少喻[1] 

机构地区：[1]中山大学附属第一医院脊柱外科,广东省广州市510700 [2]广州医科大学生理学教研室,广东省广州市510000

出　　处：《中国组织工程研究》2015年第39期6302-6308,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:Hangman骨折即创伤性枢椎滑脱,不稳定Hangman骨折的Ⅱ型、Ⅱa型及ⅡI型骨折需要手术治疗。咽后入路是上颈椎前路手术显露的常用手段。然而,重要结构周围的牵拉与分离使得手术程序复杂,增加了神经损伤的发生率。目的:评价创新性应用多聚醚酮椎间融合器治疗Hangman骨折的临床疗效及安全性。方法:收集Ⅱ型及Ⅱa型Hangman骨折患者8例,均进行C2/3椎间融合。术后随访进行X射线检查,评价融合时间及内植物位置。比较术前与术后6个月骨折处成角及移位数据和复位情况,以颈椎创伤后评分评价功能恢复,以目测类比评分评价颈部疼痛。结果与结论:所有8例患者均得以成功随访,平均随访13个月(6-26个月)。与术前相比,术后6个月患者颈椎创伤后评分增高,目测类比评分及成角畸形和移位均降低(P<0.05)。全部患者末次随访未见颈部活动受限,术后3或6个月所有患者椎间均骨性融合,无相关并发症。结果证实,应用多聚醚酮椎间融合器治疗Ⅱ型及Ⅱa型Hangman骨折临床疗效及安全性均较好。BACKGROUND： Unstable cases of Hangman＇s fracture or traumatic spondylilisthesis which are type II, IIa and III should be treated surgically. Retropharyngeal approach was employed in exposure of anterior upper cervical region. However, dissection and traction around important structures make the procedure complicated and increase the chance of nerve injury. OBJECTIVE： To evaluate the clinical curative effect and safety of an innovative operative technique in which a polyetheretherketone cage was used to perform cervical spinal fusion for the treatment of Hangman＇s fracture. METHODS： Eight patients with type II or IIa Hangman＇s fracture were enrolled in this study and received cervical fusions at C2/3 levels. During follow-up postoperatively, they received X-ray examination. Fusion time and implant position were evaluated. The angle of deformity（α） and the displacement distance（β） were compared pre-operatively and 6-month post-operatively to measure reduction. The functional outcomes were also compared using the Post-Traumatic Neck Score（Mayo） pre-operatively and 6-month post-operatively, while neck pain was further investigated by Visual Analogue Scale score. RESULTS AND CONCLUSION： All eight patients were followed-up successfully, with an average follow-up of 13 months（range 6-26 months）. Compared with pre-operatively, Clinical Post-Traumatic Neck Score（Mayo） was increased, Visual Analogue Scale score, angle deformity（α） and displacement distance（β） were reduced at 6-month post-operatively（P 0.05）. Neck activity was not limited in final follow-up. Bone fusion was found in all patients at 3 or 6 months post-operatively, and no complication was detected. Results confirm that polyetheretherketone cage for type II and IIa Hangman＇s fracture could achieve good outcomes and safety.

关 键 词：组织工程 脊柱 骨折 椎间盘 骨科植入物 脊柱植入物 颈椎 融合 HANGMAN骨折 多聚醚酮 咽后 入路 手术 植入物 史密斯-罗宾逊 融合器 

分 类 号：R318[医药卫生—生物医学工程]