不稳定Hangman骨折前路减压融合内固定术后颈椎矢状面形态的影像学研究  

Sagittal cervical alignment in unstable Hangman fracture patients undergoing anterior cervical discectomy and fusion

作　　者：王强[1] 吴寅良[1] 周波[1] 李法年 陈亮[1] 江龙[1] 

机构地区：[1]宜兴市人民医院骨科,江苏214200

出　　处：《中国骨与关节损伤杂志》2016年第7期681-684,共4页Chinese Journal of Bone and Joint Injury

基　　金：江苏省卫生计生委面上科研课题(YG201505)

摘　　要：目的评估不稳定Hangman骨折行C（2、3）前路减压融合内固定术后的矢状面形态。方法对自2011-03—2015-02在本院接受C（2、3）前路减压融合内固定术且有完整术后随访资料的19例不稳定Hangman骨折进行回顾性分析。比较术前、术后以及末次随访时的C（2、3）局部后凸角（LK）、C2椎体前移距离、上颈椎角（C0~2）、下颈椎角（C2~7）、颈椎矢状面平衡（C2~7SVA）。结果 19例术后平均随访10（6~24）个月。术中均未出现脊髓及神经损伤。术后仅1例ASIA C级,脊髓及神经功能改善。术后及末次随访时的LK、C2椎体前移距离、上颈椎角、下颈椎角、C2~7SVA均较术前明显改善,差异有统计学意义（P〈0.05）;且术后及末次随访时比较差异均无统计学意义（P〉0.05）。结论 C（2、3）前路减压融合内固定术可矫正不稳定Hangman骨折后C2成角及前移,恢复颈椎局部及整体矢状面平衡,是一种良好的手术方法。Objective To evaluate the sagittal cervical profile in unstable Hangman fracture（UHF） patients undergoing anterior C（2、3）discectomy and fusion. Methods From March 2011 to February 2013, 19 UHF patients in our center undergoing anterior C（2、3）discectomy and fusion and having complete follow-up data were retrospectively reviewed. Five parameters including C（2、3）local kyphosis（LK）, C2translation（C2T）, upper cervical angle（C0~2）, lower cervical angle（C2~7）, sagittal cervical vertical axis（C2~7SVA） were analyzed before and after operation and at the last follow-up. Results All patients received a follow-up from 6 to 24 months（mean 10 months）. The neurological function was significantly improved after surgery, the ASIA score was grade C only in one patient. All parameters were significantly improved after operation and at the last follow-up when compared with those before operation（P〈0.05）, but no significant difference was found between those after operation and at the last follow-up（P〈0.05）. Conclusion Anterior C（2、3）discectomy and fusion can correct the instability of C2 and restore the local and overall sagittal balance, which is a good surgical strategy in patients with unstable Hangman fracture.

关 键 词：不稳定Hangman骨折 颈椎前路减压融合内固定术 矢状面 医学影像学 

分 类 号：R687.3[医药卫生—骨科学]