椎弓根螺钉或拉力螺钉内固定治疗老年人不稳定性Hangman骨折  

Treatment of Unstable Hangman Fractures in Elderly Patients with PedicleScrew or lag Screw Fixation

作　　者：刘波 武霞 黄寿国 陈波 李伟 徐以春 张英华 

机构地区：[1]临沂市中心医院脊柱外科,山东临沂276400

出　　处：《中国伤残医学》2017年第15期11-13,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨椎弓根螺钉或拉力螺钉内固定治疗老年人不稳定性Hangman骨折的临床疗效.方法：2010年3月~2016年8月共收治不稳定性Hangman骨折老年患者12例,其中男9例,女3例,年龄62~84岁,平均72.3岁.损伤类型按Levine-Edwards分型标准： II型5例,IIa型5例,III型2例.脊髓神经损伤按Frankel分级：D级2 例,E级10例.在颈椎侧位X线片上测量上颈椎前凸角（C0~C2角）、颈椎前凸角（C0~C7角）、C2~3后凸角（LK）、颈椎矢状面垂直距离（C2~C7SVA）、C2椎体前移距离（C2T）.对所有患者进行日本骨科协会（JOA）颈髓功能、VAS评分.采用独立样本t检验对上述指标进行比较,并行Pearson相关性分析.结果：所有患者术中未发生脊髓及椎动脉损伤,12例患者随访结果示颈椎生理曲度维持良好,骨折线消失,术后神经功能改善,疼痛明显减轻.结论：椎弓根螺钉或拉力螺钉内固定技术是治疗老年人不稳定性Hangman骨折安全有效的方法.Objective： To investigate the clinical effect of pedicle screw or lag screw fixation in the treatment of unstable Hangman fractures in elderly patients. Methods： 12 elderly patients with unstable Hangman＇s fracture were converged from March 2010 to August 2016, 9 males and 3 females, aged from 62 to 84 years, with an average age of 72.3 years. 5.5 and 2 patients were classified as type II, IIa and III injuries respectively according to Levine -Edwards classification, and the grade was made as D in 2 cases and E in 10 cases ac- cording to Frankel scale. The occipitocervical parameters and cervical spine sagittal parameters were as follows： CO - C2 angle, CO - C7 angle, LK angle, C2 - C7 sagittal vertical axis （ SVA）, C2T. All of the patients were performed cervical spinal cord function （JOA） and VAS score. The independent samples t test was used to compare the above indexes, and the correlation analysis of parallel pearson. Re- sults：The spinal cord and vertebral artery injury did not occur in all patients, 12 cases of patients with follow - up results show cervical lordosis was maintained, fracture line disappeared, improve the neurological function after surgery, pain significantly reduced. Conclu- sion： Pedicle screw or lag screw internal fixation is a safe and effective method for the treatment of unstable Hangman fractures in elderly patients.

关 键 词：HANGMAN骨折 颈椎后路 内固定 

分 类 号：R683[医药卫生—骨科学]