红外导航辅助下枢椎椎弓根拉力螺钉微创内固定治疗Hangman骨折的疗效观察  

Observation of the efficacy of minimally invasive internal fixation of the infrared navigation assisted dentata spinal pedicle tension screw in the treatment of Hangman fracture

作　　者：陈毅 王利民[1] 赵亮[2] CHEN Yi;WANG Li-min;ZHAO Liang(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China;The Second Ward of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学第一附属医院骨科,河南郑州450000 [2]郑州大学第一附属医院骨科二病区,河南郑州450000

出　　处：《颈腰痛杂志》2020年第6期650-653,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：宁夏回族自治区自然科学基金(编号:NZ16212)。

摘　　要：目的探讨红外导航辅助下枢椎椎弓根拉力螺钉微创内固定治疗Hangman骨折的临床疗效。方法本研究纳入2016年1月~2018年1月于本院收治的38例Hangman骨折患者,均采用红外导航辅助下枢椎椎弓根拉力螺钉微创内固定治疗。随访2~4年,平均(3.21±0.43)年,记录患者手术指标,术前、术后3个月、末次随访时评价日本骨科协会(Japanese orthopaedic association,JOA)评分、VAS评分,术后3个月、末次随访时测量颈椎后伸、前屈、左弯、右弯活动度,记录随访期并发症发生情况。结果所有患者均完成手术,手术时间(62.11±8.43)min,出血量(58.11±14.01)mL,住院时间(5.98±2.01)d;术后2例患者出现颈部间歇性疼痛,1例发生肺部感染,均无脊髓、椎动脉损伤、内固定断裂等发生;术后3个月、末次随访JOA评分较术前显著升高,VAS评分显著降低,差异有统计学意义(P<0.05);末次随访时,患者颈椎后伸、前屈、左弯、右弯活动度较术后3个月增加,差异有统计学意义(P<0.05)。结论红外导航辅助下枢椎椎弓根拉力螺钉微创内固定治疗Hangman骨折,手术创伤小、置钉准确,可有效改善疼痛及颈椎功能障碍,恢复颈椎活动度。Objective To explore the clinical efficacy of minimally invasive internal fixation of the infrared navigation assisted dentata spinal pedicle tension screw in the treatment of Hangman fracture.Methods Thirty-eight patients with Hangman fracture in our hospital from January 2016 to January 2018 were selected as the study subjects.All patients were treated with infrared navigation assisted minimally invasive internal fixation of internal fixation of dentata spinal pedicle tension screw,and followed up for 2 to 4 years,with an average(3.21±0.43)years.The patients’surgical indicators were recorded.The Japanese orthopedic association(JOA)score and VAS score of preoperation,postoperative 3 months,and last follow-up were evaluated.The cervical spine extension,forward flexion,left bend,right bend activity of last follow-up were measured.The incidence of complications during follow-up were recorded.Results All patients completed the operation,the operation time was(62.11±8.43)min,the amount of bleeding was(58.11±14.01)mL,and the length of hospital stay was(5.98±2.01)d.Intermittent pain in the neck occurred in 2 patients after operation,and pulmonary infection occurred in 1 patient.No spinal cord,vertebral artery injury,or internal fixation fracture occurred.The JOA score at 3 months and the last follow-up was significantly increased compared with before surgery,and the VAS score was significantly decreased.The differences were statistically significant(P<0.05).The activity of cervical extension,forward flexion,left curve,and right curve at the last follow-up increased compared with 3 months after operation,and the differences were statistically significant(P<0.05).Conclusion Infrared navigation assisted minimally invasive internal fixation of the pedicle tension screw of the vertebral pedicle in the treatment of Hangman fracture has advantages of minimal trauma and accurate nail placement,which can effectively improve pain and cervical dysfunction,and restore cervical spine mobility.

关 键 词：红外导航 枢椎椎弓根拉力螺钉内固定 HANGMAN骨折 颈椎活动度 

分 类 号：R687.3[医药卫生—骨科学]