李金泉;徐皓;姚晓东;唐焕章;陈建梅;王万宗;

• 1:南京军区福州总医院骨科

摘要(Abstract)：

[目的]比较颈后路多节段椎弓根螺钉内固定术与颈前路钢板内固定术两种手术方法治疗不稳定Hangman骨折的临床疗效。[方法]32例不稳定Hangman骨折患者,其中男21例,女11例,年龄17～65岁,平均43.4岁。按Levine-Edwards分类,其中Ⅱ型骨折15例,ⅡA型骨折14例,Ⅲ型骨折3例。脊髓损伤按Frankle分级:D级4例,E级28例。所有患者受伤至手术时间1～15 d,平均5 d。采用颈后路多节段椎弓根螺钉内固定术治疗18例,颈前路钢板内固定术治疗14例,对两组患者的手术时间、术中出血量、手术并发症、骨折愈合情况及脊髓功能恢复情况进行比较分析。[结果]两组在手术时间[颈后路椎弓根螺钉内固定组平均(121±20)min、颈前路钢板内固定组平均(116±13)min]、术中出血量[颈后路椎弓根螺钉内固定组平均(360±25)ml、颈前路钢板内固定组平均(320±21)ml]、骨折愈合情况[颈后路椎弓根螺钉内固定组均获骨性愈合(无畸形愈合)、颈前路钢板内固定组均获骨性愈合("鹅颈"畸形1例)]及脊髓功能恢复情况方面差异无统计学意义(P>0.05);手术并发症[颈后路椎弓根螺钉内固定组出现1例(静脉丛损伤1例)、颈前路钢板内固定组出现6例(喉上神经损伤4例、颈部切口血肿1例、食管损伤1例)]方面差异有统计学意义(P<0.05)。[结论]颈后路多节段椎弓根螺钉内固定术是治疗不稳定Hangman骨折较理想的方法。

关键词(KeyWords)： Hangman骨折;枢椎;椎弓根螺钉;内固定

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李金泉;徐皓;姚晓东;唐焕章;陈建梅;王万宗;

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参考文献(References)：

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