CAJ | 학술논문

目的探泔颈椎后路椎弓根螺钉内同定治疗不稳定Hangman骨折的临床效果.方法 2001年10月至2006年4月收治15例不稳定Hangman骨折患者,骨折按照Levine-Edwards分型:Ⅱ犁3例,ⅡA型4例,Ⅲ型8例.入院后均给予颅骨牵引,行颈后路切开复位、椎弓根螺钉内固定术治疗.在复位不完全时,脱位不严重者采用C2.3复位固定;脱位严重时,在C<.2>椎弓根钉和C3侧块螺钉固定的基础上,增加C4的侧块螺钉固定.结果术后随访3～30个月,平均17个月.6例术前脊髓功能Frankel分级为D级的患者术后恢复至E级,所有患者术后复奋X线片示:骨折全部获得骨件愈合,无明显的颈椎功能受限.结论 C2.3或C2-4后路椎弓根螺钉内固定手术是治疗不稳定Hangman骨折的有效方法,可达到早期复位、坚强同定的目的 .
목적 탐감경추후로추궁근라정내동정치료불은정Hangman골절적림상효과.방법 2001년10월지2006년4월수치15례불은정Hangman골절환자,골절안조Levine-Edwards분형:Ⅱ리3례,ⅡA형4례,Ⅲ형8례.입원후균급여로골견인,행경후로절개복위、추궁근라정내고정술치료.재복위불완전시,탈위불엄중자채용C2.3복위고정;탈위엄중시,재C<.2>추궁근정화C3측괴라정고정적기출상,증가C4적측괴라정고정.결과 술후수방3～30개월,평균17개월.6례술전척수공능Frankel분급위D급적환자술후회복지E급,소유환자술후복강X선편시:골절전부획득골건유합,무명현적경추공능수한.결론 C2.3혹C2-4후로추궁근라정내고정수술시치료불은정Hangman골절적유효방법,가체도조기복위、견강동정적목적 .
Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.