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Apofix联合枢椎椎弓根螺钉内固定治疗Hangman骨折并寰枢椎不稳 被引量:4

Treatment of Hangman fracture complicating atlantoaxial instability by Apofix interlaminar clamps combined with dentata pedicle screw
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摘要 目的:探讨Apofix联合枢椎椎弓根螺钉治疗Hangman骨折合并寰枢椎不稳的临床疗效并初步评价其安全性。方法:Hangman骨折合并寰枢椎不稳患者12例,男7例,女5例;年龄27~67岁;依据Levine Edwards对Hangman骨折分型:Ⅰ型2例,Ⅱ型6例,ⅡA型3例,Ⅲ型1例。脊髓功能依据ASIA标准:C级1例,D级3例,E级8例。经颈后路联合使用Apofix和枢椎椎弓根螺钉内固定,术中未行寰枢椎融合。术后3个月骨折达骨性愈合后取出Apofix固定器。结果:12例均获随访,随访时间24~36个月,平均29个月。所有患者均获骨性稳定,10例颈部活动度基本恢复正常,2例活动度较正常减少20%~30%,无神经损伤等并发症。结论:应用Apofix联合枢椎椎弓根螺钉治疗Hangman骨折合并寰枢椎不稳是一种有效、安全并能最大程度保留颈部功能的较好方法。 Objective:To evaluate the clinical effect and salty of Apofix interlaminar clamps combined with dentata pedicle screw internal fixation in treating the Hangman fracture complicating atlantoaxial instability. Methods:Twelve patients (7 male and 5 female;The age ranging from 27 to 67 years)suffered from the Hangman fracture complicating atlantoaxial instability. According to Levine-Edwards classification, the patients included 2 cases of type Ⅰ ,6 of type Ⅱ ,3 of type ⅡA,1 of type Ⅲ. Evaluated by ASIA standard of spinal cord function,1 case was in grade C,3 in grade D,8 in grade E. All patients were treated by Apofix interlaminar clamps combined with dentata pedicle screw through posterior approach and no bone graft. The Apofix interlaminar clamp were taken out while bone healing of postoperative three months. Results : All patients were followed up for from 24 to 36 months( mean 29 months). All patients were obtained bone stability. The cervical activity of 10 patients recovered to normal. The cervical activity of 2 patients reduced 20% to 30% than that of the normal. No nerve injury or other complications occurred. Conclusion:It is an effective and simple methods to treat the Hangman fracture complicating atlantoaxial instability by Apofix interlaminar clamps combined with dentata pedicle screw and it can ultimately preserve the cervical function.
机构地区 解放军第
出处 《中国骨伤》 CAS 2006年第5期264-265,共2页 China Journal of Orthopaedics and Traumatology
关键词 Hangmann骨折 寰枢关节 骨折固定术 Hangman fracture Atlanto-axial joint Fracture fixation,internal
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  • 1Lavine AM,Edwards CC.The management of traumatic spondylolisthesis of the axis.J Bone Joint Surg(Am),1985,67:217-226.
  • 2关骅,石晶,郭险峰,王德成,姚爱明.脊髓损伤神经学分类国际标准(2000年修订)[J].中国康复理论与实践,2001,7(2):49-52. 被引量:187
  • 3Samaha C,Lazzennec JY,Laporte C,et al.Hangman fracture:The relationship between asymmetry and instability.J Bone Joint Surg (Br),2002,82:1046.

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