颈1～2关节突间隙螺钉治疗颈2椎弓骨折

目的探讨应用颈1～2关节突间隙螺钉固定技术治疗颈2双侧椎弓骨折(Hangman骨折)的可行性及临床疗效.方法自2000年9月～2002年9月应用颈后路经颈1～2关节突间隙螺钉固定加植骨融合术治疗Hangman骨折6例,观察术后寰枢椎的稳定性、植骨融合率及颈椎活动度.结果 6例病人术中无神经及血管损伤等并发症,术后上颈椎即刻获得稳定,经6～26个月随访,全部病人均获得骨性愈合,螺钉无松动、退出及断裂,颈椎旋转活动度平均丧失35.72%.结论颈1～2关节突间隙螺钉固定技术治疗Hangman骨折是安全有效的,为重建寰枢椎间的稳定性提供了一种新的内固定方法.

Posterior C1～2 transarticular screw fixation for hangman''s fracture

Objective To study the possibility and effect of posterior C_1~2 transarticular screw fixation for the Hangman's fracture.Methods From September 2000 through September 2002, the posterior C_1~2 transarticular screw fixation and autograft fusion of C_1~2 were applied for treating six patients with Hangman's fracture. The atlanto-axial stability, the bone graft fusion and the cervical mobility were observed.Results Six patients had no complications in respect to the blood vessel and nerve injuries during the operation. The antlanto-axial stability was obtained immediately after the operation. On follow up from six months to twenty six months,being 14.7 months in average after operation,the result showed that all of the autograft had been well fused and no plate or screw was broken or loose. The average loss of cervical mobility was 35.72 per cent. As a whole, the outcome was satisfactory. Conclusion The Posterior C_1~2 transarticular screw fixation was safe and effective to treat the Hangman's fracture. It provides a new and ideal technique to the atlanto-axial stability.