本文關(guān)鍵詞： Hangman骨折 前路 療效　出處：《福建醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的:通過對國內(nèi)外文獻(xiàn)報道和福建附屬第一醫(yī)院的Hangman骨折臨床病例進行回顧性分析,回顧性觀察不穩(wěn)定的hangman骨折前路治療的療效及相關(guān)性研究。研究方法:本研究收集了2009年-2014年我校附屬第一醫(yī)院的Hangman骨折患者病例,排除未能定期隨訪及后路手術(shù)的病例,其中采用C2,3前路減壓融合治療hangman骨折18例,臨床資料完善并且定期隨訪。所有患者術(shù)前均行頸椎正側(cè)位片、頸椎CT平掃三維重建、頸椎磁共振等相關(guān)檢查。根據(jù)Levine-Edwards分型標(biāo)準(zhǔn),其中II型9例,IIA型9例,無III型病例。術(shù)前根據(jù)骨折的損傷機制及移位、成角情況等進行持續(xù)顱骨牽引,時間2-7天,重量約2-4KG.定期行頸椎正側(cè)位片復(fù)查,根據(jù)情況對牽引進行實時調(diào)整。均行C2,3前路減壓融合術(shù),利用ASIA評分及術(shù)后影像學(xué)復(fù)查評價療效。結(jié)果:所有病例獲得3-50個月隨訪,平均26個月,未出現(xiàn)明顯不穩(wěn)。影像學(xué)復(fù)查均獲得骨性融合,未出現(xiàn)手術(shù)相關(guān)并發(fā)癥,14例術(shù)前神經(jīng)功能正�；颊�,術(shù)后無神經(jīng)損害;4例不全癱患者均有不同程度等恢復(fù)。結(jié)論:1.Hangman骨折患者入院需常規(guī)行頸椎正側(cè)位片、頸椎CT三維重建及磁共振檢查,明確骨折分型及椎間盤、脊髓損傷相關(guān)情況,對于后期手術(shù)方案的制定至關(guān)重要。2.對于II型及IIA型的hangman骨折,行“C2,3前路減壓融合”起到減壓的效果,并且重建了頸椎的生理曲度,穩(wěn)定了前中柱,對頸椎復(fù)位的維持較穩(wěn)定。
[Abstract]:Objective: to analyze retrospectively the clinical cases of Hangman fracture in the first affiliated Hospital of Fujian Province through the literature reports at home and abroad. Retrospective study on the efficacy and correlation of anterior approach to unstable hangman fracture. Methods:. Cases of Hangman fracture were collected from 2009 to 2014 in the first affiliated Hospital of our University. 18 cases of hangman fracture were treated with C2T3 anterior decompression fusion. The clinical data were perfect and followed up regularly. All the patients underwent anterior and lateral cervical vertebrae radiography before operation and three-dimensional reconstruction with plain CT scan of cervical spine. According to Levine-Edwards classification criteria, 9 cases of type II type IIA, no cases of III type. Preoperative according to the fracture injury mechanism and displacement. Continuous cranial traction was performed for 2-7 days with a weight of about 2-4 KG. The cervical vertebrae axial and lateral radiographs were re-examined regularly and the traction was adjusted in real time according to the situation. All patients were treated with C2A3 anterior decompression and fusion. Results: all the patients were followed up for 3-50 months with an average of 26 months without obvious instability. No postoperative complications were found in 14 patients with normal nerve function before operation, and no nerve damage was found after operation. Conclusion: 1. The patients with Hangman fracture should be treated with axial and lateral cervical radiography, three-dimensional CT reconstruction and magnetic resonance imaging. Clear classification of fractures and disc, spinal cord injury related conditions, for the formulation of post-operative plan is very important .2. for type II and IIA type of hangman fractures, with "C2". (3) anterior decompression fusion had the effect of decompression, and reconstructed the physiological curvature of the cervical spine, stabilized the anterior and middle column, and maintained the stability of the reduction of the cervical vertebrae.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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相關(guān)期刊論文 前1條

1 謝雁春;項良碧;劉軍;王琪;陳語;;Hangman骨折損傷類型與手術(shù)方式的選擇[J];創(chuàng)傷與急危重病醫(yī)學(xué);2014年05期

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本文編號：1458901