Jain Vaibhav, Thakur Manoj Kumar, Thakur Amit, Sud Sachin, Lal Mukund, Madan Ankit
Department of Orthopaedics Surgery, Indira Gandhi Medical College, Shimla, Himachalpradesh, India.
J Craniovertebr Junction Spine. 2017 Oct-Dec;8(4):350-353. doi: 10.4103/jcvjs.JCVJS_113_17.
To study the functional outcome in unstable Hangman s fracture managed with anterior decompression and stabilization with cervical locking plate and tricortical bone graft.
Between 2010 and 2016, 44 patients (range: 19-75 years) with unstable Hangman's fracture underwent anterior decompression and stabilization with cervical locking plate and tricortical bone graft in our institution.
According to the Levine and Edwards classification, all patients were unstable with Type IA 6 (13.6), Type IIA 35 (79.5%), Type II (0), and Type III (6.8). The mean period of follow-up was 17 months (range: 6-48 months). Neurological recovery was observed in all nine patients. All patients were relieved from axial pain. None of the patients received blood transfusion. All patients showed solid fusion with no complication related to bone graft and plate.
The anterior C2/C3 discectomy, fusion, and stabilization with cervical locking plate and tricortical bone graft are feasible and safe method in treating HangmanÊs fracture, with the benefit of high primary stability, anatomical reduction, and direct decompression of the spinal cord.
研究采用前路减压、颈椎锁定钢板及三面皮质骨移植进行稳定治疗的不稳定型绞刑者骨折的功能预后。
2010年至2016年期间，我院对44例（年龄范围：19 - 75岁）不稳定型绞刑者骨折患者采用颈椎锁定钢板及三面皮质骨移植进行前路减压及稳定治疗。
根据Levine和Edwards分类，所有患者均为不稳定型，其中IA型6例（13.6%），IIA型35例（79.5%），II型0例，III型3例（6.8%）。平均随访时间为17个月（范围：6 - 48个月）。9例患者均有神经功能恢复。所有患者的轴向疼痛均得到缓解。无一例患者接受输血治疗。所有患者均实现牢固融合，未出现与骨移植及钢板相关的并发症。
前路C2/C3椎间盘切除、融合以及采用颈椎锁定钢板和三面皮质骨移植进行稳定治疗是治疗绞刑者骨折的一种可行且安全的方法，具有初期稳定性高、解剖复位以及直接减压脊髓的优点。
