Department of Spine Surgery, Affiliated Hospital of Southwest Medical University, 646000 Sichuan, China.
Department of Spine Surgery, Affiliated Hospital of Southwest Medical University, 646000 Sichuan, China.
Orthop Traumatol Surg Res. 2019 Jun;105(4):709-711. doi: 10.1016/j.otsr.2019.03.005. Epub 2019 Apr 19.
The treatment of hangman's fracture is controversial. If treated with a traditional surgical procedure, there will likely be many complications, such as kyphosis, pseudarthrosis and nonunion. Our present study aims to describe a bucking bar method with pedicle screw fixation to treat hangman's fracture. Thirty-two patients with an unstable hangman's fracture who underwent posterior C2-3 pedicle lag screw fixation surgery assisted by a bucking bar between May 2004 and Jan 2017 were evaluated. All the participating patients were successfully treated using this novel technique, and follow-up revealed anatomical fusion in 27 patients, incomplete fusion in 4 patients, and C2-3 angular deformity healing in 1 patient. No patient developed throat wall edema or pseudomembrane formation. Satisfactory reduction, fixation and fusion of C2 pedicle fractures can be achieved using a pedicle screw assisted with the transoral bucking bar technique. LEVEL OF EVIDENCE: IV, retrospective case-series study.
Hangman 骨折的治疗存在争议。如果采用传统的手术治疗方法，可能会出现许多并发症，如后凸畸形、假关节和骨不连。本研究旨在描述一种应用撑开棒辅助经皮寰枢椎椎弓根螺钉固定治疗 Hangman 骨折的方法。2004 年 5 月至 2017 年 1 月，我们对 32 例不稳定型 Hangman 骨折患者采用撑开棒辅助后路寰枢椎椎弓根螺钉固定手术进行治疗。所有患者均成功应用该新技术进行治疗，随访发现 27 例患者达到解剖融合，4 例患者存在不完全融合，1 例患者出现 C2-3 成角畸形愈合。无患者出现咽壁水肿或伪膜形成。经皮寰枢椎椎弓根螺钉辅助经口撑开棒技术可实现 C2 椎弓根骨折的满意复位、固定和融合。证据等级：IV，回顾性病例系列研究。
