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-  2015 

Hangman骨折诊断和治疗进展

DOI: doi:10.7507/1002-1892.20150109

Keywords: Hangman骨折, 内固定, 前路, 颈椎序列

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Abstract:

目的对Hangman骨折诊断和治疗研究进展进行综述。 方法广泛查阅近年国内外有关Hangman骨折诊断和治疗的研究文献,并进行综合分析。 结果Hangman骨折的诊断和稳定性判定除了应用颈椎X线片外,还应常规采用颈椎CT三维重建和MRI。不稳定性Hangman骨折可采用后路C2、C3内固定,前路C2、C3内固定和前后路联合内固定。前路内固定可选用上颈椎前咽后入路和下颈椎前入路,以上入路能直接切除破碎的椎间盘,有效维持颈椎正常序列,避免术后轴性疼痛;而后路内固定需在骨折的峡部植入C2椎弓根螺钉,血管神经损伤风险增大。 结论不稳定性Hangman骨折手术方法选择应根据患者损伤情况及术者经验进行选择,目前尚缺乏不同治疗方法的随机对照研究

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