两种非融合术式治疗Ⅱ型和Ⅱa型Hangman骨折的疗效比较

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Abstract Objective To compare the efficacy of posterior C₂ pedicle screw +“Ω”transverse internal fixation and posterior C_{1~ 3} non-fusion fixation followed by two-stage internal fixation removal in the treatment of type Ⅱ and type Ⅱa Hangman fractures.Methods A total of 37 patients with Hangman fracture who underwent different surgical methods in 904 Hospital of the joint logistics support force of the Chinese people's Liberation Army from March 2015 to July 2021 were retrospectively analyzed.In Group A，16 patients (male 11，female 5)，aged from 29 to 65(45.6±10.2)years，underwent posterior C₂ pedicle screw plus“Ω”shaped transverse fixation.In Group B，21 patients(male 14，female 7) were treated.The Age ranged from 30 to 63 years (45.5±9.3)years.The operation time，intraoperative blood loss，hospital stay，hospitalization costs and fracture healing time，visual analogue scale(VAS)，neck disability index (NDI) and total cervical rotation at follow-up were recorded and compared between the two groups.Results The clinical symptoms of occipitocervical pain and limited cervical movement were significantly improved during follow-up in both groups.In group A，the operation time was (67.2±11.1)min，intraoperative blood loss was (65.6±18.3)mL，hospital stay was (10.6±1.4)d，and hospitalization cost was (3.5±0.5)0000 yuan.In group B，the operation time was (118.6±17.8)min，intraoperative blood loss was (106.7±25.2)mL，hospital stay was (15.1±1.2)d，and hospitalization cost was (7.4±0.5) 000 yuan.The differences in the operation time，blood loss，hospital stay and hospitalization costs between the two groups had statistical significance (P＜0.01).A group of fracture healing time was (9.0±2.3)month，and B group fracture healing time was (9.1±2.3)month，and the difference between the two groups had no statistical significance (P＞0.05).The VAS score and NDI at follow-up were significantly improved in both groups，and the differences were statistically significant (P＜0.01).The VAS score and NDI of group A were (1.6±0.7) points and (2.3±1.1)%，respectively，while those of group B were (2.1±0.7) points and (3.7±1.8)%，respectively.There was significant difference between the two groups (P＜0.05).The total rotation of cervical vertebra was (138.1±7.8)° during follow-up in group A，(77.4±8.7)° before internal fixation removal in group B，and(125.9±11.9)° during follow-up，and the differences had statistical significance (P＜0.05).Conclusion Both posterior C₂ pedicle screw +“Ω” transverse internal fixation and posterior C_{1~ 3} non-fusion fixation are effective in the treatment of type Ⅱ and type Ⅱa Hangman fractures，but single-level fixation is more beneficial to the preservation of cervical movement.

Key words： Hangman fractures non-fusion single-segment fixation“Ω&rdquo transverse connection

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	Zhang Shuai 1
	Zhang Yin 1
	Li Xinwu 2
	Wu Peng 2
	Yao Jian 2
	Jin Genyang 1
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Zhang Shuai 1,Zhang Yin 1,Li Xinwu 2, et al. Comparison of the Efficacy of Two Non-fused Treatments for Type Ⅱ and Type Ⅱa Hangman Fractures[J]. sygkzz, 2022, 27(2): 97-102.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V27/I2/97

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