Anterior Cervical Decompression And Internal Fixation In The Treatment Of Unstable Hangman Fractures

Research purposes: Based on the literature reported and the First Affiliated Hospital of Fujian Hangman fracture were analyzed retrospectively, and the correlation between the curative effect of anterior treatment were observed retrospectively the unstable hangman fractures.Methods: 20 cases of Hangman were collected for the study of 2009-2014 in our school the First Affiliated Hospital of patients with fracture of 3 cases, including the use of C2, anterior decompression and fusion for the treatment of 18 cases of Hangman fracture, the clinical data and follow-up improvement. All patients underwent preoperative cervical spine radiographs and the cervical CT scan and three-dimensional reconstruction, cervical spine MRI examination. According to the Levine-Edwards classification, including 8 cases of type II, 8 cases of type IIA, type III cases. Based on the preoperative injury mechanism of fracture and displace and angulation of sustained skull traction, time is 2-7 days, weight about 2-4KG. regular cervical spine radiographs were, according to the situation of real time adjustment of traction. Were examined by C2, 3 by anterior decompression and fusion, to evaluate the efficacy of ASIA score and postoperative imaging examinations.Results: all cases were followed up for 3-50 months, average 26 months, there was no obvious instability. The imaging examination showed bony fusion, no operation related complications, 14 cases of patients with normal preoperative neurological function, no nerve injury after operation; 4 cases of incomplete paralysis patients had different degree of recovery.Conclusion: 1.Hangman fracture patients need routine cervical spine radiographs and the cervical CT and three-dimensional reconstruction of magnetic resonance imaging, to clarify the type of the fracture and intervertebral disc, spinal cord injury, is essential for the post operation plan.2 for type II and type IIA Hangman fractures, "C2, 3 anterior decompression and fusion" plays the effect of decompression, and reconstruction of the cervical physiological curvature, the stability of the anterior column, the maintenance of cervical vertebra reduction and stable.