摘要
目的观察颈椎单开门椎管扩大成形微型钢板固定术后椎板铰链侧不同程度骨折的断端骨愈合情况。方法2009年9月至2011年12月采用颈椎单开门椎管扩大成形Centerpiece钢板固定术治疗的患者49例，男41例，女8例；年龄34~83岁，平均61岁。根据术后CT扫描，将椎板铰链侧骨折分为不完全骨折和完全骨折。完全骨折分为四型：Ⅰ型，骨折断端无移位分离；Ⅱ型，骨折断端部分移位或分离；Ⅲ型，骨折断端完全移位分离；Ⅳ型，骨折断端向椎管内移位或塌陷。观察铰链侧骨折愈合情况并比较不同类型骨折愈合率的差异。结果随访6-35个月，平均16个月。术后1周CT扫描243个节段，椎板铰链侧完全骨折占58．0％（141／243）；其中Ⅰ型完全骨折占66．O％（93／141）、Ⅱ型25．5％（36／141）、Ⅲ型6．4％（9／141）、Ⅳ型2．1％（3／141）。术后6个月不完全骨折的愈合率97．7％，高于完全骨折愈合率89．7％，差异有统计学意义。术后3个月及6个月不同类型完全骨折愈合率的差异均有统计学意义，Ⅲ型骨折术后愈合率最低。结论椎板铰链侧完全骨折以Ⅰ型骨折为主，完全骨折的骨愈合率低，Ⅲ型骨折最差。
Objective To investigate the different bony fusion for different hinge fracture types in unilateral open-door cervical expansive laminoplasty with centerpiece mini-plate fixation. Methods Forty- nine patients received the unilateral open-door cervical expansive laminoplasty from September 2009 to De- cember 2011, including 41 males and 8 females, with the average age of 61 years old （ranging from 34 to 83）. The hinge fracture was divided into incomplete fracture and complete fracture according to the postop- erative CT scan. The complete fracture hinge was divided into four groups： type Ⅰ in which there was no displacement, type Ⅱ in which there was mild to moderate displacement, type Ⅲ in which there was com- plete displacement or separated, type IV in which there was hinge＇s collapse into cervical canal. The hinge side fracture healing would be observed in the follow-up and the difference of different types of fracture heal- ing rate would be compared. Results The follow-up time was 16 months on average, ranging from 6 to 35 months. CT scanned 243 segments a week after the operation. 58.0% （141/243） of the laminae had complete fractures on the hinge side after surgery. And type Ⅰ fracture accounted for 66.0%（93/141）, type Ⅱ fracture 25.5% （36/141）, type Ⅲ 64%（9/141） and type Ⅳ 2.1% （3/141）. The incomplete fracture hinge has a higher bony fusion rate 6 months after the operation compared with the complete fracture hinge. Significant differ- ences were found among different complete fracture types in the healing rate 3 months after the operation and 6 months after the operation respectively. Type Ⅲ fracture has the lowest bony fusion rate. Conclusion Type Ⅰ fracture was the major type for complete fractured hinge. The hinges with complete fracture get a relativelv bad bony fusion and tvne m fracture has the lowest bonv fusion rate.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2013年第6期601-606,共6页
Chinese Journal of Orthopaedics
关键词
颈椎
椎管狭窄
骨折愈合
Cervical vertebrae
Spinal stenosis
Fracture, healing
