MANAGEMENT OF FRACTURE SEPARATIONS OF THE ARTICULAR MASS USING POSTERIOR CERVICAL PLATING
MANAGEMENT OF FRACTURE SEPARATIONS OF THE ARTICULAR MASS USING POSTERIOR CERVICAL PLATING
复制标题
DOI：
10.1097/00007632-199210001-00018
复制
发表时间：
1992-10-01
期刊：
影响因子：
3
通讯作者：
ROYCAMILLE, R
中科院分区：
文献类型：
--
作者：
LEVINE, AM;MAZEL, C;ROYCAMILLE, R
关节块骨折分离是一组特殊的单侧小关节面骨折，由于其独特的两级不稳定性，必须单独考虑。这种骨折类型包括椎板纵向骨折和脊柱同侧同一水平处椎弓根骨折。它的x线特征是侧块水平化，平均平移4.6 mm，平均成角6.9度。在本研究中，畸形最常发生在骨折以下的节段（19例），但也发生在骨折以上的节段（5例）。神经系统受累的发生率很高（24例患者中有14例），最常见的是神经根性受累。这种损伤导致两节段不稳定，需要三节段两间隙稳定。本系列的所有24例患者均接受了不对称(8)、对称(9)或门状(7)结构的后颈钢板植入。对称结构和门形结构均获得统计学上更好的结果（P < 0.05）。不对称组的并发症包括神经功能缺损和矫正功能丧失。
Fracture separations of the articular mass are a specific group of unilateral facet fractures that must be considered separately because of their unique two-level instability. This fracture pattern involves a longitudinal fracture of the lamina and a fracture of the pedicle on the same side of the spine at the same level. It is characterized roentgenographically by horizontalization of the lateral mass, with a mean translation of 4.6 mm and a mean angulation of 6.9 degrees. In this study the deformity most commonly occurs at the level below the fracture (19 patients) but also occurred at the level above (5 patients). There is a high incidence of neurologic involvement (14 of 24 patients), most often radicular in nature. This injury results in two level instability requiring a three-level, two-interspace stabilization. All twenty-four patients in this series underwent posterior cervical plating with either an asymmetric (8), symmetric (9) or porte manteau (7) construct. Statistically significantly better results (P < 0.05) were achieved with either a symmetric or porte manteau construct. Complications including neurologic deficit and loss of correction were more frequent in the asymmetric group.