本文選題：頸椎病 + 椎間盤�。� 參考：《第一軍醫(yī)大學(xué)》2005年碩士論文

【摘要】：研究背景: 頸椎間盤是頸椎椎體間主要的堅(jiān)強(qiáng)聯(lián)系與支持結(jié)構(gòu),同時(shí)也是脊柱運(yùn)動(dòng)和吸收振蕩的主要結(jié)構(gòu),能承受身體的重力,將施加于脊柱的載荷吸收并重新分布。頸椎間盤的退變是頸椎病發(fā)病機(jī)理的核心環(huán)節(jié),嚴(yán)重影響了人類健康,其相關(guān)基礎(chǔ)及臨床研究均引起了人們的廣泛興趣。 1928年,Stookey提出頸椎病的概念,認(rèn)為頸椎病是造成脊髓功能障礙的最為常見(jiàn)的原因之一。1956年Clarke和Robinson系統(tǒng)地指出了頸椎病的病理性改變,認(rèn)為頸椎病是由于頸椎間盤退行性變導(dǎo)致各類組織增生,頸脊髓受壓并出現(xiàn)相應(yīng)的病理改變和功能障礙。50年代Robinson和Smith提出從頸椎前方對(duì)突出的椎間盤進(jìn)行摘除,并予以椎體間植骨融合以來(lái),在脊柱外科領(lǐng)域,頸前路減壓和椎間植骨融合術(shù)(anterior cervical decompression and fusion,ACDF)一直是治療頸椎病,尤其是治療脊髓型頸椎病(cervical spondylotic myelopathy,CSM)首選方法,應(yīng)用也最為廣泛,但單節(jié)段或多節(jié)段融合對(duì)頸部活動(dòng)的影響較大,鄰近功能性脊柱單元(functional spine unit,FSU)的生物力學(xué)或者生理學(xué)改變:旋轉(zhuǎn)軸改變,負(fù)荷重新分布,彈性緩沖喪失,功能脊柱單元活動(dòng)度異常增多或者減少,營(yíng)養(yǎng)供應(yīng)不足,加速了相鄰節(jié)段的退變。長(zhǎng)期資料顯示:由于椎間融合所引起的放射形態(tài)學(xué)改變和臨床并發(fā)癥非常明顯。Hilibrand等研究中發(fā)現(xiàn)頸椎融合術(shù)后的患者毗鄰節(jié)段的退變癥狀多有發(fā)生,其中三分之二需要再次手術(shù);Goffin等在其融合后平均8.6年的隨訪中,毗鄰節(jié)段發(fā)生放射學(xué)可見(jiàn)的退行性改變的發(fā)生率為92%。
[Abstract]:Background: Cervical intervertebral disc is the main supporting structure between cervical vertebrae, and it is also the main structure of spine motion and absorption oscillation. It can withstand the gravity of the body, absorb and redistribute the load applied to the spine. The degeneration of cervical intervertebral disc is the core part of the pathogenesis of cervical spondylosis, which seriously affects human health. In 1928, Stookey put forward the concept of cervical spondylosis, which was considered as one of the most common causes of spinal dysfunction. In 1956, Clarke and Robinson systematically pointed out the pathological changes of cervical spondylosis. It is believed that cervical spondylopathy is caused by degeneration of cervical intervertebral disc, cervical spinal cord compression and corresponding pathological changes and dysfunction. In the 1950s Robinson and Smith proposed to remove the herniated intervertebral disc from the front of cervical vertebrae. In the field of spinal surgery, anterior cervical decompression and fusion have been the first choice in the treatment of cervical spondylosis, especially in the treatment of cervical Spondylotic myelopathy. But one or more segments of fusion have a greater effect on cervical activity. Biomechanical or physiological changes in the adjacent functional spinal unit, functional spine unit FSUS, include rotation axis changes, load redistribution, and loss of elastic buffers. The activity of functional spinal unit increased or decreased, and the nutrition supply was insufficient, which accelerated the degeneration of adjacent segments. Long-term data showed that radiomorphologic changes and clinical complications caused by intervertebral fusion were very obvious. Hilibrand and other studies found that degenerative symptoms of adjacent segments occurred in patients after cervical fusion surgery. 2/3 of them needed reoperation and Goffin et al. In the mean follow-up of 8.6 years after fusion, the incidence of radiologically visible degenerative changes in adjacent segments was 92.
【學(xué)位授予單位】：第一軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2005
【分類號(hào)】：R687.3;R322

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本文編號(hào)：1901743