本文選題：經(jīng)口咽前路 + 顱頸交界區(qū)��； 參考：《第一軍醫(yī)大學(xué)》2005年碩士論文

【摘要】：背景 寰樞椎的畸形、損傷、炎癥和腫瘤均可使正常的解剖結(jié)構(gòu)出現(xiàn)異常,失去穩(wěn)定性,造成寰樞椎脫位,出現(xiàn)急性脊髓損傷,危及生命,也可以漸進(jìn)性發(fā)展成為慢性高位頸脊髓病,往往需要進(jìn)行外科治療。以往寰樞椎不穩(wěn)的固定方法均為進(jìn)行后路手術(shù)。但是后入路手術(shù)無法解決難復(fù)性寰樞椎脫位伴脊髓壓迫的患者的復(fù)位問題,對(duì)于此類患者,目前常規(guī)的治療方法是先行經(jīng)口前路齒突切除及瘢痕松解,然后再?gòu)难雠P體位變?yōu)楦┡P位行后路固定,而在此過程中有可能會(huì)因脊柱的低穩(wěn)定性造成對(duì)脊髓致命的損傷。我科尹慶水主任設(shè)計(jì)、研制并開發(fā)成功了寰樞椎即時(shí)復(fù)位鋼板系統(tǒng)(transoralphatyngeal atlantoaxial reduction plate, TARP),在經(jīng)口前路顯露下進(jìn)行松解、減壓后,用特制的器械將脫位的寰椎進(jìn)行復(fù)位,恢復(fù)正常的寰樞解剖關(guān)系,創(chuàng)造性的將前路減壓、復(fù)位和寰樞融合固定一次性完成,避免了因翻身過程造成對(duì)脊髓的損傷和后路手術(shù)的創(chuàng)傷,在該領(lǐng)域取得重大突破。然而,目前關(guān)于寰樞椎經(jīng)口鋼板和C1、C2前方結(jié)構(gòu)應(yīng)用解剖方面鮮有報(bào)道。該項(xiàng)研究旨在給寰樞椎即時(shí)復(fù)位鋼板系統(tǒng)手術(shù)提供解剖依據(jù),起到使顯露更為有效,復(fù)位更順利,避免血管神經(jīng)的損傷,縮短手術(shù)時(shí)間的作用。 顱頸交界區(qū)(craniovertebral junction,CVJ)包括斜坡、枕骨大孔、寰椎和樞椎,毗鄰上呼吸消化道、腦干、多對(duì)腦神經(jīng)、頸內(nèi)動(dòng)脈、椎基底動(dòng)脈等重要
[Abstract]:Background Atlantoaxial malformations, injuries, inflammation and tumors can make normal anatomical structure abnormal, lose stability, cause atlantoaxial dislocation, acute spinal cord injury and life-threatening. It can also develop progressively into chronic high cervical myelopathy, often requiring surgical treatment. The previous fixation of atlantoaxial instability was performed by posterior approach. However, posterior approach cannot solve the problem of reduction in patients with intractable atlantoaxial dislocation with spinal cord compression. Then the supine position is changed to the prone position with posterior fixation, which may result in fatal spinal cord injury due to the low stability of the spine. Director Yin Qingshui of our department designed, developed and developed the atlantoaxial immediate reduction plate system, transormal phatyngeal atlantoaxial reduction plate, Tarp, which was released through the anterior approach of the mouth. After decompression, the dislocated atlas was reduced with a specially made instrument. Restoration of normal atlantoaxial anatomical relationship, creative anterior decompression, reduction and atlantoaxial fusion fixation can avoid the injury of spinal cord caused by the process of turning over, and make a great breakthrough in this field. However, there are few reports on applied anatomy of atlantoaxial transoral plate and C _ 1 C _ 2 anterior structure. The aim of this study is to provide anatomical evidence for the immediate reduction of the atlantoaxial plate system, so as to make the exposure more effective, the reduction more smooth, and to avoid the injury of the blood vessels and nerves. Craniovertebral junction (CVJ) includes Clivus, foramen magnum, atlas and axis, adjacent upper respiratory tract, brain stem, cranial nerve, internal carotid artery, vertebrobasilar artery, etc.
【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;R322

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本文編號(hào)：2003845