本文選題：寰樞關(guān)節(jié) + 椎動(dòng)脈　； 參考：《青島大學(xué)》2014年碩士論文

【摘要】：目的：探討經(jīng)頸后正中入路一次完成寰樞關(guān)節(jié)松解、復(fù)位、內(nèi)固定融合治療難復(fù)性寰樞椎脫位的理論可行性。 方法： 1.通過(guò)MRI對(duì)實(shí)驗(yàn)動(dòng)物術(shù)前及術(shù)后各時(shí)間寰椎上緣至樞椎下緣脊髓進(jìn)行掃描,測(cè)量各時(shí)間段脊髓面積的大小和矢狀面圖像上T1WI、T2WI相對(duì)信號(hào)強(qiáng)度,并對(duì)各時(shí)間段測(cè)量數(shù)據(jù)進(jìn)行對(duì)比分析。 2.根據(jù)2012年3月—2013年3月行頸部CT血管造影并符合入選標(biāo)準(zhǔn)的227例患者掃描數(shù)據(jù),對(duì)椎動(dòng)脈寰樞關(guān)節(jié)部的走形與變異、寰椎下關(guān)節(jié)面部骨性結(jié)構(gòu)、樞椎上關(guān)節(jié)面部骨性結(jié)構(gòu)進(jìn)行三維測(cè)量與分析。 結(jié)果： 1.實(shí)驗(yàn)動(dòng)物術(shù)前脊髓面積,T1WI、T2WI相對(duì)信號(hào)強(qiáng)度與術(shù)后各時(shí)間相比較均無(wú)顯著性差異(P0.01)。 2.椎動(dòng)脈在寰樞外側(cè)關(guān)節(jié)部常形成4個(gè)恒定連續(xù)的彎曲及存在4種變異類型。左右側(cè)寰樞外側(cè)關(guān)節(jié)部椎動(dòng)脈直徑、椎動(dòng)脈溝底部后弓的寬度和高度、樞椎上關(guān)節(jié)面外傾角、橫突孔外傾角及椎動(dòng)脈壓痕比較,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論： 1.結(jié)扎實(shí)驗(yàn)動(dòng)物寰樞外側(cè)關(guān)節(jié)部靜脈叢前后,不影響寰椎上緣至樞椎下緣脊髓血供,不會(huì)引起脊髓損傷的發(fā)生。 2.通過(guò)頸部血管CT及三維重建對(duì)寰樞外側(cè)關(guān)節(jié)部結(jié)構(gòu)的觀察和測(cè)量,可以為經(jīng)頸后正中入路行寰樞外側(cè)關(guān)節(jié)部松解、復(fù)位、內(nèi)固定融合提供理論依據(jù)。
[Abstract]:Objective: to investigate the theoretical feasibility of atlantoaxial joint release, reduction and internal fixation fusion in the treatment of irreducible atlantoaxial dislocation through the posterior cervical approach. Methods: 1. The spinal cord from the upper edge of atlas to the lower edge of axis was scanned by MRI before and after operation. The size of the spinal cord and the relative signal intensity of T1WIN T2WI on sagittal images were measured in each time period, and the measured data were compared and analyzed. 2. According to the scanning data of 227 patients with cervical CT angiography performed from March 2012 to March 2013, the shape and variation of atlantoaxial joint of vertebral artery and the facial bone structure of inferior atlas joint were studied. The facial bone structure of superior articular axis was measured and analyzed. Results: 1. There was no significant difference in the relative signal intensity of T _ 1WI ~ T _ 2WI between the preoperative spinal cord area and the postoperative time. 2. Vertebral arteries often form four constant contiguous bends and four types of variation in the lateral atlantoaxial joint. The diameter of the lateral atlantoaxial joint, the width and height of the posterior arch at the bottom of the sulcus of the vertebral artery, the external inclination angle of the superior articular surface of the axis, the external inclination angle of the transverse foramen and the indentation of the vertebral artery were all significantly different (P 0.05). Conclusion: 1. Ligation of the venous plexus of the lateral atlantoaxial joint did not affect the blood supply of the upper edge of the atlas to the lower edge of the axis and would not cause spinal cord injury. 2. The observation and measurement of atlantoaxial lateral joint structure by CT and 3D reconstruction of cervical vessels can provide theoretical basis for atlantoaxial lateral articular release reduction and internal fixation fusion through the posterior cervical approach.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R687.4;R445.2

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