本文選題：寰樞關節(jié) + 椎動脈�。� 參考：《青島大學》2014年碩士論文

【摘要】：目的：探討經頸后正中入路一次完成寰樞關節(jié)松解、復位、內固定融合治療難復性寰樞椎脫位的理論可行性。 方法： 1.通過MRI對實驗動物術前及術后各時間寰椎上緣至樞椎下緣脊髓進行掃描,測量各時間段脊髓面積的大小和矢狀面圖像上T1WI、T2WI相對信號強度,并對各時間段測量數(shù)據(jù)進行對比分析。 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準的227例患者掃描數(shù)據(jù),對椎動脈寰樞關節(jié)部的走形與變異、寰椎下關節(jié)面部骨性結構、樞椎上關節(jié)面部骨性結構進行三維測量與分析。 結果： 1.實驗動物術前脊髓面積,T1WI、T2WI相對信號強度與術后各時間相比較均無顯著性差異(P0.01)。 2.椎動脈在寰樞外側關節(jié)部常形成4個恒定連續(xù)的彎曲及存在4種變異類型。左右側寰樞外側關節(jié)部椎動脈直徑、椎動脈溝底部后弓的寬度和高度、樞椎上關節(jié)面外傾角、橫突孔外傾角及椎動脈壓痕比較,差異均具有統(tǒng)計學意義(P0.05)。 結論： 1.結扎實驗動物寰樞外側關節(jié)部靜脈叢前后,不影響寰椎上緣至樞椎下緣脊髓血供,不會引起脊髓損傷的發(fā)生。 2.通過頸部血管CT及三維重建對寰樞外側關節(jié)部結構的觀察和測量,可以為經頸后正中入路行寰樞外側關節(jié)部松解、復位、內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.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R687.4;R445.2

【參考文獻】

相關期刊論文 前10條

1 馬向陽,鐘世鎮(zhèn),劉景發(fā),尹慶水,徐達傳,彭成宏;寰椎椎弓根螺釘進釘點的解剖定位研究[J];骨與關節(jié)損傷雜志;2003年10期

2 劉偉;宋滇文;嚴望軍;馬君;賈連順;;寰樞椎椎弓根螺釘固定技術治療陳舊性難復性寰樞椎前脫位[J];中國骨與關節(jié)損傷雜志;2009年06期

3 王紹武;脊髓損傷的MRI臨床應用近展[J];國外醫(yī)學(臨床放射學分冊);1998年01期

4 陳前芬;金大地;肖增明;張忠民;閻慧博;;寰樞椎椎弓根螺釘技術的應用解剖研究[J];廣西醫(yī)科大學學報;2009年03期

5 蔡斌;王文軍;;寰樞椎前路內固定術的研究進展[J];醫(yī)學臨床研究;2008年01期

6 陳莊洪;蔡賢華;黃衛(wèi)兵;黃繼鋒;徐峰;劉曦明;王慶;;前路經寰樞關節(jié)螺釘內固定術治療創(chuàng)傷性寰樞椎不穩(wěn)定(附14例療效觀察)[J];華中醫(yī)學雜志;2008年05期

7 童杰;劉社庭;劉曉嵐;房佐忠;譚震;胡文軍;蘭圖;;一期前路松解后路椎弓根釘固定融合治療難復性寰樞椎脫位[J];頸腰痛雜志;2011年04期

8 尹慶水;夏虹;王建華;;寰樞椎脫位治療的現(xiàn)狀與展望[J];脊柱外科雜志;2011年03期

9 王建華;尹慶水;夏虹;吳增輝;馬向陽;艾福志;章凱;;數(shù)字骨科技術在寰樞椎個體化置釘手術中的應用[J];脊柱外科雜志;2011年03期

10 艾福志;尹慶水;夏虹;張宇;萬磊;;數(shù)字骨科技術在顱頸交界疾患外科治療中的臨床應用[J];脊柱外科雜志;2011年03期

，

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