本文關鍵詞：寰樞椎脫位不同后路融合術對相鄰節(jié)段退變的影響　出處：《中國脊柱脊髓雜志》2017年01期 　論文類型：期刊論文

  更多相關文章： 寰樞椎脫位 寰樞融合術 枕頸融合術 相鄰節(jié)段退變

【摘要】：目的:觀察寰樞椎脫位不同后路融合術對其相鄰節(jié)段退變的影響。方法:2000年6月~2010年6月共納入43例寰樞椎脫位患者,按照后路融合方式分為寰樞融合組(23例)和枕頸融合組(20例)。記錄兩組患者末次隨訪時相鄰節(jié)段C2-3半脫位(SAS)的出現(xiàn)率及活動度,術前及末次隨訪時的C2/3椎間隙高度與C3椎體高度的比值(S值)及C2-7矢狀位角度,并進行統(tǒng)計學比較。結(jié)果:兩組術前的JOA評分、S值及C2-7矢狀位角度差異均無統(tǒng)計學意義(P0.05)。寰樞融合組隨訪時間為7.40±1.51年,枕頸融合組隨訪時間為6.97±1.32年,組間比較無統(tǒng)計學差異(P0.05)。23例行寰樞融合術者出現(xiàn)2例SAS(8.7%),20例行枕頸融合術者出現(xiàn)7例SAS(35%),差異有統(tǒng)計學意義(P0.05)。寰樞融合組和枕頸融合組末次隨訪時S值均較術前減小,枕頸融合組S值減小更明顯,兩組之間差異有統(tǒng)計學意義(P0.05)。末次隨訪時,寰樞融合組及枕頸融合組C2-3活動度分別為3.78°±3.01°和1.45°±1.72°,兩組比較有統(tǒng)計學差異(P0.05)。寰樞融合組C2-7矢狀位角度由術前的15.16°±5.66°降至末次隨訪的12.40°±9.34°,枕頸融合組由術前的15.54°±6.54°降至末次隨訪的-0.22°±12.45°,兩組末次隨訪的C2-7矢狀位角度有統(tǒng)計學差異(P0.05)。結(jié)論:寰樞融合術比枕頸融合術的頸椎相鄰節(jié)段退變發(fā)生率低、程度輕,臨床上應嚴格掌握手術指征,不要輕易行枕頸融合。
[Abstract]:Objective: to observe the effect of different posterior fusion of atlantoaxial dislocation on adjacent segmental degeneration. Methods: from June 2000 to June 2010, 43 patients with atlantoaxial dislocation were included. According to the posterior approach, the patients were divided into atlantoaxial fusion group (n = 23) and occipitocervical fusion group (n = 20). The ratio of C _ 2 / 3 intervertebral space height to C _ 3 vertebral body height and the sagittal angle of C _ 2-7 were compared before and after the last follow-up. Results: the preoperative JOA scores of the two groups were compared. There was no significant difference in S value and C2-7 sagittal angle (P 0.05). The follow-up time of atlantoaxial fusion group was 7.40 鹵1.51 years. The follow-up time of occipitocervical fusion group was 6.97 鹵1.32 years. There was no significant difference between the two groups. In 20 cases of occipitocervical fusion, 7 cases had SASV 35, the difference was statistically significant (P 0.05). The S values of atlantoaxial fusion group and occipitocervical fusion group at the last follow-up were lower than those before operation. The S value of occipitocervical fusion group decreased more obviously, and the difference between the two groups was statistically significant (P 0.05). C2-3 activity of atlantoaxial fusion group and occipitocervical fusion group were 3.78 擄鹵3.01 擄and 1.45 擄鹵1.72 擄, respectively. The sagittal angle of C2-7 in atlantoaxial fusion group decreased from 15.16 擄鹵5.66 擄before operation to 12.40 擄鹵9.34 擄at the last follow-up. The occipitocervical fusion group decreased from 15.54 擄鹵6.54 擄before operation to -0.22 擄鹵12.45 擄at the last follow-up. The C2-7 sagittal angle was significantly different between the two groups. Conclusion: atlantoaxial fusion has lower incidence and less degree of cervical degeneration than occipitocervical fusion. Clinically, we should strictly grasp the surgical indications and do not easily perform occipitocervical fusion.
【作者單位】： 中日友好醫(yī)院脊柱外科;
【基金】：首都臨床特色重大研究項目(編號:Z161100000516009)
【分類號】：R687.3
【正文快照】： 寰樞椎脫位(atlantoaxial dislocation,AAD)常累及延髓生命中樞與椎-基底動脈,可導致嚴重殘疾,甚至威脅生命。常需要通過手術重建其穩(wěn)定性,恢復并保持其生理功能。治療寰樞椎脫位的主要后路手術方式包括枕頸融合術與寰樞融合術。隨著脊柱外科理論與手術技術的提升,目前枕頸融

【參考文獻】

相關期刊論文 前7條

1 王鑫鑫;王利民;王衛(wèi)東;劉屹林;;枕頸融合角度與顱頸交界區(qū)畸形患者下頸椎退變的關系[J];中國組織工程研究;2014年04期

2 張光鉑;;我國上頸椎外科已跨入國際先進行列[J];中國脊柱脊髓雜志;2013年05期

3 譚明生;李顯;董亮;劉楚吟;吳迪;麻昊寧;移平;楊峰;唐向盛;郝慶英;;對我國近20年來寰樞椎脫位外科治療文獻的統(tǒng)計分析[J];中國脊柱脊髓雜志;2013年05期

4 李金泉;龔冰南;徐皓;姚曉東;陳建梅;;寰樞椎融合與頸枕融合治療上頸椎疾患的臨床療效比較[J];中華臨床醫(yī)師雜志(電子版);2013年04期

5 付松;邵詩澤;劉海軍;孫秀琛;侯海濤;王歡;黃相鵬;;枕頸融合與寰樞椎融合治療上頸椎失穩(wěn)癥的療效比較[J];骨科;2012年02期

6 譚明生;張光鉑;王文軍;譚遠超;鄒海波;移平;蔣欣;韋z延，

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