本文關(guān)鍵詞： 雜交式 融合 三個階段 前路 頸椎病　出處：《吉林大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 回顧性研究以評價前路雜交式（ACCF聯(lián)合ACDF）融合的手術(shù)方案治療多節(jié)段頸椎病的臨床療效。 方法： 對自2012年3月至2014年6月11例多節(jié)段病變的頸椎病患者采用前路雜交式（主要病變節(jié)段椎體次全切、次要節(jié)段單純間盤摘除、鈦籠植骨、Cage撐開、鋼板固定）融合手術(shù)方案治療，分析患者年齡、手術(shù)時間、術(shù)中出血量、病變節(jié)段、融合節(jié)段Cobb角、比較術(shù)前術(shù)后JOA評分，計(jì)算改善率，影像學(xué)資料衡量術(shù)后內(nèi)固定狀況與愈合情況，以及有無嚴(yán)重并發(fā)癥發(fā)生。 結(jié)果： 隨訪時間8至24個月，平均隨訪時間15個月，術(shù)后JOA評分較術(shù)前提高，改善率優(yōu)良，平均手術(shù)時間，術(shù)中平均出血量；采用前路雜交式融合的手術(shù)方案術(shù)后未出現(xiàn)C5神經(jīng)根刺激征、硬膜囊破裂、神經(jīng)功能惡化等嚴(yán)重并發(fā)癥，隨訪過程中無植骨塊延期愈合、內(nèi)固定物下沉等并發(fā)癥發(fā)生；至末次隨訪，未出現(xiàn)椎體坍塌、內(nèi)固定失敗等嚴(yán)重并發(fā)癥，1例在末次隨訪中出現(xiàn)鄰近節(jié)段退變，但未出現(xiàn)脊髓壓迫癥狀及不適主訴，隨訪過程中復(fù)查X線片、CT證實(shí)植骨愈合良好。 結(jié)論: 前路雜交式（ACCF聯(lián)合ACDF）融合手術(shù)方案是治療多節(jié)段頸椎病的一種可供選擇的較理想手術(shù)方案。
[Abstract]:Objective:. A retrospective study was conducted to evaluate the clinical efficacy of anterior hybrid ACCF combined with ACDF fusion in the treatment of multilevel cervical spondylosis. Methods:. From March 2012 to June 11th 2014, patients with cervical spondylopathy with multiple segmental lesions were treated with anterior hybridization (subtotal dissection of the main lesions, simple dissecting of the secondary segments, and cage bone graft Cage). Age, operation time, intraoperative bleeding volume, lesion segment and Cobb angle of fusion segment were analyzed. The JOA score before and after operation was compared, and the improvement rate was calculated. Imaging data were used to measure the internal fixation and healing, and the occurrence of severe complications. Results:. The follow-up time was 8 to 24 months, the average follow-up time was 15 months, the postoperative JOA score was higher than that before operation, the improvement rate was good, the average operation time and the average amount of blood loss during operation were improved. There were no serious complications such as C5 nerve root irritation, dural sac rupture, nerve function deterioration, etc. During the follow-up, there were no complications such as delayed healing of bone graft and sinking of internal fixation. At the last follow-up, there was no vertebral collapse, one case with severe complications such as failure of internal fixation and adjacent segment degeneration, but no symptoms of spinal cord compression and discomfort. During follow-up, X-ray film and CT confirmed good union of bone graft. Conclusion:. Anterior hybrid ACCF combined with ACDF fusion surgery is an ideal alternative for the treatment of multilevel cervical spondylosis.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.32

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