本文選題：椎弓根釘系統(tǒng)　切入點：后路椎間融合術(shù)　出處：《天津醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:針對腰椎滑脫癥患者采用椎弓根釘固定全板減壓椎間融合術(shù)式,通過對比術(shù)中撐開椎間隙高度提拉復(fù)位與不撐開只提拉復(fù)位兩種復(fù)位固定融合術(shù)的術(shù)后臨床效果,觀察恢復(fù)椎間隙生理高度的臨床效果。方法:選取2012年1月-2016年1月期間一組60例L5椎體前滑脫癥(L5/S1間隙滑脫)患者為研究對象,所有患者均經(jīng)X線片、MRI和腰椎CT檢查確診,全部病例均行椎弓根釘固定+全椎板減壓+Cage椎間融合術(shù)治療。按照術(shù)中是否行撐開復(fù)位(恢復(fù)椎間隙高度)操作,病例被分為撐開組(A組)與單純提拉組(B組)2組,每組各30例。其中,撐開組行椎弓根釘系統(tǒng)提拉+撐開復(fù)位+后路減壓椎間融合術(shù)治療,其椎間融合器均選取的為威高公司12mm高度椎間融合器融合;單純提拉組行RF椎弓根釘系統(tǒng)單純提拉復(fù)位+后路減壓椎間融合術(shù)治療,術(shù)中并不做椎間撐開處理,其椎間融合器均為威高公司8mm高度椎間融合器融合。分別記錄兩組患者一般資料及術(shù)前術(shù)后1個月及末次隨訪的VAS\JOA\ODI評分,以及術(shù)后滑脫的矯正程度及骨融合情況,采用Macnab評分臨床療效,制表對比統(tǒng)計學(xué)分析。結(jié)果:術(shù)后1個月及末次隨訪提示,撐開組較單純提拉組在椎間隙高度、椎間隙高度/椎體高度比、椎間孔高度、椎間隙角度及臨床療效評分方面均占優(yōu)勢(P0.05)。結(jié)論:應(yīng)用椎弓根釘固定加后路全椎板減壓椎間融合術(shù)治療腰椎滑脫癥,術(shù)中盡可能恢復(fù)正常椎體間隙高度,有助于恢復(fù)更優(yōu)的脊柱序列,對于改善患者癥狀具有一定優(yōu)勢,且術(shù)中操作不增加難度,可達到更好的術(shù)后效果,推薦臨床首選。
[Abstract]:Objective: to compare the postoperative clinical effect of two kinds of reduction and fixation fusion of lumbar spondylolisthesis patients with lumbar spondylolisthesis by pedicle nail fixation with total plate decompression and interbody fusion. Methods: from January 2012 to January 2016, a group of 60 patients with L5 / S1 space spondylolisthesis from January 2012 to January 2016 were selected as the study subjects. All the patients were confirmed by X-ray MRI and lumbar CT examination. All cases were treated with pedicle screw fixation total laminar decompression and Cage intervertebral fusion. According to the operation of distraction reduction (restoring the height of intervertebral space), the patients were divided into two groups: open group (group A) and simple Czochralski group (group B). There were 30 cases in each group. In the open group, the pedicle screw system was used to treat the posterior decompression interbody fusion. The fusion of interbody fusion cage with 12mm height was selected for the interbody fusion cage of Weigao Company. The RF pedicle screw system was used to treat the posterior decompression and intervertebral fusion in the simple traction group, and the intervertebral distraction was not performed during the operation. The interbody fusion cages were all 8 mm height fusion cage of Vigo Company. The general data of the two groups and the VAS\ JOA\ ODI scores of 1 month and the last follow-up before and after operation were recorded, as well as the degree of correction and bone fusion of the postoperative slippage. Results: 1 month and the last follow-up showed that the height of intervertebral space, the ratio of height of intervertebral space to height of vertebral body, the height of intervertebral foramen, the ratio of height of intervertebral space to height of vertebral body, the ratio of height of intervertebral space to height of vertebral body, and the height of intervertebral foramen in the open group were higher than those in the. Conclusion: pedicle screw fixation and posterior total laminar decompression and intervertebral fusion were used to treat lumbar spondylolisthesis, and the normal height of vertebral space was restored as much as possible during the operation. It is helpful to restore a better spinal sequence, has certain advantages to improve the symptoms of patients, and does not increase the difficulty of operation during operation, and can achieve better postoperative results. The first choice of clinical practice is recommended.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3

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