本文選題：單側(cè)固定　切入點(diǎn)：Cage植骨融合　出處：《南華大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討單側(cè)椎弓根螺釘固定結(jié)合椎間Cage植骨融合術(shù)對(duì)融合節(jié)段對(duì)側(cè)小關(guān)節(jié)突形態(tài)的影響。方法通過收集我院脊柱外科2012年12月至2013年12月收治的L4/L5節(jié)段已行腰椎后路單側(cè)椎弓根螺釘固定結(jié)合單枚Cage椎間融合手術(shù)的腰椎退行性疾病30例患者資料進(jìn)行回顧性分析。調(diào)出患者術(shù)前及術(shù)后CT數(shù)據(jù),利用CT測(cè)量軟件平行于L5椎體上終板層面測(cè)量L4/L5節(jié)段手術(shù)對(duì)側(cè)小關(guān)節(jié)角的大小以及小關(guān)節(jié)突橫徑距離,所采集數(shù)據(jù)利用統(tǒng)計(jì)學(xué)軟件進(jìn)行分析,同時(shí)采用日本矯形外科學(xué)會(huì)所采用(JOA)應(yīng)用評(píng)分和VAS疼痛視覺模擬評(píng)分法評(píng)價(jià)術(shù)后患者腰骶部疼痛較術(shù)前有無明顯減輕及術(shù)后療效。結(jié)果1.小關(guān)節(jié)角度在術(shù)前為(42.61±5.75)度,術(shù)后為(42.85±5.394)度,P0.05,無統(tǒng)計(jì)學(xué)意義,故認(rèn)為小關(guān)節(jié)角度在術(shù)前和術(shù)后沒有明顯變化。2.小關(guān)節(jié)橫徑在術(shù)前為(15.60±1.01)mm,術(shù)后為(15.89±1.48)mm,P0.05,無統(tǒng)計(jì)學(xué)意義。故認(rèn)為小關(guān)節(jié)橫徑在術(shù)前和術(shù)后沒有明顯變化。3.VAS視覺模擬評(píng)分結(jié)果:術(shù)前VAS評(píng)分為(5.26±1.02),術(shù)后1周、6個(gè)月、12個(gè)月的VAS評(píng)分依次為(1.85±0.26)、(1.6±0.23)、(0.85±0.08),術(shù)后VAS評(píng)分明顯低于術(shù)前,P0.05,具有統(tǒng)計(jì)學(xué)意義。術(shù)后腰骶部疼痛較術(shù)前明顯緩解。4.由JOA評(píng)分結(jié)果可知,所有患者術(shù)前JOA評(píng)分為(10.47±1.36),術(shù)后1周、6個(gè)月、12個(gè)月的JOA評(píng)分依次為(21.77±1.55)、(23.58±1.58)、(23.64±1.80),術(shù)后患者JOA評(píng)分結(jié)果明顯高于術(shù)前評(píng)分,P0.05,具有統(tǒng)計(jì)學(xué)意義。結(jié)論1、單側(cè)椎弓根螺釘固定結(jié)合Cage椎間融合術(shù)對(duì)融合節(jié)段對(duì)側(cè)小關(guān)節(jié)面角及小關(guān)節(jié)橫徑無明顯影響。2、單側(cè)椎弓根螺釘固定結(jié)合Cage椎間融合術(shù)對(duì)小關(guān)節(jié)形態(tài)的改變與腰骶部疼痛無明顯的關(guān)系。3、單側(cè)椎弓根螺釘固定結(jié)合單枚Cage椎間融合術(shù)是臨床上治療退行性腰椎病變中較經(jīng)濟(jì)且療效確切的一種手術(shù)方式。
[Abstract]:Objective to investigate the effect of unilateral pedicle screw fixation combined with intervertebral Cage bone grafting and fusion on the morphology of the facet facet process in the contralateral facet of fusion. Methods L4 / L5 segment of spinal surgery admitted to our hospital from December 2012 to December 2013 was collected from December 2012 to December 2013. The data of 30 patients with lumbar degenerative diseases treated by posterior unilateral pedicle screw fixation and single Cage fusion surgery were retrospectively analyzed. The lateral facet angle of L4 / L5 segment was measured by using CT measurement software parallel to the upper end plate of L5 vertebrae, and the distance of facet facet transverse diameter was measured. The collected data were analyzed by statistical software. At the same time, the Japanese Orthopedic Surgical Association (JOAA) score and VAS pain visual analogue score were used to evaluate the postoperative lumbosacral pain and the postoperative curative effect. Results 1. The facet joint angle was 42.61 鹵5.75 degrees before operation. The postoperative value was 42.85 鹵5.394 degrees (P 0.05), no significant difference was found between the two groups. It is concluded that the facet joint angle does not change significantly before and after operation. The transverse diameter of facet joint is 15.60 鹵1.01 mm before operation and 15.89 鹵1.48 mm / mm after operation (P 0.05). It is considered that the transverse diameter of facet joint does not change significantly before and after operation .3.VAS visual analogue score (VAS). Results: the preoperative VAS score was 5.26 鹵1.02g, and the VAS score of 1 week, 6 months and 12 months postoperatively was 1.85 鹵0.26 and 0.85 鹵0.08, respectively. The postoperative VAS score was significantly lower than that before operation (P 0.05), and the postoperative lumbosacral pain was significantly relieved than that before operation. The preoperative JOA score of all patients was 10.47 鹵1.36, and the JOA scores of 1 week, 6 months and 12 months after operation were 21.77 鹵1.55 and 23.64 鹵1.80, respectively. The JOA score of all patients after operation was significantly higher than that of preoperative score (P 0.05). Conclusion 1. Unilateral pedicle screw fixation combined with Cage is significantly higher than that of preoperative score (P < 0.05). Intervertebral fusion had no significant effect on facet angle and transverse diameter of facet joint, and unilateral pedicle screw fixation combined with Cage intervertebral fusion had no significant relationship with lumbosacral pain. Pedicle screw fixation combined with single Cage interbody fusion is an economical and effective method for the treatment of degenerative lumbar disease.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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相關(guān)期刊論文 前1條

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本文編號(hào)：1637363