本文選題：難復(fù)性寰樞椎脫位　切入點(diǎn)：復(fù)位指數(shù)　出處：《青島大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:評價(jià)矢狀面寰樞關(guān)節(jié)角度和復(fù)位指數(shù)在難復(fù)性寰樞椎脫位的診斷和治療價(jià)值。方法:回顧性分析2008年1月至2014年7月間我院收治的難復(fù)性寰樞椎脫位患者24例。男13例,女11例;年齡20-62歲,平均43歲。根據(jù)手術(shù)方式不同分為兩組:A組:前路松解+后路復(fù)位固定組,B:單純后路復(fù)位固定組,此外,12名頸椎正常個(gè)體為對照組。測量參數(shù)包括:矢狀位寰樞椎關(guān)節(jié)傾斜角、牽引前后寰齒前間距(atlas-dens interval,ADI)并計(jì)算復(fù)位指數(shù)。利用統(tǒng)計(jì)學(xué)軟件對復(fù)位指數(shù)及矢狀位寰樞關(guān)節(jié)傾斜角進(jìn)行對比分析。結(jié)果:對照組平均矢狀位寰樞關(guān)節(jié)面傾斜角:左側(cè)為(5.6±1.9)°,右側(cè)為(5.1±2.1)°;A組:左側(cè)為(38.8±5.8)°,右側(cè)為(39.5±6.0)°;B組:左側(cè)為(23.9±6.1)°,右側(cè)為(23.1±7.0)°。統(tǒng)計(jì)學(xué)分析顯示對照組與A、B兩組以及A和B組矢狀位寰樞關(guān)節(jié)面傾斜角存在統(tǒng)計(jì)學(xué)意義差異(P0.05)。A組平均復(fù)位指數(shù)為(17.6±9.3)%,B組為(34.4±5.2)%,兩組數(shù)據(jù)差異明顯(P0.05)。A、B組矢狀位寰椎傾斜角和復(fù)位指數(shù)間存在明顯負(fù)相關(guān)性,即矢狀位寰椎傾斜角越大,復(fù)位指數(shù)越小。結(jié)論:矢狀位寰樞椎關(guān)節(jié)傾斜角和復(fù)位指數(shù)可作為評價(jià)寰樞椎脫位可復(fù)性程度的重要影像學(xué)指標(biāo)。即復(fù)位指數(shù)27.9%,矢狀位寰椎傾斜角32.5°時(shí),可單純采用后路手術(shù);如復(fù)位指數(shù)27.9%,矢狀位寰椎傾斜角32.5°時(shí),需采用前路松解的前后聯(lián)合手術(shù)。
[Abstract]:Objective: to evaluate the value of sagittal atlantoaxial joint angle and reduction index in the diagnosis and treatment of irreducible atlantoaxial dislocation. 11 female patients, aged 20-62 years, with an average of 43 years old, were divided into two groups according to the different surgical methods: group A: group B: group B: group B: group B: group B: group B: group B: group B: group B: anterior and posterior reduction and fixation; In addition, 12 normal individuals of cervical vertebrae served as control group. The measurement parameters included: sagittal atlantoaxial joint inclination angle, Atlas-dens intervalation before and after traction) and the reduction index was calculated. The reduction index and the atlantoaxial angle of the atlantoaxial joint in the sagittal position were analyzed by statistical software. Results: the average sagittal angle of the atlantoaxial articular surface in the control group: the left side of the atlantoaxial joint. The left side was 5.6 鹵1.9 擄, the right side was 5.1 鹵2.1 擄擄A group: the left side was 38.8 鹵5.8 擄, the right side was 39.5 鹵6.0 擄擄group B: the left side was 23.9 鹵6.1 擄, the right side was 23.1 鹵7.0 擄. Statistical analysis showed that there was a statistical difference between the control group and the AB group, as well as the sagittal atlantoaxial angle in group A and B. The average reduction index was 17.6 鹵9.3% and 34.4 鹵5.2% in group B. There was a significant negative correlation between the sagittal atlas inclination angle and reduction index in the two groups. That is, the sagittal angle of atlas is greater, Conclusion: the sagittal atlantoaxial joint inclination angle and reduction index can be used as an important imaging index to evaluate the degree of atlantoaxial dislocation, that is, when the reduction index is 27.9 and the sagittal angle of atlantoaxial tilt is 32.5 擄, the posterior approach can be used. If the reduction index is 27.9 and the sagittal atlas angle is 32.5 擄, the anterior and posterior decompression should be performed.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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本文編號：1641131