本文選題：頸椎病 + 顯微鏡椎間盤摘除術(shù)��； 參考：《遵義醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過(guò)對(duì)比直視下頸前路手術(shù),探討顯微鏡下行前路頸椎間盤摘除cage植骨融合鈦板內(nèi)固定術(shù)治療頸椎病的優(yōu)點(diǎn)。方法:對(duì)2009年-2016年大連大學(xué)附屬中山醫(yī)院骨三科行手術(shù)治療的符合入選標(biāo)準(zhǔn)的156例頸椎病的臨床資料進(jìn)行回顧性分析。按手術(shù)方式分為顯微鏡手術(shù)組(A組)108例及開(kāi)放手術(shù)組(B組)48例。(1)比較兩組患者在性別、年齡、病變節(jié)段構(gòu)成、術(shù)前Cobb角度、體質(zhì)指數(shù)(BMI)、JOA評(píng)分、頸部及上肢VAS評(píng)分、NDI評(píng)分,明確兩組患者是否具備可比性;(2)比較兩組患者手術(shù)切口長(zhǎng)度、手術(shù)時(shí)間、術(shù)中出血量、術(shù)后并發(fā)癥、住院時(shí)間是否存在差異;(3)比較兩組患者術(shù)前及術(shù)后JOA評(píng)分、頸部及上肢VAS評(píng)分、NDI評(píng)分、影像學(xué)表現(xiàn)(融合節(jié)段椎間隙高度、Cobb角度)等指標(biāo)判定臨床療效。結(jié)果:(1)兩組患者在性別、年齡、病變節(jié)段構(gòu)成、術(shù)前Cobb角度、BMI、JOA評(píng)分、頸部及上肢VAS評(píng)分、NDI評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),兩組具備可比性;(2)A組患者與B組患者比較,手術(shù)切口長(zhǎng)度更短、手術(shù)時(shí)間更短、術(shù)中出血量更少、術(shù)后并發(fā)癥發(fā)生率更低、住院時(shí)間更短(P0.05);(3)兩組患者術(shù)后JOA評(píng)分、頸部及上肢VAS評(píng)分、NDI評(píng)分、影像學(xué)表現(xiàn)(融合節(jié)段椎間隙高度、Cobb角度)均較術(shù)前明顯改善(P0.05),兩組術(shù)后JOA評(píng)分、頸部及上肢VAS評(píng)分、NDI評(píng)分、影像學(xué)表現(xiàn)(融合節(jié)段椎間隙高度、Cobb角度)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:應(yīng)用顯微鏡行頸前路融合手術(shù)與直視下頸椎前路融合手術(shù)治療頸椎病均可取得良好的治療效果,顯微鏡下手術(shù)具有切口小、損傷小、出血少、術(shù)后并發(fā)癥的發(fā)生率低、住院時(shí)間短的優(yōu)點(diǎn),且近期療效更滿意。
[Abstract]:Objective: to investigate the advantages of anterior cervical intervertebral disc removal (cage) and fusion titanium plate fixation under direct vision for cervical spondylosis.Methods: the clinical data of 156 patients with cervical spondylosis who were treated by surgery in three departments of Zhongshan Hospital affiliated to Dalian University from 2009 to 2016 were analyzed retrospectively.According to the operation mode, 108 patients were divided into two groups: group A (n = 108) and group B (n = 48). Sex, age, pathological segment composition, preoperative Cobb angle, body mass index (BMI) and VAS score of neck and upper extremity were compared.To compare the operative incision length, operation time, intraoperative bleeding volume, postoperative complications and hospitalization time between the two groups, and to compare the JOA scores between the two groups before and after operation.Cervical and upper limb VAS scores and imaging findings (fusion height of intervertebral space and Cobb angle) were used to evaluate the clinical efficacy.The length of incision was shorter, the operative time was shorter, the amount of intraoperative bleeding was less, the incidence of postoperative complications was lower, and the hospitalization time was shorter (P0.05).There was no significant difference between the two groups in JOA score, neck and upper extremity VAS score, and the imaging manifestation (fusion level of intervertebral space height and Cobb angle) between the two groups (P 0.05), and there was no significant difference between the two groups in the imaging manifestations (fusion segment height of intervertebral space and Cobb angle) before and after operation (P 0.05).Conclusion: the treatment of cervical spondylosis by anterior cervical fusion under microscope and anterior fusion of cervical vertebrae under direct vision can achieve good results. The operation under microscope has the advantages of small incision, little injury, less bleeding, and low incidence of postoperative complications.The advantages of short hospital stay are more satisfactory in the near future.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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1 冉春梟;顯微鏡下前路頸椎手術(shù)與傳統(tǒng)開(kāi)放前路頸椎手術(shù)治療頸椎病臨床對(duì)比分析[D];遵義醫(yī)學(xué)院;2017年

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