本文選題：頸椎前路手術(shù) + 自體髂骨　； 參考：《吉林大學(xué)》2015年碩士論文

【摘要】：目的：闡述兩種頸椎前路手術(shù)對單節(jié)段頸椎病患者愈后的影響。 方法：回顧2012年7月至2014年6月單節(jié)段頸椎病患者55名，分為A、B兩組。其中A組(頸椎前路間盤摘除同種異體骨墊植入鎖定鋼板螺絲釘內(nèi)固定)43名患者，其中男25例，女18例，年齡34-68歲，，平均年齡51.4歲；B組(頸椎前路間盤摘除自體髂骨植入鎖定鋼板螺絲釘內(nèi)固定)12名患者，其中男7例，女5例；年齡為42-71歲，平均年齡為57.7歲；臨床療效評估采用：對患者手術(shù)的時(shí)間、手術(shù)出血量、術(shù)后并發(fā)癥、頸椎融合情況、頸椎融合節(jié)段椎體前后高度改變（HAB、HPB）、頸椎曲度改變(應(yīng)用D值、cobb角)、鋼板及鈦網(wǎng)的位置是否改變、神經(jīng)功能改善（采用mJOA評分）及生活質(zhì)量狀況（應(yīng)用SF-36量表）進(jìn)行統(tǒng)計(jì)對比。 結(jié)果：術(shù)后隨訪時(shí)間為9-18個(gè)月，平均隨訪時(shí)間12個(gè)月，A組與B組手術(shù)時(shí)間、手術(shù)出血量、HAB及HPB、D值及cobb角改變有統(tǒng)計(jì)學(xué)意義(P＜0.05)；而A組與B組椎體融合率、mJOA評分無統(tǒng)計(jì)學(xué)意義(P＞0.05)；兩組均未發(fā)生鈦網(wǎng)或（及）鋼板位置的改變；B組有7例患者出現(xiàn)髂骨取骨處疼痛；通過SF-36量表分析，對兩組患者進(jìn)行生活質(zhì)量評估發(fā)現(xiàn),文化程度、職業(yè)、醫(yī)療費(fèi)用來源是影響其手術(shù)方式選擇的主要因素。 結(jié)論： 1.兩種頸椎前路手術(shù)治療單節(jié)段頸椎病椎體融合率相當(dāng)，取髂骨可增加手術(shù)時(shí)間及手術(shù)出血量； 2.取髂骨組與骨墊組比較，前者HAB、HPB、D值、cobb角改變較明顯；兩組HAB、HPB、D值及cobb角均在術(shù)后3個(gè)月內(nèi)變化幅度較大；術(shù)后3個(gè)月后HAB、HPB、D值及cobb角兩組均趨于穩(wěn)定； 3.在一定時(shí)期內(nèi)相同階段，兩種手術(shù)頸椎融合率、HAB及HPB減小、D值及cobb角改變與mJOA評分無明確相關(guān)性，但其遠(yuǎn)期相關(guān)性有待進(jìn)一步研究； 4.頸椎前路手術(shù)應(yīng)用同種異體骨墊與自體髂骨治療頸椎病均能使神經(jīng)功能得到明顯改善，文化程度、職業(yè)、醫(yī)療費(fèi)用來源是影響其手術(shù)方式選擇的主要因素；
[Abstract]:Objective: to study the effect of two kinds of anterior cervical surgery on the recovery of patients with single cervical spondylosis.Methods: from July 2012 to June 2014, 55 patients with single cervical spondylosis were divided into two groups.In group A, 43 patients (25 males and 18 females aged 34 to 68 years old) were treated with locking plate screw fixation, including 25 males and 18 females.The average age of group B was 51.4 years old (12 patients (7 males and 5 females) with internal fixation of locking plate screw, 42-71 years old, with an average age of 57.7 years).The time of operation, the amount of blood loss, postoperative complications and cervical fusion were evaluated.The changes of anterior and posterior height of cervical fusion segment, cervical curvature (using D value of cobb angle, the position of plate and titanium mesh), the improvement of nerve function (mJOA score) and the quality of life (SF-36 scale) were compared statistically.Results: the follow-up time was 9-18 months, and the average follow-up time was 12 months.There were significant changes in Hab and HPBG D and cobb angle between group A and group B (P < 0.05), but there was no significant difference in spinal fusion rate between group A and group B (P > 0.05), and there was no change in titanium mesh or / or plate position in group B (n = 7).Pain at iliac bone extraction;The quality of life (QOL) of the two groups of patients was evaluated by SF-36 scale. It was found that the educational level, occupation and source of medical expenses were the main factors affecting the choice of operation mode.Conclusion:1.The fusion rate of the two anterior cervical vertebrae for single cervical spondylosis was similar, and the operation time and the amount of blood loss could be increased by iliac bone extraction.2.In the iliac bone group and the bone pad group, the cobb angle and the cobb angle of the two groups changed more obviously than those of the bone pad group, and the cobb angle and the cobb angle of the two groups tended to be stable 3 months after operation.3.At the same stage in a certain period, there was no clear correlation between the rate of cervical fusion and the decrease of D value of HPB and the change of cobb angle with mJOA score, but the long-term correlation of the two operations needed to be further studied.4.Anterior cervical surgery with allogeneic bone pad and autogenous iliac bone for cervical spondylopathy can significantly improve the neurological function, education level, occupation, medical expenses are the main factors affecting the choice of surgical methods.
【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】：R687.3

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