本文選題：顱底凹陷癥 + 寰樞椎脫位　； 參考：《中國(guó)脊柱脊髓雜志》2017年01期

【摘要】：目的:評(píng)估顱底凹陷癥(basilar invagination,BI)合并寰樞椎脫位(atlantoaxial dislocation,AAD)患者枕頸角(O-C2角)與下頸椎曲度(C2-7 Cobb角)之間的關(guān)系。方法:回顧性分析2009年1月~2013年6月21例于我院因BI合并AAD行后路復(fù)位枕頸融合術(shù)患者的臨床資料。21例患者中男12例,女9例;年齡21~65歲(41.6±10.7歲);病程4個(gè)月~18年(4.3±3.9年)。于手術(shù)前和術(shù)后末次隨訪時(shí)在頸椎中立位側(cè)位X線片上測(cè)量O-C2及C2-7 Cobb角(C2-7角),并計(jì)算O-C2角及C2-7角的變化量dO-C2角和dC2-7角,前凸為“+”值,后凸為值。根據(jù)O-C2角的大小,將21例患者術(shù)前和末次隨訪時(shí)分為10°≤O-C2角≤20°組、O-C2角10°組及O-C2角20°組。觀測(cè)手術(shù)前后不同O-C2角組C2-7角的差異,分析手術(shù)前后O-C2角與C2-7角的相關(guān)性。結(jié)果:21例患者中,12例患者固定節(jié)段為C0-C3,9例患者為C0-C4。隨訪時(shí)間為10~32個(gè)月(18.3±6.6個(gè)月)。術(shù)后末次隨訪時(shí)O-C2角較術(shù)前平均增大6.3°,C2-7角較術(shù)前平均減小6°,手術(shù)前后兩指標(biāo)比較均存在顯著性差異(P0.05)。術(shù)前6例(28.6%)患者O-C2角在10°~20°間,12例(57.1%)10°,3例(14.3%)20°。OC2角10°組C2-7角顯著大于O-C2角10°~20°組及20°組(P0.05),O-C2角10°~20°組與20°組比較無顯著性差異(P0.05)。末次隨訪時(shí)10例(47.6%)患者O-C2角在10°~20°間,4例(19.0%)20°,7例(33.4%)10°,O-C2角20°組C2-7角顯著小于O-C2角10°~20°組及10°組(P0.05),O-C2角10°~20°組與10°組比較無顯著性差異(P0.05)。術(shù)前及術(shù)后末次隨訪時(shí)O-C2角與C2-7角均存在顯著性負(fù)相關(guān)(術(shù)前r=-0.732,P0.05;術(shù)后r=-0.603,P0.05);d0-C2角及dC2-7角亦存在顯著性負(fù)相關(guān)(r=-0.721,P0.05)。結(jié)論:BI合并AAD患者枕頸角與下頸椎曲度關(guān)系密切,行后路復(fù)位枕頸融合術(shù)時(shí)需監(jiān)測(cè)枕頸角的固定角度,若枕頸角過大有可能導(dǎo)致術(shù)后下頸椎曲度出現(xiàn)代償性減小。
[Abstract]:Objective: to evaluate the relationship between basilar invagination (BI) and occipitocervical angle (O-C2) and lower cervical curvature (C2-7 Cobb) in patients with atlantoaxial dislocation.Methods: the clinical data of 21 patients who underwent posterior reduction of occipitocervical fusion in our hospital with AAD from January 2009 to June 2013 were analyzed retrospectively. There were 12 males and 9 females, aged from 21 to 65 years old, 41.6 鹵10.7 years old and 4 months to 18 years, 4.3 鹵3.9 years.The changes of O-C2 and C2-7 Cobb angle C2-7 angle were measured before operation and at the last follow-up after operation. The dO-C2 angle and dC2-7 angle of O-C2 angle and C2-7 angle were calculated. The kyphoid angle was "" and "kyphosis" value.According to the size of O-C2 angle, 21 patients were divided into 10 擄鈮，

本文編號(hào)：1768195