本文選題：頸椎后路雙開門 + 頸椎矢狀面平衡�。� 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:通過對(duì)術(shù)前T1斜坡角與術(shù)后頸椎曲度相關(guān)參數(shù)的測(cè)量,探索T1斜坡角對(duì)頸后路雙開門椎管擴(kuò)大成形術(shù)后頸椎曲度變化的影響。方法:對(duì)吉林大學(xué)中日聯(lián)誼醫(yī)院2014年至2016年期間48例因脊髓型頸椎病行頸3-6后路雙開門椎管擴(kuò)大成形術(shù)患者的臨床及影像學(xué)資料進(jìn)行回顧性分析。測(cè)量術(shù)前站立位及維持視線水平時(shí)T1椎體上緣與水平線的夾角(T1-Slope),比較術(shù)前及末次隨訪時(shí)站立位及維持視線水平時(shí)側(cè)位片X線上C2及頸C7椎體下緣垂線的夾角(Cobb角)。結(jié)果:隨訪平均14.6(12-18)個(gè)月,患者Cobb C2-7由術(shù)前(14.43±4.24)°減小到(8.18±3.01)°,術(shù)前T1-S與術(shù)前Cobb C2-7大小呈正相關(guān)。根據(jù)術(shù)前測(cè)得的T1-S值,將其分為高T1-S和低T1-S組,兩組之間年齡無統(tǒng)計(jì)學(xué)差異(P0.05),兩組之間術(shù)前Cobb角及術(shù)后Cobb角均存在統(tǒng)計(jì)學(xué)差異(P0.05),高T1-S組術(shù)前與術(shù)后Cobb差值為(7.50±3.99)°,低T1-S組術(shù)前與術(shù)后Cobb差值為(4.89±3.99)°,兩者之間存在統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:術(shù)前T1-S的大小與頸椎前凸大小呈正相關(guān)。頸椎后路雙開門椎管擴(kuò)大成形術(shù)后頸椎矢狀面平衡發(fā)生明顯變化,頸椎曲度減小,頸椎前凸不同程度喪失,表現(xiàn)為頸椎向前傾斜。其中頸椎前凸喪失的程度與術(shù)前T1-Slope相關(guān),T1-S較大者,頸椎后路雙開門術(shù)后前凸喪失程度較大。但術(shù)前T1-S較大的患者術(shù)后頸椎前凸仍大于T1S較小的患者。
[Abstract]:Objective: to investigate the effect of T 1 slope angle on cervical curvature after double open laminoplasty by measuring the parameters of preoperative T 1 Clivus angle and postoperative cervical curvature. Methods: the clinical and imaging data of 48 patients with cervical Spondylotic myelopathy treated with open door spinal canal reconstruction via 3-6 posterior approach from 2014 to 2016 in the Sino-Japanese Friendship Hospital of Jilin University were retrospectively analyzed. The angle between the upper edge of T1 vertebral body and horizontal line was measured in the standing position and maintaining line of sight before operation. The angle of Cobb angle was compared between the vertical line of C2 and the lower margin of the cervical C7 vertebra on X-ray radiographs before and after the last follow-up and at the level of line of sight. Results: Cobb C2-7 decreased from 14.43 鹵4.24 擄to 8.18 鹵3.01 擄after follow-up for an average of 14.6 鹵12-18 months. There was a positive correlation between preoperative T1-S and preoperative Cobb C2-7. According to the values of T1-S measured before operation, they were divided into high T1-S group and low T1-S group. There was no significant difference in age between the two groups (P 0.05). There was a significant difference in preoperative Cobb angle and postoperative Cobb angle between the two groups (P 0.05). The difference between preoperative and postoperative Cobb was 7.50 鹵3.99 擄in high T1-S group and 4.89 鹵3.99 擄in low T1-S group. There was a statistical difference between the two groups (P 0.05 擄). Conclusion: there is a positive correlation between the size of T 1 S and the size of cervical kyphosis. The sagittal balance of cervical vertebrae was changed obviously after double open door laminoplasty, the curvature of cervical vertebra decreased and the kyphosis of cervical spine was lost to different degrees, which showed that the cervical vertebrae tilted forward. The degree of loss of cervical kyphosis was higher than that of preoperative T1-Slope associated with T1-S, and the degree of loss of anterior kyphosis was greater after double open door operation. But the patients with larger T 1 S before operation were still larger than those with smaller T 1 S after operation.
【學(xué)位授予單位】：吉林大學(xué)
【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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