本文選題：頸椎病 + 前路減壓植骨融合��； 參考：《新疆醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：比較前路減壓植骨融合內(nèi)固定與頸椎間盤置換治療單節(jié)段頸椎病的中期療效。方法：回顧性收集新疆醫(yī)科大學(xué)第一附屬醫(yī)院脊柱外科2008年1月至2010年12月收治的114例單節(jié)段頸椎病患者,86例行前路減壓植骨融合內(nèi)固定,28例行人工頸椎間盤置換。比較兩組患者手術(shù)時間、出血量、日本矯形外科協(xié)會(JOA)評分、頸部及上肢視覺模擬評分、頸椎殘障功能指數(shù)(NDI)及鄰近節(jié)段退變情況。根據(jù)Odom標(biāo)準(zhǔn)與JOA改善優(yōu)良率評定臨床療效。結(jié)果：①兩組患者末次隨訪時JOA評分、視覺模擬評分、NDI均較治療前明顯改善(尸0.05)。組間比較兩組患者手術(shù)時間、出血量、治療前及末次隨訪時JOA評分、視覺模擬評分、NDI及其差值差異無顯著性意義(P0.05)。JOA優(yōu)良率前路減壓植骨融合組為86%,頸椎間盤置換組為89%；根據(jù)Odom標(biāo)準(zhǔn)優(yōu)良率前路減壓植骨融合組為83%,頸椎間盤置換組為93%,差異均無顯著性意義(P0.05)。②末次隨訪時前路減壓植骨融合組有22例手術(shù)鄰近節(jié)段出現(xiàn)退變,其中上位節(jié)段15例,下位節(jié)段7例,22例中有3例因出現(xiàn)臨床癥狀再次手術(shù)；頸椎間盤置換組有2例出現(xiàn)相鄰節(jié)段退變,上位節(jié)段與下位節(jié)段各1例,無再次手術(shù)病例。結(jié)論：兩種手術(shù)方式都能有效治療單節(jié)段頸椎病且療效相當(dāng)；與融合相比,椎間盤置換術(shù)可降低術(shù)后相鄰節(jié)段的發(fā)生率或延緩其發(fā)生前路減壓植骨融合術(shù)可加速鄰近節(jié)段的退變,尤其是手術(shù)節(jié)段的上位節(jié)段。
[Abstract]:Objective: To compare the medium-term efficacy of anterior decompression and fusion internal fixation and cervical disc replacement in the treatment of single segment cervical spondylosis. Methods: retrospective collection of 114 cases of single segment cervical spondylosis treated in the First Affiliated Hospital of Xinjiang Medical University from January 2008 to December 2010, 86 cases with anterior decompression, bone fusion and internal fixation, 28 cases. Artificial cervical disc replacement. Compare the operation time, the amount of bleeding, the Japanese Orthopedic Association (JOA) score, the visual simulation score of the neck and upper limbs, the cervical disability function index (NDI) and the adjacent segment degeneration. The outcome of the two groups was evaluated by the improvement of the good rate according to the Odom standard and the JOA. Results: (1) the JOA score at the last follow-up of the two groups, Visual analogue score, NDI was significantly better than before treatment (0.05). Compared with the two groups, the operation time, the amount of bleeding, the JOA score, the visual analogue score, the difference between NDI and the difference value were not significant (P0.05).JOA good rate of anterior decompression and fusion group was 86%, the cervical intervertebral disc replacement group was 89%, according to the Odom mark. The quasi fine rate anterior decompression and fusion group was 83%, and the cervical disc replacement group was 93%, the difference was not significant (P0.05). In the last follow-up, there were 22 cases of adjacent segment degeneration in anterior decompression and fusion group, of which 15 cases were the upper segment, 7 cases in the lower segment, 3 cases in 22 cases were reoperated because of clinical symptoms; cervical disc intervertebral disc was found in 22 cases. There were 2 cases of adjacent segment degeneration in the replacement group, 1 cases in the upper and lower segments and no reoperation cases. Conclusion: the two kinds of surgical methods can effectively treat the single segment cervical spondylosis and the curative effect is quite effective. Compared with the fusion, the intervertebral disc replacement can reduce the incidence of adjacent segments after the operation or delay its anterior decompression and fusion. It can accelerate the degeneration of adjacent segments, especially the upper segment of the operative segment.

【學(xué)位授予單位】：新疆醫(yī)科大學(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：1873163