本文選題：雙開門椎管擴大成型術 + 后縱韌帶骨化�。� 參考：《吉林大學》2015年碩士論文

【摘要】：目的： 通過測量C2-7各節(jié)段椎板傾斜角并推導雙開門術中的開槽角，結果數據行統(tǒng)計學分析，了解不同頸椎節(jié)段開槽角的變化趨勢及差異，，并探討其臨床意義。 方法： 選取我院門診行頸椎CT檢查病人100例。其中男50例，女50例。年齡27-79歲，平均47.35歲。選取C2-7各節(jié)段CT軸位像上椎板最厚層面，于椎板上緣與棘突交界處內外側骨皮質各取一點，連成一線段，取其中點。于椎板下緣與關節(jié)突交界處得一線段中點，穿過兩中點連線作一直線做為椎板平行線，該線與正中矢狀線夾于一角，即為椎板傾斜角。取開槽點做垂直于椎板平行線的直線相交正中矢狀線于一角，即為雙開門術中開槽角，開槽角與傾斜角互補。于三維CT工作站測量C2-7各節(jié)段椎板傾斜角，并推導開槽角，測量角度精確至0.01°。對測得數據進行統(tǒng)計分析。 結果： C2-7各節(jié)段椎板平均開槽角分別為：42.27°、37.44°、37.20°、38.53°、38.40°、40.16°，C2C7C5C6C3C4。C2與C3-7間差異有統(tǒng)計學意義（P 0.05），C7與C3-6間差異有統(tǒng)計學意義（P 0.05），C3-6間任兩組比較差異均無統(tǒng)計學意義（P0.05）。按不同性別分組，各節(jié)段平均開槽角度男性均大于女性，差異具有統(tǒng)計學意義。 結論： 1、雙開門椎管擴大成形術需減壓C2節(jié)段時，其開槽角應較C3-7增大。2、行C7節(jié)段開門時應較C3-6增大開槽角。3、C2-7相同節(jié)段的開槽角男性均應大于女性。4、對累及C2擬行雙開門椎管擴大成形術的病例，可術前于CT測量減壓節(jié)段開槽角，制定個體化的手術方案，減少手術風險。
[Abstract]:Objective: to measure the inclination angle of C2-7 lamina and deduce the slotted angle during double open door operation. The data were analyzed statistically to find out the change trend and difference of different cervical slotted angle. Methods: 100 patients with cervical spine CT were selected. There were 50 males and 50 females. The average age was 47.35 years. C2-7 CT axial images of the thickest layer of the upper lamina were selected, and the internal and external cortex of the upper margin of the lamina and the spinous process were taken at the junction of the upper lamina and the spinous process. At the junction of the lower edge of the lamina and the articular process, a midline is obtained, and a straight line is made through the two midpoints as the parallel line of the lamina. The line is clamped in one corner with the median sagittal line, that is, the angle of the vertebral lamina. The slotted point is taken as the straight line intersecting the median sagittal line perpendicular to the parallel line of the vertebral lamina at one corner, that is, the slotted angle during the double door opening, the slotting angle and the inclined angle complement each other. The oblique angle of C2-7 lamina was measured by 3D CT workstation, and the slotted angle was deduced. The measurement angle was accurate to 0.01 擄. Results: the average slotted angle of each segment of C2-7 vertebral lamina was: 1 / 42.27 擄/ 37.44 擄/ 37.20 擄/ 38.53 擄/ 38.40 擄/ 40.16 擄C _ 2C _ 7C _ 5C _ 6C _ 3C _ 4.C2 and C _ 3-7 respectively. There was no significant difference between C _ 2C _ 7C _ 5C _ 6C _ 3C _ 4.C2 and C _ 3-7 (P 0.05). The average slotted angle of each segment was greater in male than in female, and the difference was statistically significant. Conclusion: 1. The slotted angle should be larger than that of C3-7, and the slotted angle of the same segment of C7 should be larger than that of C3-6. The slotted angle of males in the same segment of C7 should be larger than that of females. Preoperative CT can be used to measure the slotted angle of decompression segment and make individual operation plan to reduce the risk of operation.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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