本文選題：鈦網(wǎng) + 植骨融合��； 參考：《皖南醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的:回顧并分析頸前路椎體次全切減壓鈦網(wǎng)植骨融合內(nèi)固定術(shù)治療雙節(jié)段脊髓型頸椎病的中遠(yuǎn)期療效。方法:回顧并分析2008年1月~2011年12月間,皖南醫(yī)學(xué)院第一附屬醫(yī)院弋磯山醫(yī)院里采用頸前路椎體次全切減壓融合植骨內(nèi)固定術(shù)治療雙節(jié)段脊髓型頸椎病患者43例,男29例,女14例,年齡39~74歲,平均(56.3±12.7)歲,術(shù)前病程3~36個(gè)月,病變椎體:C3-5節(jié)段11例,C4-6節(jié)段16例,C5-7節(jié)段16例。43例患者完成完成了術(shù)前和術(shù)后及隨訪的影像學(xué)檢查及臨床問(wèn)卷調(diào)查,根據(jù)患者術(shù)前、術(shù)后,末次隨訪時(shí)腰背痛手術(shù)評(píng)分標(biāo)準(zhǔn)(Japanese Orthopedic Assoeiation JOA)、頸椎生理彎曲與錐間高度的變化來(lái)評(píng)估其術(shù)前、術(shù)后及隨訪時(shí)患者的肢體功能障礙恢復(fù)情況及神經(jīng)壓迫緩解情況。結(jié)果:所有患者均完成獲隨訪,平均隨訪2.9±1.23年。未出現(xiàn)內(nèi)固定位置松動(dòng)、斷裂及脫落,腰椎無(wú)畸形、序列恢復(fù)良好。手術(shù)后及末次隨訪患者神經(jīng)癥狀有明顯緩解,所有患者術(shù)前術(shù)后JOA評(píng)分術(shù)前平均8.5±1.4分,術(shù)后JOA評(píng)分12.5±1.3分,末次JOA評(píng)分14.5±1.3分�；颊咝g(shù)前術(shù)后JOA評(píng)分差異有統(tǒng)計(jì)學(xué)意義(P0.05);末次隨訪與術(shù)前JOA評(píng)分差異有統(tǒng)計(jì)學(xué)意義(P0.05),神經(jīng)改善率優(yōu)良率83.72%,性別差別對(duì)術(shù)后神經(jīng)改善率無(wú)影響,年齡大小及病程長(zhǎng)短影響患者術(shù)后神經(jīng)改善率,且患者年齡及病程越長(zhǎng),術(shù)后療效越差�；颊咝g(shù)后頸椎生理曲度較術(shù)前有明顯恢復(fù),患者術(shù)前術(shù)后頸椎生理彎曲差異有統(tǒng)計(jì)學(xué)意義(P0.05),末次隨訪與術(shù)前頸椎生理彎曲差異有統(tǒng)計(jì)學(xué)意義(P0.05),而且患者術(shù)后椎間高度較術(shù)前有明顯改善。結(jié)論:對(duì)頸前路椎體次全切減壓融合鈦網(wǎng)植骨內(nèi)固定術(shù)治療雙節(jié)段頸椎病進(jìn)行了回顧性的研究,根據(jù)患者術(shù)前、術(shù)后,末次隨訪時(shí)腰背痛手術(shù)評(píng)分標(biāo)準(zhǔn)(Japanese Orthopedic Assoeiation JOA)、頸椎生理彎曲與錐間高度的變化證實(shí)了,頸前路椎體次全切減壓融合植骨內(nèi)固定術(shù)能夠明顯改善雙節(jié)段脊髓型頸椎病患者神經(jīng)功能,穩(wěn)定頸椎及恢復(fù)頸椎生理彎曲度及椎間高度,而且中遠(yuǎn)期療效明顯。
[Abstract]:Objective: to review and analyze the mid-and long-term effect of anterior cervical vertebra subtotal decompression and titanium mesh fusion and internal fixation for two-segment cervical Spondylotic Spondylotic Spondylotic Disease. Methods: from January 2008 to December 2011, 43 patients (29 males) with two-level cervical Spondylotic myelopathy were treated by anterior cervical subtotal decompression and fusion with bone graft fixation in the first affiliated Hospital of Southern Anhui Medical College. 14 women (3974 years old, mean 56.3 鹵12.7) years old. The course of disease was 3 ~ 36 months before operation. 16 cases of C4-6 segment, 16 cases of C5-7 segment and 16 cases of C5-7 segment had completed the imaging examination and the clinical questionnaire survey before and after operation, including 16 cases of C4-6 segment and 16 cases of C5-7 segment. Preoperative, postoperative, and final follow-up of patients with low back pain (LBP) was evaluated according to Japanese Orthopedic Assoeiation JOAA, changes in cervical curvature and height between cones. Recovery of limb dysfunction and remission of nerve compression after operation and follow-up. Results: all patients were followed up with an average of 2.9 鹵1.23 years. No internal fixation position loosening, fracture and shedding, no malformation of lumbar vertebrae, and good sequence recovery. The neurologic symptoms of all the patients were relieved after operation and the last follow-up. The JOA scores were 8.5 鹵1.4, 12.5 鹵1.3 and 14.5 鹵1.3, respectively. The difference of JOA score before and after operation was statistically significant (P 0.05), the difference between the last follow-up and the preoperative JOA score was significant (P 0.05), the rate of nerve improvement was 83.72%, and the difference of sex had no effect on the rate of postoperative nerve improvement. Age and duration of disease affect the rate of postoperative nerve improvement, and the longer the patient's age and course, the worse the postoperative effect. The physiological curvature of cervical vertebrae recovered significantly after operation. There were significant differences in the preoperative and postoperative physiological curvature of cervical vertebrae (P 0.05), and there was a significant difference between the last follow-up and preoperative cervical curvature (P 0.05), and the postoperative height of cervical vertebrae was significantly improved compared with that before operation. Conclusion: a retrospective study was carried out on the treatment of two-segment cervical spondylosis by anterior cervical subtotal decompression and fusion with titanium mesh and internal fixation. At the last follow-up, Japanese Orthopedic Assoeiation JOAA, cervical vertebra physiological bending and interconical height changes confirmed that anterior cervical anterior subtotal decompression and fusion bone graft internal fixation can significantly improve the neurological function of patients with two-segment cervical spondylosis. To stabilize the cervical spine and restore the physiological curvature and intervertebral height of the cervical vertebrae, and the mid-and long-term effect is obvious.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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