本文選題：鈦網 + 植骨融合��； 參考：《皖南醫(yī)學院》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植骨融合內固定術治療雙節(jié)段脊髓型頸椎病的中遠期療效。方法:回顧并分析2008年1月~2011年12月間,皖南醫(yī)學院第一附屬醫(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固定術治療雙節(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,術前病程3~36個月,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前和術后及隨訪的影像學檢查及臨床問卷調查,根據患者術前、術后,末次隨訪時腰背痛手術評分標準(Japanese Orthopedic Assoeiation JOA)、頸椎生理彎曲與錐間高度的變化來評估其術前、術后及隨訪時患者的肢體功能障礙恢復情況及神經壓迫緩解情況。結果:所有患者均完成獲隨訪,平均隨訪2.9±1.23年。未出現(xiàn)內固定位置松動、斷裂及脫落,腰椎無畸形、序列恢復良好。手術后及末次隨訪患者神經癥狀有明顯緩解,所有患者術前術后JOA評分術前平均8.5±1.4分,術后JOA評分12.5±1.3分,末次JOA評分14.5±1.3分。患者術前術后JOA評分差異有統(tǒng)計學意義(P0.05);末次隨訪與術前JOA評分差異有統(tǒng)計學意義(P0.05),神經改善率優(yōu)良率83.72%,性別差別對術后神經改善率無影響,年齡大小及病程長短影響患者術后神經改善率,且患者年齡及病程越長,術后療效越差�；颊咝g后頸椎生理曲度較術前有明顯恢復,患者術前術后頸椎生理彎曲差異有統(tǒng)計學意義(P0.05),末次隨訪與術前頸椎生理彎曲差異有統(tǒng)計學意義(P0.05),而且患者術后椎間高度較術前有明顯改善。結論:對頸前路椎體次全切減壓融合鈦網植骨內固定術治療雙節(jié)段頸椎病進行了回顧性的研究,根據患者術前、術后,末次隨訪時腰背痛手術評分標準(Japanese Orthopedic Assoeiation JOA)、頸椎生理彎曲與錐間高度的變化證實了,頸前路椎體次全切減壓融合植骨內固定術能夠明顯改善雙節(jié)段脊髓型頸椎病患者神經功能,穩(wěn)定頸椎及恢復頸椎生理彎曲度及椎間高度,而且中遠期療效明顯。
[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.
【學位授予單位】：皖南醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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