【摘要】：目的觀察頸椎后路單開門椎管擴大成形術結合側塊螺釘治療頸椎管狹窄伴頸椎不穩(wěn)的臨床療效。方法回顧性分析2012年5月至2015年6月收治的15例頸椎后路單開門椎管擴大成形術結合側塊螺釘治療的頸椎管狹窄伴頸椎不穩(wěn)的患者,其中男13例,女2例;年齡36～84歲,平均59.6歲。致傷原因:高處墜落傷4例,交通事故傷4例,重物砸傷2例,摔傷5例。入院后均行頸椎正側位X線片、頸椎CT及MRI檢查,均接受頸椎的后路單開門椎管擴大成形術結合側塊螺釘手術治療。比較患者術前及術后的頸椎JOA評分、VAS評分、C2-7Cobb角和椎體前滑移距離。末次隨訪時同時復查頸椎活動度。結果所有患者均獲得隨訪,隨訪時間為12-20月,平均15.6個月。末次隨訪時JOA評分、VAS評分、C2-7Cobb角和椎體前滑移距離均顯著優(yōu)于術前,差異有統(tǒng)計學意義(P0.05)�；颊咝g后仍保留較好的頸椎活動度,未發(fā)生內(nèi)固定松動、斷裂等并發(fā)癥。結論采用頸椎后路單開門椎管擴大成形術結合側塊螺釘治療頸椎管狹窄伴頸椎不穩(wěn)可使受壓頸髓充分減壓并獲得較好的頸椎穩(wěn)定性,是一種安全,有效的手術方式。
[Abstract]:Objective to observe the clinical effect of posterior open door laminoplasty combined with lateral mass screw in the treatment of cervical spinal stenosis with cervical instability. Methods from May 2012 to June 2015, 15 patients (13 males and 2 females) with cervical spinal stenosis associated with cervical instability treated by posterior open door laminoplasty combined with lateral mass screw were retrospectively analyzed. The average age is 59.6 years. The causes of injury were as follows: fall injury in 4 cases, traffic accident in 4 cases, heavy object injury in 2 cases and fall injury in 5 cases. After admission, all patients underwent X-ray film, CT and MRI examination. All patients were treated by posterior open door laminoplasty combined with lateral mass screw surgery. The cervical JOA scores were compared before and after operation with C 2-7 Cobb angle and anterior slip distance. At the last follow-up, the range of cervical vertebrae motion was reexamined at the same time. Results all patients were followed up for 12-20 months (mean 15.6 months). At the last follow-up, the JOA score and the C2-7 Cobb angle and the anterior slip distance of the vertebral body were significantly better than those before the operation, the difference was statistically significant (P0.05). The patient still retained good cervical mobility after operation, without internal fixation loosening, fracture and other complications. Conclusion posterior open door laminoplasty combined with lateral mass screw in the treatment of cervical spinal stenosis with cervical instability can fully decompress the compressed cervical spinal cord and obtain better cervical stability. It is a safe and effective surgical method.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

【參考文獻】

相關期刊論文 前8條

1 肖俊;唐廣滿;;后路單開門微型鋼板固定術和全椎板切除側塊螺釘固定術治療多節(jié)段脊髓型頸椎病的對比研究[J];骨科;2016年03期

2 費琦;楊雍;;術式改良:重新探討頸椎后路單開門椎管擴大成形術的應用[J];中華醫(yī)學雜志;2015年23期

3 陳果;王清;;單開門椎管擴大成形術并發(fā)癥研究進展[J];西南軍醫(yī);2014年04期

4 張世民;馬明;劉昱彰;張兆杰;李星;;頸前路椎間隙減壓聯(lián)合椎體次全切除術治療三節(jié)段脊髓型頸椎病[J];頸腰痛雜志;2013年03期

5 劉金銳;楊慶國;;單開門頸椎管擴大成形術的術式及并發(fā)癥的研究進展[J];頸腰痛雜志;2012年02期

6 崔明宇;;脊髓型頸椎病不同手術入路的療效比較研究[J];中國醫(yī)藥導報;2012年01期

7 劉記存;劉懷軍;黃勃源;崔彩霞;賀丹;王志紅;;脊髓慢性壓迫損傷的磁共振擴散張量成像研究[J];中國醫(yī)學影像技術;2007年03期

8 楊金江;王炳強;王志義;楊雍;李強;;下頸椎單側側塊鋼板內(nèi)固定的穩(wěn)定性研究[J];頸腰痛雜志;2006年03期

，

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