【摘要】：近年來,頸椎病的發(fā)生率逐漸升高,在各種類型頸椎病中,尤其以脊髓型頸椎病的危害最大。因為頸椎間盤的退變,導致頸部脊髓受到壓迫,引起神經(jīng)功能的損害,嚴重影響患者的生活質(zhì)量。目前,手術(shù)治療是脊髓型頸椎病的主要治療手段。手術(shù)方式包括頸椎前路椎間盤切除植骨融合內(nèi)固定術(shù)、頸椎前路椎體次全切除融合術(shù)、頸后路椎管擴大成形術(shù)、以及前后路聯(lián)合手術(shù)。對于短節(jié)段受壓的脊髓型頸椎病,大多數(shù)骨科醫(yī)生采用經(jīng)前路減壓植骨融合固定術(shù)。然而,對于多節(jié)段受壓的脊髓型頸椎病,最佳的手術(shù)治療方式的選擇仍然存在著爭議。每種手術(shù)方式都有各自的優(yōu)缺點。其中,頸后路椎管擴大成形術(shù)是治療多節(jié)段頸髓受壓頸椎病的一種效果良好并且常用的手術(shù)方式。大部分學者認為,在行手術(shù)前,頸椎要有前凸的曲度,才能保證術(shù)后脊髓向后漂移,達到神經(jīng)壓迫解除的效果。然而,很多接受此手術(shù)治療的患者,術(shù)后出現(xiàn)了頸椎后凸畸形,并且嚴重影響了患者術(shù)后生活的質(zhì)量。目前,對于術(shù)后頸椎后凸畸形的發(fā)生機制并無統(tǒng)一定論。通過查閱有關(guān)手術(shù)后頸椎后凸畸形的文獻,就其相關(guān)因素和預防措施的研究進展綜述如下,以便更好的指導臨床工作,提高手術(shù)療效。通過總結(jié)相關(guān)文獻,頸后路椎管擴大成形術(shù)后引起頸椎后凸畸形的相關(guān)危險因素有:高年齡患者,手術(shù)前頸椎曲度不佳,不恰當?shù)氖中g(shù)方式,手術(shù)后頸椎失穩(wěn)、頸椎后方肌肉韌帶復合體及其骨骼附著點的破壞,以及術(shù)后未進行正規(guī)的功能鍛煉。因此,在手術(shù)前、手術(shù)中和手術(shù)后避免上述相關(guān)危險因素,可明顯的減少手術(shù)后頸椎后凸畸形的發(fā)生概率。
[Abstract]:In recent years, the incidence of cervical spondylopathy has gradually increased. Among all types of cervical spondylosis, especially the cervical Spondylotic myelopathy is the most harmful. Because of the degeneration of cervical intervertebral disc, the cervical spinal cord is compressed, the nerve function is damaged, and the patient's quality of life is seriously affected. At present, surgical treatment is the main treatment of cervical Spondylotic myelopathy. The surgical methods include anterior intervertebral disc resection, bone grafting and internal fixation, anterior subtotal vertebral body resection and fusion, posterior cervical spinal canal angioplasty, and combined anterior and posterior approach. For short segment compression cervical Spondylotic myelopathy, most orthopedic surgeons use anterior decompression and fusion fixation. However, the choice of optimal surgical treatment for multilevel compression cervical Spondylotic myelopathy remains controversial. Each operation has its own advantages and disadvantages. The extended posterior cervical canal angioplasty is an effective and commonly used method for the treatment of multilevel cervical spinal cord compression. Most scholars believe that before surgery, the cervical spine should have convex curvature to ensure the spinal cord drift backward and relieve the nerve compression. However, cervical kyphosis was found in many patients who received the operation, which seriously affected the quality of life. At present, there is no unified conclusion on the mechanism of postoperative cervical kyphosis. By consulting the literature about cervical kyphosis after operation, the research progress of its related factors and preventive measures is summarized below, in order to better guide clinical work and improve the curative effect of operation. By summarizing the relevant literature, the related risk factors of cervical kyphosis after posterior cervical spinal canal dilatation are as follows: older patients, poor cervical curvature before operation, inappropriate surgical methods, post-operative instability of the cervical spine. The destruction of posterior musculoligamentous complex and its bone attachment, and no regular functional exercise after operation. Therefore, avoiding these risk factors before, during and after surgery can significantly reduce the probability of cervical kyphosis.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

【參考文獻】

相關(guān)期刊論文 前10條

1 于憲貴;陳海;沈廣榮;劉忠雙;劉勇;;頸后路雙開門椎管擴大椎板成形自體棘突植骨術(shù)后頸椎矢狀面形態(tài)學觀察[J];中國脊柱脊髓雜志;2016年06期

2 易振恒;;頸椎后路單開門椎管擴大成形鉚釘內(nèi)固定治療頸椎管狹窄癥的臨床分析[J];世界最新醫(yī)學信息文摘;2016年35期

3 郭朝陽;張樹芳;李明恒;陳榮春;;單開門椎管擴大椎板成形術(shù)保留一側(cè)肌肉韌帶復合體治療多節(jié)段脊髓型頸椎病[J];中國現(xiàn)代醫(yī)生;2015年30期

4 蔡文濤;林明俠;沈?qū)幗?;保留頸7棘突頸椎后路單開門微型鈦板固定成形術(shù)治療多節(jié)段脊髓型頸椎病的效果[J];廣東醫(yī)學;2014年21期

5 韋敏克;尹東;梁斌;丘德贊;韋建勛;歐裕福;;頸后路椎管擴大減壓微型鈦板固定椎板成形術(shù)與傳統(tǒng)頸椎后路單開門椎管擴大減壓術(shù)治療頸椎病的比較研究[J];中國矯形外科雜志;2014年19期

6 林圣榮;周非非;孫宇;陳仲強;張鳳山;潘勝發(fā);;頸后路單開門椎管擴大椎板成形術(shù)后頸椎矢狀面平衡的變化[J];中華醫(yī)學雜志;2014年35期

7 李玉偉;王海蛟;嚴曉云;王玉記;;頸椎單開門椎管擴大成形術(shù)不同椎板固定方法治療多節(jié)段脊髓型頸椎病的療效分析[J];中國脊柱脊髓雜志;2013年11期

8 張紹文;李盛華;樊成虎;唐曉棟;;微型鈦板與改良錨定法在頸椎管擴大成形術(shù)中應(yīng)用的早期療效觀察[J];臨床骨科雜志;2013年03期

9 于淼;孫宇;劉忠軍;潘勝發(fā);張鳳山;;保留單側(cè)肌肉韌帶復合體頸椎椎板成形術(shù)近期療效的比較研究[J];中國微創(chuàng)外科雜志;2011年01期

10 陳廣東;楊惠林;王根林;干e，

本文編號：2167647