【摘要】：目的探討單側(cè)椎弓根螺釘固定結(jié)合椎間Cage植骨融合術(shù)對(duì)融合節(jié)段對(duì)側(cè)椎間孔解剖結(jié)構(gòu)的影響。方法通過(guò)對(duì)南華大學(xué)附屬南華醫(yī)院脊柱外科2012年12月至2013年12月施行腰椎4/5后路單側(cè)椎弓根螺釘固定結(jié)合椎間Cage植骨融合手術(shù)治療的30位患者的病例資料進(jìn)行回顧性研究。應(yīng)用計(jì)算機(jī)多層螺旋CT三維重建技術(shù),分別測(cè)量術(shù)前及術(shù)后腰4/5節(jié)段手術(shù)側(cè)對(duì)側(cè)椎間孔的縱徑和橫徑的數(shù)據(jù);應(yīng)用日本矯形外科學(xué)會(huì)(JOA)評(píng)分評(píng)價(jià)30位參加研究的患者術(shù)前及術(shù)后腰腿疼痛緩解的情況,并統(tǒng)計(jì)分析實(shí)施手術(shù)后融合節(jié)段對(duì)側(cè)椎間孔形態(tài)的改變。結(jié)果術(shù)后椎間孔椎間孔縱徑17.39±2.21mm、橫徑10.23±0.99mm與術(shù)前椎間孔縱徑為17.18±2.87mm、橫徑為9.98±1.53mm通過(guò)統(tǒng)計(jì)學(xué)分析,P0.05,不具有統(tǒng)計(jì)學(xué)意義,表明手術(shù)前后數(shù)值無(wú)明顯變化。由JOA評(píng)分結(jié)果可知,所有患者術(shù)前JOA評(píng)分為(11.73±1.337),術(shù)后1周、6個(gè)月、12個(gè)月的JOA評(píng)分依次為(21.00±3.824)、(25.13±2.945)、(25.53±3.794),術(shù)后患者JOA評(píng)分結(jié)果明顯高于術(shù)前評(píng)分,P0.05,具有統(tǒng)計(jì)學(xué)意義,表明手術(shù)效果良好。結(jié)論采用單側(cè)椎弓根螺釘固定結(jié)合Cage椎間融合手術(shù)治療腰椎退行性疾病后手術(shù)節(jié)段對(duì)側(cè)椎間孔橫徑與縱徑并無(wú)明顯改變,且術(shù)后患者腰腿疼痛明顯緩解,說(shuō)明部分患者術(shù)后發(fā)生手術(shù)節(jié)段對(duì)側(cè)下肢疼痛與椎間孔不存在直接的因果關(guān)系。
[Abstract]:Objective to investigate the effect of unilateral pedicle screw fixation and intervertebral Cage fusion on the anatomical structure of the contralateral intervertebral foramen. Methods from December 2012 to December 2013, 30 patients treated with unilateral pedicle screw fixation combined with intervertebral Cage fusion were retrospectively studied. The longitudinal and transverse diameters of the contralateral intervertebral foramen were measured before and after lumbar 4 / 5 segment operation by computer multislice CT reconstruction. The (JOA) score of the Japanese Orthopedic Society was used to evaluate the pain relief of lumbar and leg in 30 patients before and after operation, and the morphological changes of contralateral intervertebral foramen in fusion segment after operation were statistically analyzed. Results the longitudinal diameter of intervertebral foramen was 17.39 鹵2.21mm, the transverse diameter was 10.23 鹵0.99mm and the preoperative diameter of intervertebral foramen was 17.18 鹵2.87mm. The transverse diameter was 9.98 鹵1.53mm. According to the JOA score, the preoperative JOA score of all patients was (11.73 鹵1.337), the JOA score of 1 week, 6 months and 12 months after operation was (21.00 鹵3.824), (25.13 鹵2.945), (25.53 鹵3.794), and the JOA score of postoperative patients was significantly higher than that of preoperative score (P 0.05), which indicated that the operation effect was good. Conclusion the transverse and longitudinal diameter of the contralateral intervertebral foramen in the treatment of lumbar degenerative diseases by unilateral pedicle screw fixation combined with Cage intervertebral fusion surgery has no obvious change, and the pain of the lumbar leg and the lumbar leg after operation is obviously alleviated. The results showed that there was no direct causal relationship between postoperative contralateral lower limb pain and intervertebral foramen in some patients.
【學(xué)位授予單位】：南華大學(xué)
【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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