背景:腰椎間孔椎間融合術(shù)（TLIF）是一種常見的腰椎融合手術(shù),廣泛應(yīng)用于腰椎退行性椎間盤疾病的治療。在椎間融合手術(shù)中使用傳統(tǒng)椎弓根螺釘（PS）進(jìn)行腰椎固定有幾個(gè)優(yōu)點(diǎn),但同時(shí)也存在著一些缺點(diǎn),如侵犯上關(guān)節(jié)面和肌肉損傷的風(fēng)險(xiǎn)。最近,人們發(fā)明了一種新的椎弓根螺釘植入軌跡,稱為皮質(zhì)骨軌跡（CBT）,它可以在不存在傳統(tǒng)椎弓根螺釘缺陷的情況下進(jìn)行插入。然而,使用CBT的TLIF與使用PS TLIF臨床療效尚未得到充分評估。目的:比較皮質(zhì)骨螺釘軌道（CBT）和傳統(tǒng)椎弓根螺釘（PS）技術(shù)在腰椎間孔椎間融合術(shù)（TLIF）手術(shù)中的臨床療效。研究設(shè)計(jì):這是回顧性觀察研究。方法與材料:收集東南大學(xué)附屬中大醫(yī)院脊柱中心單間隙TLIF手術(shù)合格患者71例,分為A組（45例）,采用PS,B組（26例）,采用CBT螺釘。使用X線片和計(jì)算機(jī)斷層掃描（CT）在1年時(shí)評估融合狀態(tài)。通過背部和腿部疼痛的VAS評分、Oswetry殘疾指數(shù)（ODI）評分和日本骨科協(xié)會（JOA）評分評估臨床結(jié)果。同時(shí)記錄兩組患者的手術(shù)時(shí)間、失血量,切口長度和術(shù)后住院時(shí)間,并進(jìn)行比較。兩組患者術(shù)后隨訪1年。采用不同的統(tǒng)計(jì)方法進(jìn)行數(shù)據(jù)分析,P值<... 

【文章來源】：東南大學(xué)江蘇省 211工程院校 985工程院校 教育部直屬院校

【文章頁數(shù)】：54 頁

【學(xué)位級別】：碩士

【文章目錄】：
中文摘要
ENGLISH ABSTRACT
PREFACE
ABBREVIATIONS
CHAPTER1:BACKGROUND
CHAPTER2:REVIEW OF LITERATURE
    2.1 Anatomy of Human Spine
        2.1.1 Spinal Curvatures
        2.1.2 Vertebra
        2.1.3 Intervertrebal disc
        2.1.4 Facet joint and Ligaments
        2.1.5 Spinal cord and spinal nerves
    2.2 Spinal Pathologies
        2.2.1 Degenerative disc disease
        2.2.2 Facet Joint Degeneration
        2.2.3 Spinal stenosis
        2.2.4 Spondylolysis
        2.2.5 Spondylolisthesis
    2.3 Treatments
        2.3.1 Conservative treatment
        2.3.2 Surgical Treatment
        2.3.3 Anterior lumbar interbody fusion(ALIF)
        2.3.4 Oblique lumbar interbody fusion(OLIF)
        2.3.5 Posterior lumbar interbody fusion(PLIF)
        2.3.6 Transforaminal lumbar interbody fusion(TLIF)
    2.4 Spinal fixation
        2.4.1 Traditional pedicle screw fixation(PS)
        2.4.2 Cortical bone trajectory(CBT)
CHAPTER3:RESEARCH AIMS
CHAPTER4:METHODS AND MATERIALS
    4.1 Data Collection
    4.2 Inclusion and Exclusion criteria
    4.3 Surgical Techniques
        4.3.1 CBT-TLIF
        4.3.2 PS-TLIF
    4.4 Outcome Measurement
        4.4.1 Visual analog scale(VAS score)
        4.4.2 Oswetry disability index(ODI)score
        4.4.3 Japanese Orthopedic association(JOA)score for low back pain
    4.5.Statistical analysis
CHAPTER5:RESULTS
    5.1 Patient characteristics
    5.2 Fusion rate
    5.3 Clinical Outcomes measures
        5.3.1 Visual analog scale(VAS)score
        5.3.2 Oswestry disability index(ODI)and Japanese Orthopedic Association(JOA)scores
    5.4 Surgical Outcomes and Complications
CHAPTER6:DISCUSSION AND CONCLUSION
    6.1 Discussion
    6.2 Conclusion
ACKNOWLEDGEMENT
AUTHOR’S INFORMATION
REFERENCES



本文編號：3272721