颈人工椎间盘置换术的解剖学参数研究

发布时间：2018-05-17 14:31

本文选题：颈椎病 + 椎间盘　；参考：《第一军医大学》2005年硕士论文

【摘要】：研究背景: 颈椎间盘是颈椎椎体间主要的坚强联系与支持结构,同时也是脊柱运动和吸收振荡的主要结构,能承受身体的重力,将施加于脊柱的载荷吸收并重新分布。颈椎间盘的退变是颈椎病发病机理的核心环节,严重影响了人类健康,其相关基础及临床研究均引起了人们的广泛兴趣。 1928年,Stookey提出颈椎病的概念,认为颈椎病是造成脊髓功能障碍的最为常见的原因之一。1956年Clarke和Robinson系统地指出了颈椎病的病理性改变,认为颈椎病是由于颈椎间盘退行性变导致各类组织增生,颈脊髓受压并出现相应的病理改变和功能障碍。50年代Robinson和Smith提出从颈椎前方对突出的椎间盘进行摘除,并予以椎体间植骨融合以来,在脊柱外科领域,颈前路减压和椎间植骨融合术(anterior cervical decompression and fusion,ACDF)一直是治疗颈椎病,尤其是治疗脊髓型颈椎病(cervical spondylotic myelopathy,CSM)首选方法,应用也最为广泛,但单节段或多节段融合对颈部活动的影响较大,邻近功能性脊柱单元(functional spine unit,FSU)的生物力学或者生理学改变:旋转轴改变,负荷重新分布,弹性缓冲丧失,功能脊柱单元活动度异常增多或者减少,营养供应不足,加速了相邻节段的退变。长期资料显示:由于椎间融合所引起的放射形态学改变和临床并发症非常明显。Hilibrand等研究中发现颈椎融合术后的患者毗邻节段的退变症状多有发生,其中三分之二需要再次手术;Goffin等在其融合后平均8.6年的随访中,毗邻节段发生放射学可见的退行性改变的发生率为92%。
[Abstract]:Background: Cervical intervertebral disc is the main supporting structure between cervical vertebrae, and it is also the main structure of spine motion and absorption oscillation. It can withstand the gravity of the body, absorb and redistribute the load applied to the spine. The degeneration of cervical intervertebral disc is the core part of the pathogenesis of cervical spondylosis, which seriously affects human health. In 1928, Stookey put forward the concept of cervical spondylosis, which was considered as one of the most common causes of spinal dysfunction. In 1956, Clarke and Robinson systematically pointed out the pathological changes of cervical spondylosis. It is believed that cervical spondylopathy is caused by degeneration of cervical intervertebral disc, cervical spinal cord compression and corresponding pathological changes and dysfunction. In the 1950s Robinson and Smith proposed to remove the herniated intervertebral disc from the front of cervical vertebrae. In the field of spinal surgery, anterior cervical decompression and fusion have been the first choice in the treatment of cervical spondylosis, especially in the treatment of cervical Spondylotic myelopathy. But one or more segments of fusion have a greater effect on cervical activity. Biomechanical or physiological changes in the adjacent functional spinal unit, functional spine unit FSUS, include rotation axis changes, load redistribution, and loss of elastic buffers. The activity of functional spinal unit increased or decreased, and the nutrition supply was insufficient, which accelerated the degeneration of adjacent segments. Long-term data showed that radiomorphologic changes and clinical complications caused by intervertebral fusion were very obvious. Hilibrand and other studies found that degenerative symptoms of adjacent segments occurred in patients after cervical fusion surgery. 2/3 of them needed reoperation and Goffin et al. In the mean follow-up of 8.6 years after fusion, the incidence of radiologically visible degenerative changes in adjacent segments was 92.
【学位授予单位】：第一军医大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R687.3;R322

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