单节段、双节段颈椎融合术后颈椎活动度的改变

发布时间：2018-02-09 18:18

本文关键词： 颈椎融合手术融合节段活动度　出处：《皖南医学院》2015年硕士论文　论文类型：学位论文

【摘要】：目的:探讨单节段及双节段颈椎融合手术对颈椎活动度的影响。方法:选取2010年6月至2012年6月在皖南医学院第一附属医院弋矶山医院脊柱外科行颈椎前路减压融合术的43例颈椎病患者,其中单节段融合29例,双节段融合14例。根据JOA评分及X线片评价手术的有效率及融合节段的融合率。使用颈椎活动度测量仪(cervical range of motion device,CROM)测量患者术前及术后随访24个月时颈椎前屈、后伸、左右侧弯、左右旋转六个方向的活动度。结果:患者术后随访24月,通过JOA评分量表及x线片等影像学评价手术治疗效果及融合节段融合率,从患者主诉分析,所有患者临床症状均得到缓解,有2例患者颈部轻微疼痛,5例患者颈部活动轻度受限。但所有患者治疗效果的改善率均60%,所有融合节段的融合率为100%,无人工骨移位、内固定松动以及椎间高度塌陷。与术前相比单节段融合术后患者颈椎左右侧弯方向活动度无明显差异(P0.05),而在前屈、后伸及左右旋转方向的活动度均较术前明显减低(P0.05)。行双节段融合手术后患者颈椎在六个方向的活动度较术前均明显减低(P0.05)。对两种不同融合术后患者颈椎活动度的差异进行统计学分析后发现双节段融合患者术后颈椎活动度在六个方向均较单节段融合患者降低(P0.05)。结论:颈椎融合能很好的治疗脊髓型颈椎病,但手术能够降低患者颈椎的活动度,与单节段融合相比双节段融合术后颈椎活动度的降低更为明显。
[Abstract]:Objective: to investigate the effect of single and double segmental cervical fusion surgery on cervical vertebra mobility. Methods: anterior cervical decompression was performed from June 2010 to June 2012 in the spine surgery department of the first affiliated Hospital of Southern Anhui Medical College. Fusion of 43 patients with cervical spondylosis, Among them, 29 cases were single segment fusion. 14 cases of double segment fusion were evaluated according to JOA score and X-ray radiography. Cervical flexion and extension were measured before and after 24 months follow up by using cervical motion measurement instrument (Cervical range of motion device). Results: the patients were followed up for 24 months after operation. The effect of surgical treatment and fusion rate of fusion segment were evaluated by JOA scale and X-ray film. The clinical symptoms of all the patients were relieved, and there were 2 patients with mild neck pain and 5 patients with mild cervical movement limitation, but the improvement rate of treatment effect in all patients was 600.The fusion rate of all fusion segments was 100 and there was no artificial bone displacement. Internal fixation loosening and intervertebral height collapse. There was no significant difference in the movement of left and right lateral curvature of cervical vertebrae in patients with single segment fusion compared with those before operation (P 0.05), but in anterior flexion. The range of motion in the direction of posterior extension and left and right rotation was significantly lower than that in pre-operation. The motion of cervical vertebrae in six directions after two-segment fusion operation was significantly lower than that in pre-operation. The motion of cervical vertebrae in two different fusion patients after operation was significantly lower than that before operation. After statistical analysis, it was found that the cervical motion in the patients with double segmental fusion was significantly lower than that in the patients with single segment fusion in six directions. Conclusion: cervical fusion can be used to treat cervical Spondylotic myelopathy (cervical Spondylotic myelopathy). But the operation can reduce the cervical vertebrae motion, compared with the single segment fusion, the reduction of the cervical spine motion is more obvious.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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