前路“杂交式”减压融合治疗多节段颈椎病

发布时间：2018-02-22 20:23

本文关键词： 杂交式融合三个阶段前路颈椎病　出处：《吉林大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：回顾性研究以评价前路杂交式（ACCF联合ACDF）融合的手术方案治疗多节段颈椎病的临床疗效。方法：对自2012年3月至2014年6月11例多节段病变的颈椎病患者采用前路杂交式（主要病变节段椎体次全切、次要节段单纯间盘摘除、钛笼植骨、Cage撑开、钢板固定）融合手术方案治疗，分析患者年龄、手术时间、术中出血量、病变节段、融合节段Cobb角、比较术前术后JOA评分，计算改善率，影像学资料衡量术后内固定状况与愈合情况，以及有无严重并发症发生。结果：随访时间8至24个月，平均随访时间15个月，术后JOA评分较术前提高，改善率优良，平均手术时间，术中平均出血量；采用前路杂交式融合的手术方案术后未出现C5神经根刺激征、硬膜囊破裂、神经功能恶化等严重并发症，随访过程中无植骨块延期愈合、内固定物下沉等并发症发生；至末次随访，未出现椎体坍塌、内固定失败等严重并发症，1例在末次随访中出现邻近节段退变，但未出现脊髓压迫症状及不适主诉，随访过程中复查X线片、CT证实植骨愈合良好。结论: 前路杂交式（ACCF联合ACDF）融合手术方案是治疗多节段颈椎病的一种可供选择的较理想手术方案。
[Abstract]:Objective:. A retrospective study was conducted to evaluate the clinical efficacy of anterior hybrid ACCF combined with ACDF fusion in the treatment of multilevel cervical spondylosis. Methods:. From March 2012 to June 11th 2014, patients with cervical spondylopathy with multiple segmental lesions were treated with anterior hybridization (subtotal dissection of the main lesions, simple dissecting of the secondary segments, and cage bone graft Cage). Age, operation time, intraoperative bleeding volume, lesion segment and Cobb angle of fusion segment were analyzed. The JOA score before and after operation was compared, and the improvement rate was calculated. Imaging data were used to measure the internal fixation and healing, and the occurrence of severe complications. Results:. The follow-up time was 8 to 24 months, the average follow-up time was 15 months, the postoperative JOA score was higher than that before operation, the improvement rate was good, the average operation time and the average amount of blood loss during operation were improved. There were no serious complications such as C5 nerve root irritation, dural sac rupture, nerve function deterioration, etc. During the follow-up, there were no complications such as delayed healing of bone graft and sinking of internal fixation. At the last follow-up, there was no vertebral collapse, one case with severe complications such as failure of internal fixation and adjacent segment degeneration, but no symptoms of spinal cord compression and discomfort. During follow-up, X-ray film and CT confirmed good union of bone graft. Conclusion:. Anterior hybrid ACCF combined with ACDF fusion surgery is an ideal alternative for the treatment of multilevel cervical spondylosis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.32

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