矢状面寰枢关节角度和复位指数在难复性寰枢椎脱位的诊断和治疗价值

发布时间：2018-03-20 22:46

本文选题：难复性寰枢椎脱位　切入点：复位指数　出处：《青岛大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:评价矢状面寰枢关节角度和复位指数在难复性寰枢椎脱位的诊断和治疗价值。方法:回顾性分析2008年1月至2014年7月间我院收治的难复性寰枢椎脱位患者24例。男13例,女11例;年龄20-62岁,平均43岁。根据手术方式不同分为两组:A组:前路松解+后路复位固定组,B:单纯后路复位固定组,此外,12名颈椎正常个体为对照组。测量参数包括:矢状位寰枢椎关节倾斜角、牵引前后寰齿前间距(atlas-dens interval,ADI)并计算复位指数。利用统计学软件对复位指数及矢状位寰枢关节倾斜角进行对比分析。结果:对照组平均矢状位寰枢关节面倾斜角:左侧为(5.6±1.9)°,右侧为(5.1±2.1)°;A组:左侧为(38.8±5.8)°,右侧为(39.5±6.0)°;B组:左侧为(23.9±6.1)°,右侧为(23.1±7.0)°。统计学分析显示对照组与A、B两组以及A和B组矢状位寰枢关节面倾斜角存在统计学意义差异(P0.05)。A组平均复位指数为(17.6±9.3)%,B组为(34.4±5.2)%,两组数据差异明显(P0.05)。A、B组矢状位寰椎倾斜角和复位指数间存在明显负相关性,即矢状位寰椎倾斜角越大,复位指数越小。结论:矢状位寰枢椎关节倾斜角和复位指数可作为评价寰枢椎脱位可复性程度的重要影像学指标。即复位指数27.9%,矢状位寰椎倾斜角32.5°时,可单纯采用后路手术;如复位指数27.9%,矢状位寰椎倾斜角32.5°时,需采用前路松解的前后联合手术。
[Abstract]:Objective: to evaluate the value of sagittal atlantoaxial joint angle and reduction index in the diagnosis and treatment of irreducible atlantoaxial dislocation. 11 female patients, aged 20-62 years, with an average of 43 years old, were divided into two groups according to the different surgical methods: group A: group B: group B: group B: group B: group B: group B: group B: group B: group B: anterior and posterior reduction and fixation; In addition, 12 normal individuals of cervical vertebrae served as control group. The measurement parameters included: sagittal atlantoaxial joint inclination angle, Atlas-dens intervalation before and after traction) and the reduction index was calculated. The reduction index and the atlantoaxial angle of the atlantoaxial joint in the sagittal position were analyzed by statistical software. Results: the average sagittal angle of the atlantoaxial articular surface in the control group: the left side of the atlantoaxial joint. The left side was 5.6 卤1.9 掳, the right side was 5.1 卤2.1 掳掳A group: the left side was 38.8 卤5.8 掳, the right side was 39.5 卤6.0 掳掳group B: the left side was 23.9 卤6.1 掳, the right side was 23.1 卤7.0 掳. Statistical analysis showed that there was a statistical difference between the control group and the AB group, as well as the sagittal atlantoaxial angle in group A and B. The average reduction index was 17.6 卤9.3% and 34.4 卤5.2% in group B. There was a significant negative correlation between the sagittal atlas inclination angle and reduction index in the two groups. That is, the sagittal angle of atlas is greater, Conclusion: the sagittal atlantoaxial joint inclination angle and reduction index can be used as an important imaging index to evaluate the degree of atlantoaxial dislocation, that is, when the reduction index is 27.9 and the sagittal angle of atlantoaxial tilt is 32.5 掳, the posterior approach can be used. If the reduction index is 27.9 and the sagittal atlas angle is 32.5 掳, the anterior and posterior decompression should be performed.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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