颅底凹陷症合并寰枢椎脱位患者枕颈角与下颈椎曲度的关系

发布时间：2018-04-18 11:24

  本文选题：颅底凹陷症 + 寰枢椎脱位　； 参考：《中国脊柱脊髓杂志》2017年01期

【摘要】：目的:评估颅底凹陷症(basilar invagination,BI)合并寰枢椎脱位(atlantoaxial dislocation,AAD)患者枕颈角(O-C2角)与下颈椎曲度(C2-7 Cobb角)之间的关系。方法:回顾性分析2009年1月~2013年6月21例于我院因BI合并AAD行后路复位枕颈融合术患者的临床资料。21例患者中男12例,女9例;年龄21~65岁(41.6±10.7岁);病程4个月~18年(4.3±3.9年)。于手术前和术后末次随访时在颈椎中立位侧位X线片上测量O-C2及C2-7 Cobb角(C2-7角),并计算O-C2角及C2-7角的变化量dO-C2角和dC2-7角,前凸为“+”值,后凸为值。根据O-C2角的大小,将21例患者术前和末次随访时分为10°≤O-C2角≤20°组、O-C2角10°组及O-C2角20°组。观测手术前后不同O-C2角组C2-7角的差异,分析手术前后O-C2角与C2-7角的相关性。结果:21例患者中,12例患者固定节段为C0-C3,9例患者为C0-C4。随访时间为10~32个月(18.3±6.6个月)。术后末次随访时O-C2角较术前平均增大6.3°,C2-7角较术前平均减小6°,手术前后两指标比较均存在显著性差异(P0.05)。术前6例(28.6%)患者O-C2角在10°~20°间,12例(57.1%)10°,3例(14.3%)20°。OC2角10°组C2-7角显著大于O-C2角10°~20°组及20°组(P0.05),O-C2角10°~20°组与20°组比较无显著性差异(P0.05)。末次随访时10例(47.6%)患者O-C2角在10°~20°间,4例(19.0%)20°,7例(33.4%)10°,O-C2角20°组C2-7角显著小于O-C2角10°~20°组及10°组(P0.05),O-C2角10°~20°组与10°组比较无显著性差异(P0.05)。术前及术后末次随访时O-C2角与C2-7角均存在显著性负相关(术前r=-0.732,P0.05;术后r=-0.603,P0.05);d0-C2角及dC2-7角亦存在显著性负相关(r=-0.721,P0.05)。结论:BI合并AAD患者枕颈角与下颈椎曲度关系密切,行后路复位枕颈融合术时需监测枕颈角的固定角度,若枕颈角过大有可能导致术后下颈椎曲度出现代偿性减小。
[Abstract]:Objective: to evaluate the relationship between basilar invagination (BI) and occipitocervical angle (O-C2) and lower cervical curvature (C2-7 Cobb) in patients with atlantoaxial dislocation.Methods: the clinical data of 21 patients who underwent posterior reduction of occipitocervical fusion in our hospital with AAD from January 2009 to June 2013 were analyzed retrospectively. There were 12 males and 9 females, aged from 21 to 65 years old, 41.6 卤10.7 years old and 4 months to 18 years, 4.3 卤3.9 years.The changes of O-C2 and C2-7 Cobb angle C2-7 angle were measured before operation and at the last follow-up after operation. The dO-C2 angle and dC2-7 angle of O-C2 angle and C2-7 angle were calculated. The kyphoid angle was "" and "kyphosis" value.According to the size of O-C2 angle, 21 patients were divided into 10 掳鈮，

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