带线锚钉固定与微型钛板固定在颈椎后路单开门椎管扩大成形术中的应用效果比较

发布时间：2018-05-05 01:24

本文选题：微型钛板 + 带线锚钉　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:比较带线锚钉固定与微型钛板固定在颈椎后路单开门椎管扩大成形术中的应用效果。方法:回顾性分析我院2010年1月至2012年6月因多节段脊髓型颈椎病分别采用颈后路单开门带线锚钉固定与颈后路单开门微型钛板固定治疗的病例,比较两组在手术时间、术中出血量、术后JOA评分、最窄椎管面积、并发症等方面的差异。结果:手术时间及术中出血量:带线锚钉组与微型钛板组组间差异有统计学意义;JOA评分:术前及术后1周,带线锚钉组与微型钛板组组间差异无统计学意义,术后两年,组间差异有统计学意义,微型钛板组评分高于带线锚钉组;最窄椎管面积:术前及术后1周,组间差异无统计学意义,术后两年,组间差异有统计学意义,微型钛板组最窄椎管面积大于带线锚钉组;并发症:两组患者切口均为甲级愈合,未出现伤口感染、脑脊液漏等严重并发症。结论:颈椎后路单开门椎管扩大成形术的两种固定方法均能增加脊髓受压患者病变部位的椎管面积,有效改善患者神经功能,微型钛板固定虽有手术时间长、出血量大等缺点,但能有效防止再关门现象,具有更好的远期疗效。
[Abstract]:Objective: to compare the effect of wire anchor screw fixation and micro titanium plate fixation in posterior open door laminoplasty. Methods: from January 2010 to June 2012, patients with cervical Spondylotic myelopathy in our hospital were treated with posterior cervical open door fixation with wire anchor nail and posterior cervical open door mini-titanium plate fixation respectively. The operative time was compared between the two groups. Differences in intraoperative bleeding, postoperative JOA score, area of the narrowest spinal canal, complications, etc. Results: the time of operation and the amount of intraoperative bleeding: there was significant difference in JOA score between the group with wire anchor nail and the group with micro titanium plate. There was no significant difference between the group with wire anchor nail and group with mini titanium plate before operation and one week after operation, but there was no significant difference between the group with wire anchor nail and group with mini titanium plate two years after operation. There was no significant difference in the area of the narrowest spinal canal between the two groups before and 1 week after operation, but two years after the operation, the difference between the two groups was statistically significant, while the score of the mini-titanium plate group was higher than that of the group with wire anchor nail, and the area of the narrowest spinal canal had no significant difference between the two groups. The area of the narrowest spinal canal in the miniature titanium plate group was larger than that in the wire anchor nail group, and the complications were as follows: the incision of both groups was grade A healing, no wound infection, cerebrospinal fluid leakage and other serious complications. Conclusion: the two methods of open door laminoplasty in posterior cervical spine can increase the area of spinal canal in patients with spinal cord compression, and improve the nerve function of patients effectively. Although the microplate fixation has the disadvantages of long operation time and large amount of bleeding, etc. But can effectively prevent the phenomenon of re-closing, has a better long-term effect.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

【参考文献】