T1斜坡角对颈后路双开门椎管扩大成形术后颈椎曲度变化的影响

发布时间：2018-05-07 20:04

本文选题：颈椎后路双开门 + 颈椎矢状面平衡　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:通过对术前T1斜坡角与术后颈椎曲度相关参数的测量,探索T1斜坡角对颈后路双开门椎管扩大成形术后颈椎曲度变化的影响。方法:对吉林大学中日联谊医院2014年至2016年期间48例因脊髓型颈椎病行颈3-6后路双开门椎管扩大成形术患者的临床及影像学资料进行回顾性分析。测量术前站立位及维持视线水平时T1椎体上缘与水平线的夹角(T1-Slope),比较术前及末次随访时站立位及维持视线水平时侧位片X线上C2及颈C7椎体下缘垂线的夹角(Cobb角)。结果:随访平均14.6(12-18)个月,患者Cobb C2-7由术前(14.43±4.24)°减小到(8.18±3.01)°,术前T1-S与术前Cobb C2-7大小呈正相关。根据术前测得的T1-S值,将其分为高T1-S和低T1-S组,两组之间年龄无统计学差异(P0.05),两组之间术前Cobb角及术后Cobb角均存在统计学差异(P0.05),高T1-S组术前与术后Cobb差值为(7.50±3.99)°,低T1-S组术前与术后Cobb差值为(4.89±3.99)°,两者之间存在统计学差异(P0.05)。结论:术前T1-S的大小与颈椎前凸大小呈正相关。颈椎后路双开门椎管扩大成形术后颈椎矢状面平衡发生明显变化,颈椎曲度减小,颈椎前凸不同程度丧失,表现为颈椎向前倾斜。其中颈椎前凸丧失的程度与术前T1-Slope相关,T1-S较大者,颈椎后路双开门术后前凸丧失程度较大。但术前T1-S较大的患者术后颈椎前凸仍大于T1S较小的患者。
[Abstract]:Objective: to investigate the effect of T 1 slope angle on cervical curvature after double open laminoplasty by measuring the parameters of preoperative T 1 Clivus angle and postoperative cervical curvature. Methods: the clinical and imaging data of 48 patients with cervical Spondylotic myelopathy treated with open door spinal canal reconstruction via 3-6 posterior approach from 2014 to 2016 in the Sino-Japanese Friendship Hospital of Jilin University were retrospectively analyzed. The angle between the upper edge of T1 vertebral body and horizontal line was measured in the standing position and maintaining line of sight before operation. The angle of Cobb angle was compared between the vertical line of C2 and the lower margin of the cervical C7 vertebra on X-ray radiographs before and after the last follow-up and at the level of line of sight. Results: Cobb C2-7 decreased from 14.43 卤4.24 掳to 8.18 卤3.01 掳after follow-up for an average of 14.6 卤12-18 months. There was a positive correlation between preoperative T1-S and preoperative Cobb C2-7. According to the values of T1-S measured before operation, they were divided into high T1-S group and low T1-S group. There was no significant difference in age between the two groups (P 0.05). There was a significant difference in preoperative Cobb angle and postoperative Cobb angle between the two groups (P 0.05). The difference between preoperative and postoperative Cobb was 7.50 卤3.99 掳in high T1-S group and 4.89 卤3.99 掳in low T1-S group. There was a statistical difference between the two groups (P 0.05 掳). Conclusion: there is a positive correlation between the size of T 1 S and the size of cervical kyphosis. The sagittal balance of cervical vertebrae was changed obviously after double open door laminoplasty, the curvature of cervical vertebra decreased and the kyphosis of cervical spine was lost to different degrees, which showed that the cervical vertebrae tilted forward. The degree of loss of cervical kyphosis was higher than that of preoperative T1-Slope associated with T1-S, and the degree of loss of anterior kyphosis was greater after double open door operation. But the patients with larger T 1 S before operation were still larger than those with smaller T 1 S after operation.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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