累及枢椎的双开门椎管扩大成形术开槽角的测量及临床意义

发布时间：2018-06-08 23:49

本文选题：双开门椎管扩大成型术 + 后纵韧带骨化　；参考：《吉林大学》2015年硕士论文

【摘要】：目的：通过测量C2-7各节段椎板倾斜角并推导双开门术中的开槽角，结果数据行统计学分析，了解不同颈椎节段开槽角的变化趋势及差异，，并探讨其临床意义。方法：选取我院门诊行颈椎CT检查病人100例。其中男50例，女50例。年龄27-79岁，平均47.35岁。选取C2-7各节段CT轴位像上椎板最厚层面，于椎板上缘与棘突交界处内外侧骨皮质各取一点，连成一线段，取其中点。于椎板下缘与关节突交界处得一线段中点，穿过两中点连线作一直线做为椎板平行线，该线与正中矢状线夹于一角，即为椎板倾斜角。取开槽点做垂直于椎板平行线的直线相交正中矢状线于一角，即为双开门术中开槽角，开槽角与倾斜角互补。于三维CT工作站测量C2-7各节段椎板倾斜角，并推导开槽角，测量角度精确至0.01°。对测得数据进行统计分析。结果： C2-7各节段椎板平均开槽角分别为：42.27°、37.44°、37.20°、38.53°、38.40°、40.16°，C2C7C5C6C3C4。C2与C3-7间差异有统计学意义（P 0.05），C7与C3-6间差异有统计学意义（P 0.05），C3-6间任两组比较差异均无统计学意义（P0.05）。按不同性别分组，各节段平均开槽角度男性均大于女性，差异具有统计学意义。结论： 1、双开门椎管扩大成形术需减压C2节段时，其开槽角应较C3-7增大。2、行C7节段开门时应较C3-6增大开槽角。3、C2-7相同节段的开槽角男性均应大于女性。4、对累及C2拟行双开门椎管扩大成形术的病例，可术前于CT测量减压节段开槽角，制定个体化的手术方案，减少手术风险。
[Abstract]:Objective: to measure the inclination angle of C2-7 lamina and deduce the slotted angle during double open door operation. The data were analyzed statistically to find out the change trend and difference of different cervical slotted angle. Methods: 100 patients with cervical spine CT were selected. There were 50 males and 50 females. The average age was 47.35 years. C2-7 CT axial images of the thickest layer of the upper lamina were selected, and the internal and external cortex of the upper margin of the lamina and the spinous process were taken at the junction of the upper lamina and the spinous process. At the junction of the lower edge of the lamina and the articular process, a midline is obtained, and a straight line is made through the two midpoints as the parallel line of the lamina. The line is clamped in one corner with the median sagittal line, that is, the angle of the vertebral lamina. The slotted point is taken as the straight line intersecting the median sagittal line perpendicular to the parallel line of the vertebral lamina at one corner, that is, the slotted angle during the double door opening, the slotting angle and the inclined angle complement each other. The oblique angle of C2-7 lamina was measured by 3D CT workstation, and the slotted angle was deduced. The measurement angle was accurate to 0.01 掳. Results: the average slotted angle of each segment of C2-7 vertebral lamina was: 1 / 42.27 掳/ 37.44 掳/ 37.20 掳/ 38.53 掳/ 38.40 掳/ 40.16 掳C _ 2C _ 7C _ 5C _ 6C _ 3C _ 4.C2 and C _ 3-7 respectively. There was no significant difference between C _ 2C _ 7C _ 5C _ 6C _ 3C _ 4.C2 and C _ 3-7 (P 0.05). The average slotted angle of each segment was greater in male than in female, and the difference was statistically significant. Conclusion: 1. The slotted angle should be larger than that of C3-7, and the slotted angle of the same segment of C7 should be larger than that of C3-6. The slotted angle of males in the same segment of C7 should be larger than that of females. Preoperative CT can be used to measure the slotted angle of decompression segment and make individual operation plan to reduce the risk of operation.
【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】：R687.3

【参考文献】