Denis三柱理论评价胸、腰椎结核稳定性的可行性研究

发布时间：2018-06-24 09:42

本文选题：Denis三柱理论胸 + 腰椎结核胸　；参考：《遵义医学院》2015年硕士论文

【摘要】：目的:探讨Denis三柱理论评价胸、腰椎结核稳定性的可行性研究,从而指导临床工作。方法:选取(2013年1月至2015年1月)在我科住院治疗的胸、腰椎结核患者共102例,并收集其临床资料(影像学资料:CT、X片、MRI,术后病理结果等),以每例患者单个病变椎及其下位椎间盘(共268个节段)为研究对象,根据Denis三柱分类,1.统计268个病变节段前柱、中柱、后柱、前中柱、前中后柱、前后柱、中后柱分别的破坏情况;2.统计不稳节段前柱、中柱、后柱、前中柱、前中后柱、前后柱、中后柱分别的破坏情况;3.分析不稳节段与三柱破坏之间的关系;4.使用χ2检验,比较一柱、两柱、三柱受破坏后与不稳节段量是否有统计学差异,计算r了解破坏柱数与不稳节段量的相关性。结果:1.据统计在268个病变节段中,前柱破坏21个、中柱破坏5个、后柱破坏1个、前中柱破坏216个、前中后柱破坏23个、前后柱破坏1个、中后柱破坏1个;2.据统计不稳定节段共92个,其中前中柱破坏76个、前中后柱破坏16个,前柱、中柱、后柱、前后柱及中后柱未发现不稳定节段,92个不稳节段中均累积中柱,且至少破坏两柱;3.据统计破坏一柱的病变节段27个,无不稳定节段,破坏两柱的病变节段218个,其中不稳定节段76个,不稳定节段占病变节段的35%,破坏三柱的病变节段23个,其中不稳定节段16个,不稳定节段占病变节段的70%;4.根据统计学结果(P=0.001)P0.05,差异有统计学意义,可认为一柱、两柱、三柱受破坏后与不稳节段量不全相同,(r=0.236)0r1,可认为破坏柱数与不稳节段量有关联且呈正相关。结论:1.中柱在胸、腰椎结核稳定性方面起到重要作用;2.单纯中柱受损并不能确定造成胸、腰椎结核不稳定;3.胸、腰椎结核破坏两柱或三柱后出现潜在不稳或不稳节段;4.用Denis三柱理论能较好判断胸、腰椎结核稳定性。
[Abstract]:Objective: to study the feasibility of Denis three-column theory in evaluating the stability of thoracic and lumbar tuberculosis. Methods: from January 2013 to January 2015, 102 patients with lumbar spine tuberculosis were treated in our department. The clinical data were collected (imaging data:% CTX, MRI, postoperative pathological results, etc.). Each patient with a single lesion vertebra and its lower intervertebral disc (totally 268 segments) was selected as the study object, and was classified according to Denis three-column classification. The destruction of the anterior column, the middle column, the posterior column, the anterior column and the posterior column in 268 lesion segments were analyzed. The failure of the anterior column, the middle column, the posterior column, the front column, the back column, the front column and the back column in the unstable segment were calculated. The relationship between unstable segments and failure of three columns is analyzed. 蠂 2 test was used to compare whether there was statistical difference between one column, two columns and three columns after failure, and to calculate the correlation between the number of damaged columns and the number of unstable segments. The result is 1: 1. According to statistics, 21 of 268 lesion segments were damaged in anterior column, 5 in middle column, 1 in posterior column, 216 in anterior and middle column, 23 in anterior and posterior column, 1 in anterior column and 1 in posterior column. According to statistics, there are 92 unstable segments, including 76 anterior and middle columns, 16 anterior, middle and posterior columns, 16 anterior column, middle column, posterior column, front column and middle column, no unstable segment, and at least two columns are destroyed in 92 unstable segments. According to statistics, there were 27 lesions in one column, no unstable segments, 218 lesions in two columns, 76 unstable segments, 35 unstable segments and 23 lesion segments in three columns. There were 16 unstable segments and 70% unstable segments. According to the statistical results (P0. 001) P0. 05, the difference is statistically significant. It can be concluded that the number of damaged columns is positively correlated with the number of unstable segments, and the quantity of unstable segments is not all the same after the destruction of one column, two columns and three columns are destroyed, (rn 0. 236) 0 r1.The results show that there is a positive correlation between the number of damaged columns and the number of unstable segments. Conclusion 1. The middle column plays an important role in the stability of thoracic and lumbar tuberculosis. Simple injury of the middle column can not be identified as the cause of thoracic and lumbar tuberculosis instability. The potential instability or instability of thoracic or lumbar tuberculosis after the destruction of two or three columns. The stability of thoracolumbar tuberculosis can be well judged by Denis three-column theory.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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