单侧椎弓根螺钉固定结合Cage椎间融合对融合节段对侧椎间孔的影响

发布时间：2018-09-04 21:06

【摘要】：目的探讨单侧椎弓根螺钉固定结合椎间Cage植骨融合术对融合节段对侧椎间孔解剖结构的影响。方法通过对南华大学附属南华医院脊柱外科2012年12月至2013年12月施行腰椎4/5后路单侧椎弓根螺钉固定结合椎间Cage植骨融合手术治疗的30位患者的病例资料进行回顾性研究。应用计算机多层螺旋CT三维重建技术,分别测量术前及术后腰4/5节段手术侧对侧椎间孔的纵径和横径的数据;应用日本矫形外科学会(JOA)评分评价30位参加研究的患者术前及术后腰腿疼痛缓解的情况,并统计分析实施手术后融合节段对侧椎间孔形态的改变。结果术后椎间孔椎间孔纵径17.39±2.21mm、横径10.23±0.99mm与术前椎间孔纵径为17.18±2.87mm、横径为9.98±1.53mm通过统计学分析,P0.05,不具有统计学意义,表明手术前后数值无明显变化。由JOA评分结果可知,所有患者术前JOA评分为(11.73±1.337),术后1周、6个月、12个月的JOA评分依次为(21.00±3.824)、(25.13±2.945)、(25.53±3.794),术后患者JOA评分结果明显高于术前评分,P0.05,具有统计学意义,表明手术效果良好。结论采用单侧椎弓根螺钉固定结合Cage椎间融合手术治疗腰椎退行性疾病后手术节段对侧椎间孔横径与纵径并无明显改变,且术后患者腰腿疼痛明显缓解,说明部分患者术后发生手术节段对侧下肢疼痛与椎间孔不存在直接的因果关系。
[Abstract]:Objective to investigate the effect of unilateral pedicle screw fixation and intervertebral Cage fusion on the anatomical structure of the contralateral intervertebral foramen. Methods from December 2012 to December 2013, 30 patients treated with unilateral pedicle screw fixation combined with intervertebral Cage fusion were retrospectively studied. The longitudinal and transverse diameters of the contralateral intervertebral foramen were measured before and after lumbar 4 / 5 segment operation by computer multislice CT reconstruction. The (JOA) score of the Japanese Orthopedic Society was used to evaluate the pain relief of lumbar and leg in 30 patients before and after operation, and the morphological changes of contralateral intervertebral foramen in fusion segment after operation were statistically analyzed. Results the longitudinal diameter of intervertebral foramen was 17.39 卤2.21mm, the transverse diameter was 10.23 卤0.99mm and the preoperative diameter of intervertebral foramen was 17.18 卤2.87mm. The transverse diameter was 9.98 卤1.53mm. According to the JOA score, the preoperative JOA score of all patients was (11.73 卤1.337), the JOA score of 1 week, 6 months and 12 months after operation was (21.00 卤3.824), (25.13 卤2.945), (25.53 卤3.794), and the JOA score of postoperative patients was significantly higher than that of preoperative score (P 0.05), which indicated that the operation effect was good. Conclusion the transverse and longitudinal diameter of the contralateral intervertebral foramen in the treatment of lumbar degenerative diseases by unilateral pedicle screw fixation combined with Cage intervertebral fusion surgery has no obvious change, and the pain of the lumbar leg and the lumbar leg after operation is obviously alleviated. The results showed that there was no direct causal relationship between postoperative contralateral lower limb pain and intervertebral foramen in some patients.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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