颈后路单开门椎管扩大成形术后C5神经根麻痹危险因素分析

发布时间：2018-10-23 12:20

【摘要】：目的:探究颈椎病病人接受颈后路单开门椎管扩大成形手术之后颈5神经根麻痹的风险因素。方法:收集山西医科大学第二临床医院骨科2011年3月至2014年3月期间96例接受颈后路单开门椎管扩大成形术的颈椎病病人。收集病人的医疗记录、影像数据,以及术后复查资料。患者入院后均行颈椎X线、颈椎CT以及颈椎MRI检查,择期接受颈后路单开门椎管扩大成形手术治疗,术后给予营养神经、补液、消炎消肿等对症治疗并密切观察病情变化。对患者影像学资料进行分析,提取数据:颈椎曲度指数,颈5椎间孔宽度,上关节突的位置。将出现颈5神经根麻痹病例与没有出现的病例分组,比较两组因素数据。应用统计学回归研究方法,评估颈5神经根麻痹的危险因素。结果:本研究项目共计96例接受颈后路单开门椎管扩大成形术的病人资料,其中7例出现颈5神经根麻痹,89例无颈5神经根麻痹。颈5神经根麻痹出现概率为7.3%。麻痹组与无麻痹组在颈5椎间孔宽度,以及上关节突向前位移的差异有统计学意义。logistic回归统计研究结论表明第一、二、三区间C5神经根麻痹的风险分别增加66.140(95%CI,4.811—908.857)、8.147(95%CI,0.575—115.141)及3.554倍(95%CI,0.154—80.861)。结论:术前C5椎间孔狭窄为颈后路单开门椎管扩大成形术后C5神经根麻痹的重要危险因素。
[Abstract]:Objective: to investigate the risk factors of cervical 5 nerve root paralysis in patients with cervical spondylosis after open door spinal canal reconstruction. Methods: from March 2011 to March 2014 96 patients with cervical spondylopathy underwent open door laminoplasty were collected from Department of Orthopaedics of the second Clinical Hospital of Shanxi Medical University. Collect patient's medical records, imaging data, and postoperative review data. After admission, all patients underwent X-ray examination, cervical spine CT and cervical MRI examination. The patients were treated with open door spinal canal enlargement surgery via posterior cervical approach. The patients were treated with nutritional nerve, fluid replacement, anti-inflammatory and swelling treatment, and the changes of the disease were observed closely. The imaging data of the patients were analyzed, and the cervical curvature index, the width of intervertebral foramen and the position of the upper articular process were extracted. The patients with cervical 5 nerve root paralysis were divided into two groups. The risk factors of cervical 5 nerve root paralysis were evaluated by statistical regression method. Results: a total of 96 patients underwent open door laminoplasty via posterior cervical approach, of which 7 had cervical 5 nerve root paralysis and 89 had no cervical 5 nerve root paralysis. The probability of occurrence of cervical 5 nerve root paralysis was 7.3. There were significant differences in the width of intervertebral foramen and the forward displacement of the upper articular process between the paralytic group and the non-paralyzed group. The risk of nerve root palsy increased by 66.140 (95CI 4.811-908.857), 8.147 (95CI0.575-115.141) and 3.554 times (95CI0.154-80.861), respectively. Conclusion: preoperative stenosis of intervertebral foramen is an important risk factor for C5 nerve root palsy after open door laminoplasty.
【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

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