颈椎前路不同减压植骨融合治疗连续双节段颈椎病的疗效观察

兰州大学机构库 >第一临床医学院

	颈椎前路不同减压植骨融合治疗连续双节段颈椎病的疗效观察
Alternative Title	Comparison clinical efficacy of different anterior cervical methods in the treatment of two-level contiguous cervical spondylosis
	钱选昆
Subtype	硕士
Thesis Advisor	王建民 ; 王勇平
	2016-05-24
Degree Grantor	兰州大学
Place of Conferral	兰州
Degree Name	硕士
Keyword	脊柱植入物颈椎病前路减压髂骨植骨钛网 cage
Abstract	目的：比较颈椎前路三种术式治疗连续双节段颈椎病的有效性及安全性。方法：回顾分析2012年至2015年本院骨科收治并行手术的62例患者，据术式分为三组：椎间盘切除髂骨植骨术、椎体切除钛网植骨术和椎间盘切除cage植骨术。比较手术时间、出血量、植骨融合率、神经功能、椎体高度及曲度。结果：共纳入62例患者，结果显示髂骨组手术时间长于其他两组；出血量髂骨组>钛网组>cage组；三组术后JOA评分较术前均显著提高；术后3月植骨融合率髂骨组>钛网组和cage组，末次随访时均骨性融合；术后椎体高度较术前均增加，后缘高度增加量cage组大于其他两组。术后3月前缘高度丢失髂骨组>钛网组和cage组。后缘高度丢失量髂骨组>钛网组>cage组；融合节段Cobb角增加值钛网组大于髂骨组和cage组，术后3月Cobb角变化量髂骨组>钛网组>cage组，终访时前后缘高度、Cobb角与术后3月的差值相比较组间差异均无统计学意义。术后三组D值均较术前增加。3组术后均出现相关并发症，髂骨组并发症高于钛网组和cage组。结论：3种术式治疗连续双节段颈椎病均可取得满意的临床疗效。髂骨组手术时间长，术中出血量多，术后椎体后缘高度丢失明显。钛网组和cage组较髂骨组能更好的维持颈椎高度与曲度，且并发症较少，但cage组优势更明显。
Other Abstract	Objective: To compare the clinical and radiological efficacy and safety of three types of anterior cervical surgery in treating two-level contiguous cervical spondylosis. Methods: We collected clinical data of patients who underwent anterior decompression and fusion. Patients were divided into three groups according to different surgical methods: iliac bone group received anterior cervical discectomy with iliac bone graft fusion, titanium mesh group received cervical corpectomy with titanium mesh fusion and cage group received anterior cervical discectomy with cage fusion. Operation time, blood loss, complication rate and JOA scores, fusional segment height, fusional segment curvature and the D value were evaluated. Results: We collected 62 patients, results showed that operation time of the iliac bone group was significantly longer than that in titanium mesh and cage groups. Blood loss of iliac bone group was more than that of iliac bone group. JOA scores were significantly improved after treatment. The fusion rate of iliac bone group was higher than other two groups at 3 months after treatment, all patients showed complete fusion at the last follow-up. Height of anterior and posterior margin was significantly increased after treatment. The increase in the height of posterior margin in the Cage group was higher than other groups. Vertebral height loss was higher in the iliac bone group than other two groups, but vertebral height loss of was highest in the iliac graft group at 3 months after treatment. The increase value of Cobb angle was higher in the titanium mesh group than in the bone graft group and Cage group. At 3 months, the altered value of Cobb angle was highest in the iliac bone group. No significant difference in the height of anterior and posterior margins and Cobb angle was detectable between final follow-up and 3 months post-treatment. D value of the three groups was significantly increased after treatment. Conclusion: These findings indicated that three kinds of fusion method could achieve satisfactory clinical efficacy. The operation time of iliac bone group was long and blood loss was more. Postoperative height loss of the posterior margin was visible. Compared with the iliac bone group, titanium mesh and Cage groups could better maintain the height and curvature of the cervical vertebra.
URL	查看原文
Language	中文
Document Type	学位论文
Identifier	https://ir.lzu.edu.cn/handle/262010/201267
Collection	第一临床医学院
Recommended Citation GB/T 7714	钱选昆. 颈椎前路不同减压植骨融合治疗连续双节段颈椎病的疗效观察[D]. 兰州. 兰州大学,2016.

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