经口咽显微镜下切除齿状突联合后路枕颈融合治疗颅底凹陷症

经口咽显微镜下切除齿状突联合后路枕颈融合治疗颅底凹陷症

ID:23256782

大小:1.04 MB

页数:30页

时间:2018-11-06

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1、126°,withtheaverageof112.6±9.2°.Thesymptomsofallpatientsdidnotimproveafterthetreatmentofskulltraction,and2casesbecameworse.Allpatientswereoperatedbycombiningtransoralodontoidectomywithoccipital-cervicalfusionwithintraoperativeneuro-physiologicalmonitoring.Amongthem,4caseswereoperatedbythe

2、traditionaltransoralapproach;11caseswereoperatedbymicroscopictransoralapproach.TomeasureparametersofthesepatientsonCL,ML,WL,Klausheightindex,extensioncordangleandclivuscanalanglebeforeandafteroperationaccordingtoeachpatientimagingdataandcompareditwithpairedTteststatistics.TheJapaneseOrtho

3、pedicAssociation(JOA)wasusedforevaluatingspinalcordfuncionofeachpatient.Surgicalcomplicationsandgraft-bonefusionwerealsorecorded.Result:Allpatientswereachievedsatisfiedfollowed-up.Thefollowed-uptimeofallpatientsrangedfrom12monthsto20months,withtheaverageof16months.Theimagingparametersofth

4、esepatientsonCL,ML,WL,Klausheightindex,cervicomedullaryangleandclivuscanalanglebeforeoperationwere15~20mm、10~16mm、13~19mm、10~23mm、95~126°、105~128°respectively.Andafteroperationitwere-5~-2mm、-7~-3mm、-5~2mm、30.5~42.5mm、152~175°、131~146°respectively.Comparedtopreoperativeimagingparameters,po

5、stoperativeimagingparameterswereimprovedobviously.Therewereobviousstatisticalsignificanceinimagingparametersofthesepatientsbeforeand5万方数据afteroperation(p<0.01).ThemeanJOAscoresofpreoperationandlastfollowed-upafteroperationwere6.5±1.6、14.1±1.2respectively.Theimprovementratiowas71.5%.thenth

6、ecurativeeffectswereshowed:exellentin5cases,goodin9cases,commonin1caseandnopoorcases.Andtherateofexcellentandgoodoftheclinicalresultwas93.3%.TherewerenoobviousdeclinephenomenononamplitudesofSEPandMEPunderintraoperativeneuro-physiologicalmonitoring.Allpatientsshowednocomplications,suchasve

7、rtebral-arteryinjury,leakageofcerebrospinalfluid,infection,failureofgraft-bonefusion,spinalcordandnerverootinjury,etc.4casesoperatedbythetraditionaltransoralprocedureperformedwithtemporomandibularjointpain,while11casesoperatedbymicroscopictransoralapproachdidnotappe

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