后纵韧带切除和保留在脊髓型颈椎病前路减压融合术中的适应症

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1、湖北中医药大学学位论文原创性声明本人声明：所呈交的学位论文是在导师的指导下进行的研究工作及取得的研究成果。除了论文中特别加以标注和致谢的地方外，本论文不包含其他个人或集体已经发表或撰写过的研究成果，也不包含为获得湖北中医药大学或其他单位的学位或证书而使用过的材料。对本文的研究做出贡献的个人和集体，均已在论文中作了明确的说明。本人完全意识到本声明的法律结果由本人承担。学位论文作者签名：文夕垆年厂月1芦关于学位论文使用授权的声明本人完全了解湖北中医药大学有关保留、使用学位论文的规定，即：学校有权保留学位论文，允许学位论文被查阅和借阅；学校可以公布学位论文的全部或部份内容，可以

2、采用复印、缩印或其他手段保留学位论文；学校可以根据国家或湖北省有关部门的规定送交学位论文。同意《中国优秀博硕士论文全文数据库出版章程》的内容。同意授权中国科学技术信息研究所将本人学位论文收录到《中国学位论文全文数据库》。(保密论文在解密后遵守此规定)论文作者签名：7豇诧／导师签名：f甲年}月、)日目录中文摘要············一一一一一一一一一一一一一一““一一一一lABSTRACT····················································III缩略词表·······-··························

3、··················Ⅵ前言····························-··············一一一一一一一1正文·························································．21、临床资料······-········································．22、手术方法·········································一一一·33、结果········································一一一．．

4、一·．44、讨论································-·················一55、结语·············································一一一11参考文献············································一一一·12附录一·····················································15综述····················································一·15l、流行病

5、学研究···································一一一一152、自然史研究·················一一一一一一一“一“一一一一均3、COPLL的病因病机····································一·164、影像学研究·········································一一175、COPLL的临床治疗手段···································．18参考文献·········································一一一一2

6、3附录二······················································27附表························································33致谢．．．．．．．．．．．．············································35中文摘要目的：探讨临床上后纵韧带切除和保留在脊髓型颈椎病前路减压融合术中的适应症。方法：回顾性研究2012年6月一2013年12月湖北省人民医院脊柱外科行颈椎前路减压植骨融合内固定术治疗脊髓型颈椎病患者69例，分A组和

7、B组，其中A组为脊髓受压且伴椎体后缘增生，共40例，B组为单纯椎间盘突出致脊髓受压，共29例。由同一医生记录患者术前JOA评分，并且患者出院后由该医生通过门诊复查的方式，记录术后JOA评分，分别计算出两组中后纵韧带切除组和保留组的术后改善率，通过t检验，分别对比A组和B组中的后纵韧带切除组和后纵韧带保留组的术后改善情况，以及术中出血量和手术时间。结果：A组平均随访12个月，B组平均随访13．5个月。其中术中A组一共24例切除后纵韧带，16例保留后纵韧带。B组一共15例切除，14例保留。术后有l例并发脑脊液漏，为A组中的行后纵韧