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ID:44891587
大小:353.50 KB
页数:16页
时间:2019-11-01
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1、摘要是原来发表时已经翻译好的!后路椎板切除、钉棒系统内固定治疗上颈椎椎管内肿瘤Treatmentofcanaltumorsoftheuppercervicalspinebyposteriorlaminectomyandfixationscrewrodsystem【摘要】目的探讨后路椎板切除、钉棒系统内固定及自体髂骨植骨融合术治疗上颈椎椎管内肿瘤的方法及疗效。方法2003年1月至2008年6月,共收治上颈椎椎管内肿瘤患者16例,男10例,女6例;年龄33-68岁,平均44.7岁。硬膜外肿瘤2例,硬脊膜下脊髓外肿瘤13例,髓内肿
2、瘤1例。肿瘤位于延髓-C1,3例,C1,28例,C2水平2例,C1-32例,C2,3l例;其中4例肿瘤位于颈髓腹侧。15例患者行CT或MR检查示肿瘤组织压迫脊髓。Frankel分级:C级5例,D级10例,E级1例。采用后路椎板切除肿瘤,同时行钉棒系统内固定及自体髂骨植骨融合术。结果所有患者术后均获得随访,随访时间8个月,平均27.4个月。根据JOA17分法评分,术前争6-17分,平均8.8分;术后6个月14-17分,平均16分,平均改善率88.1%。术后影像学检查示植骨融合良好。Frankel分级:7例由术前的D级恢复至E级
3、,5例由C级恢复至D级,3例D级及l例E级的患者术后未改变。结论后路椎板切除肿瘤、钉棒系统内固定及植骨融合治疗上颈椎椎管内肿瘤,可彻底切除肿瘤病灶,解除颈脊髓及神经根压迫,重建上颈椎的稳定。【关键词】颈椎;椎管;肿瘤;内固定器【Abstract】ObjectiveToinvestigatethemethodsandcurativeeffectsofposteriorlaminectomyandfixationscrewrodsystemintreatmentofcanaltumorsoftheuppercervicalspi
4、ne.MethodsBetweenJanuary2003andJune2008,16patients(10malesand6females,averageage44.7years,range33-68years)withcanaltumoroftheuppercervicalspineweretreated,includingepiduralneoplasmsin2cases,intraduralextramedullarytumorsin13,andintramedullarytumorinlcase.Thetumorsw
5、erelocatedbetweenmedullaoblongataandC1in3cases,C1,2in8,C2in2,Cl-3in2,C2,3inl;4caseswerelocatedatventralisofcervicalcord.SpinalcordwaspressedbytissueoftumorinFifteenpatientswhichwerediagnosedbyMRIandcomputerizedtomographic(CT)scans.AccordingtotheFrankelgradingsystem
6、,thereWasCin5eases,Din10cases.Einlcase.Theyweretreatedbyposteriorapproachtoremoveoftumorsafterlaminectomy,fixationwithpediclescrewrodsystemandfusionwithautogenousbonegrafts.ResultsThefollowupwasobtainedfor6-58months(mean27.4months).AccordingtotheJOAgradingsystem,th
7、epreoperativeaveragescorewas8.8,16at6monthspostoperatively,andtheaverageimprovementratewas88.1%.AccordingtotheFrankelgradingsystem,7casesimprovedfromDtoE,5fromCtoD,butnonein3caseswithFrankelDandlwithE.ThegoodfusionofbonegraftWasfoundiniconographyexamination.Conclus
8、ionThetreatmentbyposteriorapproachtoremoveoftumorsafterlamineetomy,andfixationwithpediclescrewsystemandfuIsionwithautogenousbonegrafts,canrelivec
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