颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及治疗【临床医学毕业论文设计，精品.doc

《颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及治疗【临床医学毕业论文设计，精品.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、临床医学论文-颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及治疗【摘要】探讨颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及其治疗｛方法〕对76例颈椎后纵韧带骨化症患者的临床资料进行回顾性分析。根据原始X线片测量颈椎椎体、椎管矢状径，计算Pavlov比値，根据计算结果将患者分为伴发育性椎管狭窄颈椎后纵韧带骨化症组（DSS组）和不伴发育性椎管狭窄颈椎后纵韧带骨化症组（NDSS组）。根据CT分别测量两组骨化灶最大厚度，计算椎管矢状径残存率。其中前路手术4例，后路手术72例，按JOA标准评分判断术后改善率。〔结果〕DSS组53例，NDSS组23例；NDSS组骨化灶最大厚度比DSS组大，有

2、统计学意义；发病时两组椎管矢状径残存率有差异，但是无统计学意义；两组术前、术后3个月JOA评分有差别，但是无统计学意义。〔结论〕发育性椎管狭窄是影响颈椎后纵韧带骨化症病程的重耍病理基础，创伤是诱发其发病的主要因素，后路减压术是一种较合理的治疗方式。【关键词】颈椎后纵韧带骨化发育性椎管狭窄创伤手术治疗Abstract:(Objective]Todiscussclinicfeatureandtreatmentofossificationofcervicalposteriorlongitudinal1igamentassociatedwithdevelopmentalspinalste

3、nosis・〔Method〕Theclinicdataof76patientswithossificationofcervicalposteriorlongitudinal1igamentwerereviewedandanalyzed・McasuringthemiddlesagittaidiameterratioofvertebralcanalandvertebralbodybytheoriginallateralcervicalvertebraXrayandcalculatingPavlovratio.Al1theenrolledpatientsweredividedintot

4、wogroups:DSSgroupconsistedof53patientsassociatedwithdevelopmentalspinalstenosis,NDSSgroupconsistedof23patientswithoutdevelopmentalspinalstenosis・MeasuringthebiggestthicknessofossificationfocusandtheresidualsagittaldiameterofthespinalcanalrateatthenarrowestlevelattributabletoOPLL.4ofthemwerede

5、compressedfromananteriorapproachand72fromaposteriorapproach.TheimprovementrateaccordingtoJOAscoringwereevaluated.(Result〕DSSgroupconsistedof53patients,NDSSgroupconsistedof23patients.Thebiggestthicknessofossificationfocus,NDSSgroup>DSSgroup,withstatisticalsignificance.Theresidualsagittaidiamet

6、erofthespinalcanalrateatthenarrowestlevel,NDSSgroup>DSSgroup,althoughwithoutstatisticalsignificance.JOAscoreoftwogroupsbeforeandaftersurgerywithoutstatisticalsignificance・〔Conclusion〕Developmentalspinalstenosisispathologyfound,whichinfluencescourseofossificationofcervicalposteriorlongitudinal

7、1igament.Theprincipalfactoristrauma,whichinducesossificationofcervicalposteriorlongitudinalligament.Decompressedfromaposteriorapproachisareasonabletreatmentway.Keywords:cervicalspine;ossificationofcervicalposteriorlongitudinalligament;develop