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时间:2017-12-10
《前路手术治疗颈椎管狭窄症的疗效观察》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、万方数据·296·前路手术治疗颈椎管狭窄症的疗效观察吕碧涛袁文陈华江王新伟周许辉.脊柱外科研究.【摘要】目的探讨前路手术治疗颈椎管狭窄症的疗效及方法。方法回顾性分析2007年3月至2010年3月采用前路手术治疗的颈椎管狭窄症162例t统计手术时间、术中出血量、术后住院时间,观察术后植骨融合情况,在颈椎标准侧位x线片上测量Cobb角变化,在颈椎MRI中矢位上测量纤维性椎管矢状径变化,以JOA评分法评价神经功能改善情况。结果术后随访9一18个月,平均12.8个月,平均手术时间86.4min,平均术中出血量80.2“,平均术后住院5.3d,术后3个月所有病例均达到骨性融合,椎管矢状径较术前平
2、均增加4.23咖,颈椎前凸Cobb角平均增加7.2。,神经功能JOA评分平均升高6.1分。结论颈椎管狭窄症压迫大多来自前方,前路手术能够直接减压,手术时间短、术中出血量少、病人恢复快,能够有效恢复颈椎生理曲度和椎管容积,疗效满意。【关键词】椎管狭窄;颈椎;外科手术;前路手术EflicadesofanteriorapproachforcervicalspinalcanalstenosisLOBi—tao,YUANWen,CHENHua一面昭,WANG瓜n-wei,ZHOUXu—halDepartmentofspinalSurgery,ShanghaiChangzhengHospital,
3、Shanghai200003,ChinaCorrespondingauthor·YUANWen,Email:yuanwenspine@163.com【Abstract】ObjectiveToevaluatethetherapeuticefficaciesandsurgicalproceduresofanteriorapproachforcervicalspinalcanalstenosis.MethodsAtotalof162casesofcervicalspinalcanalstenosisunderwentanteriorsurgicalprocedurefromMarch2007
4、toMarch2010.Theoperativeduration,thevolumeofbloodlossandthedaysofpostoperativehospitalstay'wererecordedandanalyzed.TheCobbangieandcanalsagittaldiameterweremeasured.Thebonegraftfusionandnervefunctionswereevaluatedpostoperatively.ResultsTheaverageoperativedurationwas86.4minuteswimanin订aopertiveblo
5、odlossof80.2mlandapostoperativehospitalstayof5.3days.Afollow—upvisitof9—18months(average:12.8)showedthatbonegraftfusionwasachievedinallcasesandCobbangleincreasedbyanaverageof7.2degree.Thespinalcanalsagittaldiameterincreasedby4.23m/ILAndtheJOA(JapaneseOrthopedicAssociationlscoreincreasedbyanavera
6、geof6.1pointsat3Monthpost-operation.CondusionForcervicalspinalcanalstenosis,thepressurecomesmostlyfromthefrontpart.TheanteriorsurgicalprocedureCandecompressdirectlywithashorteroperativeduration,asmallervolumeofbloodloss,ashorterhospitalizationstayandaneffectiverecoveryofcervicalcurvatureandcanal
7、volume.【Keywords】Spinalstenosis;Cervicalvertebrea;Surgicalproceduresoperative;Anteriorapproach颈椎管狭窄症是由先天或后天因素造成的颈椎椎管、神经根管的容量减少,导致脊髓及神经根受压而产生的临床症状【1J,颈椎管发育性椎管狭窄常为其发病基础。颈椎管狭窄症既往多采用后路手术治疗,后路手术创伤较大,手术时间长,术中出血多,术后患者往往存在颈椎轴性疼痛、颈椎后
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