颈胸结合部重建手术的临床分析-骨科三学专业毕业论文.docxVIP

优秀毕业论文 精品参考文献资料 山两医科人学七年纯4 山两医科人学七年纯4临床医学坝lj专业学位论义 中文摘要 目的探讨颈胸结合部疾患的手术方案的选择及其重建的稳定性。 方法自2001年1月一2008年2月手术治疗颈胸结合部疾患131例，其中行前路手术 88例，后路手术31例，前后联合入路5例，颈胸联合固定7例。对83例颈胸结合部脊柱 损伤采用ASIA评分，对其余48例颈胸结合部病变采用同本骨科学会的JOA评分(Japanese Orthopaedic Association)评价神经功能恢复情况，Bohlman的X线标准判定植骨融合及脊 柱生理曲度、 椎间隙高度的恢复情况。 结果ASIA评分术前平均1．6，术后2．1分；JOA评分术前平均10．5分，术后13．0 分，术后改善率为37．8％。按Bohlman标准植骨均融合，98例颈胸段椎节椎间隙高度及生 理弧度恢复。 结论颈胸结合部疾患手术重建能恢复椎间隙高度及生理曲度，改善神经功能、恢复 颈椎序列，可早期下地活动、减少并发症等特点。重建方法的选择应根据致压因素及脊柱 稳定性等综合考虑。 关键词颈胸结合部，手术重建 AbstractObjective Abstract Objective To discuss the selection of operative methods and stability of reconstitution of affection of cervicothoracic junction． Methords From January 2001 to February 2008，1 3 1 cases of affection of cervicothoracic junction were treated surgically．88 patients were treated with anterior approach，31 with posterior approach， 5 with anterior combined posterior approach and 7 with cervicothoracic fixation．The neurological function of 83 cases of injury of cervicothoracic junction was assessed by ASIA criteria，and the rest was assessed by JOA criteria；bone arthrodesis and restoring lordosis of cervical spinf was assessed by Bohlman radiographic criteria． Results The ASIA score increased from 1．6 preoperatively to 2．1 postoperatively；The JOA score increased from 10．5 preoperatively to 13．0 postoperatively．Bone fusion reached in all patients；The lordosis of cervical spine of 98 cases was restored． Conclusion The advantage of surgical reconstitution of cervicothoracic junction included promoting the nerofunction recovery,restoring the alignment and lordosis of cervical spine and decreasing the rate of complication．The selection of reconstituted methods depends on decompression and spinal stabilization synthetically． Key words Cervicothoracic Junction，Surgical Reconstruction 学位论文独创性声明本人声明，所呈交的学位论文系在导师指导下本文独立完成的研究成果。文中任何引 学位论文独创性声明 本人声明，所呈交的学位论文系在导师指导下本文独立完成的研究成果。文中任何引 用他人的成果，均已做出明确标注或得到许可。论文内容未包含法律意义上已属于他人的 任何形式的研究成果，也不包含本人已用于其他学位申请的论文或成果。与我一同工作的 同志对本研究所做的任何贡献均已在