發(fā)布時(shí)間：2018-06-08 23:49

  本文選題：雙開(kāi)門(mén)椎管擴(kuò)大成型術(shù) + 后縱韌帶骨化�。� 參考：《吉林大學(xué)》2015年碩士論文

【摘要】：目的： 通過(guò)測(cè)量C2-7各節(jié)段椎板傾斜角并推導(dǎo)雙開(kāi)門(mén)術(shù)中的開(kāi)槽角，結(jié)果數(shù)據(jù)行統(tǒng)計(jì)學(xué)分析，了解不同頸椎節(jié)段開(kāi)槽角的變化趨勢(shì)及差異，，并探討其臨床意義。 方法： 選取我院門(mén)診行頸椎CT檢查病人100例。其中男50例，女50例。年齡27-79歲，平均47.35歲。選取C2-7各節(jié)段CT軸位像上椎板最厚層面，于椎板上緣與棘突交界處內(nèi)外側(cè)骨皮質(zhì)各取一點(diǎn)，連成一線段，取其中點(diǎn)。于椎板下緣與關(guān)節(jié)突交界處得一線段中點(diǎn)，穿過(guò)兩中點(diǎn)連線作一直線做為椎板平行線，該線與正中矢狀線夾于一角，即為椎板傾斜角。取開(kāi)槽點(diǎn)做垂直于椎板平行線的直線相交正中矢狀線于一角，即為雙開(kāi)門(mén)術(shù)中開(kāi)槽角，開(kāi)槽角與傾斜角互補(bǔ)。于三維CT工作站測(cè)量C2-7各節(jié)段椎板傾斜角，并推導(dǎo)開(kāi)槽角，測(cè)量角度精確至0.01°。對(duì)測(cè)得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。 結(jié)果： C2-7各節(jié)段椎板平均開(kāi)槽角分別為：42.27°、37.44°、37.20°、38.53°、38.40°、40.16°，C2C7C5C6C3C4。C2與C3-7間差異有統(tǒng)計(jì)學(xué)意義（P 0.05），C7與C3-6間差異有統(tǒng)計(jì)學(xué)意義（P 0.05），C3-6間任兩組比較差異均無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。按不同性別分組，各節(jié)段平均開(kāi)槽角度男性均大于女性，差異具有統(tǒng)計(jì)學(xué)意義。 結(jié)論： 1、雙開(kāi)門(mén)椎管擴(kuò)大成形術(shù)需減壓C2節(jié)段時(shí)，其開(kāi)槽角應(yīng)較C3-7增大。2、行C7節(jié)段開(kāi)門(mén)時(shí)應(yīng)較C3-6增大開(kāi)槽角。3、C2-7相同節(jié)段的開(kāi)槽角男性均應(yīng)大于女性。4、對(duì)累及C2擬行雙開(kāi)門(mén)椎管擴(kuò)大成形術(shù)的病例，可術(shù)前于CT測(cè)量減壓節(jié)段開(kāi)槽角，制定個(gè)體化的手術(shù)方案，減少手術(shù)風(fēng)險(xiǎn)。
[Abstract]:Objective: to measure the inclination angle of C2-7 lamina and deduce the slotted angle during double open door operation. The data were analyzed statistically to find out the change trend and difference of different cervical slotted angle. Methods: 100 patients with cervical spine CT were selected. There were 50 males and 50 females. The average age was 47.35 years. C2-7 CT axial images of the thickest layer of the upper lamina were selected, and the internal and external cortex of the upper margin of the lamina and the spinous process were taken at the junction of the upper lamina and the spinous process. At the junction of the lower edge of the lamina and the articular process, a midline is obtained, and a straight line is made through the two midpoints as the parallel line of the lamina. The line is clamped in one corner with the median sagittal line, that is, the angle of the vertebral lamina. The slotted point is taken as the straight line intersecting the median sagittal line perpendicular to the parallel line of the vertebral lamina at one corner, that is, the slotted angle during the double door opening, the slotting angle and the inclined angle complement each other. The oblique angle of C2-7 lamina was measured by 3D CT workstation, and the slotted angle was deduced. The measurement angle was accurate to 0.01 擄. Results: the average slotted angle of each segment of C2-7 vertebral lamina was: 1 / 42.27 擄/ 37.44 擄/ 37.20 擄/ 38.53 擄/ 38.40 擄/ 40.16 擄C _ 2C _ 7C _ 5C _ 6C _ 3C _ 4.C2 and C _ 3-7 respectively. There was no significant difference between C _ 2C _ 7C _ 5C _ 6C _ 3C _ 4.C2 and C _ 3-7 (P 0.05). The average slotted angle of each segment was greater in male than in female, and the difference was statistically significant. Conclusion: 1. The slotted angle should be larger than that of C3-7, and the slotted angle of the same segment of C7 should be larger than that of C3-6. The slotted angle of males in the same segment of C7 should be larger than that of females. Preoperative CT can be used to measure the slotted angle of decompression segment and make individual operation plan to reduce the risk of operation.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.3

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