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第2至第7颈椎与第3至第7颈椎椎板成形术后脊髓前间隙的MRI测量比较
其他题名Measurement and comparison of postoperative anterior cord space between C2-7 and C3-7 laminoplasty on MRI
刁垠泽; 孙宇; 王少波; 张凤山; 潘胜发; 刘晓光; 刘忠军
关键词颈椎 脊髓 磁共振成像 脊髓压迫症 Cervical Vertebrae Spinal Cord Magnetic Resonance Image Spinal Cord Compression
刊名中华外科杂志
2014
DOI10.3760/cma.j.issn.0529-5815.2014.10.006
52期:10页:745-749
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的 了解第2至第7颈椎(C2~7)椎板成形术对脊髓前间隙(ACS)的影响,并与传统的第3至第7颈椎(C3~7)椎板成形术比较,为合理的向头侧扩大减压范围提供依据.方法 对2008年2月至201 1年10月行颈后路单开门椎板成形术57例患者的资料进行回顾性分析.按减压节段的不同分为C3~7组(32例)和C2~7组(25例).比较各组手术前后神经功能、颈肩痛以及颈椎曲度;测量并比较两组患者术后MRI上C2~3至C7 ~T1各节段ACS数值.结果 两组患者手术后神经功能均有显著改善,颈肩痛程度及颈椎曲度较术前差异无统计学意义;C3~7组在C2~3及C3~4水平上ACS分别为6.13 mm(95% CI:5.71 ~6.55)和6.60 mm(95% CI:6.10 ~7.11),与之相比,C2~7组在C2~3及C3~4水平上ACS分别增加2.5 mm和2.1 mm,两组间差异有统计学意义(P<0.01);两组在C4~5及以下水平ACS无明显差异.结论 与传统的C3~7单开门椎板成形术相比,向头侧扩大减压至C2,可以在C2~3及相邻的C3~4水平获得更大的ACS;当C3~4水平脊髓前方致压物在中矢径>6.10 mm时,行C3~7减压可能造成该水平脊髓减压不充分,应考虑向头侧扩大减压范围. Objectives To investigate the effect of C2-7 laminoplasty on postoperative anterior cord space (ACS) compared with C3-7 laminoplasty,and to provide evidence for reasonable enlargement of decompression range cephalad.Methods Fifty-seven Patients underwent cervical laminoplasty from February 2008 to October 2011 were studied retrospectively,which were divided into two groups by decompression range:Group C3-7 and Group C2-7.The pre-and post operative JOA scores,VAS scores of neek and shoulder pain,and cervical alignment were compared in each group.The postoperative ACS at each level from C2-3 to C7-T1 measured on MRI were compared between the two groups.Results The postoperative JOA scores increased significantly in both groups.VAS scores and cervical alignment showed no significant difference.ACS at C2-3 and C3-4 was 6.13 mm (95% CI:5.71-6.55) and 6.60 mm (95% CI:6.10-7.11) respectively in Group C3-7,which increased 2.5 mm and 2.1 mm respectively in Group C2-7 at the same segment,there was significant difference (P < 0.01).However,there was no significant difference of ACS at C4-5 and any other caudal levels between the two groups.Conclusions Compared with conventional C3-7 laminoplasty,the extensive decompression cephalad to C2 leads to larger ACS at C2-3 and C3-4.When the mid-sagittal diameter of anterior compression is more than 6.10 mm at C3-4,C3-7 laminoplasty may cause insufficient decompression,and enlargement of decompression range cephalad should be considered.
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/70423
专题北京大学第三临床医学院_骨科
作者单位100191,北京大学第三医院骨科
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刁垠泽,孙宇,王少波,等. 第2至第7颈椎与第3至第7颈椎椎板成形术后脊髓前间隙的MRI测量比较[J]. 中华外科杂志,2014,52(10):745-749.
APA 刁垠泽.,孙宇.,王少波.,张凤山.,潘胜发.,...&刘忠军.(2014).第2至第7颈椎与第3至第7颈椎椎板成形术后脊髓前间隙的MRI测量比较.中华外科杂志,52(10),745-749.
MLA 刁垠泽,et al."第2至第7颈椎与第3至第7颈椎椎板成形术后脊髓前间隙的MRI测量比较".中华外科杂志 52.10(2014):745-749.
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