摘要
目的探讨颈胸段脊柱疾病的临床特点及手术治疗策略。方法回顾性分析自2007-01—2014-12采用前路、后路或前后路联合手术治疗的83例颈胸段脊柱疾病。19例骨折、11例椎间盘病变、6例肿瘤、5例结核采用下颈椎低位前方入路手术;11例骨折、6例椎间盘病变、5例肿瘤、3例结核经颈前胸骨柄联合入路手术;6例骨折、3例后凸畸形采用颈胸段后方入路手术;6例骨折、2例结核采用前后联合入路手术。结果本组手术时间80~260 min,平均145 min;术中出血量100~3 100 ml,平均780 ml。75例术后获得随访9~62个月,平均26个月。所有患者术后植骨部位均达到骨性融合,骨性融合时间6~12个月,平均8.5个月。所有患者颈胸段脊柱生理力线恢复,无内固定失败等并发症发生。结论颈胸段脊柱疾病发生率低,但手术风险大,手术入路的选择应根据病变的位置、患者的耐受能力以及手术医师的熟悉程度而定,以减少创伤和并发症的发生。
Objective To investigate the clinical characteristics and surgical treatment strategies for cervicothoracic spinal diseases. Methods Eighty-three patients with cervicothoracic spinal diseases were retrospectively analyzed from Jan 2007 to Dec 2014. The patients were treated with anterior, posterior and combined surgical approaches. Among the patients, lower cervical anterior surgeries were performed for patients with fracture in 19 patients, intervertebral disc disease in 11, tumor in 6 and tuberculosis in 5. Combined anterior cervical sternal approaches were performed in 11 cases of fracture, 6 cases of intervertebral disc disease, 5 cases of tumor and 3 cases of tuberculosis. Posterior surgeries were performed in 6 cases of fracture and 3 cases of kyphosis deformity. Combined surgeries were performed in 6 cases of fracture and 2 cases of tuberculosis. Results The operative time ranged from 80 to 260 min with an average of 145 min. The intraoperative blood loss ranged from 100 to 3 100 ml with an average of 780 ml. All patients underwent surgeries successfully, 75 patients were followed-up from 9 to 62 months, with an average of 26 months. Bone fusion was achieved in all patients from 6 to 12 months, with a mean of 8.5 months. All patients had significant improvement of clinical symptoms. No perioperative complications occurred in relation to instrumentation or decompression. Conclusion The spinal diseases in cervicothoracic region have the characteristics of low occurrence and high risk. The choice of surgical treatment should be according to the location of the lesion, patient tolerance, and anatomy familiarity of surgeons.
出处
《中国骨与关节损伤杂志》
2017年第1期10-13,共4页
Chinese Journal of Bone and Joint Injury
基金
国家自然科学基金项目(81401843)
关键词
颈胸段
脊柱疾病
手术治疗
手术入路
Cervicothoracic
Spine diseases
Surgery
Operative approach
