COA 2014:一期前路手术治疗强制性脊柱炎下颈椎骨折脱位

2014-11-25 小闪 整理 医学论坛网

中华医学会第十六届骨科学术会议暨第九届COA国际学术大会于2014年11月20~23日在北京国家会议中心隆重召开。广西医科大学第一附属医院吴昊医生作了研究报告,内容:一期前路手术治疗强制性脊柱炎下颈椎骨折脱位。 韧带、纤维环骨化而使脊柱的弹性和韧性显著降低。AS患者发生脊柱骨折的危险性比正常人高3.5倍。AS患者颈椎骨折同时累及三柱,且更易伴发脱位。前路手术的优点:手术体位摆放简单;显露

中华医学会第十六届骨科学术会议暨第九届COA国际学术大会于2014年11月20~23日在北京国家会议中心隆重召开。广西医科大学第一附属医院吴昊医生作了研究报告,内容:一期前路手术治疗强制性脊柱炎下颈椎骨折脱位

韧带、纤维环骨化而使脊柱的弹性和韧性显著降低。AS患者发生脊柱骨折的危险性比正常人高3.5倍。AS患者颈椎骨折同时累及三柱,且更易伴发脱位。前路手术的优点:手术体位摆放简单;显露简单;手术时间短;手术创伤小;前后路联合手术的优点:复位效果好;固定牢固可靠;减压比较彻底。强直性脊柱炎颈椎骨折患者围手术期的最严重的并发症。思路:采用最简单的体位,采用创伤小的手术方法,缩短手术时间,减少颈髓二次损伤的风险。

方法:2004年~2014年16例强制性脊柱炎下颈椎骨折脱位并脊髓损伤患者,均为男性,年龄38~65岁,平均47.5岁。损伤原因:交通事故伤7例,摔伤6例,重物砸伤3例。术前脊髓Frankel分级:A级4例,B级4例,C级7例。手术方法:仰卧位,颈椎右侧前方入路,插管全麻,颈椎前路减压、椎体复位、钛网植入及前路带锁钢板固定术。

结果:平均手术时间1.5h;术中出血350ml;2例术前Frankel分级A级患者术后一周死于呼吸衰竭;其余14例病人平均随访24个月;13例病人骨折处颈椎与钛网融合良好,无颈椎脱位,无钛网移位,无螺钉钢板松脱等并发症。术后并发症:1例病人术后2个月出现螺钉钢板松脱,无钛笼移位。术后脊髓损伤Frankel分级:2例Frankel分级B级患者7例Frankel分级C级患者神经功能改善,Frankel分级平均提高1~2级;3例Frankel分级A级患者2例Frankel分级B级患者疼痛、麻木等得到缓解,但脊髓功能无恢复。

结论:强制性脊柱炎下颈椎骨折脱位并颈髓损伤的患者可应用颈椎前路手术进行有效地颈椎复位,椎管减压。颈椎固定。



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    2016-01-27 doctording1

    非常实用

    0

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    2016-01-27 doctording1

    值得进一步关注

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=60323, encodeId=23a56032320, content=非常实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:48:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60324, encodeId=e5a060324f7, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:48:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60320, encodeId=93d46032022, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:47:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60321, encodeId=a7c46032185, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:47:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60322, encodeId=439f603227e, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:47:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1820306, encodeId=164318203061a, content=<a href='/topic/show?id=96e31006244c' target=_blank style='color:#2F92EE;'>#颈椎骨折#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100624, encryptionId=96e31006244c, topicName=颈椎骨折)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Fri Jul 03 03:09:00 CST 2015, time=2015-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1699577, encodeId=fcc916995e791, content=<a href='/topic/show?id=15a24951c2' target=_blank style='color:#2F92EE;'>#COA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4951, encryptionId=15a24951c2, topicName=COA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=224929955832, createdName=circumcision, createdTime=Thu Mar 05 23:09:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21034, encodeId=a8fd21034a9, content=脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 08:02:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21035, encodeId=8a2021035aa, content=脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 08:02:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290558, encodeId=a2771290558ff, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Thu Nov 27 05:09:00 CST 2014, time=2014-11-27, status=1, ipAttribution=)]
    2016-01-27 doctording1

    不错,赞一个

    0

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    2016-01-27 doctording1

    这篇文章有一定深度

    0

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    2016-01-27 doctording1

    是一篇不错的文章

    0

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    2015-03-05 circumcision
  8. [GetPortalCommentsPageByObjectIdResponse(id=60323, encodeId=23a56032320, content=非常实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:48:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60324, encodeId=e5a060324f7, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:48:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60320, encodeId=93d46032022, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:47:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60321, encodeId=a7c46032185, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:47:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60322, encodeId=439f603227e, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 00:47:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1820306, encodeId=164318203061a, content=<a href='/topic/show?id=96e31006244c' target=_blank style='color:#2F92EE;'>#颈椎骨折#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100624, encryptionId=96e31006244c, topicName=颈椎骨折)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Fri Jul 03 03:09:00 CST 2015, time=2015-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1699577, encodeId=fcc916995e791, content=<a href='/topic/show?id=15a24951c2' target=_blank style='color:#2F92EE;'>#COA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4951, encryptionId=15a24951c2, topicName=COA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=224929955832, createdName=circumcision, createdTime=Thu Mar 05 23:09:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21034, encodeId=a8fd21034a9, content=脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 08:02:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21035, encodeId=8a2021035aa, content=脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 08:02:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290558, encodeId=a2771290558ff, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Thu Nov 27 05:09:00 CST 2014, time=2014-11-27, status=1, ipAttribution=)]
    2015-04-12 x35042875

    脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别

    0

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    2015-04-12 x35042875

    脊柱融合术中是否使用BMP后的骨不连的发生率无统计学差别

    0

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