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上胸椎

上胸椎的相关文献在1990年到2021年内共计90篇,主要集中在外科学、肿瘤学、基础医学 等领域,其中期刊论文80篇、会议论文4篇、专利文献164373篇;相关期刊55种,包括脊柱外科杂志、实用骨科杂志、天津医科大学学报等; 相关会议3种,包括第三届全国脊柱及骨关节结核病专题研讨会、第九届全国脊柱脊髓学术会议、第十次全国中西医结合创伤骨科学术大会等;上胸椎的相关文献由257位作者贡献,包括肖增明、詹新立、严小虎等。

上胸椎—发文量

期刊论文>

论文:80 占比:0.05%

会议论文>

论文:4 占比:0.00%

专利文献>

论文:164373 占比:99.95%

总计:164457篇

上胸椎—发文趋势图

上胸椎

-研究学者

  • 肖增明
  • 詹新立
  • 严小虎
  • 周静
  • 孙志明
  • 常山
  • 罗巨利
  • 贺聚良
  • 邓树才
  • 陈前芬
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 汪立平; 黄稳定; 严望军; 叶亿通; 金宪政; 范立北
    • 摘要: 目的 观察基于上胸椎解剖学基础的个性化手术入路的选择,以提高上胸椎疾患的外科治疗效果.方法 收集2017年6月至2018年11月于浙江金华广福肿瘤医院骨科就诊的存在上胸椎病变患者27例,分别采用下颈椎入路、后正中入路、后外侧入路(经椎弓根入路、经肋横突入路、经侧方肩胛旁胸膜外入路)进行手术.记录患者术前、术后胸背部疼痛VAS评分、胸椎后凸Cobb角、脊髓损伤Frankel分级情况,观察手术并发症发生情况.结果 27例中5例仅累及T1~T2水平病变的患者采用单纯下颈椎入路;5例累及T3~T4水平病变的患者采用后外侧经椎弓根入路;4例累及T3~T4水平病变的患者采用后外侧经肋横突入路;5例累及T3~T4水平病变的患者采用后外侧经侧方肩胛骨胸膜外入路;其余8例采用后正中入路.随访有2例出现脑脊液漏,但未引起不良后果,随访期内无死亡病例,植骨均实现骨性融合.Frankel分级降低共19例(70.4%).术后胸腰背部疼痛、胸椎后凸畸形均有所改善,差异有统计学意义(P<0.05).结论 上胸椎手术入路的选择取决于病变的程度和类型,前柱重建的必要性和患者对手术的耐受程度,应根据患者病情制定个体化的手术治疗方案.
    • 王海蛟; 张冠锋; 李玉伟
    • 摘要: 目的 探讨经胸骨前入路行后纵韧带骨化块切除减压内固定术治疗上胸椎后纵韧带骨化症(OPLL)的远期效果.方法 回顾性分析2010-01—2018-01漯河市中心医院骨科收治的17例上胸椎OPLL患者的临床资料.男9例,女8例;年龄37~67岁,平均51.8岁;胸脊髓功能(JOA)评分3~7分.病变节段T1~3.采用经胸骨前入路行后纵韧带骨化块切除减压内固定术.记录术中情况、术后临床指标.术后平均随访64.7个月(24~121个月),评价随访期间的疗效.结果 17例均顺利完成手术,2例术中出现心跳缓慢,去除拉钩解除压迫后恢复正常.手术平均时间158.6 min(130~190 min),术中平均出血量560.6 mL(300~800 mL).3例发生脑脊液漏,未发生纵隔液体潴留引起的并发症.全部患者术后3~17个月恢复正常生活及从事体力劳动.末次随访JOA评分由术前平均5.4分增加到9.9分,术后JOA评分平均改善率80.4%(62.5%~100.0%);胸椎X线片及MRI均显示脊髓减压满意,植骨均获骨性融合.结论 切开胸骨的前入路可有效显露T1~4范围,能切除T1~3后纵韧带骨化块,满足内固定操作;而且保留了脊柱后柱结构,远期疗效优良,是治疗上胸椎OPLL的理想术式.
    • 崔利宾; 袁鑫; 许崧杰; 张衍军; 张志鹏; 陈学明
    • 摘要: 目的 研究3D打印技术制备上胸椎椎弓根螺钉置入导板并辅助置钉,评价螺钉置入的准确性及可行性.方法 选取6具正常成人上胸椎(T1~T4)尸体标本,行CT扫描获取相关数据后以DICOM格式存储,将相关数据导入Mimics软件后构建三维模型并通过逆向工程原理设计理想的椎弓根螺钉进针点及钉道方向,根据胸椎附件的解剖形态设计与之契合的反向模块,然后结合进针点与最佳钉道设计导板,最终3D打印成型,利用该导板辅助完成上胸椎椎弓根螺钉的置入.对实际进针点和理想进针点的位置进行统计学分析,应用Kawaguchi等级评价螺钉置入的准确性.结果 每具上胸椎标本左右侧各置入4枚椎弓根螺钉,6具标本共置入48枚椎弓根螺钉.48枚螺钉中有1枚螺钉穿破椎弓根壁,优良率为95%.椎弓根螺钉实际进针点与理想进针点位置的差异无统计学意义(P>0.05).结论 应用3D打印导板辅助上胸椎椎弓根螺钉置入能获得满意的置钉精准度,操作简便可行,能够实现置钉的个体化.
    • 覃文航; 施冬冬; 陈昌成; 陈前芬
    • 摘要: 目的 通过与上胸椎传统前方内固定对比,探讨经腋中线胸腔入路侧方内固定拔出强度是否可以达到重建上胸椎稳定的要求.方法 12例人尸体分离出C7-T6节段随机分为两组,分别使用同一类型钛板装置行侧方内固定法(n=6)和前方内固定法(n=6)植入钛板螺丝钉内固定,并进行内固定装置整体拔出强度力学测试,利用生物力学仪器进行记录并分析.结果 侧方内固定组内固定装置最大拔出强度为(700.83±92.98)N与前方内固定组最大拔出强度为(552.13±103.07)N相比,经腋中线胸腔入路侧方内固定组钛板螺丝钉的拔出强度高出传统前方内固定组21.2%,差异有统计学意义(P<0.05).结论 腋中线胸腔入路上胸椎侧方植入内固定在力学上是可行的.
    • 施冬冬; 李晓峰; 熊货杰; 胡峰; 赵劲民; 陈前芬
    • 摘要: 背景:随着脊柱内固定技术的全面推广,重塑脊柱力学稳定越来越引起人们的关注,经腋中线胸腔入路侧方内固定治疗上胸椎病损是一种新的手术入路,目前有关其固定后上胸椎生物力学的研究较为少见.目的:对比侧方和前方钢板内固定模型的上胸椎三维运动稳定性和负重载荷强度,评估经腋中线胸腔入路侧方钢板内固定重建上胸椎是否可以达到符合脊柱生物力学稳定.方法:从12具人尸体获取C7-T6脊柱并双侧肋椎关节标本,进行完整上胸椎模型三维运动稳定性测试,记录为完整椎体组.随后将标本随机分为2组,分别建立传统前方钢板内固定(前方内固定组)与经腋中线入胸腔路侧方钢板内固定模型(侧方内固定组),每组6例标本,先后进行三维运动实验、垂直加压实验与垂直加压破坏实验.实验通过广西医科大学第二附属医院伦理委员会批准,批准号:NO.伦审2017(KY-0080)号.结果 与结论:①完整椎体组左/右侧屈、前屈/后伸、左/右旋转运动下的载荷均小于侧方内固定组、前方内固定组(P<0.01),前方内固定组左/右旋转运动下的载荷均小于侧方内固定组(P<0.05),前方内固定组左/右侧屈、前屈/后伸运动下的载荷与侧方内固定组比较差异无显著性意义(P> 0.05);②当载荷到达600 N时,前方内固定组椎体下沉位移小于侧方内固定组[(1.39±0.20),(2.15±0.17)mm,P<0.01];③前方内固定组与侧方内固定组最大强度载荷比较差异无显著性意义[(1 839.70±122.45),(1 798.65±120.21)N,P=0.571];④结果表明,经腋中线胸腔入路侧方钢板内固定方式是稳定的,它能够满足脊柱重建生物力学需要.
    • 薛文; 管晓鹂; 刘林
    • 摘要: Objective To investigate the clinical effects of one-stage posterior approach total vertebral resection combined with bone cement infuse and screw fixation for upper thoracic metastatic tumors.Methods A retrospective review was conducted on 11 consecutive patients (from March 2014 to June 2016),with an average age of (61.6±18.3) years old.A total of 251 vertebrae were involved.All of them were metastatic tumors,including breast cancer (4 cases), lung cancer (3 cases),rectal cancer (1 case),thyroid carcinoma (1 case),esophageal cancer (1 case),and prostate canc-er (1 case).VAS scores from 3 to 5 points (good),covering 2 of 11 cases;6 to 8 points (general)in 3 cases;8 to 10 points (poor)in 6 cases,with an average of 7.7 points.All the patients were treated with one-stage posterior total verte-bral resection and pedicle screw fixation combined with bone cement perfusion.Results The average surgery time was (155±37.2)min (120~210 min);the intraoperative blood loss was (1100±324)mL (800~2000 mL).There were no pneumothorax,epidural damage,nervous symptoms or other operation-related complications,nor any internal fixation and bone cement perfusion associated with blood vessels or nervous inj ury perioperative.The average follow-up time of patients was (16.3±13.7)months (6~33 months).The mean preoperative VAS score was 7.7 points,which decreased to 4.3 points postoperative.3 patients died of original cancer,while the other 8 patients remained alive.Conclusion The operation method of one-stage posterior approach total vertebral resection combined with bone cement infuse and screw fixation for upper thoracic metastatic tumors is safe,minimal invasive and reliable,which can obviate anterior surgery injury.%目的 探讨一期后路全椎体切除椎弓根螺钉固定联合骨水泥灌注,在上胸椎(T1~4)转移性肿瘤手术治疗中的应用价值.方法 2014年3月至2016年6月,收治上胸椎转移肿瘤11例,其中男6例,女5例;年龄41~78岁,平均(61.6±18.3)岁.T14例,T23例,T33例,T41例,均为转移性肿瘤.来源于乳腺癌4例,肺癌3例,直肠癌1例,甲状腺癌1例,食管癌1例,前列腺癌1例.视觉模拟评分(visual analogue scale,VAS)评分3~5分(良)2例,6~8分(可)3例,8~10分(差)6例,平均7.7分.均采用一期后路全椎体切除椎弓根螺钉固定联合骨水泥灌注.结果 本组手术时间120~210 min,平均(155.0±37.2)min;出血量为800~2000 mL,平均(1100±324)mL.无血气胸、硬膜损伤、神经症状加重等并发症的发生,未出现任何与内固定器械和骨水泥灌注有关的神经、血管损伤.本组11例均获得随访,随访时间6~33个月,平均(16.3±13.7)个月.近期疗效较满意,VAS评分3~5分(良)9例,6~8分(可)2例,平均4.3分,疼痛缓解明显.随访期间3例分别于术后16.2、9.4、11.9个月死亡;其余8例继续生存,术后至末次随访平均17.7个月,其中6例无病生存.结论 上胸椎转移肿瘤一期后路全椎体切除椎弓根螺钉固定联合骨水泥灌注重建稳定性安全、有效,提高了患者的生存质量.
    • 杨立井; 肖增明; 梁栋柱; 贺聚良; 刘云
    • 摘要: 目的 比较上胸椎前路椎弓根钉板系统(ATPSPS)、后路椎弓根钉棒系统(PTPSRS)和前路普通椎体钉板系统(AVBSPS)在上胸椎的刚度.方法 12例防腐尸体标本分成3组,各组标本随机分配使用以上3种不同的内固定器械固定.测试各标本在原始状态下的轴向压缩、前屈、后伸、左右侧屈等5个方向的刚度.将所有标本模拟手术行T2椎体次全切除(损伤状态)后,再测试各标本在损伤状态下各方向的刚度.根据分组结果,选择相应的内固定系统进行安装固定,再测试各个方向上的刚度.结果 在原始状态及损伤状态下,各组之间的各向刚度差异无统计学意义(P>0.05).各标本行固定后,各组之间在各个方向上的刚度差异均有统计学意义(P<0.05).ATPSPS组的前屈刚度大于其他两组,各组间比较差异有统计学意义(P< 0.05).PTPSRS组的轴向压缩刚度和后伸刚度大于其他两组,各组间比较差异有统计学意义(P<0.05).AVBSPS组的侧屈刚度小于其他两组,差异有统计学意义(P<0.05),而其他两组差异无统计学意义(P>0.05).结论 ATPSPS在各方向上的刚度均高于AVBSPS,前屈刚度大于PTPSRS,而轴向压缩刚度和后伸刚度不及PTPSRS,左右侧屈刚度则与PTPSRS相当.%Objective To compare the rigidity at upper thoracic spine among the anterior transpedicular screw-plate system (ATPSPS),posterior transpedicle screw-rod system (PTPSRS) and anterior vertebral body screw-plate system (AVBSPS).Methods Twelve embalmed cadaver specimens were divided into three groups.The specimens in each group were randomly allocated to use the above 3 different internal fixation devices for conducting fixation.The stiffness of each specimen on the directions of axial compression,flexion and extension,and left and right lateral bending was detected under original status.All specimens conducted the simulated corpectomy of T2 (damage status).Then the rigidity on various directions was re-detected on the damage status.The corresponding internal fixation system was selected for conducting the install and fixation according to the grouping results.The intra-group and inter-group rigiditieson different directions were compared amongoriginal status,damage status and after internal fixation.Results The rigidities on different directions under original and damage statushad no statistical difference among various groups (P<0.05).After conducting fixation in each group,the rigidity after fixation on different directions had statistically significant difference among groups(P<0.05).The stiffness of anterior flexion in the ATPSPS group was greater than that in the other two groups (P<0.05).The rigidity of axial compression and extension in the PTPSRS group was greater than that in the other two groups,the difference among groups was statistically significant (P<0.05).The stiffness of lateral bending in the AVBSPS group was smaller than that in the other two groups,the difference was significant (P<0.05),but the difference between the other two groups had no statistical significance (P>0.05).Conclusion The rigidity of ATPSPS in all directions is higher than that of AVBSPS.The anterior flexion rigidity is greater than PTPSRS,and the axial compression and extension rigidity are less than PTPSRS,but the lateral bending rigidity is equivalent to PTPSRS.
    • 杨立井; 肖增明; 梁栋柱; 肖善文; 贺聚良
    • 摘要: Objective To compare the pullout strength between anterior transpedicular screw, posterior pedicle screw,and anterior vertebral body screw at upper thoracic spine.Methods Six embalmed cadavers,containing the entire structure from C7to T5,were selected,and then were divided into three groups:the group of anterior transpedicular screw (ATPS group),the group of posterior transpedicular screw(PTPS group),and the group of anterior vertebral body screw (AVBS group).Randomization process was carried out on the specimens of each vertebra from T 1to T4before experiment. The both sides of pedicle of each vertebra was randomly assigned as two different numbers.According to the random re-sults,we inserted either ATPS or PTPS in the pedicle,and inserted a AVBS in the front of the same vertebral body.The screw axial pullout test was carried out on mechanics testing machine,and we recorded each screw length and peak pullout force,then made statistical analysis for the data.Results The length of screw path of the ATPS group increased from T 1to T4,and T1was shorter than T2to T4in the PTPS group, and T4was longer than T1to T3in the AVBS group(all P0.05).Under the same condition for T1to T4,the length of screw path and the maximum pullout strength were greater in the ATPS group than in the PTPS,by the same token,PTPS was greater than AVBS(all P0.05).T1~T4相同椎体条件下,前路椎弓根螺钉组钉道长度、最大拔出力均大于后路椎弓根螺钉组和普通椎体螺钉组,后路椎弓根螺钉组钉道长度、最大拔出力均大于普通椎体螺钉组(P均<0.05).螺钉的钉道长度与其最大拔出力呈正相关关系(r=0.997,P=0.000).结论 上胸椎前路椎弓根螺钉的抗拔出强度大于后路椎弓根螺钉和前路普通椎体螺钉,具有更好的生物力学稳定性.
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