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颈椎不稳

颈椎不稳的相关文献在1993年到2022年内共计126篇,主要集中在外科学、临床医学、基础医学 等领域,其中期刊论文119篇、会议论文7篇、专利文献11303篇;相关期刊89种,包括中国骨伤、护理学报、颈腰痛杂志等; 相关会议6种,包括第一届全国中青年颈椎病专题论坛、第三届全国脊柱外科学术论坛、第三届医学影像山东论坛等;颈椎不稳的相关文献由347位作者贡献,包括贾连顺、吴彬、夏群等。

颈椎不稳—发文量

期刊论文>

论文:119 占比:1.04%

会议论文>

论文:7 占比:0.06%

专利文献>

论文:11303 占比:98.90%

总计:11429篇

颈椎不稳—发文趋势图

颈椎不稳

-研究学者

  • 贾连顺
  • 吴彬
  • 夏群
  • 孟纯阳
  • 巩腾
  • 徐荣明
  • 王景贵
  • 王海滨
  • 苏学涛
  • 倪斌
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 范维娇; 杜良杰; 武亮; 何件根; 靳沙沙; 张芹; 王茜; 王营营; 田春艳
    • 摘要: 目的研究颈性眩晕与颈椎不稳的相关性。方法收集门诊就诊的150例颈性眩晕患者,给予每位患者颈椎正侧位及过伸过屈侧位动态X线片检查。根据White测量标准分析影像学结果,测量评估患者颈椎是否失稳以及失稳的类型,分析颈椎退变的特点。结果①80.7%的颈性眩晕患者都存在颈椎不稳。其中C4-C5之间不稳的发生率最大,颈椎过伸和过屈时C4-C5角度位移不稳发生率分别为41.3%和44.6%,上位椎体相对于下位椎体向前和向后水平位移不稳发生率分别为28.9%和20.6%。②无明显颈椎不稳的颈性眩晕患者颈椎项韧带骨化发生率为10.3%,椎间隙狭窄发生率为72.4%,骨质增生发生率为69%。结论颈椎不稳是颈性眩晕的主要发病原因。无明显颈椎不稳的颈性眩晕患者存在潜在的颈椎退变和颈椎不稳以及代偿性增生反应。
    • 何祺; 黄定贵; 范锲; 潘柳先; 李发添; 王聪
    • 摘要: 目的 探讨血清维生素D水平、骨密度与颈椎不稳之间的相关性。方法 选取行颈椎X线检查的255例30~60岁受检者为研究对象,根据颈椎检查情况将其分为颈椎不稳组(109例)和颈椎正常组(146例),比较两组的血清25-羟维生素D[25(OH)D]水平、骨密度及骨质改变情况,并分析维生素D水平与骨密度的关系。结果 颈椎不稳组血清25(OH) D水平较颈椎正常组低(P0.05)。两组受检者中正常骨密度、骨密度减少、骨质疏松者的占比比较,差异无统计学意义(P>0.05)。不同维生素D水平受检者的骨密度值差异无统计学意义(P>0.05)。结论 颈椎不稳患者的血清25(OH) D水平明显降低,但骨密度与颈椎稳定情况、维生素D水平均无直接相关性,血清25(OH) D水平可作为颈椎不稳的一个早期预判指标。
    • 辛荣超; 党建军; 郑勇; 李强; 郑宇; 贾承明; 赵武杰
    • 摘要: 目的 探讨颈性眩晕患者颈椎动力位X线检查及椎动脉彩超检查的影像学特点.方法 以2019年1月至2019年12月陕西省中医医院骨科门诊收治的147例颈性眩晕患者为观察组,以同时间段进行健康体检的30名正常人为对照组.测量两组X线C2~C7椎间角位移和椎体后缘滑移距离,分析颈椎不稳发病率及病变节段分布特点;统计分析椎动脉彩超检查异常率及左椎动脉(LVA)、右椎动脉(RVA)的血流动力学状态.结果 观察组责任节段颈椎不稳的总发生率、椎动脉彩超检查异常率、两项检查结果异常率均高于对照组(P<0.05).相较于对照组,观察组LVA、RVA的VP更缓慢,LVA的RI更高,LVA的VAD更小(P<0.05).结论 颈椎动力位X线、椎动脉彩超两项检查与颈性眩晕密切相关,可在一定程度上为颈性眩晕的诊断提供参考.
    • 覃爱同; 李双军; 黄德芳; 蔡秀花; 刘丽叶; 王亮亮; 刘晓峰; 宋俊玲; 权建渊
    • 摘要: 目的:通过对青壮年颈椎曲度改变与产生椎体不稳之间的统计学分析,以期了解X线颈椎生理曲度改变对诊断颈椎不稳的价值和临床意义。方法:在2017年—2019年某部1286参检人员中,收集86例24~40岁体检人员的颈椎X线侧位平片生理曲度异常的病例,另随机抽取同期90例年龄亦在24~40岁之间颈椎侧位生理曲度无异常的受检者作为对照组,均加摄过伸过曲位,测量其水平位移与角位移,对所得数据进行统计学分析。结果:86例颈椎曲度异常的受检者中,无位移16例,水平位移>3.5mm 24例,角位移>11°66例,90例对照组例,无位移74例,水平位移>3.5mm 4例,角位移>11°12例,二组之间的差异具有统计学意义(P<0.05)。结论:颈椎曲度异常可以作为诊断颈椎不稳的X线特征之一,测量颈椎生理曲度具有对诊断椎体不稳具有重要的临床意义。
    • 覃爱同; 李双军; 黄德芳; 蔡秀花; 刘丽叶; 王亮亮; 刘晓峰; 宋俊玲; 权建渊
    • 摘要: 目的:通过对青壮年颈椎曲度改变与产生椎体不稳之间的统计学分析,以期了解X线颈椎生理曲度改变对诊断颈椎不稳的价值和临床意义.方法:在2017年—2019年某部1286参检人员中,收集86例24~40岁体检人员的颈椎X线侧位平片生理曲度异常的病例,另随机抽取同期90例年龄亦在24~40岁之间颈椎侧位生理曲度无异常的受检者作为对照组,均加摄过伸过曲位,测量其水平位移与角位移,对所得数据进行统计学分析.结果:86例颈椎曲度异常的受检者中,无位移16例,水平位移>3.5mm 24例,角位移>11°66例,90例对照组例,无位移74例,水平位移>3.5mm 4例,角位移>11°12例,二组之间的差异具有统计学意义(P<0.05).结论:颈椎曲度异常可以作为诊断颈椎不稳的X线特征之一,测量颈椎生理曲度具有对诊断椎体不稳具有重要的临床意义.
    • 钱晶晶; 徐浩; 王路; 赵嘉懿
    • 摘要: 目的:观察颈椎后路单侧椎弓根螺钉内固定术结合单开门椎管扩大成形术治疗合并颈椎不稳的多节段脊髓型颈椎病的临床疗效和安全性。方法:2013年1月至2015年10月收治21例多节段脊髓型颈椎病患者。男11例,女10例。年龄41~69岁,中位数57岁。影像学检查显示,所有患者脊髓受压节段均≥3个,均合并不同程度的颈椎不稳(邻近椎体移位> 3. 5 mm或成角> 11°),3例合并黄韧带骨化、6例合并后纵韧带骨化、8例合并发育性颈椎管狭窄、8例合并不同程度的颈椎反弓,所有患者椎弓根螺钉植入条件良好。病程6~24个月,中位数14个月。均经后路行单侧椎弓根螺钉内固定术和单开门椎管扩大成形术,单开门椎管扩大成形术中以Centerpiece钛板固定开门侧。分别于术前和末次随访时评定患者的颈肩部疼痛视觉模拟量表(visual analogue scale,VAS)评分、日本骨科学会(Japanese Orthopedic Association,JOA)脊髓型颈椎病评分及C_2~C_7 Cobb角,同时观察术中及术后的并发症发生情况。结果:所有患者均顺利完成手术,其中C_3~C_6节段手术9例、C_3~C_7节段手术12例。21例患者均获得随访,随访时间12~36个月,中位数18个月。均未出现门轴侧断裂及再关门现象,椎弓根螺钉位置良好。1例出现C_5神经根麻痹症状,1例出现颈部轴性症状,给予康复锻炼等对症治疗,至术后6个月时症状基本消失。与术前相比,末次随访时患者的颈肩部疼痛VAS评分明显降低[(5. 6±1. 6)分,(3. 1±1. 1)分,t=3. 150,P=0. 000],JOA评分明显增加[(7. 6±2. 4)分,(14. 1±1. 6)分,t=4. 320,P=0. 000],C_2~C_7Cobb角明显增大(7. 2°±6. 5°,12. 6°±7. 4°,t=5. 020,P=0. 000)。结论:采用颈椎后路单侧椎弓根螺钉内固定术结合单开门椎管扩大成形术治疗合并颈椎不稳的多节段脊髓型颈椎病,可有效改善因脊髓受压引起的症状和体征、维持颈椎稳定、恢复颈椎正常曲度,且并发症较少。
    • 巩腾; 苏学涛; 夏群; 王景贵
    • 摘要: 目的 探讨术前颈椎不稳和术中不同内固定对多节段颈椎后纵韧带骨化症(OPLL)患者行颈椎管后路单开门扩大成形减压术后并发轴性痛(PAP)特征和门轴侧骨槽融合率影响.方法回顾性分析2010年1月—2014年4月武警部队后勤学院附属医院和天津医院脊柱外科106例OPLL患者的临床资料.其中男82例,女24例;年龄51~68岁,平均58.7岁;均行颈椎管后路单开门扩大成形减压术.按照患者术前合并颈椎不稳与否,分为颈椎不稳组(36例)和颈椎稳定组(70例);再按照辅助内固定装置类型,将颈椎不稳组36例分为连续节段Centerpiece微型钛板固定组(14例)和椎弓根钉棒固定组(22例),颈椎稳定组70例分为椎弓根钉棒固定组(17例)和微型钛板固定(53例).所有患者术后均随访3年以上,比较两组患者PAP发生率,以及组内实施不同内固定术式的两亚组间术后3个月门轴侧骨槽融合率、PAP发生率、首发时间、严重程度和持续时间.结果术后颈椎不稳组PAP发生率高于颈椎稳定组,两组分别为27.78%(10/36)和11.43%(8/70),差异有统计学意义(χ2=4.516,P0.05).术前颈椎不稳组患者,椎弓根固定组术后PAP发生率低于微型钛板固定组,差异有统计学意义(χ2=9.841,P0.05).结论术前颈椎不稳患者更易继发PAP,其辅助椎弓根较微型钛板固定者可在一定程度减少PAP发生率.术前颈椎稳定患者行颈椎管后路单开门扩大成形减压术治疗时,联合应用椎弓根钉棒较Centrepiece微型钛板固定,更有利于提高早期门轴侧骨槽融合率和缩短PAP持续时间.%Objective To analyze the influence from preoperative instability and intraoperative different internal appliances on union rate of hinge trough and characteristics of postoperative axial pain ( PAP) after decompression of unilateral expansive laminoplasty for patients with multilevel ossification of cervical posterior longitudinal ligament(OPLL). Methods From January 2010 to April 2014, the study retrospectively reviewed 106 OPLL patients who underwent unilateral laminoplasty supplemented by continuous mini-plates or pedicular screws fixation with a minimum of 36 months of follow-up. According to complicated with preoperatively cervical instability or not, the sufferers were divided into cervical steadiness group and unsteadiness group. Subsequently, every group was divided into fixation of mini-plate and transpedicular screw subgroups in terms of instrumentation types. Thirty-six cases of preoperative instability comprised of 22 cases of pedicle fixation and 14 cases of mini-plates. Seventy cases of preoperative stability included 17 cases of pedicle fixation and 53 cases of mini-plate. The prevalence, initial onset, severity, duration of PAP and union rate of hinge groove at postoperative 3 months were compared to analyze the influence of two internal methods and preoperative unsteadiness on features of PAP. Results Significantly statistic difference in incidence of PAP between preoperative unsteadiness group ( 27. 78%, 10/36 ) and steadiness group(11. 43%, 8/70) existed(χ2 =4. 516, P0. 05). With the state of preoperative instability, incidence of PAP in pedicle group was lower in comparison of that in mini-plate group, the difference achieved statistic significance(χ2 =9. 841, P=0. 042). There were no significantly statistic differences in other index between two subgroups respectively(all P values>0. 05). Conclusions Pedicle fixation is prone to reducing incidence of PAP in contrast to mini-plate fixation to some extent under the condition of preoperative instability which tends to induce occurrence of PAP. The study suggests that pedicular fixation will be beneficial to improving and promoting fusion ratio of hinge groove and shortening duration period of PAP under the condition of cervical stability.
    • 巩腾; 苏学涛; 夏群; 王景贵; 阚世廉
    • 摘要: Objective To investigate clinical characteristics, pathological mechanism and risk factors of postoperative axial pain (PAP) after decompression of unilaterally expansive laminoplasty with open-side fixation of Centrepiece mini-plates system for treating multilevel cervical degenerative myelopathy(MCDM). Methods The 79 MCDM pa-tients with ≥4 operated segments who underwent unilateral en bloc laminoplasty instrumented with Centrepiece mini-plates of open-side were entrolled,who were divided into two groups according to occurrence of PAP or not, they were PAP group(12 cases) and non-PAP group(67 cases). The differences of preoperative and postoperative values of cer-vical curvature,cervical lordosis index,range of angular motion from flexion to extension, lateral bending and rotation were compared between PAP and non-PAP groups. The correlations of preoperative type or dimension of cervical curve of C2~7 segments as well as cervical instability and prevalence of PAP were evaluated, respectively. Results Twelve patients with PAP accepted non-surgical treatment, and got fundamental improvement at the final follow-up. The ratio of concomitantly preoperative instability in PAP group was higher than that in non-PAP group, the difference had statistical significance(P<0.05). Postoperative amplitude of reduction of sagittally angular motion in PAP group was more than that in non-PAP group, the difference had statistical significance(P<0.05). Conclusions If MCDM patients are complicated with preoperative cervical instability, pronounce loss of sagittal amplitude of motion and sec-ondary onset of PAP of neck and shoulder will be incurred easily after unilaterally expansive laminoplasty adjuncted with fixation of Centrepiece mini-plates and screws of open-side.%目的 探讨多节段脊髓型颈椎病(MCDM)患者行单开门扩大成形联合开门侧Centrepiece微型板钉固定术后轴性痛(PAP)临床特点、病理机制及危险因素.方法 对79例MCDM患者行单开门扩大成形联合开门侧Centrepiece微型板钉固定,手术节段均≥4 个.根据是否发生PAP分为两组,PAP组(12 例)和非PAP组(67例)患者,比较手术前后颈椎曲度、颈椎前凸指数、颈椎屈伸、侧弯和侧旋活动度差异,评估术前C2~7节段颈椎曲度类型、大小及术前合并颈椎不稳与PAP发作的关系.结果 PAP组均接受非手术治疗,末次随访时基本改善. PAP组术前合并颈椎不稳比例高于非PAP组,差异有统计学意义(P<0.05). PAP组术后颈椎屈伸活动度下降幅度大于非PAP组,差异有统计学意义(P<0.05).结论 术前合并颈椎不稳的MCDM患者行单开门扩大成形联合开门侧Centrepiece微型板钉固定,术后更易继发颈椎屈伸活动度的下降和颈肩PAP.
    • 张吉辉; 赵刘军
    • 摘要: 颈椎不稳疾病需要手术来重建其稳定性.以往而言,手术方式可分为前路与后路两种,但各自有各自的缺点.前路椎体螺钉的失败率较高,有时需要再次手术;而后路椎弓根螺钉、侧块螺钉、关节突关节螺钉的创伤较大,导致患者住院时间较长.一般的颈椎不稳疾病,根据疾病所在的位置,单用前路或者后路就可以达到稳定的效果.但是,对于单节段的三柱损伤、需要多节段的椎体次全切除术和椎间盘摘除术的疾病,单一的前路或后路往往不能达到预期的牢固稳定效果.同时,联合应用前后路又有其更突出的缺点:如手术时间延长、手术损伤更大、感染风险增加等等.近些年来,颈椎前路椎弓根螺钉作为一种新近提出的颈椎固定技术.它的生物力学特性、形态学的可行性、抗拔出力的强度、影像学特点及新兴置钉技术已经有了相关的实验室及临床研究.因其重建的牢固稳定性、良好的力学特性和患者的满意疗效得到了较多学者的认可.虽然颈椎前路椎弓根螺钉技术已经被运用于临床上,但它的长期临床效果还需待进一步明确.尽管如此,其创新性的提出,将为广大医师同仁为治疗颈椎不稳疾病提供新的解决思路.%Instability of the cervical spine disease requires surgery to restore stability.In the past,surgical methods were divided into two kinds of anterior and posterior.But each has its own disadvantages:anterior vertebral screw has a higher failure rate,sometimes need a second operation;and posterior pedicle screw,lateral mass screw and facet joint screw may make greater trauma,lead to longer hospitalization.For general instable cervical spine disease,according to the location of the disease,only with the anterior or posterior approach can achieve a stable effect.However,it often fails to achieve the desired stability with only anterior or posterior approach for the three column injury of single segment,the disease need for multi-segment corpectomy and discectomy.Meanwhile,combined with the anterior and posterior have more obvious disadvantages:such as prolonged operation time,greater surgical injury,increased risk of infection and so on.In recent years,anterior transpedicular screw (ATPS) as a new technique was used for cervical spine fixation.Its laboratory and clinical studies have been conducted about biomechanical properties,morphological feasibility,pull-out strength,radiological features and new technology for inserting screws.Because of its strong stability,perfect mechanical properties and the satisfactory results of patients,which has been recognized by many scholars.Although this technique has been used in clinical practice,Its long-term clinical effect needs to be further clarified.Even so,the innovative proposal will provide a new thread for the majority of doctors and colleagues in treating unstable cervical disease.
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