2017 Medical Thesis Proposal Report Sample

Thesis title: Comparison of different therapeutic effects of multi-level cervical spondylosis surgery

1. Research background And significance

Imaging shows multi-segment cervical disc herniation or degeneration, compression of the spinal cord, bone hyperplasia at the posterior edge of multi-segment vertebral bodies, and a series of pathological changes such as osteophytes and lesions. Involving 3 or more segments is called multi-level cervical spondylosis (MLCS), which often occurs in older people. The main clinical manifestations are: (1) cervical spondylotic radiculopathy with nerve root compression, manifesting as radicular radiating pain; (2) cervical spondylotic myelopathy with damage to the pyramidal system, manifesting as sensory function and limb movement disorders; (3) Mixed type of the above two symptoms. MLCS is a common disease in spinal surgery, with a slow onset and no statistically significant difference in gender. After the spinal cord is damaged, it may cause irreversible changes and make treatment difficult. If the diagnosis is not timely and the treatment is inappropriate, it can lead to limb disability and even life-threatening. With the rapid development of modern medical imaging technology, especially the application of Magnetic Resonance Imaging (MRI), the incidence and discovery rate of MLCS have increased significantly. Early correct diagnosis and timely and reasonable treatment can significantly increase the curative effect and improve the patient's quality of life.

MLCS can be directly and effectively treated through surgery. The therapeutic efficacy of different anterior "hybridizations" was studied.

In 1958, Smith et al. However, the CAP technique is highly invasive. In most cases, a single anterior or posterior approach can effectively decompress, and it is not necessary to use anterior and posterior surgery in the first stage.

With the intensification of aging, the incidence of cervical spondylosis is on the rise among middle-aged and elderly people. At present, decompression and bone grafting fusion through the anterior cervical approach can effectively treat cervical spondylosis of 1-2 levels, but whether to use anterior or posterior surgery to treat MLCS, especially cervical spondylosis of 4 or more levels, is difficult. Many doctors have different opinions. Some studies have compared the long-term efficacy of long-segment anterior decompression and fusion and posterior laminectomy and concluded that there is no significant difference in the efficacy of anterior and posterior surgery. However, some scholars believe that posterior surgery is more effective in treating spinal cord injuries. Patients with severe MLCS may be better candidates. Therefore, depending on the patient's condition and disease course, the surgical procedures used will also be different.

Although the surgical treatment of MLCS has made great progress, there is still no gold standard for the selection of surgical methods. In particular, there are few reports on the surgical treatment of cervical spondylosis of 4 or more levels [25, 26] . This topic aims to conduct a retrospective analysis of patients with 4-segment cervical spondylosis who underwent surgical treatment in the Department of Spine and Orthopedics of our hospital from April 2008 to June 2014 with complete data and no previous history of cervical spine surgery, and to explore the effects of different treatment methods on 4-segment cervical spondylosis. Outcomes in patients with segmental cervical spondylosis.

2. Main contents and methods of the research

3. Expected goals

4. Difficulties and existing problems

5. Preliminary steps of the research Plan

References

[1] Liao Xinyuan, Chen Deyu, Chen Yu, et al. Progress in surgical treatment of multi-level cervical spondylotic myelopathy[J]. Chinese Journal of Spine and Spinal Cord, 2013 , 23(1):73-76.

[2] Fang Jiahu, Jia Lianshun, Zhou Xuhui, et al. Surgical options for resection of compressive objects in cervical spondylotic myelopathy [J]. Chinese Journal of Orthopedics, 2008,5:383-384.

[3] Yuan Wen. Selection of surgical approaches and techniques for cervical spondylotic myelopathy—elements in selecting surgical plans for multi-level cervical spondylotic myelopathy[J] . Chinese Journal of Spine and Spinal Cord, 2009, 19(14): 483-484.

[4] Zhu Qingsan, Gu Rui. Basic surgical procedures for the treatment of multi-segmental cervical spondylotic myelopathy [J]. Chinese Spine Journal of Spinal Cord, 2009, 19(14): 484-485.

　[5] Matsumoto M, Toyama Y, Ishikawa M, et al. Increased signal intensity of spinal cord on magnetic resonance images in cervical compressive myelopath . Spine, 2000, 25(6):677-682.

　[6] Morio Y, Teshima R, Nagashima H, et al. Correlation between operative outcomes of cervical compression myelopathy and MRI of the spinal cord . Spine, 2001, 26(11):1238-1245.

[7] Edwards CC, Riew KD, Anderson PA, et al. Cervical myelopathy: current diagnostic and treatment strategies. Spine J, 2003; 3(1):68-81. ;