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椎体后凸成形骨水泥注射治疗的有限元模型数字化评价 预览
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作者 王祎娅 张涵 兰海 《中国组织工程研究》 CAS 北大核心 2020年第9期1378-1383,共6页
背景:由于经皮椎体后凸成形的治疗原理、远期疗效、并发症均与其生物力学密切相关,其生物力学引起了广泛关注。目的:建立椎体后凸成形骨水泥注射治疗后的生物力学变化及骨水泥泄漏虚拟数字化评价系统。方法:在前期实验已建立的L3-L5三... 背景:由于经皮椎体后凸成形的治疗原理、远期疗效、并发症均与其生物力学密切相关,其生物力学引起了广泛关注。目的:建立椎体后凸成形骨水泥注射治疗后的生物力学变化及骨水泥泄漏虚拟数字化评价系统。方法:在前期实验已建立的L3-L5三维模型的基础上进行椎体后凸成形骨水泥注射操作,并导入Abaqus2016软件将模型立体化,进行有限元分析,分析骨水泥注射方式、注射压力及注射量对L4骨折椎体终板应力的影响。结果与结论:①模拟经皮稚体后凸成形手术操作填充骨水泥后,L4骨折椎体终板在骨水泥的承载分压作用下应力明显降低。不同注射方式对L4骨折椎体终板所受应力影响不显著(P>0.05),但双侧注射使骨水泥分布更加均匀,效果最好;②不同注射压力对A骨折椎体终板所受应力影响不显著(P>0.05),但随着注射压力的增加,骨水泥分布更加分散,更容易出现渗漏;③随着骨水泥注射剂量逐渐增加,L4骨折椎体终板应力逐渐降低(P<0.05),注射2 mL时不能恢复椎体的生理刚度,4 mL时骨水泥分布更加集中,8 mL时达到屈服点;④骨水泥注射后,下位椎体上终板比上位椎体下终板更容易出现再骨折的情况;⑤结果表明,模拟手术前后椎体终板应力发生明显转移,即L4上终板应力增加,L4下终板应力减少;不同注射方式对手术结果影响不大,但双侧注入的骨水泥分布更加均匀,降低了术后再次骨折和塌陷的概率;选用低注射压力可降低术后骨水泥泄露风险;4 mL注射量既能使病椎恢复较好的刚度及生理曲度又未达到屈服点而引起再次骨折。 展开更多
关键词 椎体后凸成形 骨水泥 有限元分析 脊柱 生物力学 缓解疼痛 骨水泥渗漏
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A Rare Case of a Thoracic Spinal Hemangiopericytoma 预览
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作者 Derou Keableon Louis Irié Bi Gohi Serge +3 位作者 Tokpa André Konan Serge Yao Bougaci Nassim Lonjon Michel 《现代神经外科学进展(英文)》 2019年第1期1-6,共6页
Spinal hemangiopericytomas are rare tumors. To date, only 80 cases of spinal hemangiopericytomas have been reported in the literature. The postoperative evolution of this condition in rare cases can be complicated by ... Spinal hemangiopericytomas are rare tumors. To date, only 80 cases of spinal hemangiopericytomas have been reported in the literature. The postoperative evolution of this condition in rare cases can be complicated by a symptomatic compressive epidural hematoma that can be the source of serious neurological complications requiring emergency surgery. We report a rare case of intradural and extramedullary spinal hemangiopericytomas with favorable evolution after treatment in an 82 years old woman. 展开更多
关键词 HEMANGIOPERICYTOMA SPINE INTRADURAL EXTRAMEDULLARY RADIOTHERAPY Emergency Surgery
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Magnetic Resonance Imaging of the Spine at the Douala General Hospital (Cameroon) 预览
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作者 Mathurin Neossi Guena Florent Alapha Zilbinkai +7 位作者 Antonia Djougnye Regine Gaelle Ngah Etoundi Edwige Vekoun Ngadjere Emmanuela Manka’a Wankie Narcisse Nwedjiwe Nana Celestine Nguemgne Wanko Woguep Laure Vanina Joseph Fotsin Gonsu 《现代神经外科学进展(英文)》 2019年第3期237-247,共11页
Objectives: The objective of this study was to evaluate the interest of MRI in the diagnosis of spinal disorders in our area. Method: It was a cross-sectional, descriptive and retrospective study during a nine-month p... Objectives: The objective of this study was to evaluate the interest of MRI in the diagnosis of spinal disorders in our area. Method: It was a cross-sectional, descriptive and retrospective study during a nine-month period from January to September 2015 involving all patients who performed a spine MRI in the Imaging Department of Douala General Hospital. All the patients were scanned using an open-sided mid-field MRI APERTO LUCENT (0.4 T) using sagittal and axial slices in T1-weighted and T2-weighted FSE spin echo and STIR sagittal slices and T1 gado. Water-fat saturation (WFS) slices were obtained after injection of a contrast agent. All the data collected were analyzed using Microsoft Excel 2010 and Sphinx version 4.0. Results: 220 patients were recruited. The mean age was 46.34. There was male predominance with a sex ratio of 1.5. The main indication was lumbar spine pain (36.8%), followed by cervical spine pain, sensory and motor disorder. Neurosurgeon (33.6%), neurologist (23.1%) and rheumatologist (13.6%) were the main referring physicians. The lumbar spine was the most explored (53.2%). Discal hernia (46.6%), arthrosis (31.3%) and degenerative disc disease (25.5%) were the main observed lesion. Infectious disorders were mainly represented by spondylitis (5%);Traumatic disorders by spondylolisthesis (8.6%). Tumors were mainly metastasis (4%). 21.3% of MRI were normal. MRI-clinical concordance was 78.63%. Conclusion: MRI allows an accurate assessment of spinal and spinal cord pathologies without exposing patients to radiation. It helped to confirm or refute the diagnosis suspected by clinics. However, its availability is limited in our country. 展开更多
关键词 SPINE MRI SPINAL DISORDERS Douala GENERAL HOSPITAL
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Isokinetic Strength of Trunk Flexors and Extensors Muscles in Adult Men with and without Nonspecific Back Pain: A Comparative Study 预览
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作者 Wael Gabr Reda S. Eweda 《行为与脑科学期刊(英文)》 2019年第9期340-350,共11页
Background: There is no proven relationship between back pain and trunk muscle strength, researches in this field yielded conflicting results: some found significant weakness of trunk muscles in back pain patients com... Background: There is no proven relationship between back pain and trunk muscle strength, researches in this field yielded conflicting results: some found significant weakness of trunk muscles in back pain patients compared with healthy subjects, however many researches did not show any relationship. Objectives: The focus of this study is to assess the trunk muscles strength using isokinetic dynamometer then tries to find a relation between back pain and trunk muscles strength. Materials and Methods: Fifty patients with back pain (BP) and 50 healthy subjects were recruited in this study. The flexors and extensors of the trunk muscles were evaluated by Isokinetic dynamometer and compared with control groups. Results: Patients with acute back pain show a significant reduction of the trunk muscles strengths at 120°/s velocities (p value < 0.05) with reversed flexor/extensor ration in comparison with sound subjects. Such a relationship does not show in subacute or chronic back pain patients. Conclusions: Acute back pain associated with decreased the strength of the trunk flexors and extensors at 120°/s. The trunk muscle reinforcement programs must be considered in-patients with acute back pain. 展开更多
关键词 Back PAIN TRUNK Muscles ISOKINETIC SPINE TORQUE
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“Syndrome of Contractures” According to Prof. Hans Mau;Problems of Shanks, Knees, Hips, Pelvis and Spine;Children, Adolescents, Adults, Diagnosis, Treatment 预览
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作者 Karski Tomasz Karski Jacek Domaga?a Marian 《外科学(英文)》 2019年第1期24-38,共15页
The problems of movement apparatus in children, youth and even adolescents aren’t connected with “a weakness of muscles” but with a shortening of muscles, tendons, and capsules which in orthopaedic literature is ca... The problems of movement apparatus in children, youth and even adolescents aren’t connected with “a weakness of muscles” but with a shortening of muscles, tendons, and capsules which in orthopaedic literature is called “contracture” [1] [2] [3] [4]. The older way of thinking about the problem was based on the conviction that “weak muscles” cause and make problems;we, however, present on many examples that “restriction of movements” doing by shortening of soft tissues makes contracture and incorrect position of joints, body parts, the serious and frequent clinical problems. 展开更多
关键词 CONTRACTURE Incorrect Position of Body Influence on Shanks HIPS PELVIS Neck SPINE Physiotherapy
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Retracted Article:Application of 3D printing technology in orthopedic medical implant-Spinal surgery as an example 预览
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作者 Rong Feng Zhang Peng Yun Wang +4 位作者 Ming Yang Xuebo Dong Xue Liu Yiguang Sang An Tong 《国际生物打印期刊》 2019年第2期3-11,共9页
Additive manufacturing has been used in complex spinal surgical planning since the 1990s and is now increasingly utilized to produce surgical guides,templates,and more recently customized implants.Surgeons report bene... Additive manufacturing has been used in complex spinal surgical planning since the 1990s and is now increasingly utilized to produce surgical guides,templates,and more recently customized implants.Surgeons report beneficial impacts using additively manufactured biomodels as pre-operative planning aids as it generally provides a better representation of the patient’s anatomy than on-screen viewing of computed tomography(CT)or magnetic resonance imaging(MRI).Furthermore,it has proven to be very beneficial in surgical training and in explaining complex deformity and surgical plans to patients/parents.This paper reviews the historical perspective,current use,and future directions in using additive manufacturing in complex spinal surgery cases.This review reflects the authors’opinion of where the field is moving in light of the current literature.Despite the reported benefits of additive manufacturing for surgical planning in recent years,it remains a high niche market.This review raises the question as to why the use of this technology has not progressed more rapidly despite the reported advantages–decreased operating time,decreased radiation exposure to patients intraoperatively,improved overall surgical outcomes,pre-operative implant selection,as well as being an excellent communication aid for all medical and surgical team members.Increasingly,the greatest benefits of additive manufacturing technology in spinal surgery are customdesigned drill guides,templates for pedicle screw placement,and customized patient-specific implants.In view of these applications,additive manufacturing technology could potentially revolutionize health care in the near future. 展开更多
关键词 Additive manufacturing biomodeling rapid PROTOTYPING SPINE DEFORMITY complex SPINE surgery
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人体脊柱胸腰段椎骨显微骨硬度分布特征研究
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作者 李升 张晓娟 +6 位作者 吴卫卫 刘国彬 王建朝 殷兵 胡祖圣 付蕾 张英泽 《中华解剖与临床杂志》 2019年第4期313-317,共5页
目的探讨人体胸腰椎段椎骨显微骨硬度的分布特征及临床应用前景。方法选取3具新鲜成人尸体标本,取出其T11~L2椎骨后剔除软组织。将每一个椎骨分为椎体区和附件区,经高精慢速锯切割成若干厚约3 mm的骨组织切片,12块椎骨标本共计产生72个... 目的探讨人体胸腰椎段椎骨显微骨硬度的分布特征及临床应用前景。方法选取3具新鲜成人尸体标本,取出其T11~L2椎骨后剔除软组织。将每一个椎骨分为椎体区和附件区,经高精慢速锯切割成若干厚约3 mm的骨组织切片,12块椎骨标本共计产生72个骨组织切片。应用维氏显微硬度测量仪测量骨组织切片不同区域皮质骨和松质骨的显微硬度值,每一个区域选取5个有效显微硬度值,全体有效值的平均值作为该区域的硬度值。结果12块椎骨共进行660次有效压痕实验并取得显微硬度值。(1)胸腰段椎休总体硬度为11.6~48.3 HV,其中皮质骨硬度为13.8~48.3(31.62±5.66)HV,松质骨硬度11.6~44.9(29.62±5.38)HV;(2)胸腰段椎体区和附件区皮质骨硬度分别为(29.99±5.27)HV和(32.92±5.63)HV,松质骨硬度分别为(28.44±4.79)HV和(30.81±5.71)HV,附件区均高于椎体区,差异均有统计学意义(t=5.098、2.011,P值均<0.05);(3)椎体区皮质骨硬度由高到低依次为下终板(33.94±4.31)HV、上终板(29.76±4.35)HV、外周终板(28.13±5.07)HV,下终板皮质的骨硬度高于上终板、外周终板,差异均有统计学意义(P值均<0.05);(4)附件区皮质骨中,硬度由高到低依次为椎弓根皮质(34.78±5.30)HV、上关节突(33.73±5.68)HV、椎板(33.15±5.28)HV、横突(31.69±5.37)HV和下关节突(31.26±5.91)HV,其中椎弓根皮质骨硬度与横突和下关节突相比,差异均有统计学意义(P值均<0.05)。结论本实验首次应用维氏显微硬度方法对人体胸腰椎段椎骨显微硬度的分布规律进行研究,发现胸腰椎段椎骨附件区皮质骨、松质骨骨硬度分别高于椎体区皮质骨、松质骨骨硬度,胸腰椎段T11~L2之间、不同标本的胸腰椎段的骨显微硬度存在差异,但分布规律相对一致,是微观结构、力学承载共同作用的结果,符合人体正常生理及负重功能。本研究结果可为3D打印制备具有梯度硬度的人工椎骨提供数据支持。 展开更多
关键词 脊柱 胸腰椎 椎骨 骨硬度实验 维氏硬度 显微硬度 人体骨骼
椎旁型脊柱血管瘤与神经鞘瘤的MRI鉴别诊断
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作者 杨欢 高剑波 梁盼 《实用放射学杂志》 CAS 北大核心 2019年第6期865-868,共4页
目的分析椎旁型脊柱血管瘤和神经鞘瘤的MRI表现及鉴别诊断特征.方法回顾性分析经手术及病理证实为椎旁型脊柱血管瘤11例和椎旁型神经鞘瘤患者17例的MRI和临床资料.结果椎旁型脊柱血管瘤位于胸段硬膜外,T2WI呈高信号,似脑脊液,增强后明... 目的分析椎旁型脊柱血管瘤和神经鞘瘤的MRI表现及鉴别诊断特征.方法回顾性分析经手术及病理证实为椎旁型脊柱血管瘤11例和椎旁型神经鞘瘤患者17例的MRI和临床资料.结果椎旁型脊柱血管瘤位于胸段硬膜外,T2WI呈高信号,似脑脊液,增强后明显均匀强化,伴同层椎体破坏和椎体血管瘤.椎旁型神经鞘瘤位于中上颈段和胸段硬膜内外,T2WI信号不均匀,实性区域呈稍高信号,其内不规则片状更高信号,不均匀明显强化,囊变区不强化.对比2组病例,在病灶发生位置、伴发椎体血管瘤、病变同层椎体受累、病变与脊髓关系、T2WI信号、强化方式差异有统计学意义(P<0.05).在年龄、性别、临床表现,形态、体积、附件受累、T1WI信号差异无统计学意义(P>0.05)。结论椎旁型脊柱血管瘤与神经鞘瘤的MRI表现在位置、伴发椎体血管瘤、病变同层椎体受累、病变与脊髓关系、T2WI信号、强化方式方面存在差异,充分认识MRI表现有助于诊断。 展开更多
关键词 脊柱 血管瘤 神经鞘瘤 磁共振成像
脊柱骨巨细胞瘤影像学分析及鉴别诊断 预览
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作者 牛富业 徐才国 +2 位作者 尹雪军 何东雷 刘林 《中华消化病与影像杂志(电子版)》 2019年第2期68-71,共4页
目的,分析脊柱骨巨细胞瘤的影像学表现,提高术前诊断水平。方法,对36例经手术病理证实的脊柱骨巨细胞瘤的X线、CT和MRI资料进行回顾性分析。结果,发生于颈椎7例,胸椎16例,腰椎6例,骶椎7例。合并动脉瘤样骨囊肿9例。影像学表现为偏心性... 目的,分析脊柱骨巨细胞瘤的影像学表现,提高术前诊断水平。方法,对36例经手术病理证实的脊柱骨巨细胞瘤的X线、CT和MRI资料进行回顾性分析。结果,发生于颈椎7例,胸椎16例,腰椎6例,骶椎7例。合并动脉瘤样骨囊肿9例。影像学表现为偏心性、膨胀性骨质破坏25例,27例首次手术患者伴发病理性骨折12例,椎管狭窄21例,周围软组织肿块形成20例,囊变17例。9例复发者均合并软组织肿块及椎管狭窄,病灶边界不清,囊变、出血7例。MRI多表现为T1WI呈等、低信号,T2WI呈等、低或混杂高信号。合并动脉瘤样骨囊肿者表现为多囊状高信号,内可见液-液平面。结论,脊柱骨巨细胞瘤影像学表现具有一定的特征性,CT和MRI结合分析,可以提高术前诊断率,对临床分期、手术方案制定及术后评估具有重要价值。 展开更多
关键词 脊柱 骨巨细胞瘤 计算机体层摄影术 磁共振成像
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ALK-positive anaplastic large cell lymphoma of the thoracic spine occurring in pregnancy: A case report 预览
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作者 Sen Yang Wei-Min Jiang Hui-Lin Yang 《世界临床病例杂志》 2019年第18期2857-2863,共7页
BACKGROUND Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin’s lymphoma (NHL). ALCL is rare as a bone lesion and in pregnancy. CASE SUMMARY We present the first case of anaplastic lymphoma kinase (ALK)+ ... BACKGROUND Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin’s lymphoma (NHL). ALCL is rare as a bone lesion and in pregnancy. CASE SUMMARY We present the first case of anaplastic lymphoma kinase (ALK)+ ALCL of the thoracic spine during pregnancy. A 25-year-old pregnant woman was presented to us at 24 wk’ gestation with severe back pain and weakness in the left lower limb. Imaging examination showed lesions at T10 and T11. She underwent posterior pedicle screw fixation and vertebroplasty. Pathological examination showed ALK+ ALCL. The patient chose to have therapeutic abortion after surgery and received chemotherapy in the hematology department. She now remains disease free with no neurological deficit after 30 mo’ follow-up. CONCLUSION ALK+ ALCL with the thoracic spine involvement is uncommon, especially in pregnancy. Many symptoms can be misunderstood during pregnancy;therefore, when a pregnant patient has persistent back pain or lower limb neurological symptoms, imaging examinations should be performed. 展开更多
关键词 ANAPLASTIC large cell LYMPHOMA PREGNANCY THORACIC SPINE Surgical treatment Chemotherapy Case report
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脊柱手术后并发静脉血栓栓塞症8例临床分析 被引量:1
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作者 叶一 蒋国强 +4 位作者 宋焕军 叶志方 诸进晋 卢斌 罗科锋 《中华全科医学》 2019年第3期500-503,共4页
目的分析脊柱手术后并发静脉血栓栓塞症(VTE)患者的临床资料,探讨其诊断与防治方法。方法对宁波大学医学院附属医院脊柱外科于2010年1月—2017年12月收治的8例脊柱手术后并发VTE患者的临床表现、诊断方法、治疗过程及转归等资料进行回... 目的分析脊柱手术后并发静脉血栓栓塞症(VTE)患者的临床资料,探讨其诊断与防治方法。方法对宁波大学医学院附属医院脊柱外科于2010年1月—2017年12月收治的8例脊柱手术后并发VTE患者的临床表现、诊断方法、治疗过程及转归等资料进行回顾性分析,结合VTE防治的相关文献,对脊柱手术后并发VTE的流行病学、防治措施进行详细阐述。结果本组脊柱手术后并发VTE共8例,其中4例为单纯症状性深静脉血栓(DVT),1例为单纯症状性肺血栓栓塞症(PTE),3例为症状性PTE合并无症状性DVT,VTE总的发生率为0.47%(8/1 699)。4例单纯症状性DVT患者经抗凝及取栓、溶栓、下腔静脉滤网(IVCF)植入术等积极治疗,均治愈出院。4例PTE患者中,有1例为致死性PTE患者,经抢救无效死亡,其余3例经溶栓、抗凝等积极治疗,均治愈出院。结论虽然脊柱手术后VTE的发生率较低,但一旦发生后果严重,因此,应务必提高脊柱手术后VTE的预防意识,完善术前的危险因素评估,建立和完善VTE的防治体系,并进一步深化研究,改进脊柱手术VTE风险评估及分级预防模型,以便为今后脊柱手术VTE预防提供理论依据。 展开更多
关键词 外科手术 脊柱 并发症 静脉血栓栓塞
皮质骨通道螺钉技术在腰椎退变性疾病中的临床应用 预览
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作者 赵永辉 陆声 +6 位作者 马宇龙 施荣茂 王龙 梁金龙 陈太邦 罗浩天 徐永清 《中华老年骨科与康复电子杂志》 2019年第3期123-129,共7页
目的探讨经椎弓根皮质骨通道(CBT)螺钉内固定技术在腰椎退变性疾病中的临床疗效。方法回顾性收集中国人民解放军联勤保障部队第九二○医院2016年8月~2018年5月间收治的腰椎退变性疾病患者53例,均行经后路椎管减压椎间植骨融合内固定手... 目的探讨经椎弓根皮质骨通道(CBT)螺钉内固定技术在腰椎退变性疾病中的临床疗效。方法回顾性收集中国人民解放军联勤保障部队第九二○医院2016年8月~2018年5月间收治的腰椎退变性疾病患者53例,均行经后路椎管减压椎间植骨融合内固定手术治疗,其中23例应用CBT螺钉技术,30例应用传统椎弓根螺钉技术,分别观察两组患者手术时间、术中出血量、VAS评分、JOA评分和改善率以及术后恢复情况、有无并发症等,综合评价临床疗效。结果所有患者均获得随访,随访时间为3~18个月,平均(12±4)个月。手术置钉过程中均未出现螺钉把持力不足、峡部或椎弓根劈裂以及在置钉过程中引起的血管、神经损伤等情况。两组患者症状均得到不同程度改善,术后JOA评分[CBT组:(23.7±2.3)分,传统组:(23.9±2.0)分]和VAS评分[CBT组:(1.2±0.7)分,传统组:(1.3±0.8)分]均较术前降低[JOA评分:CBT组:(9.1±2.7)分,传统组:(10.3±2.0)分;VAS评分:CBT组:(5.3±1.2)分,传统组:(5.4±1.2)分;],差异均具有统计学意义(均P<0.05)两组间比较手术时间[CBT组:单节段为(2.0±0.3)h,双节段为(2.8±0.4)h。传统组:单节段为(2.1±0.3)h,双节段为(3.0±0.2)h]、术后VAS评分[(CBT组:(1.2±0.7)分,传统组:(1.3±0.8)分]和JOA评分[(CBT组:(23.7±2.3)分,传统组:(23.9±2.0)分]无明显统计学差异,但CBT螺钉组的术中出血量[(单节段:(297±48)ml,双节段:(367±41)ml]少于传统椎弓根螺钉组[(单节段:(347±44)ml,双节段:(427±46)ml](t=-3.209,t=-2.692,P<0.05)。术后影像学随访均未见螺钉松动、尾冒脱落、钉棒断裂、椎间隙高度丢失、椎间融合器位移等不良事件的发生。结论应用CBT螺钉内固定技术治疗腰椎退变性疾病是一种手术创伤更小、术后恢复更快且安全可靠、固定有效的置钉方法。 展开更多
关键词 椎弓根螺钉 脊柱 腰椎
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神经病理性疼痛大鼠不同大小DRG神经元兴奋性分型的研究 预览
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作者 谭朝阳 周颖 +8 位作者 屈祖卫 张萌 陈沁怡 田俊杰 许珍珍 邓诗瑜 李丽 马克涛 司军强 《中国现代医学杂志》 CAS 2019年第11期1-7,共7页
目的研究神经病理性疼痛状态下,不同大小背根神经节(DRG)神经元兴奋性分型的特点,探讨不同大小DRG神经元兴奋性分型与神经病理性疼痛的关系。方法将SD大鼠随机分成正常组(Control组)、假手术组(Sham组)和坐骨神经分支选择性损伤模型组(... 目的研究神经病理性疼痛状态下,不同大小背根神经节(DRG)神经元兴奋性分型的特点,探讨不同大小DRG神经元兴奋性分型与神经病理性疼痛的关系。方法将SD大鼠随机分成正常组(Control组)、假手术组(Sham组)和坐骨神经分支选择性损伤模型组(SNI组)。运用热和冷刺激实验观察大鼠疼痛行为学变化;运用膜片钳技术记录不同大小DRG神经元兴奋性分型变化。结果与Control组比较,SNI组大鼠热缩足潜伏期无改变,但冷刺激抬足时间增加(P<0.05);与Control组比较,SNI组大鼠DRG神经元的1型和2型细胞构成比增加,3型细胞构成比减少(P <0.05);在Control组内,与大细胞比较,中、小细胞3型细胞的构成比较低,而1型和2型细胞的构成比较高(P <0.05);在SNI组内,与大细胞比较,中细胞3型细胞构成比较低,1型和2型细胞构成比较高(P <0.05),而小细胞与大细胞的构成比差异无统计学意义(P>0.05)。结论不同大小的DRG神经元兴奋性分型的改变是产生神经病理性疼痛的机制之一。 展开更多
关键词 神经痛 神经节 膜片钳术 细胞大小 兴奋性分型
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Remodeling dendritic spines for treatment of traumatic brain injury 预览
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作者 Ye Xiong Asim Mahmood Michael Chopp 《中国神经再生研究:英文版》 SCIE CAS CSCD 2019年第9期1477-1480,共4页
Traumatic brain injury is an important global public health problem.Traumatic brain injury not only causes neural cell death,but also induces dendritic spine degeneration.Spared neurons from cell death in the injured ... Traumatic brain injury is an important global public health problem.Traumatic brain injury not only causes neural cell death,but also induces dendritic spine degeneration.Spared neurons from cell death in the injured brain may exhibit dendrite damage,dendritic spine degeneration,mature spine loss,synapse loss,and impairment of activity.Dendritic degeneration and synapse loss may significantly contribute to functional impairments and neurological disorders following traumatic brain injury.Normal function of the nervous system depends on maintenance of the functionally intact synaptic connections between the presynaptic and postsynaptic spines from neurons and their target cells.During synaptic plasticity,the numbers and shapes of dendritic spines undergo dynamic reorganization.Enlargement of spine heads and the formation and stabilization of new spines are associated with long-term potentiation,while spine shrinkage and retraction are associated with long-term depression.Consolidation of memory is associated with remodeling and growth of preexisting synapses and the formation of new synapses.To date,there is no effective treatment to prevent dendritic degeneration and synapse loss.This review outlines the current data related to treatments targeting dendritic spines that propose to enhance spine remodeling and improve functional recovery after traumatic brain injury.The mechanisms underlying proposed beneficial effects of therapy targeting dendritic spines remain elusive,possibly including blocking activation of Cofilin induced by beta amyloid,Ras activation,and inhibition of GSK-3 signaling pathway.Further understanding of the molecular and cellular mechanisms underlying synaptic degeneration/loss following traumatic brain injury will advance the understanding of the pathophysiology induced by traumatic brain injury and may lead to the development of novel treatments for traumatic brain injury. 展开更多
关键词 TRAUMATIC brain injury dendritic SPINES SYNAPTIC plasticity spinogenic agents TREATMENT spine REMODELING memory functional recovery
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Curative Effects of Warming Needle Moxibustion Combined with Manipulation Massage on Cervical Spondylotic Vertebral Arteriopathy and Its Influence on the Cerebral Blood Flow Parameters and Cervical Vertebral Function 预览
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作者 翟炳生 《世界中西医结合杂志(英文)》 2019年第3期17-23,共7页
OBJECTIVE: To explore the curative effects of warming needle moxibustion combined with manipulation massage on cervical spondylotic vertebral arteriopathy and its influence on the cerebral blood flow and cervical vert... OBJECTIVE: To explore the curative effects of warming needle moxibustion combined with manipulation massage on cervical spondylotic vertebral arteriopathy and its influence on the cerebral blood flow and cervical vertebra function. METHODS: A total of 84 patients with cervical spondylotic vertebral arteriopathy admitted to our hospital from February 2016 to June 2017 were selected, and all patients were divided into an observation group (n=42) and a control group (n=42) according to the random number table method. The patients in the control group were given conventional western treatment, and the patients in the observation group were treated with warming needle moxibustion combined with manipulation massage on the basis of the control group. After 4 weeks of treatment, the changes of main clinical symptoms (vertigo, headache, neck and shoulder pain, tinnitus), cervical function (clinical symptoms, clinical examination, daily life action) and cerebral blood flow parameters (average blood flow velocity of left vertebral artery, right vertebral artery and basilar artery) of the 2 groups were observed, and the clinical efficacy of the 2 groups were statistically analyzed. RESULTS: The scores of vertigo, headache, neck and shoulder pain and tinnitus in the 2 groups were all significantly lower than before treatment (P < 0.05), and the clinical symptom scores in the observation group were significantly lower after treatment (P < 0.05);After treatment, the scores of clinical symptoms, clinical examination and daily life action in the 2 groups were significantly higher than those before treatment (P < 0.05), and the increase of cervical vertebral function score in the observation group was better than that in the control group (P < 0.05);The mean blood flow velocity of the left vertebral artery, right vertebral artery and the basilar artery in the 2 groups after treatment were significantly higher than before treatment (P < 0.05), and the increase of the above cerebral blood flow parameters in the observation group wer 展开更多
关键词 CERVICAL spondylotic VERTEBRAL ARTERIOPATHY WARMING needle MOXIBUSTION Manipulation MASSAGE Cerebral blood flow parameters CERVICAL spine function
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脊柱转移瘤治疗策略:3D打印技术与精准治疗带来的优势 预览
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作者 崔嘉明 杨大志 《中国组织工程研究》 CAS 北大核心 2019年第36期5875-5881,共7页
背景:脊柱转移瘤患者的预计生存时间相对有限,目前有关脊柱转移瘤的治疗决策尚未形成统一标准。目的:就脊柱转移瘤的诊断、病情评估、治疗策略的最新进展进行综述。方法:使用计算机在PubMed数据库、中国知网和万方数据库检索2010年1月至... 背景:脊柱转移瘤患者的预计生存时间相对有限,目前有关脊柱转移瘤的治疗决策尚未形成统一标准。目的:就脊柱转移瘤的诊断、病情评估、治疗策略的最新进展进行综述。方法:使用计算机在PubMed数据库、中国知网和万方数据库检索2010年1月至2018年12月发表关于脊柱转移瘤以及脊柱转移瘤治疗的文献,中文检索关键词为“脊柱转移瘤,病情评估,治疗”,英文检索关键词为“Spinalmetastases,prognosis,therapy”。结果与结论:①共纳入符合标准的文献61篇;②脊柱转移瘤患者的预计生存期有限,且起病较隐匿,肿瘤来源、恶性程度及临床表现多样,准确的病情评估、合理的治疗策略是患者良好预后的关键;③传统的开放性手术创伤大,术中出血较多,术后并发症的发生率较高,脊柱转移瘤的手术治疗已逐渐趋向于微创手术联合术后辅助性治疗;④随着计算机科学以及生物材料学的发展,最新的3D打印技术已应用于脊柱转移瘤的治疗并逐渐成熟,精准切除肿瘤已成为脊柱转移瘤手术的一个新兴趋势;⑤当然原发肿瘤的控制以及全身情况的治疗仍是脊柱转移瘤治疗的基石,多学科、多团队共同参与是达到最佳治疗效果的必备条件。 展开更多
关键词 脊柱 转移瘤 诊断 病情评估 脊柱微创手术 放射治疗 椎体成形术 3D打印技术
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两种止血材料在腰椎退变手术中止血疗效的临床研究 预览
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作者 马立泰 杨毅 +5 位作者 帅文彬 洪瑛 刘浩 龚全 陈华 戎鑫 《生物骨科材料与临床研究》 CAS 2019年第1期33-37,共5页
目的观察评价可吸收流体明胶与明胶海绵在腰椎退变后路手术中的止血效果。方法前瞻性随机对照研究自2016年8月至2017年5月在本科收治的腰椎管减压固定融合的后路手术患者,随机分为两组:流体明胶组28例中,男12例,女16例;明胶海绵组27例中... 目的观察评价可吸收流体明胶与明胶海绵在腰椎退变后路手术中的止血效果。方法前瞻性随机对照研究自2016年8月至2017年5月在本科收治的腰椎管减压固定融合的后路手术患者,随机分为两组:流体明胶组28例中,男12例,女16例;明胶海绵组27例中,男12例,女15例;术中分别应用流体明胶和(或)明胶海绵止血,如果出血速度逐渐减慢至不再有明显的出血即认为止血成功,否则视为止血失败。记录止血3 min、5min的止血成功率,记录手术时间、术中出血量、自体血回输量、止血过程中的出血量、输血量,记录术前、术后2~3 d和术后5~7 d的BP、RBC、HCT、HB的变化,记录术后每天的引流量,记录全部的不良事件。结果全部病例至少随访1个月。明胶海绵组有18例3 min成功止血、3例5 min成功止血,流体明胶组有21例3min内快速止血,3例5 min成功止血。两组止血过程中的出血量差异明显(P=0.000);术前流体明胶组RBC和HCT小于明胶海绵组(P=0.038,P=0.030),术后两组之间差异无统计学意义(P>0.05);术前两组收缩压差异无统计学意义(P>0.05),术后2~3 d流体明胶组收缩压比明胶海绵组高(P=0.005);流体明胶组的术后1 d和术后2~4 d的引流量均少于明胶海绵组(P=0.014;P=0.011)。结论与明胶海绵相比,可吸收流体明胶可以减少止血过程中的出血量,可以减少术后引流量,是一种安全、有效的脊柱外科术中止血剂。 展开更多
关键词 脊柱 手术 止血材料 可吸收流体明胶 可吸收明胶海绵
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脊柱LCH影像表现分析及鉴别诊断
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作者 张立华 袁慧书 《临床放射学杂志》 CSCD 北大核心 2019年第5期882-886,共5页
目的探讨脊柱朗格汉斯组织细胞增生症(LCH)的CT和MRI影像表现,以提高对该病影像诊断准确率。方法回顾性分析75例临床病理确诊为LCH患者的临床和影像资料,分析其特征性的影像表现。结果 75例患者中男47例,女28例;18岁及以下50例,18岁以... 目的探讨脊柱朗格汉斯组织细胞增生症(LCH)的CT和MRI影像表现,以提高对该病影像诊断准确率。方法回顾性分析75例临床病理确诊为LCH患者的临床和影像资料,分析其特征性的影像表现。结果 75例患者中男47例,女28例;18岁及以下50例,18岁以上25例,平均年龄15.9岁,中位年龄10岁。75例中62例为单灶性,13例为多灶性;受累脊柱共117处,其中颈椎65处,胸椎36处,腰椎15处,骶椎1处;受累脊柱呈"地图样"43处(36.8%)、"虫蚀样"44处(37.6%)或穿透样骨质破坏9处(8%);21处(17.9%)骨破坏周围可见硬化边;T1WI呈等信号28例、低信号19例;T2WI呈等信号22例、低信号8例、高信号16例或混杂信号1例;49处伴椎旁软组织肿块,32处伴椎旁软组织肿胀。临床随访64例患者,随诊0.5~11年,56例无明显症状,7例有遗留症状,1例复发。结论脊柱LCH青少年多见;单节段累及多见;颈椎相对多见,骨质破坏边界相对清晰,"地图样"和"虫蚀样"骨破坏多见;硬化边不少见;MRI信号相对均匀;椎旁软组织肿块不少见;预后相对良好。 展开更多
关键词 脊柱 朗格汉斯组织细胞增生症 体层摄影术 X线计算机 磁共振成像
中国脊柱外科发展史
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作者 海涌 《中国骨与关节杂志》 CAS 2019年第10期721-725,共5页
我国近代脊柱外科的开端1921年,美国医生George W Gorder在北京协和医院成立了第一个西医骨科,这是现代骨科在我国的开端。随后,一批优秀的中国骨科医师先后远赴欧美地区,将西方骨科先进的治疗理念和治疗技术带回中国,正是他们促进了西... 我国近代脊柱外科的开端1921年,美国医生George W Gorder在北京协和医院成立了第一个西医骨科,这是现代骨科在我国的开端。随后,一批优秀的中国骨科医师先后远赴欧美地区,将西方骨科先进的治疗理念和治疗技术带回中国,正是他们促进了西方骨科在中国的逐步普及。孟继懋教授于1925年毕业于芝加哥医学院,跟随美国知名教授进修骨科,孟继懋教授回国后担任了北京协和医学院第一任华人骨科主任,并于1935年主编了我国第一本现代骨折教材——《骨折与脱位入门》。建国后,孟继懋教授开创了著名的北京积水潭医院并担任首任院长。方先之教授1933年毕业于北京协和医院,1938年赴美国波士顿儿童医院骨科深造。回国后方先之教授受卫生部任命,在天津市组织开展骨科培训,培养了600多名年轻的骨科医师。牛惠生教授是中国最早在美国接受系统培训的骨科医生之一,他1915年毕业于哈佛大学医学院,回国后任上海圣约翰大学骨科教授,并在上海建立了中国第一所骨科医院。 展开更多
关键词 脊柱 学会 医学 脊柱疾病
老年腰椎管狭窄症患者腰椎内固定手术并发症的临床分析 预览
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作者 何玉宝 徐林 +1 位作者 任龙喜 刘波 《河北医学》 CAS 2019年第3期645-650,共6页
目的:分析老年腰椎管狭窄症患者腰椎内固定手术后并发症的发生的影响因素,及其发生率,探讨减少手术并发症的相关措施。方法:回顾性分析2013年6月至2017年6月60岁以上腰椎减压固定融合的手术治疗的腰椎管狭窄症患者,分为无并发症组和有... 目的:分析老年腰椎管狭窄症患者腰椎内固定手术后并发症的发生的影响因素,及其发生率,探讨减少手术并发症的相关措施。方法:回顾性分析2013年6月至2017年6月60岁以上腰椎减压固定融合的手术治疗的腰椎管狭窄症患者,分为无并发症组和有并发症。评价手术效果,记录术中及术后3个月内并发症发生情况。分析年龄、体重指数(Body Mass Index,BMI)、病程、合并症、手术节段、手术时间、失血量、住院时间和围手术期并发症的相关性。通过分析结果、查阅文献确定减少并发症的措施。结果:73例患者中总共11例发生并发症,其中3例全身并发症,8例局部并发症。两组比较,发生并发症患者的BMI值大(t=2.177,P=0.038),术前合并症多(χ~2=7.207,P=0.027),手术节段多(χ~2=6.402,P=0.041),手术时间长(t=2.907,P=0.007)、出血量多(t=2.204,P=0.036),住院时间长(t=4.655,P=0.000)。手术节段越多,手术时间越长(F=100. 222,P=0. 000),出血量也随之增多(F=130.050,P=0.000)。两组患者术后3个月ODI评分(t=0.901,P=0.375)和Odom分级比较没有明显差异(U=309.000,P=0.541)。失血量和手术时间(r=0.591,P=0.000)、住院时间呈正性强相关(r=0.517,P=0.003),BMI和失血量呈弱正相关(r=0.374,P=0.038)。结论:并发症发生率与失血量和手术时间呈强相关。通过术中应用氨甲环酸、骨刀椎板切除、双侧同时显露和操作,减少融合节段可以减少手术时间和出血量,有助于减少并发症。 展开更多
关键词 合并症 腰椎融合 老年医学 脊柱
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