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1.
极外侧型腰椎间盘突出症指脱出的椎间盘组织位于椎间孔外,机械性压迫或炎性刺激同序数的神经根,造成剧烈的下肢放射性疼痛,合并腰骶部疼痛,同时伴有不同程度的皮肤感觉或运动功能损伤,其发病与长期承受以旋转负荷为主的应力有关。临床上遇到根性症状严重,神经损害严重,且症状与影像学椎管内表现不符的患者,应警惕本病可能。分型可分为:Ⅰa型——突出间盘向头侧移位至椎弓根下缘;Ⅰb型——Ⅰa型合并后外侧突出;Ⅱa型——极外侧型突出,突出间盘轻微头侧移位;Ⅱb型——Ⅱa型合并后外侧突出。手术治疗常为最佳选择,包括传统的开放手术及微创经间盘镜摘除突出的椎间盘术。  相似文献   

2.
目的探讨采用椎管减压、全节段椎弓根钉棒系统治疗退行性脊柱侧凸的临床效果。方法总结31例退行性脊柱侧凸患者,采用后路椎管减压、椎间Vigor植入、全节段椎弓根钉棒矫形内固定、后外侧植骨融合术治疗。结果平均随访1.5年,31例患者腰椎侧凸矫形良好、腰椎生理前凸恢复满意,神经功能恢复。结论后路减压全节段椎弓根螺钉系统可达到矫形、固定、重建脊柱稳定的目的,有利于退行性脊柱侧凸患者腰背痛及神经根性症状的改善。  相似文献   

3.
腰椎退变性侧凸症的临床发病特点与治疗   总被引:1,自引:0,他引:1  
[目的]分析腰椎退变性侧凸的自然史和转归,探讨腰椎退变性侧凸的诊断、分型与治疗原则。[方法]对退变性腰椎侧弯患者的症状、体征、影像学、治疗方法、治疗结果、并发症进行临床分析并进行统计学处理。[结果]腰椎退变性侧凸的影像学特点是椎体高度降低,腰椎单侧或者双侧侧突,关节突密度增高、增生,部分患者MRI和椎管造影表现为腰椎管狭窄,神经根受压;临床特点表现为严重的腰痛和(或)间歇性跛行或神经根性疼痛;临床分型:(1)按照发病的原因分型:①可复性代偿性退变性侧凸;②不可复性退变性侧凸。(2)按照柔韧度将腰椎退变性侧凸分为:①强直型;②非强直型又分Ⅲ度、Ⅱ度、Ⅰ度。Binding片表现为一定的柔软性,腰椎明显改变,Cobb’s角降低原角度的一半为非强直型Ⅲ度;Cobb’s角降低原角度的1/3为非强直型Ⅱ度;Cobb’s角无明显改变,但有明显的腰椎疼痛为非强直性Ⅰ度。(3)按照侧凸的形状分为:①单纯腰弯型;②大腰弯型(以腰椎为主,影响到部分胸椎);③腰弯合并代偿性胸弯型。治疗上在全身情况允许的情况下进行侧凸矫形,对强直型不强调完全矫形,但强调有严重关节突病变节段行融合手术;非强直型强调矫形,恢复正常生理力线。[结论]腰椎退变性侧凸症是腰椎退变的严重病理变化,腰痛是其主要症状,其原因是腰椎退变导致的腰椎关节突关节炎,手术矫正腰椎畸形的同时进行关节突减压是治疗老年下腰痛的主要环节,诊断依据症状、体征和影像学表现,分型依据临床特点和影像学特点进行,治疗依据临床和影像学特征综合分析采用手术和保守治疗,手术的方式根据腰椎退变的程度决定。  相似文献   

4.
腰椎退变性侧弯伴椎管狭窄的外科治疗   总被引:1,自引:0,他引:1  
目的 探讨退变性脊柱侧弯伴椎管狭窄的特点、手术减压范围及其临床效果;方法 32例腰椎退变性侧弯伴椎管狭窄患者,5例行椎板间开窗侧隐窝扩大减压(A组),19例行全椎板切除减压椎弓根螺钉内固定椎间融合术(B组),8例行全椎板减压并神经根管扩大减压椎弓根螺钉内固定椎间融合术.对所有术前术后影像学特点、减压方式、减压范围和功能评分(症状、体征)进行比较和评估.结果 A组中5例行开窗减压患者中3例效果良好,1例有好转但仍有症状,1例术后症状无明显减轻;B组中16例效果良好,2例症状缓解不完全,1例出现马尾神经损伤症状;C组中8例效果良好.结论 退变性脊柱侧弯伴椎管狭窄病变较复杂,手术方案要根据椎管狭窄的程度、范围和侧弯的类型确定,外科治疗的主要目的 是神经减压和最大限度最大可能的稳定和重排脊柱.对单纯侧隐窝狭窄而中央椎管不狭窄者可选择椎板间开窗减压,但这种减压范围往往不能达到完全减压,部分患者会残留狭窄症状,对合并中央椎管和侧隐窝同时狭窄者要采用双侧全椎板减压,部分出现神经根管狭窄者要对狭窄的神经根管进行减压和扩大或者通过纠正侧弯和旋转改善狭窄的神经根管和改善神经根牵拉紧张状况. 状缓解不完全,1例出现马尾神经损伤症状 C组中8例效果良好.结论 退变性脊柱侧弯伴椎管狭窄病变较复杂,手术方案要根据椎管狭窄的程度、范围和侧弯的类型确定,外科治疗的主要目的 是神经减压和最大限度最大可能的稳定和重排脊柱.对单纯侧隐窝狭窄而中央椎管不狭窄者可选择椎板间开窗减压,但这种减压范围往往不能达到完全减压,部分患者会残留狭窄症状,对合并中央椎管和侧隐窝同时狭窄者要采用双侧全椎板减压,部分出现神经根管狭窄者要对狭窄的神经根管进行减压和扩大或者通过纠正侧弯和旋转改善狭窄的神经根管和改善神经根牵拉紧张状况. 状缓解不完全,1例出现马尾神经损伤症状 C组中8例效果良好.结论 退变性脊柱侧弯伴椎管狭窄病变较复杂,手术方案要根据椎管狭窄的程度、范围和侧弯的类型确定,外科治疗的主要目的 是神经减压和最大限度最大可能的稳定和重排脊柱.对单纯侧隐窝狭窄而中央椎管不狭窄者可选择椎板间开窗减压,但这种减压范围往往不能达到完全减压,部分患者会残留狭窄症状,对合并中央椎管和侧隐窝同时狭窄  相似文献   

5.
目的:通过比较特发性脊柱侧凸(idiopathic scoliosis,IS)、先天性脊柱侧凸(congenital scoliosis,CS)顶椎凹凸侧椎旁肌和无脊柱侧凸患者椎旁肌的组织形态学改变及胶原蛋白表达的变化,探讨椎旁肌在IS发展中的作用机制。方法:分别取IS患者(A组)、CS患者(B组)顶椎凹凸两侧及无脊柱侧凸患者(对照组,C组)的椎旁肌,光镜和电镜下观察其组织学形态学改变;应用Masson三色染色法显示胶原蛋白的表达,图像分析系统测量各组胶原的阳性表达面积百分比;对各组结果采用SPSS13.0软件进行统计学处理。应用免疫组织化学方法对Ⅰ型和Ⅲ型胶原染色,观察其在各组的表达情况。结果:光镜和电镜下均显示A、B组凹侧椎旁肌形态明显异常,胶原表达增强、分布紊乱;A、B组凸侧椎旁肌及C组未见明显异常。A、B组凹侧椎旁肌中阳性胶原面积的百分比分别为0.255±0.036和0.253±0.023,明显高于凸侧(A、B组分别为0.057±0.006和0.055±0.002)及C组(0.056±0.004),差异有显著性(P<0.05)。免疫组织化学染色示A、B两组凹侧椎旁肌中Ⅰ型、Ⅲ型胶原表达无明显差异,而在凸侧椎旁肌中以Ⅰ型胶原阳性者为主。结论:IS患者凹侧椎旁肌形态明显异常,胶原表达增强且分布紊乱,其变化可能为IS的继发性改变。  相似文献   

6.
[目的]通过对151例腰椎滑脱症手术植骨治疗病人的回顾性临床分析,探讨有关腰椎滑脱症的手术适应证、手术植骨方式选择及治疗效果。[方法]依据病人情况分别采取以下4种术式,A组:后路钉棒系统固定单纯椎板植骨融合术21例,均Ⅰ度滑脱。B组:减压、钉棒系统固定、复位、经椎管椎体间植骨融合术46例,Ⅰ度20例,Ⅱ度26例。C组:减压、钉棒系统固定、复位、经关节突椎间椎板植骨融合术29例,Ⅰ度6例,Ⅱ度16例,Ⅲ度7例;D组:减压、钉棒系统固定、复位、经关节突椎间、横突间椎板植骨融合术55例,Ⅰ度4例,Ⅱ度41例,Ⅲ度10例。[结果]随访8个月~6年,平均3年7个月,A组滑脱复位率63.22%,融合率76.12%,腰痛JOA评分改善率90.33%;B组滑脱复位率93.41%,融合率93.48%,JOA评分改善率84.61%;C组滑脱复位率90.54%,融合率94.11%,JOA评分改善率77.58%;D组滑脱复位率92.49%,融合率98.00%,JOA评分改善率79.64%。[结论]对腰椎滑脱应依据滑脱程度、临床症状、病人全身情况选择相应的手术方式。  相似文献   

7.
目的:探讨退变性腰椎侧凸患者的临床症状、体征及其与影像学的关系。方法:回顾分析38例退变性腰椎侧凸患者的临床资料,采用日本骨科学会(JOA)29分法对患者神经功能和生活能力进行评分,并对病程、年龄、退变椎数、侧凸Cobb角、椎体侧方移位等因素与JOA评分的关系进行统计学分析。结果:38例患者均有腰痛,16例坐位腰痛;34例有根性症状;29例有腰部压痛;21例有根性体征;7例有大小便功能障碍,其中3例行走后出现尿失禁。侧凸顶椎多位于L3(19例,50.00%)、L4(15例,39.47%);33例有侧向不稳定;38例均有小关节退变:36例存在椎管狭窄或椎间盘突出,超过60%的狭窄节段在L3/4、L4/5间隙。JOA评分平均13.47+4.89分.JOA评分与病程、年龄、退变椎数、侧凸Cobb角、椎体侧方移位等因素均无明显相关关系。结论:退变性腰椎侧凸患者多有腰痛和根性症状,其症状及根性体征源于狭窄和,或局部不稳定,而非侧凸或侧方滑移的轻重。  相似文献   

8.
 目的 探讨先天性胸腰段侧后凸畸形三柱截骨矫形术后冠状面失代偿的发生机制。方法 2008年1月至2012年6月因先天性胸腰段侧后凸畸形接受三柱截骨矫形术治疗的患者118例,男55例,女63例;年龄10~30岁,平均18岁。冠状面平衡类型:Ⅰ型(平衡状态),C7偏移小于2 cm;Ⅱ型(凸侧失平衡),C7向主弯凸侧偏移大于2 cm;Ⅲ型(凹侧失平衡),C7向主弯凹侧偏移大于2 cm。Ⅱ型和Ⅲ型为冠状面失平衡。结果 术后胸腰段侧凸和后凸均获得满意矫正。冠状面C7偏移从术前平均1.1 cm增加至术后1.5 cm。术前冠状面平衡Ⅰ型71例、Ⅱ型45例、Ⅲ型2例;术后Ⅰ型92例、Ⅱ型26例。26例(22%,26/118)有冠状面失代偿,且均为凸侧失平衡。术后Ⅱ型患者较Ⅰ型有较大的C7偏移(3.1 cm比0.2 cm)和C7偏移变化量(1.8 cm比-0.8 cm);术前Ⅱ型患者较Ⅰ型有更高的术后凸侧失平衡发生率(33%比15%)。远端固定于L5及骶骨者冠状面失平衡发生率高于固定于L4及以上者(36%比14%)。术后失代偿与术前C7偏移呈正相关(r=0.31,P=0.047)。22例在术后1年内凸侧失代偿改善。结论 顶椎区三柱截骨矫形术可有效矫正先天性胸腰段侧后凸畸形,但术后易发冠状面失代偿。术后冠状面失代偿可能与截骨矫形和术前凸侧失平衡有关。  相似文献   

9.
经椎弓根后外侧椎管减压椎间植骨内固定治疗胸腰椎骨折   总被引:1,自引:0,他引:1  
目的探讨经椎弓根后外侧入路椎管减压椎间植骨内固定治疗胸腰椎骨折的疗效。方法从2001年2月至2006年6月对23例胸腰椎骨折患者施行经椎弓根后外侧入路椎管减压,椎间植骨,椎弓根钉-棒内固定治疗。骨折块侵占椎管35%~95%,均伴有不同程度神经功能障碍,FrankeI分级,A级1例,B级2例,C级11例,D级9例。结果23例随访6~31个月,伤椎椎体高度基本恢复,Cobb角由平均21°恢复到3°未发现。植骨块和骨折的移位,脊髓神经功能A级1例无恢复外,其余均获1~2级恢复。结论经椎弓根后外侧椎管减压,椎间植骨,椎弓根钌-棒内固定治疗胸腰椎骨折可达有效减压,脊柱稳定性好,特别适宜于严重的下腰椎骨折和多节段腰椎骨折患者。  相似文献   

10.
新鲜齿状突骨折的分型与治疗方式选择   总被引:1,自引:0,他引:1  
目的:总结新鲜齿状突骨折的治疗效果,探讨不同类型骨折治疗方法的选择.方法:2000年1月~2007年12月,共收治新鲜齿状突骨折患者54例.按Grauer改良的Anderson-D'Alonzo分型,ⅡA型7例,ⅡB型23例,ⅡC型8例,Ⅲ型16例.4例伴有脊髓损伤(ⅡB型3例,ⅡC型1例).ⅡA型、2例合并相邻椎体骨折的ⅡB型、6例ⅡC型和Ⅲ型患者采用Halo-vest外固定;16例ⅡB型采用齿状突螺钉固定,5例移位严重的ⅡB型和2例ⅡC型采用后路寰枢固定融合术.随访时间均超过24周,拍摄颈椎侧位、开口位X线片并行CT检查观察骨折愈合情况.结果:31例Halo-vest外固定治疗者中,30例在12周时获得骨折愈合,其中4例(ⅡB型1例,Ⅲ型3例)原始骨折有前移位者,在牵引复位、Halo-vest固定后发生再移位,畸形愈合,但无神经压迫表现;1例2周时复查骨折前移位,改行后路寰枢椎固定融合术后获骨性融合.16例采用齿状突螺钉固定的ⅡB型骨折患者13例骨折愈合,3例在24周时骨折仍未愈合,骨折端有明显骨质吸收;7例寰枢关节固定融合患者在12周时均获得骨性融合.4例有脊髓损伤的患者均有不同程度的功能恢复.结论:Halo-vest外固定适合治疗ⅡA型、无或轻度移位ⅡC型和Ⅲ型齿状突骨折,但原始有前移位的骨折在固定过程中容易出现再移位.可复位的ⅡB型骨折适合齿状突螺钉固定,但骨折移位大的ⅡB型和粉碎性骨折宜及早采用寰枢固定融合术.  相似文献   

11.
Rotatory olisthesis in idiopathic scoliosis   总被引:2,自引:0,他引:2  
T R Trammell  R D Schroeder  D B Reed 《Spine》1988,13(12):1378-1382
Lateral subluxation of one vertebral body upon another (rotatory olisthesis) has been associated with increased incidence of back pain in scoliosis. This study was undertaken to identify the presence of and characterize rotatory olisthesis and its association with the following parameters: age, sex, curve type, curve magnitude, level of occurrence, region within curves, primary vs. secondary curves, severity of slip, and association with pain. Charts of 636 patients were reviewed for the presence or absence of pain. Curve measurements and the occurrence of rotatory olisthesis were noted. Rotatory olisthesis was statistically unrelated to the occurrence of pain associated with idiopathic scoliosis. It was significantly associated with increasing age and curve magnitude. Lumbar curves with rotatory olisthesis were more likely to be associated with radicular pain.  相似文献   

12.
J Dvorak  M Panjabi  M Gerber  W Wichmann 《Spine》1987,12(3):197-205
Twelve specimens of the upper cervical spine were functionally examined by using radiography, cineradiography and computerized tomographic (CT) scan. The range of rotation was measured from CT images after maximal rotations to both sides. The left alar ligament was then cut and the examination repeated. The alar and transverse ligaments could be differentiated on CT images in axial, sagittal, and coronal views. Rotation at occiput-atlas was 4.35 degrees to the right and 5.9 degrees to the left and at atlas-axis it was 31.4 degrees to the right and 33 degrees to the left. After one-sided lesion of the alar ligament, there was an overall increase of 10.8 degrees or 30% of original rotation to the opposite side, divided about equally between the occiput-atlas and the atlas-axis. It is concluded that a lesion (irreversible overstretching or rupture of alar ligaments) can result in rotatory hypermobility or instability of the upper cervical spine.  相似文献   

13.
[目的]探讨腰椎活动节段关节突矢状方向对关节接触力和接触部位的作用和意义。[方法]采用一种有效的CAD方法精确构建三种关节突矢状方向的三维腰椎L4、5活动节段有限元模型。剪力载荷下,分别对3种有限元模型的关节突接触力和接触部位进行测试。[结果]前剪载荷条件下,关节突接触力随关节突矢状方向角度的增加而减小;后剪载荷下,关节突接触力随关节突矢状方向角度的增加丽增大。前剪和后剪载荷条件下,关节突接触力的矢状和水平分力均随关节突矢状方向角度的减小而增大。相同载荷条件下,不同矢状方向的关节突其接触部位相同。[结论]与矢状型关节突相比,冠状型关节突的空间方向和形态结构对抵抗关节突水平和矢状方向的运动更加有效;前剪载荷较后剪载荷在促进冠状型关节突退变方面起着更为突出的作用。  相似文献   

14.
15.
TSRH器械在特发性脊柱侧凸中的应用   总被引:8,自引:4,他引:4  
[目的]观察TSRH三维矫形系统矫正特发性脊柱侧凸冠状面、矢状面和轴状面的疗效,评价应用钉棒系统和钉钩棒系统随访时的效果。[方法]分析采用TSRH系统治疗特发性脊柱侧凸79例,男48例,女31例,平均15.5岁。全部应用椎弓根螺钉系统56例,胸椎应用椎弓根钩或椎板钩,腰椎应用椎弓根螺钉23例。对照分析2组的矫正效果。[结果]术后冠状位矫正为18~31°,矫正率为56%~87%,平均为68%,矢状位矫正为21~33°,平均25°,旋转矫正Ⅰ度。身高平均增高3 cm。63例平均随访2.5 a,2组冠状面和矢状面的矫正率以及冠状面矫正度的丢失有明显的差异。[结论]TSRH矫形系统治疗脊柱侧凸可得到满意的治疗效果,应用椎弓根螺钉效果更佳。  相似文献   

16.
目的 探讨合并胸腰段后凸的青少年特发性脊柱侧凸(AIS)的临床特点和手术治疗策略. 方法对2001年1月至2007年1月收治的413例AIS患者进行回顾性分析,合并胸腰段后凸者共10例,其中男2例,女8例;年龄12~18岁,平均14.3岁.侧凸类型包括PUMC Ⅱb2型3例,Ⅱc 3型4例,Ⅱd2型1例,Ⅲb型2例.单纯后路内固定术8例,前路松解+后路内固定术2例.术前、术后及随访时摄X线片,对侧凸类型、Cobb角、顶椎旋转度、顶椎偏距、侧凸柔韧性、胸腰段后凸、冠状面及矢状面躯干偏移进行评测和分析.结果 本组患者中双弯8例,三弯2例;胸腰弯/腰弯Cobb角≥45°者7例,柔韧性指数≤70%者6例,顶椎旋转度≥Ⅱ度者9例.所有病例的融合范围均符合PUMC分型原则.手术前后平均胸弯冠状面Cobb角分别为71.7°和37.4°,平均矫正率为47.8%;手术前后平均胸腰弯/腰弯冠状面Cobb角分别为65.0°和27.8°,平均矫正率为57.2%;手术前后平均胸腰段后凸分别为35.5°和4.2°,平均矫正率为88.2%.全部病例随访12~72个月,平均23.1个月;最终随访时无躯干失平衡发生. 结论 合并胸腰段后凸的AIS一般多为双弯或三弯,胸腰弯/腰弯畸形往往比较严重,并有明显的旋转畸形.对合并胸腰段后凸的AIS,应融合胸腰弯/腰弯以防止术后发生失代偿或后凸加重, PUMC分型可以有效识别病变类型并指导融合范围的选择.  相似文献   

17.
BackgroundOpen-wedge high tibial osteotomy (OWHTO) has extensively been used for the correction of medial knee osteoarthritis. The proximal tibia is osteotomized and distracted to enable the rotation of tibial fragments around the lateral hinge. Both, wedge inclination on the medial side and saw progression near the lateral cortex determine the hinge orientation. This study focused on the interaction between hinge orientation and distraction sites on the coronal, sagittal, and horizontal planes of the distracted plateau.MethodsThree parameters of wedge inclination, saw progression, and distraction site (i.e., posterior, middle, and anterior) were systematically varied. Using a three-dimensional (3D)-printing technique, the osteotomized tibiae were manufactured as the specimens for the in vitro experiments. In total, 27 variations (3 × 3 × 3) were tested. After distraction, the specimens were scanned by computed tomography and spatially registered with the original tibia to compare the 3D angles of the distracted plateaus.ResultsCoronal rotation is the main purpose of OWHTO; therefore, all the values of the coronal angles were positive and significantly higher than the other two. The sagittal and horizontal angles had relatively similar values. Distraction in the middle site seems to have the least impact on sagittal rotation. Large angles of hinge orientation show the superior ability in adjusting the sagittal rotation than small angles. However, the larger the horizontal angles the greater the wedge inclination.ConclusionsThe wedge inclination, saw progression, and distraction site constitute a complex mechanism that affects 3D rotations of the distracted plateau. The coronal angles are sensitive to hinge orientation and distraction site. The intraoperative planning of manipulating hinge orientation is an effective method to adjust sagittal rotation. A large angle of wedge inclination is an indicator of horizontal rotation, and it should be carefully mitigated to reduce the risk of cracking in the lateral hinge.  相似文献   

18.
The effects of femoral shaft malrotation on lower extremity anatomy   总被引:1,自引:0,他引:1  
OBJECTIVE: To determine how axial rotation around the anatomic axis of the femur, as would occur with malrotation of a femoral fracture, affects frontal and sagittal plane alignment and knee joint orientation. DESIGN: Computer-generated models of the lower extremity were constructed using standardized dimensions. To simulate a malrotated fracture, these models were rotated in the shaft around the anatomic axis in 15 degrees increments from 60 degrees internal to 60 degrees external rotation. Rotation was performed at the proximal fourth, mid-shaft, and distal fourth. MAIN OUTCOME MEASUREMENTS: At each rotational position, the mechanical axis deviation in millimeters and the changes in mechanical lateral distal femoral angle in degrees were measured to quantify frontal plane malalignment and malorientation, respectively. The mechanical axis deviation in millimeters in the sagittal plane was also measured at each rotatory position. RESULTS: Femoral shaft malrotation greater than 30 degrees internal rotation of a subtrochanteric fracture or more than 45 degrees of a midshaft fracture or external rotation of 30 degrees or greater of a supracondylar fracture resulted in frontal plane malalignment. External rotation of a supracondylar fracture of 45 degrees or more results in knee joint malorientation. Any external rotation at all 3 fracture levels caused posterior displacement of the weight-bearing axis in the sagittal plane. CONCLUSIONS: Malrotation of a femoral shaft fracture is not just a cosmetic problem. Internal and external rotation causes malalignment and malorientation in the frontal plane, depending on the level of the fracture and the magnitude of malrotation. External rotation of any degree at the proximal fourth, mid-shaft, and distal fourth causes a posterior shift of the weight-bearing axis in the sagittal plane.  相似文献   

19.
青少年特发性脊柱侧凸的选择性胸椎融合治疗   总被引:7,自引:1,他引:6  
目的 探讨青少年特发性脊柱侧凸选择性胸椎融合治疗的适应证。方法 回顾性分析12例行选择性胸椎融合患者术前、术后及随访时的X光像 ,对侧凸类型、侧凸Cobb角、顶椎旋转度、顶椎偏距、侧凸柔韧性、躯干偏移及胸腰段矢状面Cobb角进行测量和分析。患者 12例中男 2例 ,女10例 ,平均年龄 15 1(13~ 18)岁。侧凸均为KingⅡ型 ,其中PUMCⅡb1型 9例 ,Ⅱc3型 3例。所有病例均行选择性胸椎融合 ,平均随访 3 5 (1~ 10 5 )年。结果 手术前后胸弯冠状面Cobb角分别为5 4 0°、19 0° ,平均矫正率 6 2 7% ;腰弯冠状面Cobb角分别为 34 6°、12 5° ,自动矫正率为 6 4 7%。最后随访时 ,胸、腰弯的冠状面Cobb角分别为 18 8°、15 9°;腰弯冠状面Cobb角、顶椎偏距及顶椎旋转度与术后相比无显著变化。术后发生胸腰段后凸 1例 ,最终随访时未见进一步加重。无躯干失平衡现象发生。选择性胸椎融合较后路融合双弯平均减少 3 5个融合节段。结论 对腰弯柔韧性好且度数较小的KingⅡ (PUMCⅡb1和部分Ⅱc3)型特发性脊柱侧凸 ,可安全有效地行选择性胸椎融合  相似文献   

20.
The Ad Hoc Committee of Terminology of the Japanese Society for Surgery of the Foot (JSSF) proposes novel terminology for motion of the ankle, foot, and toe because there are some ambiguities in the current terminology. Articles were identified by searching the electronic databases of PubMed that compared definitions of American Orthopaedic Foot and Ankle Society (AOFAS), International Society of Biomechanics (ISB), and in the textbook of Kapandji as well as the American Academy of Orthopaedic Surgeons (AAOS). A total of 11 articles described the transverse (horizontal) plane motion in the hindfoot as external rotation/internal rotation and 10 as abduction/adduction. In all, 2 articles described the transverse (horizontal) plane motion in midfoot as external rotation/internal rotation and 10 as abduction/adduction. Another 4 articles described the transverse (horizontal) plane motion in the forefoot as external rotation/internal rotation and 8 as abduction/adduction. Altogether, 109 articles described the sagittal plane motion of the foot/ankle as dorsiflexion/plantarflexion and 20 as extension/flexion. In all, 99 articles described the frontal (coronal) plane motion of the foot/ankle as inversion/eversion and 4 as supination/pronation. Furthermore, 12 articles described the sagittal plane motion of toes as dorsiflexion/plantarflexion and 15 as extension/flexion. Another 16 articles described the frontal (coronal) plane motion of toes as supination/pronation and 1 as inversion/eversion. The transverse (horizontal) plane motion of the foot/ankle was defined as abduction/adduction in the hindfoot, midfoot, and forefoot; the sagittal plane motion of the foot/ankle was defined as dorsiflexion/plantarflexion; and the frontal (coronal) plane motion of the foot/ankle as inversion/eversion. The transverse (horizontal) plane motion of toes was defined as abduction/adduction; the sagittal plane motion of toes was defined as extension/flexion; and the frontal (coronal) plane motion of toes was defined as supination/pronation.  相似文献   

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