CF脊柱内固定器治疗腰椎滑脱临床分析

目的探讨CF脊柱内固定器在治疗腰椎滑脱的临床效果。方法选取2008年12月1日—2010年12月31日该院收治的罹患腰椎滑脱患者48例,行CF内固定器结合双开窗椎管减压和植骨融合治疗腰椎滑脱。通过随访的方式对48例患者情况采用SPSS11.0软件进行Logistic多因素回归性分析。结果 48例患者中32例完全复位,27例椎间骨性融合达到94.1%,44例下肢疼痛麻木情况完全消除,32例间歇性跛行情况显著改善,28例功能性障碍得到明显缓解。结论 CF脊柱内固定器在治疗腰椎滑脱症上具有一定的疗效。     

全麻俯卧位腰椎间盘摘除手术的术中护理干预探讨

目的分析全身麻醉（全麻）俯卧位腰椎手术患者术中护理效果,为提升患者俯卧位耐受力,降低并发症提供理论参考依据。方法对该院手术室采取全麻俯卧位腰椎手术的患者36例分别进行术前访问、术中及术后护理分析。结果患者手术中无不良情况发生。结论正确安顿患者俯卧位,及时巡视患者情况,可确保全麻腰椎俯卧位手术的顺利进行。     

健康宣教对腰椎间盘突出症围手术期护理质量的影响

目的探讨健康宣教对椎间盘突出症围手术期护理质量的影响。方法选择腰椎间盘突出症行单节段髓核摘除手术的患者120例,随机分为观察组和对照组各60例,对照组实施骨科的常规护理。观察组在常规护理的基础上对患者进行健康宣教。结果观察组医患关系满意度明显高于对照组;观察组健康宣教知识知晓率明显高于对照组;观察组术后腰腿痛残留率明显低于对照组（P〈0.01）。结论健康宣教有助于提高医患关系满意度及健康宣教知晓率;降低患者术后腰腿痛残留率。     

神经刺激器定位下腰丛-坐骨神经联合阻滞在老年患者股骨头置换中的应用

目的探讨神经刺激器定位下的腰丛-坐骨神经联合阻滞麻醉在老年患者股骨头置换手术中麻醉效果。方法选择择期行单侧股骨头置换手术的老年患者56例,年龄〉65岁,ASAⅠ～Ⅲ级,随机分为两组,神经阻滞组（N组）和硬膜外阻滞组（E组）,每组28例,在麻醉前（T1）,麻醉后（T2）,手术开始时（T3）,手术结束时（T4）,记录MAP、HR、SpO2、麻醉效果以及不良反应。结果 56例患者均阻滞完善,麻醉效果满意,两组患者的MAP在麻醉前（T1）和手术结束时（T4）差异无统计学意义（P〉0.05）,硬外阻滞组患者的MAP在麻醉后（T2）和手术开始时（T3）显著低于神经阻滞组（P〈0.05）。两组患者的HR和SpO2在各时点均无显著差异（P〉0.05）。结论神经刺激器定位技术下腰丛-坐骨神经联合阻滞应用于老年患者股骨头置换手术是安全有效的,对血流动力学影响小,不良反应少。     

舒适护理在腰椎间盘突出症患者术后的应用

目的探讨舒适护理在腰椎间盘突出症患者术后的应用。方法对38例腰椎间盘突出症术后患者实施心理、生理的舒适护理。结果38例患者在心理、生理上均获得满足和安全感,使治疗达到了最佳效果,减少了并发症,增强了自信心。结论对腰椎间盘突出症患者术后实施的舒适护理提高了患者的满意度和护理工作质量,取得良好的护理效果。     

前列地尔注射液联合甘露醇治疗腰椎管狭窄症的疗效观察

目的:观察前列地尔注射液(曼新妥)联合甘露醇常规疗法治疗腰椎管狭窄症的临床疗效。方法:将92例腰椎管狭窄症患者以随机抽样法分为2组,治疗组46例应用前列地尔注射液和甘露醇联合治疗,对照组46例应用丹参注射液和甘露醇联合治疗。结果:治疗组治疗总有效率明显优于对照组,2组差异显著,具有统计学意义(P<0.05)。结论:前列地尔注射液联合甘露醇治疗腰椎管狭窄症的疗效显著。     

Conservative management of thoracolumbar and lumbar spine compression and burst fractures: functional and radiographic outcomes in 136 cases treated by closed reduction and casting

Introduction  Both fractures of the lumbar spine and at the thoracolumbar junction are quite common. The treatment of these fracture types is discussed controversially. Some authors advocate surgical treatment even in fractures without neurologic compromise while other series report good results after non-operative treatment. Materials and methods  Between January 1997 and April 2004, 324 patients with spinal fractures were admitted to our institution. Hundred and thirty-six patients with compression and burst type fractures treated by closed reduction and casting were available for follow-up. Their medical records, radiographs and computer tomography scans were reviewed and their functional status was assessed. Results  94 male (69.1%) and 42 female (30.9%) patients with a mean age of 48.6 years (range 17–81) at time of injury were included. The thoracolumbar junction (T11-L1) was affected in 104 patients (76.5%). 23.5% had lumbar fractures. All of the burst type fractures with involvement of the posterior column affection were type A3.3. fractures according to the Magerl classification. Significant correction of radiographic parameters was achieved in the early postreduction period (P < 0.0001). Reduction could not be maintained at the final follow-up but still showed slight improvement compared to the initial presentation. Reduction could be maintained better in the thoracolumbar region than in the lumbar spine. Neurologic function was restored in all patients with unilateral radicular pain but only one patient recovered fully after cauda equina-syndrome. Patients after lumbar spine indicated a higher level of pain when compared to patients with fractures at the thoracolumbar junction. Discussion  Closed reduction and casting is a safe and effective method for treatment of compression and burst type fractures at the thoracolumbar junction and can restore neurologic function in patients with unilateral radicular pain. It is of limited value in lumbar fractures and in burst type fractures with posterior column involvement.     

Fresh stress fractures of lumbar pedicles in an adolescent male ballet dancer: Case report and literature review

Stress fracture in the pars interarticularis is a common cause of low back pain in young athletes. Pedicle stress fractures have also been reported in adolescent sport players, and most of them were associated with contralateral spondylolysis. Only a few cases with bilateral pedicle stress fractures have been reported. We report a 14-year-old ballet dancer with fresh bilateral pedicle fractures treated conservatively, together with a review of the literature.     

Impact of spinal kyphosis on gastroesophageal reflux disease symptoms in patients with osteoporosis

Summary  Spinal kyphosis has been speculated to participate in the increased frequency of gastroesophageal reflux disease (GERD) in patients with osteoporosis. The present study provides further evidence that increases in lumbar kyphosis and number of vertebral fractures represent very important risk factors for GERD in patients with osteoporosis. Introduction  Osteoporosis and spinal kyphosis have been speculated to participate in the increased frequency of gastroesophageal reflux disease (GERD). The present study examined whether GERD in patients with osteoporosis is affected by spinal factors including spinal kyphosis in the presence of oral pharmacotherapies. Methods  Subjects comprised 112 patients with osteoporosis (mean age, 78 years) who responded to the Frequency Scale for Symptoms of GERD (FSSG) questionnaire, regardless of complaints. Relationships between total FSSG score and number of vertebral fractures, angles of kyphosis, use of bisphosphonates and nonsteroidal anti-inflammatory drugs (NSAIDs), and total number of oral medicines per day were evaluated. Logistic regression identified factors associated with GERD. Results  Bisphosphonates and NSAIDs did not affect total FSSG score. Total FSSG score showed significant positive correlations with total number of medicines (r = 0.283, p = 0.0025), angle of lumbar kyphosis (r = 0.576, p = 0.0001), and numbers of thoracic vertebral fractures (r = 0.214, p = 0.0232) and lumbar vertebral fractures (r = 0.471, p < 0.0001). Angle of lumbar kyphosis and number of lumbar vertebral fractures were identified by multivariate analysis as indices affecting the presence of GERD. Conclusion  Increases in angle of lumbar kyphosis and number of lumbar vertebral fractures may5 represent very important risk factors for GERD in osteoporotic patients.