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31.
Posterior cranial fossa dimensions in the Chiari I malformation: Relation to pathogenesis and clinical presentation 总被引:8,自引:0,他引:8
Summary Skull dimensions were measured on lateral skull radiographs in 33 adult patients with MRI-verified Chiari I malformations and in 40 controls. The posterior cranial fossa was significantly smaller and shallower in patients than in controls. In the patients, there was a positive correlation between posterior fossa size and the degree of the cerebellar ectopia, which might indicate that a posterior cranial fossa which was originally too small had been expanded by the herniation of hindbrain structures at an early stage. Pyramidal signs and cerebellar symptoms and signs, which may be due to compression of neural structures, were associated with a large degree of ectopia and a relatively large posterior cranial fossa. Syringomyelia and headache, which may be due to the valve action of the herniated cerebellar tissue, were not associated with a particularly large posterior fossa or herniation. No special clinical presentation was associated with a very small posterior cranial fossa, which may indicate that a small posterior cranial fossa per se has little or no clinical significance, although it may be the primary developmental anomaly. 相似文献
32.
下腰痛患者后路手术并发症的防治 总被引:30,自引:0,他引:30
目的:分析下腰痛患者后路手术并发症出现的原因,探讨防治办法。方法:回顾分析我科自1988~1998年6月间采用后路手术治疗下腰痛,即腰椎间盘突出症和/或腰椎管狭窄症患者570例的临床资料。结果:33例发生术后并发症,发生率5.79%,早期(术后2周以内)并发症18例,晚期并发症15例,但无一例并发神经根损伤。结论:除了术中操作技能外,术前严格掌握手术适应证,术后及时观察、早期功能锻炼,都有利于并发症的防治。 相似文献
33.
Yasuhiro Yamaoka Takatomo Mine Hiroshi Tanaka Yoichiro Ishida Tosihiko Taguchi 《Knee surgery, sports traumatology, arthroscopy》2007,15(11):1346-1349
An avulsion fracture of the tibial tubercle is a common injury in traffic accident. If the fracture is closed, then a comparatively
good prognosis can be expected through reinforcement of the bone via osteosynthesis and the use of artificial ligaments. In
this case, an open wound was observed in the tibial tubercle, and the wound was so polluted that the healing process was significantly
delayed. It was therefore difficult to provide simultaneous surgical treatment and so three operations were required to perform
the reconstruction of the extensor mechanism. The reconstruction of extensor mechanism and the frame fixation between the
patella and tibia was performed. Six months after the injury, the patient was able to walk without aid, had a range of movement
from 5°to 130°, and did not show any indications of ADL disorder. Using this method of frame fixation between the patella
and tibia proved to be an effective technique for the reconstruction of the open knee extension mechanism injury. 相似文献
34.
Tadeusz F. Wisniewski 《European Journal of Trauma》2004,30(2):120-123
AbstractBackground: Posterior acromioclavicular dislocation is rare.
Dislocation associated with fracture of the clavicle and
simultaneous entrapment of the lateral end of the clavicle by
trapezius muscle has not been reported. Posterior dislocation
occurs frequently owing to forceful move of the scapula
anteriorly and superiorly or from direct force applied to the
lateral end of the clavicle and this may be associated with
clavicular fracture. In acute dislocations, open reduction,
internal joint stabilization and soft tissues reconstruction
have been recommended.Case Study: Acute posterior dislocation occurred in a 32-year-old man.
The lateral end of the clavicle was displaced posteriorly and
inferiorly, and firmly entrapped in trapezius muscle. The
clavicular fracture was undisplaced. The coracoclavicular
ligaments were stretched but intact. Open reduction was secured
with two smooth Kirschner wires. The disrupted soft tissues were
repaired. The clavicular fracture was not explored. Shoulder
movement started at 6 weeks. Wires were removed. 10 years later
he had pain-free, unrestricted shoulder movement, and the
radiographs showed wellreduced, essentially normal
acromioclavicular joint.Conclusion: Open reduction, internal joint stabilization and soft
tissue reconstruction will result in return and long lasting
unrestricted pain-free function of the shoulder. 相似文献
35.
Two-level posterior lumbar interbody fusion for degenerative disc disease: improved clinical outcome with restoration of lumbar lordosis 总被引:2,自引:0,他引:2
Akira Hioki MD Kei Miyamoto MD PhD Hirotaka Kodama MD PhD Hideo Hosoe MD PhD Hirofumi Nishimoto MD Hirofumi Sakaeda MD PhD Katsuji Shimizu MD DMSc 《The spine journal》2005,5(6):600-607
BACKGROUND CONTEXT: Although posterior lumbar interbody fusion (PLIF) for degenerative lumbar diseases is routine, there are few reports on double-level PLIF. PURPOSE: To evaluate the clinical outcomes of double-level PLIF. STUDY DESIGN/SETTING: A retrospective study of operated cases in Gifu, Japan. PATIENT SAMPLE: Nineteen patients (8 men and 11 women, 59.5+/-10.2 years) who underwent double-level PLIF between 1996 and 2001. OUTCOME MEASURES: Operation time, blood loss, complications, the Japanese Orthopaedic Association (JOA) score for back pain and lumbar sagittal alignment were evaluated. METHODS: Patients were examined retrospectively at follow-ups of 3.6+/-1.7 years. Primary diseases were spondylolisthesis, spinal canal stenosis, degenerative scoliosis and herniated intervertebral disc. Fusion areas were L3 to L5 in 15 cases and L4 to S1 in 4 cases. RESULTS: The mean JOA score increased from an initial score of 12.9+/-3.5 to 21.3+/-4.9 at the final follow-up. There was a positive correlation (R=0.718, p<.001) between the increase in lordotic angle and the increase in the JOA score. Several parameters suggested that the surgical invasiveness was not minimal. CONCLUSION: Double-level PLIF provided satisfactory results and preserved lumbar spine lordosis. 相似文献
36.
microRNAs(miRNAs)是一类分布十分广泛的内源性非编码RNA,在动物、植物、病毒中广泛存在。miRNAs与肿瘤的发生发展预后有关,并在肿瘤的增殖、分化及调亡等方面有重要的作用。结合最近相关文献,本文就miRNAs与泌尿系肿瘤方面的进展作简要概述。 相似文献
37.
38.
颈椎病伴椎管狭窄患者再手术问题探讨 总被引:1,自引:0,他引:1
目的:探讨颈椎病伴椎管狭窄患者再手术的原因、手术方式及其相关问题。方法:我院2002年7月~2003年12月对40例颈椎病伴椎管狭窄术后疗效不佳或症状复发的患者进行了后路多节段(5个或以上)减压手术。根据其手术治疗方式及影像学资料分析再手术原因,并进行术后疗效评价。结果:经前路手术者再手术的主要原因为:(1)伴有多节段颈椎管狭窄因素时,只选择部分压迫重的节段行减压融合15例;(2)经前路多节段(≥3个节段)减压融合后,相邻节段继续退变,出现新的脊髓压迫表现及椎间不稳定9例;(3)伴有OPLL时,行部分节段前路减压融合后,病变呈进展表现,产生或加重对脊髓的压迫8例。经后路手术者再手术的原因为:(1)后路减压节段不够5例(包括1例前后路联合手术者);(2)后路减压不充分3例。再手术后随访1.3~2.7年,平均2.1年,所有患者脊髓功能获得一定的提高,JOA评分改善率为51.3%。结论:颈椎病伴椎管狭窄病例再手术的主要原因为椎管狭窄因素仍然存在,经后路多节段(5个或以上)减压手术治疗可彻底去除颈椎管狭窄因素,有效解除脊髓前、后方所受的压迫,可获得较满意的临床疗效。 相似文献
39.
Posterior dislocations of the sternoclavicular joint are uncommon, but are potentially quite serious. Radiologic diagnosis and management are frequently difficult. The specialized projections available are not widely known, and the role of plain films is poorly understood. The incidence, pathomechanics, and clinical manifestations of such dislocations are presented and the radiologic diagnosis is discussed. 相似文献
40.
颈椎后纵韧带骨化的治疗方法 总被引:5,自引:2,他引:3
从1983年8月至1991年3月,手术治疗63例颈韧后纵韧带骨化(OPLL)的患者。手术方法包括前路椎间减压融合,椎体次全切除植骨融合、后路全椎板切除。单开门椎板成形椎管扩大手术、双开门椎板成形椎管扩大手术,及前后路两次手术。随诊6到96个月,疗效为39例代。16例良,优良率87.2%。本文讨论了前路椎间减压、椎体次全切除及后路椎板成形椎管扩大手术的方法。作者认为对OPLL伴广泛性椎管狭窄者以后路双开门椎板成形椎管扩大手术较为合理。 相似文献