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41.
特发性颈椎后凸畸形的手术治疗 总被引:3,自引:1,他引:2
目的 :明确颈椎前路手术治疗特发性颈椎后凸畸形的可行性和局限性。方法 :本文对 14例颈椎特发性后凸畸形患者采取手术方法进行治疗 ,所有患者均采用颈椎前路椎间盘切除减压 ,椎间隙植骨和前路钢板内固定。结果 :手术后患者临床体征明显改善 ,颈椎后凸畸形由手术前平均 -15 6°矫正为手术后平均 -6 4° ,矫正效果明显 ;手术后患者的短期随访表明颈椎矫正度数在随访中没有丢失。结论 :前路手术 ,延长颈椎前柱能够矫正颈椎的后凸畸形 ,改善临床症状和体征 相似文献
42.
A 17-year-old young man presented with a highly unstable fracture dislocation of the third and fourth thoracic vertebrae with neurological deficit, in which the fractured spine had perforated the thoracic esophagus. Open reduction and internal fixation of the spinal fractures in combination with aggressive treatment of the mediastinitis caused by esophageal perforation, consisting of two re-thoracotomies, was performed. Two years after the accident, the patient had recovered well. The neurological deficit had recovered, and there were no difficulties with swallowing. 相似文献
43.
44.
Anterior lumbar fusion using a hybrid interbody graft 总被引:3,自引:0,他引:3
Summary This is a radiographic report of 40 patients (20 men, 20 women) who underwent anterior lumbar interbody fusions (73 levels)
utilizing a “hybrid” interbody graft composed of femoral cortical allograft (FCA) bone and iliac crest cancellous autograft
bone. The average age at surgery was 38 years (range 17–64 years), and follow-up averaged 1.4 years (range 1.0–2.4 years).
Nineteen of the patients had undergone previous lumbar surgery. Thirty-two patients (63 levels) underwent anterior fusion
combined with some type of posterior fixation, and eight patients (10 levels) had no posterior fixation. Types of posterior
fixation included: for 20 patients (36 levels) Steffee variable screw placement fixation, for 10 patients (23 levels) translaminar
facet screws (TFS), for 1 patient (3 levels) Knodt rods and for 1 patient (1 level) facet screws. Based on the persistence
of lucent lines at the graft-host interface, three patients (one level each) were felt to have non-unions at their latest
follow-ups at 1.4, 1.5 and 2.0 years, respectively. Two of these patients had no posterior fixation, and the other had TFS
fixation. The overall fusion rate was 96% (70 of 73 levels). The fusion rate for all levels treated with posterior fixation
was 98% compared with 75% for those without fixation. Intervertebral disc heights (IVDH) were measured on all films and corrected
for magnification with computer assistance. On average, the IVDH was increased postoperatively but returned to preoperative
values at follow-up. IVDH loss was independent of the type of instrumentation used. No complications arose from the use of
the hybrid graft. Incorporation of the allograft portion of the graft is slow and was felt to be complete in only 7 of the
73 levels at follow-up. We conclude that the hybrid interbody graft technique is a safe and reliable method for performing
anterior lumbar interbody fusions and should be combined with some type of posterior fixation. Long-term follow-up will be
required to assess the behaviour of the allograft until incorporation is complete. 相似文献
45.
Summary The delayed onset of symptomatic pain following lumbar discography (with no immediate pain response) is described in six patients,
five with a minimum 2-year follow-up. It is usually seen in patients with nearly normal disc morphology who have incomplete
or discrete annular tears that are not filled at the time of injection. Later (2–12 h in this study), dye leakage occurs through
these lesions, thereby precipitating the discogenic pain This phenomenon may be missed and is probably more common than previously
believed due to early discharge from the hospital, the patient expecting discomfort after the invasive study (hence no complaint
is made), and the clinician being unaware of this delayed symptom, thereby not asking about it in follow-up. Close patient
questioning regarding a delayed onset of symptomatic pain after discography is, therefore, an essential element in diagnostic
information following this study. 相似文献
46.
FQ-I型清创(冲洗)机的研制 总被引:1,自引:1,他引:0
介绍一种电脑清创(冲洗)机的工作原理和系统功能。该机由水泵、水箱、压力调节器、温控器、喷枪等组成。操作时仅需打开开关,根据伤口类型调节压力、水温和冲洗水流的方式即可进行伤口冲洗,简单易行、省时省力,特别适合于战时救治。能降低火器伤的感染率、致残率,提高伤口清创冲洗的效率。 相似文献
47.
Two cases are reported in which, after ACL reconstruction with autologous hamstring grafts, tibial polylactide interference
screws migrated into the knee joint. Clinically, both patients presented with recurrent locking of the joint. In one case,
a broken 15 mm-long tip of the screw was found intra-articularly. In the other case, the whole screw had migrated into the
joint cavity. The degradation process of polylactic acid, operative technique and bone quality are discussed as possible reasons
for these complications. 相似文献
48.
关节镜下采用四股和八股腘绳肌肌腱双束重建前十字韧带的比较研究 总被引:8,自引:0,他引:8
目的比较关节镜下采用四股和八股腘绳肌肌腱双束重建前十字韧带的临床效果。方法2001年9月至2002年8月,将76例陈旧性前十字韧带损伤患者随机分为两组进行双束重建。一组采用四股腘绳肌肌腱移植物:取同侧半腱肌肌腱,做成两个两股肌腱移植物,分别重建前十字韧带前、后束;一组采用八股腘绳肌肌腱移植物:取同侧半腱肌肌腱做成一个四股肌腱移植物重建前束,取同侧股薄肌肌腱做成另一个四股肌腱移植物重建后束。按照IKDC、Lysholm和Tegner膝关节评分标准评价疗效。结果四股肌腱移植物组有33例、八股肌腱移植物组有35例获得随访,随访时间1~3年,平均16个月。四股肌腱移植物组KT-1000检查示,双侧膝关节前向松弛度差异<3mm者25例(75.8%,25/33),3~5mm者5例(15.2%,5/33),6~10mm者3例(9.1%,3/33);轴移试验阴性28例(84.8%),阳性5例(15.2%)。八股肌腱移植物组KT-1000检查示,双侧膝关节前向松弛度差异<3mm者33例(94.3%,33/35),3~5mm者2例(5.7%,2/35);轴移试验阴性34例(97.1%),阳性1例(2.9%)。根据IKDC检查标准,四股肌腱移植物组有29例(87.9%,29/33)、八股肌腱移植物组有34例(97.1%,34/35)为正常或者接近正常,Lysholm评分分别为(90.2±2.9)分和(97.3±1.7)分,两组比较差异有统计学意义(P<0.05)。结论关节镜下采用八股腘绳肌肌腱较采用四股腘绳肌肌腱双束重建前十字韧带能够明显提高膝关节稳定性。 相似文献
49.
Can we predict the outcome of a partial rupture of the anterior cruciate ligament?
A prospective study of 43 cases 总被引:2,自引:0,他引:2
D. Fritschy Andreas Panoussopoulos Richard Wallensten Robin Peter 《Knee surgery, sports traumatology, arthroscopy》1997,5(1):2-5
The concept of partial rupture of the anterior cruciate ligament (ACL) has been confirmed by arthroscopic examination and
palpation. We present a prospective study of 43 patients who were diagnosed arthroscopically as suffering from a partial rupture
of the ACL by the same surgeon. The patients followed a rehabilitation protocol and were examined by an independant observer
after 5 years. Twenty-five patients had a stable knee, whereas 18 eventually suffered a complete ACL rupture. ACL partial
rupture is easily recognizable with arthroscopy, but the quantity and state of the still intact fibres is difficult to assess.
Received: 20 April 1996 Accepted: 17 December 1996 相似文献
50.
目的:通过膝关节损伤MRI影像的分析,确定其诊断价值及意义。材料和方法:本文收集了自1992年以来我院所检查的42例膝关节损伤患者,52个膝关节成像。其中男性34人;女性8人,各年龄组以30~40岁组最多。损伤以前交叉韧带和外侧半月板损伤者多见,分别占总损伤数的20%及30%。损伤又以左膝多见,占总数的61%。结果:MRI能较明确地显示膝关节的半月板、关节软骨、韧带、滑膜及骨质的改变,明显地比CT所能看到的层次多,对软组织的损伤显示清晰。结论:只要正确地应用不同序列及切层方向、厚度等技术,可清晰地显示其信号特征,从而能确定其损伤部位、程度。 相似文献