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71.
72.
目的 探讨计算机体层成像多平面重建(CTMPR)在评价椎间融合中的作用,寻找定量评价椎间融合的新方法.方法 13例行腰椎间融合的患者术后1周、3个月、6个月行CTMPR,行椎间融合器(Cage)内植骨CT值定量测量.结果 术后1周Cage内植骨CT值为(619.52±26.97)Hu,术后3个月为(628.69±42.60)Hu,术后6个月为(657.77±37.43)Hu.术后1周与术后3个月相比无显著性差异,与术后6个月相比有显著性差异.结论 CT值的测量在椎间融合的判断中具有高准确性. 相似文献
73.
74.
Summary An anatomical study of the lumbar apophyseal joints was carried out to facilitate recognition of facet joint lesions, which we now examine routinely by percutaneous arthrography. Special attention was given to the configuration of the different compartments of the joint space and to its relationships with the contents of the intervertebral foramen. The abnormalities seen on lumbar facet joint arthrography are very varied; two major groups should be stressed: synovial fringe hypertrophy and pseudodiverticular synovial ectasia. The percutaneous approach to lumbar facet joint arthrography allows it to be used a therapeutic measure, with injection of anti-inflammatory drugs into the joint space, the beneficial effects of which were confirmed in our series. The precision, efficiency and cost-effectiveness of this outpatient technique justify and should encourage its more widespread application in the diagnosis and treatment of low back pain. 相似文献
75.
目的 观察X线电视引导下经皮穿刺腰椎间盘切吸术治疗腰椎间盘突出症的远期疗效。方法 32例经CT扫描证实的腰椎间盘突出症患者,其中,膨出型29例,游离型2例,以及突出型1例,均经X线电视引导下经皮穿刺腰椎间盘切吸术治疗,术后均经随访0.5~11.0a。结果 术后1周~3个月,32例中的24例临床症状与体征得到有效控制或明显减轻,随访5~11a观察表明,症状完全消失和明显减轻者分别见于23例和6例,总有效率90.6%,预后极好和较好者均见于膨出型腰椎间盘突出症患者。结论 游离型和突出型腰椎间盘突出症的疗效均不理想,因此,术前认真选择适应证是获得理想疗效的关键性因素。 相似文献
76.
The role of JOA score as an indication for surgical or conservative treatment of symptomatic degenerative lumbar spinal stenosis 总被引:1,自引:0,他引:1
G. Costanzo P. Cellocco A. Di Francesco C. Rossi 《Journal of orthopaedics and traumatology》2005,6(3):150-153
Abstract
The aim of this study was to evaluate the short- to medium-term results (up to 2 years) of conservative and surgical treatments
of patients with symptomatic lumbar stenosis. To our knowledge, no previous study has provided strict indications for conservative
or surgical treatment. We retrospectively studied 184 patients, who were divided into 3 groups according to JOA (Japanese
Orthopaedic Association) score. A cutoff JOA score was arbitrarily fixed at 7.
Patients with a score ≤7 (n=12; group A) underwent surgery, while patients with a score >7 (n=172) were conservatively treated.
Group A included patients surgically treated within two months from diagnosis. Group B consisted of 144 patients who received
conservative treatment, while group C (28 patients) represented patients who underwent surgery after a period of failed conservative
treatment. The outcomes of surgical and conservative treatments were evaluated after 12 and 24 months, and were rated as satisfactory,
not totally satisfactory, not satisfactory or totally unsatisfactory. Conservative treatment consisted of physical, orthotic
and drug therapy, whereas surgical treatment included spinal decompression and instrumentation (if indicated), either rigidly
or dynamically performed. Surgery was indicated in 22% of all patients and we obtained excellent results in 85% of them. Operative
treatment provides excellent results for patients with severe clinical presentation (JOA score ≤7), while individuals with
mild to moderate spinal stenosis (JOA score >7) should receive conservative treatment. 相似文献
77.
显微椎间盘镜治疗腰椎间盘突出症 总被引:8,自引:3,他引:5
目的探讨显微内镜腰椎间盘切除术(microendoscopy discectomy,MED)治疗腰椎间盘突出症的疗效. 方法回顾分析MED治疗59例腰椎间盘突出症的临床资料,总结经验教训. 结果 59例随访4~24个月,平均15个月,按Macnab评定标准,优43例,良14例,可1例,差1例,术后出现神经功能障碍,优良率96.6%(57/59). 结论 MED是包容性腰椎间盘突出症的首先治疗方法,严格掌握手术适应证及提高手术技巧是MED成功的关键. 相似文献
78.
The Stiles-Crawford effect of the first kind (SCE-I) was measured on both emmetropic and myopic subjects at six different retinal locations. The results revealed a number of significant discrepancies in receptor alignment between the groups of different refractive errors. In myopic subjects, the receptors in the nasal retina (i.e. between the fovea and the optic nerve head) were found to be aligned nasally towards the optic nerve head, whereas the receptors in the temporal retina were aligned towards the centre of the exit pupil. In emmetropic subjects, the receptors across the retina were finely tuned towards the centre of the exit pupil. The magnitude of the receptor displacement in myopic subjects was found to be directly associated with the length of the eyeball. 相似文献
79.
80.
后凸成形术结合体位复位治疗创伤性胸腰椎椎体骨折的临床观察 总被引:1,自引:0,他引:1
目的:观察在体位复位辅助下后凸成形术治疗创伤性胸腰椎椎体骨折的临床疗效。方法:37例新鲜单节段胸腰椎椎体骨折患者,男28例,女9例;年龄24~79岁,平均48岁。通过体位复位及Sky扩张器撑开复位后,经双侧椎弓根穿刺充填自固化磷酸钙人工骨(CPC)。根据Denis胸腰椎骨折的分型:压缩性骨折,B型27例,C型3例,D型5例;爆裂性骨折2例,均为B型。利用体位复位,经皮穿刺,Sky椎体成形器扩张椎体,注入可降解的自固化磷酸钙人工骨。根据术前和术后侧位X线片测量椎体高度、后凸畸形角度,并计算椎体高度丢失率和后凸畸形矫正率,记录分析视觉模拟评分(VAS)及伤椎形态变化。结果:术后随访9~24个月,平均13个月。术后伤椎处疼痛均显著缓解,VAS评分改变从术前平均(7.6±2.5)分降至术后平均(1.8±1.5)分,椎体前壁高度和中间高度明显恢复,后凸畸形得到矫正。随访期间疗效满意,伤椎高度无明显丢失。结论:在严格掌握适应证、选择合适病例的前提下,采用体位复位辅助下经皮椎体后凸成形术治疗创伤性胸腰椎椎体骨折,能迅速缓解疼痛,有效恢复椎体高度和矫正后凸畸形。 相似文献