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41.
C. Faldini S. Pagkrati F. Acri M. T. Miscione D. Francesconi S. Giannini 《Journal of orthopaedics and traumatology》2007,8(3):128-133
Degenerative spondylolisthesis is characterized by the slippage of one vertebral body over the one below, with association
of intervertebral disc degeneration and degenerative arthritis of the facet joints, which cause spinal stenosis. The aim of
this study was to evaluate the clinical and radiographic results of 22 patients with symptomatic degenerative spondylolisthesis,
operated on by decompressive laminectomy and instrumented posterolateral fusion associated with interbody fusion (PLIF). Mean
age at surgery was 64 years (range, 57–72). Clinical results were evaluated on a questionnaire at the last follow-up visit
concerning postoperative low back and leg pain, restriction of daily life activities, and resumption of sports activity. Lumbar
spine radiographs were used to evaluate the status of fixation devices, the reduction of the spondylolisthesis, the lumbar
sagittal balance and the presence of spinal fusion. No intraoperative or postoperative complications were encountered. There
were no superficial or deep infections, fixation device loosening, or hardware removal. Mean follow-up time was 4 years (range,
3–6 years). Clinical outcome was excellent or good in 19 patients and fair in 3 patients. Preoperatively, mean forward vertebral
slipping on neutral lateral radiographs was 5 mm, while postoperatively it decreased to 3 mm. Preoperatively, mean sagittal
motion was 3 mm and angular motion was 8°, while postoperatively these values decreased to 1 mm and 1°, respectively. This
study demonstrated that spinal decompression followed by transpedicular instrumentation associated with PLIF technique is
a valid surgical option for the treatment of degenerative spondylolisthesis with symptomatic spinal stenosis. Clinical outcome,
intended as relief of pain and resumption of activity, was improved significantly and fusion rate was high. 相似文献
42.
肘管综合征的解剖和病因学探讨 总被引:9,自引:0,他引:9
[目的]探讨肘管综合征的解剖特点和发病原因。[方法]对65例肘管综合征患者的临床资料和术中所见,以及其中25例患者术前肌电图检查的结果进行综合研究分析。[结果]术中见60例患者存在肘管弓状韧带的肥厚增生,卡压磨损尺神经导致炎性病变;术前肌电图检查发现25例患者的尺神经传导速度均减慢,平均传导速度为27.97m/s;运动反应波幅降低,平均电压为1.95mv;潜伏期延长,平均时间为5.41ms;65例肘管综合征患者,继发于肘部创伤25例,慢性劳损15例,慢性骨关节炎14例,占位病变5例,先天异常有6例。[结论]肘部的创伤及慢性劳损可以导致肘管弓状韧带出现肥厚增生,引起尺神经卡压磨损,这是肘管综合征最常见的病因;其他病因还包括慢性骨关节炎,占位病变和先天异常;尺神经可被机械性卡压和磨损,出现慢性缺血缺氧,导致肘管综合征的发生;详细的体格检查和术前的肌电图检查是诊断肘管综合征的主要手段,在诊断时应注意该病与其他部位迟发性尺神经麻痹的鉴别。 相似文献
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Background : Many recent reports of the results of decompression of the median nerve in the carpal tunnel have concentrated on only one aspect of recovery (numbness, grip etc.), and there are no reports of a comprehensive study of outcome. The aim of the present study was to review comprehensively the results of the direct visualization method of decompression of the carpal tunnel and to compare them with the published results of endoscopic release. Methods : Patients' perceptions of the severity of pain, numbness and paraesthesiae due to carpal tunnel syndrome (CTS), before and after open carpal tunnel release (CTR) in 188 hands were reviewed retrospectively at a minimum time of follow-up of 18 months. Motor and sensory testing, provocation testing and measurement of scar tenderness in 135 hands were performed at a clinical review. Results : Subjective results showed that 70% experienced a reduction in the severity of pain after CTR, 78% of hands experienced a reduction in the severity of paraesthesiae and 77% experienced a reduction in the severity of numbness. A total of 49% had improvements in all three symptoms after CTR. At the clinical review, sensory testing revealed that 59% of hands had normal or slightly diminished light touch, 35% had normal static two-point discrimination and 61% had normal dynamic two-point discrimination. Results for Tinel's test, Phalen's test and pressure provocation testing were positive in 10% of hands. There was no scar tenderness in 38%, no persisting thenar atrophy in 90%. Normal grip strength was found in 93% and 91% had normal pinch strength. Conclusions : It was concluded that open carpal tunnel release remains a safe and reliable treatment for carpal tunnel syndrome. The very low incidence of serious complications from the open technique of CTR, when compared with endoscopic CTR as published by different authors in the literature, and the comparable clinical results, appears to make the open technique a safer and preferable option. However, a properly controlled trial of both techniques is necessary to compare them. 相似文献
46.
R. M. Escorihuela A. Fernández-Teruel A. Tobeña W. Langhans K. Bättig P. Driscoll 《Behavior genetics》1997,27(6):573-578
An inbreeding program has been carried out with the Swiss sublines of Roman high- and low-avoidance rats since 1993. The present study reports the first experiments conducted with young animals of those inbred strains (RHA-I/Verh and RLA-I/Verh, respectively) from the sixth and seventh inbreeding generations. The results confirmed expected behavioral profiles. Compared to the RHA-I/Verh strain, RLA-I/Verh rats showed decreased entries into the illuminated central arena of an hexagonal tunnel maze, as well as decreased spontaneous locomotor activity and increased defecations, in two independent experiments. Young RLA-I/Verh females explored less than did their RHA-I/Verh counterparts during session 1 of a conditioned-fear experiment preceding shock administration, and in session 2 (conducted 24 h after the application of three footshocks), they showed greater conditioned behavioral inhibition (i.e., reduced amount of rearing), as well as higher defecation scores, than did RHA-I/Verh females.Karl Bättig tragically and unexpectedly died on December 27, 1996 相似文献
47.
Kiyosho Otani Tadahiko Aihara Akihiko Tanaka Keiichi Shibasaki 《International orthopaedics》1986,10(2):135-139
Summary Ossification of the ligamentum flavum has been recognised as a definite clinical entity as is ossification of the posterior longitudinal ligament. The incidence of both is high in Japan. This study demonstrates that the incidence of ossification of the ligamentum flavum in persons who have a kyphosis of the thoracic or lumbar spine is higher than in those who do not. It is considered that localised mechanical stress affecting the ligamentum flavum is a contributing factor to the development of ossification, together with the generalised factors which may favour bone formation. However, the aetiology of this lesion is still obscure as is that of ossification of the posterior longitudinal ligament.
Résumé L'ossification du ligament jaune représente une entité clinique définie, de même que celle du ligament longitudinal postérieur. Les deux affections sont fréquentes au Japon. Cette étude montre que l'ossification du ligament jaune s'observe plus souvent chez les sujets qui présentent une cyphose dorsale ou lombaire. On peut penser que les contraintes mécaniques localisées au ligament jaune constituent un facteur contribuant au développement de l'ossification, et s'ajoutant aux facteurs généraux susceptibles de favoriser la formation osseuse. Cependant, l'étiologie de cette affection demeure mystérieuse de même que l'ossification du ligament longitudinal postérieur.相似文献
48.
以硫酸二乙酯(DES)诱变处理黄色短杆菌(Brevibacteriumflavum)XQ5122,得到突变株V3-36<Leu ̄1、α-AB ̄r、AHV ̄r),在10%葡萄糖培养基中可积累2.3%L-缬氨酸。以亚硝基胍(NTG)诱变V4-153,得到一株突变株(Leu ̄1、α-AB ̄r、AHV ̄r、2-TA ̄r),再进行单菌落分离,得到突变株ZQ-2,能在培养基中积累L-缬氨酸4.2%~4.5%,最高达5.57%. 相似文献
49.
A common misconception attributes sparing of the flexor carpi ulnaris (FCU) in ulnar neuropathy at the elbow (UNE) to its innervating branch arising "at or above the elbow." We examined the relationship of FCU branches to the medial epicondyle (ME) and humeroulnar aponeurotic arcade (HUA) in 30 cadaver elbows. In only three did the first FCU branch arise at or proximal to the ME. In 36 UNE cases with fibrillations in the first dorsal interosseous, the FCU was normal in 10, mildly abnormal in 11, and severely abnormal in 15. FCU involvement correlated with the severity of the neuropathy and with whether compression was retroepicondylar or at the HUA. We conclude that sparing of the FCU in UNE is unrelated to the level of origin of its innervating branch, but rather is related to the internal neural topography and to the severity and level of compression. 相似文献
50.
Nakama S Kikuchi M Yashiro T Sakamoto A Kikkawa I Ookami H Saita K Hoshino Y 《Medical molecular morphology》2005,38(3):173-180
Ossification or calcification of the ligamentum flavum (LF) is relatively common in the middle and lower cervical, thoracic, and lumbar spine but extremely rare in the upper cervical region. This clinical fact suggests that there exist local factors promoting or preventing ossification or calcification of LF. However, little is known about the differences in the ultrastructure and cellular alterations of the LF between the different spinal levels, even in the cervical spine. With electron microscopy, we examined samples of LF collected surgically from the upper and lower cervical spine regions; we then studied the apoptotic appearance of ligament cells using a preferential labeling method. We found direct evidence of apoptosis of ligament cells in the LF. Apoptosis was more apparent in the upper region samples than in the lower region samples. The spaces around the normal fibroblasts were filled with thick collagen fibrils, but the collagen fibrils disappeared around the apoptotic bodies and thin fibrils were formed. The difference of the level of apoptosis may correlate to the ultrastructual difference of LF, and our data will benefit further investigations seeking to clarify the mechanism of various pathological conditions in the human LF. 相似文献