齿状突游离小骨

齿状突游离小骨较少见到，但其可导致寰枢椎不稳与脊髓压迫。为引起临床医生的警惕，作者报告１７例齿状突游离小骨。除３例无症状者未行手术治疗外，１４例存在寰枢椎不稳者均行枕颈融合，术后均获骨性融合。本组病例术后随访２～１６年，临床症状消失或基本消失者９例，明显减轻者５例。３例非手术治疗者无变化。作者认为，对于齿状突游离小骨存在寰枢椎不稳者应行手术治疗     

椎弓根钉固定的侧后方植骨融合和径后路椎体间融合治疗老年人腰椎滑脱症的效果评价

Objective Clinical and radiographic results in 30 consecutive patients undergoing posterior lumbar fixation and posterior facet joint or posterior interbody fusion for Meyerding Grade Ⅱ/Ⅲ spendylolisthesis were assessed: (1) to address the suitability of a dynamic stabilization; and (2) to investigate whether there are differences in terms of clinical and functional results between these two types of arthrodesis. Methods Fourteen patients underwent posterior inteffacet fusion (PLF) and implantation of TSRH-3D system. Posterior lumbar interbody fusion (PLIF) and placement of the same system were performed in 16 patients. Clinical, economic, functional and radiographic data were recorded both pre- and postoperatively. Results The average changes in Prolo Scale of economic and functional scores were 1.25 and 1.64 respectively, in patients undergoing posterior fusion; the average measured vertebral slippage was 48.6% (range 32% -65%) preoperatively and 17. 5% (range 15% -25%) postoperatively. In patients undergoing PLIF, the average changes in economic and functional score were 1.18 and 1.39 respectively, and the average preoperative vertebral slippage was 44. 2% (range 30% - 55%) versus 20. 3% (range 18% -26%) postoperatively. Conclusion The use of a segmental pedicle screw fixation with TSRH-3D was able to successfully combine the goal of solid fusion with the requirements of nerve root decompression. When these two fusion techniques were compared, PLIF was superior to PLF because of an overall superior reliability and system resistance. But their clinical outcomes did not differ greatly (P > 0. 05).     

骶管内囊肿的临床研究

目的探讨骶管内囊肿的发病机理、临床特点及治疗方法。方法回顾性分析35例手术治疗的骶管内囊肿的临床资料，根据术前的影像学检查、术中所见、术后病理和手术后疗效，分析其特点。结果28例随访结果发现，囊壁部分切除治疗骶管内囊肿的疗效满意，随访中未发现囊肿复发和神经损伤再加重。结论骶管内囊肿是相对较常见的疾病，该病尤其是在40岁以上人群中发病较多，与退变性腰椎疾病的表现有很大的相似处。本病最好的诊断方法是行腰骶椎MRI检查。治疗上采用手术简单的囊壁部分切除具有较好的疗效。     

脊椎血管瘤的影像诊断（附30例分析）

目的：探讨脊椎血管瘤的影像表现特征及临床意义。材料与方法：结合临床资料回顾性分析３０例脊椎血管瘤的Ｘ线、ＣＴ或ＭＲＩ影像特征。结果：Ｘ线片可见椎体呈典型的栅栏样改变，ＣＴ可见网眼状影像中夹杂着低密度脂肪，在ＭＲＩ Ｔ１加权像上呈等或高低混杂信号，Ｔ２加权像上呈均匀高信号，并见随回波时间延长信号逐渐变亮这一典型血管瘤信号特征，ＭＲＩ可发现脊髓受压变性程度。据ＭＲＩ表现和临床资料，作者提出了脊椎血管瘤     

多节段胸椎黄韧带骨化症2例报告

胸椎黄韧带骨化症较少见，常造成胸椎管狭窄，压迫脊髓，手术治疗难度较大。我院收治2例，报告如下。例1，男，35岁。因双下肢感觉运动障碍进行性加重6个月入院。曾于外院行胸椎板切除减压术，术后双下肢感觉运动障碍加重，大小便正常。X线片示：T4～T10。棘突间隙有致密影突入椎管。CT片示：T4～T10。黄韧带骨化，椎板增厚，小关节突增生，谁管严重狭窄。MRI示T4～T10。椎管后方低信号影，呈锯齿样突向前面，严重压迫脊髓，脊髓信号无改变。体检：T7平面以下皮肤感觉减退，双下肢肌萎缩，双下肢震颤，膝、跟位反射亢进，踝阵挛阳性，…     

颈椎前路锁定钢板加钛网复合固定的并发症

目的：分析颈椎前路锁定钢板加钛网复合固定在临床应用中发生的并发症及其发生原因，提出预防措施。方法：回顾总结颈椎前路锁定钢板加钛网复合固定治疗的颈椎骨折脱位、颈椎病和颈椎椎体肿瘤共140倒患者的临床资料，分析与此类复合固定相关的并发症。结果：平均随访16个月(12—28个月)，12例(8．6％)患者出现3种共17例次与使用钢板、钛网复合固定相关的并发症，包括颈椎生理曲度明显丢失5例，钛网下沉7例，内固定松动、移位5例。结论：颈椎前路锁定钢板加钛网复合固定有一定的并发症发生率，必须谨慎选择应用，严格掌握手术指征。     

五例强直性脊柱炎并发脊柱骨折的处理

五例强直性脊柱炎并发脊柱骨折的处理刘祖德周许辉贾连顺刘鸿奎强直性脊柱炎是一种慢性进展性的炎性疾患，炎症累及脊柱的关节突、韧带、椎间盘及纤维环，整个脊柱出现弥漫性骨质增生、韧带钙化．晚期患者脊柱成“竹节样”改变，类似于长管状骨，整个脊柱呈前屈性畸形．脊...     

Effect of platelet activating factor on blood spinal cord barrier following cervical cord injury

Bloodspinalcordbarrierdamagefollowingcervicalcordinjuryplaysanimportantroleinthepathophysiologicalprocessofsecondarybleeding,edemaandnecrosisofcervicalcordtissue-Plateletactivatingfactor(PAF)isaverystrongbiologicalactivatinglipidmediator-Inrecentyears,interesthasbeenfocusedontheroleofPAFinbloodbrainbarrierdisruption'IthasbeenprovedthatPAFplaysanimportantroleininducingthepathologicalprocessofstrokeLlj.ThestudyoftherelationshipbetweenPAFandbloodspinalcordbarrierisrarelyreported.Inthepresen…     

临床非手术治疗急性脊髓损伤

熟练的非手术急救处理是治疗脊髓损伤的一个重要方面，应用适当的复苏技术，配合特殊的生命抢救措施，可以保护脊髓免遭进一步损伤；正确地诊断，注意观察神经功能变化和应用适当的脊柱牵引和固定，都是非常重要的措施，预防慢性并发症如感染、血栓形成和褥疮是早期处理的目标，综合应用这些措施，将有利于脊髓损伤患者达到最大程度的恢复。