跳水运动员颈椎损伤的生物力学研究

作者通过在新鲜成人颈椎标本上做了椎体静力性负荷和动力性负荷实验,表明颈椎在后伸位应力为前屈位的50%,最大应力位于颈椎4-6,是跳水运动员头颈部入水时引起颈椎致伤的生物力学因素。     

"四天穴方"对神经根型颈椎病患者疗效的红外热像观测

目的　分析“四天穴方”(天牖、天容、天窗、天鼎 )与颈夹脊穴治疗神经根型颈椎病的效果比较。方法　运用红外热像技术对“四天穴方”和颈夹脊穴两种取穴法治疗后项背部皮肤温度的变化进行对照观察。结果　治疗后两组项背部皮肤温度较治疗前有明显降低 ,且“四天穴方”组的改善幅度优于颈夹脊穴组。结论　“四天穴方”对神经根型颈椎病患者项背部病理性高温的改善作用优于传统颈夹脊穴     

颈椎不稳在交感型颈椎病发病中的作用

目的：研究交感型颈椎病的病理因素及治疗方法。方法：回顾分析了1988-2000年收治的20例手术治疗的交感型颈椎病患者。根据术前及术后颈椎伸屈侧位X光片判断有无颈椎不稳。结果：20例患者术前均有颈椎不稳,颈椎不稳主要发生在C3-C4和C4-C5,颈椎高位硬膜外封闭对大部分患者有短期效果。每例患者均于不稳节段行颈前路融合术,手术有效率为90％。结论：颈椎不稳是导致交感型颈椎病发病的重要因素;颈椎高位硬膜外封闭可有短期疗效因此具有重要的诊断价值;颈椎前路植骨融合术是治疗交感型颈椎病的有效方法。     

"排针透刺法"治疗腰椎病的临床观察

目的和方法采用客观公认的腰椎病诊断标准和疗效判定标准,观察了“排针透刺法”治疗腰椎间盘突出症、腰椎管狭窄症和腰椎骨性关节炎的疗效,并设常规针刺的对照组,对治疗前后的疼痛评分以及疗效等进行了比较分析。结果“排针透刺法”治疗腰椎病,治愈率为48.08%,总有效率为92.31%;治疗后,患者疼痛的症状评分明显改善,明显优于对照组（P〈0.05）。结论“排针透刺法”治疗腰椎病具有显著而肯定的临床疗效。其疗效优于传统的针刺法。     

颈段椎体骨赘发生率及其年龄分布的相关性研究

目的观测颈段椎体骨赘的发生率及其年龄分布特点。方法测量颈椎侧位X线片300张(男性159张,年龄20~87岁;女141张,年龄20~90岁),并分为<30岁组(A组)、30~39岁组(B组)、40~49岁组(C组)、50~59岁组(D组)、60~69岁组(E组)和70~90岁组(F组)。将C1~C7椎体骨赘分为椎体上缘骨赘及椎体下缘骨赘。结果骨赘发生率为,A组0.0%、B组4.0%~4.7%、C组20.0%~23.3%、D组38.7%~39.2%、E组56.7%~60.0%、F组72.7%~80.9%;B组与C组比较;C组与D组比较;D组与E组比较;E组与F组比较,骨赘发生率有显著性差异(P<0.05~0.01)。男性骨赘好发于C6,其次为C5;女性骨赘好发于C5,其次为C6。结论颈段骨赘的发生率随年龄的增长而增加,好发部位为C5和C6,但男性多见于C6,女性多见于C5。     

针刀治疗动静力失衡性大鼠颈椎间盘退变模型的研究

目的通过完全切断颈后伸肌群的方法,建立针刀治疗的动静力失衡性大鼠颈椎间盘退变模型,为针刀治疗颈椎病提供一种较可靠的实验模型。方法将36只SD大鼠随机分为模型组(18只)、对照组(18只),每组又分1个月、3个月、5个月组,每组6只,模型组采用手术方法完全切断颈后伸肌群,对照组行伪手术。造模术后于相应时间点进行组织形态学观察,并进行免疫组化和定量多聚链反应(PCR)检测Ⅰ、Ⅱ型胶原表达强度及基因表达变化。结果组织形态学观察:颈椎间盘退变程度逐渐加快、加重,模型组颈椎间盘退变较对照组明显;3个月时模型组与对照组比较差异有统计学意义(P0.05)。Ⅰ、Ⅱ型胶原蛋白检测:(1)免疫组化染色法,Ⅰ型胶原与椎间盘退变呈正相关性,Ⅱ型胶原与椎间盘退变呈负相关性,二者在椎间盘退变过程中发生转换。模型组Ⅰ、Ⅱ型胶原表达均在3个月时较对照组明显(P0.05),而对照组Ⅰ、Ⅱ型胶原表达5个月较1个月时才开始明显(P0.05)。(2)PCR检测:随着椎间盘退变进程,Ⅰ型胶原基因表达逐渐增加;Ⅱ型胶原基因表达逐渐减少。模型组Ⅰ、Ⅱ型胶原基因表达均在3个月时较对照组有明显变化(P0.05)。结论完全切断颈后伸肌群可造成大鼠颈椎动静力失衡,从而加快颈椎间盘退变进程,3个月时即退变明显,为针刀治疗颈椎病的机制研究提供一种理想的动物模型。     

颈痛的中药治疗与微循环关系的临床探讨

目的 探讨颈痛对微循环的影响及痹痛消的疗效。方法 ６０例神经根型颈椎病所致的颈痛患者,承发为治疗组（痹痛消组）和对照组（颈复康组）,采用常规微循环测定方法,观测了应用痹痛消和颈复康冲剂治疗前后根型颈椎病疼痛及微循环的改变。结果 治疗后,两组疼痛分值均明显减少,两组间治疗前后疼痛积分差值比较有显著性差异（ｔ＝１．９４３,ｐ〈０．０５）,治疗组疼痛的缓解优于对照组。治前两组微循环异常者分别高达８０％和     

Differential diagnosis of cervical nerve compression syndrome of the external intervertebral foramen

The aim of the present research is to study the mechanism of cervical nerve compression syndrome of the external intervertebral foramen and its differential diagnosis with cervical spondylosis. Diagnostic treatment with muscle relaxant, vasodilator, neurotrophic medicine and celecoxib (COX)-2 inhibitor were performed in 20 patients with cervical nerve compression syndrome of the external intervertebral foramen and 20 patients with cervical spondylosis confirmed by operation. Diagnostic local block therapy was performed additionally in cases showing little effect after diagnostic treatment. All the patients were followed up postoperatively for more than one year. Fifteen cases with cervical nerve compression syndrome of the external intervertebral foramen were healed by the diagnostic treatment. The other five cases had a short-term remission and there was no recurrence after diagnostic local block therapy. Diagnostic treatment led to short-term alleviation of the symptom in 20 cases with cervical spondylosis confirmed by operation, the results of which was far from satisfactory and operation was undertaken finally in all the 20 cases. The etiology of cervical nerve compression syndrome of the external intervertebral foramen lies in the compression of the cervical plexus, brachial plexus and cervical dorsal rami by the tendinous decussating fibers of the scalenus anticus, medius, minimus and the posterior muscles of the neck. Diagnostic treatment was propitious to differentiate cervical nerve compression syndrome of the external intervertebral foramen from cervical spondylosis. Translated from Journal of Shanghai Jiaotong University (Medical Science), 2006, 26(2): 117–119 [译自: 上海交通大学学报 (医学版)]     

Experimental study on mechanism of vertebral osteophyte formation

Objective:The purpose of this experimental study was to explore the mechanism of the vertebral osteophyte formation.Methods:An experimental model of cervical spondylosis in rabbits was established by resection of the cervical supraspinous and interspinous ligaments and detachment of the posterior paravertebral muscles from cervical vertebrae.Because of individual difference,The natural development procedure of the vertebral osteophyte formation could be seen with a microscope by dynamic observation.Results:The cartilage end-plate was divided into a growth cartilage layer and an articular cartilage layer.Vertebrae and discs from the 3-month control group rabbits showed normal structure.The changes of cartilage plates from the 3-monthe experimental group and the 8-month control group animals showed proliferation in peripheral articular cartilage.The osteophytes from the 8-monthe experimental group animals could be seen.The osteophyte obviously arised from proliferation,calcification and ossification of the peripheral articular cartilage.Conclusions: The vertebral osteophyte arises from proliferation of peripheral articular cartilage which undergoes cartilaginous osteophyte,and then changes into bony osteophyte through an endochondrqal calcification and ossification.