脊柱外科的现状和展望

10余年来 ,随着科学的不断进步以及广大骨科医生的辛勤努力 ,脊柱外科取得了飞速的发展 ,一些重要的概念、原则、诊断标准和治疗手段不断改进 ,并日臻完善。为此 ,有必要回顾脊柱外科的过去 ,展望未来 ,与广大脊柱外科医师共勉。一、基础研究脊柱外科的基础研究在国内较为薄弱 ,主要集中于腰椎间盘突出、慢性腰痛、特发性脊柱侧凸等一些常见病的发病机制和病因学的研究。腰椎间盘退变是腰背痛最常见的原因。近年来 ,椎间盘的超微结构研究发现 ,退变椎间盘内胶原纤维形态发生变化 ,椎间盘细胞出现特征性的凋亡并被细胞外基质所包绕 ,从而导致…     

微创脊柱外科研究进展

Farooq[Eur Spine J，2004，13(7)：639—644]等比较了两组接受腰椎前路椎间融合手术患者的临床效果，35例患者分为两组，一组(16例)采用传统的侧前方腹膜后入路．另一组(19例)采用气囊辅助的微创侧前方腹膜后入路．比较两组患者手术时间、出血量、并发症、术后疼痛缓解情况、下地活动时间和住院时间。结果发现．对单节段融合患者两组的手术时间、术后疼痛和术后下地活动时间存在显著性差异；而对多节手术患者则没有显著性差异。     

脊柱外科的回顾与展望

脊柱外科己经历了一百多年历史。粗略划分有如下一些里程碑。就我所知,有文字记载是十九世纪1895年,英国伦敦泰晤士报报告一例颈椎损伤采用钢丝固定,     

脾脏外科临床研究进展与展望

随着脾脏功能探索的不断深入以及外科技术的迅速发展,脾脏外科取得了巨大的进步。在保证脾脏功能和兼顾微创观念的前提下,科学理性保脾,各种保脾术式得到了不断的完善与成熟;随着腹腔镜技术的普及,腹腔镜下脾切除术及门静脉高压症断流手术的开展取得了良好的效果;目前,腹腔镜与开放手术指征的选择尚未统一;在微创时代背景下,新的脾肿大分级应运而生。     

血管外科临床研究进展及展望

近20年间血管外科的治疗技术进展迅速,尤其集中于复杂主动脉弓部疾病（夹层和动脉瘤）、复杂腹主动脉瘤、胸-腹主动脉瘤、颈动脉狭窄、重症动脉硬化性下肢缺血、静脉血栓性疾病和静脉曲张等病的治疗方面,发展出了烟囱技术、开窗技术、分支支架技术、药物涂层技术、腔内减容技术等在内的多种新技术、新理念,以新型口服抗凝药物为代表的新药研发,也取得了良好的临床疗效。     

新世纪脊柱外科的回顾与展望

转眼间,我们已经步入新世纪的第三年,《脊柱外科杂志》于此时诞生,确为我国脊柱外科的一大喜事。值此《脊柱外科杂志》创刊之际,笔者试图回顾脊柱外科的过去,展望未来发展趋势,与广大脊柱外科医生共勉。脊柱外科是骨科学的重要分支,随着医学科学的发展,工程学与材料学的密切结合、近代新技术和新方法的积极应用、基础研究的不断深入以及诊疗设备和手术器械的革新,近10余年来脊柱外科已经取得很大发展。一些重要的概念、原则、诊断标准和治疗手段不断朝着更科学的方向迈进,并日臻完善。现从以下几方面分别阐述:基础研究目前人们初步掌握了椎…     

我国脊柱外科的现状与展望

我国脊柱外科的现状与展望中华医学会骨科学会脊柱外科学组组长唐天驷随着基础医学与临床研究和材料、工程学等各学科的发展以及互相渗透与结合；高精设备、近代高新技术的发展与应用，我国脊柱外科有了长足的进步。１９９４年１０月，中华医学会骨科学会脊柱外科学组召开...     

脊柱外科的百年回顾与展望

过去一个世纪 ,由于影像学、神经生物学、生物力学及外科技术的发展 ,给脊柱外科带来巨大的变化。推测在 2 1世纪 ,脊柱外科将会有更大的进展。1　影像学自 1891年Ｒ ｎｔｇｅｎ发现Ｘ射线 ,给骨科带来革命性的变化 ,但Ｘ线平片技术对脊柱外科疾病诊断有一定的局限性 ,椎管内组织结构及病变无法分辨。到 2 0世纪初期 ,首先由Ｄａｎｄｙ(1919)报道用空气注入椎管内进行颅脑造影。不久 ,Ｂｉｎｇｅｌ(192 1)应用空气造影法诊断腰段脊髓病变。同年 ,Ｓｉｃａｒｄ及Ｆｏｒｅｓｔｉｅｒ用脂质溶液造影剂代替空气。 1931年Ａｍｅｌｌ及Ｌｉｄｓｔ…     

脊柱结核外科治疗研究进展

本文从脊柱结核外科治疗的目的、指征、方法及术后康复治疗等方面逐一进行了回顾性介绍,并对各种手术方式进行了适应症分析,强调了脊柱结核术后康复治疗的重要性。笔者认为脊柱结核的外科治疗技术目前已日臻成熟,手术方式的多样化、微创治疗技术的兴起,都成为了目前及今后的主流研究方向。     

Advances in osteobiologics in spine surgery

In spine surgery, fixation devices that revolutionized spinal fusion are becoming mature technologies, and new tools derived from biologics are becoming more important in clinical practice. Thus, surgeons need to become more sophisticated in evaluating and using these new biologics, which are rapidly entering the market. The majority of these biologics are aimed at enhancing spinal fusion and can be called osteobiologics. Osteobiologic products vary from recombinant proteins to specially prepared allograft or autograft materials. Their financial costs are considerable, and the level of proof for the efficacy and safety of these products varies widely. In this article, I delineate useful principles that can be used to evaluate current and future generations of osteobiologic products, and I discuss the most pertinent examples of specific osteobiologics.     

Fostering reproducibility and generalizability in machine learning for clinical prediction modeling in spine surgery

As the use of machine learning algorithms in the development of clinical prediction models has increased, researchers are becoming more aware of the deleterious effects that stem from the lack of reporting standards. One of the most obvious consequences is the insufficient reproducibility found in current prediction models. In an attempt to characterize methods to improve reproducibility and to allow for better clinical performance, we utilize a previously proposed taxonomy that separates reproducibility into 3 components: technical, statistical, and conceptual reproducibility. By following this framework, we discuss common errors that lead to poor reproducibility, highlight the importance of generalizability when evaluating a ML model's performance, and provide suggestions to optimize generalizability to ensure adequate performance. These efforts are a necessity before such models are applied to patient care.     

Advances in technology and surgical technique in spine surgery

This comprehensive review article encompasses a broad variety of topics within the spinal literature and includes an update on the latest technology and techniques for the spine.     

脾脏外科的沿革与展望

本文总结脾脏外科的沿革与展望.沿革的动力关键是在临床实践中对多种脾脏功能(抗感染、抗癌及对某些血液的影响)认识的逐渐深入,从而导致脾外伤时各种保脾手术的兴起.但在肝硬化门脉高压时保脾与切脾各有利弊,孰优尚无定论.腹腔镜切脾是近年的重大技术进展,其标准术式有待进一步探讨.脾移植治疗血友病甲是我国脾外科的特色之一,居国际领先,研究重点是如何防止慢性移植脾失功.展望未来,宜继续上述各方面研究,并加强学术交流,使我国的脾外科进入国际先进学科行列.     

脾脏外科的沿革与展望

本文总结脾脏外科的沿革与展望.沿革的动力关键是在临床实践中对多种脾脏功能(抗感染、抗癌及对某些血液的影响)认识的逐渐深入,从而导致脾外伤时各种保脾手术的兴起.但在肝硬化门脉高压时保脾与切脾各有利弊,孰优尚无定论.腹腔镜切脾是近年的重大技术进展,其标准术式有待进一步探讨.脾移植治疗血友病甲是我国脾外科的特色之一,居国际领先,研究重点是如何防止慢性移植脾失功.展望未来,宜继续上述各方面研究,并加强学术交流,使我国的脾外科进入国际先进学科行列.

Abstract：

To summarize the evolution of spleen surgery and prospects the future. The knowledge on the splenic function (anti-infection, cancer and certain blood effects)gradually promotes the reform of spleen surgery in clinical practical, resulting all kinds of spleen-preserving surgery when splenic injury. However,there is still controversy about spleen removal or reservation under the condition of portal hypertension in liver cirrhosis patients, because advantages and disadvantages between these different operations. Laparoscopic splenectomy is a major progress in recent years,the standard operation need to be further explored. Spleen transplantation in the treatment of hemophilia A is one of the characteristics of the spleen surgery in China, and this is the leading position in the world, now we will focus on how to prevent chronic spleen graft dysfunction. To keep the advanced international level, Chinese teams on spleen surgery are still required to deepen the related research and strengthen the academic communication in the future.     

Advances in technology and surgical technique in spine surgery.

This comprehensive review article encompasses a broad variety of topics within the spinal literature and includes an update on the latest technology and techniques for the spine.