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重度强直性脊柱炎后凸畸形手术治疗 总被引:1,自引:0,他引:1
目的 探讨重度强直性脊柱炎畸形的手术治疗方案和意义。方法 对脊柱后凸畸形明显,伴发髋关节强直和椎管狭窄症的54例病人进行手术治疗,选择合理的手术方式和手术顺序,手术方法包括“一次性多平面全脊柱楔形截骨术”、全髋关节置换术和椎管减压术。结果 随访1-16年,脊柱后凸畸形改善,髋关节功能良好,脊髓压迫症状缓解,疗效满意。结论 手术治疗重度强直性脊柱炎畸形是有效和唯一的方法。 相似文献
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目的讨论严重强直性脊柱炎畸形的手术治疗方案和意义。方法对脊柱后凸畸形明显,伴发椎管狭窄症和髋关节强直的49例病人进行手术治疗,选择合理的手术方式和手术顺序,手术方法包括“一次性多平面全脊椎楔形截骨术”、椎管减压术和全髋关节置换术。结果随访1—17年,脊柱后凸畸形改善,脊髓压迫症状缓解,髋关节功能良好,疗效满意。结论手术治疗严重强直性脊柱炎畸形是有效和唯一的方法。 相似文献
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强直性脊柱炎是以骶髂关节和脊柱慢性炎症为主的周身性疾病,临床表现为腰骶部疼痛伴僵硬,活动后可缓解,晚期可并发脊柱强直、畸形,造成严重的功能障碍。中国医科大学附属第一医院采用康复训练的方法治疗51例强直性脊柱炎患者,效果较为满意。 相似文献
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运动疗法对强直性脊柱炎患者关节功能的影响 总被引:3,自引:0,他引:3
强直性脊柱炎是以骶髂关节和脊柱慢性炎症为主的周身性疾病,临床表现为腰骶部疼痛伴僵硬,活动后可缓解,晚期可并发脊柱强直、畸形,造成严重的功能障碍。中国医科大学附属第一医院采用康复训练的方法治疗51例强直性脊柱炎患者,效果较为满意。 相似文献
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背景:对于强直性脊柱炎合并胸腰椎骨折患者,采用传统方法行短节段经椎弓根内固定或前路钉板或钉棒系统固定由于其骨质疏松明显,螺钉抗拔出力较差,治疗后容易出现内固定松动。目的:探讨多节段经椎弓根内固定治疗强直性脊柱炎合并胸腰椎骨折的效果。方法:选择2009年1月至2012年12月中山大学附属梅州医院骨科收治的强直性脊柱炎合并胸腰椎骨折患者11例,行后路复位多节段椎弓钉内固定,其中6例采用经伤椎椎弓根固定。结果与结论:11例患者均获随访,随访时间13—36个月。所有患者影像学显示均骨性愈合,未见内固定松动断裂现象。3例脊髓神经损伤按Frankel分级由C级恢复至E级。JOA评分评估腰背痛改善率为100%。结果显示经后路复位多节段椎弓根钉置入治疗强直性脊柱炎合并胸腰椎骨折,可获得坚强内固定,骨折愈合良好。 相似文献
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Robert M. Domeier Rawden W. Evans Robert A. Swor Edgardo J. Rivera-Rivera Shirley M. Frederiksen 《Prehospital emergency care》2013,17(1):11-15
Objective. The objective of this study was to identify clinical findings that are associated with spinal fracture and/or spinal cord injuries in prehospital trauma patients.Methods. A retrospective chart review was performed at three tertiary referral centers in Southeastern Michigan. All charts of patients with spinal fractures or spinal cord injuries during 1992 and 1993 were reviewed. Patients with available pre-hospital records were included in the study analysis. Prehospital data points included documentation of head injury; altered mental status; neurologic deficit; evidence of intoxication; cervical, thoracic, and lumbar pain or tenderness; nonspecified back pain or tenderness; and a narrative for all other documented injuries. Hospital data collected included type and level of spinal injury and age and sex of the patient.Results. Of 867 injury patients identified, 536 were excluded, leaving 346 analyzable fractures in 331 patients. The 346 spinal fractures/spinal cord injuries were distributed as: 100 (29%) cervical, 83 (24%) thoracic, 128 (37%) lumbar, and 35 (10%) sacral. Prehospital documentation of altered mental status, neurologic deficit, evidence of intoxication, spinal pain, or suspected extremity fracture was found for every patient with a cervical injury, 82/83 patients with thoracic injuries (99%), and 124/128 patients with lumbar injuries (97%). All five patients who were not documented as having one of the predictors had stable injuries.Conclusion. Prehospital clinical findings of altered mental status, neurologic deficit, evidence of intoxication, spinal pain, and suspected extremity fracture were documented for all patients with significant spinal injuries in this series. These findings may be useful to identify patients who require prehospital spinal immobilization. 相似文献
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Sarah K. Waldman Christopher Brown Luis Lopez de Heredia Richard J. Hughes 《The Journal of emergency medicine》2013
Background
Individuals with ankylosing spondylitis are at an increased risk of vertebral fractures. These are often unstable, leading to primary and secondary neurological injury and conferring high levels of morbidity and mortality. Fractures in these patients can occur after minimal trauma and are easily missed, with potentially disastrous consequences.Objectives
To educate health professionals who may be involved in the initial assessment and management of ankylosing spondylitis patients with possible spinal injuries, despite not being spinal specialists.Case Reports
We present three cases from our own hospital, which illustrate the pitfalls associated with traumatic spinal injury in ankylosing spondylitis. Case 1 shows why delayed presentation of spinal injury is common, as well as demonstrating the need for multiple imaging modalities in some patients. Case 2 is an example of primary neurological injury in this patient group, and case 3 highlights the risk of secondary neurological injury, as well as the effect of multiple comorbidities on patient outcomes.Conclusions
It is important that staff in the Emergency Department have an understanding of the extreme caution that is needed in the management of possible spinal injuries in patients with or suspected of having ankylosing spondylitis. 相似文献14.
Glinkowski W 《Ortopedia, traumatologia, rehabilitacja》2000,2(4):51-53
This article presents a rare case of a fracture of the thoracic spine accompanied by significant dislocation but without spinal cord injury in a 74-year-old male patient with ankylosing spondylitis. A literature search failed to reveal a similar case. Conservative treatment produced a good outcome. 相似文献
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目的 探讨强直性脊柱炎(AS)脊柱骨折的多种影像学特征和影像诊断的价值.方法 回顾性分析20例AS合并脊柱骨折患者的影像学和临床资料.结果 损伤节段位于颈椎5例(25.00%),胸腰椎15例(75.00%),其中屈曲型损伤11例(55.00%),屈曲过伸型损伤9例(45.00%),前中后三柱同时损伤14例(70.00%),伴脊髓损伤8例(40.00%).X线平片共发现脊柱损伤征象43个,多层螺旋CT(MSCT)发现93个,MRI发现102个.结论 AS脊柱骨折常表现为累及三柱的贯通性骨折,MRI和MSCT是早期诊断的重要手段,MRI显示脊髓损伤和后柱损伤有明显优势,是评估AS合并脊柱骨折的首选影像学检查方法. 相似文献
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In 576 patients quantitative scintigraphy of the sacroiliac joints and the spinal cord with 99mTc-Pyrophosphate was performed. 328 were patients with proven ankylosing spondylitis according to the New-York criteria. 120 were patients with a clinically and roentgenologically suspected ankylosing spondylitis and 128 persons formed a healthy control group. The count rate in small regions of interest (ROI) in the sacroiliac joints, the spinal cord and the os sacrum were compared on the basis of indexes. The scintigraphic data of patients with ankylosing spondylitis were compared with healthy control group and with the radiographic findings and radiologic staging of the disease: In a longitudinal follow-up study during 1 to 6 years these investigations were continued together with clinical and roentgenological checks. Quantitative bone scintigraphy provides characteristic indexes for ankylosing spondylitis, indicating the increased mineral metabolism of the sacroiliac joints and the spinal chord. Skeletal scintigraphy is recommended for early detection and monitoring of ankylosing spondylitis. 相似文献
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背景:生物力学的观点认为:强直性脊柱炎的矫形在后凸的顶点处截骨最佳,但术中脊髓损伤的风险大。目的:分析联合应用椎板间截骨+椎体截骨+长节段椎弓根钉系统内固定治疗强直性脊柱炎后凸畸形的临床效果。方法:强直性脊柱炎患者共36例,均采用PSO(Pedicle Subtraction Osteotomy)截骨+SPO(Smith-Peterson Osteotomy)联合截骨治疗。随访时间3个月至2年。结果与结论:36例患者未发现植入物修复后矢状位失平衡者,矢状位失衡的改善率为64%。患者植入物修复后胸腰椎后凸角的到恢复,改善率为60%;颌眉角的改善率为98%,疼痛症状缓解程度为64%,ODI 指数95%;均未发生拔钉、断钉、断棒现象。说明选择性截骨矫形技术+长节段内固定手术能够获得稳定的内固定疗效,防止出现矢状位失平衡,以及强直性脊柱炎因骨质疏松导致的拔钉、断钉、断棒现象的发生。 相似文献
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查永曙 《临床医学研究与实践》2020,5(4):175-176
目的探讨系统护理在脊柱骨折合并脊髓损伤患者中的应用效果。方法随机将2017年10月至2018年10月68例脊柱骨折合并脊髓损伤患者分为观察组(34例,系统护理)与对照组(34例,常规护理)。比较两组患者的护理效果。结果观察组出院后3、6个月的SCIM-Ⅲ评分高于对照组(P<0.05)。观察组患者的并发症总发生率低于对照组(P<0.05)。出院后3个月,两组患者的各项生活质量评分均升高,且观察组高于对照组(P<0.05)。结论将系统护理应用于脊柱骨折合并脊髓损伤患者中,可降低患者的并发症发生率,提高患者生活质量。 相似文献
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急性脊髓损伤后血清中ALT和AST活性变化的临床初步观察 总被引:1,自引:0,他引:1
目的:探讨血清中谷丙转氨酶(ALT)和谷草转氨酶(AST)的活性与急性脊柱脊髓损伤的关系。并评价ALT和AST活性的主民脊髓损伤严重程度的关系。方法:测定136例急性脊柱脊髓损伤患者在急性期及恢复期血清中ALT和AST的水平,以及30例急性仍柱骨折患者血清中ALT和AST的浓度,分别进行统计学处理分析。结果:急性脊柱脊髓损伤患者血清中ALT和AST活性显著高于其恢复期及单纯脊柱骨折患者,并且在急性 相似文献
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无骨折脱位型颈脊髓损伤的治疗和康复 总被引:1,自引:2,他引:1
目的探讨无骨折脱位型颈脊髓损伤手术治疗和保守治疗的临床疗效圾早期康复效果。方法48例男性患者分为手术组29例,行颈后路双开门椎管扩大成型术,并进行早期康复训练;保守治疗组19例,入院后即行康复训练。根据ASIA标准分别于治疗前和治疗后3个月、6个月、12个月对患者进行感觉和运动评分。结果两组在治疗后感觉及运动功能较治疗前提高(P〈0.05);但手术组疗效明显优于保守治疗组(P〈0.01)。结论无骨折脱位型颈脊髓损伤患者早期施行减压及稳定手术可取得比保守治疗更好的康复效果。 相似文献