Experimental study on interbody fusion with CFR/PEEK

Polyetheretherketone(PEEK)isanewsemi-crys-talthermal-contouredpolymer,whichhasidenticalphysical-chemistrycapability,electricalconductivitycapabilityandmechanicsstabilitywithinawiderangeoftemperature.Studyhaveshowedthatwhenpoly-etheretherketonecompositematerialswerereinforcedbycarbonfiber,theirmechanicalstrengthandelasticmoduluscouldkeepstableeitherinphysiologicalsalineofavarietyoftemperaturesorafterimplantedintheanimals'muscles[1].CFR/PEEKhadgoodbiocom-patibilityｉｎｖｉｔｒｏandinthequant…     

碳纤维增强的聚醚醚酮复合材料椎体间植入的实验研究

目的;研究碳纤维增强的聚醚醚酮复合材料（CFR/PEEK）椎间植入后,在骨组织内的生物相容性及在椎间融合术中的作用。方法：选取13只Beagle狗,分为2组,实验组7只狗L6-7椎间植入盘状带孔CFR/PEEK;对照组6只狗,相同位置植入环氧乙烷处理的冷冻异体骨,分别于术后6、12和24个月行X线片、螺旋CT（QCT）扫描及病理检查。结果：X线、QCT及病理检查三对椎间融合判断的符合率为100%。术后12个月,实验组的融合率高于对照组;术后24个月,两组均全部融合,病检查显示复合材料前方的软组织为非特异性的纤维结缔组织,碳微粒见于其周围组织内,细小微粒被异物巨细胞吞噬,骨磨片示新骨组织长入复合材料的小孔内,碳微粒对骨组织无明显影响。结论：CFR/PEEK对骨组织有良好的相容性。     

Recording of spared motor evoked potentials and its augmentation by 4-aminopyridine in chronic spinal cord-injured rats

Objective To research the direct electrophysiological evidence of discomplete spinal cord injury (SCI) and the effect of 4-aminopyridine on it.Methods Motor evoked potentials (MEPs), both spinal cord recorded MEPs (scMEPs) and extr acellularly recorded MEPs (exMEPs) were recorded and characterized on a T(13) epidural electrode (scMEPs) and an extracellular microelectrode (exMEPs) for 10 normal rats and 40 rats with lesions of various severity (sham, 35 g·cm for ce (gcf), 70 gcf, 100 gcf impact injury) at the T(8)-T(9) cord using the Allen ’s drop model. The incline plane and Tarlov techniques were used to assess clin ical neurological function. Results MEPs in the normal rats were elicited by applying transcortical suprathreshold s timulation consisting of 3-4 early negative peaks (N(1), N(2), N(3) and N(4)) f ollowed by several late waves. The N(1) and N(2) peaks were largest in the ante rior and ventrolateral funiculus, respectively, which was indicative of extrapyr amidal pathways. The 100 gcf impact injuries and the cord transection abolishe d the MEP distal to the lesion, whereas the 35 gcf injuries resulted in a laten cy shift and amplitude decrement of the MEP peaks. Eighteen of the 20 rats wit h 70 gcf injuries showed clinical paraplegia. Among them, 7 rats had neurophys iological evidence of residual conduction pathways through the lesioned cord seg ment, such as the presence of N(1) and N(2) peaks in the scMEPs or exMEPs. Afte r 4-aminopyridine (4-AP) administrations (1 mg/kg), the amplitude of the spar ed exMEP increased significantly and spread more widely. Conclusions MEPs evoked by transcortical stimulation travel mostly in the extrapyramidal tra ct. MEP monitoring could provide an excellent method of detecting the functiona l integrity of the motor tracts after SCI, and could even detect spared motor fi bers after discomplete SCI. Furthermore, the use of 4-AP or other K(+) channel blocking agents may be a potential treatment for patients with chronic moderate to severe SCI.     

脊髓型颈椎病与性功能障碍

脊髓型颈椎病与性功能障碍石志才１袁文１李家顺１贾连顺１性功能障碍或性功能不全可由多种原因引起。精神因素、全身性疾病及下腰部病变（包括创伤和肿瘤等）均可导致性功能损害。然而脊髓型颈椎病所致的性功能减退较少见。我院自１９９３年９月至１９９７年２月共收治脊...     

脊髓栓系综合征医源性损伤4例报告

脊髓栓系综合征（ Tethered cord syndrome, TCS）是由于各种先在或后天原因牵拉圆锥,使圆锥位置下降并产生一系列神经功能障碍和畸形的症侯群。由于其临床表现和病理状态复杂,除容易引起误诊和漏诊外 [1],医源性损伤是临床处理上最严重的并发症。自 1981年 8月～ 1998年 4月共收治 TCS患者 56例,其中成人 22例,幼年或青少年 34例。发生医源性损伤 4例,均为成人,报告如下。1 病例摘要 病例 1,女, 42岁,因外伤后右下肢酸痛麻木 6个月收住入院。在外院行 CT检查 L 4－ 5椎间盘后突,诊为腰椎间盘突出症并在硬膜外麻醉下行 L 4…     

周围神经侧侧吻合治疗痉挛性脑瘫初步报告

目的：用周围神经侧侧吻合术治疗肢体痉挛性脑瘫并探讨其机制。方法：对１６例肢体痉挛性脑瘫患者采用正常神经干与病变神经干的侧侧吻合术,即将支配痉挛肌群的主要神经干与相对正常的邻近神经干的近端显露出５～６ｃｍ后相互靠拢,切开两神经相邻面的神经外膜和束膜１～２ｃｍ,直至神经纤维裸露后相互紧密对合再吻合其束外膜。结果：经１０～３９个月（平均２４个月）的随访,所有患者的肢体痉挛、畸形均有明显的缓解,其中６例患     

寰椎(第一颈椎)损伤

寰椎骨折脱位是较常见的一种上颈椎损伤,约占上颈椎损伤的５０％,临床上见到的寰椎骨折脱位,神经症状轻重不一,有的当场死亡,有的伴有不同程度脊髓高位损伤,表现为脑神经瘫痪、四肢瘫或不全瘫和呼吸功能障碍,常需立即辅助呼吸;有的仅为枕颈部疼痛和活动障碍,神经症状轻微。恰恰是这类患者临床上最常见并有潜在危险,应予以高度重视和积极采用相应治疗。１　寰椎骨折１．１　发生机制与特点本病发生于高处落下的物体撞击头顶部,或由高处坠落,头颈垂直触地所致。寰椎连接枕骨和其他颈椎,是一节非典型的脊椎,外观呈椭圆环状,无椎…     

脊髓急性损伤后神经细胞凋亡的时相和空间分布特点

目的 研究脊髓急性损伤后神经细胞的凋亡及其时相和空间特点。方法 大鼠脊髓（T8,9）经中度压迫损伤后,分别在30min、2h、4h、8h、24h、48h、72h、7d、14d、和21d处死取材（n=4)。应用HE、Nissl染色及凋亡细胞原位末端标记法对脊髓组织进行标记。结果 损伤4h后,在损伤段及邻近段可见末端标记阳性神经细胞,损伤段灰质中阳性细胞数8h达高峰,24h白质中阳性胶质细胞数量达高峰。相邻节段阳性细胞数量在72h达高峰。阳性细胞以白质中胶质细胞为主,主要分布于相邻节段。结论 脊髓损伤后神经细胞凋亡是继发损伤期的重要病理变化,并有其时相和空间分布特点。     

脊髓栓系综合征术后并发症分析

脊髓栓系综合征术后并发症分析石志才贾连顺李家顺袁文倪斌脊髓栓系综合征是相对少见的脊柱脊髓疾患。如不及时治疗，将产生无法挽救的后果。外科手术是唯一有效的治疗方法。手术并发症是影响其疗效的重要原因之一。１临床资料我院自１９８１年８月至１９９６年７月手术治...     

腰椎小关节囊切除治疗慢性腰痛的前瞻性研究

目的: 研究腰椎小关节在退变性腰椎疾患中的病理演变和致病机理; 观察小关节囊切除对腰痛的影响。方法: 将516例退变性腰椎疾病手术患者随机分为两组, 每组258例, 分别采取不同方式处理腰椎小关节突。分别于术后观察腰椎活动度, 随访腰痛改善情况。结果: 两组腰椎活动度无显著差异(P>0 .05)。实验组腰痛完全消失172例, 明显缓解64例, 无变化16例, 术后腰痛加重6例。对照组腰痛完全消失114例, 明显缓解108例, 无变化28例, 加重8例。两者有显著差异(P<0. 05)。结论: 腰痛与腰椎小关节病变有明显关系, 术中切除小关节囊有利于减轻或缓解术后腰痛。