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排序方式: 共有5467条查询结果,搜索用时 15 毫秒
41.
目的:评价一期后、前路手术治疗发育性颈椎管狭窄合并巨大椎间盘突出的特点及疗效。方法:回顾分析2002年2月至2006年1月接受该术式的21例患者的临床资料,对手术前后临床表现、JOA评分、MRI影像变化以及术后神经功能改善率及并发症进行总结分析。结果:术后未发生神经系统症状加重、感染及内固定失效等并发症。获得1年以上随访者21例,平均随访时间为29.2个月,术后3个月、12个月时神经功能改善率分别为:58%、66%;16例获得2年以上随访者神经功能改善率为71%。结论:一期后、前路手术治疗发育性颈椎管狭窄合并巨大椎间盘突出可缩短治疗周期,相对节省治疗费用,同时解除了硬膜囊前、后方的压迫,减压彻底,疗效满意。 相似文献
42.
43.
A prospective study in 31 patients was designed to compare contrast quantitatively using axial conventional, gated spin-echo T2-weighted (T2W) (SE) (asymmetrical echo TE 30 and 80 ms) and axial dual-echo fast spin-echo (FSE) sequences (TEeff20 and 120 ms) to image lumbar discs, nerve roots, and cerebrospinal fluid CSF. We used two quantitative measures, percent (%) contrast and contrast-to-noise ratio (CNR), to compare the sequences. The FSE sequence had greater % contrast and CNR on the first and second echo images for both disc and nerve root detection using these scan parameters. An axial FSE sequence, therefore, provided contrast characteristics similar to those of gated axial T2W SE sequence in the lumbar spine, with a 60% saving in acquisition time. The FSE sequence is now our standard axial T2W study for the lumbar spine. 相似文献
44.
Disc herniation in the lumbar spine during growth: Long-term results of operative treatment in 18 patients 总被引:1,自引:0,他引:1
M. Poussa D. Schlenzka S. Mäenpää J. Merikanto P. Kinnunen 《European spine journal》1997,6(6):390-392
We studied 18 patients who had undergone surgery for herniated lumbar discs between the ages of 11 and 17 years. The inclusion criteria for girls was an age of 15 years or below and for boys 17 or below at surgery. The mean follow-up time was 10 years and the clinical outcome was good. Age at surgery and length of the follow-up had no effect on the result. The radiological disc height at follow-up did not correlate with the follow-up time or age of the patient at operation. MRI scans at follow-up from ten patients operated at less than 15 years of age revealed multilevel disc degeneration but favourable clinical results. 相似文献
45.
This report describes an experimental model of chronic tonsillar herniation and its effects on the spinal cord. In ten rats, a small piece of chemically induced mammary cancer was transplanted to the supraoccipital bone. In all cases, the transplanted cancers grew into the posterior fossa, destroying the supraoccipital bone and compressing the cerebellum extradurally. In six of the ten rats, tonsillar herniation was observed at 8–14 weeks after transplantation. Transdural infiltration of the tumor cells was not apparent in any animal. In those rats with tonsillar herniation (n=6), the spinal cord from the C5 to the T8 segments showed enlargement of the central canal without exception. Histological examination revealed the following changes: stretching and thinning of the ependymal cells; swelling of the astrocytic processes; and extracellular edema, predominantly in the dorsal gray matter, but also in the ventral inner portion of the dorsal column. In the control group (n=4) and those rats without tonsillar herniation (n=4), such histological changes of the spinal cord were not observed. Although the lesions can not be regarded as representing mature syringomyelia, they most likely constitute an earlier evolutionary stage. 相似文献
46.
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目的 探讨腹腔镜食道裂孔疝修补术的可行性及安全性。方法 回顾性分析 2 0 0 1年 3月至 2 0 0 3年12月天津南开医院行腹腔镜食道裂孔疝修补术 11例病人的临床资料。结果 10例行裂孔疝修补后同时行胃底折叠术 ,其中 7例行Nissen胃底折叠术 ,3例行Toupet胃底折叠术 ,1例仅行裂孔修补术。术后症状完全缓解。食道下段压力由 (8 6± 2 4 )mmHg(1mmHg =0 133kPa)提高到 (18 2 0± 3 4 3)mmHg(P <0 0 1) ,2 4hpH值监测评分由 5 3 4± 39 7降低到 8 0 4± 2 12 (P <0 0 1) ,较手术前有明显改善 ,并达到正常范围。无手术并发症 ,无中转开腹及死亡病例。结论 对于食道裂孔疝 ,腹腔镜食道裂孔疝修补术是一种安全、有效的治疗方法 相似文献
47.
A new technique for the treatment of lumbar far lateral disc herniation: technical note and preliminary results 总被引:2,自引:0,他引:2
A newly designed technique for a minimally invasive approach to the laterally herniated disc is presented. Fifteen patients suffering from far lateral disc herniation (extraforaminal) were operated according to this technique. Through a small skin incision (1.5 cm), the paraspinal muscles are spread by dilators, until a working channel of 9 mm inner diameter and 11 mm outer diameter can be placed. The next steps are done through this channel using the surgical microscope. No bone resections are necessary and the facet joints are left untouched. However, partial resection of the intertransverse ligament may be necessary. The mean follow-up period for these 15 patients was 11.5 months, and they were evaluated by using the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). The average surgical time was 43 min. The ODI improved from 30.6 (preoperative) to 14.3 (postoperative). The VAS of leg pain improved from 7 (preoperative) to 3.6 (postoperative), which represented a statistically significant improvement at the significance level of (P<0.01). No intra-operative or early postoperative complications occurred. However, one recurrence did occur, which was treated by the same technique. This technique combines the advantages of three-dimensional visual control (operating microscope) with the minimal surgical trauma of endoscopic techniques, while avoiding some of the shortcomings of both the microsurgical and endoscopic techniques. 相似文献
48.
Modic changes following lumbar disc herniation 总被引:4,自引:3,他引:1
Only a small proportion (20%) of patients with LBP can be diagnosed based on a patho-anatomical entity. Therefore, the identification
of relevant subgroups, preferably on a patoanatomical basis, is strongly needed. Modic changes have been described by several
authors as being closely linked with LBP. The aims of this study were to describe the prevalence of Modic changes, their development
as well as their association to LBP, previous disc contour, and surgery in patients with previous severe sciatica. This is
a longitudinal cohort study where the patients were recruited from an RCT comparing two active conservative treatments, the
181 patients, who at baseline had radicular pain in or below the knee; all underwent a physical examination and MRI. MRI’s,
pain history and physical examination of 166 patients were obtained at follow-up 14 months later. The prevalence of Modic
changes type 1 increased from 9% at baseline to 29% at follow-up. At that time, a strong association between Modic changes
and non-specific LBP was noted. Apparently, Modic changes type 1 was more strongly associated with non-specific lumbar pain
than Modic changes type 2. The development of new Modic changes was closely related to the level of a previous disc herniation.
A lumbar disc herniation is a strong risk factor for developing Modic changes (especially type 1) during the following year.
Furthermore, Modic changes are strongly associated with LBP. 相似文献
49.
A prospective and controlled study of training after surgery for lumbar disc herniation (LDH). The objective was to determine
the effect of early neuromuscular customized training after LDH surgery. No consensus exists on the type and timing of physical
rehabilitation after LDH surgery. Patients aged 15–50 years, disc prolapse at L4–L5 or L5–S1. Before surgery, at 6 weeks,
4, and 12 months postoperatively, the following evaluations were performed: low back pain and leg pain estimated on a visual
analog scale, disability according to the Roland–Morris questionnaire (RMQ) and disability rating index (DRI). Clinical examination,
including the SLR test, was performed using a single blind method. Consumption of analgesics was registered. Twenty-five patients
started neuromuscular customized training 2 weeks after surgery (early training group=ETG). Thirty-one patients formed a control
group (CG) and started traditional training after 6 weeks. There was no significant difference in pain and disability between
the two training groups before surgery. Median preoperative leg pain was 63 mm in ETG and 70 mm in the CG. Preoperative median
disability according to RMQ was 14 in the ETG and 14.5 in the CG. Disability according to DRI (33/56 patients) was 5.3 in
the ETG vs. 4.6 in the CG. At 6 weeks, 4 months, and 12 months, pain was significantly reduced in both groups, to the same
extent. Disability scores were lower in the ETG at all follow-ups, and after 12 months, the difference was significant (RMQ
P=.034, DRI P=.015). The results of the present study show early neuromuscular customized training to have a superior effect on disability,
with a significant difference compared to traditional training at a follow-up 12 months after surgery. No adverse effects
of the early training were seen. A prospective, randomized study with a larger patient sample is warranted to ultimately demonstrate
that early training as described is beneficial for patients undergoing LDH surgery. 相似文献
50.
Disc replacement using Pro-Disc C versus fusion: a prospective randomised and controlled radiographic and clinical study 总被引:4,自引:0,他引:4
A. Nabhan F. Ahlhelm T. Pitzen W. I. Steudel J. Jung K. Shariat O. Steimer F. Bachelier D. Pape 《European spine journal》2007,16(3):423-430
Anterior cervical discectomy and fusion (ACDF) may be considered to be the gold standard for treatment of symptomatic degenerative
disc disease within the cervical spine. However, fusion of the segment may result in progressive degeneration of the adjacent
segments. Therefore, dynamic stabilization procedures have been introduced. Among these, artificial disc replacement by disc
prosthesis seems to be promising. However, to be so, segmental motion must be preserved. This, again, is very difficult to
judge and has not yet been proven. The aim of the current study was to first analyse the segmental motion following artificial
disc replacement using a disc prosthesis. A second aim was to compare both segmental motion as well as clinical result to
the current gold standard (ACDF). This is a prospective controlled study. Twenty-five patients with cervical disc herniation
were enrolled and assigned to either study group (receiving a disc prosthesis) or control group (receiving ACDF, using a cage
with bone graft and an anterior plate.) Radiostereometric analysis was used to quantify intervertebral motion immediately
as well as 3, 6, 12 and 24 weeks postoperatively. Further, clinical results were judged using visual analogue scale and neuro-examination.
Cervical spine segmental motion decreased over time in the presence of disc prosthesis or ACDF. However, the loss of segmental
motion is significantly higher in the ACDF group, when looked at 3, 6, 12 and 24 weeks after surgery. We observed significant
pain reduction in neck and arm postoperatively, without significant difference between both groups (P > 0.05). Cervical spine disc prosthesis preserves cervical spine segmental motion within the first 6 months after surgery.
The clinical results are the same when compared to the early results following ACDF. 相似文献