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81.
腰椎间盘突出症再次手术诊治体会 总被引:1,自引:0,他引:1
目的:总结腰椎间盘再次手术诊治的临床经验。方法:1998年来,对50例腰椎间盘术后腰腿痛复发患者进行了再次手术,对其临床资料进行回顾性分析。结果:50例患者共61个节段进行了再次手术,术后随访3~50个月,术后优良率为82%。结论:医源性因素是腰椎间盘手术失败的重要原因。通过完善的术前检查和恰当的手术技巧,腰椎间盘突出症再次手术可望获得良好的疗效。 相似文献
82.
平衡针灸治疗腰椎间盘突出症临床观察 总被引:9,自引:0,他引:9
运用平衡针法,针刺臀痛穴、腰痛穴等平衡穴位,配合电针夹脊穴治疗腰椎间盘突出症,取得理想治疗效果。 相似文献
83.
《Journal of Manual and Manipulative Therapy》2013,21(3):154-163
AbstractThis literature review discusses the epidemiology and etiology of thoracic disc lesions and describes signs and symptoms, diagnostic procedures, differential diagnosis, and treatment. Data presented in case series reports published between 1985-2001 is summarized: Thoracic disc herniations are more common than previously thought. They may cause mild, moderate, severe or confusing symptoms or be asymptomatic; 49% of cases were in men and 51% in women. Trauma was a precipitating factor in 31%; multiple herniations were reported in 9%. In symptomatic cases, 57% of patients presented with radicular pain, 48% with back pain, 63% with weakness, 60% with sensory complaints, 25% with bowel or bladder symptoms, and 59% with hyperreflexia. Typical presentations of upper, middle, and lower thoracic disc are summarized. Diagnosis is made by correlating clinical signs and symptoms with the results of diagnostic imaging. Surgery is recommended for patients with progressive neurological dysfunction. Research on the efficacy of conservative treatment is lacking in the literature. 相似文献
84.
Background contextLumbar intradural disc herniation (IDH) is rare, and intradural cyst associated with IDH is quite rare. Only seven cases of an intradural cyst associated with lumbar disc herniation have been reported, and all were gas-filled cysts. We report the first case, to our knowledge, of a fluid-filled intradural cyst associated with IDH.PurposeTo report an extremely rare case of a fluid-filled intradural cyst associated with lumbar IDH and suggests the possible pathogenesis.Study designCase report.MethodsAn 82-year-old woman presented with right leg pain and motor weakness. Computed tomography and magnetic resonance imaging (MRI) scans showed calcified lumbar disc herniation and an intradural cystic mass at the L1–L2 level. An MRI, which was performed 2 years before admission, showed an IDH without a cyst at the same level.ResultsSurgical resection of the intradural cyst was performed. Intraoperative finding showed a fluid-filled intradural cyst with 1-cm diameter of displacing nerve rootlets. The cyst was connected with extradural cystic components through a ventral dural hole, but the tract was blocked by fibrous septum. Histopathologic examination showed a pseudocyst that consisted of degenerative cartilaginous and fibrous tissues, including degenerative disc materials. We concluded that the cyst was an intradural cyst transformed from the intradural disc fragment.ConclusionsThe current case is the first report to our knowlege of a fluid-filled intradural cyst associated with IDH. The possible mechanism may be focal degeneration and spontaneous absorption of the intradural disc with fluid production. Unlike the gas-filled intradural cysts, the cause of the pure fluid-filled cyst may be disconnection from the intervertebral vacuum because of a calcified disc and septation of the cyst. 相似文献
85.
目的:观察中医保守治疗腰椎间盘突出症的疗效。方法:收集300例腰椎间盘突出症患者,采用一般治疗及药物、牵引、针灸、推拿、物理的中医保守疗法治疗1-3个疗程,随访3个月评估疗效。结果:总有效率98.67%。结论:中医保守治疗腰椎间盘突出安全有效。 相似文献
86.
87.
《Radiography》2018,24(1):52-56
IntroductionNerve root block (NRB) and facet block (FB) are viable options for pain arising from facet and lumbar disc herniation (LDH) not responding to conservative therapy but still not suitable for surgery. Classically, they are performed under fluoroscopy and computed tomography (CT) guidance, which have the disadvantages of radiation exposure and limited accessibility. The aim of this study was to assess the effectiveness of US guided FB and NRB in patients suffering from facet arthropathy and LDH.Methods14 patients were involved in the study. After defining nerve root (for NRB) or facet joints (for FB) under a standard US investigation, real-time injection of methylprednisolone and bupivacaine was performed. Pain was measured before and after procedure by VAS.ResultsTen patients underwent FBs (8 bilateral and 2 unilateral) and 4 underwent NRBs (2 bilateral and 2 unilateral). 11/14 (79%) patients improved after the block (8 in FB, 3 in NRB) and the VAS had significantly decreased 1 week after procedure (mean [range] −1.7 [−6 to 0]). For the 11 patients that improved after FB or NRB, the effect lasted for a mean of 59 days (range: 30–130 days). Analysis showed that neither block procedure (NRB vs. FB) nor block level (L4L5 vs. L5S1) had an effect on result.ConclusionsResults of our preliminary study shows that in appropriately selected patients, nerve root and facet blocks can be effectively performed under ultrasonography guidance without notable complications, with effects lasting for a mean 2 months. 相似文献
88.
Nurul Haiza Sapiee Ashvin Thambyah Peter A. Robertson Neil D. Broom 《The spine journal》2019,19(3):532-544
BACKGROUND CONTEXT
The cartilaginous and bony material that can be present in herniated tissue suggests that failure can involve both cartilaginous and vertebral-endplates. How structural integration is achieved across the junction between these two distinct tissue regions via its fibril and mineral components is clearly relevant to the modes of endplate failure that occur.PURPOSE
To understand how structural integration is achieved across the cartilaginous-vertebral endplate junction.STUDY DESIGN
A micro- and fibril-level structural analysis of the cartilage-vertebral endplate region was carried out using healthy, mature ovine motion segments.METHODS
Oblique vertebra-annulus-vertebra samples were prepared such that alternate layers of lamellar fibers extended from vertebra to vertebra. The endplate region of each sample was then decalcified in a targeted manner before being loaded in tension along the fiber direction to achieve incomplete rupture within the region of the endplate. The failure regions were then analyzed with differential interference contrast microscopy and scanning electron microscopy.RESULTS
Microstructural analysis revealed that failure within the endplate region was not confined to the cement line. Instead, rupture continued into the underlying vertebral endplate with bony material still attached to the now unanchored annular bundles. Ultrastructural analysis of the partially ruptured regions of the cement line revealed clear evidence of blending/interweaving relationships between the fibrils of the annular bundles, the calcified cartilage and the bone with no one pattern of association appearing dominant. These findings suggest that fibril-based structural cohesion exists across the cement line at the site of annular insertion, with strengthening via a mechanism somewhat analogous to steel-reinforced concrete. The fibrils are brought into a close intermingling association with interfibril forces mediated via the mineral component.CONCLUSIONS
This study provides clear evidence of structural connectivity across the cartilaginous-vertebral endplate junction by the intermingling of their fibrillar components and mediated by the mineral phase. This is consistent with the clinical observation that in some disc herniations bony material can be still attached to the extruded soft tissue. 相似文献89.
Tullio Valente Giovanni Rossi Francesco Lassandro Gaetano Rea Maurizio Muto 《Clinical anatomy (New York, N.Y.)》2013,26(8):1008-1013
Isolated herniation of the pancreas through a gastroesophageal hiatus is an extremely rare condition, and only one case has been reported in the world literature. We describe a MDCT diagnosis of isolated partial hiatal hernia containing the body of a normal pancreas in an asymptomatic patient, give an anatomical explanation and review the corresponding literature. Clin. Anat. 26:1008–1013, 2013. © 2013 Wiley Periodicals, Inc. 相似文献
90.
《Neuro-Chirurgie》2021,67(6):624-627
BackgroundSpinal cord herniation (SCH) remains a challenging diagnosis for neuroradiologists and may require treatment challenging for neurosurgeons. Most cord herniations are usually found at anterior thoracic levels.Clinical presentationA 28-year-old woman presented at our department with a 7-year history of progressive myelopathy. MR analysis showed a displacement of the spinal cord in a lateral thoracic dural defect. The herniated cord was released using a microscope and the patient significantly recovered 6 months after surgery.ConclusionWe present a unique case of pure lateral SCH. In the light of reviewed literature and operative findings, the underlying pathophysiological mechanisms are discussed. 相似文献