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71.
Two-level posterior lumbar interbody fusion for degenerative disc disease: improved clinical outcome with restoration of lumbar lordosis 总被引:2,自引:0,他引:2
Akira Hioki MD Kei Miyamoto MD PhD Hirotaka Kodama MD PhD Hideo Hosoe MD PhD Hirofumi Nishimoto MD Hirofumi Sakaeda MD PhD Katsuji Shimizu MD DMSc 《The spine journal》2005,5(6):600-607
BACKGROUND CONTEXT: Although posterior lumbar interbody fusion (PLIF) for degenerative lumbar diseases is routine, there are few reports on double-level PLIF. PURPOSE: To evaluate the clinical outcomes of double-level PLIF. STUDY DESIGN/SETTING: A retrospective study of operated cases in Gifu, Japan. PATIENT SAMPLE: Nineteen patients (8 men and 11 women, 59.5+/-10.2 years) who underwent double-level PLIF between 1996 and 2001. OUTCOME MEASURES: Operation time, blood loss, complications, the Japanese Orthopaedic Association (JOA) score for back pain and lumbar sagittal alignment were evaluated. METHODS: Patients were examined retrospectively at follow-ups of 3.6+/-1.7 years. Primary diseases were spondylolisthesis, spinal canal stenosis, degenerative scoliosis and herniated intervertebral disc. Fusion areas were L3 to L5 in 15 cases and L4 to S1 in 4 cases. RESULTS: The mean JOA score increased from an initial score of 12.9+/-3.5 to 21.3+/-4.9 at the final follow-up. There was a positive correlation (R=0.718, p<.001) between the increase in lordotic angle and the increase in the JOA score. Several parameters suggested that the surgical invasiveness was not minimal. CONCLUSION: Double-level PLIF provided satisfactory results and preserved lumbar spine lordosis. 相似文献
72.
白细胞介素-6对椎间盘细胞中蛋白多糖代谢影响的实验研究 总被引:3,自引:0,他引:3
目的:研究白细胞介素-6(interleukin-6,IL-6)对椎间盘纤维环和髓核细胞中蛋白多糖代谢的影响。方法:自然流产的胎儿4例,4h内无菌取出椎间盘,分别进行纤维环和髓核细胞的体外培养。在纤维环细胞的培养液中分别加入IL-60(对照组)、400、800ng/ml,培养24h后,用Alcian法检测培养液中硫酸软骨素的含量。在培养中的髓核细胞中加入IL-60(对照组)、100、400、800ng/ml,培养24h,然后测量培养液中硫酸软骨素的含量。结果:在纤维环细胞中加入IL-6组较不加IL-6对照组培养液中硫酸软骨素的含量增加,在髓核细胞组中加入IL-6组和对照组的差别无显著性。结论:IL-6可以刺激椎间盘纤维环细胞中蛋白多糖的合成,但对髓核细胞中蛋白多糖的合成没有明显的作用。 相似文献
73.
儿童颈椎间盘钙化症(cervical incervertebral dise calcification in children)是一种少见的疾病。1924年Baron首先报道本病.国内1982年至今陆续报道,迄今仅百余例。作者经治儿童颈椎间盘钙化症5例.结合文献对其诊断和治疗加以讨论。 相似文献
74.
目的 探 讨极 外 型腰 椎间 盘 突出 症患 者 的临 床特 点 与神 经节 位 置的 相关 性 方 法:通过 术前 神 经根 造影 : 。确定 受压 神 经根 的背 根 神经 节的 位 置,根 据 其神 经节 的 位置 ,将 27 例极 外侧 腰 椎间 盘突 出 症患 者 分为 三 组 :椎管内 组,5 例;椎间 孔内 组 ,15 例 ;椎 间孔 外组 ,7 例 。分 别比 较神 经 节的 位置 与 临床 参数 ,如 受压 神 经根 的水 平 ,直腿 抬高 试 验的 度数 ,术 前和 术 后症 状(腿痛 ,下 腰痛 和 行走 能力 )及 体 征(感 觉 和运 动障 碍 )的 严重 程 度 及 与恢复率 之间 的 关系 。结 果:与椎 管 内和 椎间 孔 内组 相比 ,椎 间孔 外 组患 者直 腿 抬高 试验 的 度数 较低 ,下 腰 痛的 程度较轻 ,术 前的 腿痛 明 显重 ,而 行走 能 力低 于椎 管 内和 椎间 孔 组。 背根 神 经节 的位 置 与术 前的 感 觉和 运 动 障 碍以及手 术效 果 没有 明显 差 异。结论 :神 经节 的 位置 会影 响 极外 型腰 椎 间盘 突出 患 者根 性症 状 (腿痛 和 行走 能力 )的严重 程度 。 相似文献
75.
Osamu Yokota Kuniaki Tsuchiya Yoshimasa Noguchi Hisamasa Akabane Hideki Ishizu Yukinobu Saito Haruhiko Akiyama 《Neuropathology》2007,27(6):539-550
We report a case of a 68‐year‐old right‐handed man with sporadic amyotrophic lateral sclerosis (ALS) and argyrophilic grain disease (AGD) having a 22‐month duration. His initial symptoms were dysarthria and swallowing difficulty at the age of 67. Subsequently bulbar palsy and pyramidal signs developed. His cognitive functions including face recognition, personality, and behavior were not changed compared with that of before the disease onset. However, magnetic resonance imaging disclosed severe right side‐predominant temporal atrophy. The neurological diagnosis was bulbar type ALS. Pathological examination disclosed histological evidence of ALS, including loss of Betz cells and lower motor neurons, corticospinal tract degeneration, and Bunina bodies. In addition, severe neuronal loss in the bilateral temporal cortex with an anterior gradient was found. Ubiquitin‐positive inclusions were encountered in the spinal anterior horn cells and hippocampal dentate gyrus, while few ubiquitin‐positive inclusions were noted in the affected temporal cortex. The amygdala, especially the basolateral nuclear group, was severely affected by neuronal loss with tissue rarefaction. Moderate neuronal loss was encountered in the parahippocampal gyrus, and to a lesser degree, in the ambient gyrus. Unexpectedly, many argyrophilic grains, coiled bodies, tau‐positive bush‐like astrocytes, pretangles, and ballooned neurons were found in the limbic system and temporal cortex. In the hippocampus, selective tau accumulation with minor neurofibrillary changes was observed in CA2 neurons. The present case suggests that (i) ALS and AGD do rarely coexist, and (ii) when ALS patients have severe temporal atrophy, not only ALS with dementia but also concurrent AGD should be considered in the differential diagnosis. 相似文献
76.
李利琼 《中国医学研究与临床》2007,5(2):43-44
目的观察硬膜外间隙注药配合牵引治疗腰椎间盘突出症。方法162例经体查,X线、CT、MRI摄片确诊为腰椎间盘突出症。硬膜外间隙注入利多卡因lmg/kg与强的松龙lmg/kg的混合液10ml,注药1次/7d,3次为一疗程。并行牵引4h/d。结果疗效优良率94.4%。结论此疗效确切。 相似文献
77.
78.
Kulbir S. Walia MD ; Daniel E. Muser MD ; Shariq S. Raza MD ; Tricia Griech MSPT ; Yasin N. Khan MD 《Pain practice》2004,4(4):303-306
Abstract: We present a case of a 13-year-old boy who developed signs and symptoms of neuropathic pain/early Complex Regional Pain Syndrome (CRPS) Type I, formerly known as Reflex Sympathetic Dystrophy (RSD), after spraining his ankle while wrestling. Aggressive pain control, using medications and sympatholytic blocks, with physical therapy and rehabilitation, led to the resolution of his painful condition. This prevented the disease from possibly progressing to a full-blown case of CRPS I (RSD) that is very challenging to treat. 相似文献
79.
80.
Jocelyn M. Cottrell BS Marjolein C. H. van der Meulen PhD Joseph M. Lane MD Elizabeth R. Myers PhD 《HSS journal》2006,2(1):12-18
The clinical goal of spinal fusion is to reduce motion and the associated pain. Therefore, measuring motion under loading
is critical. The purpose of this study was to validate four-point bending as a means to mechanically evaluate simulated fusions
in dog and rabbit spines. We hypothesized that this method would be more sensitive than manual palpation and would be able
to distinguish unilateral vs bilateral fusion. Spines from four mixed breed dogs and four New Zealand white rabbits were used
to simulate posterolateral fusion with polymethyl methacrylate as the fusion mass. We performed manual palpation and nondestructive
mechanical testing in four-point bending in four planes of motion: flexion, extension, and right and left bending. This testing
protocol was used for each specimen in three fusion modes: intact, unilateral, and bilateral fusion. Under manual palpation,
all intact spines were rated as not fused, and all unilateral and bilateral simulated fusions were rated as fused. In four-point
bending, dog spines were significantly stiffer after unilateral fusion compared with intact in all directions. Additionally,
rabbit spines were stiffer in flexion and left bending after unilateral fusion. All specimens exhibited significant differences
between intact and bilateral fusion except the rabbit in extension. For unilateral vs bilateral fusion, significant differences
were present for right bending in the dog model and for flexion in the rabbit. Unilateral fusion can provide enough stability
to constitute a fused grade by manual palpation but may not provide structural stiffness comparable to bilateral fusion. 相似文献