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Ch. Probst 《Acta neurochirurgica》1990,107(1-2):30-36
Summary Using an improved microsurgical technique, cordotomy was carried out by the cervicothoracic route in 20 patients with persistent radicular pain due to epi-/intradural fibrosis following operation for lumbar disc herniation. 65% of them had good long-term results with respect to radicular pain (follow-up period 6–132 months; mean 66 months). Permanent severe motor impairment was not observed. In patients with severe pain of benign organic origin microsurgical cordotomy can be considered as a last resort. 相似文献
104.
E. Anker-Møller N. Spangsberg J. B. Dahl E. F. Christensen P. Schultz P. Carlsson 《Acta anaesthesiologica Scandinavica》1990,34(6):468-472
In 20 patients a continuous block of the lumbar plexus was administered after knee-joint surgery, and the analgesic effect of two different concentrations of bupivacaine was compared. The same volume of bupivacaine was given to both groups of patients: a bolus dose of 0.4 ml/kg, 0.5% or 0.25%, followed by infusion of 0.14 ml/kg/h, 0.25% or 0.125%, respectively, via a catheter placed in the neurovascular fascial sheath of the femoral nerve according to the "3-in-1 block" technique. The median morphine consumption during the first 16 h postoperatively was 6.0 mg when bupivacaine 0.5/0.25% was used and 9.5 mg when 0.25/0.125% was used. This difference is not significant. The visual analogue pain scores were also similar in the two groups (P greater than 0.05). All plasma concentrations were below 4 micrograms/ml, the highest concentration measured being 3.6 micrograms/ml. It is concluded that when used for a continuous block of the lumbar plexus after knee-joint surgery, bupivacaine in a concentration of 0.125% offers the same pain relief as a concentration of 0.25%, and the risk of toxic reactions is reduced. 相似文献
105.
M. W. Berfelo 《European spine journal》1993,2(2):89-95
Summary A new kinematic concept is described that relates to the notion that the lumbar spine behaves as a complete structure. This concept is called the R-zero line and represents kinematically the neutral position of the lumbar spine between anteflexion and retroflexion. The clinical significance of this parameter is evaluated in normal individuals and in patients with a symptomatic herniated disc at L4–5, with a symptomatic herniated disc at L5–S1, and with spondylolysis/spondylolisthesis. The results of this study show that the R-zero line has a characteristic configuration in all four test groups. 相似文献
106.
Percutaneous endoscopic lumbar discectomy (PELD) is a new technique for the decompression of the lumbar disc space and removal of nucleus pulposus via a posterolateral approach. The technique was introduced in Germany by the authors in April 1987. The method is indicated in patients with non-equestrated lumbar disc herniation with an intact lorsal longitudinal ligament. In local anesthesia, a working cannula (OD 5 mm) is placed at the dorsal lateral border of the disc. The disc space is opened with anulus trephines and the nucleus pulposus is removed with rigid and flexible forceps as well as with automated shaver systems under intermittent endoscopic control (discoscopy). The procedure is performed in local anesthesia. The results of the first thirty patients with a follow-up time between 6 months and 17 months could be graded as excellent in 13 cases, as good in 9 cases, as fair in 6 cases, and as bad in 2 cases. The relief of symptoms as judged by the patients was between 70–100 percent in the majority of the cases. Three patients had to be reoperated at the same level and site, because of either persistent or recurrent sciatica. The performance in local anesthesia, the atraumatic extraspinal approach, the reduced time of hospitalization and post-operative morbidity as well as the reduced time of work incapability are the main advantages of this new method. 相似文献
107.
腰椎穿刺蛛网膜下腔置管持续引流防治脑血管痉挛的初步观察 总被引:21,自引:3,他引:18
目的:探讨腰椎蛛网膜下腔置管持续引流对蛛网膜下腔出血(SAH)后脑血管痉挛的预防与治疗效果。方法:对88例颅内动脉瘤性SAH患,在超早期行电解可脱卸弹簧圈(GDC)栓塞术后,实施腰椎蛛网膜下腔置管持续引流,通过临床症状、经颅多普勒超声(TCD)及脑血管造影、ECT判断血管痉挛的发生率及严重程度。结果:11例出现症状性脑血管痉挛,平均随访11个月,恢复良好10例,中度致残1例。无引流相关并发症。结论:腰椎蛛网膜下腔置管持续引流可以清除蛛网膜下腔积血、引流血管收缩物质,预防血管痉挛的发生及缓解痉挛程度。 相似文献
108.
[目的 ]探讨非手术方法治疗腰椎间盘突出症的疗效 .[方法 ]将 98例腰椎间盘突出症患者分成腰痛组和腿痛组 ,前者采用骶管阻滞加严氏椎间隙阻滞法 ,后者采用骶管阻滞加腰大肌肌沟阻滞法 .[结果 ]两组治疗前后分值相比较均有显著性差异 ,其优良率分别为 88%和 84% .[结论 ]采用骶管阻滞加严氏椎间隙阻滞或腰大肌肌沟阻滞法治疗腰椎间盘突出症具有疗效 相似文献
109.
110.
腰椎间盘突出症继发马尾神经综合征手术治疗的疗效 总被引:9,自引:0,他引:9
目的:研究腰椎间盘突出症继发马尾神经综合征手术治疗的疗效。方法:对67例腰椎间盘突出症并发马尾神经综合征的患者发病因素、病程、影像学的表现特征、手术时机的选择同其治疗的随访结果进行综合分析。随访时间3个月至3.5年,平均1年4个月。结果:急性发病的患者其手术时机的选择同患者功能恢复的优良率有关,发病1周、2周、1个月、1个月以上疗效优良率分别为72.22%,63.64%,50.00%,33.33% 相似文献