Lumbar disc herniation in teenagers

Summary We report 48 patients operated on for lumbar disc herniation in the second decade of life (aged 13–20 years) in our Neurosurgical Division. To analyze the clinical and diagnostic features and surgical outcome of the disease in teenagers and to point out any differences from adults, we made a detailed study of over 900 juvenile cases and compared them with 11000 adult cases reported in the literature. Low-back pain proved to be less frequent among youngsters both as a first symptom and at diagnosis, while sensorimotor deficits have the same frequency in the two age groups. Herniation occurs more often at L4–L5 and is more frequently median among teenagers. The long-term surgical results in children and adolescents are better than in adults.     

Histochemical and ultrastructural observations on brown degeneration of human intervertebral disc

Thirty-eight fresh human intervertebral discs collected during anterior interbody fusion surgery were histochemically and ultrastructurally analyzed for pigments. Macroscopically, five stages of degeneration were classified according to the color, fibrosis, and fragility of the nucleus pulposus of the discs. In order to demonstrate lipofuscin granules, specimens were subjected to special staining procedures, including carbol fuchsin lipofuscin stain, the Schmorl's reaction, and autofluorescence. Lipofuscin granules were distributed from the inner layer of the annulus fibrosus to the nucleus pulposus. Such granules were numerous in cases of slight or severe degeneration, whereas fewer granules were found in cases of moderate degeneration. However, the stage of macroscopic degeneration of the intervertebral disc did not necessarily correlate with the incidence of lipofuscin granules. By ultrastructural observation, the morphological features of the components of the intervertebral disc and the ultrastructure of the lipofuscin granule were clarified. The ultrastructure of the "brown degeneration" disc exhibited markedly increased amorphous electron-dense bodies located among collagen fibrils in the matrix.     

针刺、自主牵引、药物外敷治疗腰椎间盘突出症疗效观察

目的 :观察针刺、自主牵引、药物外敷治疗腰椎间盘突出症 (简称治疗组 )的疗效。方法 :随机分为针刺、自主牵引、药物外敷组和单纯针刺组进行对比观察。结果 :治疗组总有效率 94 .1% ,明显高于对照组 75 .8% ,经统计学处理 ,P <0 .0 5 ,具有显著性差异。结论 :治疗组疗效优于对照组     

经椎板间隙入路显微内窥镜手术治疗腰椎间盘突出症

目的：探讨经椎板间隙入路显微内窥镜手术治疗腰椎间盘突出症的手术适应证，手术存在问题及解决方法。方法：用METRX治疗腰椎间盘突出症l16例，详细介绍手术过程、操作技巧、手术适应证和术中注意问题。结果；平均随访15．1个月，按Nakal疗效评定分级属优90例，良22例，可2例，差2例，优良率96．6％。结论：严格掌握手术适应证、准确定位、娴熟操作技巧、彻底止血、术后有计划的康复训练是手术成功的关键。     

药敏纸片的质量控制研究

目的：探讨和研究药敏纸片质量控制的方法。方法：以克拉霉素药敏纸片为例，参照美国临床实验室标准化委员会(NCCLS)和联邦法规全书(CFR)的方法，建立一套药敏纸片质量控制的指标，包括鉴别、检查及含量测定。结果：采用专属性较强、灵敏度较高的TLC法进行鉴别，最低检出量为50μg；制订纸片的的直径、重量差异、含量均匀性及干燥失重作为检查项，采用短小芽孢杆菌(Bacillus pumilus)[CMCC(B)63202]作为检定菌，进行含量测定。结论：建立的克拉霉素药敏纸片质量标准能够控制其质量，可作为其他抗生素药敏纸片建立质量标准的参考。     

"脊柱九针疗法"治疗腰椎间盘突出症40例

目的　观察采用“脊柱九针疗法”治疗腰椎间盘突出症的疗效。方法与结果　选择 4 0例经 CT检查确诊为腰椎间盘突出症 ,并有典型临床症状的患者作为研究对象 ,选用突出椎间盘的相应椎体及上下两个节段椎体棘突下和“夹脊穴”为主进针点 ,针刺治疗腰椎间盘突出症 ,总有效率为 10 0 %。结论　“脊柱九针疗法”较常规针刺取穴方法具有针对性强 ,针感强 ,疗效明显之特点 ,且取穴简便 ,操作简单安全。     

腰椎间盘退变动物模型的建立

目的　建立腰椎间盘退变的动物模型并行组织学和MRI观察。　方法　健康成年恒河猴 8只 ,手术组 6只 ,在其腰4 ,5、腰5,6、腰6,7椎间盘分别作一 5mm× 3mm切口 ,分别于术前及术后 1、4、8、13、2 0周对手术椎间盘行MRI观察 ;8只恒河猴分别于术前 (对照组 )及术后 4、8、2 0周随机取 2只处死后行椎间盘组织学观察。　结果　正常成年恒河猴腰椎间盘组织学结构特点与人类相似 ;手术椎间盘高信号区域面积的百分比于术后 8、13、2 0周显著减少 (P <0 0 5 ) ;术后 4周椎间盘切口外被纤维组织覆盖 ,术后 8周 ,切口外层纤维样愈合 ,其内无愈合迹象 ,术后 2 0周 ,切口向椎间盘内延伸 ,部分髓核出现纤维化。　结论　恒河猴是一种生理特性与人类相接近的动物 ,以其为对象应用纤维环切开法可以获得可靠的腰椎间盘退变动物模型 ;通过测量MRI轴位T2加权像椎间盘高信号区域面积百分比的方法可于早期无损伤地发现椎间盘退变。     

Acupuncture treatment of 32 cases of lumbar intervertebral disc protrusion

Yaoyangguan (GV 3), Shiqizhui (Ex-B 8) and Yanglingquan (GB 34) were selected as main points and a three-part needle insertion technique was used to treat 32 cases of lumbar intervertebral disc protrusion. The curative rate was 96.9%. Deep puncture is the key to the treatment. Author: Chen Feng(1962-), male, junior consultant doctor Translator: Wang Si-you     

七叶皂苷钠治疗椎间盘突出症的临床疗效

目的:对七叶皂苷钠与甘露醇 地塞米松用于椎间盘突出症的治疗进行临床疗效分析比较.方法:通过回顾性病案分析,对两组资料进行对比统计.结果:两组的临床资料差异无显著性(P＞0.05),但七叶皂苷钠组的治疗效果优于甘露醇 地塞米松组,有统计学差别(P＜0.05).结论:两组药物均为临床有效治疗药物.七叶皂苷钠比甘露醇 地塞米松在治疗效果方面有一定的优势.     

SOMATOM PLUS 4 CT NVRAM故障的排除

文章分析了SOMATOM PLUS 4的NVRAM故障原因,并介绍了该故障的排除方法.