硬膜外间隙注药配合牵引治疗腰椎间盘突出症

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。     

A Management of Early CRPS I Caused by Ankle Sprain: A Case Report

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.     

Assessing the Stiffness of Spinal Fusion in Animal Models

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.     

腰椎间盘突出的CT诊断价值

腰椎间盘突出是骨科常见病。CT扫描能够显示间盘组织的直接影像，是诊断间盘病变的重要方法。本文对80例腰间盘突出进行分析，探讨CT对腰间盘突出的诊断价值。1 材料和方法 1.1一般资料 选用临床及CT表现均典型病例80例，男13例，女37例，年龄17岁-74岁，病程最短2d，最长22a,     

腰神经通道卡压综合征病因的探讨

为了探讨腰神经通道狭窄的病因，我们对２２４例腰椎间盘突出及腰椎管狭窄症患者进行了腰神经通道探查手术，结果发现其病因以腰部组织变性为主。除外伤及反复慢性腰部损伤引起腰部病变外，活动少，或很少进行腰部锻炼，体形肥胖也是引起腰神经通道狭窄日趋加重的致病因素。在治疗时强调不只满足于切除突出的椎间盘，应沿神经通道探查，清除一切卡压神经根的病变组织才能获得较好的治疗效果。我们随访１９７例，平均随访３ａ，优良率９３５％。     

经皮弧式椎间盘切除器械治疗腰5骶1椎间盘突出症初步报告

采用经皮弧式椎间盘切除器械治疗Ｌ_５～Ｓ_１椎间盘突出症２２例，２１例成功。术后优良率为８６．４％。该器械能够避开髂嵴阻挡进入Ｌ_５～Ｓ_１椎间隙，并增加椎间盘切除量，提高经皮Ｌ_５～Ｓ_１椎间盘切除成功率。定位正确是成功的关键。     

The biomechanics of vibration and low back pain

This work is a review of the mechanical factors related to low back pain production in a vibration environment. The sitting posture is an extreme orientation for the lumbar intervertebral disc that 1) increases its internal pressure, 2) increases its anteroposterior shear flexibility, while: 3) decreasing its resistance to buckling instability and 4) stressing the posterior region of the disc. Vibration is an additional mechanical stressor. Several studies suggest that the following preventive measures be taken to reduce the risk of low back pain due to driving: 1) minimize the vibration reaching the driver, 2) avoid lifting or bending immediately following driving, and 3) walk around for a few minutes following driving. © 1993 Wiley-Liss, Inc.     

开式涡轮转盘塔的操作区域

考察了开式涡轮转盘塔(OTRDC)中的分散相滞留率和液泛特性。采用五种不同的液-液体系,在两种不同直径的塔中进行了实验。给出了估算分散相滞留率的关联式及无传质时临界转速的判据,进而大体上确认了OTRDC的操作区域。     

免疫反应在实验性游离型腰椎间盘突出自然吸收中的意义

目的：通过检测CD3和IgG在实验性游离型腰椎间盘突出自然吸收中的表达，探讨腰椎间盘突出后能否自然吸收及其可能的吸收机制。方法：将25只成年狗平均分成5组，从L2/3切取髓核组织，置于L5处的硬脊膜外，于术后2，4，6，8，12周，取动物标本以及正常部位的髓核组织，用CD3抗体和抗IgG进行免疫组化检测。结果：约30%的标本局部为脂肪组织，54%的标本局部硬脊膜与骨粘连，16%的标本既无粘连也无脂肪，免疫组化测定显示，随着时间的推移，CD3^ 细胞的浸润程度呈递减趋势，而IgG沉积的分布程度呈递增趋势，正常髓核无CD3^ 细胞浸润，IgG沉积分布极少。结论：在椎管内，狗游离的髓核组织8-12周后可部分或全部自然吸收，其吸收机制是机体自身免疫反应的结果。