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排序方式: 共有909条查询结果,搜索用时 15 毫秒
1.
2.
Detailed pathological changes of human lumbar facet joints L1–L5 in elderly individuals 总被引:4,自引:1,他引:3
Facet joints play an important role in intervertebral load transmission and are crucial for rotational kinematics. Clinically, the role of facet joints as a possible source of low back pain is seen as controversial and at present is not sufficiently investigated. In this study, human lumbar facet (zygapopyhysial) joints from donors with advanced age were analyzed macroscopically, for degenerative changes. The aim was to determine the extent and morphology of degenerative changes in these joints. Lumbar facet joints (L1–L5) of 32 donors were studied (mean age 80.1±11.2 years). Joint capsules were carefully removed and joint surfaces (5 zones) examined using magnifying glasses and probes. In the result, the majority of facet joints showed cartilage defects of varying extent. Defects were located mostly at the margins of the articular surface, the central zone being relatively well preserved. Defect localization was different between superior (most cartilage defects in superior zone) and inferior (most defects inferiorly) facets. Further, defects were more severe caudal (level of L5) and in older persons. Osteophytes were present in up to 30%, located mostly at the latero-dorsal enthesis of the joint capsule on the superior facet. In conclusion, most margins of the articular facets are subject to degenerative changes in the lumbar spine of elderly persons, the topographical pattern being different in superior and inferior facets. This observation can be explained by the segmental motion patterns during extension/flexion movements of the facets. Sometimes, due to the marginal extension, it is obvious that not all changes can be assessed by CT or MRI. 相似文献
3.
J. P. Kuhtz-Buschbeck A. Boczek-Funcke M. Illert C. Weinhardt 《The European journal of neuroscience》1994,6(7):1187-1198
With pulsed X-ray cinematography we have analysed the angular excursions of the distal hindlimb joints (proximal interphalangeal, PIP; metatarsophalangeal, MTP; ankle) in cats walking on a treadmill. These distal joints transmit the body weight and the dynamic forces onto the ground. We have included the knee and hip joints in the analysis to relate the angular excursions of the proximal and distal joints and to verify the data previously obtained with external markers on the kinematics of the proximal joints. At the beginning of the stance phase the PIP joints flexed rapidly, the MTP joints extended slowly and the ankle and knee yielded under body weight. Whereas the PIP joints maintained a rather constant angular position of −75° throughout the stance phase, extension continued in the MTP joints from −230° at touch-down to −270° at the end of the stance phase. Around 50 ms before lift-off the MTP joints flexed rapidly. Early (−30 ms) after lift-off this flexion changed into a slow extension. The PIP joints extended swiftly at the stance-swing transition and moderately at the end of the swing phase. During the middle part of the swing phase they flexed slowly. Small rotatory movements around the long axis of the foot took place in the last 100 ms of the swing phase. The results of this study on the distal joints are discussed in relation to the placing of the paw, to the translation of forward propulsion into a MTP movement and to the lifting of the paw (conventionally described as toe curling). They show a differentiated mechanical interaction between the different distal limb joints during these different phases, which must be known in detail to interpret the corresponding electromyographic data and to understand how the hip is moved forward over the MTP joints which serve as the final pivot during stance. 相似文献
4.
腰椎节段形态对峡部、小关节应力及小关节接触力影响的有限元分析 总被引:1,自引:0,他引:1
目的:探讨腰椎形态结构变化对峡部裂性滑脱及小关节退变的作用和意义。方法:采用改良的“非种子区域分割方法”及非平行“最佳切割平面”等一系列新型计算机辅助设计(CAD)方法精确建立包括椎间盘高度、腰椎小关节角、椎间盘前凸角改变的L4~L5活动节段有限元模型;在2700N轴向压缩载荷条件下,分别对各有限元模型的峡部、小关节应力、小关节接触力以及椎间盘负载进行测试。结果:压缩载荷下,腰椎活动节段峡部、小关节等效应力及小关节接触力随椎间盘高度的减小而减小,随小关节角的增大而增加,随椎间盘前凸角的增加而减小。结论:椎间盘高度、腰椎小关节角、椎间盘前凸角等形态结构变化对腰椎节段有限元模型的峡部、小关节应力及小关节接触力有明显的影响。提示腰椎峡部应力性骨折及小关节退变的发生与椎间盘高度、腰椎小关节角、椎间盘前凸角等解剖形态因素有关。 相似文献
5.
我院自 1993年 5月 - 2 0 0 1年 5月采用闭合复位或切开复位克氏针内固定治疗跖跗关节骨折脱位2 1例 ,取得满意疗效 ,现报告如下。1 临床资料 本组 2 1例 ;男 14例 ,女 7例 ;左侧 12例 ,右侧 8例 ,双侧 1例 ;年龄 2 1~ 6 8岁 ,平均 4 0 5岁 ;闭合性骨折脱位 16例 ,开放性骨折脱位 5例 ;按照Kuss分类法 :同向性脱位 15例 ,分离性脱位 6例 ;伤因 :车祸伤 12例 ,高处坠落伤 5例 ,重物压伤 3例 ,扭伤 1例。同时伴肢体骨折 6例 ,胸腹伤 3例。2 治疗方法本组 16例闭合性损伤均采用闭合复位克氏针内固定。一般在硬麻下进行 ,取平卧位 ,膝关… 相似文献
6.
Total joint arthroplasty is among the most remarkable advances in orthopaedic surgery for the elderly, enabling themto regain physical function and be free of pain. Although uncommon, infection of the prosthetic joint causes serious morbidity leading to poor functional outcome with a mortality approaching 8% in the elderly. Most infections occur through inoculation of the prosthesis at the time of implantation and are due to Gram-positive cocci, although a third of the episodes are due to Gram-negative bacilli from a secondary focus. The management presents a major clinical and therapeutic challenge due to systemic and local comorbid conditions in the elderly. Medical and surgical treatment decisions for infected joint prosthesis are complex and should be individualized in each case. Optimal nutrition is essential for a successful outcome. Adverse reactions to medications are more common in the elderly due to end organ dysfunction and drug-drug interactions. 相似文献
7.
Summary An anatomical study of the lumbar apophyseal joints was carried out to facilitate recognition of facet joint lesions, which we now examine routinely by percutaneous arthrography. Special attention was given to the configuration of the different compartments of the joint space and to its relationships with the contents of the intervertebral foramen. The abnormalities seen on lumbar facet joint arthrography are very varied; two major groups should be stressed: synovial fringe hypertrophy and pseudodiverticular synovial ectasia. The percutaneous approach to lumbar facet joint arthrography allows it to be used a therapeutic measure, with injection of anti-inflammatory drugs into the joint space, the beneficial effects of which were confirmed in our series. The precision, efficiency and cost-effectiveness of this outpatient technique justify and should encourage its more widespread application in the diagnosis and treatment of low back pain. 相似文献
8.
Tun Hing Lui 《Knee surgery, sports traumatology, arthroscopy》2007,15(5):671-675
We describe an arthroscopic approach of tarsometatarsal arthrodesis for post-traumatic arthritis. Five tarsometatarsal portals
(medial, P1–2, P2–3, P3–4, P4–5) are identified at the junctional points between the metatarsals by means of image intensifier.
The first metatarsocuneiform joint is approached through the medial and P1–2 portal. Articular cartilage is denuded and micro-fracture
of subchondral bone is performed with an arthroscopic awl. The second metatarsocuneiform joint is approached through the P1–2
and P2–3 portals and the third metatarsocuneiform joint is approached through the P2–3 and P3–4 portals. The articular surfaces
are prepared for arthrodesis. The articulations are kept in desired position and transfixed with 4.0 mm cannulated screws.
The fourth and fifth metatarsocuboid articulations are rarely included in the procedure. Arthroscopic arthrodesis or tendon
arthroplasty of the lateral column can be performed through the P3–4 and P4–5 portals. 相似文献
9.
颈椎肿瘤单侧关节突关节切除后的稳定性重建 总被引:1,自引:0,他引:1
目的:探讨颈椎肿瘤单侧关节突关节切除后稳定性重建的方法及效果。方法:对1999—2005年存我院骨科手术治疗且得到随访的18例切除单侧关节突关节的颈椎肿瘤患者的资料进行分析,男10例,女8例;年龄16~72岁,平均46岁。神经根受压表现为主者10例,VAS评分2~8分,平均4.2分;脊髓压迫表现为主者8例.ASIA分级C级5例.D级3例。均采用颈后路患侧关节突关节、侧块切除,完整切除肿瘤组织,其中10例行单侧侧块钢板固定植骨融合,8例行双侧侧块钢板固定植骨融合。结果:随访3—60个月,平均20个月,1例透明细胞癌肺转移患者死亡.余存活无复发。10例神经根受压表现为主者术后疼痛VAS评分0—4分,平均1.6分。8例脊髓压迫表现为主者,5例术前C级者术后C级2例、E级3例,3例术前D级者术后D级2例.E级l例。双侧侧块钢板固定植骨融合者术后3个月4例m现骨性融合(其中1例3个月后失访),6个月7例达到骨性融合,内固定无断裂、松动、移位。无颈椎不稳。单侧侧块钢板固定植骨融合者.1例术后5个月出现颈部疼痛;9例在术后9个月骨性融合;1例12个月时仍未能骨性融合,螺钉松动。结论:颈后路侧块钢板同定植骨融合可以实现颈椎肿瘤单侧关节突关节切除后的颈椎稳定性重建。 相似文献
10.
We present a rare case of a 27-year-old man sustaining a bilateral fracture dislocation of the sacroiliac joints without
disruption of the anterior pelvis, following a fall from a height. Reconstructed images in the coronal plane and three-dimensional
CT images were invaluable in the diagnosis and assessment of this injury. 相似文献