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Objective:To measure C3-C5 anterior fixed parametersment for the segmental anterior fixation surgery. Methods:The examination of the cervical spine in patients with CT imaging data were randomly selected from January 2009 - December 2012 , C4 - C6 cervical no lesions in 35 cases of imaging data were selected (20 males and 5 females , 25 to 50 years old, average 41. 2 years) ,The image data were rebuilded and measured di-ameter by Mimics 16. 01 software, vertebral body height, vertebrae transverse process hole diameter and diameter around, the left and right sides of the horizontal distance between the flange hole inside, left and right sides of the axis of the pedicle and sagittal axis and the horizontal axis angle and length were measured. Results and conclu-sion:the vertebral body diameter of C4-C6, (26. 67±0. 25) mm gradually increased to (32. 89±0. 12) mm, an-terior and posterior diameter of C4 -C6 ,(6. 89±0. 12) mm gradually increased to (8. 85±0. 44) mm, comparing differences between different segments were statistical significance;Vertebral body midline sagittal anterior, middle and posterior height from C4 [anterior was (7. 99 ±0. 51) mm, middle was(7. 09±0. 42) mm, posterior was (7. 76±0. 49) mm]. To C6 [anterior was (9. 89±0. 45 mm, middle was (8. 42±0. 75) mm, posterior was (8. 84±0. 26) mm], vertebral bodies were significant difference (P<0. 05); the vertebrae transverse process hole diameter and diameter around anterior and posterior were gradually increased with the increase of the sequence; on both sides of C4~C6 were by transverse process hole inside edge distance ( 25 . 10 ± 0 . 45 ) mm gradually increased to (28. 89±0. 56) mm, comparing differences between different segments were statistical significance;Pedicle axis , the sagittal axis and horizontal axis angle and length were gradually increasing with the increase of the cervical spine ordinal, difference is statistically significant.
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颈椎椎管内黑色素细胞瘤一例报告
临床资料患者男性,22岁.因颈背部疼痛2个月余,加重伴左侧肢体麻木无力1个月入院.2个月前无明显诱因出现颈背部疼痛,夜间为甚,当地医院考虑“颈椎病”,未行特殊治疗.1个月前,上述症状加重,并伴左侧肢体麻木无力,且向左转头时症状明显,遂来我院.
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上颈椎损伤及内固定治疗生物力学机制的有限元研究进展
上颈椎通常指C1、C2,即寰、枢椎,其上连头颅,下接下位颈椎,在脊柱中的力学作用非常复杂,超过50%的颈椎损伤发生在C1和C2[1、2],而上颈椎损伤的生物力学机制又是临床治疗的基础。随着计算机技术的飞速发展,有限元方法作为一种新的生物力学研究方法,较之传统动物实验或尸体实验具有可动态反映外部载荷下实验模型内部应力/应变变化,以及通过改变参数可重复模拟实验进行持续性研究等方面的突出优点,目前已广泛应用于上颈椎生物力学研究。笔者对近年来有限元技术在上颈椎损伤机制、内固定治疗等方面的生物力学研究进展进行相关综述。
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颈椎管内恶性黑色素瘤1例报道
患者男性,44岁.因颈肩疼痛1年,加重伴四肢进行性麻木无力10余天,于2012年3月14日收入院.体检:体温36.2℃,血压130/80mmHg,营养中等,神志清,巩膜无黄染,浅表淋巴结未触及肿大,全身皮肤、粘膜无黑色素痣和黑色素沉着.颈椎棘突无明显压痛、叩痛,无双上肢放射痛;压颈试验(+),双侧臂丛神经牵拉试验(+),双侧三角肌、屈肘肌力正常,右侧伸肘肌力2级,有侧屈伸腕肌力、右手握力均3级,左侧伸肘肌力3级,双侧霍夫曼征(+);双下肢肌张力高,肌力均正常,提睾反射未引出,双膝腱反射亢进,双巴彬斯基征阴性.
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颈椎前路减压并发脊髓损伤加重的原因分析
脊髓损伤加重是颈椎前路减压严重的手术并发症,发生率虽低,但后果严重.我科自1976年~1997年行颈椎前路减压植骨融合术294例,其中发生脊髓损伤加重11例,占3.7%,经极积治疗,6例基本恢复正常.本文复习了这些病例资料,对颈椎前路减压加重脊髓损伤的原因作了分析.
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胸椎管狭窄症合并颈椎病的治疗
2014年4月25~26日在北京成功举办了第三届全国胸椎管狭窄症专题研讨会,会上就胸椎管狭窄症与颈椎病的鉴别诊断、多节段胸椎管狭窄症患者的精准定位诊断等问题进行了深入研讨。会议期间与会专家围绕我们提供的1例胸椎管狭窄症合并颈椎病患者进行了热烈讨论,终达成了部分共识。现将该病例资料及讨论结果报告如下。
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伴明显颈椎畸形的食管异物二例
食管异物是耳鼻咽喉科常见急诊,诊断和治疗常用手段是经硬性食管镜检查,取出异物,患者即可恢复健康.但是对于伴有明显颈椎畸形的食管尖锐异物取出方法文献报道较少,按教科书介绍则属于硬性食管镜检查的禁忌证,同时也属于纤维食管镜检查的禁忌证.现将泸州医学院附属医院2004年至2006年收治2例患者诊治经验介绍如下.
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Cervical Spine Alignment and Motion in the Acute Management of Potential Catastrophic Cervical Spine Injuries in Sport
The incidence of spinal cord injury in the United States is estimated to be 11,000 new cases each year[1].Sport participation constitutes the fourth most common cause[1](approximately 8. 7%) of these injuries overall but is the second most common cause for those under the age of 30[2]. The majority of all cervical spine injuries since 2000 have occurred in individuals between the ages of 16 and 30[1].
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1例颈椎骨折术后食管瘘病人的护理
颈椎损伤后颈椎前路减压植骨融合内固定术成为首先术式[1].颈椎前路手术发生食管瘘机会较小.Gandinez等[2]报告25年中,颈椎前路手术后发生食管瘘44例.陈雄生等[3]报道约为0.06%.我院曾治疗1例颈椎前路手术后食管瘘的病人.现将其护理报告如下.
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The Clinical Analysis and Biomechanical Study of Multilevel Anterior Cervical Spinal Decompression with Fusion and Fixation for the Degenerative Disorder
Unstabilitaion would be occurred after multilevel anterior decompression on the cervical spine, sometimes the failure of fusion would happen followed with pseudoarthrosis of the cervical spine. This paper is to review the clinic results of the 38 cases treated with more than three levels anterior decompression and to test the biomechanical stabilization of the cervical spine with 6 fresh human cervical specimens.
关键词: Cervical spine -
一种新的颈椎活动度测量方法及其可行性研究
颈椎活动度的测量方法较多,但都存在各自的缺点.因此到目前为止,在所有的测量工具中还没有临床实用的、客观的测量工具,颈椎活动度测量工具研制仍旧是基础和临床研究人员所面临的艰巨任务之一.
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颈椎(精装)
该书由颈椎研究学会编辑委员会(The Cervical Spine Research Society Editorial Committee)主席编著,是颈椎领域新、全面、权威的参考书。该教科书汇集权威骨科医师、神经外科医师,神经病学、风湿病学、放射学、解剖学以及生物工程学专家的新理念,代表了该领域基础和临床研究、诊断方法、药物和外科治疗手段的先进水平。第5版则提供了新信息、新技术以及临床决策制定方面的新进展。主要章节包括解剖学、生理学、生物力学、神经病学和功能评估、影像学评估,并全面阐述儿科问题、骨折、脱位、脊髓损伤、肿瘤、感染、炎症情况、退行性疾患、畸形以及并发症等。
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颈椎后凸畸形外科治疗的几个相关问题
颈椎后凸畸形是近年来受到广泛关注的颈椎疾病.随着影像学技术和诊断水平的提高,临床上该病的发现率逐年增加.目前外科手术已成为治疗该病的主要手段,但学者们对此类畸形的病理机制和外科治疗策略尚未形成明确一致的意见,手术适应证亦无公认标准.本文就颈椎后凸畸形的手术适应证、手术时机、术前评价和手术技术等提出几点看法,以期加深对该病外科治疗相关问题的认识.
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老年颈椎骨折患者的临床特点及治疗
60岁以上老年人占中国人口的比例不断上升.2006年,我国老年人口占总人口比例为11.3%,高龄人口(80岁以上)占老年人口的比例为10.7%~([1]).
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强直性脊柱炎合并颈椎骨折的诊断与外科治疗
强直性脊柱炎(ankylosing apondylitis,AS)是一种影响中轴骨骼,引起疼痛和脊柱进行性强直的慢性炎症性疾病,主要引起各个椎间关节滑膜炎性改变、滑膜增生,血管翳形成致软骨和骨的破坏和侵蚀,进而引起机体修复反应、关节纤维性或骨性强直、全身骨骼骨质疏松及骨骼韧性减弱[1-2].因此,强直性脊柱炎患者在遭受外力作用时容易脊柱骨折并引起脊髓损伤.强直性脊柱炎脊柱创伤与普通脊柱损伤的特点明显不同,主要包括:骨折多为三柱骨折,高度不稳,部分患者普通x线检查易漏诊,脊髓损伤发生率较高[3].
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颈椎后纵韧带骨化症的病因及诊疗进展
颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament ofthe cervical spine,OPLL)是指因颈椎的后纵韧带发生骨化,从而压迫颈脊髓和神经根,产生肢体的感觉和运动障碍及内脏植物神经功能紊乱的疾患.1839年,Key首先报道了脊柱韧带骨化现象,并称之为"韧带骨化性脊柱炎"[1].1960年,日本学者尸解时发现颈椎后纵韧带骨化导致了脊髓压迫症[2].1964年,Terayma将该病理变化命名为"颈椎后纵韧带骨化",OPLL患者通常有放射学表现,而无症状或只有轻微神经根、脊髓症状,无进一步恶化的倾向,可行非手术治疗[3].若出现颈部脊髓诱发电位(SSEP)明显延迟,T2 加权脊髓局部高信号,放射影像显示脊髓明显压迫或出现中度至重度脊髓症状或四肢瘫痪,则必须手术治疗.
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颈椎骨折合并脊髓损伤患者呼吸道的护理体会
颈脊髓损伤是颈椎骨折严重的合并伤,呼吸困难是颈脊髓损伤初期及术后常见的症状,也常常是损伤初期的致命原因.2006年1月~2O07年1月,我院共收治颈椎骨折合并颈脊髓损伤致呼吸困难患者36例,现将护理体会报告如下.
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拉肩带在颈椎CT扫描中的应用
为了使下部颈椎显示清楚,在颈椎X线投照时,经常用手提砂袋的方法使两肩下垂。而颈椎CT扫描是卧位中进行的,不能使用砂袋。有些体胖肩高的患者,因与肩部重叠,而使下部颈椎扫描效果不佳,需更换扫描模,这样给工作带来很大麻烦。为此,我们使用了两条拉肩带,经过10余例颈椎CT扫描的应用,获得良好效果,该法简单易行。
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颈椎损伤治疗的相关问题
随着现代建筑业及交通运输业的迅猛发展,颈椎损伤的发生率也随之明显上升.该类损伤如处理不当可给患者带来严重的后果.近年来,颈椎损伤的诊断和治疗取得了可喜的进步,但有些问题仍存在争议,笔者仅对其中几个问题进行讨论.
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Objective: To study the mechanism and treatment principle of spinal fractures combined with paraplegia and diaphragm injury. Methods: A total of 16 patients (14 males and 2 females, aged from 18 to 50 years) with spinal fractures combined with paraplegia and diaphragm injury, receiving emergency treatment and admitted to our hospital in the past 20 years, were retrospectively analyzed in this study. Results: The injuries were caused by direct or indirect violence. Six cases were of fractures of cervical spine combined with paraplegia and diaphragm injury, 2 of fractures of thoracic vertebra combined with paraplegia and diaphragm injury, and 8 of thoracolumbar fractures combined with paraplegia and diaphragm injury. Six cases received non-operative treatment, but died finally. Ten cases received spine surgical treatment, of which 4 died and 6 were improved. The total mortality rate was 62.5%. Conclusions: Spinal fractures combined with paraplegia and diaphragm injury are one of the most severe traumas in departments of orthopaedics. Paraplegia can be found easily, but diaphragm injury is often neglected and missed. When a patient suffers from both of them, he is in danger of death. What measures should be taken to rescue the patients life depends on the severity of the wounds.