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Full Length Spine CT and MRI 认领
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作者 Tae-Keun Ahn Stephane Bourret +3 位作者 Wendy Thompson Cecile Roscop Thibault Cloché Jean-Charles Le Huec 《临床医学国际期刊(英文)》 2020年第5期270-281,共12页
Spine is a complex and long structure in the human body. Visualization of the spine is essential to treat and manage spine disease and commonly requires further imaging modalities such as computed tomography (CT) and ... Spine is a complex and long structure in the human body. Visualization of the spine is essential to treat and manage spine disease and commonly requires further imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). In most clinical fields, spine CT and MRI examinations are focused on the region of interest. However, spine is composed of cervical, thoracic, lumbar, sacrum and coccyx and sometimes demands examination of entire structure as well as regional spine depending on disease, patient’s state and physician’s decision. This review considers the available literature to describe when and how full length spine evaluation by CT and MRI is applied according to each spinal disease such as spinal trauma, deformity, infection, axial spondyloarthropathy and metastatic tumor. 展开更多
关键词 Full LENGTH SPINE CT Full LENGTH SPINE MRI Trauma DEFORMITY Infection Axial SPONDYLOARTHROPATHY Metastasis
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Outcome of Long Segment Transpedicular Screw Fixation in Unstable Thoracolumbar Spine Injury with Incomplete Neurological Deficit 认领
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作者 Shah Md. Rezaul Karim A. K. M. Shahidur Rahman +6 位作者 Syed Abdus Sobhan Md. Shahidul Islam Akon Muhammad Akter Hossain Ashraf Ali Shah Newas Md. Ruhul Quddus Md. Moshiur Rahman Mollick 《生物科学与医学(英文)》 2020年第3期166-187,共22页
Background: Long segment transpedicular screw fixation in thoracolumbar spine injury has gained popularity in the last decades as it provides immediate stability, prevents further risk of complications and allows earl... Background: Long segment transpedicular screw fixation in thoracolumbar spine injury has gained popularity in the last decades as it provides immediate stability, prevents further risk of complications and allows early mobilization of patient. Objectives: Evaluation of clinical and functional outcome after long segment transpedicular screw fixation in unstable thoracolumbar spine injury with incomplete neurological deficit patients. Methods: This quasi experimental study was conducted at Dhaka Medical College and Hospital (DMCH), Dhaka, Bangladesh from January 2016 to December 2017. A total of twenty four (24) patients with traumatic unstable fracture of the thoracolumbar spine with incomplete neurological deficit underwent long segment transpedicular screw fixation were included in this study. Clinical and radiologic outcomes were assessed pre-operatively and post-operatively. Results: A total of 24 patients aged between 20 - 60 years of both sexes (Male-21, Female-03) were included in this study. Their mean (±SD) age was 33.12 (±8.57) years. Most of them were farmer [09 (37.5%)] and day labour [08 (33.33%)]. Motor vehicle accidents were the most common [16 (66.67%)] cause of injury and then fall from height [08 (33.33%)]. The most common level of injury involved was L1-10 (41.67%) patients, followed by L2-07 (29.17%), T12-05 (20.83%) and T11-02 (8.33%) of the study patients. Burst fracture was the commonest [22 (91.67%)] type of fracture followed by Chance fracture [02 (8.33%)]. Pre-operative mean (±SD) Cobb angle, Kyphotic deformation of vertebral body, Beck index and vertebral compression deformity were 21.83 ± 4.5 degrees, 22.09 ± 4.40 degrees, 0.78 ± 2.65 and 0.18 ± 0.93 mm respectively, after procedure which were significantly (p Conclusions: Long segment transpedicular screw fixation is an effective method of treatment in patients having thoracolumbar spine injury with incomplete neurological deficit. 展开更多
关键词 NEUROLOGICAL DEFICIT TRANSPEDICULAR Screw Fixation UNSTABLE THORACOLUMBAR Spine Injury
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浅析“脊柱枢纽论” 认领
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作者 师宁宁 兰鹏飞 +2 位作者 杨吉勃 郭明妮 杜佳慧 《按摩与康复医学》 2020年第10期6-8,共3页
脊柱两端的枕寰枢关节与骶髂关节及脊柱各节段的交接部位颈7胸1交接区、胸12腰1交接区、腰5骶1交接区,甚至椎体与椎体之间的连接结构均是脊柱的关键部位,是脊柱的枢纽部分,对整个脊柱的结构与功能起着制约和调控的作用,对治疗脊柱及其... 脊柱两端的枕寰枢关节与骶髂关节及脊柱各节段的交接部位颈7胸1交接区、胸12腰1交接区、腰5骶1交接区,甚至椎体与椎体之间的连接结构均是脊柱的关键部位,是脊柱的枢纽部分,对整个脊柱的结构与功能起着制约和调控的作用,对治疗脊柱及其相关性疾病有着重要的临床指导意义。 展开更多
关键词 脊柱相关性疾病 脊柱 枕寰枢关节 骶髂关节 脊柱枢纽论
Unusual Foreign Bodies of Surgical Discovery on a Traumatic Spine 认领
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作者 Habib Abdoul Karim Ouiminga Julien T. Savadogo +5 位作者 Denléwendé Sylvain Zabsonré Anatole Jean Innocent Ouedraogo Diane Ndzana Mengyou Li Désiré Harouna Sankara Magatte Gaye 《神经科学国际期刊(英文)》 2020年第1期15-21,共7页
Introduction: Para-spinal non-metallic foreign bodies (fabrics or plastics) are rare and poorly documented. They are often unknown and discovered at the stage of infectious complications and present big therapeutic ch... Introduction: Para-spinal non-metallic foreign bodies (fabrics or plastics) are rare and poorly documented. They are often unknown and discovered at the stage of infectious complications and present big therapeutic challenges. We report a rare case of three para-spinal foreign bodies (fabric, plastic and postoperative gauze) discovered during surgery of a traumatic thoracic spine. Case report: A 32-year-old man admitted for a polytrauma (collision motorcycle-cart). The admission examination noted closed trauma of the thoracic spine, an ASIA score of A, dyspnea, a penetrating wound of the left side of the chest. The CT scan showed a compressive left pleural effusion, multiple ribs fractures, pulmonary contusion, unstable fracture of fifth and sixth thoracic vertebrae associated with posterior epidural hematoma responsible for medullar compression. There was a rounded, para-spinal image, dotted with small areas of low density, air bubbles. We lifted the vital emergency by draining the left pleural effusion, debriding the penetrating chest wound, and administering broad-spectrum antibiotic therapy. Fourteen days later, we decided to stabilize the spine. After a posterior approach, we discovered free pus and para-vertebral three foreign bodies. Enterobacter spp.was isolated in pus susceptible to imipenem. The immediate operative follow-up was simple. Conclusion: The best treatment remains preventive by simple measures, exploration of penetrating wounds, repeated count and careful verification of gauze, because the infectious complications that they generate are source of mortality and serious medico-legal implications. 展开更多
关键词 TEXTILOMA Foreign Body SPINE Traumatism Surgery
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Rod and Screw Fixation for Cranio-Cervical Instability 认领
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作者 Hedaya Hendam Ahmed Taha Mohamed Youssef 《现代神经外科学进展(英文)》 2020年第1期19-26,共8页
Background Data: Atlanto-occipital dislocation is a rare and fatal condition. Pain, limitation of movements, and weakness, were the main complaints of patients with upper cervical lesions. Internal fixation and fusion... Background Data: Atlanto-occipital dislocation is a rare and fatal condition. Pain, limitation of movements, and weakness, were the main complaints of patients with upper cervical lesions. Internal fixation and fusion was indicated in all patients of Atlanto occipital dislocation with deficits. CT scan is the imaging modality of choice for evaluation. Objective: To evaluate the efficacy and safety of rod and screw fixation in cranio-cervical instability. Study Design: Retrospective study reviewed all patient treated by rod and screw fixation, they were 12 patient operated for atlanto-occipital instability from April 2013 to April 2016 in Alazher University Hospital Damietta. Pre and postoperative data collection and analysis of the outcome were completed based on the Frankel classification and grading. Patients and Methods: We operated 12 patients, 10 with traumatic and 2 with pathologically diagnosed Atlanto occipital instability. From April 2013 to April 2016. All patients presented with neck pain, limitation of neck movement, and neurological deficits. The patients were investigated by standard plain X ray to the cervical spine, CT scan and MRI of the cervical spine pre-operatively, and they operated thorough posterior Cranio-cervical fixation. These patients followed post-operatively clinically for improving neural functions and radiologically for alignment, stability, fusion and efficacy of hard ware fixation. Results: The mean age of the studied cases was 42.1 years, trauma was the cause of instability in 10 patients, and 2 patients one with rheumatoid arthritis and one with neoplastic lesion. The mean follows up period is 14.7 months. We used screw rod system in posterior craniocervical fixation with iliac bone graft without operative or post-operative complications. All our patients were improved neurologically post-operatively and no hardware failure during the follow up period. Conclusion: Craniocervical instability was rare condition, with miss diagnosis and may be fatal condition. Posterior occipitoce 展开更多
关键词 SPINE Atlanto-Axial Atlanto-Occipital Cranio-Cervical Internal FIXATION
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Lumbar and cervical viscoelastic disc replacement:Concepts and current experience 认领
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作者 Jean Yves Lazennec 《世界骨科杂志:英文版》 2020年第8期345-356,共12页
The ideal lumbar and cervical discs should provide six degrees of freedom andtri-planar (three-dimensional) motion. Although all artificial discs are intended toachieve the same goals, there is considerable heterogene... The ideal lumbar and cervical discs should provide six degrees of freedom andtri-planar (three-dimensional) motion. Although all artificial discs are intended toachieve the same goals, there is considerable heterogeneity in the design oflumbar and cervical implants. The “second generation total disc replacements”are non-articulating viscoelastic implants aiming at the reconstruction ofphysiologic levels of shock absorption and flexural stiffness. This review aims togive an overview of the available implants detailing the concepts and thefunctional results experimentally and clinically. These monobloc prostheses raisenew challenges concerning the choice of materials for the constitution of theviscoelastic cushion, the connection between the components of the internalstructure and the metal endplates and even the bone anchoring mode. Newobjectives concerning the quality of movement and mobility control must bedefined. 展开更多
关键词 Lumbar disc replacement Cervical disc replacement VISCOELASTIC Total disc replacement Lumbar spine Cervical spine Disc arthroplasty
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Guideline for diagnosis and treatment of spine trauma in the epidemic of COVID-19 认领
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作者 Yu-Long Wang Feng-Zhao Zhu +10 位作者 Lian Zeng Dionne Telemacque Jamal Ahmad Saleem Alshorman Jin-Ge Zhou Ze-Kang Xiong Ting-Fang Sun Yan-Zhen Qu Sheng Yao Tian-Sheng Sun Shi-Qing Feng Xiao-Dong Guo 《中华创伤杂志:英文版》 CAS CSCD 2020年第4期196-201,共6页
Outbreak of COVID-19 is ongoing all over the world.Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production.Patien... Outbreak of COVID-19 is ongoing all over the world.Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production.Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery.The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients.To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease,multidisciplinary collaboration is needed.This expert consensus is formulated in order to(1)prevent and control the epidemic,(2)diagnose and treat patients with spine trauma reasonably,and(3)reduce the risk of cross-infection between patients and medical personnel during the treatment. 展开更多
关键词 COVID-19 Spine fracture Spinal cord injuries Diagnosis and treatment
MSCT后处理技术在脊柱侧弯诊断中的应用 认领
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作者 胡雅琼 平安松 谢江涛 《中国CT和MRI杂志》 2020年第10期141-144,共4页
探究多层螺旋CT(MSCT)后处理技术在脊柱侧弯诊断中的价值。选择2016年2月至2019年3月我院收治的71例脊柱侧弯患者作为研究对象,所有患者均行脊柱正、侧位X线片、MSCT及其后处理技术检查。分析MSCT后处理技术对椎体的显示情况,比较MSCT及... 探究多层螺旋CT(MSCT)后处理技术在脊柱侧弯诊断中的价值。选择2016年2月至2019年3月我院收治的71例脊柱侧弯患者作为研究对象,所有患者均行脊柱正、侧位X线片、MSCT及其后处理技术检查。分析MSCT后处理技术对椎体的显示情况,比较MSCT及X线片对脊柱异常的检出率。71例患者X线共检出脊柱畸形88处,MSCT检出畸形178处,X线及MSCT对脊柱畸形的检出率比较差异具统计学意义(P<0.05);多平面重建(MPR)/曲面重建(CRP)可允许各个角度观察畸形椎体冠状面、矢状面影像,可较好的显示椎管及脊髓情况;表面遮盖显示(SSD)重建对脊柱侧弯椎体形态显示良好,重建后通过图像旋转可观察脊柱矢状位曲度的改变,但对于椎管结构及软组织显示欠佳;容积显示技术(VRT)可通过调节不同密度阈值观察骨质及椎管形态,对脊柱形态、附件、椎管、脊髓等均可较好显示。MSCT及其图像后处理技术可提供脊柱侧弯畸形立体结构及空间位置信息,对于脊柱异常的检出率优于X线片,可为临床诊断提供可靠的影像资料。 展开更多
关键词 体层摄影机 X线计算机 脊柱侧弯 脊椎
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脊柱转移瘤放疗研究进展 认领
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作者 许珍 于甬华 《中华肿瘤防治杂志》 CAS 北大核心 2020年第1期80-84,共5页
目的放疗是目前脊柱转移瘤重要的治疗方式,在脊柱转移瘤患者的综合治疗中,尤其是止痛方面起到了重要的作用。本研究旨在探讨脊柱转移瘤的放疗剂量分割方式及其靶区勾画,以期达到精准放疗的效果。方法应用PubMed和中国知网文献数据库,以&... 目的放疗是目前脊柱转移瘤重要的治疗方式,在脊柱转移瘤患者的综合治疗中,尤其是止痛方面起到了重要的作用。本研究旨在探讨脊柱转移瘤的放疗剂量分割方式及其靶区勾画,以期达到精准放疗的效果。方法应用PubMed和中国知网文献数据库,以"脊柱、转移瘤、放疗"为中文关键词,以"spine、metastasis、radiotherapy"为英文关键词,联合检索1995-01-2018-12的相关文献。共检索到中文文献150条,英文文献1 280条。纳入标准:(1)脊柱转移瘤;(2)放射治疗。排除标准:(1)其他部位转移瘤;(2)脊柱原发肿瘤;(3)手术;(4)化疗。符合纳入标准的中文文献27条,英文文献275条,根据排除标准最后纳入分析42篇文献。结果脊柱转移瘤放射治疗最为常见的分割剂量为30Gy/10次,目前8Gy/次、20Gy/5次和24Gy/6次等超分割剂量也在临床中得到应用。随着影像及放疗技术的改进,特别是调强放射治疗/立体定向放射治疗技术的出现,使得脊柱转移瘤的靶区定位勾画更为精确。结论脊柱转移分段放疗尚无统一标准,但在保证平移误差≤2mm的连续放疗方案是可以接受的。在临床实践中,放疗作为骨转移重要的治疗方式,在控制肿瘤局部进展、保护和促进神经功能恢复及姑息治疗等方面发挥着重要的作用。 展开更多
关键词 脊柱 转移瘤 放射治疗 综述文献
改良早期预警评分对老年脊柱压缩性骨折患者预后的应用价值 认领
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作者 吴玉银 《中国伤残医学》 2020年第11期16-17,共2页
目的:探讨早期预警评分对老年脊柱压缩性骨折患者预后的应用价值.方法:选取我院2018年1月-2018年12月收治的脊柱压缩性骨折患者45例为研究对象,比较2组患者的心理状态、不良事件发生率、护理满意度.结果:观察组患者心理状态、护理满意... 目的:探讨早期预警评分对老年脊柱压缩性骨折患者预后的应用价值.方法:选取我院2018年1月-2018年12月收治的脊柱压缩性骨折患者45例为研究对象,比较2组患者的心理状态、不良事件发生率、护理满意度.结果:观察组患者心理状态、护理满意度均显著优于对照组(P<0.05),而不良事件发生率显著低于对照组(P<0.05).结论:早期预警评分系统应用于老年脊柱压缩性骨折患者可改善患者的心理状态,提高护理满意度,减少不良事件发生率,值得推荐. 展开更多
关键词 改良早期预警评分 脊柱 压缩性骨折
内镜下行单、双侧减压修复对侧症状型腰椎间盘突出症的优效性比较 认领
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作者 王秋安 袁峰 +4 位作者 吴继彬 孙玛骥 吴东迎 孟强 郭开今 《中国组织工程研究》 CAS 北大核心 2020年第32期5133-5137,共5页
背景:腰椎间盘突出症多为突出部分压迫一侧神经根引起同侧神经根受压症状,一侧腰椎间盘突出而对侧出现症状的病例在临床上并不多见,因此对于此类腰椎间盘突出症目前尚无特定的分型及命名,文中将其称为"对侧症状腰椎间盘突出症"... 背景:腰椎间盘突出症多为突出部分压迫一侧神经根引起同侧神经根受压症状,一侧腰椎间盘突出而对侧出现症状的病例在临床上并不多见,因此对于此类腰椎间盘突出症目前尚无特定的分型及命名,文中将其称为"对侧症状腰椎间盘突出症"。目的:探讨在内镜下椎间孔入路腰椎髓核摘除术治疗对侧症状腰椎间盘突出症患者,行单侧或双侧减压的疗效对比。方法:回顾性选取2015年1月至2018年12月收治,并行内镜下椎间孔入路腰椎髓核摘除术的40例对侧症状型腰椎间盘突出症患者,以减压方式不同将患者分为突出侧减压组20例和双侧减压组20例。分别记录两组患者术前、术后第3天及第3,6,12个月腰部、下肢目测类比评分以及日本骨科协会JOA评分;术后12个月采用改良Macnab标准评定疗效,复查腰椎动力位X射线片评估腰椎稳定性。结果与结论:40例患者均获得随访,随访时间12-20个月,平均16个月。①两组均未出现硬膜囊撕裂、椎间隙感染等并发症;②两组患者术后腰部及下肢疼痛均有明显缓解,且与术前相比,术后JOA评分有明显提高,术后腰部及下肢目测类比评分明显降低,差异均有统计学意义(P<0.05);双侧减压组各对应时间点的目测类比评分及JOA评分均优于突出侧减压组(P<0.05);③术后12个月改良Macnab评估结果示,突出侧减压组优良率为70%,双侧减压组优良率为95%,两组间差异有统计学意义(P<0.05);④术后12个月复查腰椎动力位X射线片,两组均未出现腰椎失稳或滑脱的情况。提示:对于对侧症状腰椎间盘突出症患者采取经皮内镜下椎间孔入路腰椎髓核摘除术治疗,两种减压方式均可改善疼痛症状,但双侧减压较突出侧的单侧减压,减压更充分,术后恢复效果更佳。 展开更多
关键词 椎间孔镜 椎间孔入路 腰椎间盘突出症 对侧症状 单侧减压 双侧减压 脊柱
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脊柱源性难治性右后半规管型良性阵发性位置性眩晕验案1则 认领
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作者 张哲玮 徐厚平 《中国中医药现代远程教育》 2020年第12期111-112,120,共3页
良性阵发性位置性眩晕(BPPV)是临床上常见的疾病,多由于耳石(碳酸钙结晶体)从囊斑内脱落并落入半规管内,刺激管内的毛细胞引起动作电位所致。其给患者的生活和工作带来诸多不便。目前临床上,对于BPPV的治疗多采用手法复位,常能取得较好... 良性阵发性位置性眩晕(BPPV)是临床上常见的疾病,多由于耳石(碳酸钙结晶体)从囊斑内脱落并落入半规管内,刺激管内的毛细胞引起动作电位所致。其给患者的生活和工作带来诸多不便。目前临床上,对于BPPV的治疗多采用手法复位,常能取得较好效果,但由于患者具体情况复杂多变,难治性BPPV并不难遇到。鉴于现有文献对于难治性BPPV鲜有报道,笔者现将临床所遇难治性BPPV之一则验案整理如下。 展开更多
关键词 眩晕 脊柱 难治性 半规管
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原发性脊柱淋巴瘤CT和MRI特征 认领
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作者 李碧君 张浩 +5 位作者 曹丹 孙梦雅 王艺霏 郭柳姬 刘小闽 吴元魁 《临床放射学杂志》 CSCD 北大核心 2020年第4期751-756,共6页
目的分析总结原发性脊柱淋巴瘤的CT和MRI特征及与常见相关疾病的鉴别诊断要点。方法搜集19例经临床和病理证实为原发性脊柱淋巴瘤患者的CT和MRI资料,分析其影像特征。结果(1)多节段受累者17例,单节段受累者2例。11例患者肿瘤呈非对称性,... 目的分析总结原发性脊柱淋巴瘤的CT和MRI特征及与常见相关疾病的鉴别诊断要点。方法搜集19例经临床和病理证实为原发性脊柱淋巴瘤患者的CT和MRI资料,分析其影像特征。结果(1)多节段受累者17例,单节段受累者2例。11例患者肿瘤呈非对称性,8例为对称性生长。(2)所有肿瘤呈多间室侵犯,其中7例同时侵犯椎体、附件、椎管内及椎旁软组织。(3)骨质破坏在CT上以虫噬样溶骨性改变为主(15例),6例出现硬化边;15例椎体轮廓基本正常,但MRI信号明显异常;4例出现压缩性骨折。(4)椎旁软组织呈"围椎"改变(18例),椎管内软组织呈"袖套征"改变(16例)。(5)与脊髓相比,肿瘤CT上呈等或稍高密度(16/16例),增强扫描4/4例轻度均匀强化;MRI上T1WI呈低或等信号为主(14/16例),T2WI呈高或等信号为主(15/16例),增强扫描13/13例呈轻、中度强化。结论原发性脊柱淋巴瘤具有很强的影像学特征。 展开更多
关键词 脊柱 淋巴瘤 体层摄影术 X线计算机 磁共振成像
脊柱矢状面重建术前截骨角度的评估方法及意义 认领
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作者 张树文 徐韬 盛伟斌 《中华外科杂志》 CAS CSCD 北大核心 2020年第7期551-554,共4页
脊柱截骨矫形作为重建脊柱力线的有效方式,广泛应用于脊柱矢状序列重建中,并取得了良好效果。为避免截骨角度不佳引起的术后躯干矢状面二次失平衡,术前制定合适的手术计划,精确评估截骨角度尤为重要。目前,学者们通过对患者脊柱-骨盆参... 脊柱截骨矫形作为重建脊柱力线的有效方式,广泛应用于脊柱矢状序列重建中,并取得了良好效果。为避免截骨角度不佳引起的术后躯干矢状面二次失平衡,术前制定合适的手术计划,精确评估截骨角度尤为重要。目前,学者们通过对患者脊柱-骨盆参数及其代偿机制的全面分析,针对不同患病人群和疾病特点提出相应的脊柱矢状面重建目标,并根据不同重建目标、截骨部位和截骨方式提出多种截骨角度的预测方法,为制定最佳手术策略提供帮助。 展开更多
关键词 脊柱 截骨术 矢状面 重建
French Spine Surgery Society guidelines for management of spinal surgeries during COVID-19 pandemic 认领
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作者 Solène Prost Yann Philippe Charles +16 位作者 Jérome Allain Jean-Luc Barat Henri d'Astorg Manuel Delhaye Chistophe Eap Fahed Zairi Pierre Guigui Brice Ilharreborde Jean Meyblum Jean-Charles Le Huec Nicolas Lonjon Guillaume Lot Olivier Hamel Guillaume Riouallon Stéphane Litrico Patrick Tropiano Benjamin Blondel 《世界临床病例杂志》 SCIE 2020年第10期1756-1762,共7页
Since the outbreak of coronavirus disease 2019(COVID-19)in December 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the population.With regard to spine surgery,French ... Since the outbreak of coronavirus disease 2019(COVID-19)in December 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the population.With regard to spine surgery,French physicians are devoted to take place in the national plan against COVID-19,the French Spine Surgery Society therefore decided to elaborate specific guidelines for management of spinal disorders during COVID-19 pandemic in order to prioritize management of patients.A three levels stratification was elaborated with Level I:Urgent surgical indications,Level II:Surgical indications associated to a potential loss of chance for the patient and Level III:Non-urgent surgical indications.We also report French experience in a COVID-19 cluster region illustrated by two clinical cases.We hope that the guidelines formulated by the French Spine Surgery Society and the experience of spine surgeons from a cluster region will be helpful in order optimizing the management of patients with urgent spinal conditions during the pandemic. 展开更多
关键词 COVID-19 SPINE Surgery GUIDELINES Organization Cluster region
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动态对比增强MRI在骨科临床应用中的热点问题 认领
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作者 余浪波 卿明松 +1 位作者 赵春涛 彭笳宸 《中国组织工程研究》 CAS 北大核心 2021年第3期449-455,共7页
背景:虽然传统平扫+增强磁MRI已被应用于骨骼肌肉成像多年,但不足以评估病变组织微观改变特征或病变组织活性,而动态对比增强MRI可捕捉该方面的信息,在骨科影像学检查中显示出优势。目的:综述动态对比增强MRI在骨科临床中的应用进展。方... 背景:虽然传统平扫+增强磁MRI已被应用于骨骼肌肉成像多年,但不足以评估病变组织微观改变特征或病变组织活性,而动态对比增强MRI可捕捉该方面的信息,在骨科影像学检查中显示出优势。目的:综述动态对比增强MRI在骨科临床中的应用进展。方法:通过计算机在CNKI数据库、PubMed数据库、Web of Science及万方数据库检索1900年1月至2020年2月收录的相关文献,检索词为"动态对比增强磁共振成像;骨肌肿瘤;关节炎;脊柱;骨折;Dynamic contrast enhanced magnetic resonance imaging(DCE-MRI);osteomuscular tumor;arthritis;spinal surgery;fracture"。结果与结论:①目前在临床应用中,对于获取动态对比增强MRI图像的最佳扫描方法和分析这种图像的理想方法普遍缺乏共识,其参数分析方法主要是定性、半定量和定量分析3种;②动态对比增强MRI已被广泛应用于心力衰竭、乳腺癌、前列腺癌、肾排斥反应和肝肿瘤等不同疾病的非侵入性检测、定性和治疗监测等,在骨科临床的应用还不够成熟,但具有无限的潜力:其可以用于评估股骨颈骨折后的血运情况及预测股骨头的存活能力、骨折后骨不连的区域灌注情况,关节炎等实体的骨灌注及畸形血管的检测;与常规成像相比,动态对比增强MRI还可以更好地评估不同阶段腰椎灌注变化及椎间盘退变与终板灌注的关系。 展开更多
关键词 MRI 动态对比增强 骨肌肿瘤 关节炎 脊柱 骨折 综述
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脊柱神经鞘瘤术后无病生存期的风险因素分析 认领
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作者 汪宗伟 李道龙 +2 位作者 杨振时 付为刚 李志勇 《颈腰痛杂志》 2020年第4期438-441,共4页
目的探讨脊柱神经鞘瘤的临床治疗方式,并讨论影响手术预后的风险因素。方法回顾性分析本科自2016年1月-2017年9月行手术治疗的50例脊柱神经鞘瘤患者临床资料,随访观察其无病生存期,采用单因素及多因素分析探讨其术后无病生存期的影响因... 目的探讨脊柱神经鞘瘤的临床治疗方式,并讨论影响手术预后的风险因素。方法回顾性分析本科自2016年1月-2017年9月行手术治疗的50例脊柱神经鞘瘤患者临床资料,随访观察其无病生存期,采用单因素及多因素分析探讨其术后无病生存期的影响因素,并采用生存曲线揭示相关因素对患者无病生存期的影响。结果50例随访中,14例患者复发。患者平均无病生存时间为26.4个月(3~44个月,中位时间24个月)。单因素及多因素分析发现,术前Frankel分级和术后病理结果是其独立危险因素(P<0.05)。结论术前Frankel分级是影响脊柱神经鞘瘤患者肿瘤复发的独立危险因素;与良性脊柱神经鞘瘤相比,恶性脊柱神经鞘瘤患者术后复发率更高,预后更差。 展开更多
关键词 神经鞘瘤 脊柱 无症状生存时间 风险因素
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骨科机器人辅助经皮椎体后凸成形治疗多节段脊柱转移瘤 认领
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作者 林书 胡豇 +4 位作者 万仑 唐六一 王跃 俞阳 张伟 《中国组织工程研究》 CAS 北大核心 2020年第33期5249-5254,共6页
背景:经皮椎体后凸成形治疗多节段脊柱转移瘤存在手术时间长、透视剂量大、骨水泥易渗漏等相关问题。机器人辅助下经皮椎体后凸成形治疗可优化手术,减少并发症的发生。目的:评价机器人辅助下经皮椎体后凸成形治疗多节段脊柱转移瘤的安... 背景:经皮椎体后凸成形治疗多节段脊柱转移瘤存在手术时间长、透视剂量大、骨水泥易渗漏等相关问题。机器人辅助下经皮椎体后凸成形治疗可优化手术,减少并发症的发生。目的:评价机器人辅助下经皮椎体后凸成形治疗多节段脊柱转移瘤的安全性和优势所在。方法:回顾分析2018年1月至2019年4月收治的43例无神经损伤症状多节段脊柱转移瘤患者的临床资料,根据手术方法分为机器人辅助组(n=22)和传统透视组(n=21)。2组患者性别、年龄、病椎数量、原发肿瘤来源、术前目测类比评分等一般资料比较差异均无显著性意义(P>0.05),具有可比性。收集2组患者手术时间、透视次数、透视剂量、椎弓根突破率、穿刺内倾角及骨水泥渗漏情况;对比2组术前、术后2d及末次随访目测类比评分、椎体中线高度、Cobb角度。结果与结论:①机器人辅助组和传统透视组治疗的病椎数量分别为79个和70个;②机器人辅助组平均手术时间、透视次数明显少于传统透视组,透视剂量低于传统透视组,差异均有显著性意义(P<0.001);③机器人辅助组椎弓根突破率为6%,传统透视组为21%,差异有显著性意义(χ^2=6.040,P=0.014);④机器人辅助组穿刺内倾角大于传统透视组(P<0.001);⑤机器人辅助组骨水泥渗漏率显著低于传统透视组(8%,23%,χ^2=6.869,P=0.009);⑥术前、术后2d、末次随访2组间目测类比评分、椎体中线高度、Cobb角比较,差异均无显著性意义(P>0.05);⑦提示机器人辅助下经皮椎体后凸成形治疗多节段脊柱转移瘤可缩短手术时间,减少透视次数,降低透视剂量,穿刺准确率高,骨水泥渗漏风险低。 展开更多
关键词 机器人 椎体 后凸成形术 脊柱 转移瘤 骨水泥 影像
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基于模糊逻辑青少年特发性脊柱侧弯矫形器设计专家系统的设计与实现 认领
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作者 赵德竹 关天民 +1 位作者 吴斌 梅钊 《中国组织工程研究》 CAS 北大核心 2020年第33期5255-5261,共7页
背景:近年来人工智能技术已广泛应用于医疗各领域,有效地辅助医生进行患者的诊疗操作。在青少年特发性脊柱侧弯的保守治疗中,将人工智能技术应用于青少年特发性脊柱侧弯矫形器的辅助设计,从而缩短矫形器的开发周期。目的:设计并实现一... 背景:近年来人工智能技术已广泛应用于医疗各领域,有效地辅助医生进行患者的诊疗操作。在青少年特发性脊柱侧弯的保守治疗中,将人工智能技术应用于青少年特发性脊柱侧弯矫形器的辅助设计,从而缩短矫形器的开发周期。目的:设计并实现一款基于模糊逻辑的青少年特发性脊柱侧弯矫形器设计专家系统(SODES),借助该专家系统,实现快速、有效地辅助医生设计青少年特发性脊柱侧弯矫形器的目的。方法:借助专家系统工具C Language Integrated Production System(CLIPS)与C++混合编程开发了SODES。SODES的主要的功能模块包括模糊推理机、议程、知识库管理系统、知识库、事实库、解释器、人机接口。针对于青少年特发性脊柱侧弯矫形器设计过程中存在的不确定性信息,通过模糊集实现了青少年特发性脊柱侧弯矫形器设计的知识表达,并通过基于可信度的模糊推理实现了SODES的推理。最后,通过2例青少年特发性脊柱侧弯患者的诊疗实例,验证了基于模糊逻辑的SODES设计方法的可行性。结果与结论:①SODES提高了50%的青少年特发性脊柱侧弯矫形器的设计效率,且其推理值与领域专家实际操作值的偏差率均小于10%;②结果表明,通过SODES可以辅助医生快速、有效地设计青少年特发性脊柱侧弯矫形器。 展开更多
关键词 脊柱 脊柱侧弯 青少年 矫形器 模糊逻辑 人工智能 数字医学
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椎管狭窄症的相关研究 认领
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作者 陈伯华 《中国骨与关节杂志》 CAS 2020年第7期481-485,共5页
椎管狭窄既可以是自然退变的"内源性"因素引起,又可以是发育、创伤、感染、肿瘤等"外源性"因素引起,但终究是影响神经功能的正常运行,按照发病部位来说,颈椎管狭窄与腰椎管狭窄在临床诊疗中最为常见,发病率也最高,... 椎管狭窄既可以是自然退变的"内源性"因素引起,又可以是发育、创伤、感染、肿瘤等"外源性"因素引起,但终究是影响神经功能的正常运行,按照发病部位来说,颈椎管狭窄与腰椎管狭窄在临床诊疗中最为常见,发病率也最高,尤以颈椎管狭窄危害性最大且相关的并发症、手术相关问题解释不清,其中颈性眩晕因其临床症状复杂、致病机制不明确、诊断标准模糊、涉及理论众多,近年来一直难有统一的认识,这也对疾病的成因解释造成了很大困难,特别是伴有某些常见症状的颈椎管狭窄疾。 展开更多
关键词 椎管狭窄 脊柱 述评
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