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应用后路钛网椎管成形术治疗胸椎椎管内肿瘤

中国骨与关节杂志 2012年第4期1卷 354-357页

作者：张立赵敏周江军朱治宇吕仁发张懿城解放军第184医院骨科鹰潭335000

目的椎管内肿瘤全椎板减压术是椎管内肿瘤摘除的常规手术方式,术后易造成椎管内粘连导致椎管再次狭窄引起一系列的并发症,造成2次手术困难,本文对这一术式进行改良,采用后路钛网椎管成形对所减压的椎管进行修复重建,恢复椎管内有效容积... 详细信息

目的椎管内肿瘤全椎板减压术是椎管内肿瘤摘除的常规手术方式,术后易造成椎管内粘连导致椎管再次狭窄引起一系列的并发症,造成2次手术困难,本文对这一术式进行改良,采用后路钛网椎管成形对所减压的椎管进行修复重建,恢复椎管内有效容积、减少粘连。方法 2007年10月至2011年2月共收治9例胸椎椎管内肿瘤的患者,男6例,女3例,年龄25～64岁,平均37.8岁。硬膜外肿瘤5例,硬膜内肿瘤4例。全部给予后路全椎板减压,肿瘤切除,椎弓根钉内固定并钛网椎管成形术。术后病理学诊断:神经鞘瘤3例,脊膜瘤2例,脂肪瘤2例,囊肿2例。肿瘤复发1例,给予2次手术切除后未复发。结果手术时间90-185min,平均142min,失血量200～1200ml,平均521ml,全部9例患者术后得到定期随访12-45个月,平均21个月。采用frankel评分标准对术后患者症状进行评价,A:0例,B:1例,C:3例,D:2例,E:3例。术后复发1例。术后CT显示椎管内未出现粘连。对术前术后肿瘤占位所在节段椎管横截面CT图片进行分析,每例患者随机取5个横截面进行椎管内矢状径测量,取平均值,术前矢状径为16.89±1.27mm,术后矢状径为27.11±2.52mm,进行配对t检验,t=-15.441,P<0.01,术后椎管矢状径明显大于术前。结论后路钛网椎管成形手术难度相对较低,减少手术时间,降低术中出血量,术后对椎管起到较好的即刻保护作用,同时增加了术后椎管容积,减少了术后粘连,为肿瘤复发后的2次手术剥离减少风险。

关键词：钛网椎管成形胸椎肿瘤椎管重建

一期后路经椎弓根病灶清除、植骨融合、内固定治疗老年胸腰椎结核

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临床骨科杂志 2011年第4期14卷 364-366页

作者：吕晓强张永进杜英勋周方伦温州医学院附属东阳医院骨科浙江东阳322100

目的探讨一期后路经椎弓根病灶清除、植骨融合、内固定术治疗老年胸腰椎结核的疗效。方法 15例老年胸腰椎结核患者,经正规抗结核治疗2周以上,行一期后路经椎弓根病灶清除植骨融合、椎弓根钉内固定。观察手术时间、术中出血量、术后神经... 详细信息

目的探讨一期后路经椎弓根病灶清除、植骨融合、内固定术治疗老年胸腰椎结核的疗效。方法 15例老年胸腰椎结核患者,经正规抗结核治疗2周以上,行一期后路经椎弓根病灶清除植骨融合、椎弓根钉内固定。观察手术时间、术中出血量、术后神经功能恢复及植骨融合和脊柱序列保持情况。结果手术时间为（140±21）min,术中出血量为（500±88）ml。15例均获随访,时间24~36个月。神经功能frankel分级：5例D级恢复到E级4例,1例无恢复。植骨均融合。术后脊柱后凸、侧凸均有不同程度纠正,Cobb角术后为0°~24.2°,末次随访时为0°~25.3°。结论采用一期后路经椎弓根病灶清除、植骨融合、内固定治疗老年胸腰椎结核,创伤小、效果好,但应严格把握手术适应证。

关键词：结核,脊柱病灶清除内固定植骨脊柱融合术

纳米羟基磷灰石／聚酰胺66椎体支撑体在下颈椎骨折脱位前路手术重建中的应用

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中华外科杂志 2012年第4期50卷 338-341页

作者：吕超亮宋跃明刘浩刘立岷龚全李涛曾建成孔清泉裴福兴屠重棋段宏四川大学华西医院骨科成都610041

目的探讨纳米羟基磷灰石／聚酰胺66（n-HA／PA66）椎体支撑体在下颈椎骨折脱位前路手术重建中应用的临床治疗效果。方法2008年1月至2010年7月，84例下颈椎骨折脱位患者行前路椎体次全切除、椎管减压，以n-HA／PA66椎体支撑体支撑植骨、... 详细信息

目的探讨纳米羟基磷灰石／聚酰胺66（n-HA／PA66）椎体支撑体在下颈椎骨折脱位前路手术重建中应用的临床治疗效果。方法2008年1月至2010年7月，84例下颈椎骨折脱位患者行前路椎体次全切除、椎管减压，以n-HA／PA66椎体支撑体支撑植骨、钢板螺钉内固定治疗，其中男性60例，女性24例；年龄18-75岁，平均45．7岁。随访以frankel分级标准评价患者神经功能恢复情况，复查X线片及三维CT评估支撑植骨融合情况，包括椎问高度、生理曲度及支撑体是否下沉。结果84例患者均成功完成颈椎前路减压手术以及支撑体的安放固定，并获得随访，随访时间6-24个月，平均12个月。所有患者的术前症状均得到不同程度的改善，根据frankel分级标准评定，平均改善1．0级。影像学检查显示所有患者植骨融合，颈椎序列、椎问高度、颈椎稳定性以及支撑体的位置维持良好，支撑体无下沉、移位。术后即刻椎间高度（2．4±0．2）cm，术前椎间高度（1．9±0．1）cm，两组比较差异有统计学意义（q=2．48，P〈0．001）。术后即刻、3个月、1年、2年不同时期随访各组椎间高度比较，差异无统计学意义（P〉0．05）。术前颈椎融合节段Cobb角为9．8°±1．2°，术后即刻Cobb角为16．6°±1．2°，术后颈椎Cobb角与术前相比差异有统计学意义（q=14．25，P〈0．001）。术后即刻、3个月、1年、2年不同时期随访各组间比较，差异无统计学意义（P〉0．05）。结论n-HA／PA66椎体支撑体具有早期支撑稳定功能，可有效维持颈椎生理曲度和椎间高度；术后植骨融合率高且便于X线片观察，是进行颈椎骨折脱位前路手术植骨的理想支撑材料，但长期效果需进一步随访观察。

关键词：颈椎脊柱骨折脱位假体和植入物羟基磷灰石类纳米结构

Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID- 19 pandemic

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Stroke & Vascular Neurology 2021年第4期6卷 542-552,I0026-I0032页

作者： Thanh N Nguyen Diogo C Haussen Muhammad M Qureshi Hiroshi Yamagami Toshiyuki Fujinaka Ossama Y Mansour Mohamad Abdalkader Michael frankel Zhongming Qiu Allan Taylor Pedro lylyk Omer F Eker laura Mechtouff Michel Piotin Fabricio Oliveira lima Francisco Mont'Alverne Wazim Izzath Nobuyuki Sakai Mahmoud Mohammaden Alhamza R Al-Bayati leonardo Renieri Salvatore Mangiafico David Ozretic Vanessa Chalumeau Saima Ahmad Umair Rashid Syed Irteza Hussain Seby John Emma Griffin John Thornton Jose Antonio Fiorot Rodrigo Rivera Nadia Hammami Anna M Cervantes-Arslanian Hormuzdiyar H Dasenbrock Huynh le Vu Viet Quy Nguyen Steven Hetts Romain Bourcier Romain Guile Melanie Walker Malveeka Sharma Don Frei Pascal Jabbour Nabeel Herial Fawaz Al-Mufti Atilla Ozcan Ozdemir Ozlem Aykac Dheeraj Gandhi Chandril Chugh Charles Matouk Pascale lavoie Randall Edgell Andre Beer-Furlan Michael Chen Monika Killer-Oberpfalzer Vitor Mendes Pereira Patrick Nicholson Vikram Huded Nobuyuki Ohara Daisuke Watanabe Dong Hun Shin Pedro SC Magalhaes Raghid Kikano Santiago Ortega-Gutierrez Mudassir Farooqui Amal Abou-Hamden Tatsuo Amano Ryoo Yamamoto Adrienne Weeks Elena A Cora Rotem Sivan-Hoffmann Roberto Crosa Markus Möhlenbruch Simon Nagel Hosam Al-Jehani Sunil A Sheth Victor S lopez Rivera James E Siegler Achmad Fidaus Sani Ajit S Puri Anna luisa Kuhn Gianmarco Bernava Paolo Machi Daniel G Abud Octavio M Pontes-Neto Ajay K Wakhloo Barbara Voetsch Eytan Raz Shadi Yaghi Brijesh P Mehta Naoto Kimura Mamoru Murakami Jin Soo lee Ji Man Hong Robert Fahed Gregory Walker Eiji Hagashi Steve M Cordina Hong Gee Roh Ken Wong Juan F Arenillas Mario Martinez-Galdamez Jordi Blasco Alejandro Rodriguez Vasquez luisa Fonseca M luis Silva Teddy Y Wu Simon John Alex Brehm Marios Psychogios William J Mack Matthew Tenser Tatemi Todaka Miki Fujimura Roberta Novakovic Jun Deguchi Yuri Sugiura Hiroshi Tokimura Rakesh Khatri Michael Kelly lissa Peeling Yuichi Murayama Hugh Stephen Winters Johnny Wong Mohamed Teleb Jeremy Payne Hiroki Fukuda Kosuke Miyake Junsuke Shimbo Yusuke Sug Neurology RadiologyBoston Medical CenterBostonMassachusettsUSA Neurology Marcus Stroke&Neuroscience CenterGrady Memorial HospitalEmory University School of MedicineAtlantaGAUSA Radiology Radiation OncologyBoston University School of MedicineBostonMassachusettsUSA Neurology National Hospital Organization Osaka National HospitalOsakaJapan Neurosurgery National Hospital Organization Osaka National HospitalOsakaJapan Neurology Alexandria UniversityAlexandriaEgypt Radiology Boston Medical CenterBostonMassachusettsUSA Department of Neurology Xinqiao HospitalChongqingChina Neurosurgery University of Cape TownRondeboschWestern CapeSouth Africa Neurosurgery Interventional NeuroradiologyClinica La Sagrada FamiliaBuenos AiresArgentina Neuroradiologie Neurologie VasculaireHospices Civils de LyonLyonAuvergne-Rhône AlpesFrance Neurologie Vasculaire Hospices Civils de LyonLyonAuvergne-Rhône AlpesFrance Interventional Neuroradiology Fondation Ophtalmologique Adolphe de RothschildParisÎle-de FranceFrance Neurology Hospital Geral de FortalezaFortalezaBrazil Interventional Neuroradiology Hospital Geral de FortalezaFortalezaBrazil Neuroradiology Nottingham University Hospitals NHS TrustNottinghamUK Department of Neurosurgery Kobe City Medical Center General HospitalKobeHyogoJapan Interventional Neurovascular Unit University Hospital CareggiFirenzeToscanaItaly Neuroradiology University Hospital Centre ZagrebZagrebCroatia Interventional Neuroradiology Hopital BicetreLe Kremlin-BicetreFrance Stroke and Interventional Neuroradiology Lahore General HospitalLahorePakistan Neurological Institute Cleveland Clinic Abu DhabiAbu DhabiUAE Department of Radiology Beaumont HospitalDublinIreland Neurology Stroke UnitHospital-Estadual CentralVitoriaBrazil Neuroradiology Instituto de Neurocirugia Dr AsengoSantiagoChile Interventional Neuroradiology Institut National de NeurologieTunisTunisia Neurology Boston Medical CenterBostonMassachusettsUSA Neurosurgery Boston Medical Center

Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were *** study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ruptured aneurysm coiling interventions demonstrated similar *** We conducted a cross-sectional,retrospective,observational study across 6 continents,37 countries and 140 comprehensive stroke *** with the diagnosis of SAH,aneurysmal SAH,ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases,10th Revision,*** 3-month cumulative volume,monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before(1 year and immediately before)and during the pandemic,defined as 1 March-31 May *** prior 1-year control period(1 March-31 May 2019)was obtained to account for seasonal *** There was a significant decline in SAH hospitalisations,with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic,representing a relative decline of 22.5%(95%CI−24.3%to−20.7%,plisation of ruptured aneurysms declined with 1170-1035 procedures,respectively,representing an 11.5%(95%CI−13.5%to−9.8%,p=0.002)relative *** analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations,a 24.9%relative decline(95%CI−28.0%to−22.1%,plative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1%(95%CI 32.3%to 50.6%,p=0.008)despite a decrease in SAH admissions in this *** There was a relative decrease in the volume of SAH hospitalisations,aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 *** findings in SAH are consistent with a decrease in other emergencies,such as stroke and myocardial infarction.

关键词： diagnosis representing subarachnoid

后路寰枢椎椎弓根螺钉固定融合治疗上颈椎损伤

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临床骨科杂志 2013年第4期16卷 368-369页

作者：杨子斌赵伟王正祥吕乔董锡亮刘卫华程微大理州人民医院脊柱外科云南大理671000

目的探讨后路寰枢椎椎弓根螺钉钉棒系统固定治疗上颈椎损伤的临床效果。方法对13例上颈椎损伤患者行后路寰枢椎椎弓根螺钉固定融合术。结果手术时间60～150 min。5例术前frankel D级患者术后均恢复至E级。13例均获随访,时间6～22个月。... 详细信息

目的探讨后路寰枢椎椎弓根螺钉钉棒系统固定治疗上颈椎损伤的临床效果。方法对13例上颈椎损伤患者行后路寰枢椎椎弓根螺钉固定融合术。结果手术时间60～150 min。5例术前frankel D级患者术后均恢复至E级。13例均获随访,时间6～22个月。患者植骨全部融合,内固定无松动,无断钉、断棒发生。结论后路寰枢椎椎弓根螺钉固定融合治疗上颈椎损伤疗效满意。

关键词：颈椎损伤寰椎枢椎椎弓根螺钉骨折固定术,内