椎侧体

PMMA is the most used lesion filling at present; There is not significant difference between unipedicular and bipedicular vertebroplasty; Using vertebral body venography and appropriate dense bone cement can reduce leakage; Bolster for self-replacement can rebound vertebral body height, and Balloon-PKP and Sky-PKP can be avoided; In order to reduce refracture of vertebral body, anti-osteoporosis drugs should be used.

PMMA是目前最常用的填充物；单侧注射和双侧注射疗效没有明显差别；应用造影剂及掌握合适的骨水泥黏稠度可以减少骨水泥的渗漏率；术前腰部垫枕自身复位可以恢复椎体的高度，避免采用操作复杂且价格昂贵的球囊－PKP及Sky-PKP；进行PVP时应该配合应用抗骨质疏松药物，以减少椎体再骨折的发生。

Polymethyl methacrylate is the most used filling materials at present; There is not significant difference between unipedicular and bipedicular vertebroplasty; Using vertebral body venography and appropriate dense bone cement can reduce leakage of bone cement; Bolster for self-replacement can rebound vertebral body height, and balloon kyphoplasty and sky bone expander kyphoplasty can be avoided; In order to reduce refracture of vertebral body, anti-osteoporosis drugs should be used in the treatment of percutaneous vertebroplasty.

聚甲基丙烯酸甲酯是目前最常用的填充物；单侧注射和双侧注射疗效没有明显差别；应用对比剂及掌握合适的骨水泥黏稠度可以减少骨水泥的渗漏率；成形前腰部垫枕自身复位可以恢复椎体的高度，避免采用操作复杂及价格昂贵的球囊后凸成形及骨膨胀椎体后凸成形；进行经皮椎体成形时应该配合应用抗骨质疏松药物，以减少椎体再骨折的发生。

The screw entry point was located at the tip of transverse process. The average inclination angle should be 10°-20° headward and 30°-40° toward neutral line respectively. The screw was inserted and entered into the vertebral body along the external cortex of pedicle. The integrity of cortical bone around screws, the distance to segmental blood vessels and the penetration of cortex were observed after operation to evaluate the accuracy and safety of screw placement. Among 160 thoracic pedicle screws that were implanted in 34 cases, 148 screws (92.5%) were accurately inserted inside the costotransverse unit, and 12 screws (7.5%) were misplaced according to the image of X-ray and CT thin-slice scan.

应用椎弓根外内固定技术2004/2007年在中山大学附属第三医院骨科治疗34例患者，固定前采用CT加密扫描测量进钉点、进钉点至椎体前缘的深度、进钉角度和直径，固定中椎弓根钉入点为横突尖，进钉方向为平均向头侧倾斜10°~ 20°、与中线成角30°~40°，顺椎弓根外侧皮质进入椎体，固定后CT加密扫描观察螺钉周围的皮质骨是否完整、是否靠近节段血管、是否穿透皮质骨，评价置入钉的准确性和安全性。34例患者共置入160枚胸椎椎弓根螺钉，固定后CT加密扫描和X射线片观察到148枚(92.5%)螺钉置入准确，12枚(7.5%)螺钉发生错置。

From 2004 to 2007, 34 cases were treated with extrapedicular screw fixation in Department of Orthopaedics, Third Affiliated Hospital of Sun Yat-sen University. The screw entry point, angle, depth and diameter were measured and defined on the thoracic vertebrae pedicle by CT thin-slice scan in standard prone for all cases before operation. The screw entry point was located at the tip of transverse process. The average inclination angle should be 10°-20° headward and 30°-40° toward neutral line respectively. The screw was inserted and entered into the vertebral body along the external cortex of pedicle. The integrity of cortical bone around screws, the distance to segmental blood vessels and the penetration of cortex were observed after operation to evaluate the accuracy and safety of screw placement.

应用椎弓根外内固定技术2004/2007年在中山大学附属第三医院骨科治疗34例患者，固定前采用CT加密扫描测量进钉点、进钉点至椎体前缘的深度、进钉角度和直径，固定中椎弓根钉入点为横突尖，进钉方向为平均向头侧倾斜10°~20°、与中线成角30°~40°，顺椎弓根外侧皮质进入椎体，固定后CT加密扫描观察螺钉周围的皮质骨是否完整、是否靠近节段血管、是否穿透皮质骨，评价置入钉的准确性和安全性。34例患者共置入160枚胸椎椎弓根螺钉，固定后CT加密扫描和X射线片观察到148枚(92.5%)螺钉置入准确，12枚(7.5%)螺钉发生错置。

At last, ILIF in segment L3-4 and L4-5 is feasible. 2. There are enough operation space for ILIF in L3-4 and L4-5 with the root being retracted gently. And it is feasible to insert a couple transpedicle screws homolaterally. The intertransverse area was too narrow to perform ILIF on L5-S1.3. ILIF provide greater biomechanical stability than TLIF. while there was no significantly different stability between ILIF with homolateral or bilateral pedicle screw fixation. Adequate postoperative stability can be achieved by intertransverse lumbar interbody fusion with homolateral pedicle screw fixation.4. ILIF with transpedicle screws fixation homolaterally was a safe, convenient and effective operation, and less intraspinal complications were occurred of ILIF than TLIF.5. The fusion condition was satisfaction in ILIF group, which was better than TLIF group.

横突间入路腰椎椎体间融合术在L3-4、L4-5节段具有可行性。2、在L3-4、L4-5节段可提供足够的空间行ILIF手术，并可通过同一切口附加椎弓根钉固定，操作安全、简便。L5-S1节段横突间区域较小，操作困难，不适合行ILIF手术。3、ILIF手术术后生物力学稳定性有所下降但优于TLIF手术；ILIF附加同侧椎弓根钉固定与附加双侧椎弓根钉固定生物力学稳定性相当，使用ILIF术式附加侧同椎弓根螺钉固定，可提供较好的即刻稳定性。4、ILIF手术及附加同侧椎弓根钉固定是一种安全、简便、有效的手术方式，在减少椎管内并发症方面具有优势。5、ILIF手术可获得较好的融合率，其融合情况从组织学观察稍好于TLIF手术。

Intravertebral clefts were observed in none of 11 cases on sitting and flexion positions, in 4 of 11 (36%) on extension, and 11of 11 (100%) on supine and prone positions.

在直立侧位及过屈侧位X射线平片上，11例患者均未出现椎体真空征，过伸侧位上出现4例（36%），俯卧位及仰卧位均出现椎体真空征（100%）。

BACKGROUND: Many clinical studies have demonstrated that pseudoarthrosis formation after thoracolumbar vertebral compression fracture is often assessed using lateral films.

摘要背景：许多临床研究阐述了胸腰椎椎体压缩性骨折后应用常规侧位片来评定是否有假关节形成，作者所查应用仰卧或俯卧侧位X射线片来诊断椎体真空征的文献较少。

Our results showed that the most appropriate rib's level for applying force was below the apex of scoliotic spine. From this appropriate level, the stress delivered to its conjunctive vertebra was the highest, as 1.3~1.8 times compared with others. Furthermore, the correction of Cobb's angle was also the highest, achieved 15%. The ML force was dominant in alteration of Cobb's angle, whereas the AP force was dominant in alteration of axial vertebral rotation. In addition, initial vertebral rotation influenced neither correction nor stress.

研究结果显示由凸点椎体的下一节对应之肋骨施力能使传入椎体具最高平均应力，较其他施力位置高出1.3到1.8倍之间，对柯卜氏角度可达15%的最佳矫正率；其中侧向施力主导冠状面上的矫正，而前后向施力主导扭转角度的矫正；另外椎体初始旋转角度对侧弯矫正和应力分布均无明显影响。

Although these injuries may consist of a variety of posterior element pathologies spanning the spectrum from fracture separation of the lateral mass 25,26 (with translation or rotation since an undisplaced lateral mass fracture falls within the compression morphology) through completely dislocated or locked facets.

尽管这种损伤可以包含多种后方结构的病理改变，包括从侧块的骨折分离到完全的脱位或关节交锁，各种程度的棘突、椎板、侧块等后方结构的骨折伴随椎体的爆裂、矢状面和/或冠状面的骨折，如所谓的泪滴状骨折。所有这些损伤存在于1个椎体相对于邻近椎体的平移。

In case of a total en bloc resection of one or more high thoracic vertebrae, we start with a dorsal approach by exposing the affected spinal segments, cut and remove rib ends bilaterally, perform one or multilevel laminectomies and bilateral foraminectomies and facetectomies, followed by an incision and reaming of the intervertebral discs at the appropriate levels.

假设要做一个或多个高位胸椎椎体的整块切除，我们采用背侧入路显露病变节段，切除双侧肋骨末端，行一节或多节段椎板切除，双侧椎间孔及小关节切除，继以相应节段椎间盘切除和刮除。

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起初我只晓得布鲁克雷德丝是美国少男少女崇拜的偶像，后来回台湾，甚至去年在北京，居然也四处看见她的海报，才惊讶她的魅力之大。