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Methods Seven cadaveric spinal specimens were measured of neutrol zoneand range of motionin 6 movements including anteflexion,retroflexion,left and right lateral flexion,left and right axial rotation.

测试前屈、后伸、左侧弯、右侧弯、左旋转、右旋转的中性区(neutral zone,NZ)和运动范围(range of motion,ROM)。程序:完整状态;②骨折后状态;③椎体成形后;④3000次循环疲劳后。结果骨折后中性区和运动范围均明显增大。椎体成形后屈伸、侧弯、旋转在NZ及ROM均明显减少。

Results (1) 6 cases of Tuberous Sclerosis. Diffused subependymal nodular calcification lesions were found in all cases on unenhenced CT. 4 patients are 2 pairs of mother/child relationship. Both of the two mothers are found to suffer from renal angiomyolipoma.(2)1 case of neurofibromatosis showed abnormal spinal canal: scoliosis of thoracic and lumbar spine, concave change of vertebral posterior border. Bilateral renal hypogenesis was found in this patient. Diffused hyper-density lesions were found in kidney and fatty accumulation was found in back skin.(3)6 cases of Sturge-Weber syndrome. On unenhenced CT, curving and strip-shaped calcifications were found along the parietal and occipital gyrus.

结果 ①结节性硬化6例,所有病例CT平扫见两侧脑室室管膜下多发小结节状高密度钙化灶,其中4例为两对母子关系,并见两位母亲合并有肾脏错构瘤,;②神经纤维瘤病1例,MRI表现为椎管异常,胸腰段脊柱侧弯,椎体后缘呈明显的切凹改变;伴有双肾发育不良,CT示肾内多个高密度影,背部皮肤多量脂肪堆积,③脑颜面血管瘤综合征6例, CT可见顶枕部沿脑回分布的弯曲的条状高密度钙化,部分延伸致侧脑室内,增强后见病灶内有扭曲的条状和结节状明显强化的血管影;④小脑血管瘤病4例,影像学表现为小脑内大囊、小结节样占位性病变。

After initial strength and stiffness were determined, vertebral bodies were stabilized by bipedicular injection of 2, 4, 6, or 8ml ACPC and recompressed ibidem.

自8具尸体脊柱标本上截取24节胸腰段椎体,在前屈压缩载荷下造成骨折后,随机分成4组,分别经双侧椎弓根注入椎体2、4、6和8ml ACPC,再行前屈压缩。

Methods: Injured patients of cervical spine was cayyied on X-ray inspection.,then according to the result of ADI and LADS ,next to CT or MRI inspection ,and that was to guide clinical diagonosis and treatment.To observe atlanto-dental interval (anterior arch of atlas posterior border to odontoid process anterior border) and odontoid process caster(included angle between axis of ordinate of odontoid process and axis of ordinate of odontoid vertebra) on the X-ray lateral projection.

对有颈部外伤史的病人常规行X线检查,然后根据寰齿间距和齿突侧块间隙的结果,行下一步CT检查或者MRI检查,指导临床治疗方法的选择。X线侧位片观察寰齿前间隙(为寰椎前弓后缘与齿突前缘距离),齿状突后倾角(齿突纵轴与枢椎体纵轴的夹角);开口正位片上测定齿突侧块间隙。

The recoery rate was calculated as follows;(JOA score at follow up_preoperatie JOA score)/(17 _ preoperatie JOA score) _ 100,15 and the surgical outcomes were classified into four grades based on the calculated recoery rate; excellent: recoery rate 75% or higher, good: 50–75%, fair: 25–50%, and poor: lower than 25%. Ealuation was made on radiographic findings, including the range of motion and the jaw diameter (a measured line from the posteroinferior corner of the ertebral body to the anterior aspect of the subjacent lamina) at the adjacent leels in group A and the affected leels in group B and the spinal canal diameter at the C4 leel in both groups. The C4 leel was chosen for this measurement, because the spinal canal is usually narrowest at this leel.

恢复率如下计算;(随访JOA评分-术前JOA评分)/(17-术前JOA评分)*10015,按计算的恢复率将手术结果分4级;优:恢复率75%或更高,良:50-70%,中:25-50%,差:低于25%。X线片结果评价,包括活动范围和颌直径(从椎体下后角到下邻椎板前方的测量线)在A组相邻水平与B组受影响水平及两组C4水平椎管直径。C4作为该侧量的选择是因为通常在此平面椎管最为狭窄。

ConclusionOne-stage posterior hemivertebrae and osseous divide resection combined with transpedicular instrumentation and bone graft can achieve a satisfactory result for the treatment of scoliosis of thoracic hemivertebra and diastematomyelia of adolescent.It can be recommended in clinical practice because of a good stability of fixation and fine spinal fusion.

结论一期后路半椎体及骨嵴切除、椎弓根螺钉内固定植骨融合术是治疗青少年胸椎半椎体脊柱侧凸合并脊髓纵裂的有效方法,具有较好植骨融合和稳定性,值得推广应用。

Methods There were 12 cases, 10 of them were corpse specimens, the other 2 were clinic cases. Firstly we dissociate the contralateral C7 root from the intervertebral foramen to its divisions, secondly we set up a tunnel between the cone and the anterior scalenus, thirdly we moved the C7 root to the gap between the thyroid and the opposite carotid theca through the mentioned tunnel, then we dissociate the injured brachial plexus extensively, lastly we anastomose the contralateral C7 and the injured inferior trunk.

尸解10例,临床应用2例,将健侧颈7神经近端游离至神经根孔,远端游离至前后股处,于前斜角肌后椎体前建立通道,将健侧颈7神经引导至患侧颈血管鞘和甲状腺间隙处,然后患侧行下干、内侧束、尺神经、及正中神经内侧头广泛游离,患侧屈肘屈肩关节后,将健侧颈7神经直接与患侧下干无张力下吻合。

[Objective]To study the biomechanical stability of slidable pedicle screw system with the comparison of slidable pedicle screw system and universal pedicle screw system in intensity,rigidity and other biomechanical functions.[Method]Twelve spinal specimens of the pig were randomly divided into two groups and the schubweg on the vertebra of T12 were measured in different conditions.In the end the intensity and rigidity of two groups were compared which were computed by the schubweg.

[目的]对滑动椎弓根钉系统与通用椎弓根钉系统在脊柱侧凸固定强度、刚度和稳定性等方面进行生物力学比较,以测试滑动椎弓根螺钉内固定系统稳定性的生物力学性能[方法]采用12具猪新鲜脊柱标本,随机分成两组分别测量不同工况下T12椎体的位移,并计算其强度和刚度进行比较。

Results: Axial scanning including vertebral arch can show spondyloschisis and other signs. These contained widened or stenosis of the spinal canal, stenosis of he lateral recess, the double margin sign, deformity of the lateral recess, the double margin sign, deformity of the intervertebral disc, denegeration of the joint facet and thickening of the ligamentum flavum. Scotty dog sign were showed in images reconstructed along the direction of vertebralarch.

结果:包括椎弓根层而的轴位扫描均能显示峡部裂和其他伴发表现,包括椎管增大或变窄,侧隐窝狭窄、双边征、椎间盘变形、椎小关节退行性变和黄动心忍性韧带肥厚采用平行于峡部的椎弓长轴MPR、MIP斜矢状面重建能直观显示峡部裂的典型表现-猎狗项圈征,正中矢状面重建能显示椎体滑脱。

Methods:One hundred and six disarticulated human verebrae(C3~C7)were evaluated with computed tomography to determine vertebral bone mineral density.Pedicle screws and lateral mass screws were inserted to the left and right at random.Screws were loaded either axially strictly longitudinal to failure or in a coronal plane strictly perpendicular to the logitudinal axis,the strengths and displacements were recorded.

方法解离C3~C7骨块120个随机分为两组,测量每个椎体骨的松质骨密度,同一节段椎体随机配对置入椎弓根和侧块螺钉,在位移控制下分别测量位移控制下的平均最大拔出阻力和压力控制下的切向弹性与永久位移。

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