椎关节

MethodTo cut the lamina arcus vertebrae on upper 1/3 level from L2 to S1 acantha,chisel the lamina arcus vertebrae on inner edge of little processus articularis upward and lift the acanthi、lamina arcus vertebrae、ligamentum flavum upward, the spinal cannel was exposed.

方法自L2～S1各棘突、椎板的上1／3水平截骨，小关节突内缘两侧椎板向上凿开，将棘突、椎板、黄韧带向上掀起，显露椎管，节段切开硬脊膜行SPR术。

Because of the complications of abdominal organs injury or retrograde ejaculation after ALIF, and the high risk of nerve injury after PLIF, these two surgeries were reduce to perform in clinic nowadays. While TLIF has be consider to have less risk of injuries of nerve root, cauda equine, dura matar, and less incidence of lumbar unsteadiness and spondylolithesis.

研究背景腰椎椎体间融合术是目前治疗椎间盘源性下腰痛、腰椎滑脱症、腰椎不稳症等原因引起的下腰痛效果较为满意的一种腰椎融合手术方式，其主要分为前路椎体间融合术、后路椎体间融合术以及经关节突入路椎体间融合术。

The primitive characteristics include long tail with more than 20 caudal vertebrae, which are surrounded by thin rod-like extensions of the zygapophyses and chevrons, and the fifth toe bearing two long digits, whereas the derived characteristics include an elongated skull with antorbital and nasal openings fused into a large nasoantorbital fenestra, long cervical vertebrae with reduced or absent cervical ribs. The length ratio of the wing metacarpal to the humerus is between the basal pterosaurs and pterodactyloids.

它既具有原始类群的特征：比如尾长，多于20节尾椎椎体，且尾椎椎体由极度加长的、纤细的前后关节突及脉弧所包裹，构成一僵硬的尾部，第五脚趾具有两个长的趾节；又具有进步类群的特征：比如头骨加长，鼻孔和眶前孔愈合为一大的鼻眶前孔，颈椎椎体长，没有或者颈肋退化；翼掌骨与肱骨的比率介于原始类群和进步类群之间。

Result: Different projection positions of X-ray can evaluate different thoracic small joints. Image diagnosis were space changes, the deflection of the spinous process of vertebral and hyperostosis osteosclerosis. soft tissue lesions near thoracic spinal facet almost was not evaluated. CT plain scan can evaluate every changes of thoracic spinal facet. Image diagnosis were articular process hypertrophy, osteophyte formation, articular surface hyperostosis osteosclerosis, space changes, joint capsule and ligament calcification.

结果：X线平片不同投照体位可以评价不同胸椎小关节，表现为间隙改变、椎棘突偏斜及增生硬化，对胸椎小关节软组织病变基本无法评价；CT平扫对各胸椎小关节改变均可评价，表现为关节突肥大，骨赘样增生，关节面硬化，关节间隙改变，关节囊及韧带钙化。

Methods 43 cases of lumbar stenosis undergone domelike decompression were performed L(subscript 3~4) and L(subscript 4~5) CT scanning pre-and postoperatively.

对弯顶形椎管扩大成形术治疗的43例腰椎管狭窄症患者手术前后进行CT扫描，用Image-Pro软件对CT扫描片进行椎管L(下标 3~4)、L(下标 4~5)的椎管矢径、上关节突内缘间距、椎板间距、截面积测量分析。

Domelike decompression can increase APDC, IFD, ELD and CSAC significantly, especially for CSAC, which is an effective way for lumbar stenosis.

弯顶形椎管扩大成形术可明显扩大腰椎管的矢径、上关节突内缘间距、椎板间距和椎管截面积，尤其是椎管截面积扩大更为明显，是一种治疗腰椎管狭窄症有效的方法。

Results: It was found that there were 7 cases of screw loosening or breaking in the internal fixation ,1 case of connecting pole loosening or dropping,3 cases of concurrent infection from internal fixators loosening,4 cases of internal fixation screw entering the spinal canal,being driven into the intervertebral space or going through the vertebra body,5 cases of repeated postoperative lumbar pain,2 cases of postoperative pseudoarthrosis formation,3 cases of the height loss of the vertebra body after the internal fixators was taken out.

结果：内固定螺钉松动或断裂7例，内固定系统中的连接杆松动或退出1例，内固定松动合并感染3例，内固定螺钉进入椎管或打入椎间隙者或穿破椎体者4例，术后反复腰痛者5例，术后假关节形成2例，内固定取出后椎体高度丢失3例。

RESULTS AND CONCLUSLON: A total of 2 of 6 autogenous bone grafting cases suffered from graft bone dislocation, 1 suffered from pseudoarthrosis formation, and 1 suffered from donated ilium. Six of 21 autogenous bone graft with cervical plate-screw fixation suffered from loss of intervertebral height, and 3 suffered from pain of donated ilium.

结果与结论：6例单纯植骨患者中2例发生植骨块脱出，1例发生融合节段假关节形成，1例发生髂骨供区疼痛；21例椎体间自体髂骨植骨内固定患者中6例发生椎间高度丢失，3例发生髂骨供区疼痛；65例椎体间钛网植骨融合内固定患者中11例发生内植物下沉，椎间高度丢失，1例发生内固定断裂。

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。

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。

Breath, muscle contraction of the buttocks; arch body, as far as possible to hold his head, right leg straight towards the ceiling (peg-leg knee in order to avoid muscle tension).

呼气，收缩臀部肌肉；拱起身体，尽量抬起头来，右腿伸直朝向天花板（膝微屈，以避免肌肉紧张）。

The cost of moving grain food products was unchanged from May, but year over year are up 8%.

粮食产品的运输费用与5月份相比没有变化，但却比去年同期高8％。