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We report a case of a patient who underwent two-level lumbar total disc replacement at L4-L5 and L5-S1 with the ProDisc II prosthesis, who was diagnosed with early anterior migration of the caudally placed device with partial occlusion of the left common iliac vein.

我们报告一例L4-L5、L5-S1两节段ProDisc II型假体全腰间盘置换患者,尾端放置的假体发生早期前移,并导致左髂总静脉部分梗阻。

First 27 rabbits of the experimental group were destabilizated by operated on L6、7.Inj Diazepam 0.25 mg/kg,Inj Ketamine 0.02 g/kg and Inj Atropine 0.125 mg/kg was one by one injected into the rabbit through the auris vein,shearing the rabbit hair of backside waist,fixing the rabbit on operation table in face lying,using 1% Povidone Ioding to degerm the operation area.Every rabbit was incised at the backside of its waist,that incisal opening is located in the center of the intervertebral space (L6、7 space) that both side iliac crest line correspond ,from the meso-ordinate direction cut about 4 cm incision,cutting open skin and subcutaneous tissue,thoroughly ,exposing the spinous processes the vertebral plates and the upper-inferior articular processes,entirely segregating the muscles that cohere the spinous processes the vertebral plates and the articluar process,then excising the supraspinal ligaments and interspinal ligaments,biting off two sides the inferior articular processes of L6,in order that resulting in intervertebral destabilization,using 0.9% Inj.Sodium Chloride to washout the incisal opening,in order sewing up each layer tissues.

方法] 取48只6个月龄日本大耳白兔,雌雄不限,体重为(2.5±0.2) kg,随机进行分组,分为对照组和实验组,对照组为21只;实验组为27只;先将实验组兔腰背部皮毛剪除,用安定注射液1.25 mg/kg、氯胺酮0.02 g/kg、阿托品0.125 mg/kg顺次耳缘静脉注射麻醉后,俯卧固定于手术台上,用1%碘伏消毒手术区域,以髂嵴平对椎间隙(即L6、7)为中心,从正中取一长约4 cm纵行切口,切开皮肤及皮下组织,锐性分离,暴露棘突、椎板及上下关节突,将附着于棘突、椎板及小关节的肌肉全部分离开,然后依次切除L6、7棘上及棘间韧带,咬除第6腰椎两侧下关节突,造成椎间失稳,用无菌生理盐水冲洗切口,依次缝合各层组织;术后动物在笼中自由活动。

Inj Diazepam 0.25 mg/kg,Inj Ketamine 0.02 g/kg and Inj Atropine 0.125 mg/kg was one by one injected into the rabbit through the auris vein,shearing the rabbit hair of backside waist,fixing the rabbit on operation table in face lying,using 1% Povidone Ioding to degerm the operation area.Every rabbit was incised at the backside of its waist,that incisal opening is located in the center of the intervertebral space (L6、7 space) that both side iliac crest line correspond ,from the meso-ordinate direction cut about 4 cm incision,cutting open skin and subcutaneous tissue,thoroughly ,exposing the spinous processes the vertebral plates and the upper-inferior articular processes,entirely segregating the muscles that cohere the spinous processes the vertebral plates and the articluar process,then excising the supraspinal ligaments and interspinal ligaments,biting off two sides the inferior articular processes of L6,in order that resulting in intervertebral destabilization,using 0.9% Inj.Sodium Chloride to washout the incisal opening,in order sewing up each layer tissues.

方法] 取48只6个月龄日本大耳白兔,雌雄不限,体重为(2.5±0.2) kg,随机进行分组,分为对照组和实验组,对照组为21只;实验组为27只;先将实验组兔腰背部皮毛剪除,用安定注射液1.25 mg/kg、氯胺酮0.02 g/kg、阿托品0.125 mg/kg顺次耳缘静脉注射####后,俯卧固定于手术台上,用1%碘伏消毒手术区域,以髂嵴平对椎间隙(即L6、7)为中心,从正中取一长约4 cm纵行切口,切开皮肤及皮下组织,锐性分离,暴露棘突、椎板及上下关节突,将附着于棘突、椎板及小关节的肌肉全部分离开,然后依次切除L6、7棘上及棘间韧带,咬除第6腰椎两侧下关节突,造成椎间失稳,用无菌生理盐水冲洗切口,依次缝合各层组织;术后动物在笼中自由活动。

Methods Selective arterial catheter was used, and gelatin sponge processed by high temperature or chemoembolization was used to embolize the iliolumbar and internal iliac artery which nourished the tumor.

采用选择性动脉插管,用经高温处理的明胶海绵栓塞或化疗性栓塞供应肿瘤的腰动脉、髂内动脉。

For 18 cases, the ascending vein and iliolumbar vein separately drained into common iliac vein, and for 12 cases a common trunk entered into the common iliac vein.

在牵拉髂总静脉时,可能导致它们的破裂,并且在暴露血管时需注意避免损伤闭孔神经和腰骶干。

Pterion is superior to the zygomatic arch and is a H-sharped suture on the lateral aspect of the skull between: 1.frontal bone; 2.parietal bone; 3.temporal bone; 4.sphenoid.

Hamerus 桡神经紧贴沟中经过,此段骨折,易损伤桡神经。是重要的体表标志。Hip bone Iliac crest两侧髂嵴最高点的连线,平对第四腰椎脊突,临床上腰穿多用此法定位。此处用英文解释。

Results: Base on the dissection, the rabbits' sciatic nerve was composed of the seventh lumbar nerve and first and second sacral nerves. The sciatic trunk descended in front of the sacroiliac joint and escaped between the sacral bone and ilium, then left the pelvis from the greater sciatic notch. The segment of sciatic trunk which ran between the sacrum and ilium was stable and feasible for localization according to the related bony structures in CT scanning, so it was selected as irradiation target. After high dose of stereotactic radiation, the degeneration and necrosis in nerve fibers could be observed under microscope.

结果:通过解剖可见坐骨神经主干由第7腰神经和第1、2荐神经组成,坐骨神经主干从荐髂关节下、荐骨和髂骨之间穿出后,跨过坐骨大切迹的一段坐骨神经主干位置恒定,且有荐骨和髂骨做定位标志,可作为CT定位的照射靶点,单次大剂量照射后镜下可见神经纤维变性坏死。

A radiosurgery treatment planning was performed on the selected nerve segment, its changes of pathology and ultrastructure were observed. Results: Base on the dissection, the rabbits' sciatic nerve was composed of the seventh lumbar nerve and first and second sacral nerves. The sciatic trunk descended in front of the sacroiliac joint and escaped between the sacral bone and ilium, then left the pelvis from the greater sciatic notch.

结果:通过解剖可见坐骨神经主干由第7腰神经和第1、2荐神经组成,坐骨神经主干从荐髂关节下、荐骨和髂骨之间穿出后,跨过坐骨大切迹的一段坐骨神经主干位置恒定,且有荐骨和髂骨做定位标志,可作为CT定位的照射靶点,单次大剂量照射后镜下可见神经纤维变性坏死。

A radiosurgery treatment planning was performed on the selected nerve segment, its changes of pathology and ultrastructure were observed. Results: Base on the dissection, the rabbits' sciatic nerve was composed of the seventh lumbar nerve and first and second sacral nerves. The sciatic trunk descended in front of the sacroiliac joint and escaped between the sacral bone and ilium, then left the pelvis from the greater sciatic notch. The segment of sciatic trunk which ran between the sacrum and ilium was stable and feasible for localization according to the related bony structures in CT scanning, so it was selected as irradiation target.

结果:通过解剖可见坐骨神经主干由第7腰神经和第1、2荐神经组成,坐骨神经主干从荐髂关节下、荐骨和髂骨之间穿出后,跨过坐骨大切迹的一段坐骨神经主干位置恒定,且有荐骨和髂骨做定位标志,可作为CT定位的照射靶点,单次大剂量照射后镜下可见神经纤维变性坏死。

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