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老年人髋关节置换术后硬膜外吗啡和腰骶丛神经阻滞镇痛效果比较 被引量:24
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作者 严美娟 楼小侃 +1 位作者 昊佳 陈悦 《中华老年医学杂志》 CAS CSCD 北大核心 2016年第6期634-639,共6页
目的 观察比较硬膜外吗啡和腰骶丛神经阻滞在老年人髋关节置换术后的镇痛效应。方法 选择94例择期行髋关节手术的ASAⅠ~Ⅱ级的患者,均采用腰麻联合硬膜外麻醉,术后根据不同镇痛方式随机分为4组,M组硬膜外单次推注吗啡2 mg,MN1组硬... 目的 观察比较硬膜外吗啡和腰骶丛神经阻滞在老年人髋关节置换术后的镇痛效应。方法 选择94例择期行髋关节手术的ASAⅠ~Ⅱ级的患者,均采用腰麻联合硬膜外麻醉,术后根据不同镇痛方式随机分为4组,M组硬膜外单次推注吗啡2 mg,MN1组硬膜外单次推注吗啡1 mg加腰骶丛神经阻滞,MN2组硬膜外单次推注吗啡2 mg加腰骶丛神经阻滞,N组仅行腰骶丛神经阻滞;所有患者术后肌肉注射帕瑞昔布3 d。术后疼痛视觉模拟评分(VAS)≥4分时给予肌注曲马多100 mg,疼痛缓解不明显者启用静脉镇痛泵。观察术后镇痛效果、运动功能及不良反应。 结果 (1)镇痛效果:术后4组VAS评分逐渐增高,术后第1日晨至术后第2日晚均高于各自术后4 h时的VAS评分,4组间术后4 h时静息和运动VAS评分比较,差异均无统计学意义;术后6 h,MN1组和MN2组运动时VAS评分低于M组和N组,静息时差异无统计学意义;术后8 h, MN1组和MN2组静息和运动时的VAS评分均低于M组和N组,而术后4~8 h,MN1组和MN2组之间,以及M组和N组之间差异无统计学意义;术后第1日晨,M组、MN1组和MN2组静息和运动时VAS评分低于N组,N组中更多的患者需更早的给予复合曲马多和启用静脉镇痛泵镇痛。(2)运动功能:术后8 h和术后第1日晨,MN1组和MN2组的肌力弱于M组和N组,术后6 h站立能力和术后第1日晨的行走能力组间差异无统计学意义。(3)不良反应:尿潴留发生率,M组和MN2组高于MN1组和N组,MN1组高于N组;M组和MN2组瘙痒的发生率高于N组;4组间镇静评分和术后恶心呕吐发生率差异无统计学意义。 结论 老年髋关节置换术患者,硬膜外吗啡复合腰骶丛神经阻滞较单用硬膜外吗啡或腰骶丛阻滞,能获得更好的镇痛效果,虽然协同作用对术后早期肌力的恢复有一定影响,但并不影响术后早期的康复训练。在复� 展开更多
关键词 镇痛 硬膜外 关节成形术 置换 吗啡 腰骶丛
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一期后路病灶清除植骨融合内固定矫形治疗成人腰骶段结核 被引量:16
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作者 张宏其 林旻中 +4 位作者 李劲松 吴建煌 唐明星 郭超峰 刘少华 《中国脊柱脊髓杂志》 CAS CSCD 北大核心 2013年第6期493-498,共6页
目的:探讨一期后路病灶清除植骨融合内同定矫形治疗成人腰骶段结核的临床疗效。方法:回顾性研究2004年3月-2010年10月收治的17例腰骶段结核患者,男9例,女8例;年龄23-68岁,平均46.4±16.0岁。17例患者中有16例出现不完全瘫... 目的:探讨一期后路病灶清除植骨融合内同定矫形治疗成人腰骶段结核的临床疗效。方法:回顾性研究2004年3月-2010年10月收治的17例腰骶段结核患者,男9例,女8例;年龄23-68岁,平均46.4±16.0岁。17例患者中有16例出现不完全瘫痪,神经功能Frankel分级:B级4例,C级5例,D级7例。人院时血沉(ESR)33-95mm/h,平均57.4±16.8mm/h。术前腰骶角18°-23°,平均20.5°±1.7°。均采用一期后路病灶清除、内固定矫形、植骨融合治疗,应用腰骶角测量、血沉检测和神经功能Frankel分级评定来评论临床疗效,随访观察治疗结果。结果:全部病例手术均安全完成,手术平均用时145min(130-200min),术中平均出血约700ml(500-850ml);无脊髓及血管损伤及其他严重并发症。全部患者随访17-71个月,平均47.5°±17.1个月。末次随访腰骶角为25.9°-30.3°,平均28.3°±1.5°,术后ESR恢复正常(9.2±3.1mm/h),均较术前明显改善(P〈0.05)。术后6-8个月,复查X线、MRI提示所有患者植骨融合,神经压迫完全解除。除2例术前Frankel分级为B级的患者术后恢复至D级,其余患者术后Frankel分级均为E级。结论:一期后路病灶清除植骨融合内固定矫形治疗成人腰骶段结核疗效确切,安全可靠。 展开更多
关键词 腰骶段 结核 成人 一期后路
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腰骶椎终板生物力学特性的实验研究 被引量:12
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作者 李志刚 郑连杰 +2 位作者 李光灿 陈湘柘 夏重君 《中国脊柱脊髓杂志》 CAS CSCD 2007年第3期210-213,共4页
目的:研究腰骶椎终板不同位点的生物力学特性及其分布规律。方法:选用成人新鲜尸体腰骶椎标本(L1~S1)5具,共30个椎体55个终板,应用电子万能实验机(型号CSS-2205)对终板平面49个测试点用直径1.5mm的平底压头以12mm/min的速度进行连续压... 目的:研究腰骶椎终板不同位点的生物力学特性及其分布规律。方法:选用成人新鲜尸体腰骶椎标本(L1~S1)5具,共30个椎体55个终板,应用电子万能实验机(型号CSS-2205)对终板平面49个测试点用直径1.5mm的平底压头以12mm/min的速度进行连续压缩加载实验,记录最大压缩力,并对数据进行统计分析。结果:(1)L1~S1上终板最大压缩力从68.81±8.12N增加至120.41±34.33N,各节段间差异有显著性(P<0.05);L1~L4下终板最大压缩力从78.66±5.57N增加至120.44±29.27,L5降为106.65±16.10N,各节段间差异有显著性(P<0.05)。(2)L1~S1上终板中央至外周最大压缩力从65.02±6.40N增加至110.61±10.63N,下终板中央至外周最大压缩力从68.09±9.43N增加至162.69±16.46N,差异有显著性(P<0.05);上终板前侧最大压缩力为87.30±6.42N,后侧为89.25±14.30N,下终板前侧最大压缩力107.63±4.84N,后侧最大压缩力109.82±18.66N,差异均无显著性(P>0.05)。(3)L3/4、L4/5上下终板的最大压缩力的差异均有显著性(P<0.05),余间隙差异无显著性。结论:L1~S1上终板强度逐渐增大;L1~L4下终板强度逐渐增大,L4~L5减小;腰骶椎上、下终板强度从中央至外周逐渐增大,前、后侧无差异;L3/4、L4/5间隙上位椎体下终板强度大于下位椎体上终板。 展开更多
关键词 腰骶椎 终板 压缩强度 生物力学
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Differences of Sagittal Lumbosacral Parameters between Patients with Lumbar Spondylolysis and Normal Adults 被引量:6
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作者 Jin Yin Bao-Gan Peng +3 位作者 Yong-Chao Li Nai-Yang Zhang Liang Yang Duan-Ming Li 《Chinese Medical Journal》 SCIE CAS CSCD 2016年第10期1166-1170,共5页
Background: Recent studies have suggested an association between elevated pelvic incidence (PI) and the development of lumbar spondylolysis. However, there is still lack of investigation for Hart Chinese people con... Background: Recent studies have suggested an association between elevated pelvic incidence (PI) and the development of lumbar spondylolysis. However, there is still lack of investigation for Hart Chinese people concerning the normal range ofspinopelvic parameters and relationship between abnormal sagittal parameters and lumbar diseases. The objective of the study was to investigate sagittal lumbosacral parameters of adult lumbar spondylolysis patients in Han Chinese population. Methods: A total of 52 adult patients with symptomatic lumbar spondylolysis treated in the General Hospital of Armed Police Force (Beijing, China) were identified as the spondylolysis group. All the 52 patients were divided into two subgroups, Subgroup A: 36 patients with simple lumbar spondylolysis, and Subgroup B: 16 patients with lumbar spondylolysis accompanying with mild lumbar spondylolisthesis (slip percentage 〈30%). Altogether 207 healthy adults were chosen as the control group. All patients and the control group took lumbosacral lateral radiographs. Seven sagittal lumbosacral parameters, including PI, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), L5 incidence, L5 slope, and sacral table angle (STA), were measured in the lateral radiographs. All the parameters aforementioned were compared between the two subgroups and between the spondylolysis group and the control group with independent-sample t-test. Results: There were no statistically significant differences of all seven sagittal lumbosacral parameters between Subgroup A and Subgroup B. PI, PT, SS, and LL were higher (P 〈 0.05) in the spondylolysis group than those in the control group, but STA was lower (P 〈 0.001 ) in the spondylolysis group. Conclusions: Current study results suggest that increased PI and decreased STA may play important roles in the pathology of lumbar spondylolysis in Han Chinese population. 展开更多
关键词 Lumbar Spondylolysis: lumbosacral PATHOGENESIS Sagittal Parameters
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一期后路内固定、前路病灶清除植骨融合治疗腰骶段脊柱结核 被引量:7
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作者 王锡阳 李洪波 +4 位作者 李伟伟 葛磊 魏伟强 庞晓阳 周炳炎 《中国现代医学杂志》 CAS CSCD 北大核心 2010年第24期3809-3812,3815,共5页
目的探讨一期后路内固定、前路病灶清除植骨融合治疗腰骶段脊柱结核的可行性、疗效及应用指征。方法回顾性研究2005年1月-2008年8月行一期后路内固定、前路病灶清除植骨融合术治疗的腰骶段脊柱结核23例。对比研究患者手术前后的腰骶角... 目的探讨一期后路内固定、前路病灶清除植骨融合治疗腰骶段脊柱结核的可行性、疗效及应用指征。方法回顾性研究2005年1月-2008年8月行一期后路内固定、前路病灶清除植骨融合术治疗的腰骶段脊柱结核23例。对比研究患者手术前后的腰骶角、椎间隙高度、血沉、C反应蛋白及神经功能ASIA分级的变化情况。结果随访6-42个月,平均26个月,23例患者均无严重并发症发生及结核复发,至末次随访时,所有植骨均获骨性融合,无内固定松动及断裂现象出现。患者的腰骶角由术前的(18.8°±4.2°)(10.5°~26.6°)矫正为术后的(27.1°±3.8°)(20.6°~34.5°),术后的腰骶角较术前明显增大(P〈0.05);椎间隙高度由术前的(7.9±0.4)mm(6.8~9.2)mm撑开为术后的(10.4±0.5)mm(8.9~11.3 mm),术后的椎间隙高度较术前明显增高(P〈0.05);ESR由术前的(40.8±10.2)mm/h下降为术后的(28.6±6.9)mm/h,至末次随访时继续下降为(10.0±2.1)mm/h,其变化有统计学意义(P〈0.05);CRP由术前的(16.2±4.0)mg/L下降为术后的(11.5±2.3mg/L),至末次随访时继续下降为(1.9±1.1)mg/L,其变化具有统计学意义(P〈0.05)。脊髓损伤ASIA分级术前有障碍者20例,术后19例改善明显。结论一期后路内固定、前路病灶清除植骨融合术能彻底清除结核病灶,显著改善结核中毒症状,有效地维持脊柱的稳定性,植骨融合可靠,卧床时间短,是一种治疗腰骶段脊柱结核的有效方法。 展开更多
关键词 脊柱结核 腰骶段 后路内固定 前路病灶清除 植骨
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Surgical treatment of sacral fractures following lumbosacral arthrodesis: Case report and literature review 被引量:4
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作者 Yu Wang Xian-Yi Liu +2 位作者 Chun-De Li Xiao-Dong Yi Zheng-Rong Yu 《World Journal of Orthopedics》 2016年第1期69-73,共5页
Sacral fractures following posterior lumbosacral fusion are an uncommon complication. Only a few case series and case reports have been published so far. This article presents a case of totally displaced sacral fractu... Sacral fractures following posterior lumbosacral fusion are an uncommon complication. Only a few case series and case reports have been published so far. This article presents a case of totally displaced sacral fracture following posterior L4-S1 fusion in a 65-yearold patient with a 15-year history of corticosteroid use who underwent open reduction and internal fixation using iliac screws. The patient was followed for 2 years. A thorough review of the literature was conducted using the Medline database between 1994 and 2014. Immediately after the revision surgery, the patient's pain in the buttock and left leg resolved significantly. The patient was followed for 2 years. The weakness in the left lower extremity improved gradually from 3/5 to 5/5. In conclusion, the incidence of postoperative sacral fractures could have been underestimated, because most of these fractures are not visible on a plain radiograph. Computed tomography has been proved to be able to detect most such fractures and should probably be performed routinely when patients complain of renewed buttock pain within 3 mo after lumbosacral fusion. The majority of the patients responded well to conservative treatments, and extending the fusion construct to the iliac wings using iliac screws may be needed when there is concurrent fracture displacement, sagittal imbalance, neurologic symptoms, or painful nonunion. 展开更多
关键词 SACRAL FRACTURE INSUFFICIENCY FRACTURE Surgical treatment COMPLICATION lumbosacral fusion Revision surgery
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Incremental value of magnetic resonance neurography of Lumbosacral plexus over non-contributory lumbar spine magnetic resonance imaging in radiculopathy: A prospective study 被引量:4
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作者 Avneesh Chhabra Sahar J Farahani +3 位作者 Gaurav K Thawait Vibhor Wadhwa Allan J Belzberg John A Carrino 《World Journal of Radiology》 CAS 2016年第1期109-116,共8页
AIM: To test the incremental value of 3T magnetic resonance neurography(MRN) in a series of unilateral radiculopathy patients with non-contributory magnetic resonance imaging(MRI).METHODS: Ten subjects(3 men,7 women; ... AIM: To test the incremental value of 3T magnetic resonance neurography(MRN) in a series of unilateral radiculopathy patients with non-contributory magnetic resonance imaging(MRI).METHODS: Ten subjects(3 men,7 women; mean age54 year and range 22-74 year) with unilateral lumbar radiculopathy and with previous non-contributory lumbar spine MRI underwent lumbosacral(LS) plexus MRN over a period of one year. Lumbar spine MRI performed as part of the MRN LS protocol as well as bilateral L4-S1 nerves,sciatic,femoral and lateral femoral cutaneous nerves were evaluated in each subject for neuropathy findings on both anatomic(nerve signal,course and caliber alterations) and diffusion tensor imaging(DTI)tensor maps(nerve signal and caliber alterations).Minimum fractional anisotropy(FA) and mean apparent diffusion coeffcient(ADC) of L4-S2 nerve roots,sciatic and femoral nerves were recorded.RESULTS: All anatomic studies and 80% of DTI imaging received a good-excellent imaging quality grading. In a blinded evaluation,all 10 examinations demonstrated neural and/or neuromuscular abnormality corresponding to the site of radiculopathy. A number of contributory neuropathy findings including double crush syndrome were observed. On DTI tensor maps,nerve signal and caliber alterations were more conspicuous. Although individual differences were observed among neuropathic appearing nerve(lower FA and increased ADC) as compared to its contralateral counterpart,there were no significant mean differences on statistical comparison of LS plexus nerves,femoral and sciatic nerves(P > 0.05).CONCLUSION: MRN of LS plexus is useful modality for the evaluation of patients with non-contributory MRI of lumbar spine as it can incrementally delineate the etiology and provide direct objective and non-invasive evidence of neuromuscular pathology. 展开更多
关键词 Magnetic resonance imaging Neurography lumbosacral PLEXUS RADICULOPATHY
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Biomechanical effects of posterior lumbar interbody fusion with vertical placement of pedicle screws compared to traditional placement
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作者 Ji-Hong Jiang Chang-Ming Zhao +2 位作者 Jun Zhang Rong-Ming Xu Lei Chen 《World Journal of Clinical Cases》 SCIE 2024年第20期4108-4120,共13页
BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and t... BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and the insertion of pedicle screws at specific transverse section angles(TSA).Larger TSA angles require more force to pull the muscle tissue,which can increase the risk of surgical trauma and ischemic injury to the lumbar muscles.AIM To study the feasibility of zero-degree TSA vertical pedicle screw technique in the lumbosacral segment.METHODS Finite element models of vertebral bodies and pedicle screw-rod systems were established for the L4-S1 spinal segments.A standard axial load of 500 N and a rotational torque of 10 N/m were applied.Simulated screw pull-out experiment was conducted to observe pedicle screw resistance to pull-out,maximum stress,load-displacement ratio,maximum stress in vertebral bodies,load-displacement ratio in vertebral bodies,and the stress distribution in pedicle screws and vertebral bodies.Differences between the 0-degree and 17-degree TSA were compared.RESULTS At 0-degree TSA,the screw pull-out force decreased by 11.35%compared to that at 17-degree TSA(P<0.05).At 0-degree and 17-degree TSA,the stress range in the screw-rod system was 335.1-657.5 MPa and 242.8-648.5 MPa,separately,which were below the fracture threshold for the screw-rod system(924 MPa).At 0-degree and 17-degree TSA,the stress range in the vertebral bodies was 68.45-78.91 MPa and 39.08-72.73 MPa,separately,which were below the typical bone yield stress range for vertebral bodies(110-125 MPa).At 0-degree TSA,the load-displacement ratio for the vertebral bodies and pedicle screws was slightly lower compared to that at 17-degree TSA,indicating slightly lower stability(P<0.05).CONCLUSION The safety and stability of 0-degree TSA are slightly lower,but the risks of screw-rod system fracture,vertebral body fracture,and rupture are within acceptable limits. 展开更多
关键词 Vertical pedicle screw Pedicle screw technique Transverse section angle lumbosacral segment Finite element analysis
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针刺配合腰骶刺络放血治疗慢性前列腺炎 被引量:2
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作者 吕鑫娓 张开心 +3 位作者 邓婷婷 孙浩 王莹 马玉侠 《World Journal of Acupuncture-Moxibustion》 CAS CSCD 2023年第3期282-286,共5页
Objective:To observe the effect of acupuncture and bloodletting therapy at the lumbosacral region for chronic prostatitis.Methods:A total of 36 patients with chronic prostatitis were collected,and treated in the Depar... Objective:To observe the effect of acupuncture and bloodletting therapy at the lumbosacral region for chronic prostatitis.Methods:A total of 36 patients with chronic prostatitis were collected,and treated in the Department of Acupuncture and Moxibustion and the External Treatment Center of Chinese Medicine,Affiliated Hospital of Shandong University of Traditional Chinese medicine.The patients were treated with acupuncture,combined with bloodletting therapy at the lumbosacral region.The treatment for 4 weeks was as one course and 2 consecutive courses of treatment were required.The therapeutic effect,including the score of the National Institute of Health-Chronic prostatitis symptom index(NIH-CPSI),was assessed.Results:After 1 and 2 courses of treatment,the symptom scores and NIH-CPSI total score were all reduced as compared with that before treatment,respectively(all P<0.01).After 2 courses of treatment,the score of each symptom and NIH-CPSI total score were reduced as compared with that after 1 course of treatment,respectively(all P<0.01).Regrading the 3 syndromes/patterns of chronic prostatitis in the patients,i.e.downward invasion of damp heat,qi and blood stagnation and liver qi stagnation,after 1 and 2 courses of treatment,NIH-CPSI total scores were all reduced as compared with that before treatment(all P<0.01).Additionally,after 2 courses of treatment,NIH-CPSI total score of each syndrome/pattern was reduced as compared with that after 1 course of treatment(all P<0.01).For kidney yin deficiency,after 2 courses of treatment,NIH-CPSI total score was reduced as compared with that either before treatment or after 1 course of treatment(both P<0.01).The total effective rate was 91.67%after 1 course of treatment and 97.22%after 2 courses of treatment.No obvious adverse events occurred during the treatment.Conclusion:The combined treatment with acupuncture and bloodletting therapy at the lumbosacral region effectively relieves the symptoms of chronic prostatitis and improves the quality of life in the patients. 展开更多
关键词 Chronic prostatitis Jinggong Chigong Reaction points at the lumbosacral region BLOODLETTING
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Rebuilding motor function of the spinal cord based on functional electrical stimulation 被引量:3
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作者 Xiao-yan Shen Wei Du +1 位作者 Wei Huang Yi Chen 《Neural Regeneration Research》 SCIE CAS CSCD 2016年第8期1327-1332,共6页
Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functio... Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functional electrical stimulation technology.In this study,the locations of motor function sites in the lumbosacral spinal cord were determined with functional electrical stimulation technology.A three-dimensional map of the lumbosacral spinal cord comprising the relationship between the motor function sites and the corresponding muscle was drawn.Based on the individual experimental parameters and normalized coordinates of the motor function sites,the motor function sites that control a certain muscle were calculated.Phasing pulse sequences were delivered to the determined motor function sites in the spinal cord and hip extension,hip flexion,ankle plantarflexion,and ankle dorsiflexion movements were successfully achieved.The results show that the map of the spinal cord motor function sites was valid.This map can provide guidance for the selection of electrical stimulation sites during the rebuilding of motor function after spinal cord injury. 展开更多
关键词 nerve regeneration spinal cord injury functional electrical stimulation rebuilding motor function movement control spinal cord lumbosacral spinal cord motor function sites hip extension movement hip flexion movement ankle plantarflexion ankle dorsiflexion neural regeneration
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128排螺旋CT重建同层显示对腰骶神经根变异的诊断价值 被引量:1
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作者 薛强弘 潘洁娜 《中国卫生标准管理》 2023年第14期101-106,共6页
目的探究128排螺旋CT重建同层显示与常规MRI序列在腰骶神经根变异(lumbosacral nerve root animalise,LSNRA)临床诊断中的应用。方法以2021年12月—2022年12月在福建中医药大学附属第三人民医院因腰腿疼痛就诊的69例患者为研究对象,所... 目的探究128排螺旋CT重建同层显示与常规MRI序列在腰骶神经根变异(lumbosacral nerve root animalise,LSNRA)临床诊断中的应用。方法以2021年12月—2022年12月在福建中医药大学附属第三人民医院因腰腿疼痛就诊的69例患者为研究对象,所有患者先进行CT扫描,再进行神经重建同层显示,同时进行MRI扫描检测,比较不同检测手段的LSNRA发现率,并采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评价其诊断价值。结果69例患者神经在CT和MRI下L2~S2均获得较好显影。MRI发现5例神经根变异患者,发现率7.25%(5/69),分别是Ⅱ-1型(1例)、Ⅱ-2型(2例)、Ⅱ-3型(1例)、Ⅱ-4型(1例);常规CT扫描共发现4例神经根变异患者,发现率5.80%(4/69),分别为Ⅱ-1型(1例)、Ⅱ-2型(1例)、Ⅱ-3型(1例)、Ⅱ-4型(1例);CT重建神经同层显示共发现10例神经根变异患者,发现率为14.49%(10/69),分别为Ⅱ-1型(2例)、Ⅱ-2型(2例)、Ⅱ-3型(2例)、Ⅱ-4型(3例)、Ⅴ型(1例)。MRI、常规CT、CT重建神经同层的发现率差异无统计学意义(P>0.05)。MRI、常规CT和CT重建神经同层的ROC曲线下面积分别为0.676、0.710、0.847。结论128排螺旋CT重建同层显示对LSNRA具有较高的诊断价值,其发现率显著高于CT和常规MRI。 展开更多
关键词 128排螺旋CT 同层显示 核磁共振 腰骶 神经根变异 腰腿疼痛
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Prediction of transitional lumbosacral anatomy on magnetic resonance imaging of the lumbar spine 被引量:5
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作者 Majid Chalian Theodoros Soldatos +3 位作者 John A Carrino Alan J Belzberg Jay Khanna Avneesh Chhabra 《World Journal of Radiology》 CAS 2012年第3期97-101,共5页
AIM: To evaluate two simple angle measurements for predicting lumbosacral transitional vertebra (LSTV) in magnetic resonance imaging (MRI) studies of the spine. METHODS: The lumbar spine MRI studies of 50 subjects wit... AIM: To evaluate two simple angle measurements for predicting lumbosacral transitional vertebra (LSTV) in magnetic resonance imaging (MRI) studies of the spine. METHODS: The lumbar spine MRI studies of 50 subjects with LSTV and 50 subjects with normal lumbosacral anatomy were retrospectively evaluated. In each study, the mid-sagittal T2-weighted image was used to measure the angle formed by a line parallel to the superior surface of the sacrum and a line perpendicular to the axis of the scan table (A-angle), as well as the angle formed by a line parallel to the superior endplate of the L3 vertebra and a line parallel to the superior surface of the sacrum (B-angle). RESULTS: The total study population consisted of 100 subjects (46 males, 54 females, 51 ± 16 years old). There were no differences in age and sex between the two groups. Both A-angle and B-angle were significantly increased in subjects with LSTV compared to controls (P < 0.05). The optimal cut-off values of A-angle and B-angle for the prediction of LSTV were 39.8° (sensitivity = 80%, specificity = 80%, accuracy = 83%; 95% confidence interval = 74%-89%, P = 0.0001) and 35.9° (sensitivity = 80%, specificity = 54%, accuracy = 69%; 95% confidence interval = 59%-78%, P = 0.0005), respectively. CONCLUSION: On sagittal MR images of the lumbar spine, an increased A-angle and/or B-angle should alert the radiologist to the presence of LSTV. 展开更多
关键词 lumbosacral transitional vertebra Magnetic resonance imaging Lumbar spine ANGLE PREDICTION
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腰骶椎前路手术的大血管并发症及原因分析 被引量:5
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作者 邱勇 朱泽章 +5 位作者 王斌 俞杨 钱邦平 朱锋 马薇薇 孙旭 《中国骨与关节外科》 2008年第1期7-10,共4页
目的对腰骶椎前路手术的大血管并发症及其原因进行分析,并提出预防措施。方法2003年10月~2007年7月,在我院行腰骶椎前路手术、有完整资料的患者85例。男47例,女38例,年龄12~66岁(平均37岁)。其中结核44例,肿瘤6例,椎间盘炎9例,椎体骨... 目的对腰骶椎前路手术的大血管并发症及其原因进行分析,并提出预防措施。方法2003年10月~2007年7月,在我院行腰骶椎前路手术、有完整资料的患者85例。男47例,女38例,年龄12~66岁(平均37岁)。其中结核44例,肿瘤6例,椎间盘炎9例,椎体骨折20例,半椎体畸形6例。前路手术包括:旁正中经腹直肌内缘腹膜后入路64例,下腹正中经腹入路18例,下腹部斜切口3例。统计分析术中及手术后围手术期的大血管并发症。结果5例(5.8%)患者手术中或手术后围手术期出现大血管并发症。其中术中髂总静脉侧壁撕裂3例(3.5%)、左髂内静脉破裂1例(1.2%)、手术后髂总静脉血栓形成1例(1.2%)。大血管并发症见于3例(6.8%)结核、1例(16.7%)肿瘤以及1例(11.1%)椎间盘炎患者。85例中有59例手术后获6~41个月的随访,平均23个月,患者均恢复正常生活,无1例发生与大血管损伤相关的后遗症。结论腰骶椎前路手术时应充分暴露大血管、仔细解剖、避免血管过度牵拉,以减少大血管并发症的发生。 展开更多
关键词 前路 损伤 髂静脉 腰骶椎
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一期后路病灶清除植骨融合内固定治疗腰骶段脊柱结核 被引量:5
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作者 王锡阳 庞晓阳 +3 位作者 李伟伟 葛磊 胡建中 周炳炎 《中国现代医学杂志》 CAS CSCD 北大核心 2011年第28期3527-3531,共5页
目的探讨一期后路病灶清除植骨融合治疗腰骶段脊柱结核的临床疗效。方法回顾性分析2005年1月~2010年2月收治的49例腰骶段结核患者,采用一期后路病灶清除植骨融合内固定术。分析所有结核患者术前、术后3月以及末次随访时ASIA损伤分级、... 目的探讨一期后路病灶清除植骨融合治疗腰骶段脊柱结核的临床疗效。方法回顾性分析2005年1月~2010年2月收治的49例腰骶段结核患者,采用一期后路病灶清除植骨融合内固定术。分析所有结核患者术前、术后3月以及末次随访时ASIA损伤分级、腰骶角、椎间隙高度及血沉、C反应蛋白变化情况。结果所有病例随访9~27月,平均15.7月。无明显并发症发生,其中2例结核脓肿复发,1例规范化用药后治愈,1例经前路手术治愈。末次随访时,所有植骨均获得骨性融合,无内固定松动断裂出现。神经功能ASIA分级:术前有神经障碍者41例,术后3月29例改善;末次随访时39例改善。术后3月、末次随访腰骶角分别为(27.13±3.78)°、(25.93±3.75)°,高于术前(19.08±4.32)°(P<0.001)。术后3月、末次随访椎间隙高度分别为(10.40±0.50)mm、(9.90±0.48)mm,高于术前的(7.92±0.45)mm(P<0.001)。血沉由术前(49.6±14.8)mm/h减小至末次随访(5.2±2.1)mm/h,C反应蛋白由术前(18.3±7.5)mg/L降至末次随访(1.8±0.7)mg/L改善明显(P<0.05)。结论一期后路病灶清除植骨融合内固定治疗腰骶段脊柱结核可获得较好的疗效。 展开更多
关键词 腰骶段 脊柱结核 一期后路 植骨 内固定
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An integrative insight into the synsacral canal of fossil and extant Antarctic penguins
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作者 Piotr JADWISZCZAK Anders SVENSSON-MARCIAL Thomas MÖRS 《Integrative Zoology》 SCIE CSCD 2023年第2期237-253,共17页
The lumbosacral-canal system in birds most likely operates as a sense organ involved in the control of balanced walking and perching,but our knowledge of it is superficial.Penguins constitute interesting objects for th... The lumbosacral-canal system in birds most likely operates as a sense organ involved in the control of balanced walking and perching,but our knowledge of it is superficial.Penguins constitute interesting objects for the study of this system due to their upright walking,but only the Humboldt penguin,Spheniscus humboldti,and some incomplete fossil penguin synsacra have been studied in this respect.Here,we give an integrative comparative in-sight into the synsacral canal of extant Emperor penguin,Aptenodytes forsteri,Adelie penguin,Pygoscelis adeliae,and Eocene giant Anthropornis and/or Palaeeudyptes Antarctic penguins,using computed tomography imaging and associated data-extraction methodologies,complemented by analytical approaches ranging from geometric morphometrics to modularity,curvature,and wavelet analyses.We document that the variability in the number of synsacro-lumbar vertebrae is evolutionarily conserved,and all studied synsacra possess osteological correlates of the lumbosacral-canal system.We also found that Eocene and extant Antarctic penguins were separable on the basis of the main direction of the shape-related(size-independent)variability within said system,and A.forsteri was unique in the entire studied set in terms of the relative cranial shift of this compound structure.Moreover,we suggest that the evolutionary processes,shaping both the terrestrial posture and gait,were responsible,in extant penguins,for the increased simplicity and stability of the synsacral canal cross-sectional periodic patterns,as well as pave the way for the lumbosacral-canal system modularity characterized by reduced atomization/complexity. 展开更多
关键词 Antarctica CENOZOIC lumbosacral canals Sphenisciformes synsacrum
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侧隐窝联合皮内给予复方倍他米松对老年人腰骶段带状疱疹后神经痛的疗效 被引量:4
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作者 王淑萍 王静 《郑州大学学报(医学版)》 CAS 北大核心 2014年第2期281-284,共4页
目的:探讨不同方式给予复方倍他米松对老年人腰骶段带状疱疹后神经痛的疗效。方法:将82例腰骶段带状疱疹后神经痛的老年患者分为侧隐窝治疗组(n=18)、皮内治疗组(n=21)、侧隐窝联合皮内治疗组(n=24)和对照组(n=19)。所有患者入院后给予... 目的:探讨不同方式给予复方倍他米松对老年人腰骶段带状疱疹后神经痛的疗效。方法:将82例腰骶段带状疱疹后神经痛的老年患者分为侧隐窝治疗组(n=18)、皮内治疗组(n=21)、侧隐窝联合皮内治疗组(n=24)和对照组(n=19)。所有患者入院后给予盐酸曲马多100 mg/d以及加巴喷丁900 mg/d治疗,除对照组外其余3组均按分组给予复方倍他米松治疗,比较4组患者治疗前后自发性疼痛视觉模拟评分(VAS)、痛觉过敏VAS和睡眠质量评分。结果:4组患者治疗前后自发性疼痛VAS、痛觉过敏VAS、睡眠质量评分比较,差异均有统计学意义(自发性疼痛VAS:F组间=9.468,F时间=456.796,F交互=9.684,P均<0.001;痛觉过敏VAS:F组间=12.620,F时间=390.196,F交互=11.361,P均<0.001;睡眠质量评分:F组间=11.552,F时间=158.694,F交互=6.900,P均<0.001)。结论:侧隐窝联合皮内给予复方倍他米松对老年人腰骶段带状疱疹后神经痛疗效较好。 展开更多
关键词 腰骶段 带状疱疹后神经痛 侧隐窝 皮内 复方倍他米松
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腰骶段塌陷型结核后凸畸形后路截骨矫形术后内固定并发症的原因分析 被引量:4
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作者 蒋彬 王冰 +6 位作者 吕国华 徐洁涛 李亚伟 李磊 戴瑜亮 王锟 肖什朋 《中国脊柱脊髓杂志》 CAS CSCD 北大核心 2019年第12期1057-1064,共8页
目的:总结分析腰骶段塌陷型结核后凸畸形患者行后路非对称全脊椎截骨矫形术(posterior asymmetric vertebral column resection,PAVCR)后内固定并发症的原因。方法:回顾性分析2012年1月~2016年12月于我院行PAVCR治疗的45例腰骶段塌陷型... 目的:总结分析腰骶段塌陷型结核后凸畸形患者行后路非对称全脊椎截骨矫形术(posterior asymmetric vertebral column resection,PAVCR)后内固定并发症的原因。方法:回顾性分析2012年1月~2016年12月于我院行PAVCR治疗的45例腰骶段塌陷型结核后凸畸形患者的临床资料。男27例,女18例,平均年龄38.6±17.4岁(22~65岁),平均随访时间36.4±9.8个月(24~66个月)。所有患者术前常规行全脊柱正侧位X线、畸形节段CT、MRI检查,术后随访行正侧位X线检查及腰痛Oswestry功能障碍指数(Oswestry disability index,ODI)评分,必要时行CT复查。根据患者是否发生螺钉松动及连接棒断裂进行分组,比较无内固定并发症组分别与螺钉松动组、连接棒断裂组患者性别、年龄、截骨节段、融合节段、骨密度、远端锚定点数量比、术前、术后(2周)及终末随访局部后凸Cobb角、冠状面侧凸Cobb角、ODI评分。应用卡方检验、Fisher精确检验、独立样本t检验统计分析内固定并发症的原因并提出相应预防策略。结果:9例患者发生内固定并发症,平均发生时间25.4±7.3个月,发生率20%。其中固定远端螺钉松动5例,连接棒断裂3例,固定远端螺钉松动合并对侧连接棒断裂1例。无并发症组与螺钉松动组比较,术后2周局部后凸Cobb角有统计学差异(19.2°±6.3°vs 24.5°±8.7°,P<0.05)、终末随访局部后凸Cobb角有统计学差异(21.2°±6.1°vs 28.4°±8.4°,P<0.05),终末随访ODI评分有统计学差异(11.1±3.6 vs 17.3±4.3,P<0.05)。无并发症组与连接棒断裂组比较,术后2周局部后凸Cobb角有统计学差异(19.2°±6.3°vs 25.6°±7.3°,P<0.05),终末随访局部后凸Cobb角有差异(21.2°±6.1°vs 30.2°±7.9°,P<0.05),终末随访ODI评分有差异(11.1±3.6 vs 19.5±5.8,P<0.05)。无并发症组与螺钉松动组远端锚定点数量构成比有统计学差异(P<0.05),骨密度构成比有统计学差异(P<0.05);无并发症组与连接棒断裂组远端锚定 展开更多
关键词 塌陷型结核后凸畸形 腰骶段 内固定并发症 非对称截骨
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内热针治疗胸腰段椎体成形术后腰骶部疼痛临床疗效观察
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作者 黄义专 王韩 王传恩 《四川中医》 2023年第8期168-172,共5页
目的:对筋膜内热针治疗胸腰段椎体成形术后腰骶部疼痛进行临床疗效观察分析。方法:纳入2018年9月~2021年9月在成都体育学院附属体育医院住院患者中胸腰段单一椎体骨折成形术后腰骶部疼痛患者90例,采用随机抽签法将受试者分为3组,筋膜内... 目的:对筋膜内热针治疗胸腰段椎体成形术后腰骶部疼痛进行临床疗效观察分析。方法:纳入2018年9月~2021年9月在成都体育学院附属体育医院住院患者中胸腰段单一椎体骨折成形术后腰骶部疼痛患者90例,采用随机抽签法将受试者分为3组,筋膜内热针组30例,脊神经后侧支封闭治疗组30例,常规综合治疗组30例;以疼痛使用视觉模拟评分法(visual analogue scale,VAS)和Oswestry功能障碍指数问卷表(Oswestry Disability Index,ODI)作为主要结局指标,以临床疗效、复发率、遗留症状发生率和不良事件作为次要结局指标,并运用SPSS22.0系统分析。结果:三组VAS评分,三组各自组内比较在治疗第1天、第7天、第8天、第14天与治疗前及前次治疗VAS评分均有明显降低(P<0.05),且在治疗第1天、第7天、第8天、第14天后的VAS评分结果筋膜内热针组明显优于封闭组和常规治疗组,差异有统计学意义(P<0.05);三组ODI评分,三组各自组内比较在治疗第1天、第7天、第8天、第14天与治疗前及前次治疗ODI评分均有明显降低(P<0.05),且在治疗第1天、第7天、第8天、第14天后的ODI评分结果筋膜内热针组明显优于封闭组和常规治疗组,差异有统计学意义(P<0.05);临床疗效,在显效方面,筋膜内热针组显著优于封闭组和常规治疗组,差异有统计学意义(P<0.05);随访结果,出院后2周时,遗留症状情况筋膜内热针组显著优于封闭组和常规治疗组,差异有统计学意义(P<0.05),出院后3月和6月时,遗留症状情况筋膜内热针组显著优于常规治疗组,差异有统计学意义(P<0.05)。结论:筋膜内热针治疗胸腰段椎体成形术后腰骶部疼痛,能快速缓解疼痛,明显改善患者生活质量,远期疗效明显,且无不良反应,值得临床推广。 展开更多
关键词 筋膜内热针 椎体成形 腰骶部 疼痛 疗效
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小针刀联合体外冲击波治疗下腰椎融合术后腰骶部疼痛的疗效观察
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作者 黄林海 廖椿蒂 +3 位作者 韦玮 廖军 吴汉华 林振尧 《黑龙江医学》 2023年第15期1830-1832,共3页
目的:观察小针刀联合体外冲击波治疗下腰椎融合术后腰骶部疼痛的疗效。方法:选取2017年1月—2020年10月在广西医科大学附属武鸣医院就诊的60例下腰椎融合术后腰骶部疼痛患者作为研究对象,随机分为冲击波治疗组(30例)和小针刀联合冲击波... 目的:观察小针刀联合体外冲击波治疗下腰椎融合术后腰骶部疼痛的疗效。方法:选取2017年1月—2020年10月在广西医科大学附属武鸣医院就诊的60例下腰椎融合术后腰骶部疼痛患者作为研究对象,随机分为冲击波治疗组(30例)和小针刀联合冲击波治疗组(30例),将两组患者视觉模拟疼痛评分(visual analogue scale,VAS)、Oswestry腰痛功能障碍指数(oswestry disability index,ODI)等进行对比。结果:同治疗前比较,两组患者治疗后2周、1个月、3个月VAS评分、ODI评分显著下降,差异有统计学意义(t=9.52、8.52,P<0.05)。联合治疗组VAS评分、ODI评分优于冲击波治疗组,差异有统计学意义(t=12.36、11.65、10.63、9.52,P<0.05;t=10.36、11.65、11.63、8.52,P<0.05)。结论:体外冲击波联合小针刀治疗能有效改善下腰椎融合术后腰骶部疼痛及功能障碍。 展开更多
关键词 冲击波 腰椎融合 腰骶部 疼痛
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The Effect of Active Knee Extension in Sitting on Lumbopelvic Curvature in Individuals with Clinically Tight Hamstring Muscles: A Cross-Sectional Reliability Study 被引量:1
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作者 Musashi Yasuda Kana Nishimoto +2 位作者 Masataka Hori Tatsuya Noguchi Hiroshi Takasaki 《Open Journal of Therapy and Rehabilitation》 2017年第4期139-147,共9页
Relative flexibility between the hamstring and lumbar extensor muscles, which can be evaluated using lumbopelvic curvature during active knee extension in sitting, can sometimes be assessed in physical therapy. Howeve... Relative flexibility between the hamstring and lumbar extensor muscles, which can be evaluated using lumbopelvic curvature during active knee extension in sitting, can sometimes be assessed in physical therapy. However, reliability for its quantitative measure has not been established yet and its establishment was the aim of the current study. Twenty-seven individuals with clinically tight hamstring muscles were recruited. On two separate sessions, the lumbopelvic curvature was evaluated in sitting when the right knee was moved from 90&deg flexion to 10&deg flexion on 15 occasions using a flexible ruler by two examiners on Day 1 and one on Day 2. Lines drawn tangential to the lumbopelvic curvature were traced at T12 and S2 vertebral levels and the angle between the two vertical lines was calculated. Using Day 1 data, the minimum number of repetitions and inter-examiner reliability were assessed. Inter-session reliability was also examined. As a result, there was no statistical difference (P?> 0.05) in the mean absolute difference between the mean value of N-1 and N repetitions (6 ≤ N ≤ 15) in the lumbopelvic curvature angle, indicating that five was considered the minimum number of repetitions. Intraclass correlation coefficient (ICC)(1, 5)?for the inter-session reliability and ICC(2, 5)?for the inter-examiner reliability was 0.97 and 0.93, respectively, indicating excellent reliability. The measure for the lumbopelvic curvature during active knee extension in sitting, which was established in the current study, will be a foundation for further research regarding the relative flexibility of the lumbar and adjunct regions. 展开更多
关键词 lumbosacral Region Muscle TIGHTNESS HAMSTRING Physical Examination Relative Flexibility TEST-RETEST RELIABILITY
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