简介：除了常规触诊方法，运动(ROM)和活动性的脊椎的范围上的检查能帮助决定病理学的排水量并且因此为针的tuina操作提供稳固的基础。

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简介：位于威斯康星州梅库恩的TitanSpine公司，在2013年获得与公司的种植体表面技术以及内骨骼椎间装置设计和专业化的系统器械相关的四项专利。在钛合金装置上经过一种适当的处理形成一个织构化的表面，为促进融合位置骨骼生长产生最佳的表面能。

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简介：AbstractOutbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.

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简介：AbstractPurpose:Gunshot wounds are the second leading cause of spinal cord injuries. Surgical intervention for gunshot injury to the spine carries a high rate of complications. There is a scarcity of data on civilian gunshot injuries to the spine in Pakistan. Approximately 60 cases over the last 10 years have been recoded, with unusual presentation and neurological recovery. Thus it is imperative to fill this gap in data, by reviewing cases of civilian gunshot injuries to spine presenting at a tertiary care hospital (Aga Khan University Hospital, Karachi).Methods:This is a retrospective cohort study. Patients of all ages who presented to the emergency department of Aga Khan University Hospital, with gunshot injuries to spine between January 2005 and December 2016 were included in the study. Data were collected on neurological status (American Spinal Injury Association score was used for the initial and follow-up neurological assessment), extent of cord transection, motor and sensory deficits. The patients were further grouped into those with cord transection, and those with fractures of the bony spine but an intact spinal cord. These patients were then followed and the outcomes were recorded.Results:A total of 40 patients were identified. The mean ± SD of patients age was (30.9 ± 9.5) years. Of the 40 patients with gunshot wounds, 31 had the medical imaging performed at the facility, and hence they were included in this categorization. The remaining 9 patients were excluded from this additional grouping. Thirteen patients were managed surgically and 27 patients underwent the conservative management. The mean ± SD of follow-up was (8.7 ± 7.2) months. In our study, the thoracic spine was the most commonly injured region in gunshot injuries. Of the 31 patients with medical imaging performed at our institute, 17 (54.8%) had cord transection, of whom 8 (47%) ultimately developed paraplegia.Conclusion:The prognosis of gunshot injuries to the spine can be varied depending on whether the spinal cord is intact or transected. This will help healthcare providers to plan the further management of the patient and counsel them accordingly.

简介：BackgroundSpinalpainisaserioushealthandsocial-economicproblem.Endoscopicspinesurgeryasatreatmentoptionforspinalpainhasgainedtremendousattentionandgrowthinthepast2decades,andavarietyofendoscopictechniqueshavebeeninventedtotreatawiderangeofspinalconditions.PurposesThepurposesofthis2-partreviewarticleareto1)overviewthepublishedtechniquesofendoscopicspinesurgery,2)summarizetheapplicationsofthesetechniquesintreatingvariousspinalconditions,and3)evaluatetheclinicalevidenceofthesafetyandeffectivenessoftheseendoscopictechniquesintreatingsomeofthemostcommonspinalconditions.Thefirstpartofthereviewarticleprovidesanoverviewofcurrentlymostcommonlyusedtechniques.MethodsWesearchedthePubMeddatabaseforpublicationsconcerningendoscopicspinesurgeryandreviewedtherelevantarticlespublishedintheEnglishlanguage.ResultsDiscectomyandforaminotomyarethemostcommontypesofspinesurgerythatcancurrentlybedoneendoscopically.Endoscopictechniqueshavebeenusedtotreatawiderangeofspinaldisorderslocatedinthelumbar,cervical,aswellasthethoracicregionsofthespine.

简介：AbstractIntroduction:Postherpetic neuralgia (PHN) is a painful condition that occurs after herpes zoster skin lesions have subsided and that lasts for more than 1 month. PHN is usually difficult to treat.We herein present two cases of PHN comorbid with spinal metastasis of a malignant tumor. Both patients responded well to an epidural block.Case presentation:Patient 1 was a 54-year-old woman who had PHN for 35 days. Patient 2 was a 74-year-old woman who had PHN for 65 days. Both patients were treated with an epidural block and found to have spinal metastasis from a malignant tumor.Discussion:The routinely used dermatological medications for the treatment of herpes zoster and PHN have slow and unsatisfactory analgesic effects. Epidural block treatment provides a new approach for patients who cannot tolerate or do not respond to these commonly used drugs. Physicians should pay special attention to patients who have a history of a malignant tumor or are suspected to have spinal disease. Computed tomography or magnetic resonance imaging of the spine is recommended for such patients, and epidural block treatment should be performed after a spinal tumor or other lesions have been excluded.Conclusion:Epidural block treatment provides a new approach for patients of herpes zoster or PHN, but the treatment should be performed after a spinal tumor or other spinal lesions have been excluded.

简介：Havingawiderangeofmotion,thecervicalspineisratherpredisposedtotrau-maandotherdisorderswithseriousconsequences.Themotionofcervicalspineisacomplexonecomposedofmicromotions,includinghorizontaldisplacementsalongallthreeaxesandrotationsaroundthemwithsixfreedomdegreesofmovement.Reportonprecisemeasurementofthethree-dimensionalmotionofthecervicalsectionof

简介：由AO-Spine中国部主办、南京鼓楼医院骨科承办的2011年＂脊柱畸形＂高级研讨会将于2011年6月25~26日在南京举行,届时将邀请国内外著名脊柱矫形专家作专题报告。内容包括：（1）脊柱畸形的临床评

简介：Occultspinalbifidisacommondeformityinclinic.Itisoftenfoundthroughroentgenogramexaminationwhenpatientsvisitthedoctorduetolumbocruralpain.Exceptsurgicaloperation,itistreatedmostlywithanalgesicsbutthetherapeuticeffectisnotideal.Inrecentyears,weemployacupunctureandmoxibustiontherapiestotreatitandhaveachievedabettereffectinrelievingpain,regionalsoreanddistendingsensations.Hereisthesummary.

简介：AbstractWe reported two cases of jockeys who sustained fracture/dislocation of the mid-thoracic spine due to traumatic falls during horse racing. We examined the injury mechanism based upon the patients’ diagnostic images and video footage of races, in which the accidents occurred. Admission imaging of patient 1 (a 42 years old male) revealed T5 burst fracture with bony retropulsion of 7 mm causing complete paralysis below T5/6. There existed 22° focal kyphosis at T5/6, anterolisthesis of T5 relative to T6, T5/6 disc herniation, cord edema and epidural hemorrhage from T4 through T6, and cord injury from C3 through C6. Admission imaging of patient 2 (a 23 years old male) revealed T4/5 fracture/dislocation causing incomplete paralysis below spinal level. There existed compression fractures at T5, T6, and T7; 4 mm anterior subluxation of T4 on T5; diffuse cord swelling from T3 through T5; comminuted fracture of the C1 right lateral mass; right frontal traumatic subarachnoid hemorrhage; and extensive diffuse axonal injury. The injuries were caused by high energy flexion-compression of the mid-thoracic spine with a flexed posture upon impact. Our results suggest that substantially greater cord compression occurred transiently during trauma as compared to that documented from admission imaging. Video footage of the accidents indicated that the spine buckled and failed due to abrupt pocketing and deceleration of the head, neck and shoulders upon impact with the ground combined with continued forward and downward momentum of the torso and lower extremities. While a similar mechanism is well known to cause fracture/dislocation of the cervical spine, it is less common and less understood for mid-thoracic spine injuries. Our study provides insight into the etiology of fracture/dislocation patterns of the mid-thoracic spine due to falls during horse racing.

简介：Inthisstudyalumbarspinalfusionanimalmodelisestablishedtoassesstheeffectofspinalfusioncage,andexploretheminimumarearatiooftitaniumcagesectiontovertebralsectionthatensuresbonehealingandbiomechanicalproperty.Lumbarcorpectomywasconductedbyposterolateralapproachwithtitaniumcageimplantationcombinedwithplatefixation.Titaniumcageswiththesamelengthbutdifferentdiameterswereused.Afterimplantationoftitaniumcages,theprogressofbonehealingwasobservedandthebonebiomechanicalpropertiesweremeasured,includingdeformationanddisplacementinaxialcompression,flexion,extension,andlateralbendingmotion.Thefactorsaffectingtheinvivogrowthofspinesupportingbodywereanalyzed.Theresultsshowthatthearearatiooftitaniumcagesectiontovertebralsectionshouldreach1/2toensurethebonehealing,sufficientboneintensityandbiomechanicalproperties.Somebonehealingindicators,suchasBMP,suggestthatthereisarelationshipbetweenthepeaktimeandthepeakvalueofboneformationandmetabolismmarkersandthebonehealingstrength.

简介：spinalmotionpivot,spinalmanipulation,theangleoffacetjoint,forcedirection,cylinderpivotmotiontheoryThespinaljointconsistsofadiscandposteriorfacetjoints.Itisthebiomechanicalstructurethatenablesthespinewithsix(6)freedomsofmovementsofflexion/extension,sidebendsandrotations.Weidentifiedthatthesamespinaljointsinitiate,eliminateandcontrolspinalmovement.Thesefourjointsaretheatlanto-occipitalandtheatlanto-odontoidjoints,C7/T1,T12/L1andL5/S1.Theword“pivot”iscommonlyusedtodescribeanimportantruruingporintormatterinChineselanguage.Wedefinetheabovefourjointsas“pivots”inthisarticle.Thejointsarebriefedas“Occipital-vertebralpivot”(atlanto-occipitalandatlanto-odontoidjoint),“cervicalthoracicpivot”(C7/T1),“thoracic-lumbarpivot”(T12/L1)and“lumbar-sacrumpivot”(L5/S1).Aftermeasuring20humanspinalcolumns(drybones),observingtheanglebetweenthevertebralbodyandtheinferiorarticularfaeet,reviewingthespinalanatomyandbiomechanicsandanalyzingtheChinesespinalmanipulationtechniquesandtheory,thefollowingisourreport:

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简介：Objective:Tostudythefeasibilityofmulti-slicespiralcomputedtomography(MSCT)3-dimensionalreconstruc-tiontechniqueinassistingcervicalpediclescrewfixation(PSF)anddouble-doorlaminoplastytotreatmulti-segmen-taldegenerativespinalstenosiswithtraumaticinstability(MDSTI)oflowercervicalspine.Methods:FromSeptember2006toAugust2007,PSFcombinedwithdouble-doorlaminoplastywasperformedin9patientswithMDSTIoflowercervicalspine.MSCT3-dimensionalreconstructiontechniques,includingvolumerendering(VR)andmulti-planarreconstruction(MPR),wereusedtoassistpreoperativediagnosisandmeasurementtoguidetheprocedure.MPRwasperformedafteroperation.Incoronalview,thedegreeofscrewperforationwasmea-suredpreciselyandthedifferentpositionsofpediclescrewsweredividedintothreegradesaccordingtoRichter'smethod.Inaxialview,thecanalsagittaldiameterandtrans-verseareaofeverylaminoplastylevelweremeasured.Results:NinepatientswithMDSTIoflowercervicalspineunderwentPSF(total44screws).AccordingtotheclassificationofRichter,72.7%(32/44)wasinGrade1and27.3%(12/44)wasinGrade2.NoscrewperforationoccurredinGrade3andnoscrewrevisionwasdoneformisplacement.Noiatrogenicdamagewasobserved.Double-doorlaminoplastywasperformedintotal42volumes.Thepost-operativesagittaldiameterandtransverseareaofcervicalspinalcanalweresignificantlyincreased(P<0.05).Theconfi-denceintervalsofmeanincreasedratiowere23.43%-40.65%insagittaldiameterand23.18%-42.07%intransversearea.Sixmonthsafterlaminoplasty,basedonMSCTaxialview,completeunionbetween"opendoor"andallograftbonewasobtainedin76.19%ofvolumes(32/42),andallograftbonewasabsorbedpartlyin23.81%(10/42).Asolidunioninbilateralgutterswasachievedinallcases.Theywerefollowedupfrom6monthsto1year(mean7.8months).Post-operativeneuralfunctionrecoveryintwocasesimproved2ASIAgrade,5casesi

简介：Seaurchinspineswerechosenasamodelsystemforbiomimeticceramicsobtainedusingstarch-blendedslipcasting.Porousaluminaceramicswithcap-shapedlayerswithdifferentalternatingporositieswerefoundtohavesuperiorfracturebehaviorunderbulkcompressioncomparedtoceramicswithuniformporosity.Theyfailinacascadingmanner,absorbinghighamountsofenergyduringextendedcompressionpaths.TheporosityvariationinanotherwisesinglephasematerialmimicksthearchitecturalmicrostructuredesignofseaurchinspinesofHeterocentrotusmammillatus,whicharepromisingmodelmaterialsforimpactprotection.

简介：[摘要]目的：分析下颈椎骨折脱位合并脊髓损伤早期急救治疗对预后的影响。方法：选取我中心2019年3月~2021年5月收治的下颈椎骨折脱位合并脊髓损伤患者182例实施回顾性分析研究，分析患者的一般资料，根据四肢瘫痪不同程度，通过Frankel分级课氛围四个不同的等级：A级89例，B级30例，C级21例，D级42例。受伤类型包括高空坠落患者38例，车祸受伤患者144例。评估患者的脊髓损伤水平：C2患者5例，C3患者12例，C4患者30例，C5患者88例，C6患者35例，C7患者12例。结果：为患者采取日本顾客学会的评估标准，手术前的JOA评分为（4.21±1.81）分，患者手术治疗一周后的评分为（7.95±2.23）分，最后一次随访调查评分为（10.25±2.13）分，患者术后一周后和最后一次随访调查评分较手术前评分对比具有极大差异表示统计学有意义。患者实施8小时内开展甲强龙冲击治疗的患者有68例，开展早期气管切开治疗的患者有40例。实施前路手术治疗的患者有111例，实施后路手术治疗的患者有40例，实施前后路联合手术治疗的患者有31例，患者治疗后出现4例死亡，发生肺感染的患者有5例，低蛋白血症患者有22例，发生深静脉血栓患者有3例。结论：为下颈椎骨折脱位合并脊髓损伤喊着开展早期急救治疗，能够有效促进患者机体康复，降低并发症的发生，不仅保证了治疗效果也保证了治疗安全性，提高患者治疗后的生活质量评分。