mbt chaussure Lumbar vertebral spondylolisthesis c

lin06900 · Wysłany: Pią 6:25, 25 Mar 2011

Lumbar vertebral spondylolisthesis clinical exploration

Blood. The removal of the upper and lower articular process for the 8 ~ l1m/lq shaping the size of the bone, placed in the spinal column near the posterior annulus in the central part, the remaining crushed facet and the lamina, with autologous iliac mix placed on the spinal column near the front side of the annulus before the site, between the distraction device pedicle screw loose, moderate pressure through the bilateral pedicle screws in bone as a fulcrum pressure to restore lumbar protrusion, nail stick firmly connected . Check the nerve root and dural sac, routine wound closure. l6 cases of pedicle screw-rod system l2 cases with SofamorDanek company TSRH internal fixation system, 4 cases Depuy company MossMiami fixation system. All patients underwent intraoperative wake-up test to confirm the good activity of both lower extremities. Orders placed after drainage tube 24 ~ 72h,[link widoczny dla zalogowanych], antibiotics 3 ~ 5d, in bed wearing a brace after 3w sit or walk with. All patients wear a brace within six months, and prohibited activities of waist bending and torsion. 2 Results All cases were followed up for 2 to 15 months, lumbar spine X-ray showed protrusion curvature, intervertebral height recovered, the basic reduction of spondylolisthesis. 62 Chinese and foreign medical CHINAFOREIGNMEDICALTREATMENT after vertebral slip distance of 0 ~ 3.5mm, 76.5% less than that before; postoperative JOA improvement rate was 74.2%, patients were seen clearly interbody fusion. Dural tear did not occur in all patients, nerve stretch injury, internal fixation was not found broken loose. 3 discussed whether degenerative spondylolisthesis, or vertebral collapse, spondylolisthesis pedicle isthmus, the strict conservative treatment fails, patients with recurrent symptoms, and more need surgical treatment. Classic Coward, S posterior lumbar interbody fusion (PLIF) is commonly used in the treatment of lumbar surgical techniques, bone graft into the disc space through the spinal canal to spinal fusion of adjacent vertebral body to obtain stability. With the cage, the application of pedicle screws, although the PLIF technique has achieved good clinical results, but there are still more severe nerve root traction, fusion into difficulties, postoperative epidural fibrosis,[link widoczny dla zalogowanych], adhesions and scar formation, bone fusion rate not high. L-TLIF technique is based on the TLIF has been improved, the application of leverage, in theory, and other forms with more than TLIF lumbar fusion surgery advantage. L-TLIF transforaminal placement 8 ~ 1lmm through the graft in the spinal column, bone as a fulcrum as the lever arm pedicle screw rod system, through appropriate pressure recovery and maintenance of lumbar intervertebral disc protrusion height, and thus overcome the TLIF protrusion in the lumbar disc height and curvature of the shortcomings recovery; and graft immediate access to pressure overload, is conducive to bone fusion. Compared with the TLIF, L-TLIF surgical procedure does not complicate the process, not on the nerve root and dural additional harassment, only increased by the removal of the upper and lower articular process of shaping is 8 ~ 11mm size of the bones,[link widoczny dla zalogowanych], placed in the spinal column posterior annulus near the central part of a step, this step is not complicated, easy to operate. This study reports the application of L-TLIF treatment of 16 cases of lumbar spondylolisthesis patients achieved good clinical results. As subtotal disc, adjacent vertebral disc firmly connected by the full release, the relative activity increased vertebral asked, through the position adjusting and pulling the pedicle screw rod system, the role of vertebral slip by satisfactory reduction, after preoperative vertebral slip distance less than 76.5%; the bone placed on the support column and the pedicle screw rod system pressure effect, open the front lumbar vertebral body,[link widoczny dla zalogowanych], lumbar spine curvature and intervertebral disc protrusion height increased significantly compared with the preoperative and postoperative physiologic and returned the lumbar intervertebral disc protrusion and a high degree of curvature. The patients were severe low back pain and / or lower limb pain, duration of more than 1 year of conservative treatment fails spondylolisthesis cases, lumbar nerve root compression caused instability and radicular leg pain and mechanical low back pain, L-TLIF removed produce mechanical disc and stabilize the vertebral body with low back pain, and slippage of the vertebra reduction, nerve root stretch tension reduction, JOA improvement rate was 74.2%, indicating that L-TLIF technique and stable vertebra reduction in access vertebral body at the same time,[link widoczny dla zalogowanych], the full decompression of the nerve root, and is not attached to the nerve root injury. Column placed in the graft pedicle screw rod system because pressure effect, immediate access to pressure overload, is conducive to bone fusion, more than 12 months of follow-up 12 patients were seen clearly the phenomenon of interbody fusion , indicating that L-TL1F technology is the choice of treatment of lumbar a better way. Received Date】【2008-12-20
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