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The oblique flexion-extension myelography(35 cases) and dynamic CTM scans (13 cases) were performed on the patients with lumbocrural pain and lumbosacral nerve root block in the myelography. Changes of root imaging were observed. The relationship between anterio-larteral angle and nerve root in flexion or extension position of the lumbar spine during operation were explorated. It is discovered that L5 and S1 nerve root were more often compressed than L4 nerve root. Nerve root imagings changed its fluency with... The oblique flexion-extension myelography(35 cases) and dynamic CTM scans (13 cases) were performed on the patients with lumbocrural pain and lumbosacral nerve root block in the myelography. Changes of root imaging were observed. The relationship between anterio-larteral angle and nerve root in flexion or extension position of the lumbar spine during operation were explorated. It is discovered that L5 and S1 nerve root were more often compressed than L4 nerve root. Nerve root imagings changed its fluency with flexion or extension of the lumbar spine. The authors thought that lumbarsacral nerve root were of ten compressed in anterio-lateral angle of non-bony segment of lumbar canals. Degeneration of the soft tissue were main pathogenetic factor. The clinical symptoms were relieved or aggravated with position change.The dynamic oblique views myelography and dynamic CTM scans were worthy to judge narrowed segment and conduct the operation. (The Orthopedic Department of 85 Hospital, Shanghai 200052) 对临床具腰腿痛并脊髓造影显示单或双侧腰骶神经根影中断者,做了椎管斜位伸屈造影(35例)和动态CTM扫描(13例),观察了根影动态变化。其中17例术中加用伸屈腰椎拱桥探查了椎管前外侧角与神经根间关系。上述研究结果结合临床症状、体征发现:L5、S1神经根受椎管非骨性段挤压机会显著高于L4神经根。分析认为:常遇的腰骶神经根中断多发生在非骨性段的椎管前外侧角,椎间盘与黄韧带退变是神经根受压的主要病理因素,症状可随体位变动减轻或加重。斜位椎管造影和动态CTM对判断不同狭窄节段与指导手术有重要参考价值。 Myelographs were performed in 50 rabbits(divided into 5 groups) with Myodil,Iopamiro,Omnipaque, Isovist and Natrii Chloridi. Animals were killed at various intervals (in 1 day, 3 days, 1 week , 4 weeks and 7 weeks). Lumbar and cervical spinal cord were taken to evaluated histologically by light and electron microscope. The result demonstrated that Myodil is liable to arachnoiditis. The hyperplasia of arachnoid of Iopamiro is much higher than Omnipaque and Isovist.Author's address (The Orthopedic Department... Myelographs were performed in 50 rabbits(divided into 5 groups) with Myodil,Iopamiro,Omnipaque, Isovist and Natrii Chloridi. Animals were killed at various intervals (in 1 day, 3 days, 1 week , 4 weeks and 7 weeks). Lumbar and cervical spinal cord were taken to evaluated histologically by light and electron microscope. The result demonstrated that Myodil is liable to arachnoiditis. The hyperplasia of arachnoid of Iopamiro is much higher than Omnipaque and Isovist.Author's address (The Orthopedic Department of Qingdao Municipal Hospital,Qingdao, Shandong,266011) 取50只大白兔分为5组,每组10只,分别用0.9%氯化钠、Myodil(碘苯酯)、Iopamiro(碘异肽醇)、Omnipaque(碘苯六醇)、Isovist(碘帕醇)作脊髓造影。每组于造影后1天、3天、1周、4周、7周各取2只,静脉气栓处死后,取腰、颈段脊髓作光、电镜观察。作者观察到Myodil易引起粘连性蛛网膜炎;Iopamiro导致蛛网膜反应性增生远大于Omnipaque和Isovist。 From April 1976 to August 1993, 150 cases with cervical spondylosis and cervical fracturedislocation were treated by anterior cervical decompression and interbody fusion. Of them complications were found in 24 cases (26 times). Among them,injury of spinal cord in 8 cases ,injury of cervical nerve root in 2 cases,leakage of cerebrospinal in 5 cases ,injury of superior laryngeal nerve and recurrent laryngeal nerve in 4 case,deep wound hematoma in 1 case,the operation was done at the wrong level in 2 cases, injury... From April 1976 to August 1993, 150 cases with cervical spondylosis and cervical fracturedislocation were treated by anterior cervical decompression and interbody fusion. Of them complications were found in 24 cases (26 times). Among them,injury of spinal cord in 8 cases ,injury of cervical nerve root in 2 cases,leakage of cerebrospinal in 5 cases ,injury of superior laryngeal nerve and recurrent laryngeal nerve in 4 case,deep wound hematoma in 1 case,the operation was done at the wrong level in 2 cases, injury of nervus cutaneus femoris lateralis in 3 cases. The causes of complications and preventive measures were discussed.Author’s address( Orthopedic Department of Beijing Army General Hospital,Beijing, 100700) 1976年4月~1993年8月共做颈椎前路减压植骨融合术150例,发生24例(26次)与手术有关的并发症。分为七类:(1)脊髓损伤8例,其中颈椎过伸性损伤2例,明显器械刺激损伤2例,植骨块挤压1例,无明显原因术后瘫痪加重者3例;(2)脊神经根损伤2例;(3)脑脊液漏5例;(4)喉上神经与喉返神经损伤各2例;(5)颈深部血肿1例;(6)椎间盘错切2例;(7)股外侧皮神经损伤3例。对以上并发症分析了原因并提出了预防措施。
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