目的评价加速康复外科(ERAS)在双平面机器人辅助经皮骶髂关节螺钉固定治疗骶骨骨折中的临床效果。方法选取2018年12月至2020年12月内蒙古医科大学附属医院采用双平面机器人辅助经皮骶髂关节螺钉固定治疗的24例骶骨纵形骨折患者作为研究...目的评价加速康复外科(ERAS)在双平面机器人辅助经皮骶髂关节螺钉固定治疗骶骨骨折中的临床效果。方法选取2018年12月至2020年12月内蒙古医科大学附属医院采用双平面机器人辅助经皮骶髂关节螺钉固定治疗的24例骶骨纵形骨折患者作为研究对象,随机分为ERAS组与常规组(n=12),其中常规组采取常规围手术期管理模式,ERAS组在常规管理基础上实施ERAS精细化围手术期管理方案,对两组患者围手术期指标、影像学结果和疗效指标进行对比分析。结果对两组患者螺钉置入位置进行影像学检查(X线、CT扫描),均达到满意程度;Matta影像评分两组相近(P>0.05)。ERAS组术后2 d疼痛视觉模拟量表评分、术后3 d Braden压疮评分和末次随访Majeed评分均优于常规组,住院时间短于常规组,两组比较,差异具有统计学意义(P<0.05)。结论在机器人辅助经皮骶髂关节螺钉固定围手术期管理中运用ERAS理念,疼痛缓解更加有效、压疮风险更低、住院时间更短,更有利于骶骨骨折患者术后骨盆功能恢复,可在脊柱外科机器人手术中推广和应用。展开更多
BACKGROUND Fibrous dysplasia(FD)is a common benign intramedullary fibro-osseous lesion.Involvement of the spine is rare,with the literature including only case reports,and cases of monostotic FD(MFD)in the sacrum are ...BACKGROUND Fibrous dysplasia(FD)is a common benign intramedullary fibro-osseous lesion.Involvement of the spine is rare,with the literature including only case reports,and cases of monostotic FD(MFD)in the sacrum are extremely rare.A correct preoperative diagnosis of spinal MFD is important for clinicians to select proper treatment.CASE SUMMARY We retrospectively assessed a case report of MFD in the sacrum.This patient was examined by computed tomography(CT)and magnetic resonance imaging(MRI),and the diagnosis was confirmed by pathology.A review of the literature was performed to analyze the imaging characteristics and differential diagnoses of spinal MFD.For our patient,the CT scan showed the lesion to be expansile,with ground glass opacity and a sclerotic rim.On MRI,the lesion showed iso-low signal intensity on T1WI and iso-high signal intensity on T2WI.A low signal rim was found on T1WI and T2WI.Our patient was treated by posterior focal excision,decompression,bone grafting,fusion and pedicle screw fixation.A satisfactory result was achieved,with pain disappearance.No complications had occurred at the 1-year follow up.CONCLUSION MFD is an expansile osteolytic change.Ground glass opacity and a sclerotic margin are obvious characteristics.The lesion often involves the vertebral body and posterior element.Knowledge of these imaging characteristics of spinal FD could be helpful for diagnosis and prevent unnecessary procedures.展开更多
Introduction: Osseous eosinophilic granulomas commonly occur in the skull, pelvis, vertebrae, mandible, and ribs. However, the eosinophilic granuloma in the sacrum is rare. Case presentation: We present the case of a ...Introduction: Osseous eosinophilic granulomas commonly occur in the skull, pelvis, vertebrae, mandible, and ribs. However, the eosinophilic granuloma in the sacrum is rare. Case presentation: We present the case of a 13-year-old Japanese boy, who presented with left low-back pain, and was diagnosed with eosinophilic granuloma arising in the sacrum. Computed tomography (CT) and magnetic resonance imaging demonstrated an osteolytic lesion with interruption of the cortex, and signal intensity changes at the left sacral body and wing. Histologic examination indicated an eosinophilic granuloma. Two years after CT-guided biopsy, the tumor had spontaneously healed completely, with no residual pain.Conclusion: The present case was eosiophilic granuloma arising from the rare site of sacrum. The tumor was completely remodeled two years after biopsy.展开更多
The article concerns the commission that was made by the Biennale di Venezia to Stravinsky in the 50s＇ which led to the composition of the Canticum Sacrum. The discovery of the correspondence between the composer, th...The article concerns the commission that was made by the Biennale di Venezia to Stravinsky in the 50s＇ which led to the composition of the Canticum Sacrum. The discovery of the correspondence between the composer, the artistic director Alessandro Piovesan and the organizers of the Venetian Festival allows to reconstruct the events that led Stravinsky to change his initial plans for a Passion selon Saint Marc in favour of a short Canticum. The objections, which concerned above all the limited size of the piece, were repeated several times by Piovesan, but were all disregarded by Stravinsky. In the light of the eight letters deposited in the Archivio Storico delle Arti Contemporanee （ASAC） of Venice （in Appendix）, the circumstances bringing about Stravinsky＇s refusal can be fully understood. The references to recent studies by David H. Smyth, Akane Mori, and Jonathan Kramer regarding the identification of palindromic and proportional structures in the Canticum, offers further proof sustaining Stravinsky＇s declaration that to enlarge the piece would have been impossible. These events confirm the composer＇s unbending determination to undertake a new experimental stylistic direction already tried out in pieces like the Three Songs from William Shakespeare and Agon.展开更多
As quality and cost effectiveness become essential in clinical practice,an evidencebased evaluation of the utility of imaging orders becomes an important consideration for radiology’s value in patient care.We report ...As quality and cost effectiveness become essential in clinical practice,an evidencebased evaluation of the utility of imaging orders becomes an important consideration for radiology’s value in patient care.We report an institutional quality improvement project including a retrospective review of utility of sacrum magnetic resonance(MR)imaging for low back pain at our institution over a four-year period and follow-up results after physician education intervention.Sacral MR imaging for low back pain and tailbone pain were only positive for major findings in 2/98(2%)cases,and no major changes in patient management related to imaging findings occurred over this period,resulting in almost$500000 cost without significant patient benefit.We distributed these results to the Family Medicine department and clinics that frequently placed this order.An approximately 83%drop in ordering rate occurred over the ensuing 3 mo follow-up period.Sacrum MR imaging for low back pain and tail bone pain has not been a cost-effective diagnostic tool at our institution.Physician education was a useful tool in reducing overutilization of this study,with a remarkable drop in such studies after sharing these findings with primary care physicians at the institution.In conclusion,sacrum MR imaging rarely elucidates the cause of low back/tail pain diagnosed in a primary care setting and is even less likely to result in major changes in management.The practice can be adopted in other institutions for the benefit of their patients and improve cost efficiency.展开更多
文摘目的评价加速康复外科(ERAS)在双平面机器人辅助经皮骶髂关节螺钉固定治疗骶骨骨折中的临床效果。方法选取2018年12月至2020年12月内蒙古医科大学附属医院采用双平面机器人辅助经皮骶髂关节螺钉固定治疗的24例骶骨纵形骨折患者作为研究对象,随机分为ERAS组与常规组(n=12),其中常规组采取常规围手术期管理模式,ERAS组在常规管理基础上实施ERAS精细化围手术期管理方案,对两组患者围手术期指标、影像学结果和疗效指标进行对比分析。结果对两组患者螺钉置入位置进行影像学检查(X线、CT扫描),均达到满意程度;Matta影像评分两组相近(P>0.05)。ERAS组术后2 d疼痛视觉模拟量表评分、术后3 d Braden压疮评分和末次随访Majeed评分均优于常规组,住院时间短于常规组,两组比较,差异具有统计学意义(P<0.05)。结论在机器人辅助经皮骶髂关节螺钉固定围手术期管理中运用ERAS理念,疼痛缓解更加有效、压疮风险更低、住院时间更短,更有利于骶骨骨折患者术后骨盆功能恢复,可在脊柱外科机器人手术中推广和应用。
文摘BACKGROUND Fibrous dysplasia(FD)is a common benign intramedullary fibro-osseous lesion.Involvement of the spine is rare,with the literature including only case reports,and cases of monostotic FD(MFD)in the sacrum are extremely rare.A correct preoperative diagnosis of spinal MFD is important for clinicians to select proper treatment.CASE SUMMARY We retrospectively assessed a case report of MFD in the sacrum.This patient was examined by computed tomography(CT)and magnetic resonance imaging(MRI),and the diagnosis was confirmed by pathology.A review of the literature was performed to analyze the imaging characteristics and differential diagnoses of spinal MFD.For our patient,the CT scan showed the lesion to be expansile,with ground glass opacity and a sclerotic rim.On MRI,the lesion showed iso-low signal intensity on T1WI and iso-high signal intensity on T2WI.A low signal rim was found on T1WI and T2WI.Our patient was treated by posterior focal excision,decompression,bone grafting,fusion and pedicle screw fixation.A satisfactory result was achieved,with pain disappearance.No complications had occurred at the 1-year follow up.CONCLUSION MFD is an expansile osteolytic change.Ground glass opacity and a sclerotic margin are obvious characteristics.The lesion often involves the vertebral body and posterior element.Knowledge of these imaging characteristics of spinal FD could be helpful for diagnosis and prevent unnecessary procedures.
文摘Introduction: Osseous eosinophilic granulomas commonly occur in the skull, pelvis, vertebrae, mandible, and ribs. However, the eosinophilic granuloma in the sacrum is rare. Case presentation: We present the case of a 13-year-old Japanese boy, who presented with left low-back pain, and was diagnosed with eosinophilic granuloma arising in the sacrum. Computed tomography (CT) and magnetic resonance imaging demonstrated an osteolytic lesion with interruption of the cortex, and signal intensity changes at the left sacral body and wing. Histologic examination indicated an eosinophilic granuloma. Two years after CT-guided biopsy, the tumor had spontaneously healed completely, with no residual pain.Conclusion: The present case was eosiophilic granuloma arising from the rare site of sacrum. The tumor was completely remodeled two years after biopsy.
文摘The article concerns the commission that was made by the Biennale di Venezia to Stravinsky in the 50s＇ which led to the composition of the Canticum Sacrum. The discovery of the correspondence between the composer, the artistic director Alessandro Piovesan and the organizers of the Venetian Festival allows to reconstruct the events that led Stravinsky to change his initial plans for a Passion selon Saint Marc in favour of a short Canticum. The objections, which concerned above all the limited size of the piece, were repeated several times by Piovesan, but were all disregarded by Stravinsky. In the light of the eight letters deposited in the Archivio Storico delle Arti Contemporanee （ASAC） of Venice （in Appendix）, the circumstances bringing about Stravinsky＇s refusal can be fully understood. The references to recent studies by David H. Smyth, Akane Mori, and Jonathan Kramer regarding the identification of palindromic and proportional structures in the Canticum, offers further proof sustaining Stravinsky＇s declaration that to enlarge the piece would have been impossible. These events confirm the composer＇s unbending determination to undertake a new experimental stylistic direction already tried out in pieces like the Three Songs from William Shakespeare and Agon.
文摘As quality and cost effectiveness become essential in clinical practice,an evidencebased evaluation of the utility of imaging orders becomes an important consideration for radiology’s value in patient care.We report an institutional quality improvement project including a retrospective review of utility of sacrum magnetic resonance(MR)imaging for low back pain at our institution over a four-year period and follow-up results after physician education intervention.Sacral MR imaging for low back pain and tailbone pain were only positive for major findings in 2/98(2%)cases,and no major changes in patient management related to imaging findings occurred over this period,resulting in almost$500000 cost without significant patient benefit.We distributed these results to the Family Medicine department and clinics that frequently placed this order.An approximately 83%drop in ordering rate occurred over the ensuing 3 mo follow-up period.Sacrum MR imaging for low back pain and tail bone pain has not been a cost-effective diagnostic tool at our institution.Physician education was a useful tool in reducing overutilization of this study,with a remarkable drop in such studies after sharing these findings with primary care physicians at the institution.In conclusion,sacrum MR imaging rarely elucidates the cause of low back/tail pain diagnosed in a primary care setting and is even less likely to result in major changes in management.The practice can be adopted in other institutions for the benefit of their patients and improve cost efficiency.
