研究发现,神经根若被突出或膨出的椎间盘压迫,在扩散张量图像上表现为神经根纤维束的截面积减小,纤维束发生断裂及聚拢,无法显示分支。中国河北医科大学第二医院田欣博士所在课题组进行的一项关于＂Scanning pattern of diffusion tenso...研究发现,神经根若被突出或膨出的椎间盘压迫,在扩散张量图像上表现为神经根纤维束的截面积减小,纤维束发生断裂及聚拢,无法显示分支。中国河北医科大学第二医院田欣博士所在课题组进行的一项关于＂Scanning pattern of diffusion tensor tractography and an analysis of the morphology and function of spinal nerve roots＂的研究,首次将磁共振扩散张量纤维束示踪成像用于评价神经根功能,展开更多
OBJECTIVE: To observe long-term functional recovery after contralateral C7 transfer. METHODS: From August 1986 to July 2000, 224 patients with brachial plexus avulsion injuries were treated with contralateral C7 trans...OBJECTIVE: To observe long-term functional recovery after contralateral C7 transfer. METHODS: From August 1986 to July 2000, 224 patients with brachial plexus avulsion injuries were treated with contralateral C7 transfer in our department. Thirty-two patients were followed up for over 2 years for evaluation of the following items: 1 influence on healthy limb function; 2 sensory and motor recovery of the recipient nerves in the affected limb; and 3 coordination between the healthy and affected limbs. RESULTS: There was no impairment of healthy limb function. Functional recovery of the recipient area reached > or =M3 in 8 patients (8/10, 80%) after musculocutaneous nerve neurotization, > or =M3 in 4 patients (4/6, 66%) after radial nerve neurotization, > or = M3 in 7 patients (7/14, 50%) and > or = M3 in 12 patients (85.7%) after median nerve neurotization, and > or = M3 in 1 patients (1/2, 50%) after thoracodorsal nerve neurotization. Synchronic contraction of the affected limb with the healthy limb occurred within 2-3 years in 12 patients, within 5 years in 13 patients, and over 5 years in 7 patients. CONCLUSION: Contralateral C7 transfer is an ideal procedure for the treatment of brachial plexus root avulsion injury. Selection of the whole root or the posterior division as neurotizer and a staged operation are the major factors influencing treatment outcome.展开更多
Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation com...Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty （Group A, n=12） or posterior shortening osteotomy （Group B, n=16） for osteoporotic thoracolumbar Kummell＇s disease were analyzed retrospectively. Japanese orthopedic association （JOA） and visual analogue scale （VAS） scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered. Results： The follow-up period was 12-54 months （average 29 months）. Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation （t=-5.306, P〈0.001）. There was no significant difference between Groups A and B （t=0.618,P〉0.05）. The kyphosis were corrected from preoperative 33.9°（A）/ 37.3°（B） to postoperative 10.3°（A）/6.5°（B）, and 15.3° （A）/13.7°（B） at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions： The similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kummell＇s disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.展开更多
文摘研究发现,神经根若被突出或膨出的椎间盘压迫,在扩散张量图像上表现为神经根纤维束的截面积减小,纤维束发生断裂及聚拢,无法显示分支。中国河北医科大学第二医院田欣博士所在课题组进行的一项关于＂Scanning pattern of diffusion tensor tractography and an analysis of the morphology and function of spinal nerve roots＂的研究,首次将磁共振扩散张量纤维束示踪成像用于评价神经根功能,
文摘OBJECTIVE: To observe long-term functional recovery after contralateral C7 transfer. METHODS: From August 1986 to July 2000, 224 patients with brachial plexus avulsion injuries were treated with contralateral C7 transfer in our department. Thirty-two patients were followed up for over 2 years for evaluation of the following items: 1 influence on healthy limb function; 2 sensory and motor recovery of the recipient nerves in the affected limb; and 3 coordination between the healthy and affected limbs. RESULTS: There was no impairment of healthy limb function. Functional recovery of the recipient area reached > or =M3 in 8 patients (8/10, 80%) after musculocutaneous nerve neurotization, > or =M3 in 4 patients (4/6, 66%) after radial nerve neurotization, > or = M3 in 7 patients (7/14, 50%) and > or = M3 in 12 patients (85.7%) after median nerve neurotization, and > or = M3 in 1 patients (1/2, 50%) after thoracodorsal nerve neurotization. Synchronic contraction of the affected limb with the healthy limb occurred within 2-3 years in 12 patients, within 5 years in 13 patients, and over 5 years in 7 patients. CONCLUSION: Contralateral C7 transfer is an ideal procedure for the treatment of brachial plexus root avulsion injury. Selection of the whole root or the posterior division as neurotizer and a staged operation are the major factors influencing treatment outcome.
文摘Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty （Group A, n=12） or posterior shortening osteotomy （Group B, n=16） for osteoporotic thoracolumbar Kummell＇s disease were analyzed retrospectively. Japanese orthopedic association （JOA） and visual analogue scale （VAS） scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered. Results： The follow-up period was 12-54 months （average 29 months）. Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation （t=-5.306, P〈0.001）. There was no significant difference between Groups A and B （t=0.618,P〉0.05）. The kyphosis were corrected from preoperative 33.9°（A）/ 37.3°（B） to postoperative 10.3°（A）/6.5°（B）, and 15.3° （A）/13.7°（B） at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions： The similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kummell＇s disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.
