Spine :脊髓搏动超声示颈椎术后仰卧最利恢复

2014-04-23 佚名 丁香园

自1982年关于术中超声评估脊髓的首次报道以来,很多研究对脊髓搏动和搏动方式进行了探讨。关于颈椎病行椎板切除减压术后的脊髓情况的研究,也有为数不多的报道。然而,迄今为止,以经皮超声探讨颈椎板成型术后不同体位下脊髓搏动方式的变化和强度情况,尚未见报道。 日本弘前大学医学院骨科的学者进行了一项前瞻性队列研究,提示颈椎板成型术后不同体位下脊髓搏动强度不同,仰卧位更利于脊髓恢

自1982年关于术中超声评估脊髓的首次报道以来,很多研究对脊髓搏动和搏动方式进行了探讨。关于颈椎病行椎板切除减压术后的脊髓情况的研究,也有为数不多的报道。然而,迄今为止,以经皮超声探讨颈椎板成型术后不同体位下脊髓搏动方式的变化和强度情况,尚未见报道。

日本弘前大学医学院骨科的学者进行了一项前瞻性队列研究,提示颈椎板成型术后不同体位下脊髓搏动强度不同,仰卧位更利于脊髓恢复,文章于2014年4月发表在Spine上。

该回顾性病例分析共纳入33例行双开门颈椎板成型的病例,以超声评估仰卧、俯卧、端坐颈椎中立位、端坐颈椎前屈位及端坐颈椎后伸位的颈髓情况,评价指标包括脊髓搏动方式和强度,平均随访时间195天。



研究结果显示,不同体位下脊髓搏动的方式和强度、脊髓的前后位置均有变化。坐位时脊髓搏动最常见,仰卧位脊髓波动最常见。脊髓搏动强度,从高到低依次为仰卧、俯卧、端坐颈椎后伸位、端坐颈椎中立位及端坐颈椎前屈位。仰卧位蛛网膜下腔最为明显。

图2 颈椎板成型术后脊髓的超声图。图中小白箭头为脊髓,大黑箭头为椎体后壁,小黑箭头为蛛网膜下腔。

图3 三种不同类型的蛛网膜下腔。A非接触,蛛网膜下腔空间最大。B接触分离,B-1蛛网膜下腔消失,脊髓与椎体接触,B-2蛛网膜下腔重新出现。C完全接触,蛛网膜下腔空间小。

上述结果显示,考虑到好的脊髓搏动下脊髓的血供好,仰卧位时脊髓的张力小,腹侧的蛛网膜下腔最明显,对脊髓的恢复环境最为有利。

原始出处:

Kowatari K1, Nitobe T, Ono A, Tanaka T, Itabashi T, Ishibashi Y.Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty.Spine (Phila Pa 1976). 2014 Apr 1;39(7):E434-40. doi: 10.1097/BRS.0000000000000209.


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    2014-11-08 mgqwxj
  2. [GetPortalCommentsPageByObjectIdResponse(id=1699297, encodeId=050d169929e6d, content=<a href='/topic/show?id=f5821661e14' target=_blank style='color:#2F92EE;'>#Spine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16617, encryptionId=f5821661e14, topicName=Spine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba5829925263, createdName=mgqwxj, createdTime=Sat Nov 08 04:22:00 CST 2014, time=2014-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1997578, encodeId=10c3199e578cd, content=<a href='/topic/show?id=c3e510060495' target=_blank style='color:#2F92EE;'>#颈椎术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100604, encryptionId=c3e510060495, topicName=颈椎术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=310e209, createdName=yzh399, createdTime=Thu Nov 13 04:22:00 CST 2014, time=2014-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9150, encodeId=7b82915059, content=这和英语有啥关系呢?教一下贝, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fbd0101519, createdName=doudou2014, createdTime=Fri Apr 25 14:10:00 CST 2014, time=2014-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9151, encodeId=37a191511e, content=这和英语有啥关系呢?教一下贝, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fbd0101519, createdName=doudou2014, createdTime=Fri Apr 25 14:10:00 CST 2014, time=2014-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9149, encodeId=4d99914959, content=学好英语先, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=, createdTime=Fri Apr 25 13:04:00 CST 2014, time=2014-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9148, encodeId=b77e9148ed, content=我要怎么才可能发文章呢? <br> <br> <br> www.hrgjk.com, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fbd0101519, createdName=doudou2014, createdTime=Fri Apr 25 12:06:00 CST 2014, time=2014-04-25, status=1, ipAttribution=)]
    2014-11-13 yzh399
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    2014-04-25 doudou2014

    这和英语有啥关系呢?教一下贝

    0

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    2014-04-25 doudou2014

    这和英语有啥关系呢?教一下贝

    0

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    2014-04-25 匿名用户

    学好英语先

    0

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    2014-04-25 doudou2014

    我要怎么才可能发文章呢?


    www.hrgjk.com

    0

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