lumbar

腰椎
  • 文章类型: Case Reports
    开放手术切除包括延长恢复和软组织损伤,促使侵入性较小的技术的发展和越来越多的采用。虽然MastQuadrant管状牵开器已用于脊柱融合和内窥镜手术,它们在微创肿瘤切除术中的应用尚未得到广泛讨论。该报告展示了MastQuadrant管状牵开器用于腰椎椎体骨样骨瘤的微创切除。
    一个38岁的白种人,患有六年的腰椎疼痛和难治性骨样骨瘤,使用MastQuadrant管状牵开器进行微创侧入路切除。这是在侵入性较小的治疗方式失败之后,包括小平面注射和射频小平面消融。
    椎体骨样骨瘤可以使用管状牵开器切除,以保留椎旁肌肉和开放切除术的发病率,而不会复发,让患者更早地恢复工作和活动。
    UNASSIGNED: Open surgical resection involves extended recovery and soft-tissue damage, prompting the development and increasing adoption of less invasive techniques. While Mast Quadrant tubular retractors have been used in spine fusion and endoscopic procedures, their application in minimally invasive tumor resections has not been widely discussed. This report showcases the use of a Mast Quadrant tubular retractor for the minimally invasive resection of a lumbar vertebral body osteoid osteoma.
    UNASSIGNED: A 38-year-old Caucasian man, suffering from six years of lumbar pain and refractory osteoid osteoma, underwent resection using a minimally invasive lateral approach with a Mast Quadrant tubular retractor. This came after the failure of less invasive treatment modalities, including facet injections and radiofrequency facet ablation.
    UNASSIGNED: Vertebral body osteoid osteomas can be resected with no recurrence using a tubular retractor to spare paravertebral muscles and the morbidity of open resection, allowing patients an earlier return to work and activity.
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  • 文章类型: Journal Article
    该病例报告显示,在一名55岁的男性糖尿病患者中,Winkia(放线菌)神经骨髓炎的发生异常。W.neuii是以前放置在放线菌属中的独特物种,具有独特的形态学和临床特征。由放线菌引起的椎体骨髓炎是罕见的,文献中仅报道了一例先前病例。患者在住院期间通过静脉注射头孢曲松和长期口服抗生素方案的组合成功治疗。此病例报告有助于W.neuii周围的知识有限,以及放线菌椎体骨髓炎。
    This case report presents an unusual occurrence of Winkia (Actinomyces) neuii vertebral osteomyelitis in a 55-year-old male patient with diabetes mellitus. W. neuii is a distinct species formerly placed within the Actinomyces genus, exhibiting unique morphological and clinical characteristics. Vertebral osteomyelitis caused by Actinomyces species is rare, with only one prior case reported in the literature. The patient was successfully managed with a combination of intravenous ceftriaxone during hospitalization and an oral antibiotic regimen for an extended period. This case report contributes to the limited body of knowledge surrounding W. neuii, as well as actinomycotic vertebral osteomyelitis.
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  • 文章类型: Case Reports
    表现为皮肤病学症状的神经性疼痛可在受损或功能失调的神经表现出类似于皮肤相关病症的症状时发生。我们介绍了一例62岁的男性,其会阴和臀裂表现为灼痛和发红。最初,患者因皮肤症状接受治疗,导致红斑的消退。然而,疼痛持续存在,促使神经检查。尽管皮肤症状有所改善,病人的疼痛持续存在,促使神经检查。诊断成像显示腰椎有明显的退行性改变,支持神经病的病因。这个案例强调了在皮肤病学实践中考虑神经系统疾病的重要性,特别是当皮肤症状持续存在,尽管有适当的皮肤病治疗。
    Neuropathic pain presenting as dermatologic symptoms can occur when damaged or dysfunctional nerves manifest with symptoms that resemble skin-related conditions. We present a case of a 62-year-old male who presented with burning pain and redness in the perineum and gluteal cleft. Initially, the patient was treated for dermatologic symptoms, resulting in the resolution of erythema. However, the pain persisted, prompting a neurologic workup. Despite the improvement of skin symptoms, the patient\'s pain persisted, prompting a neurological workup. Diagnostic imaging revealed significant degenerative changes in the lumbar spine, supporting a neuropathic etiology. This case highlights the importance of considering neurologic disorders in dermatologic practice, especially when cutaneous symptoms persist despite appropriate dermatological treatments.
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  • 文章类型: Journal Article
    我们提出了三个新的和六个已发表的婴儿重叠的LUMBAR综合征特征(下体血管瘤,泌尿生殖系统异常,脊髓畸形,骨畸形,肛门直肠/动脉异常和肾脏异常)和OEIS复合体(脐膨出,exstrophy,肛门无孔,和脊柱缺陷),也被称为泄殖腔exstrophy。OEIS包含在最近提出的伞形创造的胚胎畸形(RCEM)的复发性星座中。RCEM代表了不明原因但可能共同发病机制的罕见尾管发育不全疾病的表型重叠谱。最近提出将LUMBAR视为RCEM。这篇关于OEIS和LUMBAR相结合的婴儿的报告是第一个证明LUMBAR和另一个RCEM之间重叠的报告。支持LUMBAR包含在RCEM光谱中。
    We present three new and six published infants with overlapping features of LUMBAR syndrome (lower body hemangioma, urogenital anomalies, spinal cord malformations, bony deformities, anorectal/arterial anomalies and renal anomalies) and OEIS complex (omphalocele, exstrophy, imperforate anus, and spinal defects), also known as cloacal exstrophy. OEIS is included under the recently proposed umbrella coined recurrent constellations of embryonic malformations (RCEMs). The RCEMs represent a phenotypically overlapping spectrum of rare disorders of caudal dysgenesis with unknown cause but likely shared pathogenesis. It has recently been proposed that LUMBAR be considered an RCEM. This report of infants with combined features of OEIS and LUMBAR is the first to demonstrate an overlap between LUMBAR and another RCEM, which supports LUMBAR\'s inclusion within the RCEM spectrum.
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  • 文章类型: Case Reports
    腰椎副神经节瘤是罕见的神经内分泌肿瘤,起源于马尾/终丝区域的特殊神经c细胞。如果它们分泌儿茶酚胺,则难以通过放射学诊断,并且难以通过手术治疗。一名38岁的女性出现了三年半的下背部和骶骨不适。她的神经系统检查正常。MRI显示L4硬膜内病变压迫马尾。进行全肿瘤切除。病理报告诊断为副神经节瘤。在腰椎硬膜内肿块的鉴别诊断中应考虑副神经节瘤。
    Lumbar paragangliomas are rare neuroendocrine neoplasms arising from specialized neural crest cells in the cauda equina/filum terminale region. They are difficult to diagnose radiologically and can be difficult to treat surgically if they secrete catecholamines. A 38-year-old woman presented with three and a half years of increasing lower back and sacrum discomfort. Her neurological examination was normal. The MRI revealed an L4 intradural lesion that was compressing the cauda equina. A total tumor resection was conducted. The paraganglioma was diagnosed by the pathology report. Paragangliomas should be considered in the differential diagnosis of intradural masses of the lumbar spine.
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  • 文章类型: Case Reports
    腰椎融合术后邻近节段性退变是腰椎融合术后常见的远期并发症之一。随着邻近节段变性的不断发展,保守治疗失败的患者通常需要再次手术以缓解症状。近年来,微通道下单侧入路双侧微减压技术已广泛应用于腰椎退行性疾病的治疗。然而,该手术对腰椎融合术后相邻节段退变的疗效尚未确定.这里,我们报道了1例腰椎融合术后邻近节段性退变患者通过单侧入路经微通道进行双侧显微减压的病例。
    一名70岁的男性患者因腰痛伴左下肢疼痛入院,麻木和虚弱了两年,加重了2个月。十年前,他因腰椎管狭窄接受了PLIF治疗,手术后恢复良好。根据影像学资料和体格检查,诊断为腰椎融合术后邻近节段退变。在微通道下通过单侧入路进行双侧微减压。术后1年随访观察到良好的临床效果。
    本报告报道了一名ASD患者在腰椎融合术10年后的成功治疗。通过在微通道下单侧入路进行双侧微减压是治疗腰椎融合术后ASD的安全有效方法,具有良好的手术效果。
    UNASSIGNED: Adjacent segmental degeneration after lumbar fusion is one of the common long-term complications after lumbar fusion. With the continuous development of adjacent segmental degeneration, patients who fail conservative treatment often need reoperation to relieve symptoms. In recent years, the technique of bilateral microdecompression through unilateral approach under microchannel has been widely used in the treatment of lumbar degenerative diseases. However, the efficacy of this procedure for adjacent-segment degeneration after lumbar fusion has not been established. Here, we report a case of bilateral microscopic decompression via a unilateral approach through a microchannel in a patient with adjacent segmental degeneration after lumbar fusion.
    UNASSIGNED: A 70-year-old male patient was admitted to hospital because of lumbago accompanied by left lower extremity pain, numbness and weakness for 2 years, which aggravated for 2 months. Ten years ago, he underwent PLIF for lumbar spinal stenosis, and recovered well after the operation. According to imaging data and physical examination, the diagnosis was adjacent segmental degeneration after lumbar fusion. Bilateral microdecompression was performed through a unilateral approach under a microchannel. Good clinical outcomes was observed through 1-year postoperative follow-up.
    UNASSIGNED: This report reports the successful treatment of a patient with ASD 10 years after lumbar fusion. Bilateral microdecompression via a unilateral approach under a microchannel is a safe and effective method for the treatment of ASD after lumbar fusion with good surgical outcomes.
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  • 文章类型: Case Reports
    手术治疗了一名40岁女性的S1-S2半椎骨引起的罕见腰s交界处后凸畸形,改善神经紊乱,和腰痛。早期干预对于先天性异常至关重要。
    Rare lumbosacral junction kyphosis due to S1-S2 hemivertebra in a 40-year-old woman was managed surgically, improving neurological disturbances, and low back pain. Early intervention is vital for congenital anomalies.
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  • 文章类型: Journal Article
    背景:可以利用较新的软件从磁共振成像(MRI)创建合成计算机断层扫描(sCT)。作为常规CT(rCT)的可能替代方案,尚待探索。在这项研究中,在尸体上获得rCT扫描和MRI衍生的sCT扫描。比较2次扫描进行形态测量分析。ExcelsiusGPS机器人用于放置具有rCT和sCT图像的腰骶螺钉。
    方法:总共,放置了14个螺钉。所有螺钉均为Gertzbein-Robbins量表上的A级。在重建的软件模型上,rCT和sCT之间的平均表面距离差为-0.02±0.05mm,平均绝对表面距离为0.24±0.05mm,放射性密度的平均绝对误差为92.88±10.53HU。sCT与rCT的总平均尖端距离为1.74±1.1对2.36±1.6mm(p=0.24);sCT与rCT的平均尾部距离为1.93±0.88对2.81±1.03mm(p=0.07);sCT与rCT的平均角度偏差为3.2°±2.05°对4.04°±2.71°(p=0.53)。
    结论:在尸体研究中,基于MRI的sCT在形态测量分析和机器人辅助的腰骶螺钉置入方面均产生了与rCT相当的结果。
    BACKGROUND: Synthetic computed tomography (sCT) can be created from magnetic resonance imaging (MRI) utilizing newer software. sCT is yet to be explored as a possible alternative to routine CT (rCT). In this study, rCT scans and MRI-derived sCT scans were obtained on a cadaver. Morphometric analysis was performed comparing the 2 scans. The ExcelsiusGPS robot was used to place lumbosacral screws with both rCT and sCT images.
    METHODS: In total, 14 screws were placed. All screws were grade A on the Gertzbein-Robbins scale. The mean surface distance difference between rCT and sCT on a reconstructed software model was -0.02 ± 0.05 mm, the mean absolute surface distance was 0.24 ± 0.05 mm, and the mean absolute error of radiodensity was 92.88 ± 10.53 HU. The overall mean tip distance for the sCT versus rCT was 1.74 ± 1.1 versus 2.36 ± 1.6 mm (p = 0.24); mean tail distance for the sCT versus rCT was 1.93 ± 0.88 versus 2.81 ± 1.03 mm (p = 0.07); and mean angular deviation for the sCT versus rCT was 3.2° ± 2.05° versus 4.04°± 2.71° (p = 0.53).
    CONCLUSIONS: MRI-based sCT yielded results comparable to those of rCT in both morphometric analysis and robot-assisted lumbosacral screw placement in a cadaver study.
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  • 文章类型: Case Reports
    角质脂瘤(LFH)是神经根病和腰背痛的罕见原因,与椎间盘突出症有着相似的症状.它主要影响腰椎胸椎。LFH的潜在机制尚不清楚;然而,手术切除血肿的结果一直很好.本病例报告的目的是强调诊断LFH的重要性。我们提出了一个手术证实的腰椎LFH病例,模仿了腰椎肿瘤,强调在诊断和后续管理过程中遇到的挑战。
    Liagmentum flavum hematoma (LFH) is a rare cause of radiculopathy and low back pain, sharing similar symptomatology with disc herniation. It predominantly affects the lumbar thoracic spine. The underlying mechanism of LFH remains unclear; however, surgical removal of the hematoma has consistently demonstrated excellent outcomes. The objective of this case report is to emphasize the significance of diagnosing LFH. We present a surgically confirmed lumbar LFH case that mimicked a lumbar tumor, highlighting the challenges encountered during diagnosis and subsequent management.
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  • 文章类型: Journal Article
    目的:全内窥镜腰椎椎间融合术(FELIF)是治疗腰椎滑脱的新一代治疗方法。然而,由于其独特的特点,两个主要的内窥镜融合轨迹,跨Kambin和后外侧入路,有重要的局限性。在这里,我们的目的是引入一种名为Kambin鱼雷FELIF(KT-FELIF)的新技术。
    方法:KT-FELIF技术基于反式Kambin方法。它还完成了同侧全软骨切除术和对侧直接减压。因此,这项新颖的技术结合了跨Kambin和后外侧入路的优点。
    结果:我们报告了KT-FELIF的适应症和技术步骤,并提供了术中和动画视频以阐明该过程。根据术后3个月的计算机断层扫描和术后至少3个月拍摄的平片图像进行短期随访,显示出足够的骨减压,大的植骨接触面积,和良好的椎间骨小梁生长,移植物之间没有射线可透的线,笼子,和端板。临床结果,如同侧和对侧视觉模拟量表和Oswestry残疾指数值,术后1个月和3个月逐渐好转。未观察到并发症。
    结论:KT-FELIF是一种有前途的FELIF技术,可通过单侧入路实现双侧直接减压,同时完成彻底的椎间盘切除术和终板准备。
    OBJECTIVE: Full-endoscopic lumbar interbody fusion (FELIF) is a new-generation treatment for spondylolisthesis. However, owing to their unique characteristics, the two main endoscopic fusion trajectories, the trans-Kambin and posterolateral approaches, have important limitations. Herein, we aimed to introduce a new technique called Kambin Torpedo FELIF (KT-FELIF).
    METHODS: The KT-FELIF technique is based on the trans-Kambin approach. It additionally completes ipsilateral total facetectomy and contralateral direct decompression. Thus, this novel technique combines the advantages of the trans-Kambin and posterolateral approaches.
    RESULTS: We reported on the indications and technical steps of KT-FELIF and provided intraoperative and animated videos to clarify the procedure. Short-term follow-up based on 3-month postoperative computed tomography and plain films images taken at least 3 months after surgery showed adequate bony decompression, a large bone graft contact area, and good intervertebral trabecular bone growth without radiolucent lines between the graft, cage, and end plate. The clinical results, such as ipsilateral and contralateral visual analog scale and Oswestry disability index values, gradually improved at 1 and 3 months postoperatively. No complications were observed.
    CONCLUSIONS: KT-FELIF is a promising FELIF technique for achieving bilateral direct decompression through a unilateral approach while accomplishing thorough discectomy and endplate preparation.
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