融合还是非融合？——脊柱手术的争论讲义.ppt

Non-fusion Technique Inter-spinous process fixation system WALLIS System Non-fusion Technique Inter-spinous process fixation system WALLIS System Non-fusion Technique Inter-spinous process fixation system WALLIS System In any case that spine loses its normal sequence, it is called sequential instability. Sequential instability Cervical spine loses its forward curvature and becomes straight. In some cases, the sequence of cervial spine becomes backward In any case that spine loses its normal sequence, it is called sequential instability. Sequential instability In some cases, cervial spine becomes instability because of dislocation In other cases, spine becomes instability because of compressed fructure Tumar and infection can destory vertebra and consequently result in spinal sequential instability Sequential instability Tumar of spine Infection of tuberculosis line a is the back edge of the upper vertebra line b is the back edge of the lower vertebra the distance between a and b is c. if c3.5 cm, the spine is instability Dignosis of sequential instability on X-ray image in saggital view a b c a b α line a is the lower endplate of the upper vertebra line b is the upper endplate of the lower vertebra the angle formed by a and b is α. if α11 °, the spine is instability There are many other manifestations of spinal instability on X-ray image in coronal view, such as scoliosis and rotation of spine. These manifestations in coronal view are often accompanied with imagings in saggital view. Dignosis of sequential instability on X-ray image scoliosis rotation The spinous processes are not along a straight line. In some cases, sequential stability is normal, but there are some neuro-symptons when patients flex, extend, or rotate their spine. Spinal cord or nerve root are compressed by movement of spine. In other words, spine fails to allow spinal cord and nerve root t