脑脊椎和脊柱不稳定性的概念不断发展
Atul Goel1,2,3, Ravikiran Vutha4, Abhidha Shah5
1Department of Neurosurgery, Lilavati Hospital and Research Center, Mumbai, India.
Advances and technical standards in neurosurgery
|June 15, 2023
概括
肌肉软弱和脊柱不稳定会导致严重的健康问题. 通过手术稳定来解决这种不稳定性,可以扭转许多二次脊柱变化.
科学领域:
- 脊柱生物力学和神经外科
- 脊椎和脊柱疾病的发病原因.
背景情况:
- 部和脊柱的肌肉软弱导致不稳定,这是椎节和脊柱病理的关键因素.
- 慢性不稳定性会导致肌肉骨和脊柱结构的逐渐变化,包括垂直脊柱不稳定性和中枢/轴向大西洋轴心不稳定性 (CAAD).
研究的目的:
- 阐明脊柱不稳定性在各种临床和病理事件中的作用.
- 要强调二次变化是对不稳定的保护性反应,并且可能是可逆的.
主要方法:
- 审查与脊柱不稳定性相关的临床和病理事件.
- 分析二次性变化 (例如,奇亚里形成,基底性发育,注射器) 作为不稳定性的指标.
- 放射性评估,并指出不稳定性可能并不总是显现在动态成像.
主要成果:
- 垂直脊柱不稳定和CAAD可能是脊柱段望远镜的结果.
- 二次性变化,如奇亚里形成,基底性发育,注射器,和Klippel-Feil异常,与慢性atlantoaxial不稳定性有关.
- 根性病变/骨髓病变可能源于垂直脊柱不稳定性,脊柱退化或后沿线带骨化.
结论:
- 二次脊柱变化是潜在不稳定的保护性指标,而不是原发性病理.
- 不稳定的脊柱段的手术稳定是基本的治疗方法.
- 在成功地稳定了atlantoaxial后,可以逆转二次变化.
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