腰椎射频治疗腰椎间盘突出症.pptx

一、Vertebrae 椎骨There are 33 vertebrae in children, arranged as follows:Cervical vertebrae 颈椎 C.7Thoracic vertebrae 胸椎 T.12Lumbar vertebrae 腰椎 L.5Sacral vertebrae 骶椎 S.5 sacrum 骶骨Coccygeal vertebrae 尾椎 Co.3~4 coccyx尾骨五、Normal Curves of vertebral columnCervical curvature颈曲 convex forwardThoracic curvature胸曲 convex backward Lumbar curvature腰曲 convex forwardSacral curvature骶曲 convex backwardGeneral features of vertebraeVertebral body 椎体Vertebral arch 椎弓pedicle of vertebral arch 椎弓根: sup. and inf. Vertebral notch 椎上、下切迹 lamina of vertebral arch 椎弓板process (7): spinous process 棘突transverse process 横突sup. and inf. articular processes 上、下关节突Vertebral foramen 椎孔 Vertebral canal 椎管Intervertebral foramen 椎间孔Lumbar vertebrae Vertebrae Body： larger, kidney-shape Vertebral foramen: larger and triangular Spinous processes: projects horizontally Transverse processes: long Articular processes: sagittal 1.Joints of the vertebral bodies 椎体间的连结Intervertebral discs 椎间盘 between bodies of adjacent vertebrae, composed of:Nucleus pulpous髓核, an inner soft, pulpy, highly elastic structure (gelatinous core )Annulus fibrosus纤维环 an outer fibrous ring consisting of fibrocartilageHernia of nucleus pulpous 髓核脱出Copyright? Copyright? Copyright? Copyright? Copyright? Copyright? duxinli 2.Joints of the vertebral arches 椎弓间的连结Ligamenta flava 黄韧带― elastic ligament, unite laminae of adjacent vertebrae, and complete the posterior wall of vertebral canal; tend to prevent hyperflexion of the vertebral columnInterspinal ligament 棘间韧带Supraspinal ligament 棘上韧带Ligamentum nuchae项韧带 Intertansverse ligament横突间韧带 Zygapophysial joint 关节突关节Copyright? Copyright? duxinli椎 管 狭 窄发生于椎管、侧隐窝和椎间孔。先天或后天性。颈10mm，腰11.5mmCT：①椎体后缘骨赘向椎管内突入。②侧隐窝狭窄：椎间盘退变膨出和上下关节突肥大是其主要原因，前后径2mm为狭窄，2-4mm为可疑。③黄韧带或后纵韧带肥厚、骨化。④椎体滑脱—椎板峡部裂或椎间盘、韧带退变。MRI：征象同CT椎 间 盘 膨 出椎间盘突出（中央型） Copyright? duxinli椎间盘膨出（较严重，向后有突出） Copyright? duxinli椎间盘突出Copyright? Copyright? duxinli