颈椎腰椎退行性疾病教学稿件.pptVIP

LOGO 颈椎退行性疾病 Cervical degenerative disease 颈椎病 Cervical spondylosis 颈椎管狭窄症 Cervical canal stenosis 颈椎间盘突出症 Cervical disc herniation 颈椎后纵韧带钙化 Ossification of cervical posterior / ongitudina / ligament 临床表现 Clinical finding 3.椎动脉型 Vertebroarterial spondylosis 椎动脉受压或刺激 椎－基底动脉供血不全 4.交感型 Sympathetic spondylosis 颈交感神经受刺激 影像学检查 imaging examination １.　Ｘ－ray　显示颈椎曲度，椎间隙变化 ２.　ＣＴ　　显示颈椎管径，椎间盘突出及钙化 ３.　ＭＲＩ　显示椎间盘信号，硬膜束间隙变化 治疗 Treatment １.保守治疗　conserative　treatment　 traction physical　therapy ２.手术治疗　surgical treatment decompression fusion 颈椎管狭窄 cervical canal stenosis 颈椎管容积变小,压迫颈髓 产生神经症状、体征 病理　Ｐathology 颈椎管狭窄： １.原法性（Ｐrimary　Ｓtenosis）：先天发育性　desplasia ２.继发性（secondary　stenosis）：退变性　degeneration 临床表现 Clinical finding 1.症状 sympton : 四肢麻木，乏力，活动不灵 2.检查 examination:　感觉、运动障碍，反射异常 临床表现 Clinical finding ３.　Ｘ－ray　a：颈椎矢状径：临界值　１３mm 　　　　　　　b：Ｐavlov 比值：　颈椎管矢状径 　　　　　　　　　　　　　　　　 颈椎体矢状径 ４.　ＣＴ、ＭＲＩ 临床表现　clinical finding 1.sympton: necl pain should pain weakiness 2.examination: movement、sensation、reflex 3.imagin examination: CT、MRI 治疗　　treatment conservative: traction，physical therapy surgical: discectomy，decompression intervertebral fusion 颈后纵韧带骨化Ossification of the posterior longitudinal ligament Opll compression of the spinal Cord fysfunction of the nerve 临床表现　clinical finding 1.sympton and sign:　头颈痛，感觉，运动障碍，二便障碍 ２.ＣＴ、ＭＲＩ：连续型，节段型，局灶型，混合型 治疗　treatment 1.conservative: traction physical therapy 2.surgical: anterior decompression and fusion posterior canaloplasty 腰椎退变性疾病 Lumbar degenerative disease 腰椎间盘突出症Lumbar disc herniation 病因病理：Etiology pathology 1.外伤　injury 2.退变　degeneration 病理生理　pathophysiology 1.disc herniation compression of nerve low back pain leg pain 2.mechanism of pain: a mechanical compression b chemical