jordan heels Percutaneous lumbar discectomy select

 
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PostWysłany: Śro 12:03, 23 Mar 2011    Temat postu: jordan heels Percutaneous lumbar discectomy select

Percutaneous lumbar discectomy selection method to improve the indication


J. Clinical symptoms Peng o 'like a typical (with repeated episodes of low back pain and the side of the lower extremity radiating pain), radiological diagnosis of lower convex outstanding cases. After obtaining some experience may be appropriate to expand the age range, but generally not more than 60 years of age. For the longer course of clinical symptoms associated with atypical or mild clinical types of calcification can only mature in experience prudent choice. The standard disc herniation with severe calcification, management and reporting standards stenosis, spondylolisthesis and other pathological changes, and incarceration-based, free APLD quasi disc herniation is a contraindication. The latter simply by imaging it will be difficult to determine, with a history of analysis is very important. If the clinical symptoms when light weight, the pressure changes within the disc, vary in prominence, that is reversible, as the indications of discectomy. Conversely, if the vote had persistent pain relief asked of the vertebral disc prolapse means that the posterior longitudinal ligament has been worn, incarcerated, or into the spinal canal, can be classified as contraindications. Methods 221, 22 preoperative administration into the routine pre-operative preparation amidine, the emphasis on photo orientation film. 1d before surgery generally carried out at the equivalent of the skin disease of vertebral spinous process asked to place the metal, with plastic sheets fixed lumbar radiograph taken. Note lateral films should be large enough to be shown the metal film on the skin. Measurement of skin disease to the vertebral spinous process from the disc center. The distance from the midline to open the program with a gentian violet skin in mind, and with the iodine fixation. 2.2.2. Disinfection and shop towels APLD intervertebral infection is the most common complications. Pay attention some of the hospital is not strong by the concept of non-sterile surgical operation is scenting is easy to produce medical cause of the infection,[link widoczny dla zalogowanych], the surgical sterile conditions in the radiology department for the poor, and the intraoperative patient position change can be observed is, lateral like, it is likely to cause pollution of sterile towels shift Erzhi also have an important reason for infection. To prevent intraoperative contamination, the surgeon's practice: preparing a special patient services, just like the clothes, surgical gowns, and doctors wearing surgical methods are the opposite clothing, belts, tie in front. Rectangular holes left waist, easy to puncture operation. Also available sterilized sheets (can be down to the ground around 20cm), the holes were, kits each one. Standing on the bed leaning over the patient to wear sterilized clothes disinfection of a single bed leaning over a bed wrapped in bed for a party with kits x-ray head was a hole the last shop. With the disinfection method of solid-bed drape sterile surface is a single block of shelter, exposure to a fungus is not easy to turn around area. The disinfection of the patient wearing clothes are not turned off when the fine, move, effectively maintain the surgical area is not contaminated. 223 needle into the needle point selection method in the midline to open the distance (set x) is equal to the vertical to the skin after the vertebral midline distance from the center asked the panel. Appear before the needle 45 with the bed. Tilted slightly to the rear corner. Spinous process and the skin entry point and asked the disc center surrounded isosceles right triangle, when the depth of the needle / 2x 25, twenty one n, (/ beetle is the hypotenuse of isosceles triangle, which is equivalent to a needle point the same distance from the center of vertebral disc, 25 hoe equivalent to 1 / 2 oblique diameter of vertebral body): the tip should reach the lateral margin after ridge Zhu 1 / 3. Not encountered resistance over the depth of needle should pay attention to the front over the vertebral body,[link widoczny dla zalogowanych], with a large retroperitoneal vascular injury or risk of abdominal organs in this case mostly 【needle angle with the sagittal plane is too small. Lancinating puncture the nerve root when the process appears more as a tip after the thorns to the side hole near the vertebral asked (more common in the sagittal plane and the angle between the needle is too large.) Need to adjust the angle and then enter. The group carried out all of preoperative localization and measurement, according to the above method of needle-free case failed. 2.24 adjuvant measures in this group cut back and leg pain relieved or disappeared after absorption, straight leg raising improved,[link widoczny dla zalogowanych], but more than half the cases of 12-24h after the onset of symptoms is not the extent Portugal. This is because the suction cut to negative pressure within the intervertebral disc with. Salient rebound by suction, ease of nerve root compression, so have an immediate effect. But after the sound of rain with the disappearance of this negative pressure, or because of bleeding increases the pressure again to recurrence of symptoms than the general level of pain before surgery reduced by bed rest and rehabilitation of low back muscle exercise under the guidance of 3 ~ 7d improved: more than 1 observation weeks still no improvement, no fever, elevated white blood cell, ESR fast, low back pain severe signs such as disc space infection, the use of epidural placed closed + stretch shake reduction method: practice is to: highlight the epidural space,[link widoczny dla zalogowanych], needle Cl towards pain side prednisone plus 2% procaine 3ml 4ml to 20ml normal saline injection in patients prone, his hands grasp the edge of the bed, assistant control arms, traction can also be used in patients with fixed upper torso on the bed , to seize the post ankle surgery Society brought the lower limbs, also showed a rhythm against the traction on the hem shaking. Closed to help eliminate amidine epidural nerve root inflammation, edema, pain relief, and traction placed after shaking can help cut smoking is still prominent, and incarceration of the disc is also satisfied that there are three cases in this group made good use of this method to teach fruit, avoid the two Rotary surgery pain. (Closing times Date :1999-08-05)

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