最新手术记录-腰椎滑脱讲课稿教学教材.doc

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1、全麻醉生效后，病人取俯卧位。以腰4、5和骶1棘突为中心常规术区消毒，铺无菌手术巾、单。取腰部后正中切口，以腰4、5和骶1棘突为中心，切口为7厘米。切开皮肤、皮下组织和深筋膜，暴露腰4、5和骶1棘突，切开椎旁韧带和肌腱，骨膜下剥离双侧棘突和椎板，直至关节突外侧。可见骶1的上关节突明显的增生，肥大。腰5的椎板不稳，双侧椎弓根处断裂。将腰5的椎板完全咬除后，显露骶一的上关节突，和腰5的椎弓根。按照术前方案，在骶1、腰5的椎弓根部分别打入一枚椎弓根钉，进针点的位置是横突中点和上关节突外缘的焦点。用尖锥在椎弓根上钻孔后，分别放入一枚铁棒，C-臂X光机透视后，确定位置正确，铁棒的位置良好，分别拔

2、出铁棒，拧入一枚椎弓根钉（椎弓根钉的大小为6.5X500mm）。透视后确定位置正确。用髓核钳将骶1和腰5椎间隙中增生的瘢痕组织咬除后，松解骶1的神经根，直至关节突下切迹，可见双侧的神经根水肿，增粗。完全松解神经根后，安放连接杆，撑开器撑开后锁紧螺丝，复位，可见前脱位的腰5椎体已经基本复位，缩紧螺丝后，固定牢固。将神经根拉向内侧后显露椎间隙，用骨刀和圆凿将骶1的上缘和腰5椎体的下缘凿除，直至松质骨。取同侧髂后上棘出的骨块，修成1X3cm的骨块后，植入两侧的椎间隙。彻底止血，冲洗创口，放置负压引流，清点纱布器械无误后，逐层闭合创口，术后安返病房。2016中考复习错题整理一．单选题1.We

3、’reheretohavefun,tolearn,toworktogetherandtomakedifference.A.a;aB.a;/C./;aD./;/2.Wecanhavebluerskyifwecreatelesspollutedworld.A.a;aB.a;theC.the;aD.the;the3.—IalwaysgetnervouswhenIstarta(n)withothers.—Takeiteasy.Believeinyourself.A.expressionB.introductionC.communicationD.celebration4.—fathersdi

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6、tenhadfunin18-foot-deepcave.A.an;theB.a;theC.an;anD.a;an10.—thefoodinthefridgeifyoucan’tfinishit.—Ok,Iwill.A.TokeepB.KeepC.KeepingD.Tokeeping11.Todaytherearetwonewstudentsinourclass.Idon’tknowofthem.A.eitherB.norC.neitherD.both12.—Kitty,whodoyouthinkisbetteratmagic,LiuQianorYIF?—ofthemisgreat.I

7、lovetheirshows.A.EitherB.NeitherC.AllD.Both13.Recyclingisonewaytoprotecttheenvironment,reusingis.A.anotherB.theotherC.otherD.other’s14.—Istillwanttodrinksomething.MayIhavecupofjuice?—Certainly.Hereyouare.A.otherB.moreC.anotherD.el