頸椎手術(shù)的適應(yīng)癥課件

單擊此處編輯母版標(biāo)題樣式,單擊此處編輯母版文本樣式,第二級(jí),第三級(jí),第四級(jí),第五級(jí),*,,*,,頸推病的手術(shù),與適應(yīng)癥,科程曉,,頸推病的手術(shù),1,,教學(xué)目標(biāo),◆頸椎的生理結(jié)構(gòu),◆頸椎病的分型與治療,◆頸椎病的手術(shù)與適應(yīng)癥,,教學(xué)目標(biāo),2,,頸椎的生理結(jié)構(gòu),顱昏,衾椎,框椎,椎間盤(pán),神經(jīng)根,椎動(dòng)脈,的椎關(guān)節(jié)一,,頸椎的生理結(jié)構(gòu),3,,顎的生理物,性體推間盎,橫突孔,交威神經(jīng)莨推問(wèn)量。角關(guān)箏,有椎動(dòng)脈通過(guò),前支,側(cè)塊及關(guān)節(jié)突,后支,推間孔,椎孔(推管,前根,內(nèi)有脊隨〕,硬膜,后根,黃韌帶,棘突,神經(jīng)根,后,從上向下看頸椎的難體,,顎的生理物,4,,頸推病的分乳與浛打,頸椎椎間盤(pán)組織退行性改變及其繼發(fā)病理,改變累及周圍組織結(jié)構(gòu)(神經(jīng)根、脊髓,椎動(dòng)脈、交感神經(jīng)等),出現(xiàn)相應(yīng)的臨床,表現(xiàn),,頸推病的分乳與浛打,5,,頸病扮,口神經(jīng)根型:60-70%,口脊髓型:12-13%,口交感型:10%,頸椎病分型,口椎動(dòng)脈型:少見(jiàn),椎動(dòng)脈型,神經(jīng)杈巫,病理?yè)p害與臨床癥狀相,髖型,結(jié)合,,頸病扮,6,,神經(jīng)根塑頸推病,臨床表現(xiàn),神經(jīng)根激惹癥狀:,肩、臂、手放射性疼痛、麻木,頸部用力、咳嗽加重,上肢無(wú)力、持物易落,肌肉萎縮,,神經(jīng)根塑頸推病,7,,神經(jīng)根塑頸推病,臨床表現(xiàn),呻經(jīng)根激惹體征:,頸椎旁壓痛、放射痛,椎間孔擠壓試驗(yàn)( atom test)(+),臂叢神經(jīng)牽拉試驗(yàn)( Sperling teot)(+),,神經(jīng)根塑頸推病,8,,神經(jīng)根塑頸推病,臨床表現(xiàn),單根或多根神經(jīng)根損害體征,頸5神經(jīng)根,感覺(jué):上臂外側(cè),運(yùn)動(dòng):三角肌、肱二頭肌,反射:肱二頭肌腱,,神經(jīng)根塑頸推病,9,,魑塑頸椎病,臨床表現(xiàn),口后果最嚴(yán)重,口脊髓損害癥狀,上肢麻木、無(wú)力,持筷困難,下肢麻木、行走不便、癱疾,束帶感,括約肌功能障礙,,魑塑頸椎病,10,,頸椎手術(shù)的適應(yīng)癥課件,11,,頸椎手術(shù)的適應(yīng)癥課件,12,,頸椎手術(shù)的適應(yīng)癥課件,13,,頸椎手術(shù)的適應(yīng)癥課件,14,,頸椎手術(shù)的適應(yīng)癥課件,15,,頸椎手術(shù)的適應(yīng)癥課件,16,,頸椎手術(shù)的適應(yīng)癥課件,17,,頸椎手術(shù)的適應(yīng)癥課件,18,,頸椎手術(shù)的適應(yīng)癥課件,19,,頸椎手術(shù)的適應(yīng)癥課件,20,,頸椎手術(shù)的適應(yīng)癥課件,21,,頸椎手術(shù)的適應(yīng)癥課件,22,,頸椎手術(shù)的適應(yīng)癥課件,23,,頸椎手術(shù)的適應(yīng)癥課件,24,,頸椎手術(shù)的適應(yīng)癥課件,25,,頸椎手術(shù)的適應(yīng)癥課件,26,,頸椎手術(shù)的適應(yīng)癥課件,27,,頸椎手術(shù)的適應(yīng)癥課件,28,,頸椎手術(shù)的適應(yīng)癥課件,29,,頸椎手術(shù)的適應(yīng)癥課件,30,,頸椎手術(shù)的適應(yīng)癥課件,31,,頸椎手術(shù)的適應(yīng)癥課件,32,,頸椎手術(shù)的適應(yīng)癥課件,33,,頸椎手術(shù)的適應(yīng)癥課件,34,,頸椎手術(shù)的適應(yīng)癥課件,35,,頸椎手術(shù)的適應(yīng)癥課件,36,,頸椎手術(shù)的適應(yīng)癥課件,37,,頸椎手術(shù)的適應(yīng)癥課件,38,,頸椎手術(shù)的適應(yīng)癥課件,39,,頸椎手術(shù)的適應(yīng)癥課件,40,,頸椎手術(shù)的適應(yīng)癥課件,41,,頸椎手術(shù)的適應(yīng)癥課件,42,,頸椎手術(shù)的適應(yīng)癥課件,43,,頸椎手術(shù)的適應(yīng)癥課件,44,,頸椎手術(shù)的適應(yīng)癥課件,45,