腰椎射頻治療腰椎間盤(pán)突出癥課件

一、Vertebrae椎骨Thereare33vertebraeinchildren,arrangedasfollows:Cervicalvertebrae頸椎

C.7Thoracicvertebrae

胸椎

T.12Lumbarvertebrae

腰椎

L.5Sacralvertebrae

骶椎

S.5sacrum骶骨Coccygealvertebrae

尾椎

Co.3~4coccyx尾骨五、NormalCurvesofvertebralcolumnCervicalcurvature頸曲

convexforwardThoraciccurvature胸曲

convexbackward

Lumbarcurvature腰曲

convexforwardSacralcurvature骶曲

convexbackwardGeneralfeaturesofvertebraeVertebralbody椎體Vertebralarch椎弓pedicleofvertebralarch椎弓根:sup.andinf.Vertebralnotch

椎上、下切跡

laminaofvertebralarch椎弓板process(7):spinousprocess棘突transverseprocess橫突sup.andinf.articularprocesses

上、下關(guān)節(jié)突Vertebralforamen椎孔

Vertebralcanal椎管Intervertebralforamen椎間孔1.Jointsofthevertebralbodies椎體間的連結(jié)Intervertebraldiscs

椎間盤(pán)

betweenbodiesofadjacentvertebrae,composedof:Nucleuspulpous髓核,aninnersoft,pulpy,highlyelasticstructure(gelatinouscore)Annulusfibrosus纖維環(huán)

anouterfibrousringconsistingoffibrocartilageHerniaofnucleuspulpous

髓核脫出8Copyright?duxinli9Copyright?duxinli11Copyright?duxinli12Copyright?duxinli13Copyright?duxinli2.Jointsofthevertebralarches椎弓間的連結(jié)Ligamentaflava

黃韌帶―elasticligament,unitelaminaeofadjacentvertebrae,andcompletetheposteriorwallofvertebralcanal;tendtopreventhyperflexionofthevertebralcolumnInterspinalligament棘間韌帶Supraspinalligament棘上韌帶Ligamentumnuchae項(xiàng)韌帶

Intertansverseligament橫突間韌帶Zygapophysialjoint關(guān)節(jié)突關(guān)節(jié)15Copyright?duxinli椎管狹窄發(fā)生于椎管、側(cè)隱窩和椎間孔。先天或后天性。頸<10mm，腰<11.5mmCT：①椎體后緣骨贅向椎管內(nèi)突入。②側(cè)隱窩狹窄：椎間盤(pán)退變膨出和上下關(guān)節(jié)突肥大是其主要原因，前后徑<2mm為狹窄，2-4mm為可疑。③黃韌帶或后縱韌帶肥厚、骨化。④椎體滑脫—椎板峽部裂或椎間盤(pán)、韌帶退變。MRI：征象同CT椎間盤(pán)膨出椎間盤(pán)突出（中央型）