The goal of spinal surgery for scoliosis is to fuse the vertebrae so the spine cannot bend and to correct deformity. 十大赌博平台排行榜会尝试将曲线矫正50%或更多.
脊柱侧凸的脊柱融合术
手术准备
An assistant from the 脊柱中心 will contact you to schedule the operation. A clinic appointment will be scheduled within a month of the operation date. 在预约期间:
- The orthopedic surgeon will go over the details of the operation and address your questions or concerns.
- x射线 will be obtained if there are no recent films or if additional films are needed.
- 麻醉师将对病人进行评估, 谁会讨论手术中和术后的疼痛管理. 脊柱融合术需要全身麻醉. 硬膜外导管(薄的), flexible tube) may be inserted into the back at the conclusion of the operation to help control pain.
- 将抽取血液样本进行分析，包括血细胞计数.
- 护士会带你去 住院和出院情况 程序.
关于手术
在背部中间做一个切口. 肌肉向一侧移动，露出脊柱. 椎骨之间的关节被移除以使其松动. The vertebrae are roughened up so that the body responds by producing new bone. The new bone eventually bridges the gaps between the vertebrae and makes them fuse together. 金属植入物。棒, 螺丝, hooks or wires – are put in to hold the spine still while the vertebrae fuse.
骨移植
植骨增强融合. This may be obtained from the patient – known as "autogenous" bone graft and harvested typically from the pelvis, 或者它也可以来自捐赠者的骨库——被称为“同种异体”." Advantages of autogenous bone graft include more rapid incorporation with the rest of the vertebrae and safety. 自体移植物的缺点包括手术, 这种手术会引起疼痛并有手术风险. 同种异体骨移植的主要风险是感染风险, in particular hepatitis at the rate of 1 in 1 million and AIDS at the rate of 1 in 10 million. The patient or the patient's parents decide on whether to go ahead with the surgery after a careful discussion of the benefits and risks with the orthopedic surgeon.
手术的长度
脊柱融合术通常需要4到6个小时, 但时间因患者个体而异. 外科十大赌博平台排行榜需要多长时间才能做好这项工作.
潜在并发症
手术的潜在并发症包括:
- 出血This is controlled by cauterizing bleeding vessels during the operation and by using a device that allows the return of blood lost back to the patient at the conclusion of the operation. If it is anticipated that a patient will lose a significant amount of blood, 而且输血的可能性很大, the patient will be asked to donate two units of blood within the month before surgery.
- 感染无论什么手术，只要皮肤被切开，这都是有风险的. Sterile precautions are taken in the operating room and the patient is given antibiotics before the operation and for 24 hours after. In addition, the incision is washed with a pressurized system before it is closed.
- 神经损伤可能的神经损伤程度可以从轻微损伤到轻微损伤, such as numbness from compression of a nerve that supplies sensation to the front of the thigh, 严重受伤, 包括瘫痪. 严重神经损伤的风险远低于1%, 但它不是零, so it is essential to have an open and honest dialogue with your orthopedic surgeon about this. The electrical activity of the nerves that transmit signals for sensation and muscle action through the spinal cord is monitored during the procedure. This gives feedback to the surgeon so that the necessary steps can be taken to remedy the problem if it occurs.
- 假关节This means that occasionally – up to 1 percent of the time in children but more often adults – the fusion doesn't take, 或者椎骨没有完全粘在一起. 它可能需要几个月或几年的时间才能变得明显. 病人可能主诉背部持续疼痛, there may be progression of the scoliosis after the operation or the implants may fail. 当聚变不发生时, motion over the long term will cause the metal implants to wear out and ultimately break. 假关节的治疗包括脊柱探查, 额外的骨移植和植入物的更换.
继续阅读
在十大赌博平台排行榜
Each patient's hospital stay may vary, depending on the individual condition. 典型的停留时间是4天，但也可能是3到7天不等. 一般, 矫形外科小组包括一名外科十大赌博平台排行榜, 高级住院外科十大赌博平台排行榜, 注册护士兼医师助理.
An epidural catheter is inserted in the back to control pain and usually is removed by the third day after surgery. A catheter also is placed in the bladder so that the patient does not have to walk to the bathroom during the first few days after surgery. 第三天，硬膜外膜取出后不久，将其取出.
理疗师在手术后帮助病人行走. 第一天，我们的目标是下床坐到椅子上. 第二天，目标是走出房间. 到第三天，患者可以正常行走. 第四天，病人开始爬楼梯.
出院前， 脊柱x射线 are taken to make sure that there are no early problems with the implants or spinal alignment. A nurse assists with discharge planning to ensure all the needs of the patient are met before going home.
The dressing covering the incision shouldn't be disturbed until a follow-up clinic visit, 除非你担心会有伤口, as determined by your surgeon during the operation or the early recovery period in the hospital.
回家
一般, 在手术后的头两周, the patient shouldn't go to school or work or participate in organized activity. 这是一个愈合的时间，无论是身体上还是精神上. 在此期间，伤口上的敷料不应被扰乱. This means sponge bathing only until the follow-up clinic appointment in two weeks.
At the follow-up appointment, the surgeon will inspect the wound and change the dressing or bandage.
Over the course of a year, the patient's activities will return to normal:
- 前六个月没有剧烈的体力活动. Activities are limited to those of daily living, meaning personal care, bending and walking. 没有重物，也就是说没有比餐盘更重的东西. 此外，不允许跑或跳.
- 六至八个月6个月时，进行身体检查，包括x光检查. 如果一切顺利，将允许更多的活动，如游泳.
- 8至10个月8个月左右, 患者开始“闭合链动力学练习”," which means that the foot is planted or fixed in place as the lower limb moves during exercise. An example is bicycling, where the foot is on a pedal as the lower limb rotates.
- 10至12个月允许跑步、跳跃和单人运动.
At 12 months, the patient will visit the surgeon for a third postsurgical appointment. 要照x光片. If all is well, the patient will be allowed to return to unrestricted activities.
加州大学旧金山分校健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
