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脊椎脊髓组 | 東京医科歯科大学 整形外科
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東京医科歯科大学 整形外科

東京医科歯科大学整形外科7

脊椎脊髓组

DSC02221对应从颈部到腰部的脊柱疾病,了解完每一位患者的生活环境和需求后提供最合适的治疗。积极采用能减少病人负担的低侵袭性手术,积极进行对高龄者脊椎压缩性骨折的经皮穿刺治疗和脊柱内视镜手术。而且,我们正在开发中的骨髓机能诊断装置是世界最先端的技术。在脊柱韧带骨化症,脊髓肿瘤,脊椎矫正手术(侧弯症,后弯症)等高难度的手术中通过这新装置做更加精准的诊断,使用显微镜,术中导航,术中CT,术中脊椎监视系统等先进的技术,施行安全,准确的手术。

脊椎诊疗组的专家不止在每周五下午的专家门诊时出诊,在每天上午的一般门诊也有出诊,为脊柱疾病患者提供诊疗。不偏向特定患者,不执着于手术治疗,向患者详细说明病状并解释说明能想到的所有治疗方法的长处和短处,选择能够最大程度满足患者需求的治疗方法。

手術実績

  2015年 2016年 2017年
颈椎前方 16 21 21
颈椎后方 64 35 49
胸腰椎前方 2 5 4
胸腰椎后方 181 133 206
肿瘤 32 25 31
其他 13 8 15
韧带骨化症 36 26 23
总计 308 227 326

脊柱韧带骨化症(后纵韧带骨化症,黄韧带骨化症)

后纵韧带骨化症是被认定为难病的疾病,在椎骨的后方纵行连接的后纵韧带骨化时,会压迫神经而对神经造成伤害。多发于颈椎,在胸椎和腰椎也有发生。现在,本科室担任着厚生劳动省韧带骨化症研究班的事务局,作为难病治疗据点,与全国的大学共同进行着研究。颈椎后纵韧带骨化症在保守治疗后效果不佳和脊髓症状明显时会选择手术治疗手段。手术一般会选择后路椎弓形成术,当骨化巢偏大或颈椎后弯的情况下会选择从前方除压固定。在本院多数进行从前方显露骨化处进行手术,从全国接受被介绍的患者。在多功能手术室并用术中CT设备,在脊髓监控系统下安全地进行手术。除此之外,也在施行很多胸椎后纵韧带骨化症,黄韧带骨化症的手术,特别是在难治的胸椎后纵韧带骨化症,从后方追加除压固定术,必要时也会增加骨化巢漂浮术。

頚椎後縦靱帯骨化症の前方骨化浮上術
頚椎後縦靱帯骨化症の前方骨化浮上術

中枢神经表面含铁血黄素沉积症

病状
脑表层含铁血黄素沉积症是蛛网膜下腔慢性出血导致的疾病。在脑脊髓的表面含铁血黄素沉积并呈现出进行性的神经症状,这是非常罕见的疾病。出血的原因有硬膜缺损,髓膜瘤,脑血管疾病,肿瘤,外伤等相关报导。

症状
引起脑和脊髓大范围损伤,呈现出多样的症状。具体典型症状有听力衰退,小脑失调(头晕)和运动障碍,根据受损部位有视觉障碍,嗅觉障碍,认知机能障碍和排尿障碍,头痛等症状。一般会缓慢地进行性恶化。

诊断,检查
典型方法是通过MRI观测脑和脊髓表面的信号变化情况。通过特殊MRI摄影方法确定硬膜缺损部位。此外,通过脊髓腔造影检查能够确认脊髓液漏出情况。

科室治疗方针
通过防止慢性的蛛网膜下腔的持续出血,可以抑制疾病的进行。对通过MRI等手段确定为硬膜缺损的患者施行硬膜修复术,目的于防止脑脊髓液继续漏出。

成人脊柱变形(脊柱后弯症,后侧弯症等)

脊柱后弯症患者的矫正治疗

脊柱变形是指,脊柱的异常弯曲。从正面看时脊柱横向弯曲称为侧弯,从侧面看时脊柱向后侧凸出称为后弯。成人脊柱变形中有脊柱后弯症,后侧弯症等。成人期的后弯症也俗称为驼背,顽固性腰背疼痛,姿势异常,下肢神经痛等导致直立,步行困难。逆流性食道炎等消化道症状也有发生。以前高龄患者不会选择手术,而近年,在各种保守治疗下未见好转时,选择手术治疗的患者也在增加。

整形外科有专治成人脊柱变形的专家,对需要行手术的患者,,使用能在术中拍摄CT的多功能手术室,并用脊髓机能监测系统,最大程度保证安全的条件下施行手术。最近为了应对患者需求,开始从侧腹部切口,施行脊柱矫正的手术,实现了手术的低侵袭化。

脊柱後弯症に対する矯正手術
 2018年12月17日 星期一
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