Floor spring range has been specifically
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Specification
1. Material: Iron
2. Body Material: Casting iron
3. Cover Material: SUS201/SUS304
4. Suitable for glass door weight: 90-180kg
5. Suitable for glass thickness: 8-12mm
6. Open Angle:90°
7. Certification: CE
8. Must be tempered glass
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LI Wei, HE Yuan-kui, CHEN Chuan-xia 277600 Imaging manifestation of Weishan County People's Hospital of Shandong Province and its guiding significance for surgical treatment. METHODS: The imaging findings and surgical treatment of 12 patients diagnosed and treated with high cervical dumbbell disease were retrospectively analyzed. Results: In all cases, the tumors were completely cut down under the microscope. The symptoms disappeared in 7 cases, significantly improved in 4 cases, and the early symptoms worsened in 1 case and gradually improved in the short term. Conclusion: There is no typical clinical manifestation in the early stage of high-neck dumbbell-type tumor. The early diagnosis mainly depends on imaging examination. Due to the complex anatomy and the difficulty of surgery, a complete imaging examination before surgery has important guiding significance for surgery, which can improve the success rate of surgery and improve the prognosis. The early symptoms of dumbbell-type tumors inside and outside the high cervical segment are non-specific. The diagnosis mainly depends on MRI and other imaging examinations. The imaging examination can clarify the relationship between the tumor location range and the adjacent structures, and has important guiding significance for surgical treatment. In 2001, 12 cases of dumbbell patients with high cervical spine were retrospectively reviewed and analyzed. The data and methods are 4 to 65 years old and mean 41.6 years old. Clinical manifestations: 2 cases of occipital neck pain; 6 cases of upper limb numbness or pain; 7 cases of limb weakness, gait instability, including 2 cases of sphincter dysfunction; dyspnea in 1 case, unilateral or bilateral positive Hoffman sign in 4 cases . Methods of examination: The whole group performed scans and enhanced scans of the neck X-ray positive and oblique radiographs, CT or MRI coronal, sagittal, and transverse sections. 2 routine 3D-CTA examination. Treatment: After the diagnosis of this group were performed under general anesthesia with tracheal intubation, except for 1 case via the anterolateral approach, the remaining 11 cases were followed by posterior median approach. The entire group of patients underwent total resection of the tumor. Results Radiographic findings: Examination of the positive and oblique slices of the neck showed that 6 cases had enlarged intervertebral foramen, 3 cases showed destruction of the vertebral body in different degrees, and 3 cases showed pedicle widening. Both CT and MRI examinations showed that the tumor was compressing the spinal cord and crossing the intervertebral foramen across the spinal canal, and the corresponding bone destruction and intervertebral foramen enlargement. MRI showed 7 cases of T1WI signal, T2WI hyperintense; 4 cases of T1WI slightly low signal, T2WI high signal; 1 case of T1WI signal, T2WI and other signals. The enhanced scans were uniformly strengthened with clear boundaries. The spinal cord was displaced by compression and edema and the vertebral artery was displaced by compression. see. Surgical results: All patients underwent total tumor resection. Postoperative pathological diagnosis: 5 cases of schwannomas, 5 cases of neurofibromas, 1 case of malignant schwannoma, and 1 case of meningioma. After 1 to 2 months of follow-up, symptoms disappeared in 7 cases, and 4 cases improved significantly. One patient's early symptoms worsened and gradually improved in the short term. Heuer defined spinal dumbbell-shaped tumors as a group of tumors 1 appearing along the spinal cord, being compressed when outgrowing through the intervertebral foramen and the dura, showing a dumbbell (hourglass) shape. However, the current "dumbbell tumor" refers not only to a dumbbell-shaped tumor, but to a single tumor distributed in two or more regions such as the spinal canal, the intervertebral foramina and the extraluminal three parts. The most common schwannomas in spine dumbbell tumors are approximately 60%. The structure of the high cervical cord is complex and functional. Tumors located in this segment are prone to compress the spinal cord, causing severe neurological dysfunction that will affect prognosis and even endanger life. a. The CT image shows that the high cervical tumor protrudes outside the spinal canal; b. The CTA sees the right vertebral artery displacing slightly outward; c. The enhanced CT can clearly show the right anterior vertebral artery; d. The root of the bow is obviously damaged. Imaging findings: radiculopathy, paresthesia and limb weakness are the main clinical manifestations. The early symptoms lack specific clinical manifestations. The diagnosis mainly relies on imaging examination and is often misdiagnosed as other diseases such as cervical spondylosis. Therefore, raising awareness of the disease is very important to reduce the misdiagnosis rate and improve the prognosis. The numbness of the occipitocervical-shoulder area should consider the possibility of the disease. Once the symptom of limb numbness occurs, a further imaging examination should be carried out as soon as possible after the diagnosis. Optional imaging methods include X-ray, CT, MRI/MRA, and so on. X-ray film can show the enlargement of intervertebral foramen, and the degree of bone destruction caused by the erosion of tumor growth. X-ray examination can be mainly used to rule out the possibility of orthopedic diseases, but it is difficult to make diagnosis only by X-ray examination. Patients with suspicious X-ray findings should undergo near-high spinal cord compression displacement. CT is better for post-necrotic cystic degeneration, intratumoral hemorrhage, calcification, etc. It can provide useful differential diagnosis information, but the resolution of CT is limited. It is easy to make misdiagnosis and misdiagnosis with simple CT results. 4. MRI is the main cause of spinal cord tumors. Diagnostic tools. On MRI, the tumor showed a signal such as T1 weighted image or slightly lower signal, and T2 hyperintensity; the signal was not uniform in cystic necrosis. Enhanced MR scanning of tumors resulted in clearer and more detailed 3D images. Preoperative imaging preparation and its significance: Before surgery, the location and extent of the tumor should be assessed based on MRI examination, and the appropriate surgical approach should be selected. Most of the tumors can be removed through the posterior median approach; 5 For a small number of extra-vertebral extravasated and forward-growing tumors, the posterior median pathway is difficult to achieve, and the anterolateral approach can be selected. The advantage of this approach is that it can be better. Exposure to the extra-spinal portion, but partial removal of the spinal canal is more difficult. It is critical to define the adjoining relationship between the tumors before operation. Dumbbell-shaped tumors often have large portions outside the spinal canal, and the vertebral arteries have two bends in the middle and at the bottom of the vertebral artery. The anatomic structure is complex. Dumbbell tumors inside and outside the spinal canal are located there. Most of them are closely related to the vertebral artery. 6. Preoperative MRA is needed to confirm the relationship between the tumor and the vertebral artery. For patients with tumor surrounding the vertebral artery, consider the possibility of injury to the vertebral artery during resection of the tumor. The vertebral artery may be pre-exposed during surgery and rubber sheets may be reserved so that the vertebral artery injury can be blocked or ligated promptly. 8. Benign is the main, although the tumor will push the vertebral artery forward to the outside, and the adhesion between the tumor and the vertebral artery is rare and can be separated under the microscope without damaging the artery. The key to treatment of high-medicated dumbbell-shaped tumors is early diagnosis and surgical treatment. Early diagnosis depends on MRI and other imaging examination methods, and a complete preoperative imaging examination can also guide the development of reasonable surgical plans and strategies to improve the success rate of surgery.
High-neck Dumbbell Type Tumor Imaging and Its Significance in Surgical Treatment
High-neck Dumbbell-shaped Tumor Imaging Features and Implications for Surgical Treatment Date:2015-10-23 15:18