Download - Discartroza
![Page 1: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/1.jpg)
Degenerescenta discala. Discartroza
![Page 2: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/2.jpg)
Discul la tanar Discul la 75 de ani
Deshidratarea discului
![Page 3: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/3.jpg)
Diferite stadii ale discopatiei
Artroza cu osteofite intercorporale
![Page 4: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/4.jpg)
Degenerescenta fara protuzie Protruzie discreta
![Page 5: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/5.jpg)
-Diminueaza diametrul vertical al foramenelor
- Uzura fatetelor si alunecarea in plan vertical si antero-posterior ingustarea foramenelor
Consecintele pensarii discului
![Page 6: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/6.jpg)
Discopatie etajata cu protuzie discala si osteofite puse in evidenta prin mielografie
Canal lombar ingust, artrozic
![Page 7: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/7.jpg)
Stenoza posibila la un singur nivel
Hernia durei sau hernia discala este inlocuita printr-o bara de osteofite
![Page 8: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/8.jpg)
Osteofitoza Stenoza (intreruperea coloanei opace - vizibila pe mielografie)
Canal lombar ingust,artrozic
![Page 9: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/9.jpg)
• Stenoza canalului • Stenoza foraminala• Alunecare vertebrala
Canal lombar ingustat, artrozic
![Page 10: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/10.jpg)
Spondilolistezisul degenerativ lombo-sacrat
• Se produce prin uzura fatetelor articulare
• Poate deveni responsabil de stenoza centrala ce provoaca sindromul cozii de cal
![Page 11: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/11.jpg)
Spondilolistezisul degenerativ
Stenoza intereseaza in special foramenele etajului care aluneca si cele doua radacini
corespunzatoare
![Page 12: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/12.jpg)
Stenoza canalului
Diametru sagital fix Diametru sagital mobil
![Page 13: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/13.jpg)
Stenoza foramenelor se accentueaza in rotatie
Foramene normale (RMN)
Rotation ++
Rotatie = 0
Rotatie++
![Page 14: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/14.jpg)
Stenoza se accentueaza in rotatie
Largirea spatiului articular
![Page 15: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/15.jpg)
Scanner – stenoza globala
![Page 16: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/16.jpg)
Dizlocare datorata discopatiei etajate
![Page 17: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/17.jpg)
Simptomatologia canalului lombar stramt, artrozic
• Claudicatie neurogena : 50 %• Radiculalgii : 97 % (poly : 44 %)• Lombalgie : 89 %• Deficit motor: 19 % (poly : 50 %)• Deficit sfincterian : 9 %
![Page 18: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/18.jpg)
Tratamentul canalului stramt
Largire chirurgicala : laminectomie
![Page 19: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/19.jpg)
Tratamentul canalului ingust
Laminectomie – Regularizarea fatetelor
![Page 20: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/20.jpg)
Laminectomie + stabilizare prin placa si grefa postero-laterala
Tratamentul canalului ingust
![Page 21: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/21.jpg)
Recalibrare fara laminectomie
Tratamentul canalului ingust
![Page 22: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/22.jpg)
![Page 23: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/23.jpg)
Canal lombar ingust cu stenoza etajata si degenerescenta si instabilitate
![Page 24: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/24.jpg)
Canal lombar ingust cu stenoza etajata si degenerescenta si instabilitate
Laminectomie si stabilizare prin artrodeza intersomatica realizata prin acelasi abord posterior la doua nivele
![Page 25: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/25.jpg)
Laminectomie si stabilizare prin artrodeza intersomatica realizata prin acelasi abord posterior la trei nivele
![Page 26: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/26.jpg)
Artrodeza segmentara cu interpozitie de custi (cage) + osteosinteza posterioara
Tratamentul canalului stramt, instabil
![Page 27: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/27.jpg)
Inconvenientele artrodezelor: discul balama situat deasupra artrodezei poate degenera
Zona artrodezata
Disc balama
![Page 28: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/28.jpg)
Artroza cervicala
Nevralgiile cervico-brahiale prin compresiunea radacinilor
![Page 29: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/29.jpg)
Artroza cervicala
Stenoza poate interesa artera vertebrala
![Page 30: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/30.jpg)
Artroza coloanei cervicale
Artroza cervicala difuza cu redori si nevralgii cervico-brahiale
![Page 31: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/31.jpg)
Canal normal Canal ingustat
![Page 32: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/32.jpg)
Stenoza centrala cu mielopatie cervicala
![Page 33: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/33.jpg)
Instabilitatea rahisului cervical
![Page 34: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/34.jpg)
Artrodeza cervicala
Grefa intre corpii vertebrali si osteosinteza prin placa anterioara (Sénégas)
![Page 35: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/35.jpg)
Osteosinteza anterioara si posterioara
Artrodeza cervicala
![Page 36: Discartroza](https://reader035.vdocumente.com/reader035/viewer/2022062313/563dbb00550346aa9aa973f5/html5/thumbnails/36.jpg)
Artrodeza cervicala
Interpozitie de custi sau substituenti ososi intre corpii vertebrali