Chapter 320： Pull out the Dragon Sword, and be haha!

Chapter 320: Pulling the Dragon Sword, Then He Ha!

When you first entered the society, with all your ambitions and struggles, you encountered all kinds of procrastination, all kinds of hidden rules, all kinds of restraints, all kinds of ups and downs. Then you feel that this industry is not saved! No one is better than you, and leadership is an egg.

Then wait for four or five years in this industry, and then you will slowly realize the truth behind it. For example, this is the case now. For an operation, it is necessary to discuss and discuss, and then let the two enemies sit together to make a plan. Procrastination, very procrastination, but this is really the normal way, for nothing else, for one reason: security. After all, genius is rare!

In the small orthopedic room, Lao Gao, Pharaoh and Zhang Fan sat together. How to say, the two were very strange. In front of everyone, the two were incompatible, but when the three of them were left, the relationship between Lao Gao and Pharaoh did not seem to be so bad. At least Lao Gao will give Pharaoh the initiative to add water, Zhang Fan can't understand, really can't understand what happened to the two old guys, but he doesn't have the heart to gossip.

"Tell me how you prepared." Lao Gao said to Zhang Fan.

"I am going to choose the posterior approach. The surgery is to make a predictive correction of Bart's lumbar spine from the posterior approach."

"You mean, soft correction?" Pharaoh asked.

"Yes!" Zhang Fan answered affirmatively.

Then he said, "Two directors, look."

Zhang Fan got up and opened the viewer, and put all Bart's image inspections on it. Then "card" opened the caliper, just like pulling out the dragon-knife. Pointing at the image on the viewer, he said, "Children with vertebral vertebrae are vertebrae. All we have to do is to fuse the upper and lower vertebrae. For each vertebra, the Cobb angle here is greater than 50 °. During the operation, the two upper and lower vertebrae are fused, and then an open intervertebral disc at the end vertebra does not need to be fused, so that the upper and lower segments can compensate for the correction of the palate. The distal vertebral body should be parallel to the sacral vertebra. When the two are inconsistent, the longest segment is selected for fixation and fusion.

After spinal fusion, the balance of the spine is maintained by the unfused active segments and not by the fusion. These can be determined by dynamic X-ray images, so in doing so, the end vertebra should be able to move in all directions, most importantly the distal end, that is, the distal vertebral space should be able to move in the bending direction. The end vertebral endplate is parallel in the curved image, and the axial surface of the curved direction should reach a neutral position. In the future, it is absolutely guaranteed that Bart will slowly change the deformity. "

Speaking of which, let's talk about this spine first. The spine is curved. Especially for slender women, the soft waist is like a willow, which makes people want to hug. This is the credit of the spine. It has a slight S-shape as a whole. Generally, the cervical and lumbar spine are most likely to cause problems.

The spine activity in these two places is relatively large. And especially the lumbar spine, which is the mainstay of the body, requires both weight-bearing and mobility, so people often have neck pain and back pain. Few people say that the back spine hurts. Once you have soreness or numbness in your waist and legs, you must pay attention. Sit less, eat less, and exercise more.

The shape of the spine is a bit like a metaphor. It's like an S-shaped post that is lumped with chess pieces. There is a latex cushion between the chess pieces and the chess pieces. This cushion is the lumbar intervertebral disc. Then, several pieces of rubber bands from top to bottom are attached to the front, back, left, and right of the chess piece to stabilize the chess piece cylinder. This is the ligament. Moreover, these chess pieces are divided into front and back, and the front is bare, with two wings on the side called transverse processes, and tails on the back called spinous processes. The pawns and puppets slam together, and then the tail and tail are lined up like layers of roof tiles.

There is a hole in the eye between the chess piece and the tail, which runs from top to bottom. There is also a small hole between the two pairs of wings and the chess piece that pierces from the top to the bottom. The hole between the chess piece and the tail is the extension of the brain: the spinal cord. Between the wings and the chess pieces is a nerve that emanates from the spinal cord like a silk thread. The human spine is probably such a structure.

The spinal cord is like a water pipe or a signal transmission line. The stimulus received by the muscles is fed back to the brain. The brain makes calculations and then feeds back to the muscles, and then the muscles respond. Or the brain can directly issue commands to the muscles after calculating.

In fact, this thing is very simple. For example, if you touch the **** of a beautiful girl, the muscles on the girl ’s **** pass this feeling to the brain, eh! Uncomfortable, the brain orders, fan girl, and then you are slapped by the beauty. Or, uh! Comfortable, ordered by the brain, kissed, and then you were kissed. This information is transmitted through the water pipe, the spinal cord.

When the latex cushion between the chess pieces is squeezed by a huge weight or a long-term bad posture, the elasticity of retraction is lost, and then it protrudes like a thin latex. When the protrusion reaches the spinal cord, this thing Although it is sparse to the upper bone, it is much harder to the upper spinal cord. It starts to oppress the bully spinal cord, the spinal cord begins to make aggrieved sounds, and then you begin to have back pain and leg numbness. This is called lumbar disc herniation. When one or more of the chess pieces are displaced, the lumbar spine is protruded or bulged. This bulge is also considered a deformity, but it is only partial.

Spine surgery is considered to be the top operation in orthopedics, because there are too many things to consider. Ordinary fracture surgery also considers the plane problem, but the tightness of the **** joints does not meet the physiological position. The spine is cumbersome, and at least three coordinates must be considered from three directions.

The median, coronal, sagittal, and median positions are easy to understand. The coronal position is generally a glass plate, facing the same direction as the eyes, and then cut directly from the head. This orientation is the coronal position. Sagittal position, is the bow and arrow shot into the face and inserted into a face. This thing is really anti-human, and it is very troublesome to explain in words. Therefore, such professional words must be explained with pictures and then memorized. For spine surgery, these three positions must be considered. As long as one position is not suitable, sequelae can occur, because the physiological position is not met, which leads to a chain reaction of problems in human stability.

Spine deformity, simply put, is a cylinder that is backed up by chess pieces. One or more pieces of it are placed in the wrong direction, and then the overall shape is changed. Orthopedic surgery is to put the wrong chess pieces in the right direction. But there is a very, very difficult thing. The child's development is growing up. After adjusting the deformity position after surgery, if the position or orientation does not meet the future growth trend, then this operation is a complete failure.

The failure of the operation resulted in a more terrible secondary injury. Not only does it not improve the symptoms, but it may worsen the condition. This is such a terrible thing, so once certain things add some uncertain factors, it will lead to an order of magnitude increase in the difficulty of things. Therefore, Lao Gao and Pharaoh must be cautious in this operation.

This treatment in early years was symptomatic. It is forced to adjust the wrong posture of the spine, and there are many postoperative complications. Because it is forced correction, often it is a pseudo joint, deformity recurrence, and huge incision trauma. Later, with the development of materials science, a variety of new materials appeared, and doctors slowly conquered the disease.

But this disease says there are many, many orthopaedic surgeons will never encounter it in their lifetime. Let's talk less, it's not a small proportion among teenagers, and it's a female majority. And there is no way to quantify this operation. For example, for appendix surgery, the sacrum is to the middle and third of the navel. Even if the position is strange, the mouth will be cut a little bigger and the cecum will be pulled a little to find it. Sooner or later it can be found.

But this operation is not possible, it must be combined with the actual situation. Different doctors have different perceptions of the patient's future growth, and surgical methods or orthopedic methods are different. For example, Lao Gao believes that the child can grow to 1.8 meters in the future, but Pharaoh thinks that the child can grow to 3 meters in the future. This is a matter that can't be quantified directly, so if there isn't a master master to take to teach, if you want to do this kind of surgery, just think about it.

This operation has been done since 1914. But so far, most hospitals still can't do it, and most spine orthopedics doctors can't do it. Imagine the difficulty of this operation.

Zhang Fanyitong's very detailed and convincing surgical plan made the two directors nodded involuntarily at the same time.

"Have you encountered this kind of surgery when you were in Bluebird?" Zhang Fan said so clearly and clearly that Pharaoh had no way to refute, but had to find other grounds to reassure himself, and Lao Gao also paid attention to it.

"Have done it!" There are so many falsehoods, especially such falsehoods. Zhang Fan feels that he is telling the truth, and he is almost splitting his mind.

"Otherwise ~" Pharaoh looked at Lao Gao and said uncertainly.

"Director, really, there must be no problem. Absolutely well done." Zhang Fan had to say in a very positive tone in order to determine the minds of the two.

"Do it!" Lao Gao gave Zhang Fan a look and agreed.

"Okay, in this case, the three of us will sign the surgical plan together. I am the director of spine surgery. Let me sign the first name."

"The sick number is in our department." Lao Gao said politely.

At this time, Zhang Fan, tears came down. Really, how lucky he is to meet such a good teacher and protect his teacher this way. The number one here is not honor or benefit. Surgery is done well, it should be, if you do not do it, you must be responsible, you must bear the main responsibility.

"I signed the first." Zhang Fan cried.

"Hehe!" The two old men looked at him at the same time and sneered! Look down naked!

(End of this chapter)