No wonder orthopedics is a gathering place for strong men and strong women. All these tasks require full strength.
We usually see seniors with their suave demeanor and Dr. Liu with his gentle demeanor. Who would have thought that they would snap and break bones during orthopedic surgery, just like Popeye who ate spinach...
When it comes to extracardiac surgery, if not for the development of thoracoscopy, traditional surgery also requires breaking bones. For this reason, Xie Wanying looked at the rib scissors and thought about it. It was impossible for the teacher to give her this opportunity when she first came on stage.
Today, I will first observe on-site how the seniors use tools to convey power and quickly achieve their goals. When I go back, I will study it myself to ensure that I will not miss it next time I have the opportunity.
After cleaning up the connecting tissues around the diseased thoracic vertebrae, the next step is to remove the entire diseased thoracic vertebrae from the human body. This is a very critical first step in the entire operation. In the imagination of outsiders, it is natural to remove the connecting things around the thoracic vertebrae.
This thing can be pulled out, so why do you need anything else.
This is a misconception based on unclear understanding of human anatomy.
There is a vertebral foramen in the middle of the thoracic vertebrae, which is connected to form the spinal canal. Running in the spinal canal is the central nervous system that controls the trunk and limbs: the spinal cord.
It is self-evident how important the spinal cord is to the human body. It can be said that without the spinal cord, the execution effect of the signals sent by the brain to the body will be zero, and the signals cannot be transmitted.
If you want to separate the vertebrae from the spinal cord without damaging the spinal cord, there is no other way but to cut the vertebrae in half and dissect the spinal cord. The vertebral foramen and the spinal cord are very close together, especially since this is a diseased vertebra and the tumor is in the vertebrae.
It has established a connection with the spinal cord, so it is very easy to accidentally injure the spinal cord. How to ensure that the bone cutting does not inadvertently injure the central nervous system? You can’t see clearly with your eyes, so you can only rely on monitoring methods like fire alarms. If there is any sign of injury, call the police immediately, and the doctor
Stop the operation and avoid the alarm zone. In spine surgery, such fire alarm monitoring is called neuroelectrophysiological testing. There are three commonly used ones: SEP, which monitors ascending sensory nerve conduction, commonly known as somatosensory evoked potential; MEP, which monitors descending motor nerve conduction, is movement.
Evoked potential; monitors nerves that control muscle activity. EMG.
Each of the three monitoring projects has its own advantages and disadvantages. If conditions permit, of course, they should use their strengths and avoid weaknesses to form complementary advantages. The more data doctors have, the more they can fully implement intraoperative monitoring and make their surgical activities accurate enough to avoid accidental injuries.
The monitoring is all in place. The surgeon is busy cutting and does not have time to look at the monitoring screen immediately. The assistant is responsible for reminding the surgeon in time. Dr. Liu on the scene quickly taught the students how to observe the data so that they can start to help as soon as possible.
"To put it simply, these monitoring items are similar to other monitoring items. A rough judgment can be made by looking at the waveform. Large changes in the waveform definitely indicate that the situation is abnormal," Dr. Liu said.
This is the significance of mankind's invention of waveform charts. The undulating curve allows the human eye to quickly and intuitively judge abnormal changes in data, without the need for the human eye to carefully identify the changes in numbers one by one.
The only disadvantage is that the waveform diagram can generally only represent one kind of data change. If you encounter a complex situation and need to combine other data to make a comprehensive judgment, human brain estimation is essential. Therefore, the brain of a doctor looking at the instrument must be running all the time.
What others think is easy. This is most often reflected in the complaints of anesthesiologists.