[神經外科]NS surgery－白袍恐懼症

NS surgery(內容有點散亂@@~)

<brain>

1. Craniotomy : removing a piece of bone from the skull (cranium) to provide access to the brain and its surrounding structures.

Indication:

(1). Brain tumors

(2). Bleeding (hemorrhage) or blood clots (hematomas) from injuries (subdural hematoma or epidural hematomas)

(3). Weaknesses in blood vessels (cerebral aneurysms)

(4). Damage to tissues covering the brain (dura)

(5). Pockets of infection in the brain (brain abscesses)

(6). Severe nerve or facial pain (such as trigeminal neuralgia or tic douloureux)

(7). Epilepsy

2. Brain lobectomy

以Temporal lobectomy最常見，用於temporal lobe tumor reduces or eliminates seizures.

當severe head injuries或large infraction時，為了避免herniation，也會考慮做lobectomy.(受損的brain tissue可以輕易用suction吸掉)

<脊椎手術>

1. Decompression

(1). 對spinal cord decompression: Laminectomy

(2). 對root decompression: Discectomy

2. Fix

前固定:cervical—caspar plate

Thoracic and lumbar—kaneda

後固定:cervical—Halifax clamp, lateral mass plate

Thoracic—hook

lumbar—TPS(transpedicular screws fixation)

Laminectomy:

remove part or all of the vertebral bone (lamina) to relieve compression of the spinal cord or the nerve roots that may be caused by injury, herniated disk, spinal stenosis (narrowing of the canal), or tumors.

A laminectomy is considered only after medical treatments have proven to be ineffective.(通常先復健3個月，大多數人會有改善，若沒效果才開刀)

Laminectomy

Anterior Cervical Discectomy and Fusion (ACDF)

Indication: intervertebral disc herniates. (a condition referred to as nerve root compression.)

Symptoms: Pain or numbness on the neck and arms/hands(C spine 支配處)

Cervical Corpectomy

remove a portion of the vertebra and adjacent intervertebral discs for decompression of the cervical spinal cord and spinal nerves. A bone graft with or without a metal plate and screws is used to reconstruct the spine and provide stability.

常用於multi-level cervical stenosis with spinal cord compression caused by bone spur