When you first entered the society, with great ambition to struggle, you encountered all kinds of procrastination, all kinds of unspoken rules, all kinds of constraints, all kinds of dumping. Then you feel that the industry is hopeless! All the people are inferior to you, and the leader is an egg.

Then when you stay in this industry for four or five years, you will slowly realize the truth contained in it. For example, it is like this now, an operation, to discuss and discuss, and then let the two enemies sit together and make a plan. It's procrastinating, it's very procrastinating, but it's really a conventional way, if nothing else, just for one reason: safety. After all, geniuses don't come by often!

In the small conference room of the first orthopedic department, Lao Gao, Lao Wang and Zhang Fan sat together. How to say it, these two people are very strange, in front of everyone, the two are incompatible, but when there are only three of them left, the relationship between Lao Gao and Lao Wang does not seem to be so bad. At least Lao Gao will take the initiative to add water to Lao Wang, Zhang Fan can't understand it, he really can't understand what the two old guys are going on, but he doesn't have the heart to gossip.

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

"I'm going to choose the posterior approach, and I'm going to do an estimated correction of Bart's lumbar spine from the posterior route. ”

"You mean, soft correction?" asked Wang.

"Yes!" Zhang Fan replied affirmatively.

Then he said: "Two directors, look. ”

Zhang Fan got up and turned on the viewer and put all of Barth's image checks on it. Then the "card" opened the caliper, as if pulling out the dragon slaying knife, and pointed to the image on the viewer and said: "The child's curved vertebral vertebrae are vertebral bodies, what we have to do is to fuse one vertebral body above and below the vertebrae, the Cobb angle here is greater than 50 °, the two upper and lower vertebrae are fused during the operation, and then an open intervertebral disc at the terminal vertebrae does not need to be fused, so that the upper and lower segments can compensate for the correction of the error, and the distal vertebral body should be parallel to the sacral vertebrae, and when the two are inconsistent, the longest segment is selected for fixed fusion."

After spinal fusion, the balance of the spine is maintained by the non-fused movable segments, not by the fusion site. These can be determined by the dynamic X-ray image, so in this way, the terminal vertebrae should be able to move in all directions, the most important is the distal end, that is, the distal intervertebral space should be able to move in the bending direction, the distal endplate should be parallel in the bending image, and the axial plane in the bending direction should reach a neutral position, and it is absolutely guaranteed that Bart will slowly change the deformity in the future. ”

Speaking of which, let's talk about this spine first. The spine is curved. Especially slender women, the soft waist is like willow, which makes people have the desire to hug, this is the credit of the spine, it is a slight S-shaped as a whole, and the cervical spine and lumbar spine are generally the most prone to problems.

The range of motion of the spine in these two places is relatively large. Moreover, especially the lumbar spine, which is directly the pillar of the body, must be weight-bearing and have a range of motion, so there are often people with neck pain and back pain. Few people say that the back spine hurts. Once there is soreness or numbness in the waist and legs, it must be taken seriously. Sit less, lose weight, eat less, and exercise more.

What is the shape of the spine, a metaphor. It's like an S-shaped cylinder stacked with chess pieces. There is a latex pad between the chess pieces and the chess pieces, and this mat is the lumbar intervertebral disc. Then, several rubber bands from top to bottom are attached to the front and back of the chess piece, which is the ligament. Moreover, these chess pieces are divided into front and back, the front is bare, and there are two wings on the side called transverse processes, and there are tails on the back called spinous processes. Chess pieces and chess pieces are stacked on top of each other, and then the tails and tails are stacked on top of each other like tiles on the roof.

There is a hole between the piece and the tail, which runs from top to bottom. Between the two pairs of wings and the chess pieces, there is also a smaller hole that falls from above and penetrates. The hole between the chess piece and the tail is an extension of the brain: the spinal cord. What runs between the wings and the chess pieces are nerves that emanate from the spinal cord like silk threads. The human spine is probably such a structure.

The spinal cord is like a tube of water, or a signal transmission line. The stimuli received by the muscles are fed back to the brain, and the brain makes calculations and feeds them back to the muscles, which then responds. Or the brain calculates and directly gives commands to the muscles to make movements.

Actually, it's very simple, for example, if you touch the butt of a beautiful woman, the muscles on the girl's ass transmit this feeling to the brain, well! uncomfortable, the brain gives an order, fan, and then you are slapped by the beautiful woman. Or, um! comfortable, the brain commands, kiss it, and you get kissed. This information is transmitted through the spinal cord, which is the water tube.

When the latex pad between the chess pieces and the chess pieces is squeezed by a huge weight or long-term bad posture, it loses the elasticity of retraction, and then it protrudes out like a sparse latex, when it protrudes to the spinal cord, although this thing is sparse to the upper bone, but it is much harder on the upper spinal cord, it begins to compress and bully the spinal cord, and the spinal cord begins to make a sound of grievance, and then you begin to have back pain and numbness in your legs, which is the so-called lumbar disc herniation. When one or more of the pieces are displaced, it is a lumbar protrusion or bulge, which is also a kind of deformity, but it is only partial.

Spine surgery is considered a top surgery in orthopedics because there are so many things to consider. In general, fracture surgery also considers the plane problem, whether the butt is tightly closed or not, and whether it is in line with the physiological position. The spine is very troublesome, and it should be considered from at least three directions and three coordinates.

Median, coronal, sagittal position, median position is easy to understand, coronal position is commonly said to be a glass plate, facing the same direction as the eye, and then cut directly from the head, this direction is coronal. The sagittal position is when the bow and arrow are shot into the face and inserted into it to form a face. This thing is really anti-human, and it is particularly laborious to explain in words, so this kind of professional word must be explained with pictures, and then go to rote memorization. For spine surgery, these three positions must be considered. As long as there is an inappropriate position, there can be sequelae, because it does not meet the physiological position, which leads to a chain reaction of problems with the stability of the human body.

Spinal deformity, simply put, is a cylinder built with chess pieces, one or more chess pieces, the direction is wrong, and then the overall shape changes. Orthopedic surgery, on the other hand, is to correct the wrong chess piece. But there is a very, very difficult thing, the child's development is growing, after the operation to adjust the deformed position, if the position or orientation does not meet the future growth trend, then the operation is a complete failure.

The failure of the operation led to an even more terrible secondary injury. Not only does it not improve the symptoms, but it may also aggravate the condition, which is such a terrible thing, so once some uncertain factors are added to some things, it will lead to an order of magnitude increase in the difficulty of things. Therefore, this operation must not be cautious by Lao Gao and Lao Wang.

This treatment in the early years was symptomatic. It is to forcibly adjust the wrong position of the spine, and there are many postoperative complications, because it is forcibly corrected, what often appears is 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 this disease.

But this disease is said to be too much, and many orthopedic surgeons will never encounter it in their lifetime. Let's say less, it also accounts for a large proportion of teenagers, and it is mostly female. And there is no way to quantify this surgery. For example, appendix surgery, which is the middle and third of the iliac bone to the navel, even if the position is strange, it is a big deal to cut the incision a little bigger, pull the cecum to find it a little bit, it can be found sooner or later.

But this operation is not possible, it must be combined with the actual situation. For example, Lao Gao thinks that the child can grow to 1.8 meters tall in the future, but Lao Wang thinks that the child can grow to 3 meters tall in the future. This is a thing that there is no way to quantify, so if you don't have a master to teach and want to do this kind of surgery, just think about it.

This kind of surgery has been done since 1914. And so far, it is still not possible in most hospitals, and most spine orthopedic doctors will not do it. Imagine how difficult this surgery is.

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

"Have you ever encountered this kind of surgery when you were a blue bird?" Zhang Fan said so clearly and clearly that Lao Wang had no way to refute it, so he could only look for other grounds to reassure him, and at the same time, Lao Gao also paid attention.

"I've done it!" Falsehoods, especially this kind of falsehood, said too much, Zhang Fan felt that he was telling the truth, and he was about to make himself schizophrenic.

"Or~~" Lao Wang looked at Lao Gao and said uncertainly.

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

"Do!" Lao Gao glanced at Zhang Fan and agreed.

"Okay, in that case, let's sign the surgical plan together, I'm the director of the spine surgery department, let me sign the first name." ”

"The patient number is from our department. Lao Gao said politely.

At this time, Zhang Fan's tears came down. Really, how lucky he must be to meet such a good teacher, such a protective teacher. The first here is not an honor, not a benefit. If the operation is done well, it should be done, and if it is not done well, you have to be responsible, and you have to bear the main responsibility.

"I'll sign the first one. Zhang Fan was crying.

"Hehe!" the two old men looked at him at the same time and let out a sneer!