No wonder people say that orthopedics is a gathering place for strong men and women, as all these jobs require full strength.
We usually see Senior Chang’s dashing appearance and Dr. Liu’s gentle and polite appearance, but who would have thought that they would break bones during orthopedic surgery, like Popeye eating spinach.
Speaking of cardiac surgery, if thoracoscopy had not been developed, traditional surgery would also require breaking bones. For this reason, Xie Wanying looked at the rib scissors and thought about trying it out. The teacher would not give her this opportunity for the first time. She could only observe how the predecessors used tools to convey power and quickly achieve their goals, and then go back to study it herself to ensure that she would not fail next time she had the opportunity.
After cleaning the tissues around the diseased thoracic vertebra, the next step is to remove the entire diseased thoracic vertebra from the human body. This is the first and most critical step in the entire operation. In the imagination of outsiders, once the tissues around the thoracic vertebra are removed, this piece of tissue can be pulled out naturally, so why would anything else be needed?
This is a misconception that comes from a lack of understanding of human anatomy.
There is a vertebral foramen in the middle of the thoracic vertebra, which is connected to form the vertebral canal. The central nervous system that controls the trunk and limbs runs in the vertebral canal: the spinal cord.
It goes without saying 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 is zero, and the signals cannot be transmitted.
If you want to separate the vertebrae and spinal cord without hurting your own spinal cord, there is no other way except to cut the vertebrae in half and dissect it from the spinal cord. The vertebral foramen and the spinal cord are close together, especially if it is a diseased vertebra, and the tumor has established a connection between the vertebrae and the spinal cord. All of this makes it very easy to accidentally hurt the spinal cord. How to ensure that bone cutting does not accidentally hurt the central nervous system? The eyes cannot see clearly, so we can only rely on monitoring methods such as fire alarms. Once there is a sign of injury, the alarm will be immediately sounded, and the doctor will stop the operation and avoid the alarm area. In spinal surgery, such fire alarm monitoring is called neuroelectrophysiological testing. There are three commonly used ones: SEP, which monitors the conduction of ascending sensory nerves, is commonly known as somatosensory evoked potentials; MEP, which monitors the conduction of descending motor nerves, is motor evoked potentials; and EMG, which monitors the nerves that control muscle activity.
The three monitoring projects have their own advantages and disadvantages. If conditions permit, they should be used together to complement each other's strengths. The more data doctors have, the more comprehensive they can implement intraoperative monitoring and make their surgical activities accurate enough to avoid accidental injuries.
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The monitoring system is fully on, and the surgeon is too busy cutting to check the monitoring screen immediately. The assistant is responsible for reminding the surgeon in time. Dr. Liu quickly taught the students how to observe the data so that they can help as soon as possible.
"Simply put, these monitoring items are similar to other monitoring items, and a rough judgment can be made by looking at the waveform. Large changes and abnormalities in the waveform definitely indicate that the situation is abnormal," said Dr. Liu.
This is the significance of humans inventing waveform graphs. The undulating curve allows the human eye to quickly and intuitively determine abnormal changes in data without the need for the human eye to carefully distinguish the changes in numbers one by one.
The only drawback is that the waveform can generally only represent one type of data change. If you encounter a complex situation and need to combine other data for comprehensive judgment, human brain estimation is essential. Therefore, the doctor who stares at the instrument has to use his brain all the time, and it is not as easy as others think. This is most often reflected in the complaints of anesthesiologists.
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