Chapter 1935 [1935] Precise Monitoring

No wonder it is said that the Department of Orthopedics is a gathering place for strong men and strong women, and all these tasks require full strength.

Usually, the seniors look suave and Dr. Liu looks gentle. Who would have thought that they would snap a broken bone during orthopedic surgery, like Popeye who ate spinach.

When it comes to cardiac surgery, if thoracoscopic surgery is not developed, traditional surgery would also require broken bones. For this reason, Xie Wanying looked at the rib scissors and thought about trying something. It is impossible for the teacher to give her this opportunity when she is on stage for the first time. She can only observe on the spot today how the seniors use tools to convey power to quickly achieve their goals.

After cleaning up the connected tissues around the diseased thoracic vertebrae, the next step is to remove the entire diseased thoracic vertebrae from the human body. This is the critical first step in the entire operation. In the imagination of outsiders, if the connection around the thoracic spine is removed, this piece can be pulled out naturally, so there is no need for anything else.

This is an illusion of not knowing the anatomy of the human body.

There is a vertebral foramen in the middle of the thoracic spine, and the vertebral foramen connects to form the spinal canal, and the central nervous system that controls the trunk and limbs runs in the spinal canal: 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 is zero, and the signals cannot be conveyed.

If you want to separate the vertebrae from the spinal cord without hurting your own spinal cord, there is no other way than cutting the vertebrae in half from the spinal cord. The vertebral foramen and the spinal cord are closely connected, especially this is a diseased vertebra, and the tumor has established a connection between the vertebra and the spinal cord. All of this is very easy to accidentally injure the spinal cord. How to ensure that the bone cutting does not accidentally injure the central nervous system? The eyes can't see clearly, and they can only rely on monitoring methods like fire alarms. Immediately call the police as soon as there is a sign of injury, and the doctor stops the operation to avoid the alarm area. In spine surgery, such fire detection is called neurophysiological monitoring. 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 motor evoked potential; and nerve EMG, which monitors innervating muscle activity.

Each of the three monitoring items has its own strengths and weaknesses. If possible, they should all increase their strengths and avoid weaknesses to form complementary advantages. The more data doctors have, the more they can fully implement intraoperative monitoring, so that their surgical activities can be accurate enough to avoid accidental injuries.

The monitoring is all on, and the chief surgeon is busy cutting and has no time to look at the monitoring screen at the first time. The assistant is responsible for reminding the chief surgeon in time. On the spot, Dr. Liu quickly explained to the students how to observe the data, so that they can get started as soon as possible and help them see it.

"To put it simply, these monitoring items are similar to other monitoring items, and the waveform can be judged at a cursory glance. A large change in the waveform must indicate that the situation is abnormal." Dr. Liu said.

This is the significance of human beings inventing the waveform chart. The undulating curve allows the human eye to quickly and intuitively judge the abnormal changes in the data, without the need for the human eye to carefully distinguish the changes in numbers one by one.

The only disadvantage is that the waveform diagram generally can only represent one kind of data change. If a complex situation needs to be combined with other data to make a comprehensive judgment, human brain estimation is essential. Therefore, the brain of the doctor staring at the instrument has to be running all the time, which is not as easy as other people think. This is most often manifested in complaints from the anesthetist.

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