介紹
Cervical discectomy is surgery to remove one or more discs from the neck. The disc is the pad that separates the neck vertebrae; ectomy means to take out. Usually a discectomy is combined with a fusion of the two vertebrae that are separated by the disc. In some cases, this procedure is done without a fusion. A cervical discectomy without a fusion may be suggested for younger patients between 20 and 45 years old who have symptoms due to a herniated disc.
頸椎間盤切除術(shù)是一種將頸部一個(gè)或多個(gè)節(jié)段椎間盤切除的外科手術(shù)。頸椎間盤是一種分隔相鄰各頸椎椎體的墊片；ectomy（切除術(shù)）就是把頸椎間盤切除并取出的意思。通常情況下，椎間盤切除后，接著需行融合手術(shù)，將上下相鄰的被椎間盤分隔的椎體連接起來。但在一部分病例中，如20-45歲的年輕的椎間盤突出的患者，可以只切除椎間盤而不再進(jìn)行融合術(shù)。
This guide will help you understand
· why the procedure becomes necessary
· what surgeons hope to achieve
· what to expect during your recovery
這個(gè)指南將讓大家明白以下內(nèi)容：
· 為什么手術(shù)是必要的？
· 外科醫(yī)生期望得到什么樣的結(jié)果？
· 患者康復(fù)時(shí)可能遇到什么樣的問題？
解剖學(xué)
What parts of the neck are involved?
涉及到頸部的哪些結(jié)構(gòu)？
Surgeons usually perform this procedure through the front of the neck. This is called the anterior neck region. Key structures include ligaments, bones, intervertebral discs, spinal cord, spinal nerves and the neural foramina.
外科醫(yī)生通常選擇做頸前部切口作為手術(shù)入路的選擇，這被稱作頸前路入路。其中關(guān)鍵結(jié)構(gòu)包括韌帶，骨，椎間盤，脊髓，脊神經(jīng)和神經(jīng)孔。
Surgery is occasionally done through the back, or posterior region, of the neck. Important structures in this area include the ligaments and bones, especially the lamina bones.
外科手術(shù)也偶爾選擇背側(cè)或者頸后路入路。在這個(gè)區(qū)域中的重要結(jié)構(gòu)包括：韌帶，骨，尤其是椎板。
Related Document: A Patient’s Guide to Cervical Spine Anatomy
相關(guān)閱讀：英漢對(duì)照：有關(guān)頸椎解剖的病人指南
相關(guān)視頻：
骨科小病不求醫(yī)050：頸椎解剖（Cervical Spine Anatomy）
骨科小病不求醫(yī)052：脊柱解剖（Spine Anatomy）
警告：請(qǐng)?jiān)谟蠾IFI的場所觀看視頻，土豪請(qǐng)隨意。
本視頻由張正陽翻譯，更多解剖視頻，請(qǐng)關(guān)注微信公眾平臺(tái)《張正陽Thomas》
基本原理
What do surgeons hope to achieve?
外科醫(yī)生期望得到什么樣的結(jié)果？
Discectomy is used to alleviate symptoms of a herniated disc. A disc herniation happens when the nucleus inside the center of the disc pushes through the annulus, the ligaments surrounding the nucleus. The herniated disc material may push outward, causing pain. Numbness or weakness in the arm occurs when the nucleus pushes on the spinal nerve root. Of greater concern is a condition in which the nucleus herniates straight backward into the spinal cord, called a central herniation. Discectomy relieves pressure on the ligaments, nerves, or spinal cord.
頸椎間盤切除術(shù)可以緩解頸椎間盤突出癥的癥狀。頸椎間盤突出癥是指位于椎間盤中心的髓核穿破其周圍的纖維環(huán)和韌帶，并向外擠壓神經(jīng)引起疼痛的疾病。髓核壓到椎管內(nèi)的神經(jīng)根，手臂就會(huì)產(chǎn)生麻木和無力的癥狀。若突出的髓核徑直向后壓迫脊髓，我們稱之為中央型突出。頸椎間盤切除術(shù)通過對(duì)周圍韌帶、神經(jīng)和脊髓的減壓來達(dá)到緩解癥狀的目的。
Discectomy is also commonly used when the surgeon plans to fuse the bones of two neck vertebrae into one solid bone. Most surgeons will take the disc out and replace the empty space with a block of bone graft, a procedure called cervical fusion.
外科醫(yī)生在對(duì)相鄰兩個(gè)頸椎進(jìn)行融合時(shí)也常會(huì)用到頸椎間盤切除術(shù)。大多數(shù)外科醫(yī)生在術(shù)中都會(huì)把椎間盤取出，并用一塊移植骨填補(bǔ)這個(gè)空隙，這個(gè)步驟稱為頸椎融合。
Discectomy alone is usually only used for younger patients (20 to 45 years old) whose symptoms are from herniation of the disc. But some surgeons think discectomy should always be combined with fusion of the bones above and below. They are concerned that the empty space where the disc was removed may eventually collapse and fill in with bone. Inserting a bone block during fusion surgery helps keep pressure off the spinal nerves because the graft widens the neural foramina. The neural foramina are openings on each side of the vertebrae where nerves exit the spinal canal. Most research on discectomy by itself shows good short-term benefits compared to discectomy with fusion. But more information is needed about whether the long-term results are equally as good.
單純髓核摘除術(shù)通常只適用于那些只表現(xiàn)為頸椎間盤突出癥的年輕患者（20-45歲）。但有些醫(yī)生認(rèn)為髓核摘除聯(lián)合相鄰頸椎融合效果更好。他們擔(dān)心將椎間盤拿掉后，如果不填充移植骨做融合，剩下的空隙最后很有可能塌陷。脊神經(jīng)經(jīng)過椎體兩側(cè)的椎間孔自脊髓發(fā)出，融合術(shù)中填塞的骨塊可以擴(kuò)大椎間孔來避免脊神經(jīng)所壓。大量研究證明，相對(duì)于髓核摘除加融合術(shù)，單純的髓核摘除術(shù)短期效果更好。但是，單純的髓核摘除術(shù)是否和髓核摘除加融合術(shù)一樣有著良好的長期療效，有待更多的研究來證實(shí)。
術(shù)前準(zhǔn)備
How will I prepare for surgery?
術(shù)前需要哪些準(zhǔn)備工作？
The decision to proceed with surgery must be made jointly by you and your surgeon. You should understand as much about the procedure as possible. If you have concerns or questions, you should talk to your surgeon.
是否進(jìn)行手術(shù)需要你和你的外科醫(yī)生共同決定。你應(yīng)該更可能多的知道手術(shù)的相關(guān)步驟。如果你有疑問，應(yīng)該和你的外科醫(yī)生及時(shí)溝通。
Once you decide on surgery, your surgeon may suggest a complete physical examination by your regular doctor. This exam helps ensure that you are in the best possible condition to undergo the operation.
一旦你決定進(jìn)行手術(shù)，你的外科醫(yī)生會(huì)建議你的私人醫(yī)生給你進(jìn)行一次全面的體格檢查，以保證術(shù)前良好的身體狀況。
On the day of your surgery, you will probably be admitted to the hospital early in the morning. You shouldn’t eat or drink anything after midnight the night before.
手術(shù)當(dāng)天，你需要盡早到醫(yī)院。從術(shù)前那晚的午夜開始不能進(jìn)食、喝水。
手術(shù)步驟
What happens during the operation?
手術(shù)是怎么樣進(jìn)行的？
Cervical discectomy is commonly done through the anterior(front) of the neck. This is called an anterior cervical discectomy. However, when many pieces of the herniated disc have squeezed into the posterior (back) of the spine, surgeons may need to operate through the back of the neck using a procedure called a posterior cervical discectomy.
頸椎間盤切除術(shù)通常是通過頸前入路來完成的，稱為頸椎前路椎間盤切除術(shù)。但是，當(dāng)一些破碎的髓核被擠壓進(jìn)入椎體后方時(shí)，醫(yī)生可能需要通過頸后入路來摘除這些髓核，稱為頸椎后路椎間盤切除術(shù)。
Patients are given a general anesthesia to put them to sleep during most spine surgeries. As you sleep, your breathing may be assisted with aventilator. A ventilator is a device that controls and monitors the flow of air to the lungs.
大多數(shù)脊柱手術(shù)中病人采用全身麻醉，整個(gè)手術(shù)中，病人都是在睡眠狀態(tài)。當(dāng)病人睡著時(shí)，由呼吸機(jī)輔助呼吸。呼吸機(jī)是一種能夠控制和監(jiān)測空氣流動(dòng)到肺的裝置。
前路椎間盤切除術(shù)
The patient’s neck is positioned facing the ceiling with the head bent back and turned slightly to the right. A two-inch incision is made two to three fingers’ width above the collar bone across the left-hand side of the neck. The left side is chosen to avoid injuring the nerve going to the voice box. Retractors are used to gently separate and hold the neck muscles and soft tissues apart so the surgeon can work on the front of the spine.
病人仰臥，頭部向后仰，并輕微轉(zhuǎn)向右側(cè)。在左側(cè)頸部鎖骨上兩到三指作一到二英寸的切口。選擇左側(cè)是為了避免損傷支配喉的神經(jīng)。用牽開器輕輕分離并保持頸部肌肉和軟組織分開，這樣術(shù)者可以在脊柱的前方操作。
A needle is inserted into the herniated disc, and an X-ray is taken to identify and confirm it is the correct disc. A long strip of muscle and the anterior longitudinal ligament that cover the front of the vertebral bodies are carefully pulled to the side. Forceps are used to take out the front half of the disc. Next a small rotary cutting tool (a burr) is used to carefully remove the back half of the disc. A surgical microscope is used to help the surgeon see and remove pieces of disc material and any bone spurs that are near the spinal cord.
穿刺針插入突出椎間盤，X線確認(rèn)它是正確的節(jié)段。將覆蓋椎體前方的肌肉（頸長肌）和前縱韌帶小心拉向一側(cè)。用髓核鉗取出椎間盤的前半部分。然后用旋轉(zhuǎn)切割工具（磨鉆）仔細(xì)去除后半部的椎間盤。使用手術(shù)顯微鏡幫助外科醫(yī)生看到和切除脊髓周圍的椎間盤碎片和骨刺。
The muscles and soft tissues are put back in place, and the skin is stitched together.
將肌肉和軟組織歸回原位，縫合皮膚。
后路椎間盤切除術(shù)
This method is used when the herniated disc has fragmented into small pieces near the spinal nerve.
椎間盤突出已經(jīng)碎裂成小塊并靠近脊神經(jīng)時(shí)采用這種手術(shù)方式。
The operation is usually done with the patient lying face down with the neck bent forward and held in a headrest. The surgeon makes a short incision down the center of the back of the neck. The skin and soft tissues are separated to expose the bones along the back of the spine.
手術(shù)時(shí)，病人通常采取俯臥位，頸部前曲，置于頭架上。外科醫(yī)生沿著頸部后方中線做一短切口。分離皮膚、軟組織以暴露脊柱后部的骨性結(jié)構(gòu)。
Then the surgeon may use an X-ray to identify the injured disc. A burr is used to shave the edge off the lamina bones, the back part of the ring over the spinal cord. When the disc has jutted straight backward into the spinal cord (central herniation), surgeons may need to completely remove both lamina bones in order to see better and to be able to clear all the pieces of the disc near the spinal cord.
然后外科醫(yī)生用X線來識(shí)別破損的椎間盤。用磨鉆削除椎板邊緣，即圍在脊髓背面的部分。當(dāng)椎間盤徑直向后突向脊髓（中央突出），外科醫(yī)生可能需要完全去除兩邊的椎板以便更好觀察，并清除脊髓周圍所有的椎間盤碎片。
Related Document: A Patient’s Guide to Cervical Laminectomy
相關(guān)閱讀：頸椎椎板切除術(shù)患者指南（翻譯招募中，有興趣者請(qǐng)留言）
相關(guān)視頻：
精美動(dòng)畫：頸后路椎間孔擴(kuò)大成形術(shù)
精美動(dòng)畫：顯微內(nèi)窺鏡下頸椎后路椎間盤摘除術(shù)
After shaving the lamina bone, the surgeon cuts a small opening in the ligamentum flavum, a ligament within the spinal canal and in front of the lamina bone. By removing part of this ligament, the surgeon exposes the spot where the disc fragments are pressed against the spinal nerve. Next, the spinal nerve is gently moved upward. Using a surgical microscope, the surgeon magnifies the area in order to carefully remove the disc fragments and any bone spurs.
將椎板部分消除后，術(shù)者會(huì)在黃韌帶上切個(gè)小口，該韌帶位于椎板前方的椎管內(nèi)。通過去除部分黃韌帶，術(shù)者能夠暴露椎間盤碎片壓迫脊神經(jīng)的位置。然后，輕輕向上牽拉脊神經(jīng)。使用手術(shù)顯微鏡，外科醫(yī)生放大手術(shù)視野以小心取出椎間盤碎片和骨刺。
The muscles and soft tissues are put back in place, and the skin is stitched together.
將肌肉和軟組織歸回原位，縫合皮膚。
并發(fā)癥
What might go wrong?
手術(shù)可能會(huì)出現(xiàn)哪些問題？
As with all major surgical procedures, complications can occur. Some of the most common complications following discectomy include
和所有主要手術(shù)一樣，頸椎間盤切除術(shù)也會(huì)出現(xiàn)并發(fā)癥，最常見的并發(fā)癥包括：
· problems with anesthesia
· thrombophlebitis
· infection
· nerve damage
· ongoing pain
· 麻醉并發(fā)癥
· 血栓性靜脈炎
· 感染
· 神經(jīng)損傷
· 持續(xù)疼痛
This is not intended to be a complete list of the possible complications, but these are the most common.
這里沒有完整列出所有可能發(fā)生的并發(fā)癥，但這些是最常見的。
Problems with Anesthesia
麻醉并發(fā)癥
Problems can arise when the anesthesia given during surgery causes a reaction with other drugs the patient is taking. In rare cases, a patient may have problems with the anesthesia itself. In addition, anesthesia can affect lung function because the lungs don’t expand as well while a person is under anesthesia. Be sure to discuss the risks and your concerns with your anesthesiologist.
當(dāng)在手術(shù)期間所實(shí)施的麻醉與患者正在服用的其他藥物發(fā)生反應(yīng)時(shí)，可能就會(huì)發(fā)生并發(fā)癥。極少數(shù)情況下病人出現(xiàn)問題是由麻醉本身所引起。另外麻醉也會(huì)影響肺功能，因?yàn)樵诼樽頎顟B(tài)下肺擴(kuò)張不好，因此一定確保與你的麻醉師交流手術(shù)的風(fēng)險(xiǎn)和你的關(guān)注點(diǎn)。
Thrombophlebitis (Blood Clots)
血栓性靜脈炎
View animation of pulmonary embolism
（原文動(dòng)畫無法下載，從網(wǎng)上找了幾個(gè)相關(guān)視頻）
警告：請(qǐng)?jiān)谟蠾IFI的場所觀看視頻，土豪請(qǐng)隨意。
警告：請(qǐng)?jiān)谟蠾IFI的場所觀看視頻，土豪請(qǐng)隨意。
Thrombophlebitis, sometimes called deep venous thrombosis (DVT), can occur after any operation. It occurs when the blood in the large veins of the leg forms blood clots. This may cause the leg to swell and become warm to the touch and painful. If the blood clots in the veins break apart, they can travel to the lung, where they lodge in the capillaries and cut off the blood supply to a portion of the lung. This is called a pulmonary embolism. (Pulmonary means lung, and embolism refers to a fragment of something traveling through the vascular system.) Most surgeons take preventing DVT very seriously. There are many ways to reduce the risk of DVT, but probably the most effective is getting you moving as soon as possible. Two other commonly used preventative measures include
血栓性靜脈炎，有時(shí)稱為深靜脈血栓形成（DVT），可在任何手術(shù)后發(fā)生。當(dāng)腿的大靜脈中的血液形成血凝塊時(shí)它就會(huì)發(fā)生。這可能會(huì)導(dǎo)致大腿腫脹，摸上去皮溫有升高，并有疼痛，如果在靜脈中的血栓掉下來，它們可以游行至肺，停留在毛細(xì)血管中并會(huì)切斷肺的一部分血供。這就叫做肺栓塞，栓塞指的是某些物品的碎片通過血管系統(tǒng)轉(zhuǎn)運(yùn)。大多數(shù)外科醫(yī)生非常重視預(yù)防深靜脈血栓，有很多方法可以減少深靜脈血栓的風(fēng)險(xiǎn)，但最有效的方法是盡快進(jìn)行活動(dòng)。另外有兩種最常見的方法包括：
· pressure stockings to keep the blood in the legs moving
· medications that thin the blood and prevent blood clots from forming
· 使用彈力網(wǎng)保持腿部血液的流動(dòng)
· 使用能降低血液稠度和阻止血栓形成的藥物
Infection
感染
Infection following spine surgery is rare but can be a very serious complication. Some infections may show up early, even before you leave the hospital. Infections on the skin’s surface usually go away with antibiotics. Deeper infections that spread into the bones and soft tissues of the spine are harder to treat and may require additional surgery to treat the infected portion of the spine.
脊柱術(shù)后出現(xiàn)感染很罕見，但這卻是一個(gè)非常嚴(yán)重的并發(fā)癥。有些感染甚至在你出院之前就已經(jīng)出現(xiàn)了，皮膚表面出現(xiàn)的感染通常在使用抗生素后會(huì)消失，但蔓延到脊柱骨和軟組織的深部感染卻更難治療，可能需要另外的手術(shù)來治療脊柱受感染的部分。
Nerve Damage
神經(jīng)損傷
Any surgery that is done near the spinal canal can potentially cause injury to the spinal cord or spinal nerves. Injury can occur from bumping or cutting the nerve tissue with a surgical instrument, from swelling around the nerve, or from the formation of scar tissue. An injury to these structures can cause muscle weakness and a loss of sensation to the areas supplied by the nerve.
在椎管附近的任何手術(shù)都有可能引起脊髓和脊神經(jīng)的損傷。當(dāng)手術(shù)器械碰撞或切割到神經(jīng)組織時(shí)會(huì)出現(xiàn)損傷，神經(jīng)損傷也可以出現(xiàn)在神經(jīng)周圍的腫脹或疤痕組織的形成。神經(jīng)損傷可導(dǎo)致神經(jīng)支配區(qū)域肌肉無力和感覺缺失。
The nerve to the voice box is sometimes injured during surgery on the front of the neck. When doing anterior neck surgery, surgeons prefer to go through the left side of the neck where the path of the nerve to the voice box is more predictable than on the right side. During surgery, the nerve may get stretched too far when retractors are used to hold the muscles and soft tissues apart. When this happens, patients may be hoarse for a few days or weeks after surgery. In rare cases where the nerve is actually cut, patients may end up with ongoing minor problems of hoarseness, voice fatigue, or difficulty making high tones.
在手術(shù)期間，脖子前部的喉部神經(jīng)有時(shí)會(huì)損傷。 當(dāng)進(jìn)行頸前路手術(shù)時(shí)，外科醫(yī)生更喜歡通過左側(cè)頸部，其喉部神經(jīng)的路徑比在右側(cè)更容易預(yù)測。在手術(shù)期間，用拉鉤來分離肌肉和軟組織時(shí)，神經(jīng)可能被牽扯太遠(yuǎn)。當(dāng)發(fā)生這種情況時(shí)，患者可能在術(shù)后幾天或幾周出現(xiàn)聲音嘶啞。在極少數(shù)情況下，神經(jīng)真正被切斷了，患者最終可能會(huì)遺留持續(xù)的聲音嘶啞，發(fā)音疲勞或高音困難等小問題。
Ongoing Pain
持續(xù)疼痛
Many patients get nearly complete relief of symptoms from the discectomy procedure. As with any surgery, however, you should expect some pain afterward. If the pain continues or becomes unbearable, talk to your surgeon about treatments that can help control your pain.
通過椎間盤切除手術(shù)，許多患者癥狀幾乎完全緩解。但是，與任何手術(shù)一樣，你應(yīng)該對(duì)術(shù)后的一些疼痛有心理準(zhǔn)備。如果疼痛持續(xù)或變得難以忍受，告訴您的手術(shù)醫(yī)生，以便可以幫助您控制疼痛。
手術(shù)后
What happens after surgery?
手術(shù)后會(huì)發(fā)生什么？
Patients are usually able to get out of bed within an hour or two after surgery. Your surgeon may have you wear a hard or soft neck collar. If not, you will be instructed to move your neck only carefully and comfortably.
患者通常在術(shù)后一兩個(gè)小時(shí)內(nèi)就可以下床。外科醫(yī)生可能會(huì)讓您戴一個(gè)硬的或軟的頸托。如果沒有，醫(yī)生會(huì)指導(dǎo)您只能在小心和舒適的情況下才能活動(dòng)脖子。
Most patients leave the hospital the day after surgery and are safe to drive within a week or two. People generally get back to light work by four weeks and can do heavier work and sports within two to three months.
大多數(shù)患者在術(shù)后的第二天出院，并且在一兩個(gè)星期內(nèi)可以安全駕駛?；颊咄ǔＴ谒膫€(gè)星期之后可以恢復(fù)輕松的工作，并且在兩三個(gè)月內(nèi)可以做更重的工作和運(yùn)動(dòng)。
Outpatient physical therapy is usually prescribed only for patients who have extra pain or show significant muscle weakness and deconditioning.
通常只有那些特別疼痛或有明顯的肌肉無力和功能失調(diào)的患者才需要進(jìn)行門診物理治療。
康復(fù)
What should I expect as I recover?
在恢復(fù)期需要做些什么？
Patients usually don’t require formal rehabilitation after routine cervical discectomy surgery. Surgeons may prescribe a short period of physical therapy when patients have lost muscle tone in the shoulder or arm, when they have problems controlling pain, or when they need guidance about returning to heavier types of work.
常規(guī)頸椎椎間盤切除手術(shù)后，患者通常不需要進(jìn)行正式的康復(fù)鍛煉。當(dāng)患者的肩膀或手臂的肌肉失去張力時(shí)，當(dāng)他們有難以控制的疼痛時(shí)，或者當(dāng)他們返回更重的工種需要有關(guān)的指導(dǎo)時(shí)，外科醫(yī)生會(huì)開出短期物理治療的處方。
If you require outpatient physical therapy, you will probably only need to attend therapy sessions for two to four weeks. You should expect full recovery to take up to three months.
如果您需要門診物理治療，您可能只需要兩到四周的療程。預(yù)計(jì)完全恢復(fù)可能需要三個(gè)月的時(shí)間。
At first, therapy treatments are used to help control pain and inflammation. Ice and electrical stimulation treatments are commonly used to help with these goals. Your therapist may also use massage and other hands-on treatments to ease muscle spasm and pain.
首先，采用某些治療方法來幫助控制疼痛和炎癥。冰敷和電刺激治療方法通常用來幫助實(shí)現(xiàn)這些目標(biāo)。您的治療師還可以用按摩和其他手法治療以緩解肌肉痙攣和疼痛。
Active treatments are added slowly. These include exercises for improving heart and lung function. Walking, stationary cycling, and arm cycling are ideal cardiovascular exercises. Therapists also teach specific exercises to help tone and control the muscles that stabilize the neck and upper back.
然后慢慢地加入運(yùn)動(dòng)療法。這些包括用于改善心肺功能的鍛煉。步行，騎固定式自行車和手臂自行車是理想的心血管鍛煉方法。治療師還教授特定的練習(xí)，以幫助調(diào)節(jié)和控制穩(wěn)定頸部和上背部的肌肉。
Your therapist works with you on how to move and do activities. This form of treatment, called body mechanics, is used to help you develop new movement habits. This training helps you keep your neck in safe positions as you go about your work and daily activities. You’ll learn how to keep your neck safe while you lift and carry items and as you begin to do other heavier activities.
治療師與您一起設(shè)法活動(dòng)和運(yùn)動(dòng)。這種治療形式，被稱為人體力學(xué)，用于幫助您養(yǎng)成新的活動(dòng)習(xí)慣。當(dāng)您開始工作和日?；顒?dòng)時(shí)，這種訓(xùn)練幫助您保持脖子在安全的位置。您將學(xué)到，抬重物并攜帶物品時(shí)，開始從事其他更重的活動(dòng)時(shí)，如何保持您的脖子安全。
As your condition improves, your therapist will begin tailoring your program to help prepare you to go back to work. Some patients are not able to go back to a previous job that requires heavy and strenuous tasks. Your therapist may suggest changes in job tasks that enable you to go back to your previous job. Your therapist can also provide ideas for alternate forms of work. You’ll learn to do your tasks in ways that keep your neck safe and free of extra strain.
隨著病情的改善，治療師將開始調(diào)整計(jì)劃，以幫助您作好回去工作的準(zhǔn)備。一些患者無法回到以前那種需要繁重和艱巨任務(wù)的工作。治療師可能建議改變工作任務(wù)，以恢復(fù)以前的工作。治療師還可以提供其他點(diǎn)子來改變干活的方法。從中您將學(xué)到干活的正確方式，以保持脖子的安全，避免額外的用力。
Before your therapy sessions end, your therapist will teach you a number of ways to avoid future problems.
在您的治療結(jié)束之前，治療師將教會(huì)您一些方法，以避免將來可能發(fā)生的問題。
（滕紅林 譯）
滕紅林，男，主任醫(yī)師，脊柱外科博士，溫州醫(yī)學(xué)院附屬第一醫(yī)院脊柱外科負(fù)責(zé)人，科室副主任，碩士生導(dǎo)師。任中國抗癌協(xié)會(huì)脊柱腫瘤學(xué)組委員、浙江省骨科學(xué)會(huì)脊柱外科學(xué)組委員、浙江省康復(fù)醫(yī)學(xué)會(huì)脊柱脊髓損傷協(xié)會(huì)委員、浙江省老年學(xué)學(xué)會(huì)脊柱關(guān)節(jié)病專業(yè)組委員、中華醫(yī)學(xué)會(huì)數(shù)字醫(yī)學(xué)分會(huì)青年委員、溫州醫(yī)學(xué)院中青年學(xué)科帶頭人（脊柱外科）和《脊柱外科雜志》編委。
1996年本科畢業(yè)于溫州醫(yī)學(xué)院醫(yī)學(xué)系，同年分配至溫醫(yī)一院骨科工作。1999年~2004年在上海第二軍醫(yī)大學(xué)長征醫(yī)院脊柱外科專業(yè)攻讀臨床型碩士、博士。師從上海長征醫(yī)院脊柱外科專家賈連順教授。畢業(yè)回院后先后赴歐洲荷蘭VU大學(xué)脊柱腫瘤中心、美國西雅圖脊柱微創(chuàng)中心、美國雙子城脊柱中心、美國Anderson脊柱腫瘤中心等進(jìn)修學(xué)習(xí)脊柱外科微創(chuàng)、脊柱腫瘤和畸形等。2005年初負(fù)責(zé)并在創(chuàng)立了脊柱外科專業(yè)。擅長上頸椎和頸椎手術(shù)、脊柱骨折、脊髓損傷、脊柱骨質(zhì)疏松骨折、脊柱骨腫瘤、脊柱側(cè)凸和后凸畸形矯形等手術(shù)。
副主譯《麥?zhǔn)涎惩础?參編《脊柱腫瘤外科學(xué)》并擔(dān)任學(xué)術(shù)秘書;另參編、編譯脊柱外科專業(yè)書籍10余本，如《枕頸部外科學(xué)》、《頸椎外科手術(shù)圖譜》、《頸椎外科學(xué)》、《腰椎外科學(xué)》、《脊柱創(chuàng)傷外科學(xué)》、《脊柱內(nèi)鏡手術(shù)學(xué)》、《脊柱微創(chuàng)外科學(xué)》和《微創(chuàng)脊柱學(xué)》等。發(fā)表國外SCI論文10多篇，其中第1作者及通訊作者共5篇。2009年關(guān)于如何選擇頸胸段脊柱手術(shù)入路的論文發(fā)表在《Journal of Neurosurgery: Spine》，2011年關(guān)于脊柱骨腫瘤的論文發(fā)表在國際脊柱外科界的權(quán)威雜志《Spine》雜志上。參與脊柱骨腫瘤的課題，2004年獲得上海市科技進(jìn)步二等獎(jiǎng)(第5)、軍隊(duì)醫(yī)療成果二等獎(jiǎng)和中華醫(yī)學(xué)科技獎(jiǎng)三等獎(jiǎng)1項(xiàng)。負(fù)責(zé)或參加國家級(jí)、省部級(jí)課題和軍隊(duì)課題5項(xiàng)。
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