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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 葉力森(Lih-Seng Yeh) | |
dc.contributor.author | Hsiang-ju Chen | en |
dc.contributor.author | 陳薌如 | zh_TW |
dc.date.accessioned | 2021-06-15T05:44:22Z | - |
dc.date.available | 2012-08-24 | |
dc.date.copyright | 2010-08-24 | |
dc.date.issued | 2009 | |
dc.date.submitted | 2010-08-19 | |
dc.identifier.citation | 1. Cerda-Gonzalez S, Dewey CW. Congenital diseases of the craniocervical junction in the dog. Vet clin North Am Small Anim Pract 2010;40: 121-141.
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Guide to the dissection of the dog, 7th ed. St. Louis, Mo.: Saunders/Elsevier; 2010. p.75-90. 8. Evans HE. Arthrology. In Evans HE, Miller ME, ed. Miller's Anatomy of the dog, 3rd ed. Philadelphia: W.B. Saunders, 1993. p.223-228. 9. Menezes AH. Craniovertebral junction anomalies: diagnosis and management. Semin Pediatr Neurol 1997;4: 209-223. 10. Norkin CC, White DJ. Measurement of joint motion : a guide to goniometry. Philadelphia: F.A. Davis Co., 2003. 11. Watson AG, Evans HE, de Lahunta A. Ossification of the atlas-axis complex in the dog. Anat Histol Embryol 1986;15: 122-138. 12. Havig ME, Cornell KK, Hawthorne JC, McDonnell JJ, Selcer BA. Evaluation of nonsurgical treatment of atlantoaxial subluxation in dogs: 19 cases (1992-2001). J Am Vet Med Assoc 2005;227: 257-262. 13. Lin JL, Coolman BR. Atlantoaxial subluxation in two dogs with cervical block vertebrae. J Am Anim Hosp Assoc 2009;45: 305-310. 14. Bailey CS, Morgan JP. Congenital spinal malformations. Vet Clin North Am Small Anim Pract 1992;22: 985-1015. 15. Bynevelt M, Rusbridge C, Britton J. Dorsal dens angulation and a Chiari type malformation in a Cavalier King Charles Spaniel. Vet Radiol Ultrasound 2000;41: 521-524. 16. Warren-Smith CM, Kneissl S, Benigni L, Kenny PJ, Lamb CR. Incomplete ossification of the atlas in dogs with cervical signs. Vet Radiol Ultrasound 2009;50: 635-638. 17. Platt SR, Chambers JN, Cross A. A modified ventral fixation for surgical management of atlantoaxial subluxation in 19 dogs. Vet Surg 2004;33: 349-354. 18. Wheeler SJ. Atlantoaxial subluxation with absence of dens in rottweiler. J small Anim Pract 1992;33: 90-93. 19. Cerda-Gonzalez S, Dewey CW, Scrivani PV, Kline KL. Imaging features of atlanto-occipital overlapping in dogs. Vet Radiol Ultrasound 2009;50: 264-268. 20. Hecht S, Thomas WB, Marioni-Henry K, Echandi RL, Matthews AR, Adams WH. Myelography vs. computed tomography in the evaluation of acute thoracolumbar intervertebral disk extrusion in chondrodystrophic dogs. Vet Radiol Ultrasound 2009;50: 353-359. 21. Kishigami M. Application of an atlantoaxial retractor for atlantoaxial subluxation in the cat and dog. J Am Anim Hosp Assoc 1984;20: 413-419. 22. Schulz KS, Waldron DR, Fahie M. Application of ventral pins and polymethylmethacrylate for the management of atlantoaxial instability: results in nine dogs. Vet Surg 1997;26: 317-325. 23. Pujol E, Bouvy B, Omana M, Fortuny M, Riera L, Pujol P. Use of the Kishigami Atlantoaxial Tension Band in eight toy breed dogs with atlantoaxial subluxation. Vet Surg 2010;39: 35-42. 24. Ryan GD. Skull, spine, and pelvis. In: Ryan GD, ed. Radiographic positioning of small animals. Philadelphia: Lea & Febiger, 1981. p. 90-92. 25. Castro WH, Sautmann A, Schilgen M, Sautmann M. Noninvasive three-dimensional analysis of cervical spine motion in normal subjects in relation to age and sex. An experimental examination. Spine (Phila Pa 1976) 2000;25: 443-449. 26. Feipel V, Rondelet B, Le Pallec J, Rooze M. Normal global motion of the cervical spine: an electrogoniometric study. Clin Biomech 1999;14: 462-470. 27. Hof AL, Koerhuis CL, Winters JC. 'Coupled motions' in cervical spine rotation can be misleading. Comment on V. Feipel, B. Rondelet, J.-P. Le Pallec and M. Rooze. Normal global motion of the cervical spine: an electrogoniometric study. Clin Biomech 1999; 14: 462-470. Clin Biomech 2001;16: 455-458. 28. Chen J, Solinger AB, Poncet JF, Lantz CA. Meta-analysis of normative cervical motion. Spine (Phila Pa 1976) 1999;24: 1571-1578. 29. Pellecchia GL, Bohannon RW. Active lateral neck flexion range of motion measurements obtained with a modified goniometer: reliability and estimates of normal. J Manipulative Physiol Ther 1998;21: 443-447. 30. Trott PH, Pearcy MJ, Ruston SA, Fulton I, Brien C. Three-dimensional analysis of active cervical motion: the effect of age and gender. Clin Biomech 1996;11: 201-206. 31. Walmsley RP, Kimber P, Culham E. The effect of initial head position on active cervical axial rotation range of motion in two age populations. Spine (Phila Pa 1976) 1996;21: 2435-2442. 32. Nilsson N, Hartvigsen J, Christensen HW. Normal ranges of passive cervical motion for women and men 20-60 years old. J Manipulative Physiol Ther 1996;19: 306-309. 33. Dvorak J, Antinnes JA, Panjabi M, Loustalot D, Bonomo M. Age and gender related normal motion of the cervical spine. Spine (Phila Pa 1976). 1992;17: S393-398. 34. Youdas JW, Garrett TR, Suman VJ, Bogard CL, Hallman HO, Carey JR. Normal range of motion of the cervical spine: an initial goniometric study. Phys Ther 1992;72: 770-780. 35. O'Driscoll SL, Tomenson J. The cervical spine. Clin Rheum Dis 1982;8: 617-630. 36. Morgan JP, Miyabayashi T, Choy S. Cervical spine motion: radiographic study. Am J Vet Res 1986;47: 2165-2169. 37. Couturier J, Rault D, Cauzinille L. Chiari-like malformation and syringomyelia in normal cavalier King Charles spaniels: a multiple diagnostic imaging approach. J small Anim Pract 2008;49: 438-443. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/46972 | - |
dc.description.abstract | 寰樞椎不穩定(atlantoaxial instability)會造成樞椎(axis)相對於寰椎(atlas)往背側移位,進而造成脊髓的壓迫。診斷寰樞椎不穩定的方式主要依據臨床症狀、基本資料、病史以及影像學上的判讀。確診的方式主要是看到寰樞椎不穩定的證據,如:於X光片側照下明顯看到寰樞椎之間距離增加或是於脊髓造影(myelography)、磁振造影(magnetic resonance imaging, MRI)下看到頸部脊髓的壓迫,或是於電腦斷層(computed tomography, CT)下看到寰椎和樞椎相對位置齒突的改變。
由於X光片下不一定可以觀察到寰樞不穩定的證據、而拍攝脊髓造影、磁振造影以及電腦斷層需要負擔較高的費用以及承擔麻醉風險;此外,於過去文獻中,僅有數篇研究指出寰樞椎之間可能具有可動性。因此本研究的目的在於建立單純放射線學拍攝之下,好發品種的無臨床症狀犬其寰樞椎關節活動在三個姿勢下(頸部伸展、自然、屈曲等三種姿勢)的參考值、好發品種及非好發品種其寰樞椎關節之可動性以及比較有症狀犬與無症狀犬其寰樞關節活動範圍之間的差異。並希望以這些數據建立出價格較低廉之診斷流程。 共46隻狗參與本研究之實驗一,包括26隻無臨床症狀犬之好發品種犬(六隻約克夏、七隻博美、七隻吉娃娃以及六隻馬爾濟斯)(組一)、14隻無臨床症狀犬之非好發品種犬(七隻迷你臘腸及七隻米格魯)(組二)以及六隻寰樞椎不穩定之好發品種犬(一隻約克夏、一隻博美、兩隻吉娃娃以及兩隻馬爾濟斯)(組三)參與本研究。所有動物皆拍攝二到三張頸部側照X光片(包括伸展姿、自然姿以及屈曲姿)以及一張腹背照X光片。並於三種側照下,以五種測量方法包括:The distance of atlantoaxial joint(AAD)、horizontal movement(HM)、vertical movement(VM)、cranial to cranial(Cr’-Cr’)以及caudal to cranial(Cd’-Cr’)計算寰樞椎之間的距離。於腹背照下,計算並紀錄齒突以及樞椎的長度。收集上列數據後,進行統計分析。 實驗一結果顯示:比較在同一組的三種不同的側照姿勢之間,組一的寰樞椎椎間距離會有顯著的改變(p<0.05);組二的寰樞椎之間距離則沒有改變。三種側照下,組一的VM及Cd’-Cr’顯著的小於組二(p<0.05)。於自然姿及屈曲姿下,組一之AAD以及Cr’-Cr’顯著小於組三(p<0.05)。 實驗二是利用實驗一所得結果,包括測量方法及寰樞椎間距之參考值,建立一問卷診斷法。再請12位臨床獸醫師(六位具三年以上臨床經驗,六位具三年以下臨床經驗)判讀12個臨床病例(組一隨機挑選六隻病例以及組三全部病例)之X光片。判讀共分為兩階段,第一階段為目測加上既有經驗判斷這12個病例是否為寰樞椎不穩定(目測檢出率),第二階段則以問卷診斷法判斷這些病例是否為寰樞椎不穩定(問卷檢出率)。 實驗二之結果顯示問卷檢出率顯著高於目測檢出率。 由實驗一可知,好發品種犬之寰樞椎關節確實存在可動性,並明顯大於好發品種犬。同時本研究也建立了三種姿勢的角度定義、測量寰樞椎之間距離的三種較為方便的方法(問卷診斷法)以及齒突佔樞椎椎體之比值。而實驗二則證實此方法能提高好發品種之寰樞椎不穩定的檢出率,並且是一種容易使用的診斷方式。 | zh_TW |
dc.description.abstract | 英文摘要
Atlantoaxial instability (AAI) refers to the instability of the atlantoaxial joint (AAJ) that leads to dorsal displacement of the axis relative to the atlas, causing spinal cord compression. Diagnosis is based on clinical signs, signalment, history and imaging findings. Definitive diagnosis is made by demonstrating the consequence of atlantoaxial instability, such as the apparent increase in space between the dorsal spinous process of the axis and the dorsal arch of the atlas in the survey lateral radiographs, atlantoaxial misalignment causing spinal cord compression in myelography or magnetic resonance imaging (MRI), and the abnormal position of atlantoaxial joint in computed tomography (CT). In some patients, the radiographic findings are not obvious and further investigations with advanced imaging would be required to achieve the diagnosis. However, the availability of the advanced imaging facilities, higher expense for the owner and the risk of general anesthesia would all potentially be the owner’s concern regarding the further investigations. To our knowledge, there are only few studies describing the motility of the atlantoaxial joint in dogs. The objective of this study include: 1) to establish the reference of the distance of the AAJ of predisposed breed dogs in three lateral projections (extended, neutral and flexed), 2) to demonstrate the motility of the AAJ of predisposed breed dogs and non-predisposed breed dogs, 3) to compare radiographic findings in dogs without AAI and clinically affected dogs, and 4) to establish a diagnostic criteria of AAI based on radiographic findings. In total, 46 dogs were included in study one and were divided into three groups. Group one included 26 AAI-predisposed breed dogs which were not affected by AAI (six Yorkshire terriers, seven Pomeranian dogs, seven Chihuahua dogs and six Maltese terriers). Group two included 14 AAI-non-predisposed breed dogs which were not affected by AAI (seven miniature Dachshunds and seven beagles). Six AAI clinically affected dogs of predisposed breed were included in Group three (one Yorkshire terrier, one Pomeranian dog, two Chihuahua dogs and two Maltese dogs). Cervical spine radiographs were obtained in neutral, extended and flexed lateral projections and ventrodorsal projection. Five methods including the distance of atlantoaxial joint (AAD), horizontal movement (HM), vertical movement (VM), cranial to cranial (Cr’-Cr’) and caudal to cranial (Cd’-Cr’) were used to measure the distance between the atlas and the axis in three lateral views. The length of dens and axis were measured in the ventrodorsal view. In Group one, the distance of the atlantoaxial joint significantly changed between three lateral projections (p<0.05), and no significant changes were found in Group two. In all three lateral projections, VM and Cd’-Cr’ of the atlantoaxial joint in Group two was significantly increased compared to that in Group one (p<0.05). In neutral and flexed lateral projections, AAD and Cr’-Cr’ of the atlantaoxial joint in Group three were significantly increased compared to that in Group one (p<0.05). In study two, based on the data analysis of study one, a diagnostic criteria of AAI was generated. Twelve veterinarians were asked to interpret radiographs of 12 dogs (six dogs in Group one and six dogs in Group three) based on their own experience (first stage) and based on the AAI diagnostic criteria (second stage). The diagnostic rate based on the AAI diagnostic criteria was significantly higher. In conclusion, the study demonstrated that the motility of the AAJ exists in several AAI-predisposed breed dogs. The reference range of the distance between atlas and axis in several breed dogs were also established. The AAI diagnostic criteria generated from the study is user friendly, and its application would increase the diagnostic rate of AAI. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T05:44:22Z (GMT). No. of bitstreams: 1 ntu-98-R97643011-1.pdf: 28309646 bytes, checksum: ecb76bc0ee3523b4b4ead26c6ad2f534 (MD5) Previous issue date: 2009 | en |
dc.description.tableofcontents | 目錄
中文摘要 I 英文摘要 III 目錄 V 表次 VII 圖次 VIII 第一章 序言 1 第二章 文獻探討 3 第一節 寰樞椎解剖構造 3 一、犬寰樞椎解剖構造 3 二、人類前頸部解剖構造 6 第二節 犬寰樞椎之胚胎學 8 一、寰椎之骨化 9 二、樞椎之骨化 11 三、骨頭的融合 13 第三節 寰樞椎不穩定 14 一、犬隻寰樞椎不穩定之簡介 14 二、犬隻寰樞椎不穩定之病生理學 14 三、犬隻寰樞椎不穩定之臨床症狀 17 四、犬隻寰樞椎不穩定之診斷 17 五、犬隻寰樞椎不穩定之治療 18 六、犬隻寰樞椎不穩定之風險因子及預後 20 第四節 頸部X光片之拍攝的姿勢 21 一、腹背照(Ventrodorsal projection) 21 二、側照(Lateral projection) 23 三、屈曲照(Flexed projection) 24 四、伸展照(Extended projection) 25 第五節 人類頸部關節活動範圍測量之現有資料 26 一、人類頸椎ROM之影響因子 26 二、量測關節活動範圍(range of motion, ROM)的方法之信度與效度(Reliability and validity) 28 第六節 犬隻寰樞椎關節活動範圍測量之現有資料 28 第三章 實驗一(Study one) 33 第一節 實驗一之目的 33 第二節 實驗一之材料及方法 33 一、實驗一之病例收集來源 33 二、實驗一之實驗方法 34 三、實驗一之統計分析 38 第三節 實驗一之結果 38 第四章 實驗二(Study two) 47 第一節 實驗二之目的 47 第二節 實驗二之材料及方法 47 第三節 實驗二之結果 48 第五章 討論 49 第一節 X光片的拍攝 49 第二節 測量寰樞椎關節距離的方式 51 第三節 結果之意義 52 一、無臨床症狀犬之寰樞椎關節之活動性 52 二、無臨床症狀犬與臨床病例之比較 53 三、以實驗一結果建立寰樞椎不穩定之診斷方法 54 第四節 誤差 56 第六章 結論 56 附錄一 60 附錄二-實驗二之問卷 61 | |
dc.language.iso | zh-TW | |
dc.title | 犬寰樞椎之放射線學表現 | zh_TW |
dc.title | Radiographic features of atlantoaxial joint in dogs | en |
dc.type | Thesis | |
dc.date.schoolyear | 98-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 張雅珮(Ya-Pei Chang) | |
dc.contributor.oralexamcommittee | 林中天,林永昌 | |
dc.subject.keyword | 犬,寰樞椎不穩定,放射線學,診斷方法,好發品種,齒突, | zh_TW |
dc.subject.keyword | dogs,atlantoaxial instability,radiology,diagnosis,dens, | en |
dc.relation.page | 63 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2010-08-19 | |
dc.contributor.author-college | 獸醫專業學院 | zh_TW |
dc.contributor.author-dept | 臨床動物醫學研究所 | zh_TW |
顯示於系所單位: | 臨床動物醫學研究所 |
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