( ! ) Deprecated: 從 2.8.0 版開始,Elementor\Scheme_Typography <strong>已淘汰不用</strong>,請改用 Elementor\Core\Schemes\Typography。 in /var/www/vhosts/neurosurgeon.hk/httpdocs/wp-includes/functions.php on line 5401
Call Stack
#TimeMemoryFunctionLocation
10.0004364864{main}( ).../index.php:0
20.0006366264require( '/var/www/vhosts/neurosurgeon.hk/httpdocs/wp-blog-header.php ).../index.php:17
31.168072985896require_once( '/var/www/vhosts/neurosurgeon.hk/httpdocs/wp-includes/template-loader.php ).../wp-blog-header.php:19
41.195373922448apply_filters( $hook_name = 'template_include', $value = '/var/www/vhosts/neurosurgeon.hk/httpdocs/wp-content/themes/hello-elementor/index.php' ).../template-loader.php:104
51.195373922856WP_Hook->apply_filters( $value = '/var/www/vhosts/neurosurgeon.hk/httpdocs/wp-content/themes/hello-elementor/index.php', $args = [0 => '/var/www/vhosts/neurosurgeon.hk/httpdocs/wp-content/themes/hello-elementor/index.php'] ).../plugin.php:189
61.267877087688ElementorPro\Modules\ThemeBuilder\Classes\Locations_Manager->template_include( $template = '/var/www/vhosts/neurosurgeon.hk/httpdocs/wp-content/themes/hello-elementor/index.php' ).../class-wp-hook.php:303
71.271777117232ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->get_settings( $setting = 'page_template' ).../locations-manager.php:148
81.271777117232ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->ensure_settings( ).../base-object.php:40
91.271777117232ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->get_init_settings( ).../base-object.php:142
101.271777117232ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->get_data( $item = 'settings' ).../controls-stack.php:2049
111.271777117232ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->sanitize_settings( $settings = ['eael_ext_toc_title' => 'Table of Contents', 'background_background' => 'classic', '__globals__' => ['background_color' => 'globals/colors?id=0e03762'], 'preview_type' => 'single/page', 'preview_id' => '408'], $controls = ??? ).../controls-stack.php:1061
121.271777117232ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->get_controls( $control_id = ??? ).../controls-stack.php:2302
131.271877117232ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->get_stack( ).../controls-stack.php:286
141.271877117232ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->init_controls( ).../controls-stack.php:480
151.271877117272ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->register_controls( ).../controls-stack.php:2215
161.271877117272ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->register_controls( ).../single-base.php:93
171.271877117272ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->register_controls( ).../theme-page-document.php:33
181.271877117272ElementorPro\Modules\ThemeBuilder\Documents\Single_Page->register_controls( ).../theme-document.php:270
191.272377120928do_action( $hook_name = 'elementor/documents/register_controls', ...$arg = variadic(class ElementorPro\Modules\ThemeBuilder\Documents\Single_Page { private ${Elementor\Core\Base\Document}main_id = 231; private ${Elementor\Core\Base\Document}is_saving = FALSE; private ${Elementor\Core\Base\Document}elements_iteration_actions = []; protected $post = class WP_Post { public $ID = 231; public $post_author = '1'; public $post_date = '2021-02-28 11:11:44'; public $post_date_gmt = '2021-02-28 03:11:44'; public $post_content = 'Previous\n\t\t\t\t\t\t\tNext'; public $post_title = 'BaS Page'; public $post_excerpt = ''; public $post_status = 'publish'; public $comment_status = 'closed'; public $ping_status = 'closed'; public $post_password = ''; public $post_name = 'bas-page'; public $to_ping = ''; public $pinged = ''; public $post_modified = '2021-04-19 10:49:30'; public $post_modified_gmt = '2021-04-19 02:49:30'; public $post_content_filtered = ''; public $post_parent = 0; public $guid = 'https://neurosurgeon.hk/?post_type=elementor_library&#038;p=231'; public $menu_order = 0; public $post_type = 'elementor_library'; public $post_mime_type = ''; public $comment_count = '0'; public $filter = 'raw' }; private ${Elementor\Controls_Stack}id = 231; private ${Elementor\Controls_Stack}active_settings = NULL; private ${Elementor\Controls_Stack}parsed_active_settings = NULL; private ${Elementor\Controls_Stack}parsed_dynamic_settings = NULL; private ${Elementor\Controls_Stack}data = ['id' => 231, 'settings' => [...], 'post_id' => 231]; private ${Elementor\Controls_Stack}config = NULL; private ${Elementor\Controls_Stack}current_section = ['tab' => 'style', 'condition' => [...], 'section' => 'eael_ext_table_of_content_header_style']; private ${Elementor\Controls_Stack}current_tab = NULL; private ${Elementor\Controls_Stack}current_popover = NULL; private ${Elementor\Controls_Stack}injection_point = NULL; private ${Elementor\Controls_Stack}settings_sanitized = FALSE; private ${Elementor\Controls_Stack}render_attributes = []; private ${Elementor\Core\Base\Base_Object}settings = NULL }) ).../document.php:585
201.272477121304WP_Hook->do_action( $args = [0 => class ElementorPro\Modules\ThemeBuilder\Documents\Single_Page { private ${Elementor\Core\Base\Document}main_id = 231; private ${Elementor\Core\Base\Document}is_saving = FALSE; private ${Elementor\Core\Base\Document}elements_iteration_actions = [...]; protected $post = class WP_Post { ... }; private ${Elementor\Controls_Stack}id = 231; private ${Elementor\Controls_Stack}active_settings = NULL; private ${Elementor\Controls_Stack}parsed_active_settings = NULL; private ${Elementor\Controls_Stack}parsed_dynamic_settings = NULL; private ${Elementor\Controls_Stack}data = [...]; private ${Elementor\Controls_Stack}config = NULL; private ${Elementor\Controls_Stack}current_section = [...]; private ${Elementor\Controls_Stack}current_tab = NULL; private ${Elementor\Controls_Stack}current_popover = NULL; private ${Elementor\Controls_Stack}injection_point = NULL; private ${Elementor\Controls_Stack}settings_sanitized = FALSE; private ${Elementor\Controls_Stack}render_attributes = [...]; private ${Elementor\Core\Base\Base_Object}settings = NULL }] ).../plugin.php:470
211.272477121304WP_Hook->apply_filters( $value = '', $args = [0 => class ElementorPro\Modules\ThemeBuilder\Documents\Single_Page { private ${Elementor\Core\Base\Document}main_id = 231; private ${Elementor\Core\Base\Document}is_saving = FALSE; private ${Elementor\Core\Base\Document}elements_iteration_actions = [...]; protected $post = class WP_Post { ... }; private ${Elementor\Controls_Stack}id = 231; private ${Elementor\Controls_Stack}active_settings = NULL; private ${Elementor\Controls_Stack}parsed_active_settings = NULL; private ${Elementor\Controls_Stack}parsed_dynamic_settings = NULL; private ${Elementor\Controls_Stack}data = [...]; private ${Elementor\Controls_Stack}config = NULL; private ${Elementor\Controls_Stack}current_section = [...]; private ${Elementor\Controls_Stack}current_tab = NULL; private ${Elementor\Controls_Stack}current_popover = NULL; private ${Elementor\Controls_Stack}injection_point = NULL; private ${Elementor\Controls_Stack}settings_sanitized = FALSE; private ${Elementor\Controls_Stack}render_attributes = [...]; private ${Elementor\Core\Base\Base_Object}settings = NULL }] ).../class-wp-hook.php:327
221.274877251280Essential_Addons_Elementor\Extensions\Table_of_Content->register_controls( $element = class ElementorPro\Modules\ThemeBuilder\Documents\Single_Page { private ${Elementor\Core\Base\Document}main_id = 231; private ${Elementor\Core\Base\Document}is_saving = FALSE; private ${Elementor\Core\Base\Document}elements_iteration_actions = []; protected $post = class WP_Post { public $ID = 231; public $post_author = '1'; public $post_date = '2021-02-28 11:11:44'; public $post_date_gmt = '2021-02-28 03:11:44'; public $post_content = 'Previous\n\t\t\t\t\t\t\tNext'; public $post_title = 'BaS Page'; public $post_excerpt = ''; public $post_status = 'publish'; public $comment_status = 'closed'; public $ping_status = 'closed'; public $post_password = ''; public $post_name = 'bas-page'; public $to_ping = ''; public $pinged = ''; public $post_modified = '2021-04-19 10:49:30'; public $post_modified_gmt = '2021-04-19 02:49:30'; public $post_content_filtered = ''; public $post_parent = 0; public $guid = 'https://neurosurgeon.hk/?post_type=elementor_library&#038;p=231'; public $menu_order = 0; public $post_type = 'elementor_library'; public $post_mime_type = ''; public $comment_count = '0'; public $filter = 'raw' }; private ${Elementor\Controls_Stack}id = 231; private ${Elementor\Controls_Stack}active_settings = NULL; private ${Elementor\Controls_Stack}parsed_active_settings = NULL; private ${Elementor\Controls_Stack}parsed_dynamic_settings = NULL; private ${Elementor\Controls_Stack}data = ['id' => 231, 'settings' => [...], 'post_id' => 231]; private ${Elementor\Controls_Stack}config = NULL; private ${Elementor\Controls_Stack}current_section = ['tab' => 'style', 'condition' => [...], 'section' => 'eael_ext_table_of_content_header_style']; private ${Elementor\Controls_Stack}current_tab = NULL; private ${Elementor\Controls_Stack}current_popover = NULL; private ${Elementor\Controls_Stack}injection_point = NULL; private ${Elementor\Controls_Stack}settings_sanitized = FALSE; private ${Elementor\Controls_Stack}render_attributes = []; private ${Elementor\Core\Base\Base_Object}settings = NULL } ).../class-wp-hook.php:303
231.276277297400spl_autoload_call( $class_name = 'Elementor\\Scheme_Typography' ).../Table_of_Content.php:594
241.276377297496Elementor\Autoloader::autoload( $class = 'Elementor\\Scheme_Typography' ).../Table_of_Content.php:594
251.276377297616Elementor\Utils::handle_deprecation( $item = 'Elementor\\Scheme_Typography', $version = '2.8.0', $replacement = 'Elementor\\Core\\Schemes\\Typography' ).../autoloader.php:336
261.276377298496_deprecated_file( $file = 'Elementor\\Scheme_Typography', $version = '2.8.0', $replacement = 'Elementor\\Core\\Schemes\\Typography', $message = ??? ).../utils.php:568
271.276477298816trigger_error( $message = '從 2.8.0 版開始,Elementor\\Scheme_Typography <strong>已淘汰不用</strong>,請改用 Elementor\\Core\\Schemes\\Typography。', $error_type = 16384 ).../functions.php:5401
微創頸椎後路手術 – 香港微創腦及脊椎神經外科手術中心

微創頸椎後路手術

張先生,46 歳,從事地盤工作, 需要在高空體力勞動。在2018年3月開始覺得手腳麻木痺痛, 左右手體温感覺有異,手腳偶爾乏力,及走路時覺得腳軟不穏定。 磁力共振醫學造影確診了頸椎第三至五節出現嚴重退化:椎間盤突出、後縱韌帶變厚及骨化, 黃韌帶變厚,頸椎神經管道變得非常陜窄,脊髓中樞神經受到嚴重擠壓。脊髓神經變形而且扁平,及有神經水腫現象。

控制我們呼吸的橫膈膜之膈神經 (Phrenic Nerve),是由頸椎 中樞神經第三至五節所負責的。所以第三至五節的頸椎神經病變,會直接影響我們的呼吸功能。張先生的中樞神經嚴重擠壓、變形扁平及水腫,除有四肢及下身癱瘓的風險外, 亦有導致他突然呼吸停頓之生命危險。

由於事態嚴重,有醫生建議張先生做傳統的頸椎後路神經減壓及頸椎融合手術,以確保張先生的人身安全。但手術需要用六至八厘米的頸後傷口,來取去病者的椎板(lamina)、棘突(spinous process)及增生的黃韌帶 (ligamentum flavum),以達到神經減額的效壓,然後再用鈦金屬螺絲來穩定張先生的頸椎。

傳統的頸椎後路神經減壓手術

可是張先生考慮到頸後將來會有長長的手術疤痕, 手術亦會導致其後頸肌崩緊痛楚、肌肉無力及萎縮,而頸椎融合手術亦會影響他頸椎活動範圍大減,繼而影響其需要負責高空戶外勞動的工作生計,所以張先生斷然拒絕了該醫生的手術建議。

張先生用了個多月的時間來嘗試了所有中、西、脊醫,物理治療,針灸及其他的另類醫學,可是他的情況不但沒有改善,而且每況愈下,就連日常生活的起居走動的簡單動作都感覺困難,更莫說是返回工作崗位。

由於張先生的家庭醫生剛巧有一位病人和張先生的病情一樣,該病人在幾個月前得到筆者的手術治療後康復,所以在其家庭醫生的建議下,張先生到筆者的診所徵詢意見。

張先生向筆者表示他多日來連用手揸筆及用筷子進食亦有難度, 亦有幾次失足跌倒。筆者認為張先生的頸椎潛在著計時炸彈,只要頸椎有輕微的受傷,就會令脊髓中樞神經永久損傷,四肢及下身癱瘓, 或突然呼吸停頓之生命危險, 所以這個計時炸彈應該盡快得到移除。

為了釋除張先生對傳統手術的後遺症之疑慮(頸後長六至八厘米的傷口、後頸肌肉崩緊痛楚、冇力和萎縮, 頸椎融合後導致頸部活動功能和範圍受到限制而影響工作生計),筆者於是建議張先生採取神經外科的頸椎後路微創脊髓神經減壓手術。要張先生知道,腦神經外科醫生的首要任務是保護中樞神經,相比起腦科手術(醫生要在顱底的腦幹、微細如頭髮般的中樞神經線,和腦動脈血管之中的狹小空間來做手術),微創的頸椎神經外科手術是相當安全和低風險的。為確保病人的神經功能完全得到保障, 在四小時的手術中,腦神經外科醫生會全程用顯微鏡及術中神經功能傳道監察。

在全程顯微鏡下,醫生會用其熟練的手指及配合精巧細緻的神經外科儀器,以少於兩毫米的幅度和準成度,開一個只有一至兩厘米的微小傷口。然後醫生會在病人後頸肌肉中間的隙縫遊走,確保對後頸肌肉造成最低損傷。在其靈活的顯微鏡技巧下,醫生會小心翼翼地移除少量的頸椎版及病變肥厚的黃韌帶和增生的骨刺,為病人的頸椎脊髓中樞神經安全地減壓。

 

在神經減壓手術過全程中,醫生會透過神經功能傳道測試,監察病人由腦部的電波、經過頸椎的中樞神經,再傳致四肢肌肉的神經傳導功能訊號。在成功減壓手術後,醫生會發現病人神經傳導功能的訊號有相當大的改善。


四小時手術後張先生臥床休息一晚。第二天早上,張先生發現四肢已經沒有麻本痹痛的感覺,四肢肌肉力度亦有明顯改善。在筆者的監察下,他下床走動,發覺雙腳站立地面上時的感覺,比起手術前實在和穩健得多;走起路來,雙腳力度及步履亦有明顯進步和相當平穩。當天下午,即手術後二十四小時, 張先生就出完回家了。

 

根據張先生及其他手術案例之臨床症狀上的明顯改善, 再加上手術前和手術後的磁力共振醫學造影對比下, 已經證明了全程使用顯微鏡的神經外科頸椎後路微創脊髓神經減壓手術, 雖然傷口非常小 (只有一至兩厘米), 但已達到頸椎中樞神經減壓的效果, 是和六至八厘米傷口的傳統手術一樣的!

個案2

手術前

手術後

個案3

手術前

手術後

 
結論是, 醫生會根據病人的病情而計劃最妥善及安全的醫療方案,在張先生和其他手術案例,我們可以分辨出傳統手術和新的微創神經外科手術的區別相當之大:
1.  一至兩厘米的小傷口和六至八厘米傳統手術傷口的區別。
2. 以一至兩厘米的小傷口, 微創手術可為多達4至5節的頸椎中樞神經減壓。
3. 由於微創手術能夠確保後頸肌肉及韌帶得到最低的損傷,所以手術後病人不會有像傳統手術後的頸肌肉崩痛、萎縮和無力,或者有頸椎不穩定而需要裝上鈦金屬螺絲,繼而令頸椎活動能力受限等等的遺症,。
4. 可是由於微創頸椎神經外科手術需要較高的顯微鏡手術技能,病人需要知道手術時間會比傳統的手術長得多。
總括來說:神經外科的微創頸椎後路脊髓減壓術是在顯微鏡下, 以非常細小傷口, 對後頸肌肉及韌帶最低的損傷, 來為頸脊髓中樞神經減壓, 根治病人位於頸椎的計時炸彈,令病人盡快康復,能夠享受正常生活和盡快回復病前的工作崗位。