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1.
China Journal of Orthopaedics and Traumatology ; (12): 576-584, 2020.
Article in Chinese | WPRIM | ID: wpr-828247

ABSTRACT

OBJECTIVE@#To systematically assess the efficacy of anterior cervical corpectomy and fusion (ACCF) versus posterior laminoplasty (LAMP) for cervical ossification of posterior longitudinal ligament (OPLL).@*METHODS@#PubMed and EMBASE, Cochrane Library, CBM, CNKI, Wanfang and VIP were collected from 7 databases of ACCF, LAMP from 1970 to May 2018. According to the criteria, the articles were included and independently screened by two authors. The quality of the articles was assessed by using the MINORS scale (methodological index for non randomized studies). After extracting the data from the article, the JOA score, cervical curvature, operation time, bleeding volume, excellent and good rate, recovery rate, adverse events and secondary surgery were analyzed by using Review Manager 5.3 software.@*RESULTS@#Finally, a total of 22 articles with 1 678 patients were included in this Meta-analysis, with 810 patients in ACCF group and 868 patients in LAMP group. Meta analysis results showed that the ACCF group had higher postoperative JOA scores[MD=0.63, 95%CI(0.05, 1.20), = 0.03], higher excellent rate [=1.85, 95%CI (1.14, 3.02), =0.01] and higher recovery rate [=11.90, 95%CI (5.75, 18.05), =0.000 1]. But the LAMP group has a shorter operative time [MD=52.19, 95%CI (29.36, 75.03), <0.000 01], less complications [=1.56, 95%CI (1.03, 2.35), =0.04] and less reoperations [=3.73, 95%CI (1.62, 8.57), =0.002]. There was no significant different in postoperative lordosis [MD=3.15, 95%CI(-0.14, 6.43), =0.06] and blood loss[SMD= 0.26, 95%CI(-0.05, 0.57), =0.10] between two groups.@*CONCLUSION@#The recovery of functionof ACCF group was better, but operation time, complications and reoperations of LAMP group were all better than ACCF group. There was no difference in postoperative lordosis and intraoperative blood loss between two groups. However, there are some limitations in this study. Therefore, higher quality and larger sample size clinical studies are needed to further verify.


Subject(s)
Humans , Calcium , Cervical Vertebrae , Decompression, Surgical , Laminoplasty , Ossification of Posterior Longitudinal Ligament , Spinal Fusion , Treatment Outcome , Vertebroplasty
2.
Chinese Acupuncture & Moxibustion ; (12): 147-151, 2020.
Article in Chinese | WPRIM | ID: wpr-793037

ABSTRACT

OBJECTIVE@#To observe the auxiliary analgesic effect of wrist-ankle acupuncture on patients undergoing transforaminal endoscope surgery.@*METHODS@#A total of 64 patients with lumbar disc herniation who underwent percutaneous lateral transforaminal endoscope surgery were randomly divided into an observation group and a control group, 32 cases in each group. The patients in the control group were treated with injection of 1% lidocaine for routine local infiltration anesthesia. The patients in the observation group were treated with wrist-ankle acupuncture at lower 5 area and lower 6 area for 30 min, 5 min before routine local infiltration anesthesia; immediately, 15 min, 30 min after insertion the left-right technique, up-down technique, and rotation technique were applied for six times, respectively. The mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO) and pain visual analogue scale (VAS) were compared between the two groups at the time points of intraoperative puncture (T), circular saw grinding (T), and placement of working channel (T). The intention of reoperation was recorded immediately after operation and 24 h after operation. The expectation and treatment credibility scale (ETCS) was used to evaluate the relationship between patients' expectation and efficacy 5 min before operation and immediately after operation.@*RESULTS@#At T and T during the operation, the MAP and HR in the obserrvation group were lower than those in the control group, while SpO was higher than that in the control group (0.05). At T, the peak VAS and average VAS in the observation group were lower than those in the control group (0.05). The intention of reoperation in the observation group was higher than that in the control group both immediately after operation and 24 h after operation (0.05). The scores of ETCS1, ETCS2 and ETCS3 immediately after operation in the observation group were higher than those in the control group (<0.05).@*CONCLUSION@#The wrist-ankle acupuncture has positive auxiliary analgesic effect on lumbago during transforaminal endoscope surgery, and strengthens the patients' confidence on the operation effect.

3.
Chinese Journal of Tissue Engineering Research ; (53): 2939-2944, 2020.
Article in Chinese | WPRIM | ID: wpr-847580

ABSTRACT

BACKGROUND: Calcaneal fractures account for approximately 60% of all tarsal fractures, and 75% of calcaneal fractures are intra-articular. Surgical treatment can restore the shape and function of calcaneus well. In recent years, transtarsal sinus incision has been recognized and applied by clinicians, but the choice of surgical approach for calcaneal fractures is still controversial. OBJECTIVE: To systematically evaluate the efficacy and surgical safety of transtarsal sinus incision and traditional L-shaped incision in the treatment of calcaneal fracture. METHODS: PubMed, Cochrane, EMbase, CNKI, VIP and Wanfang databases were searched by computer for all randomized controlled trials comparing transtarsal sinus incision with traditional L-shaped incision in the treatment of calcaneal fractures. The retrieval time was from the establishment of the database to April 2019. The meta-analysis was carried out with RevMan 5.3 software after literature screening and data extraction based on inclusion criteria and exclusion criteria. RESULTS AND CONCLUSION: (1) A total of 522 patients were enrolled in 7 randomized controlled trials. (2) Meta-analysis results showed that there was no significant difference in Bohler angle [MD=0.14, 95%CI (-0.54, 0.81), P > 0.05], Gissane angle [MD=-0.19, 95%CI (-1.36, 0.98), P > 0.05] and Maryland score [MD=-0.25, 95%CI (-3.41, 2.91), P > 0.05] between the two incisions at the last follow-up. (3) American Orthopaedic Foot and Ankle Society score [MD=6.39, 95%CI(-0.09, 12.87), P=0.05] might be different. (4) Compared with the traditional L-shaped incision, the tarsal sinus incision had certain advantages in shortening the operation time [MD=-14.98, 95%CI (-23.90, -6.06), P=0.001 < 0.05], and lower incidence of postoperative complications [OR=0.18, 95%CI (0.08, 0.38), P < 0.000 1]. (5) For Sanders II and III calcaneal fractures, the transtarsal sinus incision has no obvious advantage over the traditional L-shaped incision in terms of curative effect. However, because the transtarsal sinus incision has a relatively small wound, it has the advantages of relatively short operation time and relatively low incidence of complications after operation. This suggests that the tarsal sinus incision is safe. However, due to the small sample size of the included study, the above conclusions still need to be verified by clinical trials with higher quality and larger sample size.

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