ABSTRACT
@#Objective To retrospectively analyze the features and related factors of deep venous thrombosis(DVT)in patients with traumatic paraplegia during early rehabilitation. Methods Inpatients of our hospital from June,2014 to June,2017 were included and patients with traumatic paraplegia during early rehabilitation were analyzed.The clinical information,lower limbs deep vein ultrasonic testing and laboratory examination were collected to analyze features and related factors of DVT. Results A total of 269 patients with traumatic paraplegia during early rehabilitation were analyzed and 62 patients had DVT in lower limbs(23.0%),in which 50 patients had an isolated distal DVT and 28 cases occurred in bilateral lower limbs(45.2%).No patients younger than 14 had DVT in lower limbs(n=31).Logistic regression analysis showed that increased D-dimer (OR=1.348, 95% CI 1.193~1.525), advanced age (OR=3.450, 95% CI 1.372~8.674),male(OR=2.872,95% CI 1.095~7.533)and diabetes(OR=5.319,95% CI 1.094~25.872)were indepen-dent related factors for DVT. Conclusion The incidence of DVT in lower limbs of traumatic paraplegia patients during early rehabilitation is high. DVT develops mainly distally to the popliteal vein and bilaterally of lower limbs. Prepubertal children have a low incidence of DVT.Increased D-dimer,advanced age,male and diabetes are independent related factors for DVT.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical outcomes of semicircular decompression in treating old thoracolumbar fractures and intractable neuropathic pain.</p><p><b>METHODS</b>From September 2009 to September 2013, 21 patients with old thoracolumbar fracture and intractable neuropathic pain were treated with semicircular decompression. Among initial surgery, posterior pedicle screw fixation was used in these patients, with or without laminectomy. All patients were male, range in age from 20 to 28 years old with an average of (25.00±2.38) years. Vertebral body residual bone block resulted in intra-spinal placeholder more than 50%. All patients were complete spinal cord injury (ASIA grade) or cauda equina injury. VAS scores was from 6 to 10 points with the mean of 7.14±0.91. In these patients, MRI, CT, X-rays were performed; denomination and dosage of analgesics were recorded; nerve function and pain status were respectively evaluated by ASIA grade and VAS score before and after operation.</p><p><b>RESULTS</b>All patients were followed up from 8 to 32 months with an average of (17.29±6.02) months. All bone fragments of spinal canal were removed and spinal cord decompressions were achieved. At final follow-up, VAS scores were from 0 to 8 points with an average of (2.43±2.46) points, and were obviously reduced than peroperative data (P<0.05). Eleven cases of them stopped analgesic intake and 7 cases reduced using. Three patients' symptoms and VAS scores were not improved.</p><p><b>CONCLUSION</b>Old thoracolumbar fractures and intractable neuropathic pain need receive imaging examination as soon as possible and consider semicircular decompression therapy if bone fragments were in vertebral canal and spinal canal stenosis existed. This therapy can effectively relieve pain and profit nerve functional recovery.</p>