ABSTRACT
OBJECTIVE@#To compare the life quality between the initial and recurrent patients with osteoporotic vertebral compression fractures (OVCFs) after conservative treatment, and to explore the influential factors on life quality in the recurrent fracture patients. @*METHODS@#A total of 30 patients with recurrent fractures after the OVCFs were retrospectively observed. At the same time, 30 initial OVCFs patients with similar basic conditions to the patients in the recurrent fractures group were served as a control group. The data of the SF-36 Concise Health Status Questionnaire in the 2 groups were compared. @*RESULTS@#The eight dimensions of the SF-36 Concise Health Status Questionnaire in the recurrent fracture group were worse than those in the control group (all P<0.01). @*CONCLUSION@#The life quality for patients with the recurrent fracture is significantly poorer than that in the control group. The patients with recurrent fracture of the OVCFs may further affect their psychological expectation, emotion and social activities.
ABSTRACT
Objective To analyze and discuss the different characteristics of clinical imaging of Brucellar and tuberculous spondylitis,and to improve the diagnostic performance of the image of Brucellar spondylitis.Methods A retrospective analysis at Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University was conducted from January 2011 to December 2013.X-ray,computer tomography (CT)and magnetic resonance imaging (MRI)data of 46 cases of Brucellar spondylitis and 40 cases of tuberculous spondylitis were compared.Results The lumbar spine,especially L4,was usually involved in brucellosis,characterized with multiple small lesions mostly confined to the edge of vertebral body and surrounded by the hyperplasia and sclerosis.New damaged foci were formed in the new bone tissue and intervertebral discs destruction was slight with hyperplasia and sclerosis of articular surface. Few or no paravertebral abscesses were seen.In contrast,thoracic and lumbar spines were more usually affected in tuberculosis featured with destruction of vertebra and intervertebral discs.There could be dead bone formation.Paravertebral abscesses and osteoporosis were frequent.Conclusion The different imaging characteristics of Brucellar and tuberculous spondylitis could favor the differential diagnosis.
ABSTRACT
BACKGROUND:Spine minimaly invasive technique through foraminal mirror is the method to treat lumbar disc herniation with minimal wound. This technique can be conducted under local anesthesia, and does not need to resect the smal joint or destroy the vertebral plate, and has smal damage to the spine. OBJECTIVE: To explore the short-period effects of transforaminal endoscopic spine system for adjacent-segment degenerative changes-caused low back pain after lumbar fixation and fusion. METHODS:A total of 31 patients with degenerative changes after posterior lumbar bone graft fusion fixation, who required secondary surgery, were enroled in this study, including 23 males and 8 females, at the age of 45-81 years old. The postoperative time was 1.1-5.7 years. There were 3 cases of L3-4 single segment, 15 cases of L4-5 single segment, 8 cases of L5S1 single segment, and 5 cases of multi-segment. These patients were treated with transforaminal endoscopic spine system, and folowed up for 6 months. Visual Analogue Scale score and lumbar function Japanese Orthopedic Association score were observed. RESULTS AND CONCLUSION: Lumbar and leg pain symptoms were relieved noticeably during the operation. The patient could walk immediately after the surgery, and the postoperative recovery was quite satisfactory. Visual Analogue Scale score was lower immediately, 1, 3 and 6 months after treatment compared with pre-treatment. Lumbar function Japanese Orthopedic Association score was higher immediately, 1, 3 and 6 months after treatment compared with pre-treatment. Results verify that transforaminal endoscopic spine system for degenerative changes after posterior lumbar bone graft fusion fixation has some advantages such as high safety, short operation time, less hemorrhage, less complications, rapid restoration and easily accepted by patients.
ABSTRACT
BACKGROUND:Artificial cervical disc prosthesis simulates range of motion and buffer shock function of normal intervertebral discs. Clinical experiments verify that artificial cervical disc prosthesis material has good biocompatibility and mechanical characteristics. OBJECTIVE:To evaluate artificial cervical disc replacement and zero-profile interbody fixation and fusion system for multilevel cervical disease in 2-year folow-up. METHODS:Artificial cervical disc replacement and zero-profile interbody fixation and fusion system were used to treat 42 patients with multilevel cervical disease. The patient presented typical symptoms and signs of spinal cord or nerve root compression. There were 18 cases of cervical myelopathy, 15 cases of nerve root cervical spondylosis and 10 cases of mixed type of cervical spondylosis. After treatment, mean operation time, blood loss and reoperation rate were measured. Postoperative complications, disability index of neck function, visual analog scale, function unit range of corresponding surgery segments of the cervical spine, Cobb angle of C2-C7 vertebral body, range of motion of adjacent segment of proximal and distal vertebral bodies were observed and clinical outcomes were evaluated. RESULTS AND CONCLUSION: Al cases finished the operation and were scored at various time points. After treatment, radiating pain of shoulder and neck and upper extremity were remarkably lessened. Numbness and sensory loss symptoms disappeared obviously. Quality of life elevated noticeably. Visual analog scale and the disability index of neck function score were decreased in final folow-up compared with pre-treatment (P < 0.001). C2-C7 vertebrae Cobb angle, FSU angle, range of motion of proximal surgery adjacent segment and range of motion of the distal surgery adjacent segment were elevated compared with pre-treatment (P < 0.001). These data indicate that cervical spondylosis was improved after treatment. Each index of cervical spondylosis after artificial cervical disc replacement and zero-profile interbody fixation and fusion system was reconstructed to different degrees.
ABSTRACT
BACKGROUND:Diffusion conditions of bone cement in vertebral fracture line may be one of the main factors affecting the therapeutic effect of percutaneous vertebroplasty, but there are less related studies. OBJECTIVE:To study the effect of diffusion conditions of bone cement in vertebral fracture line on the therapeutic outcomes of percutaneous vertebroplasty. METHODS: CR and MRI data of 77 patients with T1-L2 osteoporotic vertebral compression fractures, 28 males and 49 females, aged 55-86 years, undergoing percutaneous vertebroplasty were analyzed. Al the patients were divided into test group (n=53, bone cement diffused wel in the vertebral fracture line) and control group (n=24, bone cement dispersion was unsatisfactory). Visual analogue scale, Oswestry disability index and Cobb angle change in the two groups were measured and compared before and after operation. RESULTS AND CONCLUSION:There was no difference in the visual analogue scale score, Oswestry disability index and Cobb angle between the two groups before operation, but these parameters were al improved significantly in the two groups after 2 days and 6 months of operation (P< 0.05). The visual analogue scale score and Oswestry disability index were significantly lower in the test group than the control group at 2 days after operation (P < 0.05), but there was no difference between the two groups at 6 months after operation. The Cobb angle and vertebral colapse rate became lower in the test group than the control group at 6 months after operation (P < 0.05), but there was no difference in the re-fracture rate between the two groups. These findings indicate that poor bone cement dispersion in the fracture line can affect the relief of short-term pain and dysfunction and it can increase the possibility of long-term secondary vertebral colapse.
ABSTRACT
BACKGROUND:Transforaminal endoscopic discectomy needs to dissociate the ligamentum flavum, and if combined with the continuous dilator and working channel, it can keep the intact ligamentum flavum no matter how smal the incision may be (even 3-5 mm). OBJECTIVE:To present the technique of interlaminar endoscopic lumbar discectomy with ligamentum flavum splitting. METHODS:We performed operations on 16 male and 14 female patients by interlaminar endoscopic lumbar discectomy with ligamentum flavum splitting. The average age of the patients in the study was (48±15) years. The chief complaint before surgery was radiculopathy confined to one leg. The anatomic operative level was L 3-4 in one case, L 4-5 in 13 cases and L 5-S 1 in 16 cases. The ruptured disc migrated superiorly in four cases and inferiorly in seven cases, and intraoperative electromyo-graphic monitoring was performed in al surgeries. The ligamentum flavum was split, and after withdrawing the working channel, the ligamentum flavum could reset itself. RESULTS AND CONCLUSION:The total operation time was 20-40 minutes, and the fol ow-up period was (149±108) days. There were no abnormal signals on the intraoperative electromyography in any cases, and the reported symptoms were immediately improved in al patients after the operation. Fol ow-up magneticresonance imaging showed a disappearance of the ruptured disc without defect in the ligamentum flavum. There were no operation-associated complications in al the patients. Interlaminar endoscopic lumbar discectomy with ligamentum flavum splitting is a feasible approach.
ABSTRACT
BACKGROUND:Vertebral column resection is the frequently mentioned spinal orthopaedic concept. Due to the high requirement of the operation skil , difficulty and more complications, the previous studies have reported from different aspects, and many researchers have focused on the analysis of complications, that may be related with the procedure and manner. OBJECTIVE:To analyze the efficacy and complications of posterior vertebral column resection combined with titanium screw rod fixation for the treatment of severe spinal deformity. METHODS:We retrospectively analyzed 48 patients with severe spinal deformity who treated with posterior vertebral column resection and titanium screw rod fixation, with an average removal of 1.6 vertebral. The patients were fol owed-up for 15-64 months. The Cobb angle (coronal plane and sagittal plane) of the patients before treatment, after treatment and in the final fol ow-up was analyzed, and the relative complications of the surgery were analyzed. RESULTS AND CONCLUSION:The patients with spinal deformity were divided into five categories, included kyphoscoliosis (n=11), severe scoliosis (n=20), congenital spinal deformity (n=4), spherical kyphosis (n=3), and angular kyphosis (n=10). The average coronal plane deformity angle of the patients was corrected from 84° preoperation to 35° postoperation, with the total correction rate of 54%. The average sagittal plane deformity angle was corrected from 90° preoperation to 42° postoperation, and the sagittal plane Cobb angle was decreased for 48°. The mean operation time was 545 minutes (204-1 355 minutes), the intraoperative blood loss was 1 610 mL (50-8 244 mL), and the average blood loss was 65%. After treatment, 31 cases had complications, including 13 cases of intraoperative neurological dysfunction (observed through electrophysiological monitoring and wake), permanent neurological dysfunction did not occur after timely treatment. The posterior vertebral column resection and titanium screw rod fixation can obtain better effect in the treatment of severe spinal deformity, but the procedure has high complications and is difficult for operation.
ABSTRACT
BACKGROUND:Artificial total disc replacement is one treatment of low back pain in recent years, but the report on the effect of disc replacement on lumbar sagittal plane is rare. OBJECTIVE:To analyze the effect of lumbar disc replacement on lumbar lordosis. METHODS:Retrospective analysis of radiographic data of 17 patients who underwent lumbar disc replacement for single segment degenerative disc disease was carried out. Data measurement included preoperative and postoperative lumbar lordosis, diseased segmental lordosis and lumbar intervertebral angle. RESULTS AND CONCLUSION:Al the 17 patients were fol owed-up for more than 12 months. Lumbar disc replacement was performed at L4-5 segment in three cases and L5-S1 segment in 14 cases. The average diseased segmental lordosis and lumbar lordosis were increased significantly after replacement when compared with those before replacement (P<0.05);the lumbar intervertebral angle was increased after replacement when compared with that before replacement, but the difference was not significant. The results indicate that lumbar disc replacement for the treatment of single segment degenerative disc disease can increase the lumbar lordosis and diseased segmental lordosis, which can help to improve the lumbar sagittal balance. The postoperative lumbar intervertebral angle has no correlation with the implant angle of the prosthesis on the replace segment.