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Objective To investigate the curative effects of the traditional surgical method of posterior pedicle Schanz screw fixa-tion with partially stripping injured paravertebral muscle in treating thoracolumbar fracture .Methods 52 cases with thoracolumbar fracture underwent posterior pedicle Schanz screw fixation to partially strip injured paravertebral muscle from January ,2010 to Jan-uary ,2012 .The patients were divided into partially stripping injured paravertebral muscle group (32 cases) and traditionally strip-ping injured paravertebral muscle group(20 cases) .The blood loss ,postoperative drainage ,kyphosis postoperative 3 d VAS scores , vertebral height correction rate ,Cobb angle correction ,Oswestry dysfunction indexes were copmared .Results Comparing with tra-ditionally stripping injured paravertebral muscle group ,the partially stripping injured paravertebral muscle group has better effect in transperative blood loss ,postoperative drainage and postoperative 3 d VAS scores ,the differences were statistically significant .But there was no statistical significance between the two groups in vertebral height correction rate ,kyphosis Cobb angle correction ,Os-westry dysfunction indexes .Conclusion Partially strip injured paravertebral muscle has less painful than traditional surgery does , being safe and effective with small invasion and easy to recover .
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Objective To discuss the surgical outcome of fenestration assistant by microscopy for single-level lumbar disc protrusion (LDH), compared with tradition laminotomy and discectomy. Methods From January 2008 to January 2010, forty-eight patients underwent traditional open discectomy and 40 underwent microscopy surgery. The lumbar disc protrusion involved L3- L4 level in 12 cases, L4-L5 level in 46 cases, and L5-S1 level in 30 cases; preoperative JOA score was 8-19 points (average 12.9 points) for traditional open discectomy patients and 7-19 points (average 12.7 points) for microscopy surgery patients. Results Cauda equina injury was occurred and repaired in 2 cases in traditional surgery group. The follow-up period was 10-34 months (average 18 months) for all patients. No complications such as wrong orientation, nerve root injury, and infection occurred. The JOA score 10 months after operation was (24.0 ± 2.6) for traditional surgery patients with 87.5% success rate and (24.2 ± 2.8) for microscopy surgery patients with 90% success rate. Conclusion Two methods have similar clinical outcomes, but microscopy assistant fenestration for LDH has advantages of minimal invasion, shorter operative time, shorter length of hospital stay and less intraoperative blood loss. It is one of ideal minimally invasive operations for single-level lumbar disc protrusion.
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Objective To comparison anterior cervical decompression and plating techniques for CSM between under microscope and traditional method retrospectively, investigate clinical result of surgery under microscope. Methods Sixty-seven patients with CSM underwent surgery of anterior cervical decompression and plating techniques were evaluated retrospectively from January 2008 to June 2010. Thirty-three patients underwent operation under microscope; thirty-four patients underwent traditional operation. The operating time, bleeding volume during operating and poster operating, walking time post-operation and complication were observed. Clinical outcomes were assessed by Japanese Orthopaedic Association (JOA), Image of before and after operation. Results Microsurgery operation time averaged of 100 minutes. Bleeding volume during the operation averaged of 60 ml, and after operation averaged of 40 ml. The JOA scores were improved from 8.43 pre-operatively to 14.70. Six months post operation, the average rage of JOA improvement were 83.2%. Traditional operation time averaged of 115 minutes. Bleeding volume during operation averaged of 100 ml, and after operation averaged of 50 ml. The JOA scores were improved from 7.45 pre-operatively to 11.84. Six months post operation, the average rage of JOA improvement were 82.1%. There were difference between two groups(P ＞ 0.05) in the JOA scores. No statistical difference (P ＜ 0.05) in bleeding volume and operating time. Conclusion The operation under microscope is restored significantly than the traditional method in bleeding volume, the surgical field, safety of operation, time of recovery and so on.
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Objective To evaluate the characteristics and efficacy of microscope-assisted bilateral decompression via unilateral approach for the treatment of lumbar stenosis. Methods From June 2007 to June 2010, Sixty case lumbar stenosis with bilateral decompression were treated via unilateral approach under microscopy. Patients were followed up from 6 to 24 months, average (12 ± 4.7) months. Results The pain level of each patient was assessed both before and after the opeartion, using a visual analogue scale (VAS). Intermittent claudication was completely relieved in 57 out of 60 cases, moderately relieved in 3 cases. VAS score decreased from pre-operational 9.08 ± 0.76 to post-operational 2.33 ± 1.43, and there was significantly difference between them. There was no recurrent case during the whole follow-up. Conclusion Bilateral decompression via unilateral approach under microscope is proved to be an effective and safe procedure for the treatment of lumbar stenosis, and have the advantages of minimal invasion, less pain, quick recovery, better effect, little influence on the spinal stability.