Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation.

Lumbar disc herniation (LDH) is a type of serious sinus or sciatic nerve dysfunction caused by nucleus pulposus protrusion and annulus fibrosus tears. Its clinical symptoms often include severe low back pain, limited lumbar movement, sciatic nerve pain in the lower limbs, and even cauda equina syndrome. The common treatment for LDH is a conservative treatment scheme involving medicine, rest, and physical therapy. However, if the conservative treatment scheme is ineffective, a surgical treatment approach is adopted. Traditional open lumbar surgery has some disadvantages, including the potential for severe surgical trauma, severe blood loss during the operation, instability of the lumbar spine, and loss of the lumbar motor unit. Among the minimally invasive surgical schemes, full-endoscopic spine surgery (FESS) is undoubtedly the most appropriate and has the advantages of minimal trauma, high safety, quick postoperative recovery, and the retention of the stable structure and the motor unit of the lumbar spine. However, simultaneously, incomplete removal of the nucleus pulposus and residual nerve dysfunction after surgery can occur. To avoid these shortcomings, we studied a specific spinal endoscopy technique, the "isolation zone" surgical strategy, which can effectively block the pain from the nerve conduction pathway by completely relieving the nerve compression and nerve dysfunction through the orderly treatment of the protruding nucleus pulposus, the fissure of the annulus fibrosus, the sinus nerve, and the surrounding inflammatory soft tissues.

Effect of perioperative nursing for artificial knee replacement on patients with osteosarcoma of the distal femur.

OBJECTIVE: To investigate the clinical application of perioperative nursing care for patients with osteosarcoma of the distal femur who received artificial knee replacement. METHODS: A total of 80 patients with osteosarcoma of the distal femur admitted to our hospital from March 2019 to March 2020 were selected as research subjects and divided into the control group and the study group according to their admission sequence. The control group was given routine nursing care, while the study group was given perioperative nursing care. The negative emotions, sleep quality, limb function, pain, complication rate, and nursing satisfaction of the two groups of patients after nursing care were analyzed. RESULTS: After nursing care, (1) the Hamilton depression rating scale (HAMD) and Hamilton anxiety scale (HAMA) scores of the study group were both lower than those of the control group; (2) the sleep quality score of the study group was lower than that of the control group (P < 0.001); (3) the study group obtained higher limb function score and excellent-and-good rate than the control group (P < 0.05); (4) the pain score of the study group was lower than that of the control group (P < 0.05), and the time to functional exercise and length of hospital stay of the study group were shorter than those of the control group (P < 0.05); (5) patients in the study group had a lower complication rate than those in the control group (P=0.02); (6) the nursing satisfaction rating of the study group was higher than that of the control group (P < 0.001). CONCLUSION: For patients with osteosarcoma of the distal femur treated by artificial knee replacement, in addition to the amelioration of negative emotions and sleep quality, perioperative nursing also improves the patients' limb function and satisfaction and mitigates pain and complications.

A simple method for establishing an ostrich model of femoral head osteonecrosis and collapse.

BACKGROUND: This study aimed to develop a simple method of creating an animal model of non-trauma femoral head osteonecrosis and collapse using African ostriches with weights similar to those of humans. METHODS: Eighteen African ostriches were subjected to liquid nitrogen cryo-insult in the unilateral femoral head through surgical procedures using homemade cryogenic equipment combined with tract drilling inside the femoral head. Three animals were sacrificed at postoperative weeks 6 and 12, respectively, and the remaining animals were sacrificed at postoperative week 24. Bilateral femoral heads were harvested and subjected to gross observation, histological examination using hematoxylin and eosin staining, and radiographic examination. Micro-computed tomography was performed on a portion of the specimens at postoperative week 24, and angiographic examination of the femoral head was performed before sacrificing the animals. RESULTS: Eight ostriches developed a limp at postoperative week 8, with a mean duration of 16.5 weeks. The postoperative femoral head specimens showed changes in contour and articular cartilage degeneration. Sagittal sectioning of the collapsed femoral head specimens revealed distinct boundaries among the osteonecrotic areas, osteosclerotic areas, and normal trabeculae. Histological examinations revealed active bone resorption in the osteonecrotic area of the subchondral bone, an increased number of fat cells, and active trabecular bone regeneration in the osteosclerotic areas. The postoperative radiographic examinations revealed that the height of the femoral head gradually decreased and progressed to collapse. Micro-computed tomography scans showed the interrupted trabecular bone with an irregular shape in the collapsed femoral head. Compared with the normal samples, angiographic findings revealed interrupted blood supply of the cryo-injured samples in some areas of the femoral heads, blood vessel narrowing, and decreased number of blood vessels in the cryo-injured areas. CONCLUSION: This study indicates that an animal model of osteonecrotic femoral head progressing to collapse can be established via a simplified method of cryosurgery. This model possesses histological features that are similar to those of humans; thus, it can be used as an ideal animal model for the study of femoral head necrosis.