The biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury.

OBJECTIVE: Preexisting severe cervical spinal cord compression is a significant risk factor in cervical hyperextension injury, and the neurological function may deteriorate after a slight force to the forehead. There are few biomechanical studies regarding the influence of pathological factors in hyperextension loading condition. The aim of this study is to analyze the effects of preexisting different types of cervical disc herniation and different degrees of compression on the spinal cord in cervical hyperextension. METHOD: A 3D finite element (FE) model of cervical spinal cord was modeled. Local type with median herniation, local type with lateral herniation, diffuse type with median herniation, and diffuse type with lateral herniation were simulated in neutral and extention positions. The compressions which were equivalent to 10%, 20%, 30%, and 40% of the sagittal diameter of the spinal cord were modeled. RESULTS: The results of normal FE model were consistent with those of previous studies. The maximum von Mises stresses appeared in the pia mater for all 32 loading conditions. The maximum von Mises stresses in extension position were much higher than in neutral position. In most cases, the maximum von Mises stresses in diffuse type were higher than in local type. CONCLUSION: Cervical spinal cord with preexisting disc herniation is more likely to be compressed in hyperextension situation than in neutral position. Diffuse type with median herniation may cause more severe compression with higher von Mises stresses concentrated at the anterior horn and the peripheral white matter, resulting in acute central cord syndrome from biomechanical point of view.

Effects of contusion load on cervical spinal cord: A finite element study.

Injury of cervical spine is a common injury of locomotor system usually accompanied by spinal cord injury, however the injury mechanism of contusion load to the spinal cord is not clear. This study aims to investigate its injury mechanism associated with the contusion load, with different extents of spinal cord compression. A finite element model of cervical spinal cord was established and two scenarios of contusion injury loading conditions, i.e. back-to-front and front-to-back loads, were adopted. Four different compression displacements were applied to the middle section of the cervical spinal cord. The distributions of von Mises stress in middle transverse cross section were obtained from the finite element analysis. For the back-to-front loading scenario, the stress concentration was found in the area at and near the central canal and the damage may lead to the central canal syndrome from biomechanical point of view. With the front-to-back load, the maximum von Mises stress located in central canal area of gray matter when subject to 10% compression, whilst it appeared at the anterior horn when the compression increased. For the white matter, the maximum von Mises stress appeared in the area of the anterior funiculus. This leads to complicated symptoms given rise by damage to multiple locations in the cervical spinal cord. The illustrative results demonstrated the need of considering different loading scenarios in understanding the damage mechanisms of the cervical spinal cord, particularly when the loading conditions were given rise by different pathophysiological causes.

School bullying and its influencing factors in higher vocational college students in western Hunan province / 中国学校卫生

Objective@#To understand current situation and influencing factors of school bullying among left-behind and non left-behind students in vocational colleges in western Hunan, and to provide reference for the prevention and control of campus bullying in vocational colleges in poverty-stricken areas.@*Methods@#A multi-stage stratified random cluster sampling method was used to select 1 241 students from higher vocational colleges in Xiangxi for questionnaire survey. The survey included basic demographic characteristics, health-related behaviors and school bullying. Associcted factors were compared among students with and without school bullying by using the χ2 test and Logistic regression.@*Results@#The reported rate of school bullying in vocational colleges was 41.82%. The reported rate of left-behind students (45.05%) was higher than that of non-left-behind students (39.21%). The difference was statistically significant (χ2=4.29,P<0.05). Multivariate unconditional Logistic regression showed that male students and good parental relationship negatively associated with school bullying among left-behind students(OR=0.55，0.47). While rural students, 5 years of senior vocational, smoking, drinking, and game addiction were positively associated with school bullying among left-behind students(OR=1.93,2.57,2.51,3.95,4.73); good relationship with mothers was associated with less school bullying(OR=0.40), while smoke, drinking and game addiction was associated with more school bullying among non left-behind students(OR=1.86,2.32，3.81)(P<0.05).@*Conclusion@#School bullying among students in higher vocational colleges in western Hunan is highly prevalent. The reporting rate among left-behind students is higher than that of non-left-behind students. Due to different factors, joint intervention measures by government, schools and families should be carried out as soon as possible.

The Effect of Muscle Direction on the Predictions of Finite Element Model of Human Lumbar Spine.

The normal physiological loads from muscles experienced by the spine are largely unknown due to a lack of data. The aim of this study is to investigate the effects of varying muscle directions on the outcomes predicted from finite element models of human lumbar spine. A nonlinear finite element model of L3-L5 was employed. The force of the erector spinae muscle, the force of the rectus abdominis muscle, follower loads, and upper body weight were applied. The model was fixed in a neural standing position and the direction of the force of the erector spinae muscle and rectus abdominis muscle was varied in three directions. The intradiscal pressure, reaction moments, and intervertebral rotations were calculated. The intradiscal pressure of L4-L5 was 0.56-0.57 MPa, which agrees with the in vivo pressure of 0.5 MPa from the literatures. The models with the erector spinae muscle loaded in anterior-oblique direction showed the smallest reaction moments (less than 0.6 Nm) and intervertebral rotations of L3-L4 and L4-L5 (less than 0.2 degrees). In comparison with loading in the vertical direction and posterior-oblique direction, the erector spinae muscle loaded in the anterior-oblique direction required lower external force or moment to keep the lumbar spine in the neutral position.

Effect of Graded Facetectomy on Lumbar Biomechanics.

Facetectomy is an important intervention for spinal stenosis but may lead to spinal instability. Biomechanical knowledge for facetectomy can be beneficial when deciding whether fusion is necessary. Therefore, the aim of this study was to investigate the biomechanical effect of different grades of facetectomy. A three-dimensional nonlinear finite element model of L3-L5 was constructed. The mobility of the model and the intradiscal pressure (IDP) of L4-L5 for standing were inside the data from the literature. The effect of graded facetectomy on intervertebral rotation, IDP, facet joint forces, and maximum von Mises equivalent stresses in the annuli was analyzed under flexion, extension, left/right lateral bending, and left/right axial rotation. Compared with the intact model, under extension, unilateral facetectomy increased the range of intervertebral rotation (IVR) by 11.7% and IDP by 10.7%, while the bilateral facetectomy increased IVR by 40.7% and IDP by 23.6%. Under axial rotation, the unilateral facetectomy and the bilateral facetectomy increased the IVR by 101.3% and 354.3%, respectively, when turned to the right and by 1.1% and 265.3%, respectively, when turned to the left. The results conclude that, after unilateral and bilateral facetectomy, care must be taken when placing the spine into extension and axial rotation posture from the biomechanical point of view.

The effects of muscle weakness on degenerative spondylolisthesis: A finite element study.

BACKGROUND: Whether muscle weakness is a cause, or result, of degenerative spondylolisthesis is not currently well understood. Little biomechanical evidence is available to offer an explanation for the mechanism behind exercise therapy. Therefore, the aim of this study is to investigate the effects of back muscle weakness on degenerative spondylolisthesis and to tease out the biomechanical mechanism of exercise therapy. METHODS: A nonlinear 3-D finite element model of L3-L5 was constructed. Forces representing global back muscles and global abdominal muscles, follower loads and an upper body weight were applied. The force of the global back muscles was reduced to 75%, 50% and 25% to simulate different degrees of back muscle weakness. An additional boundary condition which represented the loads from other muscles after exercise therapy was set up to keep the spine in a neutral standing position. Shear forces, intradiscal pressure, facet joint forces and von Mises equivalent stresses in the annuli were calculated. FINDINGS: The intervertebral rotations of L3-L4 and L4-L5 were within the range of in vitro experimental data. The calculated intradiscal pressure of L4-L5 for standing was 0.57MPa, which is similar to previous in vivo data. With the back muscles were reduced to 75%, 50% and 25% force, the shear force moved increasingly in a ventral direction. Due to the additional stabilizing force and moment provided by boundary conditions, the shear force varied less than 15%. INTERPRETATION: Reducing the force of global back muscles might lead to, or aggravate, degenerative spondylolisthesis with forward slipping from biomechanical point of view. Exercise therapy may improve the spinal biomechanical environment. However, the intrinsic correlation between back muscle weakness and degenerative spondylolisthesis needs more clinical in vivo study and biomechanical analysis.

Analysis of risk factors for adjacent superior vertebral pedicle-induced facet joint violation during the minimally invasive surgery transforaminal lumbar interbody fusion: a retrospective study.

BACKGROUND: The purpose was to explore possible risk factors of facet joint violation induced by adjacent superior vertebral pedicle screw during the minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF). METHODS: A total of 69 patients with lumbar degenerative disease, who underwent MIS-TLIF were retrospectively reviewed. Postoperative computed tomography images were used to assess the facet joint violation. The correlation of facet joint violations with gender, age, body mass index (BMI), the adjacent superior vertebral level, fusion segment numbers, position of screw insertion, straight leg-raising test (SLRT) results, clinical diseases and renal dysfunction were analyzed by Chi-square tests and binary logistic regression analysis. RESULTS: The incidence of adjacent superior facet joint violations was 25.4 %. Chi-square test showed the patients with age <60 and high BMI (≥30 kg/m(2)) were more prone to have facet joint violations (P = 0.007; P = 0.006). The single segment fusion presented more facet joint violations than the double segments fusion (P = 0.048). The vertebral pedicle screw implant location at L5 showed more facet joint violations compared with that at L3 and L4 (P = 0.035). No correlation was found between gender, screw implant position, SLRT results, clinical diseases and renal dysfunction and facet joint violations. Logistic regression analysis revealed that age <60 years (OR: 2.902; 95 % CI 1.227-6.864; P = 0.015) and BMI ≥30 kg/m(2) (OR: 2.825; 95 % CI 1.191-6.700; P = 0.018 < 0.05) were significantly associated with facet joint violation. CONCLUSION: These results found a high incidence of adjacent superior vertebral facet joint violation in the MIS-TLIF. Age <60 and BMI ≥30 kg/m(2) might be risk factors of facet joint violation. Evidence level: Level 4.

The strain at bone-implant interface determines the effect of spinopelvic reconstruction following total sacrectomy: a strain gauge analysis in various spinopelvic constructs.

PURPOSE: There is still some controversy regarding the optimal biomechanical concept for spinopelvic stabilization following total sacrectomy for malignancy. Strains at specific anatomical sites at pelvis/sacrum and implants interfaces have been poorly investigated. Herein, we compared and analyzed the strains applied at key points at the bone-implant interface in four different spinopelvic constructs following total sacrectomy; consequently, we defined a balanced architecture for spinopelvic fusion in that situation. METHODS: Six human cadaveric specimens, from second lumbar vertebra to proximal femur, were used to compare the partial strains at specific sites in a total sacrectomy model. Test constructs included: (1) intact pelvis (control), (2) sacral-rod reconstruction (SRR), (3) bilateral fibular flap reconstruction (BFFR), (4) four-rods reconstruction (FRR), and (5) improved compound reconstruction (ICR). Strains were measured by bonded strain gauges onto the surface of three specific sites (pubic rami, arcuate lines, and posterior spinal rods) under a 500 N axial load. RESULTS: ICR caused lower strains at specific sites and, moreover, on stress distribution and symmetry, compared to the other three constructs. Strains at pubic rami and arcuate lines following BFFR were lower than those following SRR, but higher at the posterior spinal rod construct. The different modes of strain distribution reflected different patient's parameter-related conditions. FRR model showed the highest strains at all sites because of the lack of an anterior bracing frame. CONCLUSIONS: The findings of this investigation suggest that both anterior bracing frame and the four-rods load dispersion provide significant load sharing. Additionally, these two constructs decrease the peak strains at bone-implant interface, thus determining the theoretical surgical technique to achieve optimal stress dispersion and balance for spinopelvic reconstruction in early postoperative period following total sacrectomy.

[Unilateral versus bilateral pedicle fixation at the level of fracture in the treatment of thoracolumbar fractures with mild to moderate instability].

OBJECTIVE: To evaluate the efficacies of unilateral versus bilateral pedicle screw fixation through the pedicle of fractured vertebra plus short-segment pedicle instrumentation (SSPI) in the treatment of thoracolumbar fractures. METHODS: Between June 2008 and September 2010, a total of 46 patients with fractures of thoracolumbar junction, whose scores of load sharing classification (LSC) ranging from 5 to 7, underwent the combined treatment of SSPI and fracture level pedicle screw at our department. They were divided into 2 groups. Group I included 25 patients undergoing SSPI plus unilateral pedicle screw fixation through the pedicle of fractured vertebra (5 screws) while Group II included 21 patients had SSPI plus bilateral pedicle screw fixation through the pedicle of fractured vertebra (6 screws). The data of anterior body height compression (AVHC), sagittal Cobb's angle, internal fixation failure, restoration of nervous function, visual analogue score (VAS) and Oswestry disability index (ODI) were analyzed. RESULTS: The groups were similar with regards to age, gender, LSC, AVHC and sagittal Cobb's angle preoperatively. Blood loss volume and operative duration were less in the Group I (109.2 ± 30.68 vs 110.0 ± 32.06 min, t = -0.086, P > 0.05 and 376.0 ± 303.1 vs 409.5 ± 361.1 ml, t = -0.342, P > 0.05). They were followed up for a minimum period of 12 months. In follow-up period was 17.48 ± 4.14 months in Group I versus 18.33 ± 4.31 months in Group II (t = -0.683, P > 0.05). All patients with initial partial neurologic deficits improved at the final follow-up. Radiographic parameters and clinical outcomes were similar in both groups. CONCLUSIONS: Pedicle screw fixation through the pedicle of fractured vertebra plus SSPI is an excellent surgical therapeutic choice for patients with a LSC range of 5-7 thoraclumbar fractures. The efficacies of unilateral and bilateral pedicle screw fixation at fracture level are the same.

Formative mechanism of intracanal fracture fragments in thoracolumbar burst fractures: a finite element study.

BACKGROUND: Thoracolumbar burst fracture is a common clinical injury, and the fracture mechanism is still controversial. The aim of this research was to study the formation of intracanal fracture fragments in thoracolumbar burst fractures and to provide information for the prevention of thoracolumbar bursts fractures and reduction of damage to the nervous system. METHODS: A nonlinear three-dimensional finite element model of T11-3 segments was established, and the injury processes of thoracolumbar bursts were simulated. The intact finite element model and the finite element model after the superior articular were impacted by 100 J of energy in different directions. The distribution and variation of stress in the superior posterior region of the L1 vertebral body were analyzed. Abaqus 6.9 explicit dynamic solver was used as finite element software in calculations. RESULTS: A three-dimensional nonlinear finite element model of the thoracolumbar spine was created. In the intact model, stress was concentrated in the superior posterior region of the L1 vertebral body. The stress peak was a maximum for the extension impact load and a minimum for the flexion impact load. The stress peak and contact force in the facet joint had close correlation with time. The stress peak disappeared after excision of the superior articular process. CONCLUSIONS: The three-dimensional nonlinear finite element model was suitable for dynamic analysis. The contact force in the facet joint, which can be transferred to the superior posterior vertebral body, may explain the spinal canal fragment in thoracolumbar burst fractures.

Pedicle screw fixation for traumatic fractures of the thoracic and lumbar spine.

BACKGROUND: Spine fractures are common. The treatment of traumatic fractures of the thoracic and lumbar spine remains controversial but surgery involving pedicle screw fixation has become a popular option. OBJECTIVES: To assess the effects (benefits and harms) of pedicle screw fixation for traumatic fractures of the thoracic and lumbar spine. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (March 2011), the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library, 2011 Issue 1), MEDLINE (1948 to March 2011), EMBASE (1980 to 2011 Week 11), the Chinese Biomedical Database (CBM Database) (1978 to March 2011), the WHO International Clinical Trials Registry Platform (March 2011), reference lists of articles and conference proceedings. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing pedicle screw fixation and other methods of surgical treatment, or different methods of pedicle screw fixation, for treating traumatic fractures of the thoracic and lumbar spine. DATA COLLECTION AND ANALYSIS: Three review authors independently performed study selection, risk of bias assessment and data extraction. Limited meta-analysis was performed. MAIN RESULTS: Pedicle screw fixation versus other methods of surgery that do not involve pedicle screw fixation was not looked at in any of the identified trials. Studies that were identified investigated different methods of pedicle fixation.Five randomised and three quasi-randomised controlled trials were included. All were at high or unclear risk of various biases, including selection, performance and detection bias. A total of 448 patients with thoracic and lumbar spine fractures were included in the review. Participants were restricted to individuals without neurological impairment in five trials. The mean ages of study populations of the eight trials ranged from 33 to 41 years, and participants had generally experienced traumatic injury. Mean follow-up for trial participants in the eight trials ranged from 28 to 72 months.Five comparisons were tested.Two trials compared short-segment instrumentation versus long-segment instrumentation. These studies found no significant differences between the two groups in self-reported function and quality of life at final follow-up. Aside from one participant, who sustained partial neurological deterioration that was resolved by further surgery (group not known), no neurological deterioration was noted in these trials.One trial comparing short-segment instrumentation with transpedicular bone grafting versus short-segment fixation alone found no significant difference between the two groups related to patient-perceived function and pain at final follow-up. All participants had normal findings on neurological examination at final follow-up.Two trials compared posterior instrumentation with fracture level screw incorporation ('including' group) versus posterior instrumentation alone ('bridging' group). Investigators reported no differences between the two groups in patient-reported function, quality of life, or pain at final follow-up. One trial confirmed that all participants had normal findings on neurological examination at final follow-up.One trial comparing monosegmental pedicle screw instrumentation versus short-segment pedicle instrumentation found no significant differences between the two groups in Oswestry Disability Index results or in pain scores at final follow-up. No neurological deterioration was reported.Three trials compared posterior instrumentation with fusion versus posterior instrumentation without fusion. Researchers found no differences between the two groups in function and quality of life or pain. No participants showed a decline in neurological status in any of the three trials, and no significant difference was reported between groups in the numbers whose status had improved at final follow-up. Two trials stated that patients in the fusion group frequently had donor site pain. Other reported complications included deep vein thrombosis and superficial infection. AUTHORS' CONCLUSIONS: This review included only eight small trials and five different comparisons of methods of pedicle fixation in various participants while looking at a variety of outcomes at different time points. Overall, evidence is insufficient to inform the selection of different methods of pedicle screw fixation or the combined use of fusion. However, in the absence of robust evidence to support fusion, it is important to factor the risk of long-term donor site pain related to bone harvesting into the decision of whether to use this intervention. Further research involving high-quality randomised trials is needed.

[Efficacy analysis of intermediate screws technique plus injectable calcium sulfate for thoracolumbar fracture in postmenopausal patients].

OBJECTIVE: To explore the clinical efficacies of intermediate screws plus injectable calcium sulfate MIIGX3 for thoracolumbar fracture in postmenopausal patients. METHODS: A total of 21 postmenopausal patients with vertebral compression fractures reconstructed with posterior internal fixation of intermediate screws technique and anterior vertebral augmentation of MIIGX3 technique in three dimension were retrospectively analyzed. The changes of fracture vertebral height and Cobb's angle were compared.Visual analogue scale (VAS) was performed to evaluate their symptoms. All patients were followed up. RESULTS: Intermediate screws surgical technique plus MIIGX3 was successfully performed. The average injection dose was 4.6 ml.Leakage occurred intraoperatively in two cases. The average follow-up period was 15 (6-36) months. The VAS system demonstrated that pain decreased significantly (preoperative:7.8, postoperative:2.2). The height and Cobb's angle of fractured vertebra improved greatly. The preoperative values were 45.0 ± 6.4% and 19.4 ± 4.5° and postoperative ones 15.4 ± 3.9% and 8.64 ± 3.18° respectively. There was no occurrence of severe complications related with treatment.Except for 2 patients with a loss of 15% of vertebral height, the average heights of fractured vertebra in other 19 patients recovered to 85% of normal ones. CONCLUSION: Thoracolumbar fracture in postmenopausal patients may be managed satisfactorily by intermediate screws and injectable calcium sulfate technique.Such a technique is both safe and effective. And its stable and durable reduction offers significant improvement.

[Unilateral pedicle screw fixation through the pedicle of fractured vertebra in combination with the short segment of pedicle screw in the treatment of thoracolumbar fracture of mild to moderate instability].

OBJECTIVE: To evaluate the efficacy of unilateral pedicle screw fixation through the pedicle of fractured vertebra in combination with the short segment of pedicle screw in the treatment of thoracolumbar fracture of mild to moderate instability. METHODS: Twenty-six patients with single segment thoracolumbar fracture received unilateral pedicle screw fixation through the pedicle of fractured vertebra in combination with the short segment of pedicle screw from January 2008 to December 2009. There were 16 patients were male and 10 were female with an average age of 47.3 years (range from 39 to 60 years). Fracture severity score was constructed by using the load-sharing classification (4 points for 2 cases, 5 points for 14 cases, 6 points for 10 cases). By Frankel assessment system, 2 cases were in grade C, 3 in grade D, 21 in grade E. The assessment included anterior vertebral body height, the sagittal Cobb angle, the restoration of nervous function, visual analogue score (VAS) and Oswestry disability index (ODI). RESULTS: The follow-up after the surgery was 13 - 26 months, with an average of 18.6 months. There were no fixation failure, defined as implant failure or ≥ 10° correction loss. The neurological status of 4 patients, who had an associated neurologic deficit preoperatively, was completely recovered. The Frankel grade of another case was re-rated D from the original C. The mean anterior vertebral body height increased from 57.0% ± 6.3% before the surgery to 93.1% ± 1.7% at the last follow-up(F = 455.276, P < 0.05). The sagittal Cobb angle decreased from 15.6° ± 4.7° before the surgery to 2.6° ± 5.2° at the last follow-up (F = 34.623, P < 0.05). VAS and ODI were 1.0 ± 0.7 and 17.0 ± 5.9 at the last follow-up. CONCLUSION: Unilateral pedicle screw fixation through the pedicle of fractured vertebra combined with the short segment of pedicle screw is effective for thoracolumbar fracture with mild to moderate instability.

[Building an effective nonlinear three-dimensional finite-element model of human thoracolumbar spine].

OBJECTIVE: To build an effective nonlinear three-dimensional finite-element (FE) model of T(11)-L(3) segments for a further biomechanical study of thoracolumbar spine. METHODS: The CT (computed tomography) scan images of healthy adult T(11)-L(3) segments were imported into software Simpleware 2.0 to generate a triangular mesh model. Using software Geomagic 8 for model repair and optimization, a solid model was generated into the finite element software Abaqus 6.9. The reasonable element C3D8 was selected for bone structures. Created between bony endplates, the intervertebral disc was subdivided into nucleus pulposus and annulus fibrosus (44% nucleus, 56% annulus). The nucleus was filled with 5 layers of 8-node solid elements and annulus reinforced by 8 crisscross collagenous fiber layers. The nucleus and annulus were meshed by C3D8RH while the collagen fibers meshed by two node-truss elements. The anterior (ALL) and posterior (PLL) longitudinal ligaments, flavum (FL), supraspinous (SSL), interspinous (ISL) and intertransverse (ITL) ligaments were modeled with S4R shell elements while capsular ligament (CL) was modeled with 3-node shell element. All surrounding ligaments were represented by envelope of 1 mm uniform thickness. The discs and bone structures were modeled with hyper-elastic and elasto-plastic material laws respectively while the ligaments governed by visco-elastic material law. The nonlinear three-dimensional finite-element model of T(11)-L(3) segments was generated and its efficacy verified through validating the geometric similarity and disc load-displacement and stress distribution under the impact of violence. Using ABAQUS/ EXPLICIT 6.9 the explicit dynamic finite element solver, the impact test was simulated in vitro. RESULTS: In this study, a 3-dimensional, nonlinear FE model including 5 vertebrae, 4 intervertebral discs and 7 ligaments consisted of 78 887 elements and 71 939 nodes. The model had good geometric similarity under the same conditions. The results of FEM intervertebral disc load-displacement curve were similar to those of in vitro test. The stress distribution results of vertebral cortical bone, posterior complex and cancellous bone were similar to those of other static experiments in a dynamic impact test under the observation of stress cloud. CONCLUSION: With the advantages of high geometric and mechanical similarity and complete thoracolumbar, hexahedral meshes, nonlinear finite element model may facilitate the impact loading test for a further dynamic analysis of injury mechanism for thoracolumbar burst fracture.

Diagnosis and treatment of acute mesenteric venous thrombosis in elderly patients / 中华老年医学杂志

Objective To investigate the clinical characteristics, diagnosis and treatment of acute mesenteric venous thrombosis(MVT) in the elderly. Methods The clinical features, diagnosis, treatments and prognosis of 10 aged cases with acute MVT were retrospectively analyzed. Results The chief complaints of the 10 cases were different degrees of abdominal pain, which not paralleled with abdominal signs. The accompanying symptoms were nausea, vomiting and bloody stools and so on. All of these patients were misdiagnosised as pancreatitis, appendicitis or intestinal obstruction and so on. diagnosis of two cases was confirmed by ultrasound, 8 by CT. At the same time, 2 cases underwent angiography examination. Of the 8 cases who underwent operation, 5 cases were cured, 3 cases died (1 died of toxic shock and 2 died of multiple organ failure ). Two cases underwent conservative intervention thrombolysis. Conclusions It is essential to improve the knowledge of acute MVT,especially its intricate clinical characteristics, high rates of misdiagnosis and mortality. Early proper diagnosis is crucial. The main treatment is operation and conservative intervention thrombolysis can be performed in the patients whose bowel has not necrosed yet.