[Preliminary application of intraoperative CT in treatment of severe scoliosis with posterior total pedicle screws].

OBJECTIVE: To study the clinical effects and application value of intraoperative CT in treatment of severe scoliosis with posterior total pedicle screws. METHODS: Thirty-two cases of severe scoliosis were retrospectively analysed in our hospital from June 2009 to June 2011,which were treated by posterior total pedicle screws with intraoperative CT including 12 males and 20 females with an average age of 16.8 years ranging from 10 to 38 years. There were 19 cases combined with thoracic kyphosis among 32 cases. Multiple planar reconstruction technology of intraoperative CT was applied to assess screw position. The numbers (rates) of pedicle screws were calculated and evaluated as different grades in upper thoracic vertebra (T1-T4) ,middle thoracic vertebra (T5-T8), lower thoracic vertebra (T9-T12) and lumbar vertebra. The pedicle screws of 2 grade and 3 grade were defined as malpositioned screws. Times of applicating intraoperative CT were calculated. Cobb angle of all cases and kyphosis angle of the cases combined with thoracic kyphosis were measured before and after surgery. Scoliosis correction rates and kyphosis correction rates were calculated. RESULTS: There were 686 pedicle screws placed in thoracolumbar of 32 patients (including 544 thoracic pedicle screws,142 lumbar pedicle screws) and 14 patients underwent osteotomy. The rate of malpositioned screws in thoracolumbar was 7.3% by evaluating with intraoperative CT,and it respectively was 5.6%,11.1%, 6.7% and 4.3% in upper thoracic vertebra, middle thoracic vertebra,lower thoracic vertebra and lumbar vertebra. The malpositioned screws were amended in surgery. The mean times of intraoperative CT was 2.6 times (ranged from 2 times to 4 times). The mean preoperative Cobb angle was 95 degrees (ranged from 78 degrees to 123 degrees) and the mean postoperative Cobb angle was 340 (ranged from 19 degrees to 53 degrees). The mean correction rate of Cobb angle was 64%. The mean preoperative kyphosis angle of the patients combined with thoracic kyphosis was 69 degrees (ranged from 46 degrees to 82 degrees) and the mean postoperative kyphosis angle was 32 degrees (ranged from 22 degrees to 45 degrees). The mean correction rate of kyphosis angle was 54%. Four patients suffered cerebrospinal fluid leak after surgery. No infection, vascular lesion and nervous lesion were found. All patients had an average 18-month follow-up (ranged from 12 to 26 months). No broken nails, broken rods and pseudarthrosis were founded. CONCLUSION: Application of in traoperative CT in severe scoliosis with posterior total pedicle screws can detect and amend malpositioned screws timely in surgery, to avoid secondary surgery for malpositioned screws and protect the safety of surgery. The effects of surgery is satisfactory.

[Analysis on arthroscopic debridement and visco supplement for the treatment of degenerative osteoarthropathy of ankle].

OBJECTIVE: To evaluate effects of arthroscopic debridement and visco supplement for the treatment of degenerative osteoarthropathy of ankle. METHODS: From October 2008 to May 2012, 30 patients with degenerative osteoarthropathy of ankle were treated with arthroscopy after ineffective treatment with conservative methods. Two patients lost follow-up. Among the patients, 19 patients were male and 9 patients were female, ranging in age from 28 to 56 years old, with a mean of (40.0+ 5.9)years old. Patients who had inflammatory or postinfectious arthritis,rheumatoid,gout,tuberculosis were excluded. Other exclusion criteria included previous arthroscopic treatment for ankle osteoarthropathy, intraarticular corticosteroid injection within the previous 6 months, a major neurologic deficit, serious medical illness and pregnancy. Articular cartilage iijuries were classified according to Outerbridge by the same doctor. Follow procedures were involved in the surgery: synovectomy,debridement or excision of fragments of articular cartilage or chondral flaps and osteophytes that prevented full extension. Microfracture of chondral defects was not performed. Ogilvie-Harris criteria was used to evaluate therapeutic effects. RESULTS: According to Ogilvie-Harris criteria, 10 patients got an excellent results, 14 good, 3 poor and 1 bad. The mean VAS score of pain decreased from preoperative 7.5+/-1.3 to postoperative 2.4+/-2.3. The score of dorsiflexion range (ROM-D) had no obvious change after operation [preoperative(27.0+/-7.3)degree and postoperative(29.0+/-5.6)degree]. The mean Tegner score increased from preoperative 2.7+/-1.3 to postoperative 5.6+/-2.2. CONCLUSION: Synovectomy, debridement or excision of chondral flaps and osteophytes under arthroscopy, as well as scheduled intraarticular sodium hyaluronate injection should be recommened to treat ankle degenerative osteoarthropathy.

A series of lanthanide-organic polymers incorporating nitrogen-heterocyclic and aliphatic carboxylate mixed-ligands: structures, luminescent and magnetic properties.

Seven new lanthanide-organic coordination polymers incorporating both nitrogen heterocyclic dicarboxylate and various auxiliary ligands, {[Ln(3)(Hpimda)(4)(mu(2)-HCOO).5H(2)O].H(2)O}(n)} Ln = Sm (1), Ln = Eu (2), Ln = Gd (3), Ln = Dy (4), Ln = Ho (5), {[Ce(2)(Hpimda)(2)(mu(4)-C(2)O(4)).8H(2)O].2H(2)O}(n) (6), {[Yb(2)(pyda)(mu(4)-C(2)O(4))(2).4H(2)O].3H(2)O}(n) (7) (H(3)pimda = 1H-2-propyl-4,5-imidazoledicarboxylic acid, H(2)pyda = 2,6-pyridinedicarboxylic acid) have been fabricated successfully and characterized systematically. Complexes 1-5 are isomorphous and isostructural, and are built from two-dimensional (2-D) double-decker networks based on the tetranuclear basic carboxylate as a secondary building unit (SBU). Both polymers 6 and 7 feature a (3,4)-connected 3-D framework consisting of 2-D lanthanide-organic hexagonal grids, which are further interlinked via the mu(4)-oxalate ligand. The results of magnetic determination show the same end-to-end bridging fashion of formate group results in different magnetic properties occurring between lanthanide centers. The luminescence emission spectra of the complexes vary depending on the lanthanide ion present.