Zhongguo gu shang = China journal of orthopaedics and traumatology最新文献

{"title":"[Lumbar disc nucleus pulposus excision by percutaneous endoscopic interlaminar approach for single segment giant lumbar disc herniation in young adults].","authors":"Kang Chen, Fu-Guo Yang, Yuan-Chao Luo, Ren-Jian He, Hong-Jie Huang","doi":"10.12200/j.issn.1003-0034.20240377","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20240377","url":null,"abstract":"<p><strong>Objective: </strong>To explore feasibility, clinical and imaging outcomes of percutaneous endoscopic interlaminar discectomy (PEID) for single level large lumbar disc herniation(LDH).</p><p><strong>Methods: </strong>From October 2018 to March 2023, 31 patients with single level LDH treated with PEID were retrospectively analyzed. Among patients, including 18 males and 13 females, aged from 15 to 40 years old with an average of (28.5±7.4) years old;L<sub>4,5</sub> in 10 patients, L<sub>5</sub>S<sub>1</sub> in 21 patients;14 patients on the left side, 17 patients on the right side;the courses of disease ranged from 3 to 19 months with an average of (6.8 ± 3.1) months. Operation time, blood loss, fluoroscopy times and hospital stay were observed. Visual analogue scale (VAS) was used to evaluate low back and leg pain, Oswestry disability index (ODI) was used to evaluate lumbar function, modified MacNab was used to evaluate clinical efficacy at the latest follow-up. Median sagittal diameter of spinal canal, effective sagittal diameter of spinal canal, spinal canal area, and dural sac area were used to evaluate spinal decompression. Anterior, middle, and posterior heights of intervertebral space were used to evaluate intervertebral space changes.</p><p><strong>Results: </strong>All patients were performed spinal endoscopic surgery, operation time ranged from 30 to 71 min with an average of (48.7±14.2) min, blood loss ranged from 10 to 40 ml with an average of (21.1±7.0) ml, and intraoperative fluoroscopy times ranged from 4 to 7 with an average of (4.7±0.7). The hospital stay ranged from 3 to 8 days with an average of (5.1±1.3) days, and postoperative follow-up ranged from 12 to 34 months with an average of (16.9±4.1) months. VAS of low back pain before operation and 3, 6 months after operation, the latest follow-up were (6.2±1.8), (1.4±0.8), (1.9±0.7), (1.6±0.6), respectively;VAS of leg pain were (7.6±1.6), (1.8±0.9), (1.6±0.6), (1.4±0.7), respectively;ODI were (35.74±4.62), (6.68±1.78), (6.90±1.85), (7.10±1.94), respectively;postoperative lower back pain and leg pain VAS and ODI were significantly improved at all time points after operation (<i>P</i><0.05). Postoperative VAS of low back pain at 6 months was higher than that of 3 months after operation (<i>P</i><0.05). At the laest follow-up, 14 patients were excellent, 15 good, and 2 acceptable according to modified MacNab standard. Median diameters of spinal canal were (0.77±0.18) and (1.18±0.24) cm before operation and at the latest follow-up. The effective diameters of spinal canal were (0.48±0.17) and (0.89±0.23) cm, respectively. The vertebral canal areas were (0.90±0.22) and (1.68±0.43) cm<sup>2</sup>, respectively. Dural sac areas were (0.41±0.10) and (0.81±0.24) cm<sup>2</sup>, respectively. At the least follow-up, median diameter, effective diameter, area of spinal canal and dural sac were significantly increased compared with those before operation (<i>P</i><0.05). Anterior verte","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1173-9"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Delayed displacement of stable sacral incomplete fracture:a case report].","authors":"Hui Ye, Qiong-Jie Chen, Zhao-Fang Pan, Wang-Yi Pan, Ning Zhang","doi":"10.12200/j.issn.1003-0034.20230800","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230800","url":null,"abstract":"","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1232-6"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Symptomatic spinal epidural hematoma after percutaneous vertebroplasty for Kümmell disease:a case report].","authors":"Guo-Jun Wang, Yu-Zhang Liu, Jiao Jin, Hai Lin, Fu-Dong Shi, Chun Chen, Guan-Nan Wu, Zuo-Xu Li, Shi-Min Zhang","doi":"10.12200/j.issn.1003-0034.20231069","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20231069","url":null,"abstract":"","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1229-31"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application of Solis fusion device in adjacent segment degeneration revision after anterior cervical discectomy bone grafting fusion].","authors":"Zheng Liu, Yu-Liang Lou, Hui Fei, Ren-Fu Quan","doi":"10.12200/j.issn.1003-0034.20230543","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230543","url":null,"abstract":"<p><strong>Objective: </strong>To observe the early clinical efficacy of the zero-remember cervical Solis fusion device in the treatment of adjacent segment degeneration(ASD) revision after anterior cervical discectomy and fusion(ACDF).</p><p><strong>Methods: </strong>A retrospective analysis was performed for 13 patients with adjacent spondylosis after anterior cervical discectomy bone graft fusion with Solis fusion device, including 5 males and 8 females, aging from 56 to 78 years old. The patients had intractable neck pain or superficial paresthesia of upper extremities before operation, and the effect of conservative treatment was not good. The operation time, intraoperative blood loss and postoperative complications were recorded. Before operation, 1 week postoperative and final follow-up, the visual analogue scale(VAS) and Japanese Orthopaedic Association(JOA) scores were used to assess clinical efficacy. X-ray and CT of the cervical spine were performed to measure and evaluate the height of the intervertebral space and intervertebral fusion.</p><p><strong>Results: </strong>All patients were followed up from 18 to 36 months. All 13 patients successfully completed revision surgery with single gaps. The operation time was 63 to 93 min, the intraoperative blood loss was 15 to 83 ml. The pain VAS was reduced from 4 to 7 points before surgery to 1 to 3 points at 1 week and 1 to 2 points at the final follow-up. The height of the intervertebral space was increased from 5.2 to 7.2 mm before surgery to 6.4 to 8.0 mm at 1 week after surgery and 6.4 to 7.9 mm at the final follow-up. The JOA score was increased from 11 to 17 points before surgery to 13 to 17 points at 1 week after surgery and 16 to 17 points at the final follow-up visit. At the final follow-up, AP and lateral X-ray films of cervical spine showed homogeneous bone fusion of the Solis fusion. One patient developed transient left upper limb weakness after surgery, which recovered at follow-up, and all patients had no dysphagia, incision hematoma or infection, and displacement.</p><p><strong>Conclusion: </strong>The early clinical efficacy of Solis fusion device in the treatment of orthospondylosis after anterior cervical intervertebral fusion is satisfactory, and it has the advantages of less surgical trauma, adequate decompression, high osseointegration rate and fewer complications, which can provide a new option for minimally invasive treatment of orthospondylosis after cervical spine surgery.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 11","pages":"1056-61"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Manipulation treatment of lumbar disc herniation based on the model of muscles and bones assessment].","authors":"Bin Xue, Tao Liu, Hong Zhu, Fei-Yue Li, Jia-Yu Zhang, Qiang Wang, Xiao-Bing Xi, Ling-Jun Kong, Xin Zhou, Qing-Guang Zhu, Min Fang","doi":"10.12200/j.issn.1003-0034.20230773","DOIUrl":"10.12200/j.issn.1003-0034.20230773","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the effectiveness of manipulation treatment for lumbar disc herniation (LDH) based on the model of muscle and bone assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From May 2022 to August 2023, using the methods single-center randomized controlled in &lt;i&gt;Ruijin&lt;/i&gt; Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 72 patients were treated with LDH and divided into muscle and bone assessment model manipulation group and the two step seven gimmick group according to the random number table method, the muscle and bone assessment model manipulation group fall off in 1 case, the two step seven gimmick group falls off in 2 cases. There were 35 cases in the muscle and bone assessment model manipulation group, including 12 males and 23 females;The age was 27 to 48 years old with an average of (37.77±7.63) years old. The course of disease was 35 to 180 days with an average of (83.68±69.01) days. The patients were treated with manual therapy under the guidance of muscle and bone assessment model, twice a week for 4 weeks. There were 34 cases in the two step seven gimmick group including 12 males and 22 females;The age was 26 to 49 years old with an average of (37.59±7.43) years old;The course of disease was 40 to 175 days with an average of (82.15±68.87) days. The patients were treated with two step seven gimmick method, 2 times a week, for 4 weeks. The visual analogue scale (VAS) and Oswestry disability index (Oswestry disability index, ODI) questionnaire, muscle tension and lumbar spine angle and the straight leg-raising activities were compared between two groups before and 4 weeks after treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The VAS of the muscle and bone assessment model manipulation group and the two step seven gimmick group(6.51±0.61) and (6.62±0.56) before treatment decreased to 2.40±0.81 and 3.18±0.78 after 4 weeks of treatment, respectively, and the muscle and bone assessment model manipulation group was significantly lower than the two step seven gimmick group (&lt;i&gt;P&lt;/i&gt;&lt;0.01). The ODI of the muscle and bone assessment model manipulation group and the two step seven gimmick group were (64.57±5.11) and (65.02±5.18) before treatment, decreased to (18.60±2.27) and (24.70±2.14) after 4 weeks of treatment, and the ODI of the muscle and bone assessment model manipulation group was significantly lower than that of the two step seven gimmick group (&lt;i&gt;P&lt;/i&gt;&lt;0.01). Before the treatment, side erector spinae, gluteus medius, and gastrocnemius muscle tension were (59.95±2.60), (62.59±2.51), (49.97±2.01) in the muscle and bone assessment model manipulation group and (60.39±3.84), (62.47±3.27), (49.55±1.27) in the two step seven gimmick group;After 4 weeks of treatment, the muscle tension of erector spinae, gluteus medius and gastrocnemius on the affected side were (56.58±2.71), (60.44±2.31) and (49.19±1.57) in the muscle and bone assessment model manipulation group, (58.28±3.79), (60.11±2.87), (48.","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 11","pages":"1080-6"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Relationship between cortical fragments and avascular necrosis of femoral head in young adult femoral neck fractures based on CT imaging].","authors":"Mang-Mang Chen, Xiao-Sheng Cai, Yang-Xun Lyu, Sheng-Lei Lin, Li-Peng Huang, Zhou Lin","doi":"10.12200/j.issn.1003-0034.20230118","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230118","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effect of femoral neck cortical fragments and surfacial area on avascular necrosis(AVN) after internal fixation of femoral neck fractures based on CT imaging in young adult.</p><p><strong>Methods: </strong>From January 2011 to January 2021, 218 young and middle-aged patients with femoral neck fractures were reverse triangle fixed with three cannulated lag screws, including 104 males and 114 females;aged 19 to 60 years old with a mean of (48.22±10.58) years old. The preoperative waiting time≤48 h was 155 cases, and the preoperative waiting time> 48 h was 63 cases; 68 cases were comminuted cortex of the femoral neck, 32 of them with superficial area of the comminuted cortex>25 mm². All patients were followed up for at least 2 years, the age, gender, injury side, body mass index, injury mechanism, preoperative waiting time, operation time, Garden classification, whether femoral neck cortex fracture and size by CT analysis and complications were analyzed the correlation to the definite occurrence of AVN. The AVN group and the non-AVN group were divided according to the final efficacy results.Univariate analysis yielded significant independent variables, Multiple Logistic regression analysis was further performed to identify the independent risk factors for AVN.</p><p><strong>Results: </strong>By univariate analysis, the AVN and non-AVN groups were significant in injury mechanism(<i>χ</i>²=18.552, <i>P</i>=0.000), preoperative waiting time( <i>χ</i>²=2.065, <i>P</i>=0.033), Garden classification (<i>χ</i>²=12.598, <i>P</i>=0.006), comminuted cortex (<i>χ</i>²=16.357, <i>P</i>=0.000), and the superficial area of the comminuted cortex(<i>χ</i>²=23.371, 0.000, <i>P</i>=0.000). Multiple Logistic regression indicated injury mechanism high energy injury[<i>Exp(B)</i>=3.487, 95%<i>CI</i>(1.583, 10.464), <i>P</i>=0.002], comminuted cortex of the femoral neck[<i>Exp(B)</i>=2.494, 95%<i>CI</i>(1.315, 10.861), <i>P</i>=0.002];the superficial area of the comminuted cortex>25 mm²[<i>Exp(B)</i>=22.161, 95%<i>CI</i>(3.922, 1242.828), <i>P</i>=0.001] were independent risk factors for AVN after internal fixation of femoral neck fractures.</p><p><strong>Conclusion: </strong>High energy injury mechanism, with comminuted cortex of the femoral neck and the superficial area of the comminuted cortex> 25 mm² were independent risk factors for AVN.The larger the superficial area of the cortex fragment may suggest more complicated injury mechanism and worse outcome.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 11","pages":"1096-100"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correlation analysis of the effect of postoperative drainage on surgical efficacy of thoracolumbar fractures through multifidus interspace approach].","authors":"Fan Bai, Ling-Ting Wang","doi":"10.12200/j.issn.1003-0034.20230233","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230233","url":null,"abstract":"<p><strong>Objective: </strong>To investigate correlation of the effect factors on surgical efficacythe of whether postoperative drainage through the multifidus interspace approach in the treatment of thoracolumbar fractures.</p><p><strong>Methods: </strong>A total of 66 patients with thoracolumbar fractures admitted from January 2017 to December 2021 were retrospectively analyzed. According to whether postoperative drainage, 36 patients were in drainage group and 30 patients were in no drainage group. In the drainage group, there were 17 males and 19 females with an average age of (55.4±9.5) years old ranging from 23 to 68 years old;in the no drainage group, there were 16 males and 14 females with an average age of (53.9±8.3) years ranging from 30 to 69 years old. A multifidus interspace approach was used in both groups. Then factores of age, gender, fracture site, injured segment, operation time, intraoperative blood loss, preoperative Cobb angle, preoperative vertebral anterior height ratio, preoperative Japanese 0rthopaedic Association(J0A) score, preoperative visual ana1ogue scale(VAS), preoperative Oswestry Disability Index(ODI) score may affect the postoperative drainage, using univariate and multivariate Logistic regression analysis to study their influence on the prognosis. The postoperative Cobb angle, anterior vertebral height ratio, JOA score, VAS and ODI were compared between the two groups.</p><p><strong>Results: </strong>Univariate analysis showed that whether postoperative drainage may be related to patient age, whether injury to multiple segments, operation time, and intraoperative blood loss(<i>P</i><0.05). The multivariate analysis showed that age, operation time were the main factors affecting postoperative drainage(<i>P</i><0.05). There was no significant difference in Cobb angle, anterior vertebral height loss rate, JOA score, VAS score and ODI score between the two groups at the postoperative follow-up(<i>P</i>>0.05). In terms of complications, the total incidence of postoperative low back pain in the no drainage group was lower than that in the drainage group(<i>P</i><0.05). There was no significant difference in postoperative infection and postoperative nerve loss between the two groups(<i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Age and operation time are the main factors affecting the postoperative drainage through multifidus interspace approach for thoracolumbar fractures. And no drainage does not affect the long-term effect of the operation, on the contrary, no drainage can reduce the method of low back pain and obtain more benefits.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 11","pages":"1062-8"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Unilateral biportal endoscopic posterior cervical foraminotomy for cervical radiculopathy].","authors":"Wei Cheng, Yu-Jun Zhang, Rong-Xue Shao, Cheng-Yue Zhu, Dong Wang, Jia-Ming Liang, Wei Zhang, Hao Pan","doi":"10.12200/j.issn.1003-0034.20230462","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230462","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical efficacy of posterior unilateral biportal endoscopic(UBE) cervical discectomy for cervical radiculopathy under general anesthesia.</p><p><strong>Methods: </strong>A retrospective analysis of 35 patients with cervical disc herniation uderwent posterior UBE cervical discectomy under general anesthesia from March 2021 to March 2023 was performed, including 17 males and 18 females, with an average age of (56.00±7.79) years old ranging from 42 to 69 years old. The non-operative treatment time was 6 to 27 weeks with an average of(16.03±4.56) weeks. MRI showed lateral cervical disc herniation in 19 cases and foraminal cervical disc herniation in 8 cases. The pathological segments distribution was as follows L_4,5 in 5 cases, C_5,6 in 12 cases C_6,7 in 18 cases. CT/MRI was performed 1 to 3 d after surgery to evaluate the decompression, and the visual analogue scale(VAS), the Japanese Orthopedic Association(JOA) score, the stability of cervical spine surgery segment and the change of intervertebral height were recorded.</p><p><strong>Results: </strong>All 35 patients successfully completed the operation, and the operation time was (55.88±5.02) min, the hospital stay after surgery (3.53±0.74) d. All 35 patients were followed up from 12 to 24 months with an average of (14.53±2.32) months. The VAS of preoperative, postoperative 1 day and 12 months were (7.000±0.875), (2.540±0.611), (2.143±0.772), respectively, the VAS at each time point before and after surgery were statistically significant(<i>P</i><0.05). The JOA scores of preoperative, postoperative 1 day and 12 months were (11.660±0.533), (16.430±0.655), (16.540±0.611), respectively. The intervertebral height of the lesion segment at preoperative and 12 months was (6.206±0.493) mm and (6.147±0.497) mmm, respectively, and the difference was not statistically significant(<i>P</i>>0.05). None of the patients had cervical spine segment instability before or after surgery. According to the modified Macnab criteria, the clinical efficacy was evaluated at 12 months after operation, 32 cases were excellent, 2 cases were good, and 1 case was good.</p><p><strong>Conclusion: </strong>UBE cervical discectomy is a minimally invasive, safe and effective surgical method for the treatment of single-segment cervical disc herniation, which may be an alternative to the treatment of cervical foraminal herniation, but due to the small sample size and short follow-up time, its long-term efficacy needs to be further observed.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 11","pages":"1046-50"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparison of the stability of dual INFIX and INFIX combined with sacroiliac screw fixation for C1 type pelvic fractures].","authors":"Dong-Qing Cui, Jin-Jie Wei, Hai-Yu Sun","doi":"10.12200/j.issn.1003-0034.20240300","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20240300","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the biomechanical stability of dual anterior subcutaneous internal fixation (INFIX) in pelvic C1 fractures by finite element analysis, and to compare it with INFIX combined with sacroiliac screws to determine whether it is sufficient to replace the combined fixation of anterior and posterior rings.</p><p><strong>Methods: </strong>The pelvic CT data of a 43-year-old female volunteer were imported into the computer and the normal pelvic model and pelvic C1 fractures model were constructed using Mimics, Workbench and other software. The latter was fixed with dual INFIX and INFIX combined with sacroiliac screws, respectively. First, the effectiveness of the normal pelvic model in anatomical landmarks, stress conduction and displacement distribution was verified. Then, a vertical downward load of 500 N was applied to the two internal fixation models to simulate the standing and sitting positions of the human body, and the displacement of the anterior and posterior ring fractures ends, the stress of the internal fixation and the stress of the nail channel in the bone were collected.</p><p><strong>Results: </strong>The model passed the validity verification. The maximum displacement of the anterior and posterior ring fractures in the standing dual INFIX group were 0.861 mm and 4.128 mm, respectively, which were both smaller than the 0.152 mm and 0.293 mm in the combined fixation group. The displacement of the posterior ring fractures in the sitting dual INFIX group was 3.757 mm, which was larger than the 0.560 mm in the combined fixation group, while the maximum displacement of the anterior ring fractures was 0.221 mm, which was not much different from the 0.194 mm in the combined fixation group. The maximum stress of internal fixation in the standing dual INFIX group was greater than that in the combined fixation group, while the opposite was true in the sitting position. The maximum stress of each internal fixation was lower than the yield strength of titanium alloy 790 MPa. The maximum stress of the nail channel in the standing and sitting daul INFIX groups was lower than that in the combined fixation group, and the stress of all nail channels was lower than the strength limit of bone 290 to 540 MPa.</p><p><strong>Conclusion: </strong>The stability of dual INFIX fixation in anterior and posterior ring fractures is generally inferior to that of INFIX combined with sacroiliac screw fixation. Although simple dual INFIX fixation can share part of the load for the posterior ring, the posterior ring will still have a large displacement, so the fixation of the posterior ring is very important. In addition, the fixation strength and stability of dual INFIX in the anterior ring are better than INFIX. When INFIX cannot provide sufficient strength to stabilize the anterior ring fractures, dual INFIX will be a good choice.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 11","pages":"1107-13"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Reposterior individualized three-column osteotomy for tuberculous spinal angular kyphosis deformity].","authors":"Jiang-Ping Ding, Wei-Bin Sheng, Bin Wang, Guo-Zhu Tang, Zong-Jian Li, Xin-Wen Feng","doi":"10.12200/j.issn.1003-0034.20230903","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230903","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy of posterior three-columns osteotomy in the treatment of severe tuberculous angular kyphosis.</p><p><strong>Methods: </strong>Total of 33 patients with severe tuberculous angular kyphosis were treated with posterior three-columns osteotomy from January 2006 to January 2019 including 24 males and 9 females with an average age of (40.6±23.3) years old ranging from 15 to 62 years old and an average disease duration of (23.5±15.5) years ranging from 4 to 40 years. The Cobb's angle of kyphosis was (118.65±28.82)°. Interradicular bone-disc-bone osteotomy(BDBO), posterior-only vertebral column resection (PVCR) and posterior multilevel vertebral osteotomy (PMVO) were performed to correct spinal deformity individually. The visual analogue scale (VAS), Oswestry disability index (ODI), sagittal vertical axis (SVA), ASIA spinal cord functional classification and motor function score, and deformity correction rate were measured and statistically analyzed before, after and at the final follow-up.</p><p><strong>Results: </strong>Total of 33 patients were followed up from 15 to 96 months with an average of (38.00±6.38) months. The last follow-up of kyphosis Cobb angle (23.88±5.45)° showed no significant loss from postoperative 12 months (20.40±9.13)°, <i>P</i>>0.05. The SVA, VAS, ODI and ASIA spinal cord functional classification and motor function score were significantly improved at 1 year and last follow-up after operation(<i>P</i><0.01). The fusion time of the osteotomy site was (18.50±5.16) months. The ASIA classification of 15 patients with spinal cord injury were improved by at least 2 grades after operation, and their daily life and work ability were various levels of restored. Postoperative complications of spinal cord injury occurred in 3 cases.</p><p><strong>Conclusion: </strong>Posterior three-columns osteotomy is the most effective method for the treatment of angular kyphosis of spinal tuberculosis.Careful preoperative design and individualized osteotomy can not only correct the deformity, but also a successful decompression to the spinal cord and promote the recovery of spinal cord function.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 11","pages":"1069-74"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}