Zhongguo gu shang = China journal of orthopaedics and traumatology最新文献_第3页

[Biomechanical study of load-bearing stability of Pilon fracture fixed with external fixator]. [外固定架固定Pilon骨折负重稳定性的生物力学研究]。

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20230702

Yong-Zhong Cheng, Xiao-Dong Yin, Yang Chen, Chao-Lu Wang, Guang-Wei Liu, Chang-Long Shi, Xiao-Yu Huang, Yi-Li Chen, Hong-Ying Chen, Xiong-Wei Wang, Ji-Yang Zhao

Objective: To explore weight-bearing stability of Pilon fracture fixed by external fixator.Methods: Six ankle bone models (right side) and 4 pairs (8 ankle cadaver specimens) were selected. Pilon fracture model was prepared by using the preset osteotomy line based on Ruedi Allgower Pilon fracture type. Pilon fracture model was built by using a minimally invasive osteotomy. After ankle bone model and cadaver specimen model were fixed with external fixator, axial load was carried out on mechanical loading machine. After ankle bone model and cadaver specimen model were fixed with external fixator, axial load was carried out on mechanical loading machine. Axial loads of 150, 300 and 450 N were applied to ankle bone model, and displacements of fibula fracture blocks, lateral tibia fracture blocks and medial tibia fracture blocks in three-dimensional space (X, Y and Z axes) were recorded by dynamic capture instrument. Axial loads of 300, 600 and 900 N were applied to ankle cadaver model fixed by external fixator. X-ray films of Pilon fracture cadaver model fixed by external fixator under different loading conditions were taken. The anterior tibial angle, tibial malleolar point angle, talus shift value, talus tilt angle, lateral malleolar shift value, lateral malleolar shift value, medial malleolar separation shift value and articular surface step displacement value were measured under different loads by digimizer software.Results: After 150, 300 and 450 N axial loads were applied to Pilon fracture models fixed by external fixator, no loosening or fracture of external fixator was observed, and no loosening, fracture or irreversible plastic deformation of Kirschner needle were observed. The displacement values of fibular fracture pieces on X-axis(around) were 0.032 (-0.022, 0.269), 0.061 (-0.002, 0.427), 0.212(-0.016, 1.223) mm, and the displacement values on Y-axis(above and below) were 0.002(-0.031, 0.103), 0.051(-1.133, 0.376), 0.128 (-1.394, 0.516) mm, and displacement values on Z-axis (front and rear) were -0.003 (-0.130, 0.171), 0.137 (-0.076, 0.433), 0.030(-0.487, 0.478) mm;the displacement values of lateral tibial fractures on X-axis were 0.000(-0.108, 0.027), 0.083(-0.364, 0.050), -0.121(-0.289, 0.165) mm, and displacement values on Y-axis were -0.009(-0.200, 0.025), -0.179(-0.710, 0.084), -0.257(-0.799, 0.027) mm, and displacement values on Z-axis were 0.112(-0.024, 0.256), 0.157(-0.068, 0.293), -0.210(-0.035, 0.430) mm;the displacement values of medial tibial fracture block on X-axis were -0.010(-0.060, 0.013), -0.165(-0.289, 0.056), -0.181(-0.395, 0.013) mm, and the displacement values on Y-axis were -0.036(-0.156, 0.007), -0.104(-0.269, 0.178), -0.245(-0.380, -0.011) mm, and displacement values on Z-axis were -0.005(-0.372, 0.189), -0.012 (-1.774, 0.380), 0.200 (-1.963, -0.540) mm. After 300, 600 and 900 N axial loads were applied to Pilon fracture cadaverous models fixed wi

目的：探讨外固定架固定皮隆骨折的负重稳定性。方法：选取6只踝关节骨模型（右侧）和4对踝关节尸体标本（8只）。根据Ruedi Allgower Pilon骨折类型，采用预先设定的截骨线制作Pilon骨折模型。采用微创截骨术建立皮隆骨折模型。踝关节骨模型和尸体标本模型用外固定架固定后，在机械加载机上进行轴向加载。踝关节骨模型和尸体标本模型用外固定架固定后，在机械加载机上进行轴向加载。对踝关节骨模型施加150、300和450 N的轴向载荷，通过动态捕捉仪记录腓骨骨折块、胫骨外侧骨折块和胫骨内侧骨折块在三维空间（X、Y、Z轴）的位移。采用外固定架固定踝关节尸体模型，施加300、600、900 N的轴向载荷。采用外固定架固定皮隆骨折尸体模型，拍摄不同载荷条件下的x线片。采用数字化软件测量不同载荷下胫骨前角、胫骨踝点角、距骨位移值、距骨倾斜角、外踝位移值、外踝位移值、内踝分离位移值和关节面台阶位移值。结果：外固定架固定的Pilon骨折模型，施加150、300、450 N轴向载荷后，外固定架未见松动、断裂，克氏针未见松动、断裂或不可逆塑性变形。腓骨骨折片x轴（左右）位移值分别为0.032（-0.022,0.269）、0.061（-0.002,0.427）、0.212(-0.016,1.223)mm， y轴（上下）位移值分别为0.002（-0.031,0.103）、0.051（-1.133,0.376）、0.128 (-1.394,0.516)mm， z轴（前后）位移值分别为-0.003（-0.130,0.171）、0.137（-0.076,0.433）、0.030(-0.487,0.478)mm，胫骨外侧骨折片x轴位移值分别为0.000(-0.108,0.027)，胫骨外侧骨折片x轴位移值分别为0.000（-0.108,0.027）。0.083(-0.364, 0.050), -0.121(-0.289, 0.165)毫米,轴和位移值是-0.009(-0.200,0.025),-0.179(-0.710,0.084),-0.257(-0.799,0.027)毫米,和z轴位移值是0.112(-0.024,0.256),0.157(-0.068,0.293),-0.210(-0.035,0.430)毫米;在轴内侧胫骨骨折块的位移值是-0.010(-0.060,0.013),-0.165(-0.289,0.056),-0.181(-0.395,0.013)毫米,轴和位移值是-0.036 (-0.156,0.007),-0.104 (-0.269,0.178),-0.245(-0.380, -0.011) mm， z轴位移值分别为-0.005（-0.372,0.189）、-0.012（-1.774,0.380）、0.200 (-1.963,-0.540)mm。外固定架固定的Pilon骨折尸体模型，施加300、600、900 N轴向载荷后，其胫骨前角、胫骨踝点角度、距骨斜角度、骨折步骤、距骨移位值、外踝外侧移位值、距骨侧移位值、距骨侧移位值、距骨侧移位值、距骨侧移位值、距骨侧移位值和距骨侧移位值均无显著差异。内踝外移值、不同加载条件下内踝外移值与未加载条件下内踝外移值的比较（P < 0.05）。外固定架整体未发生松动或断裂，局部固定骨折端克氏针未发生松动、断裂或不可逆变形。结论：早期负重外固定架能维持骨折端及踝关节的稳定，最大重量不超过300 n。在临床实际应用中，应选择植入物的材料特点及骨折类型。

{"title":"[Biomechanical study of load-bearing stability of Pilon fracture fixed with external fixator].","authors":"Yong-Zhong Cheng, Xiao-Dong Yin, Yang Chen, Chao-Lu Wang, Guang-Wei Liu, Chang-Long Shi, Xiao-Yu Huang, Yi-Li Chen, Hong-Ying Chen, Xiong-Wei Wang, Ji-Yang Zhao","doi":"10.12200/j.issn.1003-0034.20230702","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230702","url":null,"abstract":"Objective: To explore weight-bearing stability of Pilon fracture fixed by external fixator.Methods: Six ankle bone models (right side) and 4 pairs (8 ankle cadaver specimens) were selected. Pilon fracture model was prepared by using the preset osteotomy line based on Ruedi Allgower Pilon fracture type. Pilon fracture model was built by using a minimally invasive osteotomy. After ankle bone model and cadaver specimen model were fixed with external fixator, axial load was carried out on mechanical loading machine. After ankle bone model and cadaver specimen model were fixed with external fixator, axial load was carried out on mechanical loading machine. Axial loads of 150, 300 and 450 N were applied to ankle bone model, and displacements of fibula fracture blocks, lateral tibia fracture blocks and medial tibia fracture blocks in three-dimensional space (X, Y and Z axes) were recorded by dynamic capture instrument. Axial loads of 300, 600 and 900 N were applied to ankle cadaver model fixed by external fixator. X-ray films of Pilon fracture cadaver model fixed by external fixator under different loading conditions were taken. The anterior tibial angle, tibial malleolar point angle, talus shift value, talus tilt angle, lateral malleolar shift value, lateral malleolar shift value, medial malleolar separation shift value and articular surface step displacement value were measured under different loads by digimizer software.Results: After 150, 300 and 450 N axial loads were applied to Pilon fracture models fixed by external fixator, no loosening or fracture of external fixator was observed, and no loosening, fracture or irreversible plastic deformation of Kirschner needle were observed. The displacement values of fibular fracture pieces on X-axis(around) were 0.032 (-0.022, 0.269), 0.061 (-0.002, 0.427), 0.212(-0.016, 1.223) mm, and the displacement values on Y-axis(above and below) were 0.002(-0.031, 0.103), 0.051(-1.133, 0.376), 0.128 (-1.394, 0.516) mm, and displacement values on Z-axis (front and rear) were -0.003 (-0.130, 0.171), 0.137 (-0.076, 0.433), 0.030(-0.487, 0.478) mm;the displacement values of lateral tibial fractures on X-axis were 0.000(-0.108, 0.027), 0.083(-0.364, 0.050), -0.121(-0.289, 0.165) mm, and displacement values on Y-axis were -0.009(-0.200, 0.025), -0.179(-0.710, 0.084), -0.257(-0.799, 0.027) mm, and displacement values on Z-axis were 0.112(-0.024, 0.256), 0.157(-0.068, 0.293), -0.210(-0.035, 0.430) mm;the displacement values of medial tibial fracture block on X-axis were -0.010(-0.060, 0.013), -0.165(-0.289, 0.056), -0.181(-0.395, 0.013) mm, and the displacement values on Y-axis were -0.036(-0.156, 0.007), -0.104(-0.269, 0.178), -0.245(-0.380, -0.011) mm, and displacement values on Z-axis were -0.005(-0.372, 0.189), -0.012 (-1.774, 0.380), 0.200 (-1.963, -0.540) mm. After 300, 600 and 900 N axial loads were applied to Pilon fracture cadaverous models fixed wi","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1196-201"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882833","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}

引用次数: 0

[Characteristics and treatment measures of cages displacement after oblique lateral interbody fusion]. [斜侧体间融合术后笼型移位的特点及治疗措施]。

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20230340

Zhong-You Zeng, Xing Zhao, Deng-Wei He, Yu Zhang, Ping-Quan Chen, Hong-Fei Wu, Wei Yu, Yong-Xing Song, Shun-Wu Fan, Fei Pei, Shi-Yang Fan, Guo-Hao Song, Hai-Feng Wang

Objective: To explore characteristics, management strategies and preventive measures of fusion device displacement after oblique lateral interbody fusion (OLIF) in treating lumbar lesions.Methods: The clinical data of 12 patients with fusion device displacement after OLIF for lumbar lesions in 4 medical centers from October 2014 to December 2018 were retrospectively analyzed, including 4 males and 8 females, aged from 53 to 81 years old;2 patients with lumbar disc degeneration, 4 patients with lumbar spinal stenosis, 3 patients with lumbar degenerative spondylolisthesis and 3 patients with lumbar degenerative kyphosis;preoperative dual-energy X-ray bone mineral density (BMD) was detected in 1 patient with T-value > -1 SD, 5 patients with T-value >-1~-2.5 SD, and 6 patients with T-value <-2.5 SD;9 patients with single-segment fusion, 1 patient with 2-segment fusion, and 2 patients with 3-segment fusion;standalone OLIF was performed in 9 patients and OLIF combined with posterior pedicle screws in 3 patients. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate low back pain and lumbar function recovery at the time of fusion graft displacement and at the latest follow-up, respectively. In addition, according to imaging results during follow-up, the fusion device subsidence or redisplacement, loosening or fracture of internal fixation, and interbody fusion were observed, and the changes in the height of interbody space on the segment with fusion device displacement were measured and compared.Results: There were no necrosis or infection in skin incision of 10 patients after reoperation, and 12 patients were followed up for 12 to 48 months. VAS for low back pain decreased from 3 to 8 points at the time of fusion device displacement to 0 to 2 points at the latest follow-up. ODI recovered from 31% to 51% at the time of fusion transfer to 5% to 13% at the latest follow-up. There was no loosening or fracture of the pedicle screw system during follow-up. All 11 patients with bone grafting with fusion apparatus had fusion apparatus subsidence and no further displacement of fusion apparatus. The vertebral space height recovered from 9.0 to 12.7 mm at the time of fusion graft displacement to 8.0 to 11.8 mm at the latest follow-up. Interbody fusion was obtained in all patients except 1 with no imaging results at the latest follow-up.Conclusion: OLIF could be used for fusion of lumbar lesions, and there is a risk of fusion organ displacement after operation, especially in cases of bone loss or osteoporosis before surgery, end-plate injury during surgery, and Stand-alone mode, and most of them occur within 3 months after operation. Surgery is required for the transposition of the fusion apparatus in the Stand-alone OLIF mode during the primary operation. Although good clinical results could be obtained by timely detection and accurate treat

目的：探讨腰椎病变斜外侧椎间融合术（OLIF）后融合器移位的特点、处理策略及预防措施。方法:回顾性分析2014年10月至2018年12月4家医疗中心腰椎病变OLIF术后融合器移位12例患者的临床资料，其中男4例，女8例，年龄53 ~ 81岁；腰椎间盘退变2例，腰椎管狭窄4例，术前行双能x线骨密度（BMD）检查，t值>-1 SD 1例，t值>-1~-2.5 SD 5例，t值6例。结果：10例患者再手术后皮肤切口无坏死、感染，12例患者随访12 ~ 48个月。腰痛VAS评分从移位融合器时的3 ~ 8分下降到最近一次随访时的0 ~ 2分。ODI从融合转移时的31% - 51%恢复到最近随访时的5% - 13%。随访期间无椎弓根螺钉系统松动或断裂。采用融合器植骨的11例患者均出现了融合器下沉，融合器无进一步移位。椎间隙高度从融合移植物移位时的9.0 ~ 12.7 mm恢复到最近一次随访时的8.0 ~ 11.8 mm。除1例患者在最新随访时无影像学结果外，所有患者均获得了椎间融合。结论：OLIF可用于腰椎病变融合，术后存在融合器官移位的风险，尤其是术前骨质丢失或骨质疏松、术中终板损伤、单机模式，且多发生在术后3个月内。在初次手术中，需要在独立OLIF模式下对融合器进行移位手术。虽然及时发现、准确治疗可获得良好的临床效果，但术前需准确选择病例，术中需适当应用OLIF，术中需精确操作，防止融合器移位。

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引用次数: 0

[Degenerative lumbar spondylolisthesis treated by posterolateral transarticular puncture lumbar interbody fusion under full visual endoscopy]. [全视内窥镜下后外侧经关节穿刺腰椎椎间融合术治疗退行性腰椎滑脱]。

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20231116

Liang Xiong, Hong-Wei Zhao, Ming-Yi Luo, Feng-Ping Liu, Bin Lu, Yu-Xiang Deng

Objective: To explore clinical effect of percutaneous endoscopic posterolateral trans-facet lumbar interbody fusion (PE-PTLIF) in treating degenerative lumbar spondylolisthesis.Methods: The data of 38 patients with degenerative lumbar spondylolisthesis treated with PE-PTLIF from December 2019 to June 2021 were retrospectively analyzed, including 18 males and 20 females, aged from 39 to 75 years old with an average of (60.2±8.9) years old;1 patient with L3,4, 23 patients with L4,5, 14 patients with L5S1;29 patients with degreeⅠand 9 patients with degreeⅡaccording to Meyerding grading. Operative time, intraoperative blood loss, drainage volume, postoperative hospital stay and complcations were observed, visual analogue scale (VAS) was used to evaluate degree of lumbar and leg pain before operation, 3 d and 3, 6 and 12 months after operation, respectively. Oswestry disability index (ODI) was used to evaluate degree of low back pain dysfunction before operation, 3, 6 and 12 months after operation. The modified MacNab standard was used to evaluate clinical efficacy at 12 months after operation. Dural sac cross-sectional area (DSCSA), intervertebral disc height (IDH), lumbar spondylolisthesis rate (SR), lumbar lordosis angle (LL) and segmental lordosis angle (SL) were compared before operation and 12 months after operation. Interbody fusion at 12 months was evaluated according to Bridwell intervertebral fusion standard.Results: All patients were followed up for 13 to 28 months with an average of (18.47±4.12) months. The operative time was (181.68±19.34) min, intraoperative blood loss was (152.87±57.03) ml, drainage volume was (48.18±11.43) ml, and postoperative hospital stay was (9.45±2.18) d and 3 patients occurred complications. VAS of lumbar pain before operation, 3 days, 3, 6 and 12 months after operation were (6.68±1.16), (4.32±1.13), (2.18±0.70), (1.89±0.56) and (1.57±0.72), respectively. VAS of leg pain were (6.24±1.42), (2.95±1.09), (1.76±0.71), (1.68±0.74) and (1.26±0.69) respectively. Preoperative and postoperative 3, 6 and 12 months of ODI were (63.21±11.21) %, (25.24±6.46) %, (20.97±6.26) % and (17.73±5.88) %, respectively. Postoperative VAS of lumbar and leg pain and ODI were significantly lower than those of preoperative time points (P<0.05). According to the modified MacNab standard, 23 patients got excellent result, 10 good, 3 fair, and 2 poor at 12 months after operation. Postoperative DSCSA, IDH, SR, LL and SL at 12 months were (128.32±21.95) mm2, (11.19±1.66) mm, (4.44±2.19)%, (49.32±5.63)°, (9.16±1.90)°, respectively, and were improved compared with preoperative [(58.36±18.11) mm2, (8.19±2.06) mm (18.43±4.78) %, (42.38±4.94) ° and (8.06±2.06) °] (P<0.05). Thirty-four patients obtained gradeⅠfusion, 3 patients woth gradⅡfusion and 1 patient with grade Ⅲ fusion at 12 months after operation

目的：探讨经皮内镜后外侧经关节突腰椎椎体间融合术（PE-PTLIF）治疗退行性腰椎滑脱的临床效果。方法：回顾性分析2019年12月至2021年6月采用聚乙烯- ptlif治疗的38例退行性腰椎滑脱患者的资料，其中男性18例，女性20例，年龄39 ~ 75岁，平均（60.2±8.9）岁；L3级1例，4级23例，L4级5级14例，L5S1级29例，按照Meyerding分级Ⅰ级9例，Ⅱ级9例。观察两组患者手术时间、术中出血量、引流量、术后住院时间及并发症发生情况，分别采用视觉模拟评分法（VAS）评价术前、术后3 d及术后3、6、12个月腰、腿疼痛程度。采用Oswestry功能障碍指数（ODI）评价术前、术后3、6、12个月腰痛功能障碍程度。术后12个月采用改良MacNab标准评价临床疗效。比较术前和术后12个月两组患者的硬脑膜囊横截面积（DSCSA）、椎间盘高度（IDH）、腰椎滑脱率（SR）、腰椎前凸角（LL）和节段性前凸角（SL）。根据Bridwell椎间融合标准评估12个月椎间融合。结果：所有患者随访13 ~ 28个月，平均（18.47±4.12）个月。手术时间（181.68±19.34）min，术中出血量（152.87±57.03）ml，引流量（48.18±11.43）ml，住院时间（9.45±2.18）d，发生并发症3例。术前、术后3天、3个月、6个月、12个月腰痛VAS分别为（6.68±1.16）、（4.32±1.13）、（2.18±0.70）、（1.89±0.56）、（1.57±0.72）。腿部疼痛VAS评分分别为（6.24±1.42）、（2.95±1.09）、（1.76±0.71）、（1.68±0.74）、（1.26±0.69）。术前、术后3、6、12个月ODI分别为（63.21±11.21）%、（25.24±6.46）%、（20.97±6.26）%、（17.73±5.88）%。术后腰、腿疼痛VAS评分和ODI评分均显著低于术前时间点(P2,(11.19±1.66)mm,(4.44±2.19)%,（49.32±5.63）°，（9.16±1.90）°，与术前[(58.36±18.11)mm2,(8.19±2.06)mm,(18.43±4.78)%,（42.38±4.94）°，（8.06±2.06）°]相比均有改善(p结论：PE-PTLIF可为Ⅰ级、Ⅱ级退行性腰椎滑脱提供有效的治疗方法。它具有出血少、减压充分、术后恢复快、融合率高等优点，能有效缓解腰、腿疼痛，恢复椎间隙高度，改善腰椎矢状位平衡。PE-PTLIF是一种安全、微创的手术。

{"title":"[Degenerative lumbar spondylolisthesis treated by posterolateral transarticular puncture lumbar interbody fusion under full visual endoscopy].","authors":"Liang Xiong, Hong-Wei Zhao, Ming-Yi Luo, Feng-Ping Liu, Bin Lu, Yu-Xiang Deng","doi":"10.12200/j.issn.1003-0034.20231116","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20231116","url":null,"abstract":"Objective: To explore clinical effect of percutaneous endoscopic posterolateral trans-facet lumbar interbody fusion (PE-PTLIF) in treating degenerative lumbar spondylolisthesis.Methods: The data of 38 patients with degenerative lumbar spondylolisthesis treated with PE-PTLIF from December 2019 to June 2021 were retrospectively analyzed, including 18 males and 20 females, aged from 39 to 75 years old with an average of (60.2±8.9) years old;1 patient with L3,4, 23 patients with L4,5, 14 patients with L5S1;29 patients with degreeⅠand 9 patients with degreeⅡaccording to Meyerding grading. Operative time, intraoperative blood loss, drainage volume, postoperative hospital stay and complcations were observed, visual analogue scale (VAS) was used to evaluate degree of lumbar and leg pain before operation, 3 d and 3, 6 and 12 months after operation, respectively. Oswestry disability index (ODI) was used to evaluate degree of low back pain dysfunction before operation, 3, 6 and 12 months after operation. The modified MacNab standard was used to evaluate clinical efficacy at 12 months after operation. Dural sac cross-sectional area (DSCSA), intervertebral disc height (IDH), lumbar spondylolisthesis rate (SR), lumbar lordosis angle (LL) and segmental lordosis angle (SL) were compared before operation and 12 months after operation. Interbody fusion at 12 months was evaluated according to Bridwell intervertebral fusion standard.Results: All patients were followed up for 13 to 28 months with an average of (18.47±4.12) months. The operative time was (181.68±19.34) min, intraoperative blood loss was (152.87±57.03) ml, drainage volume was (48.18±11.43) ml, and postoperative hospital stay was (9.45±2.18) d and 3 patients occurred complications. VAS of lumbar pain before operation, 3 days, 3, 6 and 12 months after operation were (6.68±1.16), (4.32±1.13), (2.18±0.70), (1.89±0.56) and (1.57±0.72), respectively. VAS of leg pain were (6.24±1.42), (2.95±1.09), (1.76±0.71), (1.68±0.74) and (1.26±0.69) respectively. Preoperative and postoperative 3, 6 and 12 months of ODI were (63.21±11.21) %, (25.24±6.46) %, (20.97±6.26) % and (17.73±5.88) %, respectively. Postoperative VAS of lumbar and leg pain and ODI were significantly lower than those of preoperative time points (P<0.05). According to the modified MacNab standard, 23 patients got excellent result, 10 good, 3 fair, and 2 poor at 12 months after operation. Postoperative DSCSA, IDH, SR, LL and SL at 12 months were (128.32±21.95) mm2, (11.19±1.66) mm, (4.44±2.19)%, (49.32±5.63)°, (9.16±1.90)°, respectively, and were improved compared with preoperative [(58.36±18.11) mm2, (8.19±2.06) mm (18.43±4.78) %, (42.38±4.94) ° and (8.06±2.06) °] (P<0.05). Thirty-four patients obtained gradeⅠfusion, 3 patients woth gradⅡfusion and 1 patient with grade Ⅲ fusion at 12 months after operation","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1145-52"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882962","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}

引用次数: 0

[Progress on acupotomy treatment of carpal tunnel syndrome]. 针刀治疗腕管综合征的研究进展。

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20230977

Dan-Tong Wu, Jing-Yuan Zeng, Shi-Liang Li, Xiang-Yi You, Xian-Qi Huang, Qiao-Yin Zhou

Carpal tunnel syndrome (CTS) is a condition caused by compression of the median nerve in carpal canal. In recent years, due to popularity of electronic devices such as computers, the incidence of CTS has shown a rapid rising trend. Its treatment methods include surgical treatment and conservative treatment. For mild to and moderate CTS, conservative treatment is preferred. Acupotomy, as an innovative and unique treatment method, could relieve pressure in carpal canal by releasing transverse ligament of wrist and promote local blood circulation to treat CTS, and has characteristics of less trauma, short course of treatment and low cost, which is more acceptable to patients. In addition, the combination of needle-knife and other therapies also has a good effect. However, traditional needle-knife therapy has certain limitations in operation, and its safety problems can be effectively solved with the help of ultrasound technology. Therefore, ultrasus-guided needle-knife therapy for CTS has become a current research hotspot, but its long-term therapeutic effect still needs to be further verified.

腕管综合征（Carpal tunnel syndrome， CTS）是一种由腕管内正中神经受压引起的疾病。近年来，由于计算机等电子设备的普及，CTS的发病率呈快速上升趋势。其治疗方法包括手术治疗和保守治疗。对于轻中度CTS，首选保守治疗。针刀作为一种创新独特的治疗方法，可以通过释放腕横韧带来缓解腕管压力，促进局部血液循环来治疗CTS，具有创伤小、疗程短、费用低等特点，更容易被患者接受。此外，针刀结合其他疗法也有很好的效果。但传统的针刀疗法在操作上存在一定的局限性，借助超声技术可以有效解决其安全性问题。因此，超导针刀治疗CTS已成为当前的研究热点，但其远期治疗效果仍需进一步验证。

{"title":"[Progress on acupotomy treatment of carpal tunnel syndrome].","authors":"Dan-Tong Wu, Jing-Yuan Zeng, Shi-Liang Li, Xiang-Yi You, Xian-Qi Huang, Qiao-Yin Zhou","doi":"10.12200/j.issn.1003-0034.20230977","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230977","url":null,"abstract":"Carpal tunnel syndrome (CTS) is a condition caused by compression of the median nerve in carpal canal. In recent years, due to popularity of electronic devices such as computers, the incidence of CTS has shown a rapid rising trend. Its treatment methods include surgical treatment and conservative treatment. For mild to and moderate CTS, conservative treatment is preferred. Acupotomy, as an innovative and unique treatment method, could relieve pressure in carpal canal by releasing transverse ligament of wrist and promote local blood circulation to treat CTS, and has characteristics of less trauma, short course of treatment and low cost, which is more acceptable to patients. In addition, the combination of needle-knife and other therapies also has a good effect. However, traditional needle-knife therapy has certain limitations in operation, and its safety problems can be effectively solved with the help of ultrasound technology. Therefore, ultrasus-guided needle-knife therapy for CTS has become a current research hotspot, but its long-term therapeutic effect still needs to be further verified.","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1237-40"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883046","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}

引用次数: 0

[Arthroscopic triangular fibrocartilage complex trimming combined with oblique osteotomy shortening of distal ulna for ulnar impact syndrome]. [关节镜下三角形纤维软骨复合体修剪联合斜截骨短缩尺远端治疗尺撞击综合征]。

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20230271

Xiao-Guang Meng, Feng-Song Xu, Fu-Dong Shi

Objective: To explore clinical effect of arthroscopic modification of triangular fibrocartilage complex (TFCC) combined with oblique osteotomy shortening of distal ulna in treating ulna impact syndrome.Methods: A retrospective analysis was performed on 49 patients with ulnar impingement syndrome admitted from 2017 to 2021, 3 patients were lost to follow-up, and 46 patients were finally included in study, including 23 males and 23 females, aged from 21 to 53 years old with an average of (36.5±3.3) years old. The patients were divided into TFCC group and control group according to different operation methods. Twenty-four patients in TFCC group, including 13 males and 11 females, aged from 21 to 53 years old with an average of (36.5±3.2) years old;10 patients on the left side and 14 patients on the right side;arthroscopic TFCC trimming combined with oblique osteotomy shortening of distal ulna was performed. Twenty-two patients in control group, including 10 males, 12 females, aged from 21 to 53 years old with an average of (36.5±3.3) years old;13 patients on the left side, 9 patients on the right side; oblique osteotomy of distal ulna was performed. Operative time, hospital stay, intraoperative bleeding and osteotomy healing time between two groups were observed and compared. Cooney wrist function score and visual analogue scale (VAS) were used to evaluate improvement of wrist function and pain before and 12 months after operation, respectively. The variation values of ulna and grip strength were compared.Results: The follow-up time of TFCC group ranged from 12 to 21 months with an average of (15.10±2.67) months, and that of control group ranged from 12 to 20 months with an average of (15.06±2.81) months, there was no statistical significance between two groups (P>0.05). Operative time, osteotomy healing time, intraoperative bleeding and hospital stay in TFCC group were (68.51±13.50) min, (16.21±1.16) weeks, (25.13±4.22) ml and (7.35±1.20) d, respectively;while control group were (45.65±5.64) min, (17.46±2.06) weeks, (24.61±5.10) ml and (7.51±1.13) d, respectively; there were statistically significant differences in operative time and osteotomy healing time between two groups (P<0.05). There were no significant differences in intraoperative bleeding and hospital stay between two groups(P>0.05). There were no significant differences in total score and scores of Cooney wrist joint function between two groups before operation(P>0.05). Pain, functional status, range of motion, grip strength and Cooney wrist function score in TFCC group were higher than those in control group at 12 months after operation (P<0.05). According to Cooney wrist joint function score at 12 months after operation, 16 patients got excellent results, 6 good, and 2 fair in TFCC group; while 7 excellent, 11 good and 4 fair in control group;there was no significant difference betwee

目的：探讨关节镜下三角纤维软骨复合体改良联合远端尺骨斜截短术治疗尺骨撞击综合征的临床疗效。方法：回顾性分析2017 - 2021年收治的49例尺侧撞击综合征患者，其中3例失访，最终纳入研究的46例患者，男23例，女23例，年龄21 ~ 53岁，平均（36.5±3.3）岁。根据手术方式的不同将患者分为TFCC组和对照组。TFCC组24例患者，男13例，女11例，年龄21 ~ 53岁，平均（36.5±3.2）岁，左侧10例，右侧14例，采用关节镜下TFCC修整联合尺骨远端斜截骨缩短术。对照组22例，男10例，女12例，年龄21 ~ 53岁，平均（36.5±3.3）岁，左侧13例，右侧9例；行尺骨远端斜截骨术。观察比较两组手术时间、住院时间、术中出血及截骨愈合时间。采用Cooney腕功能评分和视觉模拟评分（VAS）分别评价术前和术后12个月腕功能和疼痛的改善情况。比较尺骨和握力的变化值。结果：TFCC组随访时间为12 ~ 21个月，平均（15.10±2.67）个月；对照组随访时间为12 ~ 20个月，平均（15.06±2.81）个月，两组比较差异无统计学意义（P < 0.05）。TFCC组手术时间、截骨愈合时间、术中出血量、住院时间分别为（68.51±13.50）min、（16.21±1.16）周、（25.13±4.22）ml、（7.35±1.20）d，对照组分别为（45.65±5.64）min、（17.46±2.06）周、（24.61±5.10）ml、（7.51±1.13）d；两组患者手术时间及截骨愈合时间比较，差异有统计学意义（p < 0.05）。两组患者术前总评分及腕关节功能评分比较，差异均无统计学意义（P < 0.05）。术后12个月，TFCC组疼痛、功能状态、活动度、握力、Cooney腕功能评分均高于对照组（p < 0.05）。但TFCC组腕部功能恢复比例高于对照组（P < 0.05）。术后12个月，TFCC组VAS（3.41±0.16）低于对照组（3.52±0.13），PP < 0.05)。TFCC组握力（93.6±10.1）%优于对照组（83.5±10.3）% (p结论：与尺远端斜截骨缩短术相比，TFCC切边联合尺远端斜截骨缩短术治疗尺骨碰撞综合征所需时间较长，但截骨愈合时间缩短，腕关节功能明显改善，尤其是疼痛、尺骨变化、握力和运动均有明显改善。

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引用次数: 0

[Therapeutic effect of joint injection of platelet-rich plasma combined with shock wave on osteochondral injury of talus]. 【关节注射富血小板血浆联合冲击波治疗距骨软骨损伤的疗效观察】。

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20230762

Ying Liu, Tai Liu, Ting-Ting Fu, Jun-Rong Chen, Xu-Xue Li

Objective: To explore clinical efficacy of platelet rich plasma (PRP) injection combined with extracorporeal shock wave therapy (ESWT) in treating osteochondral lesion of talus (OLT) with typeⅡa.

Methods: From January 2022 to June 2022, 45 patients with typeⅡa OLT were treated with PRP arthroscopic injection combined with ESWT, including 29 males and 16 females; aged from 18 to 63 years old with an average of(37.7±10.3) years old;the courses of disease ranged from 6 to 20 with an average of (13.3±4.8) months. American Foot and Ankle Association ankle and foot (AOFAS) score, visual analogue scale (VAS), cartilage injury volume and bone marrow edema volume were evaluated for ankle joint function and osteochondral recovery of talus before treatment, 3 and 6 months after treatment.

Results: All patients were followed for at least 6 months. No related complications occurred in all patients. AOFAS score were increased from(68.3±3.6) before treatment to (83.7±3.2) and (90.8±2.2) at 3 and 6 months after treatment, respectively (P<0.05). VAS decreased from (5.2±1.2) before treatment to (3.2±0.8) and (1.9±1.2) at 3 and 6 months after treatment (P<0.05). The injury volume of cartilage and subchondral bone decreased from (71.0±42.5) mm³ before treatment to (50.6±31.5) mm³ and (36.5±27.3) mm³ at 3 and 6 months after treatment (P<0.05). The bone marrow edema volume decreased from (1 182.7±675.1) mm³ before treatment to (656.1±455.1) mm³ and (382.1±485.6) mm³ at 3 and 6 months after treatment (P<0.05).

Conclusion: PRP intraarticular injection combined with ESWT for the treatment of typeⅡa OLT could alleviate clinical symptoms, effectively improve joint function, and promote cartilage repair and bone marrow edema absorption.

目的：探讨富血小板血浆（PRP）注射液联合体外冲击波疗法（ESWT）治疗Ⅱa型距骨软骨病变（OLT）的临床疗效。方法：于2022年1月至2022年6月，对45例Ⅱa型OLT患者进行关节镜下PRP注射联合ESWT治疗，其中男性29例，女性16例；年龄18 ~ 63岁，平均（37.7±10.3）岁；病程6 ~ 20个月，平均（13.3±4.8）个月。治疗前、治疗后3、6个月分别评价美国足踝协会踝足（AOFAS）评分、视觉模拟评分（VAS）、软骨损伤体积、骨髓水肿体积对踝关节功能及距骨软骨恢复情况的影响。结果：所有患者均随访6个月以上。所有患者均无相关并发症发生。AOFAS评分由治疗前的（68.3±3.6）分提高到治疗后3、6个月的（83.7±3.2）分和（90.8±2.2）分，治疗后3、6个月的PP3分别提高到（50.6±31.5）mm3和（36.5±27.3）mm3，治疗后3、6个月的P3分别提高到（656.1±455.1）mm3和（382.1±485.6）mm3。PRP关节内注射联合ESWT治疗Ⅱa型OLT，可缓解临床症状，有效改善关节功能，促进软骨修复和骨髓水肿吸收。

{"title":"[Therapeutic effect of joint injection of platelet-rich plasma combined with shock wave on osteochondral injury of talus].","authors":"Ying Liu, Tai Liu, Ting-Ting Fu, Jun-Rong Chen, Xu-Xue Li","doi":"10.12200/j.issn.1003-0034.20230762","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230762","url":null,"abstract":"Objective: To explore clinical efficacy of platelet rich plasma (PRP) injection combined with extracorporeal shock wave therapy (ESWT) in treating osteochondral lesion of talus (OLT) with typeⅡa.Methods: From January 2022 to June 2022, 45 patients with typeⅡa OLT were treated with PRP arthroscopic injection combined with ESWT, including 29 males and 16 females; aged from 18 to 63 years old with an average of(37.7±10.3) years old;the courses of disease ranged from 6 to 20 with an average of (13.3±4.8) months. American Foot and Ankle Association ankle and foot (AOFAS) score, visual analogue scale (VAS), cartilage injury volume and bone marrow edema volume were evaluated for ankle joint function and osteochondral recovery of talus before treatment, 3 and 6 months after treatment.Results: All patients were followed for at least 6 months. No related complications occurred in all patients. AOFAS score were increased from(68.3±3.6) before treatment to (83.7±3.2) and (90.8±2.2) at 3 and 6 months after treatment, respectively (P<0.05). VAS decreased from (5.2±1.2) before treatment to (3.2±0.8) and (1.9±1.2) at 3 and 6 months after treatment (P<0.05). The injury volume of cartilage and subchondral bone decreased from (71.0±42.5) mm3 before treatment to (50.6±31.5) mm3 and (36.5±27.3) mm3 at 3 and 6 months after treatment (P<0.05). The bone marrow edema volume decreased from (1 182.7±675.1) mm3 before treatment to (656.1±455.1) mm3 and (382.1±485.6) mm3 at 3 and 6 months after treatment (P<0.05).Conclusion: PRP intraarticular injection combined with ESWT for the treatment of typeⅡa OLT could alleviate clinical symptoms, effectively improve joint function, and promote cartilage repair and bone marrow edema absorption.","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1224-8"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883049","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}

引用次数: 0

[Zero-profile intervertebral fusion with cage-titanium plate for the treatment of multilevel cervical spondylotic myelopathy]. [零侧位椎间融合术配合钛板治疗多节段脊髓型颈椎病]。

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20230328

Jian-Bin Zhong, Yong Hu, Zhen-Tao Chu, Wei-Xin Dong, Zhen-Shan Yuan, Xiao-Yang Sun, Bing-Ke Zhu, Ou-Jie Lai

Objective: To explore clinical effect of Zero-profile intervertebral fusion with cage-titanium plate in treating multilevel cervical spondylotic myelopathy.Methods: From January 2016 to January 2020, 107 patients with multisegmental cervical spondylotic myelopathy treated by surgery were retrospectively analyzed and divided into Hybrid group and control group according to different surgical methods. There were 54 patients in Hybrid group, including 42 males and 12 females, aged from 33 to 77 years old with an average of (57.3±9.5) years old;20 patients with C3-C6, 27 patients with C4-C7 and 7 patients with C3-C7;Zero-profile intervertebral fusion with cage-titanium plate internal fixation was performed. There were 53 patients in control group, including 34 males and 19 females;aged from 36 to 79 years old with an average of (57.8±8.9) years old;17 patients with C3-C6, 27 patients with C4-C7, and 9 patients with C3-C7;titanium plate interbody fusion fixation was performed. Operation time, blood loss and complications between two groups were compared, visual analogue scale (VAS), Japanese Orthopedic Association (JOA) scores and neck disability index (NDI) were used to assess recovery of clinical symptoms;cervical lordosis (CL), cervical sagittal vertical axis (C-SVA), and T1 slope (T1S) were measured and compared to evaluate cervical sagittal plane parameters.Results: All patients were followed up, Hybrid group was followed up for 24 to 64 months with an average of (31.7±18.4) months, and control group was followed up for 24 to 65 months with an average of (32.6±15.8) months. There was no significant difference in follow-up time between two groups (P>0.05). Operation time and blood loss in Hybrid group were less than those in control group (P<0.05). VAS, JOA score and NDI were significantly improved between two groups at the lastest follow-up (P<0.05). There were no significant difference in VAS, JOA and NDI scores between two groups before and after operation (P>0.05). CL in both two groups at 3 months and the latest follow-up after operation were significantly improved than those before operation (P<0.05), there were no significant difference between two groups in T1S and C-SVA before and after operation (P>0.05). Postoperative dysphagia occurred in 2 patients in Hybrid group and 9 patients in control group, and had statistically difference in the incidence of dysphagia between two groups (χ2=5.112, P=0.024). During the follow-up, there were no complications such as loosening, displacement or fracture of internal fixation between two groups.Conclusion: Compared with titanium plate interbody fusion, Zero-profile intervertebral fusion combin

目的：探讨零侧位椎间融合术配合笼型钛板治疗多节段脊髓型颈椎病的临床疗效。方法：回顾性分析2016年1月至2020年1月107例手术治疗的多节段性脊髓型颈椎病患者，根据手术方式不同分为Hybrid组和对照组。Hybrid组54例患者，男42例，女12例，年龄33 ~ 77岁，平均（57.3±9.5）岁；C3-C6组20例，C4-C7组27例，C3-C7组7例；采用零侧位椎间融合术联合笼-钛板内固定。对照组53例，男34例，女19例，年龄36 ~ 79岁，平均（57.8±8.9）岁，C3-C6组17例，C4-C7组27例，C3-C7组9例，行钛板椎间融合固定。比较两组手术时间、出血量及并发症，采用视觉模拟量表（VAS）、日本骨科协会（JOA）评分及颈部失能指数（NDI）评估临床症状恢复情况；测量颈椎前凸度（CL）、颈椎矢状垂直轴（C-SVA）、T1斜率（T1S）进行比较，评估颈椎矢状面参数。结果：所有患者均获得随访，混合组随访24 ~ 64个月，平均（31.7±18.4）个月；对照组随访24 ~ 65个月，平均（32.6±15.8）个月。两组患者随访时间差异无统计学意义（P < 0.05）。混合组手术时间和出血量均少于对照组（PPP>0.05）。两组患者术后3个月及最新随访时CL均较术前明显改善（p < 0.05）。混合组术后出现吞咽困难2例，对照组术后出现吞咽困难9例，两组患者吞咽困难发生率比较，差异有统计学意义（χ2=5.112， P=0.024）。随访期间，两组间无内固定松动、移位、骨折等并发症发生。结论：与钛板椎间融合术相比，零侧位椎间融合术联合笼-钛板治疗多节段脊髓型颈椎病可缩短手术时间和出血量，减少手术创伤和术后吞咽困难，有利于早期快速恢复。

{"title":"[Zero-profile intervertebral fusion with cage-titanium plate for the treatment of multilevel cervical spondylotic myelopathy].","authors":"Jian-Bin Zhong, Yong Hu, Zhen-Tao Chu, Wei-Xin Dong, Zhen-Shan Yuan, Xiao-Yang Sun, Bing-Ke Zhu, Ou-Jie Lai","doi":"10.12200/j.issn.1003-0034.20230328","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230328","url":null,"abstract":"Objective: To explore clinical effect of Zero-profile intervertebral fusion with cage-titanium plate in treating multilevel cervical spondylotic myelopathy.Methods: From January 2016 to January 2020, 107 patients with multisegmental cervical spondylotic myelopathy treated by surgery were retrospectively analyzed and divided into Hybrid group and control group according to different surgical methods. There were 54 patients in Hybrid group, including 42 males and 12 females, aged from 33 to 77 years old with an average of (57.3±9.5) years old;20 patients with C3-C6, 27 patients with C4-C7 and 7 patients with C3-C7;Zero-profile intervertebral fusion with cage-titanium plate internal fixation was performed. There were 53 patients in control group, including 34 males and 19 females;aged from 36 to 79 years old with an average of (57.8±8.9) years old;17 patients with C3-C6, 27 patients with C4-C7, and 9 patients with C3-C7;titanium plate interbody fusion fixation was performed. Operation time, blood loss and complications between two groups were compared, visual analogue scale (VAS), Japanese Orthopedic Association (JOA) scores and neck disability index (NDI) were used to assess recovery of clinical symptoms;cervical lordosis (CL), cervical sagittal vertical axis (C-SVA), and T1 slope (T1S) were measured and compared to evaluate cervical sagittal plane parameters.Results: All patients were followed up, Hybrid group was followed up for 24 to 64 months with an average of (31.7±18.4) months, and control group was followed up for 24 to 65 months with an average of (32.6±15.8) months. There was no significant difference in follow-up time between two groups (P>0.05). Operation time and blood loss in Hybrid group were less than those in control group (P<0.05). VAS, JOA score and NDI were significantly improved between two groups at the lastest follow-up (P<0.05). There were no significant difference in VAS, JOA and NDI scores between two groups before and after operation (P>0.05). CL in both two groups at 3 months and the latest follow-up after operation were significantly improved than those before operation (P<0.05), there were no significant difference between two groups in T1S and C-SVA before and after operation (P>0.05). Postoperative dysphagia occurred in 2 patients in Hybrid group and 9 patients in control group, and had statistically difference in the incidence of dysphagia between two groups (χ2=5.112, P=0.024). During the follow-up, there were no complications such as loosening, displacement or fracture of internal fixation between two groups.Conclusion: Compared with titanium plate interbody fusion, Zero-profile intervertebral fusion combin","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1188-95"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883051","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}

引用次数: 0

[Rational selection of uni-portal full-endoscopic/bi-portal endoscopic spine surgery techniques based on evidence-based medicine]. 基于循证医学的单门静脉全内镜/双门静脉脊柱手术技术的合理选择

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20241102

Zhen-Zhou Li

引用次数: 0

[Comparative study of two fixation methods in single segment interbody fusion and fixation with unilateral dual channel spinal endoscopic technique]. [单节段椎体间融合和单侧双通道脊柱内窥镜技术两种固定方法的比较研究]。

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20230644

Ze-Xuan Wu, Tao Wang, Zhi-Gang Lei, Xiao-Lin Li, Hao-Zhe Liu, Xiao-Yang Li, Xin-Xin Bai, Hong-Hai Xu

Objective: To explore clinical efficacy of unilateral and bilateral nail-rod system fixation in single-level intervertebral fusion fixation of lumbar disc herniation (LDH) and instability with unilateral dual-channel spinal endoscopy.Methods: The clinical data of 63 patients with LDH complicated with instability treated by unilateral double-channel spinal endoscopy from March 2021 to June 2022 were retrospectively analyzed. According to intraoperative fixation methods, the patients were divided into two groups, included unilateral nail rod system fixation group(unilateral group) and bilateral nail rod system fixation group(bilateral group). There were 31 patients in unilateral group, including 15 males and 16 females; aged from 40 to 67 years old with an average of (54.65±7.32) years old; 3 patients with L3,4, 15 patients with L4,5, 13 patients with L5S1. There were 32 patients in bilateral group, including 18 males and 14 females, aged from 43 to 68 years old with an average of (56.19±6.63) years old;4 patients with L3,4, 17 patients with L4,5, 11 patients with L5S1. The time of operation, length of incision, operation time, length of hospital stay, cost of treatment, occurrence of complications and adverse events were recorded and compared between two groups. Visual analogue scale (VAS) of lumbar and leg pain, Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) were compared before operation, 3 and 12 months after operation. MacNab standard was used to evaluate clinical effect.Results: Both of two groups were successfully completed operation and followed up. In unilateral fixation group, follow-up time, operation time, incision length, postoperative ambulation time, hospital stay and treatment cost were (11.81±1.08) months, (122.48±13.86) min, (3.15±0.45) cm, (3.06±0.73) d, (6.87±1.09) d, and (3.49±0.09) ten thousand yuan;while (11.47±1.16) months, (134.94±10.94) min, (6.45±0.83) cm, (3.19±0.86) d, (7.03±1.03) d, (3.77±0.12) ten thousand yuan in bilateral fixation group, respectively;there were significant differences in operation time, incision length and treatment cost between two groups (P<0.05), no significant difference in follow-up time, postoperative ambulation time and hospital stay (P>0.05). There were no significant difference in VAS of low back pain, JOA score, ODI and MacNab grade between two groups before and after operation (P>0.05). No significant complications and adverse events were observed between two groups after operation.Conclusion: Both of unilateral and bilateral nail rod system for the treatment of LDH with instability could achieve the expected results. Unilateral fixation has more advantageous than bilateral fixation in terms of operation time, incision length and treatment cost. For patients with

目的：探讨单侧双通道脊柱内镜下单侧与双侧钉棒系统内固定治疗腰椎间盘突出症（LDH）及不稳定单节段椎间融合内固定的临床疗效。方法：回顾性分析2021年3月至2022年6月行单侧双通道脊柱内窥镜治疗的63例LDH合并不稳定患者的临床资料。根据术中固定方式将患者分为单侧钉棒系统固定组（单侧组）和双侧钉棒系统固定组（双侧组）。单侧组31例，其中男15例，女16例；年龄40 ~ 67岁，平均（54.65±7.32）岁；L3 3例，L4 4、15例，L5S1 5、13例。双侧组32例，男18例，女14例，年龄43 ~ 68岁，平均（56.19±6.63）岁，L3 4例，L4 17例，L5S1 5例，11例。记录两组手术时间、切口长度、手术时间、住院时间、治疗费用、并发症及不良事件发生情况，并进行比较。比较术前、术后3个月、12个月腰、腿疼痛视觉模拟评分（VAS）、日本骨科协会评分（JOA）和Oswestry残疾指数（ODI）。采用MacNab标准评价临床疗效。结果：两组患者均顺利完成手术并随访。单侧固定组随访时间、手术时间、切口长度、术后下床时间、住院时间、治疗费用分别为（11.81±1.08）个月、（122.48±13.86）min、（3.15±0.45）cm、（3.06±0.73）d、（6.87±1.09）d、（3.49±0.09）万元；双侧固定组分别为（11.47±1.16）个月、（134.94±10.94）min、（6.45±0.83）cm、（3.19±0.86）d、（7.03±1.03）d、（3.77±0.12）万元；两组切口长度及治疗费用比较（PP < 0.05）。两组患者手术前后腰痛VAS评分、JOA评分、ODI评分及MacNab评分比较，差异均无统计学意义（P < 0.05）。两组患者术后均无明显并发症及不良事件发生。结论：单侧和双侧钉棒系统治疗LDH不稳定均可达到预期效果。单侧内固定在手术时间、切口长度和治疗费用上均优于双侧内固定。对于术前骨质疏松或术中单侧椎弓根钉固定强度不足的患者，采用双侧固定可提高固定的可靠性。

{"title":"[Comparative study of two fixation methods in single segment interbody fusion and fixation with unilateral dual channel spinal endoscopic technique].","authors":"Ze-Xuan Wu, Tao Wang, Zhi-Gang Lei, Xiao-Lin Li, Hao-Zhe Liu, Xiao-Yang Li, Xin-Xin Bai, Hong-Hai Xu","doi":"10.12200/j.issn.1003-0034.20230644","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20230644","url":null,"abstract":"Objective: To explore clinical efficacy of unilateral and bilateral nail-rod system fixation in single-level intervertebral fusion fixation of lumbar disc herniation (LDH) and instability with unilateral dual-channel spinal endoscopy.Methods: The clinical data of 63 patients with LDH complicated with instability treated by unilateral double-channel spinal endoscopy from March 2021 to June 2022 were retrospectively analyzed. According to intraoperative fixation methods, the patients were divided into two groups, included unilateral nail rod system fixation group(unilateral group) and bilateral nail rod system fixation group(bilateral group). There were 31 patients in unilateral group, including 15 males and 16 females; aged from 40 to 67 years old with an average of (54.65±7.32) years old; 3 patients with L3,4, 15 patients with L4,5, 13 patients with L5S1. There were 32 patients in bilateral group, including 18 males and 14 females, aged from 43 to 68 years old with an average of (56.19±6.63) years old;4 patients with L3,4, 17 patients with L4,5, 11 patients with L5S1. The time of operation, length of incision, operation time, length of hospital stay, cost of treatment, occurrence of complications and adverse events were recorded and compared between two groups. Visual analogue scale (VAS) of lumbar and leg pain, Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) were compared before operation, 3 and 12 months after operation. MacNab standard was used to evaluate clinical effect.Results: Both of two groups were successfully completed operation and followed up. In unilateral fixation group, follow-up time, operation time, incision length, postoperative ambulation time, hospital stay and treatment cost were (11.81±1.08) months, (122.48±13.86) min, (3.15±0.45) cm, (3.06±0.73) d, (6.87±1.09) d, and (3.49±0.09) ten thousand yuan;while (11.47±1.16) months, (134.94±10.94) min, (6.45±0.83) cm, (3.19±0.86) d, (7.03±1.03) d, (3.77±0.12) ten thousand yuan in bilateral fixation group, respectively;there were significant differences in operation time, incision length and treatment cost between two groups (P<0.05), no significant difference in follow-up time, postoperative ambulation time and hospital stay (P>0.05). There were no significant difference in VAS of low back pain, JOA score, ODI and MacNab grade between two groups before and after operation (P>0.05). No significant complications and adverse events were observed between two groups after operation.Conclusion: Both of unilateral and bilateral nail rod system for the treatment of LDH with instability could achieve the expected results. Unilateral fixation has more advantageous than bilateral fixation in terms of operation time, incision length and treatment cost. For patients with ","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1158-63"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882800","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}

引用次数: 0

[Early application of bilateral decompression under single channel endoscopic laminectomy in patients with adjacent vertebrae after lumbar fusion]. 【单通道内窥镜椎板切除术下双侧减压在腰椎融合术后相邻椎体患者中的早期应用】。

Q4 Medicine

Zhongguo gu shang = China journal of orthopaedics and traumatology

Pub Date : 2024-12-25 DOI: 10.12200/j.issn.1003-0034.20240245

Tao Li, Bin Zhang

Objective: To explore clinical effect of unilateral laminotomy for bilateral decompression (ULBD) under single channel endoscopic(Delta) in treating adjacent segment disease(ASD) after lumbar fusion.

Methods: A retrospective analysis of 24 patients who underwent spinal endoscopic ULBD after lumbar fusion was performed from January 2021 to January 2023, including 10 males and 14 females, aged from 54 to 77 years old with an average of (59.2±3.6) years old;2 patients with L_2,3, 16 patients with L_3,4, and 6 patients with L₅S₁. Operative time and intraoperative blood loss were recorded, visual analogue scale (VAS) and Oswestry disability index (ODI) were recorded before oepration, 1 week, 1, 3 and 6 months after operation, respectively;the modified MacNab standard score evaluation was used to evaluate clinical effects.

Results: All patients were successfully completed operation without nerve injury or dural injury and cerebrospinal fluid leakage. Operation time was (90.3±11.8) min, intraoperative blood loss was (35.3±5.3) ml, and hospital stay was (14.4±2.1) d. All 24 patients were followed up for 6 months. ODI and VAS were improved from (51.25±5.48) % and (6.88±1.23) before operation to (9.29±1.76) % and (1.13±0.95) at one week after operation, respectively (P<0.05). ODI, VAS (9.17±1.90) % and(1.67±0.82), were improved at 1 month compared with 1 week after operation (P<0.05). There were no significant difference in postoperative ODI and VAS at 1, 3 and 6 months (P>0.05). At the latest follow-up, 8 patients got excellent result, 13 good, and 3 fair according to the modified MacNab standard.

Conclusion: ULBD under single channel endoscopy (Delta) has advantages of less trauma, less bleeding, short operation time, rapid postoperative recovery, and could receive satisfactory clinical effect.

目的：探讨单通道内镜下单侧椎板切开术双侧减压（ULBD）治疗腰椎融合术后邻段病变（ASD）的临床效果。方法：回顾性分析2021年1月至2023年1月24例腰椎融合术后行腰椎内镜下ULBD的患者，其中男性10例，女性14例，年龄54 ~ 77岁，平均（59.2±3.6）岁；L2 2例，3例，L3 16例，4例，L5S1 6例。记录手术时间和术中出血量，分别记录术前、术后1周、1、3、6个月的视觉模拟评分（VAS）和Oswestry残疾指数（ODI），采用改良MacNab标准评分法评价临床效果。结果：所有患者均顺利完成手术，无神经损伤、硬脑膜损伤及脑脊液漏。手术时间（90.3±11.8）min，术中出血量（35.3±5.3）ml，住院时间（14.4±2.1）d。24例患者均随访6个月。ODI和VAS分别由术前（51.25±5.48）%和（6.88±1.23）%改善至术后1周（9.29±1.76）%和（1.13±0.95）% （PPP>0.05）。最新随访时，根据改良MacNab标准，优8例，良13例，一般3例。结论：单通道内镜下ULBD具有创伤小、出血少、手术时间短、术后恢复快等优点，可获得满意的临床效果。

{"title":"[Early application of bilateral decompression under single channel endoscopic laminectomy in patients with adjacent vertebrae after lumbar fusion].","authors":"Tao Li, Bin Zhang","doi":"10.12200/j.issn.1003-0034.20240245","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20240245","url":null,"abstract":"Objective: To explore clinical effect of unilateral laminotomy for bilateral decompression (ULBD) under single channel endoscopic(Delta) in treating adjacent segment disease(ASD) after lumbar fusion.Methods: A retrospective analysis of 24 patients who underwent spinal endoscopic ULBD after lumbar fusion was performed from January 2021 to January 2023, including 10 males and 14 females, aged from 54 to 77 years old with an average of (59.2±3.6) years old;2 patients with L2,3, 16 patients with L3,4, and 6 patients with L5S1. Operative time and intraoperative blood loss were recorded, visual analogue scale (VAS) and Oswestry disability index (ODI) were recorded before oepration, 1 week, 1, 3 and 6 months after operation, respectively;the modified MacNab standard score evaluation was used to evaluate clinical effects.Results: All patients were successfully completed operation without nerve injury or dural injury and cerebrospinal fluid leakage. Operation time was (90.3±11.8) min, intraoperative blood loss was (35.3±5.3) ml, and hospital stay was (14.4±2.1) d. All 24 patients were followed up for 6 months. ODI and VAS were improved from (51.25±5.48) % and (6.88±1.23) before operation to (9.29±1.76) % and (1.13±0.95) at one week after operation, respectively (P<0.05). ODI, VAS (9.17±1.90) % and(1.67±0.82), were improved at 1 month compared with 1 week after operation (P<0.05). There were no significant difference in postoperative ODI and VAS at 1, 3 and 6 months (P>0.05). At the latest follow-up, 8 patients got excellent result, 13 good, and 3 fair according to the modified MacNab standard.Conclusion: ULBD under single channel endoscopy (Delta) has advantages of less trauma, less bleeding, short operation time, rapid postoperative recovery, and could receive satisfactory clinical effect.","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"37 12","pages":"1153-7"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882968","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}

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