Pub Date : 2024-12-15DOI: 10.7507/1002-1892.202403052
Dongqiang Yang, Songsong Wei, Yijun Liu, Yong Hu
Objective: A prospective study was conducted to investigate the feasibility and effectiveness of three-dimensional printed in vitro guide plates assisted hip arthroscopy in the treatment of Cam-type femoroacetabular impingement (FAI).
Methods: The clinical data of 25 patients with Cam-type FAI who met the selection criteria between December 2016 and September 2022 were collected. There were 13 males and 12 females with an average age of 42 years (range, 19-66 years). The disease duration ranged from 3 to 120 months, with an average of 22.2 months. The preoperative range of internal rotation-external rotation was (28.70±4.50)°, α angle was (69.04±0.99)°, visual analogue scale (VAS) score was 6.5±0.2, and modified Harris hip score (HHS) was 50.5±0.7. All patients were treated with hip arthroscopy assisted by three-dimensional printed in vitro guide plate. The occurrence of complications was observed postoperatively, α angle of the affected hip joint was measured on Dunn X-ray film, and the glenoid labrum injury was observed by MRI. The percentage of overlap between the Cam plasty area and the preoperative simulated grinding area was calculated by three-dimensional CT+reconstruction. The effectiveness was evaluated by VAS score and modified HHS score.
Results: Postoperative dorsalis pedis numbness occurred in 1 case, and the symptoms disappeared after 1 month of conventional drug treatment such as neurotrophy. Two cases of perineal skin injury occurred, and healed after symptomatic treatment. There was no male erectile dysfunction, deep incision infection, pulmonary embolism, or other serious complications occurred. The percentage of overlap between the Cam plasty area and the preoperative simulated grinding area was 81.6%-95.3%, with an average of 89.8%. All 25 patients were followed up 6-12 months, with an average of 8 months. At last follow-up, the range of internal rotation-external rotation was (40.10±2.98)°, α angle was (43.72±0.84)°, VAS score was 1.8±0.2, and the modified HHS score was 72.1±1.3, which significantly improved when compared with preoperative ones ( P<0.05).
Conclusion: The treatment of Cam-type FAI with three-dimensional printed in vitro guide plates assisted hip arthroscopy is safe and feasible, and can achieve good effectiveness.
{"title":"[Prospective study of three-dimensional-printed <i>in vitro</i> guide plates assisted hip arthroscopy in treatment of Cam-type femoroacetabular impingement].","authors":"Dongqiang Yang, Songsong Wei, Yijun Liu, Yong Hu","doi":"10.7507/1002-1892.202403052","DOIUrl":"10.7507/1002-1892.202403052","url":null,"abstract":"<p><strong>Objective: </strong>A prospective study was conducted to investigate the feasibility and effectiveness of three-dimensional printed <i>in vitro</i> guide plates assisted hip arthroscopy in the treatment of Cam-type femoroacetabular impingement (FAI).</p><p><strong>Methods: </strong>The clinical data of 25 patients with Cam-type FAI who met the selection criteria between December 2016 and September 2022 were collected. There were 13 males and 12 females with an average age of 42 years (range, 19-66 years). The disease duration ranged from 3 to 120 months, with an average of 22.2 months. The preoperative range of internal rotation-external rotation was (28.70±4.50)°, α angle was (69.04±0.99)°, visual analogue scale (VAS) score was 6.5±0.2, and modified Harris hip score (HHS) was 50.5±0.7. All patients were treated with hip arthroscopy assisted by three-dimensional printed <i>in vitro</i> guide plate. The occurrence of complications was observed postoperatively, α angle of the affected hip joint was measured on Dunn X-ray film, and the glenoid labrum injury was observed by MRI. The percentage of overlap between the Cam plasty area and the preoperative simulated grinding area was calculated by three-dimensional CT+reconstruction. The effectiveness was evaluated by VAS score and modified HHS score.</p><p><strong>Results: </strong>Postoperative dorsalis pedis numbness occurred in 1 case, and the symptoms disappeared after 1 month of conventional drug treatment such as neurotrophy. Two cases of perineal skin injury occurred, and healed after symptomatic treatment. There was no male erectile dysfunction, deep incision infection, pulmonary embolism, or other serious complications occurred. The percentage of overlap between the Cam plasty area and the preoperative simulated grinding area was 81.6%-95.3%, with an average of 89.8%. All 25 patients were followed up 6-12 months, with an average of 8 months. At last follow-up, the range of internal rotation-external rotation was (40.10±2.98)°, α angle was (43.72±0.84)°, VAS score was 1.8±0.2, and the modified HHS score was 72.1±1.3, which significantly improved when compared with preoperative ones ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>The treatment of Cam-type FAI with three-dimensional printed <i>in vitro</i> guide plates assisted hip arthroscopy is safe and feasible, and can achieve good effectiveness.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 12","pages":"1474-1479"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-15DOI: 10.7507/1002-1892.202409049
Qing Xu, Shuangjiang Wu, Jian Wu, Lian Zhou, Zhenhua Li, Yungang He, Yixiu Liu
<p><strong>Objective: </strong>To compare the effectiveness of poly ether ether ketone (PEEK) localization marker combined with mixed reality technology versus color doppler ultrasound guidance for the vessel localization of anterolateral thigh perforator flap.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 40 patients with tissue defects after oral cancer resection who underwent repair using the anterolateral thigh perforator flap between January 2022 and June 2023. According to the different intraoperative positioning methods of the anterolateral thigh perforator flap, they were randomly divided into PEEK group [using PEEK localization marker combined with mixed reality technology based on CT angiography (CTA) data] and color ultrasound group (using color ultrasound guidance), with 20 cases in each group. There was no significant difference in gender, age, etiology, and disease duration between the two groups ( <i>P</i>>0.05). The number of perforator vessels identified in the two groups of regions of interest was recorded, and compared them with the intraoperative actually detected number to calculate the success identifying rate of perforator vessels; the distance between the perforating point and the actual puncture point was measured, the operation time of the two groups of flaps was recorded.</p><p><strong>Results: </strong>In the PEEK group, 32 perforator vessels were identified, 34 were detected by intraoperative exploration, and the success identifying rate was 94.1% (32/34); in the color ultrasound group, 29 perforator vessels were identified, 33 were detected by intraoperative exploration, and the success identifying rate was 87.8% (29/33); there was a significant difference in the success identifying rate between the two groups ( <i>P</i><0.05). The distance between the perforating point and the actual puncture point and the operation time in PEEK group were significantly shorter than those in color ultrasound group ( <i>P</i><0.05). Patients in both groups were followed up 6-30 months, with a median of 17 months; there was no significant difference in follow-up time between the two groups ( <i>P</i>>0.05). In the PEEK group, there was 1 case of flap necrosis at the distal edge and delayed healing after trimming and dressing change. In the color ultrasound group, there was 1 case of flap necrosis at 7 days after operation and pectoralis major myocutaneous flap was selected for repair after removal of the necrotic flap. In the rest, the flap survived and the incision healed by first intention. Donor site infection occurred in 1 case in PEEK group and healed after anti-inflammatory treatment. The maxillofacial appearance of the two groups was good, the flap was not obviously bloated, and the patients were satisfied with the repair effect.</p><p><strong>Conclusion: </strong>Compared with the traditional color ultrasound guidance, the PEEK localization marker combined with mixed reality technology based on CTA
{"title":"[Application of poly ether ether ketone localization marker combined with mixed reality technology in vessel localization of anterolateral thigh perforator flap].","authors":"Qing Xu, Shuangjiang Wu, Jian Wu, Lian Zhou, Zhenhua Li, Yungang He, Yixiu Liu","doi":"10.7507/1002-1892.202409049","DOIUrl":"10.7507/1002-1892.202409049","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness of poly ether ether ketone (PEEK) localization marker combined with mixed reality technology versus color doppler ultrasound guidance for the vessel localization of anterolateral thigh perforator flap.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 40 patients with tissue defects after oral cancer resection who underwent repair using the anterolateral thigh perforator flap between January 2022 and June 2023. According to the different intraoperative positioning methods of the anterolateral thigh perforator flap, they were randomly divided into PEEK group [using PEEK localization marker combined with mixed reality technology based on CT angiography (CTA) data] and color ultrasound group (using color ultrasound guidance), with 20 cases in each group. There was no significant difference in gender, age, etiology, and disease duration between the two groups ( <i>P</i>>0.05). The number of perforator vessels identified in the two groups of regions of interest was recorded, and compared them with the intraoperative actually detected number to calculate the success identifying rate of perforator vessels; the distance between the perforating point and the actual puncture point was measured, the operation time of the two groups of flaps was recorded.</p><p><strong>Results: </strong>In the PEEK group, 32 perforator vessels were identified, 34 were detected by intraoperative exploration, and the success identifying rate was 94.1% (32/34); in the color ultrasound group, 29 perforator vessels were identified, 33 were detected by intraoperative exploration, and the success identifying rate was 87.8% (29/33); there was a significant difference in the success identifying rate between the two groups ( <i>P</i><0.05). The distance between the perforating point and the actual puncture point and the operation time in PEEK group were significantly shorter than those in color ultrasound group ( <i>P</i><0.05). Patients in both groups were followed up 6-30 months, with a median of 17 months; there was no significant difference in follow-up time between the two groups ( <i>P</i>>0.05). In the PEEK group, there was 1 case of flap necrosis at the distal edge and delayed healing after trimming and dressing change. In the color ultrasound group, there was 1 case of flap necrosis at 7 days after operation and pectoralis major myocutaneous flap was selected for repair after removal of the necrotic flap. In the rest, the flap survived and the incision healed by first intention. Donor site infection occurred in 1 case in PEEK group and healed after anti-inflammatory treatment. The maxillofacial appearance of the two groups was good, the flap was not obviously bloated, and the patients were satisfied with the repair effect.</p><p><strong>Conclusion: </strong>Compared with the traditional color ultrasound guidance, the PEEK localization marker combined with mixed reality technology based on CTA ","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 12","pages":"1499-1504"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-15DOI: 10.7507/1002-1892.202408068
Haotao Li, Liwen Li, Shimin Chang
Objective: To summarize the characteristics of posterior coronal banana-shaped fragments and its research progress in treatment of intertrochanteric femoral fracture with cephalomedullary nail, provide valuable reference for clinical practice.
Methods: Relevant domestic and foreign literature was extensively reviewed to summarize the history, anatomical structure of posterior coronal banana-shaped fragments, and the need for reduction and fixation, the influence on the stability of cephalomedullary nail, and the remedies.
Results: The posterior coronal banana-shaped fragments refers to the second level fracture line of the intertrochanteric femoral fracture, involving four anatomical structures, namely, the posterior part of the greater trochanter, the intertrochanteric crest, the lesser trochanter, and the posteromedial cortex. With the wide application of three-dimensional-CT in clinical practice, the posterior coronal banana-shaped fragments were more comprehensively understood. According to whether the anterior extension of the fracture line affects the integrity of the lateral entry of the head and neck implant, the posterior coronal banana-shaped fragments can be divided into small and large ones, of which the large single banana-shaped fragment account for about 20% of the AO/Orthopaedic Trauma Association (AO/OTA) type A2 fractures. If the large fragment involving the posteromedial wall (lesser trochanter) will increase the difficulty of the medial cortical contact reduction; or involving the posterolateral wall and resulting in rupture of the entry portal (type A2.4), which will cause sagittal swing of the nail in the femoral marrow cavity, thereby affecting the stability of the nail. There is no effective technique for reduction and fixation of the banana-shaped fragment nowadays. However, the adverse effects of posterior coronal banana-shaped fragment can be compensated by improving the quality of fracture reduction and choosing high filling cephalomedullary nail.
Conclusion: The posterior coronal banana-shaped fragments can easily lead to the rupture of the entry portal of head-neck implants, cause the sagittal swing of the cephalomedulis nail, and then lead to the loss of fracture reduction and affect the treatment effect. Whether the entry portal rupture or not and its risk factors still need further clinical and basic research.
目的：总结头髓钉治疗股骨粗隆间骨折后冠状香蕉状碎片的特点及研究进展，为临床提供有价值的参考。方法：广泛查阅国内外相关文献，总结冠状后香蕉状碎片的发病历史、解剖结构、复位固定的必要性、对头髓钉稳定性的影响及治疗措施。结果：后冠状香蕉状碎片是指股骨粗隆间骨折的第二级骨折线，累及股骨大转子后部、股骨粗隆间嵴、股骨小转子和股骨后内侧皮质四个解剖结构。随着三维ct在临床中的广泛应用，对冠状后香蕉状碎片的认识更加全面。根据骨折线前伸是否影响头颈假体外侧入口完整性，后冠状香蕉状碎片可分为大小两种，其中大单香蕉状碎片约占AO/Orthopaedic Trauma Association (AO/OTA) A2型骨折的20%。如果大碎片累及后内侧壁（小粗隆）会增加内侧皮质接触复位的难度；或累及后外壁，导致进入门静脉破裂（A2.4型），引起股骨髓腔内钉矢状摆动，从而影响钉的稳定性。目前还没有有效的香蕉形骨折复位固定技术。但提高骨折复位质量和选择高填充头髓钉可弥补后冠状香蕉状碎片的不良影响。结论：后冠状香蕉状碎片易导致头颈植入物入口破裂，引起头髓内钉矢状摆动，进而导致骨折复位丧失，影响治疗效果。入口门静脉是否破裂及其危险因素还需要进一步的临床和基础研究。
{"title":"[Characteristics of posterior coronal banana-shaped fragments and its research progress in treatment of intertrochanteric femoral fracture with cephalomedullary nail].","authors":"Haotao Li, Liwen Li, Shimin Chang","doi":"10.7507/1002-1892.202408068","DOIUrl":"10.7507/1002-1892.202408068","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the characteristics of posterior coronal banana-shaped fragments and its research progress in treatment of intertrochanteric femoral fracture with cephalomedullary nail, provide valuable reference for clinical practice.</p><p><strong>Methods: </strong>Relevant domestic and foreign literature was extensively reviewed to summarize the history, anatomical structure of posterior coronal banana-shaped fragments, and the need for reduction and fixation, the influence on the stability of cephalomedullary nail, and the remedies.</p><p><strong>Results: </strong>The posterior coronal banana-shaped fragments refers to the second level fracture line of the intertrochanteric femoral fracture, involving four anatomical structures, namely, the posterior part of the greater trochanter, the intertrochanteric crest, the lesser trochanter, and the posteromedial cortex. With the wide application of three-dimensional-CT in clinical practice, the posterior coronal banana-shaped fragments were more comprehensively understood. According to whether the anterior extension of the fracture line affects the integrity of the lateral entry of the head and neck implant, the posterior coronal banana-shaped fragments can be divided into small and large ones, of which the large single banana-shaped fragment account for about 20% of the AO/Orthopaedic Trauma Association (AO/OTA) type A2 fractures. If the large fragment involving the posteromedial wall (lesser trochanter) will increase the difficulty of the medial cortical contact reduction; or involving the posterolateral wall and resulting in rupture of the entry portal (type A2.4), which will cause sagittal swing of the nail in the femoral marrow cavity, thereby affecting the stability of the nail. There is no effective technique for reduction and fixation of the banana-shaped fragment nowadays. However, the adverse effects of posterior coronal banana-shaped fragment can be compensated by improving the quality of fracture reduction and choosing high filling cephalomedullary nail.</p><p><strong>Conclusion: </strong>The posterior coronal banana-shaped fragments can easily lead to the rupture of the entry portal of head-neck implants, cause the sagittal swing of the cephalomedulis nail, and then lead to the loss of fracture reduction and affect the treatment effect. Whether the entry portal rupture or not and its risk factors still need further clinical and basic research.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 12","pages":"1517-1523"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-15DOI: 10.7507/1002-1892.202408075
Song Wang, Hao Li, Jinlong Tang, Zhengya Zhu, Yong Liu
<p><strong>Objective: </strong>To compare the effectiveness of Achillon Achilles tendon suture guide combined with circuit suture under the perineural channel and Krachow suture with posterolateral incision of Achilles tendon in the treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture.</p><p><strong>Methods: </strong>The clinical data of 38 patients with Kuwada type Ⅱ acute closed Achilles tendon rupture who met the selection criteria between January 2020 and December 2023 were retrospectively analyzed. Krachow suture via posterolateral incision was used in 24 cases (traditional group), and Achillon Achilles tendon suture guide combined with circuit suture via perineural channel was used in 14 cases (minimally invasive group). There was no significant difference in baseline data such as age, gender, body mass index, cause of injury, time from injury to operation, characteristics of Achilles tendon injury (broken end distance, stump length), and preoperative Achilles tendon total rupture score (ATRS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot function score between the two groups ( <i>P</i>>0.05). The operation time, incision length, hospital stay, and complications (re-tear, incision infection, sural nerve irritation, deep venous thrombosis) were recorded. ATRS score and AOFAS ankle and hindfoot function score were used to evaluate the effectiveness before operation and at 3 and 6 months after operation.</p><p><strong>Results: </strong>All patients successfully completed the operation. The operation time, incision length, and hospital stay in the minimally invasive group were significantly shorter than those in the traditional group ( <i>P</i><0.05). Patients in both groups were followed up 8-16 months, with an average of 12.7 months. There was no sural nerve injury or re-tear of Achilles tendon in both groups. In the traditional group, 1 case had incision infection,1 case had suture rejection, and 1 case had intermuscular venous thrombosis; in the minimally invasive group, no incision healing complication, suture knot discomfort, or thrombosis occurred. There was no significant difference in the incidence of complications between the two groups ( <i>P</i>=0.283). The ATRS score and AOFAS ankle and hindfoot function score of the two groups were improved after operation, but there was no significant difference ( <i>P</i>>0.05). Except that there was no significant difference in AOFAS ankle and hindfoot function scores between the two groups at 6 months after operation ( <i>P</i>>0.05), the ATRS scores and AOFAS ankle and hindfoot function scores in the minimally invasive group were significantly better than those in the traditional group at other time points ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>The treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture with Achillon Achilles tendon suture guide combined with circuit suture via the perineural channel has similar ankle function compara
{"title":"[Comparative study of Achillon Achilles tendon suture guide combined with circuit suture via perineural channel and Krachow suture via posterolateral incision of Achilles tendon in treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture].","authors":"Song Wang, Hao Li, Jinlong Tang, Zhengya Zhu, Yong Liu","doi":"10.7507/1002-1892.202408075","DOIUrl":"10.7507/1002-1892.202408075","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness of Achillon Achilles tendon suture guide combined with circuit suture under the perineural channel and Krachow suture with posterolateral incision of Achilles tendon in the treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture.</p><p><strong>Methods: </strong>The clinical data of 38 patients with Kuwada type Ⅱ acute closed Achilles tendon rupture who met the selection criteria between January 2020 and December 2023 were retrospectively analyzed. Krachow suture via posterolateral incision was used in 24 cases (traditional group), and Achillon Achilles tendon suture guide combined with circuit suture via perineural channel was used in 14 cases (minimally invasive group). There was no significant difference in baseline data such as age, gender, body mass index, cause of injury, time from injury to operation, characteristics of Achilles tendon injury (broken end distance, stump length), and preoperative Achilles tendon total rupture score (ATRS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot function score between the two groups ( <i>P</i>>0.05). The operation time, incision length, hospital stay, and complications (re-tear, incision infection, sural nerve irritation, deep venous thrombosis) were recorded. ATRS score and AOFAS ankle and hindfoot function score were used to evaluate the effectiveness before operation and at 3 and 6 months after operation.</p><p><strong>Results: </strong>All patients successfully completed the operation. The operation time, incision length, and hospital stay in the minimally invasive group were significantly shorter than those in the traditional group ( <i>P</i><0.05). Patients in both groups were followed up 8-16 months, with an average of 12.7 months. There was no sural nerve injury or re-tear of Achilles tendon in both groups. In the traditional group, 1 case had incision infection,1 case had suture rejection, and 1 case had intermuscular venous thrombosis; in the minimally invasive group, no incision healing complication, suture knot discomfort, or thrombosis occurred. There was no significant difference in the incidence of complications between the two groups ( <i>P</i>=0.283). The ATRS score and AOFAS ankle and hindfoot function score of the two groups were improved after operation, but there was no significant difference ( <i>P</i>>0.05). Except that there was no significant difference in AOFAS ankle and hindfoot function scores between the two groups at 6 months after operation ( <i>P</i>>0.05), the ATRS scores and AOFAS ankle and hindfoot function scores in the minimally invasive group were significantly better than those in the traditional group at other time points ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>The treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture with Achillon Achilles tendon suture guide combined with circuit suture via the perineural channel has similar ankle function compara","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 12","pages":"1486-1491"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To compare effectiveness of injecting platelet-rich plasma (PRP) with different concentrations of leukocytes under ultrasound in treatment of supraspinatus tendon injury.
Methods: A clinical data of 30 patients with supraspinatus tendon injury, who met the selection criteria and were admitted between December 2022 and December 2023, was retrospectively analyzed. Thirty patients were treated with 4 injections of leukocyte-poor PRP (LP-PRP, n=10), leukocyte-rich PRP (LR-PRP, n=11), and triamcinolone ( n=9), with an interval of 7-10 days between each injection. There was no significant difference between groups ( P>0.05) in the age, gender, disease duration, affected shoulder side, Ellman classification, preoperative visual analogue scale (VAS) score, Constant score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and American Shoulder and Elbow Surgeons (ASES) score. At 1, 3, and 6 months after injection, the shoulder pain and function were evaluated by using the VAS score, Constant score, DASH score, and ASES score. MRI was conducted to observe supraspinatus tendon healing.
Results: No severe adverse reactions was observed in all groups. All patients were followed up 6-7 months, with an average of 6.5 months. After injection, the ASES score and Constant score gradually increased in the LR-PRP group and LP-PRP group, while the VAS score and DASH score decreased, with significant differences compared to before injection ( P<0.05). Except for no significant difference between 3 and 6 months after injection in LR-PRP group ( P>0.05), the above scores showed significant differences between different time points ( P<0.05). At 1 month after injection, the Constant score in triamcinolone group significantly increased compared to before injection, while the VAS score significantly decreased ( P<0.05). There was no significant difference in all scores between other time points in the triamcinolone group ( P>0.05). Except for 1 month after injection, there was no significant difference in Constant score and VAS score between groups ( P>0.05). At all other time points, the LR-PRP group and LP-PRP group had better scores than the triamcinolone group ( P<0.05). There was no significant difference between the LR-PRP group and the LP-PRP group ( P>0.05). MRI showed that only 4 patients in the LP-PRP group had signs of repair at the supraspinatus tendon injury site at 6 months after injection, while no significant tendon repair sign was observed in the other patients.
Conclusion: Compared with triamcinolone treatment, multiple injections of LP-PRP and LR-PRP under ultrasound can promote the recovery of shoulder joint function and significantly relieve pain in patients with supraspinatus tendon injury, and imaging improvement can be seen after LP-PRP treatment.
{"title":"[Comparative study on effectiveness of injecting platelet-rich plasma with different concentrations of leukocytes under ultrasound in treatment of supraspinatus tendon injury].","authors":"Xu Li, Jun Li, Ying Dai, Xiaoju Guo, Yongqing Xu, Yongzheng Gu, Qilin Zhao","doi":"10.7507/1002-1892.202408094","DOIUrl":"10.7507/1002-1892.202408094","url":null,"abstract":"<p><strong>Objective: </strong>To compare effectiveness of injecting platelet-rich plasma (PRP) with different concentrations of leukocytes under ultrasound in treatment of supraspinatus tendon injury.</p><p><strong>Methods: </strong>A clinical data of 30 patients with supraspinatus tendon injury, who met the selection criteria and were admitted between December 2022 and December 2023, was retrospectively analyzed. Thirty patients were treated with 4 injections of leukocyte-poor PRP (LP-PRP, <i>n</i>=10), leukocyte-rich PRP (LR-PRP, <i>n</i>=11), and triamcinolone ( <i>n</i>=9), with an interval of 7-10 days between each injection. There was no significant difference between groups ( <i>P</i>>0.05) in the age, gender, disease duration, affected shoulder side, Ellman classification, preoperative visual analogue scale (VAS) score, Constant score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and American Shoulder and Elbow Surgeons (ASES) score. At 1, 3, and 6 months after injection, the shoulder pain and function were evaluated by using the VAS score, Constant score, DASH score, and ASES score. MRI was conducted to observe supraspinatus tendon healing.</p><p><strong>Results: </strong>No severe adverse reactions was observed in all groups. All patients were followed up 6-7 months, with an average of 6.5 months. After injection, the ASES score and Constant score gradually increased in the LR-PRP group and LP-PRP group, while the VAS score and DASH score decreased, with significant differences compared to before injection ( <i>P</i><0.05). Except for no significant difference between 3 and 6 months after injection in LR-PRP group ( <i>P</i>>0.05), the above scores showed significant differences between different time points ( <i>P</i><0.05). At 1 month after injection, the Constant score in triamcinolone group significantly increased compared to before injection, while the VAS score significantly decreased ( <i>P<</i>0.05). There was no significant difference in all scores between other time points in the triamcinolone group ( <i>P</i>>0.05). Except for 1 month after injection, there was no significant difference in Constant score and VAS score between groups ( <i>P</i>>0.05). At all other time points, the LR-PRP group and LP-PRP group had better scores than the triamcinolone group ( <i>P</i><0.05). There was no significant difference between the LR-PRP group and the LP-PRP group ( <i>P</i>>0.05). MRI showed that only 4 patients in the LP-PRP group had signs of repair at the supraspinatus tendon injury site at 6 months after injection, while no significant tendon repair sign was observed in the other patients.</p><p><strong>Conclusion: </strong>Compared with triamcinolone treatment, multiple injections of LP-PRP and LR-PRP under ultrasound can promote the recovery of shoulder joint function and significantly relieve pain in patients with supraspinatus tendon injury, and imaging improvement can be seen after LP-PRP treatment.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 12","pages":"1445-1450"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-15DOI: 10.7507/1002-1892.202408050
Lu Liu, Xinuo Zhang, Nan Kang
Objective: To review the application status, clinical advantages, and complications of unilateral biportal endoscopy (UBE) technique and explore its future development direction.
Methods: By reviewing recent domestic and international literature, the evolution history of UBE technique, its surgical advantages, and its application effectiveness in various spinal diseases were analyzed, providing a comprehensive review.
Results: UBE technique, with its unique dual-channel design, provides a clearer surgical field and more flexible operating space, significantly reduces surgical trauma and postoperative recovery time. UBE technique has demonstrated high safety and effectiveness in the treatment of lumbar disc herniation, spinal stenosis, lumbar instability, and cervical spondylosis. Additionally, the complication incidence of UBE surgery is lower than that of traditional open surgery.
Conclusion: In recent years, UBE technique has shown good clinical application prospects and efficacy, but further technical optimization and large-scale clinical research are still needed to ensure the safety and effectiveness. In the future, the combination of UBE technique and intelligent medical and surgical robotics technology is expected to promote the further development of spinal surgery.
{"title":"[Application status and considerations of unilateral biportal endoscopy technique].","authors":"Lu Liu, Xinuo Zhang, Nan Kang","doi":"10.7507/1002-1892.202408050","DOIUrl":"10.7507/1002-1892.202408050","url":null,"abstract":"<p><strong>Objective: </strong>To review the application status, clinical advantages, and complications of unilateral biportal endoscopy (UBE) technique and explore its future development direction.</p><p><strong>Methods: </strong>By reviewing recent domestic and international literature, the evolution history of UBE technique, its surgical advantages, and its application effectiveness in various spinal diseases were analyzed, providing a comprehensive review.</p><p><strong>Results: </strong>UBE technique, with its unique dual-channel design, provides a clearer surgical field and more flexible operating space, significantly reduces surgical trauma and postoperative recovery time. UBE technique has demonstrated high safety and effectiveness in the treatment of lumbar disc herniation, spinal stenosis, lumbar instability, and cervical spondylosis. Additionally, the complication incidence of UBE surgery is lower than that of traditional open surgery.</p><p><strong>Conclusion: </strong>In recent years, UBE technique has shown good clinical application prospects and efficacy, but further technical optimization and large-scale clinical research are still needed to ensure the safety and effectiveness. In the future, the combination of UBE technique and intelligent medical and surgical robotics technology is expected to promote the further development of spinal surgery.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 12","pages":"1510-1516"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-15DOI: 10.7507/1002-1892.202408062
Ming Zhou, Li Gong, Huiming Hou, Wen Zou, Shaoyong Fan, Liangshen Hu, Tao Xu
Objective: To explore effectiveness of arthroscopic Eden-Hybinette procedure with Triple-Pulley and four point anti-rotation fixation technique in the treatment of recurrent anterior dislocation of shoulder joint.
Methods: A clinical data of 14 patients with recurrent anterior dislocation of shoulder joint and glenoid bone defect, who were met the selective criteria and admitted between February 2021 and February 2022, was retrospectively analyzed. All patients were treated with arthroscopic Eden-Hybinette procedure and the bone blocks were fixed by using Triple-Pulley and four point anti-rotation fixation technique. There were 9 males and 5 females with an average age of 31.2 years (range, 22-40 years). Shoulder dislocation occurred 4-10 times (mean, 6.8 times). The time from the initial dislocation to the admission was 1-6 years (mean, 3.3 years). The Instability Severity Index Score (ISIS) was 7.2±0.8, the Beighton score was 2.9±2.4, and the width ratio of glenoid bone defect was 26.64%±1.86%. Pre- and post-operative visual analogue scale (VAS) score, the University of Califonia-Los Angeles (UCLA) shoulder score, Constant score, and American Association of Shoulder and Elbow Surgeons (ASES) score were used to evaluate shoulder pain and function. The position, healing, resorption, and remodeling (glenoid area) of the bone blocks were evaluated by CT of shoulder joint.
Results: All patients underwent surgery successfully without any serious complications. All patients were followed up 11.5-13.8 months (mean, 12.0 months). The VAS scores of shoulder joint after operation decreased compared to preoperative levels, while the UCLA score, Constant score, and ASES score all increased, with significant differences ( P<0.05). And with the prolongation of time, the above indicators further improved, and the differences between different time points were significant ( P<0.05). Imaging reexamination showed that the bone block completely filled the glenoid defect, with good position and no significant displacement. Over time, the bone block healed and partially absorbed and remodelled. The postoperative glenoid area increased significantly compared to preoperative area ( P<0.05). With the prolongation of time, the glenoid area significantly decreased, but the difference was not significant between different time points ( P>0.05).
Conclusion: For the recurrent anterior dislocation of shoulder joint, Triple-Pulley and four point anti-rotation fixation technique in Eden-Hybinette procedure can effectively prevent bone rotation, make fixation more reliable, and easy to operate and achieve good effectiveness.
{"title":"[Arthroscopic Eden-Hybinette procedure with Triple-Pulley and four point anti-rotation fixation technique for recurrent anterior dislocation of shoulder joint].","authors":"Ming Zhou, Li Gong, Huiming Hou, Wen Zou, Shaoyong Fan, Liangshen Hu, Tao Xu","doi":"10.7507/1002-1892.202408062","DOIUrl":"10.7507/1002-1892.202408062","url":null,"abstract":"<p><strong>Objective: </strong>To explore effectiveness of arthroscopic Eden-Hybinette procedure with Triple-Pulley and four point anti-rotation fixation technique in the treatment of recurrent anterior dislocation of shoulder joint.</p><p><strong>Methods: </strong>A clinical data of 14 patients with recurrent anterior dislocation of shoulder joint and glenoid bone defect, who were met the selective criteria and admitted between February 2021 and February 2022, was retrospectively analyzed. All patients were treated with arthroscopic Eden-Hybinette procedure and the bone blocks were fixed by using Triple-Pulley and four point anti-rotation fixation technique. There were 9 males and 5 females with an average age of 31.2 years (range, 22-40 years). Shoulder dislocation occurred 4-10 times (mean, 6.8 times). The time from the initial dislocation to the admission was 1-6 years (mean, 3.3 years). The Instability Severity Index Score (ISIS) was 7.2±0.8, the Beighton score was 2.9±2.4, and the width ratio of glenoid bone defect was 26.64%±1.86%. Pre- and post-operative visual analogue scale (VAS) score, the University of Califonia-Los Angeles (UCLA) shoulder score, Constant score, and American Association of Shoulder and Elbow Surgeons (ASES) score were used to evaluate shoulder pain and function. The position, healing, resorption, and remodeling (glenoid area) of the bone blocks were evaluated by CT of shoulder joint.</p><p><strong>Results: </strong>All patients underwent surgery successfully without any serious complications. All patients were followed up 11.5-13.8 months (mean, 12.0 months). The VAS scores of shoulder joint after operation decreased compared to preoperative levels, while the UCLA score, Constant score, and ASES score all increased, with significant differences ( <i>P</i><0.05). And with the prolongation of time, the above indicators further improved, and the differences between different time points were significant ( <i>P</i><0.05). Imaging reexamination showed that the bone block completely filled the glenoid defect, with good position and no significant displacement. Over time, the bone block healed and partially absorbed and remodelled. The postoperative glenoid area increased significantly compared to preoperative area ( <i>P</i><0.05). With the prolongation of time, the glenoid area significantly decreased, but the difference was not significant between different time points ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>For the recurrent anterior dislocation of shoulder joint, Triple-Pulley and four point anti-rotation fixation technique in Eden-Hybinette procedure can effectively prevent bone rotation, make fixation more reliable, and easy to operate and achieve good effectiveness.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 12","pages":"1439-1444"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objective: </strong>To explore the effect of intravenous tranexamic acid on postoperative drainage and elbow joint function after traumatic elbow stiffness release.</p><p><strong>Methods: </strong>The clinical data of 44 patients with elbow joint stiffness who were treated with release surgery between March 2022 and December 2023 and met the selection criteria were retrospectively analyzed. Among them, 20 patients were given intravenous infusion of 100 mL (1 g/100 mL, once a day) of tranexamic acid solution for 3 consecutive days after surgery (group A), and 24 patients were not treated with tranexamic acid after surgery (group B). There was no significant difference in baseline data such as gender, age, side, body mass index, initial injury, and preoperative hemoglobin, visual analogue scale (VAS) score, and Mayo elbow function score (MEPS), elbow flexion and extension activity between the two groups ( <i>P</i>>0.05). The drainage volume at 1 day and 3 days after operation, total drainage volume, drainage tube indwelling time, postoperative hospital stay, VAS score before operation and at 1, 2, and 3 days after operation, MEPS score before operation, at 3 months after operation, and at last follow-up, and elbow flexion and extension activity before operation and at last follow-up were recorded and compared between the two groups.</p><p><strong>Results: </strong>Both groups of patients successfully completed the operation, and there was no significant difference in operation time ( <i>P</i>>0.05). The drainage volume at 1 day and 3 days after operation, total drainage volume, drainage tube indwelling time, and postoperative hospital stay in group A were significantly less than those in group B ( <i>P</i><0.05). Both groups of patients were followed up 6-12 months, with an average of 8.6 months. No complications such as wound infection, elbow joint varus and varus instability or dislocation, and pulmonary embolism or other thromboembolic events occurred in either group. The VAS scores of both groups were significantly higher at 1 day and 2 days after operation than before operation ( <i>P</i><0.05); the VAS score of group A was significantly lower than that of group B ( <i>P</i><0.05). The VAS scores of both groups decreased to the preoperative level at 3 months after operation, and there was no significant difference between the two groups ( <i>P</i>>0.05). At 3 months after operation and at last follow-up, the MEPS scores of both groups significantly improved when compared with those before operation ( <i>P</i><0.05); there was no significant difference between the two groups ( <i>P</i>>0.05). At last follow-up, the postoperative elbow flexion and extension activity of the two groups significantly increased when compared with that before operation ( <i>P</i><0.05); there was no significant difference in change of elbow flexion and extension activity between the two groups ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Intravenou
{"title":"[Effect of intravenous tranexamic acid on postoperative drainage and elbow joint function after traumatic elbow stiffness release].","authors":"Weihao Meng, Lingzhe Xuan, Fengfeng Li, Zitao Zhang","doi":"10.7507/1002-1892.202407012","DOIUrl":"10.7507/1002-1892.202407012","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effect of intravenous tranexamic acid on postoperative drainage and elbow joint function after traumatic elbow stiffness release.</p><p><strong>Methods: </strong>The clinical data of 44 patients with elbow joint stiffness who were treated with release surgery between March 2022 and December 2023 and met the selection criteria were retrospectively analyzed. Among them, 20 patients were given intravenous infusion of 100 mL (1 g/100 mL, once a day) of tranexamic acid solution for 3 consecutive days after surgery (group A), and 24 patients were not treated with tranexamic acid after surgery (group B). There was no significant difference in baseline data such as gender, age, side, body mass index, initial injury, and preoperative hemoglobin, visual analogue scale (VAS) score, and Mayo elbow function score (MEPS), elbow flexion and extension activity between the two groups ( <i>P</i>>0.05). The drainage volume at 1 day and 3 days after operation, total drainage volume, drainage tube indwelling time, postoperative hospital stay, VAS score before operation and at 1, 2, and 3 days after operation, MEPS score before operation, at 3 months after operation, and at last follow-up, and elbow flexion and extension activity before operation and at last follow-up were recorded and compared between the two groups.</p><p><strong>Results: </strong>Both groups of patients successfully completed the operation, and there was no significant difference in operation time ( <i>P</i>>0.05). The drainage volume at 1 day and 3 days after operation, total drainage volume, drainage tube indwelling time, and postoperative hospital stay in group A were significantly less than those in group B ( <i>P</i><0.05). Both groups of patients were followed up 6-12 months, with an average of 8.6 months. No complications such as wound infection, elbow joint varus and varus instability or dislocation, and pulmonary embolism or other thromboembolic events occurred in either group. The VAS scores of both groups were significantly higher at 1 day and 2 days after operation than before operation ( <i>P</i><0.05); the VAS score of group A was significantly lower than that of group B ( <i>P</i><0.05). The VAS scores of both groups decreased to the preoperative level at 3 months after operation, and there was no significant difference between the two groups ( <i>P</i>>0.05). At 3 months after operation and at last follow-up, the MEPS scores of both groups significantly improved when compared with those before operation ( <i>P</i><0.05); there was no significant difference between the two groups ( <i>P</i>>0.05). At last follow-up, the postoperative elbow flexion and extension activity of the two groups significantly increased when compared with that before operation ( <i>P</i><0.05); there was no significant difference in change of elbow flexion and extension activity between the two groups ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Intravenou","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1330-1335"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.7507/1002-1892.202404059
Song Guo, Ye Zhang, Jun Shang, Lei Meng, Dongfeng Li, Zhengyang Li, Mingyue Wang
<p><strong>Objective: </strong>To compare the effectiveness of robot-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open freehand TLIF for the treatment of single-level degenerative lumbar spondylolisthesis (DSL) and analyse the influence on postoperative adjacent segmental degeneration (ASD).</p><p><strong>Methods: </strong>The clinical data of 116 patients with L <sub>4、5</sub> DLS who were admitted between November 2019 and October 2021 and met the selection criteria were retrospectively analyzed. According to the surgical methods, they were divided into the robotic group (45 cases, who underwent robot-assisted MIS-TLIF) and the open group (71 cases, who underwent open freehand TLIF). There was no significant difference in baseline data such as gender, age, body mass index, DLS Meyerding grading, and preoperative Pfirrmann grading, Weishaupt grading, L <sub>3, 4</sub> intervertebral disc height (DH), L <sub>3, 4</sub> intervertebral mobility, sagittal parameters [including pelvic incidence (PI), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT)], and Cage height ( <i>P</i>>0.05). The grade of facet joint violation (FJV) by pedicle screws on the superior articular process was assessed postoperatively. Sagittal parameters, L <sub>3, 4</sub> DH, L <sub>3, 4</sub> DH loss, and L <sub>3, 4</sub> intervertebral mobility were measured preoperatively and at last follow-up in order to determine whether ASD occurred. Based on the occurrence of postoperative ASD, logistic regression analysis was used to identify the risk factors for ASD after TLIF.</p><p><strong>Results: </strong>Patients in both groups were followed up 21-47 months, with a mean of 36.1 months; there was no significant difference in the follow-up time between the two groups ( <i>P</i>>0.05). The occurrence of postoperative FJV was significantly better in the robotic group than in the open group ( <i>P</i><0.05). At last follow-up, the difference in the change values of sagittal parameters PI, PT, SS, and LL was not significant when comparing the two groups of patients ( <i>P</i>>0.05); the change values of L <sub>3, 4</sub> DH and L <sub>3, 4</sub> DH loss in the robotic group were smaller than those in the open group, and the change value of L <sub>3, 4</sub> intervertebral mobility was larger than that in the open group, and the differences were significant ( <i>P</i><0.05). At last follow-up, ASD occurred in 8 patients (17.8%) in the robotic group and 35 patients (49.3%) in the open group, and the difference in ASD incidence between the two groups was significant ( <i>P</i><0.05). logistic regression analysis showed that open surgery, preoperative Pfirrmann grading Ⅳ-Ⅴ, preoperative Weishaupt grading ≥2, and postoperative FJV grading ≥1 were risk factors for the development of ASD after TLIF ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>Compared with traditional open surgery, orthopedic robot-assisted MIS-TLIF in the treatment of singl
{"title":"[Effectiveness of robot-assisted minimally invasive and open freehand transforaminal lumbar interbody fusion in treatment of single-level degenerative lumbar spondylolisthesis and the influence on adjacent segment degeneration].","authors":"Song Guo, Ye Zhang, Jun Shang, Lei Meng, Dongfeng Li, Zhengyang Li, Mingyue Wang","doi":"10.7507/1002-1892.202404059","DOIUrl":"10.7507/1002-1892.202404059","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness of robot-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open freehand TLIF for the treatment of single-level degenerative lumbar spondylolisthesis (DSL) and analyse the influence on postoperative adjacent segmental degeneration (ASD).</p><p><strong>Methods: </strong>The clinical data of 116 patients with L <sub>4、5</sub> DLS who were admitted between November 2019 and October 2021 and met the selection criteria were retrospectively analyzed. According to the surgical methods, they were divided into the robotic group (45 cases, who underwent robot-assisted MIS-TLIF) and the open group (71 cases, who underwent open freehand TLIF). There was no significant difference in baseline data such as gender, age, body mass index, DLS Meyerding grading, and preoperative Pfirrmann grading, Weishaupt grading, L <sub>3, 4</sub> intervertebral disc height (DH), L <sub>3, 4</sub> intervertebral mobility, sagittal parameters [including pelvic incidence (PI), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT)], and Cage height ( <i>P</i>>0.05). The grade of facet joint violation (FJV) by pedicle screws on the superior articular process was assessed postoperatively. Sagittal parameters, L <sub>3, 4</sub> DH, L <sub>3, 4</sub> DH loss, and L <sub>3, 4</sub> intervertebral mobility were measured preoperatively and at last follow-up in order to determine whether ASD occurred. Based on the occurrence of postoperative ASD, logistic regression analysis was used to identify the risk factors for ASD after TLIF.</p><p><strong>Results: </strong>Patients in both groups were followed up 21-47 months, with a mean of 36.1 months; there was no significant difference in the follow-up time between the two groups ( <i>P</i>>0.05). The occurrence of postoperative FJV was significantly better in the robotic group than in the open group ( <i>P</i><0.05). At last follow-up, the difference in the change values of sagittal parameters PI, PT, SS, and LL was not significant when comparing the two groups of patients ( <i>P</i>>0.05); the change values of L <sub>3, 4</sub> DH and L <sub>3, 4</sub> DH loss in the robotic group were smaller than those in the open group, and the change value of L <sub>3, 4</sub> intervertebral mobility was larger than that in the open group, and the differences were significant ( <i>P</i><0.05). At last follow-up, ASD occurred in 8 patients (17.8%) in the robotic group and 35 patients (49.3%) in the open group, and the difference in ASD incidence between the two groups was significant ( <i>P</i><0.05). logistic regression analysis showed that open surgery, preoperative Pfirrmann grading Ⅳ-Ⅴ, preoperative Weishaupt grading ≥2, and postoperative FJV grading ≥1 were risk factors for the development of ASD after TLIF ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>Compared with traditional open surgery, orthopedic robot-assisted MIS-TLIF in the treatment of singl","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1379-1385"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objective: </strong>To compare the effectiveness of unilateral biportal endoscopy (UBE) technique assisted spinal canal decompression combined with percutaneous pedicle screw internal fixation versus traditional open decompression and internal fixation for treatment of lumbar burst fractures.</p><p><strong>Methods: </strong>A retrospective study was conducted on the clinical data of 61 patients with single-segment lumbar burst fractures who met the selection criteria and were admitted between October 2022 and December 2023. Of them, 25 patients received UBE technique assisted decompression combined with percutaneous pedicle screw fixation (UBE group), while 36 patients were treated with traditional posterior unilateral hemilaminectomy decompression and internal fixation (open group). There was no significant difference in baseline data between the two groups ( <i>P</i>>0.05), including gender, age, body mass index, fracture segment, cause of injury, AO classification of lumbar fractures, and preoperative height ratio of the anterior margin of injured vertebra, segmental kyphosis angle, rate of spinal canal invasion, the classification of American Spinal Injury Association (ASIA) grading, visual analogue scale (VAS) score, and Oswestry disability index (ODI). The operation time, intraoperative blood loss, and postoperative complications were recorded and compared between the two groups. VAS score, ODI, and ASIA grading were used to evaluate the effectiveness before operation, at 1 week after operation, and at last follow-up. Lumbar anteroposterior and lateral X-ray films and CT were performed to measure the segmental kyphosis angle, height ratio of the anterior margin of injured vertebra, and the rate of spinal canal invasion.</p><p><strong>Results: </strong>Surgery was successfully completed in both groups. No complication such as dural sac, nerve root, or vascular injury was found during operation, and all incisions healed by first intention. There was no significant difference in operation time between the two groups ( <i>P</i>>0.05), the UBE group revealed significant less intraoperative blood loss when compared with open group ( <i>P</i><0.05). Patients in both groups were followed up 6-20 months, with an average of 13 months. There was no loosening, breakage, or failure of internal fixation in all patients. The ASIA grading, VAS score, ODI of the two groups significantly improved at 1 week after operation and further improved at last follow-up ( <i>P</i><0.05). There was no significant difference in ASIA grading at 1 week after operation and last follow-up between the two groups ( <i>P</i>>0.05), but the VAS score and ODI in the UBE group were significantly superior to the open group ( <i>P</i><0.05). At 1 week after operation, the height ratio of the anterior margin of injured vertebra, segmental kyphosis angle, rate of spinal canal invasion significantly improved when compared to preoperative ones ( <i>P</i><0.05), the height ra
目的比较单侧双侧内窥镜（UBE）技术辅助椎管减压联合经皮椎弓根螺钉内固定与传统开放减压内固定治疗腰椎爆裂性骨折的效果：对符合入选标准且在2022年10月至2023年12月期间入院的61例单段腰椎爆裂性骨折患者的临床数据进行了回顾性研究。其中，25 名患者接受了 UBE 技术辅助减压联合经皮椎弓根螺钉固定术（UBE 组），36 名患者接受了传统的后路单侧半椎板切除减压和内固定术（开放组）。两组患者的性别、年龄、体重指数、骨折节段、致伤原因、腰椎骨折 AO 分级、术前受伤椎体前缘高度比、节段后凸角度、椎管侵袭率、美国脊柱损伤协会（ASIA）分级、视觉模拟量表（VAS）评分和 Oswestry 残疾指数（ODI）等基线数据无明显差异（P>0.05）。记录并比较两组患者的手术时间、术中失血量和术后并发症。采用 VAS 评分、ODI 和 ASIA 分级来评估术前、术后一周和最后一次随访的疗效。通过腰椎前后位、侧位X光片和CT测量节段后凸角、受伤椎体前缘高度比和椎管侵犯率：两组手术均顺利完成。结果：两组患者均顺利完成手术，术中未发现硬膜囊、神经根或血管损伤等并发症，所有切口均第一时间愈合。两组手术时间无明显差异（P>0.05），UBE组术中失血量明显少于开放组（PPP>0.05），但UBE组的VAS评分和ODI明显优于开放组（PPPConclusion）：UBE技术辅助椎管减压联合经皮椎弓根螺钉固定是一种安全有效的腰椎爆裂性骨折治疗方法，与传统的开放减压和内固定相比，创伤小、恢复快。
{"title":"[Effectiveness of unilateral biportal endoscopy technique combined with percutaneous pedicle screw fixation in treatment of lumbar burst fractures].","authors":"Ting Yan, Jun Zeng, Chao Wu, Xu Lin, Haigang Hu, Zeli Zhong","doi":"10.7507/1002-1892.202406050","DOIUrl":"10.7507/1002-1892.202406050","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness of unilateral biportal endoscopy (UBE) technique assisted spinal canal decompression combined with percutaneous pedicle screw internal fixation versus traditional open decompression and internal fixation for treatment of lumbar burst fractures.</p><p><strong>Methods: </strong>A retrospective study was conducted on the clinical data of 61 patients with single-segment lumbar burst fractures who met the selection criteria and were admitted between October 2022 and December 2023. Of them, 25 patients received UBE technique assisted decompression combined with percutaneous pedicle screw fixation (UBE group), while 36 patients were treated with traditional posterior unilateral hemilaminectomy decompression and internal fixation (open group). There was no significant difference in baseline data between the two groups ( <i>P</i>>0.05), including gender, age, body mass index, fracture segment, cause of injury, AO classification of lumbar fractures, and preoperative height ratio of the anterior margin of injured vertebra, segmental kyphosis angle, rate of spinal canal invasion, the classification of American Spinal Injury Association (ASIA) grading, visual analogue scale (VAS) score, and Oswestry disability index (ODI). The operation time, intraoperative blood loss, and postoperative complications were recorded and compared between the two groups. VAS score, ODI, and ASIA grading were used to evaluate the effectiveness before operation, at 1 week after operation, and at last follow-up. Lumbar anteroposterior and lateral X-ray films and CT were performed to measure the segmental kyphosis angle, height ratio of the anterior margin of injured vertebra, and the rate of spinal canal invasion.</p><p><strong>Results: </strong>Surgery was successfully completed in both groups. No complication such as dural sac, nerve root, or vascular injury was found during operation, and all incisions healed by first intention. There was no significant difference in operation time between the two groups ( <i>P</i>>0.05), the UBE group revealed significant less intraoperative blood loss when compared with open group ( <i>P</i><0.05). Patients in both groups were followed up 6-20 months, with an average of 13 months. There was no loosening, breakage, or failure of internal fixation in all patients. The ASIA grading, VAS score, ODI of the two groups significantly improved at 1 week after operation and further improved at last follow-up ( <i>P</i><0.05). There was no significant difference in ASIA grading at 1 week after operation and last follow-up between the two groups ( <i>P</i>>0.05), but the VAS score and ODI in the UBE group were significantly superior to the open group ( <i>P</i><0.05). At 1 week after operation, the height ratio of the anterior margin of injured vertebra, segmental kyphosis angle, rate of spinal canal invasion significantly improved when compared to preoperative ones ( <i>P</i><0.05), the height ra","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1372-1378"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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