ABSTRACT
Objective To assess the curative effect of microscopic anterior cervical approach in cervical spondylotic diseases. Methods A total of 75 patients were selected, who underwent microscopic subtotal anterior cervical decompres-sion and titanium mesh to fusion fixation or microscopic decompression of resection of the cervical intervertebral disc and cage implant fixation in Tianjin People's Hospital since October 2011 to October 2012. The Cervical vertebra gap involved 1 level in 41 cases, 2 levels in 30 cases and 3 levels in 4 cases. Pateints followed up regularly after operation. The nerve func-tion was assessed using Japanese orthopaedic association scoring system (JOA) function was calculated to examine the im-provement rate and to assess the curative effect of microscopic anterior cervical approach. Results All patients were fol-lowed up. The nerve function recovery was excellent in 44 cases, was well in 25 cases, was general in 6 cases, and the ex-cellent and well recovery rate was 92%. There was no significant difference between excellent recovery rate and well recov-ery rate. There were significant differences in values of each cervical levels between before and after surgery in the last fol-low-up of patients (P<0.05). Conclusion Microscopic operative treatment for cervical spondylotic is safe and effective, with less trauma and bleeding. After surgical decompression, the recovery is rapid in patients with early ambulation.
ABSTRACT
BACKGROUND:Screw loosening and shedding may occur after osteoporosis associated with lumbar degenerative disease treated with pedicle screw fixation. Application of pedicle screw enhanced with cured materials can improve the therapeutic effect. OBJECTIVE:To compare the clinical effect of pedicle screws enhanced with poly(methyl methacrylate) and injectable calcium sulfate cement in the lumbar internal fixation of osteoporosis. METHODS:Sixty-one patients diagnosed with osteoporosis combined with lumbar spondylolisthesis, lumbar spinal instability, and severe lumbar spinal stenosis were col ected. Al patients were divided into two groups according to the treatment method:poly(methyl methacrylate) bone cement enhanced pedicle screw group and calcium sulfate bone cement enhanced pedicle screw group. RESULTS AND CONCLUSION:There were no significant differences in the operation time, blood loss, preoperative and postoperative visual analog scale score, Japanese Orthopedic Association scores and the Japanese Orthopedic Association score improvement rate between two groups (P>0.05). The results showed that two patients had bone cement leakage in poly(methyl methacrylate) group which had no neurological symptoms caused by new symptoms during fol ow-up period. The bone mineral density was not improved gradual y in poly(methyl methacrylate) group with fol ow-up time prolonging;however, in calcium sulfate group, the bone mineral density was increased significantly after treatment, and the change of bone mineral density was linearly related with Japanese Orthopaedic Association score improvement rate in calcium sulfate group. No screw loosening, pul ing out or neurological dysfunction occurred in both groups. The results indicate that like poly(methyl methacrylate), balcium sulfate bone cement can increase the stability of pedicle screws.