ABSTRACT
Objective To study the clinical efficacy of total hip arthroplasty for treatment of end-stage hip with pigmented villonodular synovitis(PVNS).Methods From January 2000 to March 2015,a total of 34 patients with hip PVNS were treated by total hip arthroplasty (THA) combined with synovectomy.Pelvic X-ray,CT and MRI examinations were performed before the surgery,and Harris hip joint function score was performed before and after surgery.Systematic rehabilitation training was performed after the operation,and the hip joint X-ray films were regularly reviewed.Results All the 34 patients were reviewed and observed for an average of 5.2 years (ranged from 1.5 to 7 years).The position of the prosthesis was good and the motion of the joint was satisfactory.The mean preoperative Harris hip scores improved from (45.0 ± 6.4) perioperatively to (90.2 ± 3.2) postoperatively,with statistically significant difference (t =0.468,P ＜ 0.05).None of the patients had clinical or radiographic evidence of recurrent PVNS.Conclusion Total hip arthroplasty combined with synovectomy is an effective therapeutic choice for end-stage hip with pigmented villonodular synovitis,which can improve the clinical results and prevent the disease recurrence.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the surgical methods and clinical results of modified transforaminal lumbar interbody fusion and internal fixation for the treatment of upper lumbar disc herniation.</p><p><b>METHODS</b>Clinical data of 32 cases of upper lumbar disc herniation in our department from June 2005 to June 2009 were retrospectively analyzed. There were 21 males and 11 females, the age from 24 to 59 years with an average of 38.5 years. All the cases were treated by the use of nucleus pulposus removed, modified transforaminal lumbar interbody fusion (TLIF) and internal fixation with pedicle screw system. All patients were followed up with an average of 9 months (from 3 to 18 months), according to Japanese Orthopedic Association (JOA) scores and visual analogue scores (VAS) to evaluate clinical effects.</p><p><b>RESULTS</b>All the cases were followed up from 3 to 18 months with an average of 9 months and the fusion rate was 100%. The JOA sores before and after operation were 10.5 +/- 2.1, 26.2 +/- 2.4 respectively, and the improvement rate was 84.9%. The VAS before and after operation was 7.2 +/- 1.3 and 1.4 +/- 1.1 respectively, and the rate of catabatic pain was 80.6%. Lumbar rigidity and unwell had 4 cases, obviously leg pain had 2 cases after operation, but the systems vanished gradually at 1-8 weeks after non-operative treatment.</p><p><b>CONCLUSION</b>Modified transforaminal lumbar interbody fusion has the advantages of simple, safe operation and thoroughly decompression, and it is a therapeutic method for upper lumbar disc herniation.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Follow-Up Studies , Internal Fixators , Intervertebral Disc Displacement , General Surgery , Therapeutics , Lumbar Vertebrae , Pathology , General Surgery , Spinal Fusion , Methods , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To analyze clinical characteristics and therapeutic efficacy of acute traumatic central cervical spinal-cord syndrome without fracture and dislocation,and to investigate its treatment methods.</p><p><b>METHODS</b>Clinical data of 47 cases with acute traumatic central cervical spinal-cord syndrome without fracture and dislocation were retrospectively analyzed. There were 3 female and 44 male,with a mean age of 56.2 years (ranging from 46 to 73 years). According to Frankel classification, 30 cases were grade B, 14 cases were grade C and 3 cases were grade D. Forty-two cases were treated without operation, and 5 cases which had significant compression factors or segmental instability were treated with surgical treatment. Among them, 3 cases were treated through anterior approach and 2 cases were treated through posterior approach. Causes of injuries, mechanisms of injuries,findings of imaging, functional impairment of nerve,methods of treatment,and therapeutic efficacy were analyzed.</p><p><b>RESULTS</b>The average followed-up time was 12 months (ranging form 3 to 84 months), 2 cases of non-operation were dead and 6 were loss. Three months after treatment, some complications occurrenced on 7 patients of non-operation. The majority bequeathed different degree impairment of intrinsic muscles of hands.</p><p><b>CONCLUSION</b>Reduction and fixation through the pedicle of fractured vertebra is an effective therapeutic options to treat the thoracolumbar burst fractures and desearved clinical study and expansion.</p>