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Objective:To investigate the difference between simple posterior interbody fixation and fusion and posterior interbody fixation combined with focus debridement and bone graft fusion for the treatment of mono- and bi-segmental lumbar brucella spondylitis.Methods:A total of 63 patients (42 males and 21 females), aged 50.9±8.18 years (range from 38 to 69 years) with mono- and bi-segmental lumbar brucella spondylitis who received surgical treatment from June 2014 to Feb 2018 were retrospectively analyzed. There were 44 cases of mono-segmental and 19 cases of bi-segmental. Thirty-one cases were treated with single posterior interbody fixation and fusion (PIFF group), and 32 caseswere treated with posterior interbody fixation combined with focus debridement and bone graft fusion (debridement group). The main observation indicators include operation time, intraoperative blood loss, postoperative hospital stay, postoperative medication time, Visual Analogue Scale(VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Frankel score and clinical efficacy.Results:All of 63 patients were followed up for 27.16±6.07 months (range 15 to 38 months). The operation time of mono-segmental patients of PIFF group was 105.86±16.66 min,the intraoperative blood loss was 295.00±55.11 ml, and the postoperative hospitalization was 4.45±1.53 days, which was significantly shorter than debridement group ( P<0.001), while the postoperative medication time was without significant difference between the two groups ( P>0.05). The opration time of bi-segmental patients of PIFF group was 150.33±26.29 min, the intraoperative blood loss was 242.05±50.56 ml, and the postoperative hospitalization was 4.56±1.50 days, which was significantly shorter than debridement group ( P<0.001), while the postoperative medication time was also without significant difference between the two groups. At the last follow-up time, the VAS scores and ODI values of mono- and bi-segments in PIFF group and debridement group were lower than those preoperation, but there was no significant difference between the two groups ( P>0.05). There was no significant difference in CRP between mono-segments of PIFF group and debridement group at the preoperation, 3 months after operation and the last follow-up time ( P>0.05). The CRP in mono-segments of PIFF group and debridement group decreased at 3 months after the operation compared with that preoperation, and the difference was statistically significant ( P<0.001). There was no significant difference in CRP between bi-segments of PIFF group and debridement group at 3 months after operation and the last follow-up time ( P>0.05). There was no significant difference in ESR between mono- and bi-segments of PIFF group and debridement group at 3 months after operation and the last follow-up time ( P>0.05). There was significant difference in ESR between mono- and bi-segments of PIFF group and debridement group at the preoperation, 3 months after operation and the last follow-up time. There was no statistical difference in the proportion of excellent postoperative clinical efficacy between the two groups. Complications were observed in two patients in PIFF group (6.5%, 2/31) compared with 8 patients in debridement group (25%, 8/32, χ2=4.057, P=0.044). Conclusion:On the basis of standardized anti-brucella drug therapy, simple posterior interbody fixation and fusion for the treatment of brucella spondylitis has a satisfactory surgical effect, and has the advantages of less surgical trauma, shorter time, earlier postoperative movement time and fewer complications.
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The coronavirus disease 2019 (COVID-19) epidemic has had a serious impact in the world. In the absence of vaccines and therapeutic drugs, disinfection has become an important technical means to block the spread of the virus. By analyzing the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we studied a series of disinfection technologies for COVID-19. During the outbreak of COVID-19, Jinan Second Center for Disease Control and Prevention disinfected the houses of the cases to be investigated in a community. The effectiveness of the disinfection technology was verified through the process of disinfection preparation, sampling before disinfection, field disinfection, sampling after disinfection and evaluation of disinfection effect. Compared the data before and after disinfection, the killing rate of the total bacterial colonies in the air and on the surface of the object was more than or equal to 90%, and no SARS-CoV-2 was detected after disinfection. The results show that the disinfection effect of the disinfection technology meets the standard. Finally, through the analysis of the wrong way of disinfection and the harm of over disinfection, the importance of scientific disinfection and precise disinfection are emphasized, and the research has a good guiding value for prevention and control of the epidemic.
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Humans , Betacoronavirus , Coronavirus Infections , Disinfection , Pandemics , Pneumonia, ViralABSTRACT
Objective To discuss the clinical efficacy of surgical treatment of pathologic vertebral surgery for thoracic and lumbar tuberculosis. Methods All of 322 cases of thoracic and lumbar spinal tuberculosis patients from December 2003 to June 2014 were retrospectively analyzed in our department. All patients were underwent debridement, fusion and nerve decompres?sion surgery. According to different fixed methods, patients were divided into pathologic vertebral surgery group (fixation complet?ed within lesions invaded motion unit) including 91 males and 100 females, with an average age of 41.53 years, and non?pathologic vertebral surgery group (long segments or short segment fixation) including 61 males and 70 females, with an average age of 42.72 years. We observed the tuberculosis cure rate, degrees of deformity, pain and neurological recovery, operative time, blood loss and complications by follow?up. Results The average follow?up time was 75.52 months in pathologic vertebral surgery group and 76.21 months in non?pathologic vertebral surgery group. The total number of pathologic vertebras in pathologic vertebral surgery group and non?pathologic vertebral surgery group were 277 and 218 respectively, and the average was 1.45 and 1.66. The total number of fixed segments was 277 in pathologic vertebral surgery group and 485 in non?pathologic vertebral surgery group, and the average fixed segments was 1.45 and 3.70. The cure rate was 85.86%in pathologic vertebral surgery group and 85.49%in non?pathologic vertebral surgery group at 6 months postoperatively, and 98.95%and 98.47%at the last follow?up time, with no signifi?cant difference between groups. Graft fusion rate was 89.00%in pathologic vertebral surgery group and 89.31%in non?pathologic vertebral surgery group 6 months postoperatively, 98.38%and 98.47%at the last follow?up time, without significant difference. In lumbar spine, the average correction of Cobb's angle was 12.4° in pathologic vertebral surgery group and 13.1° in non?pathologic vertebral surgery group, and the average angle loss was 1.3 and 1.4°, with no significant difference. In thoracolumbar, the average correction of Cobb’s angle was 10.9°in pathologic vertebral surgery group and 11.1°in non?pathologic vertebral surgery group, and the average angle loss was 1.7°and 1.5° respectively, without significant difference. However, in thoracic, the average correction of Cobb's angle was 10.2° in pathologic vertebral surgery group and 12.7° in non?pathologic vertebral surgery group, and the average angle loss was 3.6° and 2.5°respectively, with significant difference. The mean operation time was 210.45 min in pathologic verte?bral surgery group and 210.45 min in non?pathologic vertebral surgery group, with significant difference. The average blood loss was 726.12 ml in pathologic vertebral surgery group and 726.12 ml in non?pathologic vertebral surgery group, with significant dif?ference. The complication rate was 11.51%in pathologic vertebral surgery group and 11.45%in non?pathologic vertebral surgery group, with no significant difference. Conclusion Pathologic vertebral surgery surgery is a safe, effective and feasible method of operation for treatment of thoracic and lumbar tuberculosis, which can effectively preserve adjacent normal vertebral motion unit features. The thoracic surgery was less satisfactory than the lumbar and thoracolumbar surgery.
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OBJECTIVE: To evaluate the clinical outcomes of single-balloon kyphoplasty in the treatment of thoracic osteoporotic compression fractures via extrapedicular approach METHODS: From July 2004 to May 2008, 38 cases (52 vertebra) of thoracic osteoporotic fractures were treated by balloon kyphoplasty via unilateral extrapedicular approach, including 12 males and 26 females with an average age of 60.3 years (range 55-72 years). There were 34 cases of primary osteoporosis, and 4 had administrated hormone due to other diseases for over 6 months. Symptomatic levels ranged from T_4 to T_(12) confirmed by physical examination, MRI and X-ray. The pain relief, restoration of vertebral height and kyphosis correction were compared before and after operation by using visual analogue scale (VAS) and radiograph, respectively. In addition, bone cement leakage location and complications were recorded. RESULTS: Operation were successfully performed in 38 cases with an average injection of bone cement volume of (3.2+ 1.4) mL (2.25-4.60 mL in unilateral infusion). The mean time of surgery was 25-55 minutes, and that of follow-up was 9.5 months (6-24 months). Back pain of 36 cases was improved, and the VAS 3 days postoperatively and the final follow-up was significantly reduced (P < 0.05). The vertebral anterior margin and median height following surgery were significantly improved detected by X-ray (P < 0.05), and average median height restoration was (50.90+34.60)%, but no significant change was found in posterior height (P > 0.05). No lateral wedging or changes in the coronal alignment was found. Three cases (5 vertebra) had cement leakage: the bone cement of 1 case leaked to posterior margin through the puncture channel, and 2 cases leaked to lateral vertebra through vertebral venous system without any adverse event. The patients could move the second day after surgery, discharged from the hospital at days 3-4, and restored to normal life at 1 month postoperatively. No blood vessel or spinal cord puncture injury or pulmonary embolism, or blood vessel embolism was found. CONCLUSION: Unilateral extrapedicular kyphoplasty is safe and effective in treating thoracic osteoporotic fractures. It rapidly releases backache, restores the body height of fractured thoracic vertebrae and improves quality of life of the patients.