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OBJECTIVE@#To explore the safety and effectiveness of one-stage posterior eggshell osteotomy and long-segment pedicle screw fixation in the treatment of ankylosing spondylitis kyphosis combined with acute thoracolumbar vertebral fracture.@*METHODS@#A clinical data of 20 patients with ankylosing spondylitis kyphosis combined with acute thoracolumbar spine fracture, who were treated with one-stage posterior eggshell osteotomy and long-segment pedicle screw fixation between April 2016 and January 2022, was retrospectively analyzed. Among them, 16 cases were male and 4 cases were female; their ages ranged from 32 to 68 years, with an average of 45.9 years. The causes of injury included 10 cases of sprain, 8 cases of fall, and 2 cases of falling from height. The time from injury to operation ranged from 1 to 12 days, with an average of 7.1 days. The injured segment was T 11 in 2 cases, T 12 in 2 cases, L 1 in 6 cases, and L 2 in 10 cases. X-ray film and CT showed that the patients had characteristic imaging manifestations of ankylosing spondylitis, and the fracture lines were involved in the anterior, middle, and posterior columns and accompanied by different degrees of kyphosis and vertebral compression; and MRI showed that 12 patients had different degrees of nerve injuries. The operation time, intraoperative bleeding, intra- and post-operative complications were recorded. The visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate the low back pain and quality of life, and the American spinal cord injury association (ASIA) classification was used to evaluate the neurological function. X-ray films were taken, and local Cobb angle (LCA) and sagittal vertical axis (SVA) were measured to evaluate the correction of the kyphosis.@*RESULTS@#All operations were successfully completed and the operation time ranged from 127 to 254 minutes (mean, 176.3 minutes). The amount of intraoperative bleeding ranged from 400 to 950 mL (mean, 722.5 mL). One case of dural sac tear occurred during operation, and no cerebrospinal fluid leakage occurred after repair, and the rest of the patients did not suffer from neurological and vascular injuries, cerebrospinal fluid leakage, and other related complications during operation. All incisions healed by first intention without infection or fat liquefaction. All patients were followed up 8-16 months (mean, 12.5 months). The VAS score, ODI, LCA, and SVA at 3 days after operation and last follow-up significantly improved when compared with those before operation ( P<0.05), and the difference between 3 days after operation and last follow-up was not significant ( P>0.05). The ASIA grading of neurological function at last follow-up also significantly improved when compared with that before operation ( P<0.05), including 17 cases of grade E and 3 cases of grade D. At last follow-up, all bone grafts achieved bone fusion, and no complications such as loosening, breaking of internal fixation, and pseudoarthrosis occurred.@*CONCLUSION@#One-stage posterior eggshell osteotomy and long-segment pedicle screw fixation is an effective surgical procedure for ankylosing spondylitis kyphosis combined with acute thoracolumbar vertebral fracture. It can significantly relieve patients' clinical symptoms and to some extent, alleviate the local kyphotic deformity.
Subject(s)
Humans , Male , Female , Animals , Adult , Middle Aged , Aged , Spinal Fractures/surgery , Pedicle Screws , Spondylitis, Ankylosing/surgery , Quality of Life , Retrospective Studies , Egg Shell/injuries , Thoracic Vertebrae/injuries , Lumbar Vertebrae/injuries , Kyphosis/surgery , Osteotomy , Fracture Fixation, Internal/methods , Fractures, Compression/surgery , Treatment OutcomeABSTRACT
[Objective]The purpose of this study was to describe mid report the result of the ulnar nerve transfer to biceps muscle to restore elbow flexion after acute and delayed upper brachial plexus injuries.[Methods]Two patients with acute brachial plexus injury (the time between the injury and the operation were six and eight months) and three patients with delayed brachial plexus injury(the time between the injury and the operation were from twevle to eighteen months) underwent nerve transfer using fascicles of the ulnar nerve to the motor branch of the biceis muscle. The average age of the patients was twenty eight and the mean follow-up periods were nine months after the surgery. Patients were evaluated with regard to reinnervation of the biceps, ulnar nerve function, elbow flexion strength, and grip strength.[Results]For the two acute patients, the first sign of biceps muscle contraction were observed within 1 week, the average time required for reinnervation of the biceps after nerve fascicle transfer was within six months. For the three delayed patients, the first sign of bicep muscle contraction was observed in about three month, and the average time required for reinnervation of the biceps was ten months.Hypoesthesia of the ulnar nerve was clinically abserved in three patients, but this symptom disappeared within month with no treatment.Compared with those delayed cases, the acute patients had faster and better recovery of their olbow flexion function.However, all patients achieved grade-3 or better elbow flexion strength according to the grading system of the Medical Research Council.[Conclusion]The author recommend this safe, simple and effective Oberlin procedure for brachial plexus injuries involving the C5、6 or C5~7 nerve roots.
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Objective To investigate the clinical effect of arthroscopic anterior cruciate ligament(ACL) reconstruction using autologous multi-strands of hamstring tendon.Method From May 2002 to Dec.2006,arthroscopic reconstruction of the anterior cruciate ligament using multi-strands of hamstring tendon was performed on 39 patients.Among them,28 cases were followed up for 7 to 48 months(average 13.5±2.3 months).Result The median Lysholm knee score was improved from 47.3±3.6 to 91.3±2.9 after operation.Conclusion Arthruscopic reconstruction of the anterior cruciate ligament using muhi-strands of hamstring tendons is a good alternative method with minimal invasion and convenient tendon harvesting and fewer complication and reliable clinical effect.
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Objective: To explore the state of mental health level of students in private college.Methods Private college students in Xi'an were tested with SCL-90,and the results were compared to those in domestic general college norm.Results: The mental health level of private college students is worse than that of general college students.Further more,there is also remarkable difference of the mental health level between new students with the junior and senior college students.Conclusion: The mental health state of private college students is not optimistic and should be taken seriously by the department responsible.For improve the mental health level of the private college students,the works and mental guides should be strengthened in private college.