Comparative study on two different methods of lumbar interbody fusion with pedicle screw fixation for the treatment of spondylolisthesis / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the clinical outcome of transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) with pedicle screw fixation on the treatment of spondylolisthesis.</p><p><b>METHODS</b>One hundred and twenty patients with spondylolisthesis who were managed in our department were retrospectively evaluated. They were categorized into TLIF group and PLIF group according to the surgical methods, with 60 cases in each group. The slippage rate, the height of intervertebral space and intervertebral foramen were measured in each patient before and after operation and were compared between the two groups correspondingly. The interbody fusion rate, JOA score and complications after operation were also determined.</p><p><b>RESULTS</b>All the 120 patients were followed up for an average of 23 months (range, 16 to 35 months). Interbody bony fusion was achieved in every case and cage excursion or subsidence occurred in not any case. JOA score was rated as good or excellent in 83.3% of the TLIF cases and in 81.7% of the PLIF cases. There were no difference between the two groups (P > 0.05). Postoperative slippage rate was significantly less than preoperative ones in both groups (P < 0.01). No difference in lost of reduction at the final follow-up was found between TLIF and PLIF groups (P > 0.05). Significant increases in the height of intervertebral space and intervertebral foramen after operation were approved in both groups (P < 0.01), but no difference in these increases was confirmed between the two groups (P > 0.05). The lost of the height of intervertebral space and intervertebral foramen at the final follow-up were also similar between the two groups (P > 0.05).</p><p><b>CONCLUSIONS</b>TLIF and PLIF are good methods for the treatment of spondylolisthesis, both leading to satisfactory clinical outcomes. However, TLIF is relatively safer owing to its unilateral approach for interbody fusion.</p>

Comparison percutaneous cervical disc nucleoplasty and cervical discectomy for the treatment of cervical disc herniation / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the therapeutic effect of percutaneous cervical disc nucleoplasty (PCN group) and percutaneous cervical discectomy (PCD group) for the treatment of cervical disc herniation.</p><p><b>METHODS</b>A retrospective study was carried out from July of 2002 to December of 2004, and there were 80 cervical disc herniation cases who were operated by PCN (42 cases) or PCD (38 cases). The time of operation, clinical result and the stability of cervical spine after operation were evaluated and compared between 2 groups.</p><p><b>RESULTS</b>All cases had been followed up from 6 months to 26 months, average (12 +/- 5) months on the PCN group and (12 +/- 4) months on the PCD group, and there was no significant difference on 2 groups (t = -0.06, P = 0.953). All cases had been successfully operated. There was significant difference in the operation time between 2 groups (t = -21.70, P = 0.000). There was significant difference in the pre- and post-operation scores of each group (PCN group: t = 14.05, P = 0.000; PCD group: t = -14.79, P = 0.000). There was no significant difference in 2 groups of the clinical outcomes (z = -0.377, P = 0.706, > 0.05). There was no instability of cervical spine cases in 2 groups after operation (P > 0.05), and the cervical spine stability was no significant difference in pre- and-operation in each group.</p><p><b>CONCLUSIONS</b>PCN and PCD for the treatment of cervical disc herniation achieves good outcomes and no difference on the stability of cervical spine. PCN and PCD is a safe, minimally invasive, short time of operation, less traumatic operation and excellent clinical outcome.</p>

A clinical study of transverse patella fractures treated with minimally invasive tension band wire suture / 中华创伤骨科杂志

Objective To discuss clinical effects and indications of minimally invasive tension band technique in treatment of transverse patella fractures.Methods Thirty-eight patients with transverse patella fracture (close or slightly polluted open ones) were treated with minimally invasive tension band technique from July 1997 to June 2005 in our department.Twenty-six were fixated with percutaneous Kirschner wire tension hand and 12 with percutaneous cannulated screw tension band.The reduction,movement range and function of the knee were analyzed.Results Surgeries went on uneventfully.All the cases were followed up from six months to 6.5 years (average,32 months).Fracture healing time lasted from 6 to 12 weeks,averaging 7.7 weeks.No such compli- cations as traumatic arthritis occurred.Reduction was excellent in 21 cases,good in 11 and fair in six,with the good-to-excellent rate being 84.2%.All the affected knee joints could move in normal range.The functional re- covery was assessed as excellent in 34 cases and good in four.Conclusions Internal fixation with minimally invasive tension band technique is good for treatment of transverse patella fractures.It is chiefly fit for close or slightly polluted open fractures with limited wound,and can also be used for the comminuted fractures if the bone fragments are no more than three and the fracture site is suitable.