ABSTRACT
BACKGROUND: In the elderly patients with degenerative lumbar spinal stenosis, bilateral nerve root canal stenosis commonly shows only one side of symptoms. There is still controversy about whether or not decompression is needed on the side without symptoms or with less symptoms and how to operate. OBJECTIVE: To explore the safety and efficacy of robot-assisted unilateral-decompression using minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) technique by investigating a series of cases with the radiographic bilateral lumbar canal stenosis presenting with unilateral symptoms and by comparing clinical decompression effect and imaging changes before and after operation. METHODS: Cases with radiographic bilateral lumbar canal stenosis presenting with unilateral symptoms subjected to unilateral decompression on the affected side, interbody fusion and bilateral fixation after robot-assisted MIS-TLIF in the same treatment group were retrospectively analyzed. Operation time, intraoperative blood loss and complications were recorded. The vertebral canal cross-sectional area, intervertebral foramen height, intervertebral space height, and lumbar lordosis angle were examined before and after surgery. Visual analogue scale scores for low back pain and leg pain were assessed before and after surgery. Oswestry disability index was used to assess lumbar function before and after surgery. Macnab criteria were used to evaluate the efficacy at the final follow-up after surgery. RESULTS AND CONCLUSION: (1) Operation time was 110-235 minutes, averagely 169.4 minutes. Intraoperative blood loss was 70-180 mL, averagely 112.4 mL. (2) After 3-8 months of follow-up, the visual analogue scale scores of low back pain and lower extremity pain 1 month after surgery and in final follow-up were significantly lower than those before operation (both P 0.05). (6) It is concluded that robot-assisted unilateral-decompression MIS-TLIF obtained satisfactory effect in bilateral lumbar canal stenosis patients presenting with unilateral symptoms.
ABSTRACT
@# Objective To summarize clinical characteristics and treatment methods of cervical vertebrae injury in the elderly.MethodsThe data of 59 elderly patients with cervical vertebrae injury from 2002 to 2006 years were retrospectively reviewed.ResultsThe most common type of injuries was hyperextension injuries of cervical spine and cervial central cord syndrome.Traffic accident and falling injury were the most common reasons.Early operation and early rehabilitation could improve the ASIA 1 or 2 grade,and avoid complications of cord injury effectively.ConclusionThe key treatment point of cervical vertebrae injury in the elderly is how to get them leave bed in order to reduce the complications of cord injury,early operation and rehabilitation are good method to decrease the mortality and increase quality of life.
ABSTRACT
@#Objective To summarize clinical characteristics and treatment methods of cervical vertebrae injury in the elderly.MethodsThe data of 59 elderly patients with cervical vertebrae injury from 2002 to 2006 years were retrospectively reviewed.ResultsThe most common type of injuries was hyperextension injuries of cervical spine and cervial central cord syndrome.Traffic accident and falling injury were the most common reasons.Early operation and early rehabilitation could improve the ASIA 1 or 2 grade,and avoid complications of cord injury effectively.ConclusionThe key treatment point of cervical vertebrae injury in the elderly is how to get them leave bed in order to reduce the complications of cord injury,early operation and rehabilitation are good method to decrease the mortality and increase quality of life.