ABSTRACT
Objective To investigate the preliminary clinical result of thoracolumbar fracture combined with posterior ligamentous complex injuries repaired by posterior transpedicular screw fixation.Methods A retrospective review was performed on 22 patients with thoracolumbar flexion-distraction fracture combined with posterior ligamentous complex injuries treated with transpedicular screw fixation from July 2008 to March 2013.There were 16 males and 6 females with mean age of 39 years (range,23-62 years).After medically stable,posterior pedicle screw fixation was performed under intravenousinhalational anesthesia.According to the degree of fracture displacement and types of ligament injury,posterolateral bone grafting or intervertebral fusion at the level of injury was conducted.Vertebral height restoration,Cobb' s angle and American Spinal Injury Association (ASIA) score were reviewed preoperatively,at postoperative 3 days and at the last follow-up.Results All the patients were operated on smoothly.There were no complications during operation.All the patients were followed up for 5-51 months (mean,26.5 months).Fracture reductions were satisfied with the closure of vertebral posterior element.Mean anterior vertebral height and Cobb' s angle improved by 20.6％ and 10.60°respectively after operation (P ＜0.01).Eight patients with neurological dysfunction showed some recovery after operation with the mean sensory score improved by 20.7％ (P ＜ 0.05) and mean motor function score improved by 30.9％ (P ＜ 0.0l).All bone grafts were healed,without pain,loosening or breakage in the fixation system.Conclusions Posterior pedicular screw fixation attains good short-term outcome for thoracolumbar flexion-distraction fracture combined with posterior ligamentous complex injuries.The surgery provides satisfactory reduction and instant spinal three-column stability for the unstable spine fracture.Sufficient bone graft is the guarantee to permanent stability.
ABSTRACT
Objective Todetect the expressions of HGF ,C-met and NRP1 protein in osteosarcoma and to investigate their corre-lation and the clinical significance .Methods The postoperative preserved paraffin block and the clinical data in 70 cases of osteosar-coma were taken as the observation group and 50 cases of the parraffin block of mature bone tissue after decalcification and the clin-ical data were taken as the control group .The expressions of HGF ,C-met and NRP1 protein were detected by the immunohisto-chemistry(IHC) method for investigating their expressions in the tumor patients with different clinicopathological characteristics and analyzing their relationship .Results The positive rates of HGF ,C-met and NRP1 expressions in the observation group were higher than those in the control group .The positive rates of HGF ,C-met and NRP1 expressions in the observation group were cor-related with metastasis ,vascular invasion ,clinical stage and Ki67 expression .The positive relationship was found between the ex-pressions of HGF and C-met with NRP1 of neoplasm .Conclusion The high expressions of HGF ,C-met and NRP1 in osteosarcoma play the important role in the progress of tumor lesion .The postoperative combined detection of HGF ,C-met and NRP1 protein could have certain value to predict the prognosis .