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Objective@#To investigate the efficacy of posterior decompression pedicle screw fixation and single pedicle screw fixation for thoracolumbar fracture with greenstick lamina fracture.@*Methods@#A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fractures combined with greenstick lamina fractures admitted to the 909th hospital from January 2011 to May 2016. There were 68 males and 38 females, aged 21-58 years [(39.5±7.1)years]. The fracture was located at T11 in 9 patients, at T12 in 6, at L1 in 28, at L3 in 11. A total of 58 patients underwent posterior decompression pedicle screw fixation including 37 males and 21 females, aged 23-58 years [(38.7±6.6)years]. The preoperative neurological function was evaluated according to ASIA grade: grade A for three patients, grade B for nine, grade C for 14, grade D for 27, and grade E for 53 patients. A total of 48 patients were treated with single posterior pedicle screws fixation including 31 males and 17 females, aged 21-57 years [(41.4±5.8)years]. Statistical indicators included operation time, intraoperative blood loss, anterior height ratio of injured vertebrae, sagittal Cobb angle, visual analogue scale (VAS), ASIA grading, dural tears and/or cauda equina entrapment, and complications.@*Results@#All patients were followed up for 24-72 months [(30.2±4.7)months]. The operation time ranged from 105 to 137 minutes [(113.5±21.3)minutes], and the intraoperative blood loss was 235-310 ml [(252.2±28.6)ml] in the posterior decompression and pedicle screws fixation group. In the posterior pedicle screw fixation group, the operation time ranged from 52 to 85 minutes [(65.3±9.6)minutes], and the intraoperative blood loss was 72-125 ml [(90.2±23.6)ml]. The anterior height ratio of injured vertebrae, sagittal Cobb angle and VAS score of the two groups were significantly improved immediately after operation and at the last follow-up (all P<0.01). At one year follow up, the ASIA grading in patients treated with single posterior pedicle screw fixation remained the same while the ASIA grading of patients treated with posterior decompression pedicle screw fixation was significantly improved compared with before operation. Dural tears were found in 12 patients and cauda equina entrapment were found in five patients during decompression. Three patients had neurological function injury after posterior pedicle screw internal fixation surgery, and they received a second decompression operation. Dural tears and/or cauda equina entrapment were subsequently found in all of the three patients. No complications related to internal fixation occurred during follow-up.@*Conclusions@#Both posterior decompression pedicle screw fixation and single pedicle screw fixation can effectively correct the kyphosis deformity, restore vertebral body height, and relieve pain in the treatment of thoracolumbar fracture with greenstick lamina fracture. Dural tears and/or cauda equina entrapment might be subsequently found in greenstick lamina fracture. Posterior pedicle screw fixation can not release the entrapped cauda nerve, so attention should be paid to the risk of secondary surgery.
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Objective To investigate the efficacy of posterior decompression pedicle screw fixation and single pedicle screw fixation for thoracolumbar fracture with greenstick lamina fracture.Methods A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fractures combined with greenstick lamina fractures admitted to the 909th hospital from January 2011 to May 2016.There were 68 males and 38 females,aged 21-58 years [(39.5 ±7.1)years].The fracture was located at T11 in 9 patients,at T12 in 6,at L1 in 28,at L3 in 11.A total of 58 patients underwent posterior decompression pedicle screw fixation including 37 males and 21 females,aged 23-58 years [(38.7 ± 6.6)years].The preoperative neurological function was evaluated according to ASIA grade:grade A for three patients,grade B for nine,grade C for 14,grade D for 27,and grade E for 53 patients.A total of 48 patients were treated with single posterior pedicle screws fixation including 31 males and 17 females,aged 21-57 years [(41.4 ± 5.8) years].Statistical indicators included operation time,intraoperative blood loss,anterior height ratio of injured vertebrae,sagittal Cobb angle,visual analogue scale (VAS),ASIA grading,dural tears and/or cauda equina entrapment,and complications.Results All patients were followed up for 24-72 months [(30.2 ± 4.7) months].The operation time ranged from 105 to 137 minutes [(113.5 ± 21.3)minutes],and the intraoperative blood loss was 235-310 ml [(252.2 ± 28.6)ml] in the posterior decompression and pedicle screws fixation group.In the posterior pedicle screw fixation group,the operation time ranged from 52 to 85 minutes [(65.3 ±9.6)minutes],and the intraoperative blood loss was 72-125 ml [(90.2 ± 23.6) ml].The anterior height ratio of injured vertebrae,sagittal Cobb angle and VAS score of the two groups were significantly improved immediately after operation and at the last follow-up (all P ＜ 0.01).At one year follow up,the ASIA grading in patients treated with single posterior pedicle screw fixation remained the same while the ASIA grading of patients treated with posterior decompression pedicle screw fixation was significantly improved compared with before operation.Dural tears were found in 12 patients and cauda equina entrapment were found in five patients during decompression.Three patients had neurological function injury after posterior pedicle screw internal fixation surgery,and they received a second decompression operation.Dural tears and/or cauda equina entrapment were subsequently found in all of the three patients.No complications related to internal fixation occurred during follow-up.Conclusions Both posterior decompression pedicle screw fixation and single pedicle screw fixation can effectively correct the kyphosis deformity,restore vertebral body height,and relieve pain in the treatment of thoracolumbar fracture with greenstick lamina fracture.Dural tears and/or cauda equina entrapment might be subsequently found in greenstick lamina fracture.Posterior pedicle screw fixation can not release the entrapped cauda nerve,so attention should be paid to the risk of secondary surgery.
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Objective To observe the long-term effect of surgical treatment in infertile varicocele patients. Methods 180 infertile patients with varicocele accepted modified Palomo operation (retroperitoneal high ligation of internal spermatic cord vein) from 2004 to 2007, and the long-term effect of thesurgery were analyzed retrospectively, such as semen parameters and spouse pregnancy. Results The operations were performed successfully in 180 cases, and semen parameters improved significantly after the surgery (Ps ＜ 0. 05 ).Among all patients, 10 cases had spouse pregnancy within 3 months after operation;47 cases had spouse pregnancy from 3 to 6 months after operation; 25 cases had spouse pregnancy from 6 to 12 months after operation;13 cases had spouse pregnancy from 12 to 24 months after operation. The fertility rate was 52. 8% (95/180) in total. Conclusion Surgical treatment of infertile male patients with varicocele has good long-term effects, made it the first choice in these patients.
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Objective To investigate the epididymal sperm ultrastructure after vasectomy. Methods During the operation of vasovasostomy (38 cases, test group) and vasectomy (13 cases,control group,group A) the proximal vas deferens fluids were collected.The epididymal sperm morphology in the proximal vas deferens fluids was observed using optical and electronic microscopes.Data were analyzed by SPSS program. Results The data from group A showed that there was no significant difference between left and right side in the percentage of normal sperm morphology.The results from both optical and electronic microscopes showed that there was a significant difference in the percentage of normal sperm morphology (a),abnormal sperm head (b),sperm with neck defect (c) and sperm with tail defect (d) between group A and group B(5 years after vasectomy). (electronic microscopes:(a):(40.28?11.53)% vs (16.80?7.93)%,(6.29? 4.57 )%,( 4.63? 5.06 )%; (b):(35.00?14.18)% vs (59.05?14.44)%,(63.43?15.23)%,(82.05? 16.71 )%;(c):(20.83? 6.40 )% vs (13.60?6.78)%,( 14.71? 6.82)%,(9.00?7.18)%;(d):(3.89?4.44)% vs (10.55?11.73)%,(15.57?9.81)%,(4.32?7.65)%. optical microscopes:(a):(49.12?20.55)% vs (19.95?15.42)%,(10.00?9.50)%,(5.84?9.63)%; (b):(35.00?14.55)% vs (22.55?16.24)%,(14.71?15.78)%,(10.68?18.65)%; (d):(15.80?9.55)% vs (57.50?24.74)%,(75.29?23.90)%,(78.21?30.33)%.There existed multi-cell organ and multi-form abnormalities in the inner structures of sperm heads,necks and tails. Conclusions The epididymal sperm defect (including head, neck and tail) after vasectomy was demonstrated in the inner cell organs.The longer after vasectomy, the higher percentage of sperm with abnormality was found.
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<p><b>OBJECTIVE</b>To observe sperm motion parameters in pre-freeze and post-thaw semen samples using computer-assisted sperm analysis (CASA) system.</p><p><b>METHODS</b>Semen analyses of 238 samples before freezing and after thawing were separately performed by Hamilton-Thorne Sperm Analyzer.</p><p><b>RESULTS</b>Sperm motility in post-thaw samples was significantly decreased. There was significant correlation and difference between pre-freeze and post-thaw samples in sperm motion parameters, including average path velocity (VAP), straight line velocity (VSL), curvilinear velocity (VCL), amplitude of lateral head displacement (ALH), straightness (STR) and linearity (LIN), except heat cross frequency (BCF). The percentage of sperm movement velocity parameters (VAP, VSL and VCL) and moving pattern parameters (ALH) significantly decreased, while that of LIN and STR significantly increased in post-thaw samples.</p><p><b>CONCLUSION</b>CASA system is of clinically applied value and is a useful tool for evaluating sperm motion parameters in pre-freeze and post-thaw semen samples.</p>