Biological treatment for intervertebral disc degeneration / 中国骨伤

Neck shoulder pain or lumbocrural pain caused by intervertebral disc degeneration (IDD) could seriously affect the qualities life of patients. Current treatments mainly focus on alleviating pain and the symptoms of nerve compression, which could not radically stop the process of intervertebral disc degeneration, but conversely lead to high recurrence rate. In recent years, scholars have turned to study the biological treatment for repair and rebuild the intervertebral disc by biological molecular therapy, gene therapy, cell therapy and tissue engineering to solve the problem of intervertebral disc degeneration, while most of the above methods are still in animal experiments or in vitro experiments and the clinical application is still a long way to go.

Anterior decompression for the treatment of cervical spondylotic myelopathy associated with ossification of posterior longitudinal ligament / 中华外科杂志

<p><b>OBJECTIVE</b>To study the technique and effect of anterior decompression for the treatment of cervical spondylotic myelopathy associated with ossification of posterior longitudinal ligament (OPLL).</p><p><b>METHOD</b>Sixty-one patients (42 male and 19 female, 45 - 74 years with mean age of 57 years old) underwent anterior decompression for the treatment of cervical spondylotic myelopathy associated with OPLL. Among them, OPLL was definitely diagnosed in 49 patients preoperatively, and was found during the operation in the other 12 patients. The occupying rate of OPLL ranged 32%-70% with an average of 52%. The preoperative JOA scores ranged 4 - 14 points with an average of 9.6 points. In additional to conventional decompression, the ossification was removed completely after discectomy and corpectomy.</p><p><b>RESULTS</b>Corpectomy was performed in 41 cases, discectomy in 6 cases and combination of corpectomy and discectomy in 14 cases. The follow-up of all patients ranged from 6 to 36 months (mean 16 months). The postoperative JOA scores ranged 8-16 points with an average of 12.8 points. The neurological improvement rate ranged from 25.0% to 87.5% with an average of 65.2%. The transient leakage of cerebrospinal fluid (CSF) occurred in 5 cases, and stopped after conservational treatment. No neurological deterioration developed.</p><p><b>CONCLUSIONS</b>The difficulty and risk of anterior decompression are significantly increased in the patients with cervical spondylotic myelopathy associated with OPLL. Remove of ossification after corpectomy and discectomy could provide complete decompression and better results.</p>

Urgent management of quadriplegia following Sichuan earthquake under field condition / 第二军医大学学报

Objective:To explore the urgent management strategy for quadriplegia following China Wenchuan earthquake under filed condition.Methods:The 57-year-old male patient was sent to the earthquake relief team of Changzheng Hospital,Second Military Medical University.He was hit by heavy object during the Sichuan earthquake 6 days ago.Physical examination revealed cervical spinal cord injury accompanied by incomplete paralysis.The patient underwent cervical 3-7 laminectomy under general anesthesia.Results: After surgery,the muscle strength of lower limbs recovered to grade four from grade one;the muscle strength of upper limbs recovered to grade five from grade three.Sensory loss was found below the nipple level and totally recovered after operation.Conclusion:Early surgery for quadriplegia following earthquake trauma can timely relieve compression to the spinal cord and therefore improve prognosis of patients.Under field condition where facilities are not readily available,decompression of spinal cord can be achieved by lamineetomy via posterior approach.The key to successful operation is correct diagnosis and skillful manipulation.