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Objective To compare the therapeutic effect of three treatments for cerebrospinal fluid leakage induced by surgical operation of spinal fracture combined with dural injury.Methods From June 2005 to June 2010,64 patients with cerebrospinal fluid leakage after surgery to spinal fracture combined with dural injury were analyzed.Patients were treated with positioning adjustment and incision pressure dressing (Group A,n =21),with cerebrospinal fluid leakage drainage via a lumbar percutaneous subarachnoid catheter (Group B,n =21),and with continuous wound drainage followed by catheter removing and wound closure when wound is completely healed (Group C,n =22).Time to stop cerebrospinal fluid leaking from a surgical incision,wound healing time,success rate in the primary intervention and postoperative complications were reviewed among these groups.Results In Group A,the incisional cerebrospinal fluid leakage disappeared at (19.0 ±3.9)days,with healing time of (25.0 ± 4.6)days.The primary wound healing was achieved in 13 patients but failure to the primary intervention occurred in 8 patients,of whom 6 patients presented complications which were then cured.In Group B,the incisional cerebrospinal fluid leakage disappeared at (3.0 ± 1.0) days,with healing time of (16.0 ± 2.6) days.There were 15 patients with primary wound healing but 6 patients got healing after further treatment,with no complications occurred.In Group C,there was no incisonal cerebrospinal fluid leakage or complications and all patients presented primary wound healing in a period of (13.0± 1.0)days.Healing time was shorter and success rate in the primary intervention in Group C was higher than those in Groups A and B (P ＜ 0.05).Conclusions Continuous wound drainage till catheter removal and wound closure on complete wound healing is a good choice for treating cerebrospinal fluid leakage induced by surgical operation of spinal fracture combined with dural injury,for it has advantages of good incisional healing,high success rate and few complications in the primary treatment.
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Objective To evaluate the efficacy of percutaneous laser hypothermia in the treatment of lumbar discogenic pain. Methods From June 2006 to March 2008,35 patients with lumbar discogenic pain were treated by low-frequency laser hypothermia in our hospital with 1 second impulse time,1 second interval time,3.5 w power,and 30 minutes duration. The effectiveness of the therapy was evaluated afterwards. Results Among the cases,15 patients were treated by one operation,20 patients received a second therapy,and 6 underwent the therapy for totally 3 time; the treatment was effective in 32 cases (excellent in 7,good in 24,and fair in 1). The therapy is ineffective in 2 cases. One case was converted to open surgery for unsatisfying outcomes of the laser hypothermia. The total effective rate was 91.4%(32/35),and fineness rate was 88.6%(31/35). Conclusions Percutaneous laser hypothermia is an effective treatment for lumbar discogenic pain. The indications for the procedure should be selected strictly.
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Objective To investigate curative outcomes of the limited-incision surgery under cold light source for treating calcified lumbar disc protrusion. Methods A total of 36 patients with calcified lumbar disc protrusion underwent limited-incision surgery under cold light visualization from January 2000 to June 2005. The patients were maintained at a prone position. The operation was carried out under local anesthesia. A longitudinal skin incision around 3 cm in length was made. After the inferior border of the vertebral plate and the intervertebral space were exposed, a lamina retractor was inserted above the superior border of the articular process. Then a fenestration and a discectomy were performed under cold light visulization. Results The operative time was 75.3?3.5 min and the intraoperative blood loss was 100.6?5.5 ml. Cerebrospinal fluid leakage occurred in 3 patients. All the 36 patients were followed for 6~60 months (mean, 27 months). Symptoms of low back pain, lower limb pain, and intermittent limping disappeared completely in all the 36 patients. According to the Nakai standard, the rate of excellent or good results was 94.4% ( 34/36 ). Conclusions Limited-incision surgery under cold light source for the treatment of calcified lumbar disc protrusion offers advantages of simplicity of performance, minimal invasion, and satisfactory outcomes.
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Objective To explore curative effects of coracolavicar ligament reconstructed with artificical tendon on treatment of complete acromioclavicular joint dislocation.Methods 32 patients with complete acromioclavicular joint dislocation received artificial tendon graft, 19 cases of whose implanted flexible carbonfiber tendon,and the others were treated with human-hair keratin artificial tendon (HHKAT). All patients were given bu internal fixation with Kirschner pins for 6 weeks after the operation.Results Fellowed-up for 4 months to 30 months showed the acromiclavicular join reduction and recovery of the anatomical relation of acromioclavicular joint checked by X-rayrecovered. According to karlsson scores, 21 cases graded excellent, 10 cases good and only one case bad, the excellent and good rate of recovery was 96 9%.Conclutions With the internal fixation with Kirschner pins in short term,and plus artificial tendon reconstructing coracoclavicalar ligament for patients with complete acromioclavicular joint dislocation, which had a little wound and a good curative effect, was easy to be performed and have worth in clinical application.