ABSTRACT
Objective To explore the effective of minimally invasive techniques for diagnosis and treatment of the spinal fungal infec-tions. Methods The clinical data of 6 patients with spinal fungal infection in our hospital from January 2012 to June 2014 was reviewd. All patients were taken biopsy diagnosis for spinal fungal infection by percutaneous endoscopic lumbar discectomy. Along with the oral antifungal drugs treatment,all the patients received the interbody fusion surgery by percutaneous pedicle screw fixation and debridement. The clinical and image data were collected during the 6 months following period. Results The symptoms of all the patients was relieved after surgery and no complications occurred. All the patients were followed up for 6 months. The value of ESR and CRP decreased to normal level at the first month after operation. The VAS scores decreased from (7. 0 ± 0. 8) to (0. 8 ± 0. 7) and the ODI scores decreased from (56. 1 ± 7. 7) to (5. 7 ± 2. 1). The X-ray image confirmed solid fusion at the 6 months after surgery. Conclusion The minimally invasive technique of spine is a good way to treat spinal fungal infection.
ABSTRACT
Objective To explore the difference between before and afteintervertebral fusion in transforaminal lumbainter-body fusion (TLIF) by unilateral obilateral pedicle screw (PS) fixation .MethodThe L3 -5 Cdatbased on the normal people were used to rebuild the L3 -5 three-dimensional finite elemenmodel(INT) and TLIF operative model .On thibasi,the unilateral Pfixation (M1) and bilateral Pfixation (M2) modelbefore the intervertebral fusion and the unilateral Pfixation (M3) and bi-lateral Pfixation (M4) modelafteintervertebral fusion were buil.Aftesetting the boundary and loading the burden ,the ante-flexion ,retroversion ,lateral bending and rotation of lumbavertebrwere simulated and the L 4 -5 segmenanguladisplacemenand the stresdistribution of implanwere recorded .ResultThe unilateral and bilateral Pfixation model before fusion reduced the range of motion(ROM ) of segmencompared with the Inmodel ,the bilateral fixation wareduced greatethan the unilateral fixa-tion ,buthe difference aftefusion wasignificantly decreased .The peak Von Misestressebefore fusion in the unilateral Pfixa-tion wasignificantly highethan thain the bilateral fixation ,while theipeak Von Misestresseaftefusion trended to be con-sisten.Conclusion The unilateral Pfixation aftefusion can provide the consistensegmenstability same to the bilateral Pfixa-tion .The long-term effecof TLIF with unilateral Pfixation isimilato thawith the bilateral Pfixation .
ABSTRACT
Objective To assess the biomechanical stability and vertebra strain distribution of asymmetrical posterior internal fixation for minimally invasive transforaminal lumbar interbody fusion ( MI-TLIF) . Methods Range of motion ( ROM) and strain distribution testing were performed in 8 fresh-frozen calf lumbar spine motion segments in flexion/extension, lateral bending, and axial rotation using 5. 0 Nm torques at the L4-5 motion segment. The sequential test configurations included intact motion segment, TLIF with unilateral pedicle screw ( UPS) , TLIF with UPS plus transfacet pedicle screws ( UPS+TFPS) , and TLIF with bilateral pedicle screw ( BPS) . The ROM was deter-mined to assess the construct stability. Strain distribution was recorded along with flexion and lateral bending configurations. Results In flexion/extension, lateral bending, and axial rotation, there was no significant difference in the ROM between BPS and UPS+TFPS fixation after TLIF. After TLIF, the UPS construct provided less segment stability than BPS and UPS+TFPS fixation in flexion, lateral bending. Strain distribution under UPS+TFPS fixation was respectively 21. 8% and 24. 2% higher than that under BPS fixation along with flexion and lateral bending. Conclusion UPS+TFPS fixation provides stability comparable to that of MI-TLIF with bilateral PS, with better load share with the vertebrae body.