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Objective:To compare the clinical outcomes between modified percutaneous kyphoplasty (PKP) and conventional PKP in the treatment of Kümmell disease.Methods:A retrospective cohort study was conducted of the 57 patients with single level kummell disease who had undergone PKP between January 2015 and December 2017 at Department of Spinal Surgery, Jiangmen Hospital Affiliated to Sun Yat-sen Uni-versity.Of them, 36 received modified PKP and 21 conventional PKP.In the modified PKP group, there were 24 males and 12 females with an age of 73.9 years±9.4 years and a course of disease of 2.2 months±1.5 months; the disease was located at a thorocic vertebra in 20 cases and at a lumbar vertebra in 16.In the conventional PKP group, there were 15 males and 6 females with an age of 72.6 years±11.9 years and a course of disease of 1.8 months±1.1 months; the disease was located at a thorocic vertebra in 10 cases and at a lumbar vertebra in 11.The 2 groups were compared in terms of operation time, bone cement volume, cement leakage, visual analogue scale (VAS), Oswestry disability index (ODI), anterior and middle heights and cobb angle of injured vertebra at postoperative 3 days, 1 and 3 months, and final follow-up.Results:There were no significant differences in the general clinical data between the 2 groups, showing compatibility between groups ( P>0.05).All the operations were accomplished uneventfully with no such serious complications as spinal cord nerve injury, wound infection, pulmonary embolism, bone cement poisoning reaction or death. There was no significant difference between the 2 groups in operation time or bone cement volume ( P>0.05).The rate of cement leakage in the modified PKP group [33.3%(9/27)] was significantly lower than that [52.4%(11/21)] in the conventional PKP group ( P<0.05).There were no significant differences be-tween the 2 groups in VAS, ODI, anterior or middle height of injured vertebra or cobb angle at postoperative 3 days or one month ( P>0.05), but the postoperative values were improved compared to the preoperative ones.At postoperative 3 months and final follow-up, the modified PKP group was significantly better in all the indexes than the conventional PKP group ( P<0.05). Conclusion:Compared with conventional PKP, the modified PKP may lead to better outcomes for Kümmell disease.
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With the advances in surgical technique,increasingly complicated and knotty surgeries were performed on neonatal and pediatric patients,and the success of many of these surgeries are ensured by an adequate and safe blood supply.Autologous and/or allogeneic blood may be used,depending upon the anticipated blood loss,types of components required,and urgency of surgery.However,in all cases,every attempt should be made to minimize the number of donor exposures to reduce the risk of transfusion,for dangers of transfusion having been payed more attention.The strategy and practice of blood support for pediatric surgery show very important.
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Objective To evaluate the influence of the single and multiple intervertebral space radiofrequency ablation nucleoplasty on the sheep cervical spine stability.Methods Twenty healthy adult sheep were randomly divided into single intervertebral space operation group (A group )and multiple intervertebral space operation group ( B group ),each group was subdivided into postoperative 24 hours group ( A1,B1 group ) and post- operative 3 months group ( A2,B2 group),each group had five sheep.Radiofrequency ablation nucleoplasty on sheep C3/4 in the single intervertebral space operation group or C3/4,C4/5 in multiple intervertebral space operation group.Preoperative cervical vertebrae roentgenograms from all samples in neutral,lateral,hyperextension and hyperflexion positions were collected,and 5F pipe was used as the survey mark of ieonography.For the postoperative 24 hours group( A1,B1 group ),the roentgenograms were collected postoperatively 24 hours later,while for post- operative 3 months group (A2,B2 group),they were collected postoperatively 3 months later.The height of operative intervertebral space,horizontal and angular displacement of neighboring vertebral body were measured respectively.Results The roentgenograms showed no any obvious decrease in the height of intervertebral disc and no any increase in horizontal and angular displacement of neighboring vertebral body were observed in single intervertebral space operation group (A group) and multiple intervertebral space operation group (B group ).There was no significant difference between pre - operation and post - operation in them ( P ＞ 0.05 ).Conclusions The stability of the sheep cervical spine had not been affected by the single or multiple intervertebral space radiofrequency ablation nucleoplasty on the basis of X-ray results.The radiofrequency ablation nucleoplasty had no influences on the stability of sheep cervical vertebrae.
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Objective To explore the feasibility and clinical result in reconstructing of femoral artery defects with external jugular vein graft. Methods Sixteen cases of femoral artery defects caused by pseudoaneurgsm resected were reconstructed with external jugular vein graft from June 2002 to August 2005. Results The limbs of all the patients were salvaged successfully.Thirteen patients were followed up from 1 to 24 months. Their dorsal arteries of foot pulsated well, and there was no pseudoaneurgsm broken or defect recurred. Femoral nerve injury was found in one case. Femoral artery continuity was detected under the color ultrasound Doppler in 6 cases. Conclusion Reconstructing of femoral artery defects with external jugular vein graft is feasible, the effect of which is sure. The shortcoming is that the scar on the neck affects appearance after resect of external jugular vein.