ABSTRACT
BACKGROUND: Open reduction and internal fixation have been used to treat thoracolumbar fractures, which possesses good efficacy, but causes large trauma and many complications. Minimally invasive treatment like Wiltse operative approach and Sextant, Zina system also has many defects such as large incision, insufficient fixed strength, limited orthopedic forces. OBJECTIVE: To access the effect of vertebral fixation with HXN pedicle screw system in the treatment of thoracolumbar fractures. METHODS: Totally 68 cases of thoracolumbar fractures admitted in the Department of Orthopedics, the First Affiliated Hospital of Xinxiang Medical University from October 2014 to December 2016 were randomly divided into two groups: the patients in group A received minimally invasive pedicle screw fixation with HXN system and those in group B were subjected to open reduction and internal fixation. The perioperative indexes (blood loss), Visual Analogue Scale scores, Oswestry Disability Index, anterior vertebral height, and Cobb angle were detected to compare the curative efficacy between two RESULTS AND CONCLUSION: (1) All patients were followed up for 3-24 months. (2) There were no significant differences in the operation time, intraoperative fluoroscopy times between two groups (P > 0.05), and the blood loss in the group B was significantly more than that in the group A (P < 0.05). (3) The preoperative Visual Analogue Scale and Oswestry Disability Index scores showed no significant differences between two groups (P > 0.05), and the postoperative and last follow-up scores were significantly decreased (P < 0.05), but the group A had lower scores than those in the group B (P < 0.05). (4) The anterior vertebral height and Cobb angle were significantly improved postoperatively (P <0.05); at the last follow-up, both indexes had no obvious loss and showed no significant difference between two groups (P > 0.05). (5) The incision healed well in the group A, while there were two cases of incision infection in the group B. No screw loosening, displacement or rupture occurred during follow-up. (6) These results suggest that the minimally invasive HXN pedicle screw system for thoracolumbar fracture not only has the advantages of fewer traumas, less blood loss, low incidence of incision infection, pain relief, but also is safe and easy to operate, which obtains good fixation stability and can achieve the same curative effect with the open surgery.
ABSTRACT
Objective To study the source of infection,the scope of epidemic and control measures in an outbreak involving students having symptoms as fever,dizziness,headache,vomiting and nausea.Methods The suspected-case was defined as fever (armpit temperature ≥37 ℃) and with one or more of the following symptoms:dizziness,headache,vomiting and nausea,among students and teachers at school from Mar 1,2012.Confirmed-case was among suspected case accompanied by both throat and rectal swabs enterovirus positive by RT-PCR.All the cases were collected through checking the medical records from 4 hospitals as well as through the absence records of students and teachers,from Mar 1,2012.We conducted a case-control study with ratio of 1 ∶ 2 and data on the exposures to water among students and teachers was collected prior to the illness.27 cases' throat and rectal swabs were collected and analyzed by RT-PCR and PCR sequence methods.2 warm-water samples were collected for testing the counts on total bacteria and E.coli.Results 103 students' cases were identified in school L,with the attack rate as 4.6％ (103/2255).Students from Grade three had the high attack rate as 18.1％ (72/397) and 77.7％ (80/103) of the cases located in the building with ' multiple-functions'.Epidemic curve of the outbreak showed a pattern with continuous common source of infection.It seemed that the exposure to warm-water appeared to be the major risk factor (OR =18.3,95％CI:2.0-169.5) together with the intake of un-boiled water (OR =15.5,95 ％CI:1.7-141.8).Specimens from 27 students (81.5％,22/27) were identified enterovirus positive by RT-PCR,and 7 of the 9 students were confirmed carrying Echo 30.Bacteria and coli were negative from the 2 warm-water samples.Conclusion This viral meningitis-outbreak was caused by Echo 30,with drinking water as the major risk factor.