ABSTRACT
Objective:To investigate the optimal cut-off values for the prediction of lumbar spinal stenosis using lumbar pedicle thickness.Methods:The clinical data of 64 patients with lumbar spinal stenosis (patient group) admitted to Binzhou Center Hospital from November 2019 to April 2021 and 48 healthy volunteers (healthy control group) who concurrently received routine physical examination involving lumbar spine MRI examination in the same hospital were retrospectively analyzed. Lumbar pedicle thickness was measured on T 2 weighted images of the L 5 vertebral body in the axial projection. Lumbar pedicle thickness was compared between groups using the independent sample t-test. The relationship between lumbar pedicle thickness and age change was analyzed using a one-way analysis of variance. The efficacy of lumbar pedicle thickness in the diagnosis of lumbar spinal stenosis was evaluated using the receiver operating characteristic (ROC) curve, optimal cut-off values, sensitivity, specificity, and the area under the ROC curve. Results:There was no significant correlation between lumbar pedicle thickness and age change ( P > 0.05). Lumbar pedicle thickness of patients with lumbar spinal stenosis was significantly higher than that of healthy controls [(13.25 ± 1.73) mm vs. (8.54 ± 1.88) mm, t = 13.75, P < 0.05]. ROC curve results showed that the optimal cut-off value was 10.50 mm, with a sensitivity of 95.3% and a specificity of 85.4. The area under the ROC curve was 0.963 (95% CI 0.928-0.998). Conclusion:The increase in lumbar pedicle thickness is related to the increase in the incidence of lumbar spinal stenosis. Lumbar pedicle thickness is an accurate, objective, and clear morphological parameter for the prediction of lumbar spinal stenosis. Application of lumbar pedicle thickness to predict lumbar spinal stenosis is innovative and scientific.
ABSTRACT
Objective To investigate the effect total hip arthroplasty and hemiarthroplasty in treatment of displaced femoral neck fractures in elderly .Methods 83 cases of elderly patients with displaced femoral neck fractures were divided into two groups according the order randomly.The control group(n=53) was given hemiarthroplasty while the observation group ( n=30) took total hip arthroplasty .The clinical efficacy and occurrence of complications after surgery were compared.Results The observation group excellent rate was 90.00%(27/30), significantly higher than the 79.25%(42/53) (χ2 =11.23,P<0.05);The observation group′s operative time,blood loss and postoperative drainage were (145.33 ±6.21)min,(575.65 ±26.84)mL and (278.51 ±14.15)mL,which was more than the control group(80.12 ±5.36)min,(322.52 ±25.34)mL and (185.46 ±12.48)mL significantly(t=9.56, 8.83,10.03,all P<0.05);The observation group′s incidence of complications was 10.00%(3/30),which was sig-nificantly lower than the control group′s 22.64%(12/53) (χ2 =12.16,P <0.05).Conclusion The total hip arthroplasty has a significant effect in the treatment of femoral neck fractures in elderly ,patients have good recovery of joint function with a low incidence of complications which can be used as the preferred solution for clinical treatment .