ABSTRACT
Objective To explore a new approach that is better than coronal scalp incision and facial percutaneous small incision in surgical treatment of zygomatic bone and zygomatic arch fracture.Methods The modified auriculotemporal incision was applied in 43 patients with zygomatic bone and zygomatic arch fracture that needed open reposition,and the exposure degree,bleeding,postoperative elasticity and texture of skin,facial nerve function and satisfactory degree were evaluated after operation.Results In present study,the upper part of zygomatic arch and lateral orbital margin could be greatly explored for operation of zygomatic bone and zygomatic arch fracture in all 43 patients by application of this approach.Less bleeding was observed during operation.All patients had primary healing and none of them presented with temporal numbness and facial palsy.After 6 months follow-up,41 cases (95.3％) and 43 cases (100％) showed fine elasticity of operative skin and satisfactory degree,respectively.Conclusions The modified auriculotemporal incision is better than conventional approach in surgical treatment of zygomatic bone and zygomaticarch fracture.
ABSTRACT
Objective To test the safety and effectiveness of transpedicular fixation combined with transpedicular bone grafting via less invasive paraspinal intermusclar approach in treatment of thoracolumbar fractures.Methods The study involved 23 cases of thoracolumbar fractures treated with paraspinal multifidus intramusclular mini-incision,transpedicular bone grafting,and short-segment pedicle screw fixation from June 2009 to June 2012.There were 16 males and 7 females at age of 19-55 years (average 38.8years).Time from injury to surgery varied from 6 hours to 7 days (average 3.2 days).Fracture level was T11 in three cases,T12 in seven,L1 in nine,and L2 in four.According to Denis fracture classification,there were altogether 10 compression fractures and 13 burst fractures.McCormack load sharing classification scored average 5.3.Before operation,anterior vertebral body height ratio was average 58.6％(range,45 ％-73％) and kyphosis angle was average 23.7° (range,15°-34°).Results Operation lasted for average 95.5 minutes (range,75-130 minutes) with intraoperative bleeding of average 160.3 ml (range,115-220 ml).Unilateral incision that was averaged 3.5 cm (range 3.2-4.0 cm) in length obtained primary healing.Average follow-up time was 12.6 months (range,7.5-18 months).Average height of the anterior border was corrected to 97.3％ and average kyphosis angle was corrected to 4.6°.There was neither instrumentation failure nor symptom of persistent postoperative back pain.Conclusions Transpedicular fixation with transpedicular bone grafting via paraspinal muscle approach provides effective recovery of vertebral morphology and correction of kyphotic deformity.Furthermore,the technique gains advantages of easy operation,small trauma,less blood loss and rapid recovery.
ABSTRACT
Objective To compare the clinical outcome of unipedicular versus bipedicular vertebroplasty treating for osteoporotic vertebral compression fracture.Methods Sixty-four patients(68 vertebra)were divided into two groups by treated methods:unipedicular kyphoplasty group(33 cases)and bipedicular vertebroplasty group(31 cases).The Cobb angle and vasual analogue pain scale(VAS)were measured preoperatively and postoperatively.The operation time was recorded.Compared the Cobb angle,VAS and the operation time between two groups.Results Of unipedicular kyphoplasty group preoperative,24 hours and 3 months after operation,VAS were(8.42 ± 1.33),(2.21 ± 1.67),(2.09 ± 1.58)scores,the Cobb angle were(31.24 ±9.12)°,(14.21 ±9.21)°,(14.43 ±9.36)° ;while those of bipedicular vertebroplasty group were(8.36 ± 1.52),(2.13 ± 1.80),(2.00 ± 1.71)scores and(30.84 ±8.77)°,(13.94 ± 8.87)°,(14.07 ± 9.87)°.VAS and the Cobb angle of both groups at 24 hours and 3 months after operation were lower than those preoperative(P＜ 0.01).VAS and the Cobb angle of both groups were similar at the same time preoperatively and postoperatively(P ＞ 0.05).The operation time of unipedicular kyphoplasty group and bipedicular vertebroplasty was(45.00 ± 8.76),(72.00 ± 9.32)min,respectively,there was statistically significant difference between two groups(P ＜ 0.01).Conclusions Compared with the bipedicular vertebroplasty,the advantages of unipedicular kyphoplasty are as follows:less trauma,less operation time and less X-rays rediation accepted of the patient and the operator.And it has the similar clinical outcome with the bipedicular vertebroplasty.