ABSTRACT
Objective To improve bone knife spinous lamina osteotomy replantation complex treatment of lumbar spinal stenosis patients.Methods Retrospective analysis from January 2014 to January 2015,the clinical data of 56 patients with lumbar spinal stenosis disease,all patients were taken modified osteotome bone cutting composite lamina spinous process and implant treatment,through follow-up,the CT,preoperatie and follow-up sessions at the end of the measurement of vertebral canal sagittal diameter,spinal canal diameter,to observe the prognosis and complications,and according to the Japanese orthopaedic society of low back pain score standard(Japanese orthopaedics asso ciation,JOA),the rate of good evaluation of clinical curative effect.Results This group of 56 patients with lumbar spinal stenosis disease,the last follow-up,vertebral canal sagittal diameter,spinal canal diameter,than preoperative significantly increased;JOA score was obviously improve the preoperative;The t test,statistically significant difference(P<0.05);The rate of good clinical curative effect was 96.43%;Follow-up period,all patients by CT review that lamina in situ fusion rate was 100%,no lumbar spinal instability,secondary lumbar spinal stenosis,composite lamina spinous complications such as shift,subsidence,fall off;6 months basic achieve bony healing.Conclusion The modified bone knife spinous lamina osteotomy replantation complex therapeutic effect of lumbar spinal stenosis precise,effective reconstruction of posterior structure stability,integrity,reduce complications,the prognosis is good,worthy of clinical use.
ABSTRACT
BACKGROUND:With deep understanding of the concept of biological fixation, more and more physicians choose interlocking intramedulary nail in the repair of femoral shaft fracture. Compared with traditional extramedulary plate, the superiority of the interlocking intramedulary nail has not been reported at present. Randomized controled clinical study is less, and lacks of systematic evaluation. OBJECTIVE:The results of meta-analysis were used to compare the therapeutic effects of interlocking intramedulary nail and steel plate for femoral shaft fractures. METHODS: We retrieved the MEDLINE, Embase, PubMed, Cochrane library, CNKI, Wanfang database, and Vip database from 2000 to 2015 by computer to colect randomized controled study on interlocking intramedulary nail and extramedulary plate for treatment of femoral shaft fractures. We screened the literatures that met the inclusion criteria, were strict quality evaluation of the selection. Excelent and good rate, operation time, intraoperative blood loss, hospitalization time, recovery time of knee joint function reaching 135°, knee joint function recovery time of the second operation to remove the internal fixation for reaching 135°, postoperative drainage volume, fracture healing time, nonunion or delayed union, internal fixation loosening, postoperative infection, and osteomyelitis were considered as the evaluation index of meta-analysis. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Colaboration. RESULTS AND CONCLUSION:Finaly 10 Chinese articles were included, including 915 patients with femoral shaft fractures. The results of meta-analysis showed that compared with extramedulary plate, interlocking intramedulary nails for femoral shaft fractures could effectively reduce the amount of blood loss, postoperative drainage, shorten operation time, hospitalization time, fracture healing time, reduce the incidence of postoperative infection, and obtain recovery of knee joint function. These results suggest that interlocking intramedulary nail for treating femoral shaft fractures has certain advantages. The interlocking intramedulary nail can be firstly selected in the permit of patient’s economic conditions and hospital conditions.