ABSTRACT
Objective:To investigate the risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF).Methods:A multi-center, large-sample, case-control study was carried out to analyze the clinical data of 2 273 OVCF patients (2 689 vertebrae) undergone PVP at four hospitals between May 2018 and October 2021, including 994 males and 1 279 females, with the age of 52-91 years [(69.1±3.1)years]. Of all, 581 patients (604 vertebrae) were allocated to leakage group and 1 692 patients (2 085 vertebrae) to no leakage group according to the occurrence of bone cement leakage. The gender, age, fracture sites, vertebral compression degree, endplate integrity of fractured vertebrae, surgical segments, surgical approaches and bone cement injection volume were recorded. Univariate analysis was used to investigate the correlation between those indicators with bone cement leakage. Multivariate Logistic regression analysis was used to identify the independent risk factors for bone cement leakage.Results:Univariate analysis showed that gender, age, fracture sites, vertebral compression degree, bone cement injection volume were related to bone cement leakage after PVP ( P<0.05 or 0.01), but no correlation was found in the endplate integrity of fractured vertebrae, surgical segments and surgical approaches (all P>0.05). Multivariate Logistic regression analysis showed that fracture sites ( OR=1.68, 95% CI 1.11-2.55, P<0.05), vertebral compression degree more than 40% ( OR=1.98, 95% CI 1.29-3.02, P<0.01), bone cement injection volume greater than or equal to 5.5 ml ( OR=1.55, 95% CI 1.07-2.26, P<0.05) were significantly associated with bone cement leakage after PVP. Conclusion:Thoracic vertebral fracture, vertebral compression degree more than 40% and bone cement injection volume greater than or equal to 5.5 ml are independent risk factors for bone cement leakage after PVP in OVCF.
ABSTRACT
Objective To evaluate the clinical outcome of lumbar spinal canal stenosis treated by microen-descopic discectomy. Methods The rear guard intervertebral discoscope was used to carry on unilateral or-bilateral "windowing" to relieve the dura mater spinalis and the nerve root oppression thoroughly. The "C" ann machine or laferal side photography position X was used for localization. Approximately 1.5 cm incision was made under local anesthesia or under the shallow epidural anaesthesia at posterior waist, the pathway tube was implanted after progressive expansion, part of lamina of vertebra was removed by drill, endoscope was inserted under the television surveillance to reveal removed lamina of verfebra, the proliferated cohesed articular process, the plump yellow ligament flava and the bulging intervertebral disc nucleus pulposus tis-sues, the nerve root canal was depressed, to relieve thoroughly its oppression, dura mater and nerve root. Results The follow-up continued from 5 months to 36 months. The evaluation with Nakai scale revealed ex-cellent in 168 cases, good in 9 cases, fair in 6 cases. The rate of good results was 96.7%. Conclusions Totally 183 cases were treated with this procedure posterior microendoscropie discectomy shows minimal inva-sion, less blood loss and quick recovery. The stability of lumbar spine can be reserved. It is safe and effec-tive for treating lumbar disc herniation complicated with spinal stenesis.
ABSTRACT
Objective Evaluate the safety and efficacy of indwelling healer tube in prevention and cure the conglutination after the surgurey of flexor tendon tenosynovitis. Methods During the year of 2001～2006, We have 38 young patients treated with indwelling of healer tube into the local or partial of the recovering muscle and sinew, then anesthetic and sodium hyaluronate were injected in the tube in certain intervals to lubicate and prevent conglutination after the operations of joint of children flexor tendon tenosynovitis. Then let the young patients do some healing training attne earlystage after surgery. Groups of patient were set up to make comparative analysis and evaluate the effectiveness of indwelling of the healer tubes according to the recovery status of the function of arthrosis and grasp after surgery. Results The result is that the rate of choiceness of 46 sinew is 89.1% in 34 cases with indwelling healer tube after the observing period from 6 months to 2 years, whereas the other group of 44 sinew in 30 cases has the rate of choiceness of 63.6%. The comparison has the significant conclusion of statistics (P<0.05). Conclusion It is convenient and safe to use indwelling healer tube to prevent the conglutination after the operation of joint the broken finger muscle and sinew of children. Therefore it is worth popularizing and promoting.