ABSTRACT
Objective To investigate the clinical effects of minimally invasive poking reduction technique in the treatment of single segment thoracolumbar fractures without neural impairment.Methods From February 2011 to June 2015,83 cases of thoracolumbar fractures without neural impairment underwent minimally invasive pedicle screw fixation in Linyi Central Hospital were selected and randomly divided into two groups.Group A (40 cases) was treated with poking reduction technique by percutaneous polyaxial pedical screw fixation,43 patients in group B were treated with only percutaneous polyaxial pedicle screw fixation.The perioperative index,pre-and postoperative radiography,relief of the low back pain and general health status of the two groups were recorded and compared.Results There were no statistically significant differences in the operation time,operative blood loss,hospitalization time.All patients were followed up for 20-27months (average 24 months),the scores of visual analogue scale (VAS) and Oswestry disablity index(ODI) had no statistically significant differences between the two groups in the same period(all P ＞ 0.05).Before operation,the Cobb angle,sagittal index and anterior height of the fracture vertebral body in group A were (66.3 ± 14.2) ％,(20.4 ± 6.5) °,(21.9 ± 6.6) °,respectively,which in group B were (64.8 ± 13.5) ％,(14.5 ± 7.7) °,(15.6 ± 5.9) °,respectively,the differences were not statistically significant (all P ＞ 0.05).After operation,the Cobb angle,sagittal index and anterior height of the fracture vertebral body in group A were (93.8 ± 9.8)％,(5.3 ± 3.3) °,(5.4 ± 2.0) °,respectively,which in group B were (88.0 ± 10.6) ％,(4.1 ± 2.8) °,(8.1 ± 4.7) °,respectively,the differences were statistically significant (t =8.893,2.345,3.351,all P ＜ 0.01).Conclusion The effect of poking reduction technique by percutaneous polyaxial pedical screw fixation is better than simply polyaxial pedicle screw in the treatment of thoracolumbar fracture,which is a safe and effective operation method.
ABSTRACT
Currently,the toxicity study of traditional Chinese medicine is faced with the following problems. Firstly,the evaluation in vitro cannot fully reflect the true state of the body. Secondly,the traditional method is not sensitive enough to the early toxicity. Lastly,the toxicity evaluation indexes cannot determine whether the compatibility of traditional Chinese medicine produces toxicity or increases toxicity systematically. The paper proposed a synthesized early evaluation research method for target organ toxicity induced by traditional Chinese medicine:screening,validation,optimization and application. This method mainly inoolves early target organ toxicity biomarkers in screening,optimi?zation,validation,biological significance explanation,and application to the traditional Chinese medicine incompatibility based on the metabolic dynamic fingerprint spectrum in order to obtain biomarkers of target organ toxicity that are sensitive and precede conventional biochemical indices for early evaluation . We attempted to analyze the pattern of chang of the biomarkers for animals acted by″18 incompatible medicaments″compatibility combination. We found that Radix Aconiti Lateralis Preparata with cardiotoxicity were compatible with Rhizoma Pinelliae,and that Trichosanthes kirilowii Maxim,Fritillaria,Ampelopsis Radix and Bletilla striata without non-cardiotoxicity produced and increased cardiotoxicity systematically.
ABSTRACT
BACKGROUND:Open reduction and internal fixation cause big trauma and many complications. With the progression of minimal y invasive concept, percutaneous pedicle screw fixation gradual y showed its obvious superiority. ＜br> OBJECTIVE:To compare clinical outcomes of minimal y invasive percutaneous pedicle screw fixation versus open surgery in the treatment of thoracolumbar fracture. ＜br> METHODS:From October 2012 to January 2014, 50 cases of thoracolumbar fractures, including 25 cases in the minimal y invasive percutaneous pedicle screw fixation group and 25 cases in the open surgery group, were retrospectively analyzed. The differences in length of skin incision, intraoperative blood loss, operation time, postoperation hospital stay, and visual analog scale scores were compared. Serum creatine kinase activity and C-reactive protein levels were measured before surgery and at 24 and 48 hours after operation. Imaging results were used to observe vertebral height and kyphosis Cobb’s angle changes. ＜br> RESULTS AND CONCLUSION:Compared with the open surgery group, the length of skin incision was smal er and intraoperative blood loss was less, operation time, bed time and hospital stay were shorter, and pain of the wound was lighter in the minimal y invasive group. No significant difference was found in serum creatine kinase activity and C-reactive protein levels between the two groups. Serum creatine kinase activity and C-reactive protein levels were higher at 24 and 48 hours after treatment compared with before treatment in both groups. Serum creatine kinase activity and C-reactive protein levels were higher in the open surgery group than in the minimal y invasive group at 24 and 48 hours. There were significant differences in vertebral height and kyphosis Cobb’s angle in both groups after treatment compared with before treatment (P＜0.01). No significant difference in vertebral height and kyphosis Cobb’s angle was detected between the two groups after treatment (P>0.05). Results indicated that minimal y invasive percutaneous pedicle screw fixation and open surgery in repair of thoracolumbar fractures had similar outcomes. However, the trauma of minimal y invasive percutaneous pedicle screw fixation was apparently less than open surgery.