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Objective@#To evaluate the safety and efficacy of oblique lateral interbody fusion (OLIF) in the surgical treatment of lumbar degenerative diseases.@*Methods@#All literatures of OLIF performed in lumbar degenerative diseases were searched in recognized databases including Pubmed, OVID, Embase, Cochrane Library, Science Direct, springer, CNKI, Wanfang and VIP databases. Methodological Indexfor Non-randomized Studies (MINORS) was used to evaluate the quality of the literatures. The meta-analysis was performed using Review Manager 5.3 and Stata 15.0 statistical software.@*Results@#A total of 35 literatures were included, including 22 English literatures and 13 Chinese literatures. There were 3 630 patients with 45.2% of males, aged from 14 to 89 years old (mean, 62.6 years). The average of length of stay (LOS), operation time (OT) and blood loss (BL) of OLIF procedure were 6.7 days, 117 minutes, and 128 ml, respectively. The VAS scores of low back pain of postoperative and final follow-up decreased by 4.33 and 4.70, respectively. The VAS scores of leg pain decreased by 4.57 points and 5.31, respectively. Compared with preoperative, the postoperative JOA score increased by 7.58 and the postoperative ODI were also improved by 33.89%. All the postoperative imaging data were significantly different from those before surgery. The surgical level intervertebral heightincreased 4.14 mm, and the intervertebral foramen height and intervertebral foramen area increased by 3.54 mm, 53.96 mm2, while the dura sac cross-sectional area increased by 36.61 mm2, and the overall lumbar lordosis increased by 13.78° with the local segmental lordosis increased by 4.62°. The overall incidence of complications of OLIF was 32%, with a 95% confidence interval of 25%-38%.@*Conclusion@#OLIF is a minimally invasive procedure for the treatment of lumbar degenerative diseases. OLIF has a simply procedure and short learning curve, with short LOS and operation time, less blood loss. OLIF can effectively open the narrow intervertebral space and increase the spinal canal and nerve root canal, significantly improve the symptoms, while the complication rate is low, so OLIF is worthy of widespread clinical application.
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Objective To investigate the effects of fresh lumbar osteoporotic vertebral compression fracture (OVCF) on spinopelvic sagittal parameters and distribution of Roussouly types.Methods One hundred and eight patients with one-level fresh lumbar OVCF and 110 patients with simple osteoporosis (OP) were diagnosed and treated at Department of Orthopedic Surgery,Shougang Hospital from January 2016 to August 2017.The basic clinical data of all the patients were documented and their lumber spines were classified by Roussouly types.The 2 groups were compared in terms of spinopelvic sagittal parameters such as pelvic incidence (PI),pelvic tilt (PT),sacral slope (SS),and lumbar lordosis (LL) and Roussouly types.The correlation between Roussouly types and fracture segments was observed in OVCF group.Results There was no significant different in PI between OVCF and OP groups (50.35° ± 11.00° versus 51.96° ± 11.73°) (P ＞ 0.05).PT in OVCF group (18.79°± 9.51°) was significantly larger than that (16.19°± 9.03°) in OP group while SS (31.56° ± 7.88°) and LL (40.22°± 12.29°) in the former significantly smaller than those in the latter (35.77° ± 8.82° and 47.89° ± 13.20°,respectively) (P ＜ 0.05).Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OVCF group were 35,40,28 and 5 cases,respectively,with types Ⅰ and Ⅱ accounting for 69.5％;Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OP group were 17,30,49 and 14 cases,respectively,with type Ⅲ being predominant (44.5％).There was a significant difference between the 2 groups in distribution of Roussouly types (P ＜03.05).In OVCF group,fractures of L1 and L2 vertebrae accounted for 82.4％.There was a significant correlation between fracture segments and lumbar Roussouly types (P =0.034).Conclusions Patients with fresh lumbar OVCF tend to have a forward gravity and sagittal disequilibrium,leading to posterior pelvic rotation,increased PT,decreased SS,and downward shift of the apex of the lumbar curve.Their Roussouly classification is mainly type Ⅰ or type Ⅱ.
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Objective By comparing clinical efficacy of percutaneous vertebroplasty with high viscosity bone cement and percutaneous kyphoplasty with conventional low viscosity bone cement for osteoporotic vertebral compression fractures,to explore the clinical value of treatment of osteoporotic vertebral compression fractures with high viscosity bone cement.Methods In this prospective study,100 patients with one-level OVCF and older than 70 years were diagnosed and treated in our hospital from June 2014 to December 2015,which were randomly divided into 2 groups (50 patients in each),applied unilateral percutaneous vertebroplasty with high viscosity bone cement and bilateral percutaneous kyphoplasty with conventional low viscosity bone cement,respectively.Collected data of basic clinical informations (including age,gender,body mass index,etc.),preoperative and postoperative visual analog scales (VAS),Oswestry disability questionnaire (ODI),operative time,intraoperative X-ray times,the amount of bone cement injection,leakage of bone cement,anterior vertebral height and kyphosis (Cobb angle) of preoperative and postoperative,and statistical analysis.Results There were significant improvement of both VAS and ODI scores of the postoperative 1 day,3 months and 12 months compared with preoperative,but there was no significant difference between two groups;The operative time,intraoperative fluoroscopy times,bone cement injection amount and intraoperative bone cement leakage of high viscosity bone cement PVP group were significantly less than those of low viscosity bone cement PKP group (P＜0.05);the anterior vertebral height and kyphosis improved,and there was a significant difference between preoperative and postoperative of low viscosity bone cement PKP group (P＜0.05).Conclusion The efficacies of unilateral PVP with high viscosity bone cement and bilateral PKP with conventional low viscosity bone cement for osteoporotic vertebral compression fractures are the same,which can relieve pain and improve function of life significantly.However,the high viscosity bone cement PVP is simpler surgical procedure,with shorter operative time,less intraoperative radiation,less bone cement leakage rate.The domestic bone cement injection device can significantly reduce the cost of surgery,it worth to be widely used for clinical application.
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Objective To study the value of serum S-100B protein in the diagnosis of cerebral radi-ation injuries in patients with brain malignant tumor. Methods Serum S-100B protein level was deteetod by enzyme-linked immunosorbent assay in 56 patients with brain malignant tumor before, during and after radio-therapy. Effects of dose and method of radiotherapy, peritumoral edema degree and Karnofsky performance status on serum S-100B level were studied. Results The levels of serum S-100B protein in the patients be-fore radiotherapy and control group were 0. 039μg/L and 0.044 μg/L ( t = 1.48 ,P =0. 186). The levels of serum S-100B protein before, in the middle of (30-40 Gy) and after (60 -70 Gy) radiotherapy were 0.044 μ/L, 0.049 μ/L and 0.079 μg/L, respectively ( F = 67.26, P = 0.000). The differences after ra-diotherapy were also significant among patients with three methods of radiotherapy (F = 20.32, P = 0.000), different degree of pefitumoral edema ( F = 12.94, P =0. 000 ) and Karnofsky perforrnanee status ( t = 2.71, P =0.007). Conclusions High level of serum S-100B protein is associated with cerebral radiation injuries in patients with brain malignant tumor, which is influenced by the dose and method of radiotherapy, Karnof-sky performance stares and degree of peritumoral edema. High level of serum S-100B protein may serve as an early predictor of cerebral radiation injury.
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Objective To retrospectively report 30 cases of distal femoral fractures treated with retrograde intramedullary interlocking naill( GSH nail). Methods From February 1999 to December 2002, 30 cases of distal femoral fractures were treated with GSH nails.According to AO/ASIF classification system, there were 11 cases of type A1, 7 A2, 3 A3, 5 C1, 3 C2 ,and 1 C3 .The follow up period ranged from 6 to 54 months. Results The average time for bone healing was 16 weeks. According to Neer s knee rating scale, there were 21 excellent cases and 5 good; the excellent and good rate was 86.6% . Conclusion It's a good method to treat type A& C (AO/ASIF) distal femoral fractures with GSH nail.