ABSTRACT
[Objective]To analyze the feasibility and clinical efficacy of one-stage debridement,bone grafting and in-ternal fixation for the treatment of single-segmental lumbar spinal tuberculosis with extreme lateral approach.[Methods]Thirteen patients of single-segmental lumbar spinal tuberculosis that received the surgeries from April 2013 to August 2016 were included.The operation duration and the amount of intraoperative blood loss were recorded.The VAS and ODI of the back pain,lumbar kyphosis angle,segment height restoration,and vertebral fusion rate were used to analyze the clinical efficacy.[Results]Thirteen patients were successfully followed up for 13-32 months(mean,20.3 months);the operation duration was 160-280 min(average,214±96)min;the amount of intraoperative blood loss was 150-350 mL, average(average,263±63)mL. At the final follow-up,ESR and CRP were normal and lower back pain(VAS)and Oswestry disability index(ODI)were significantly reduced(7.2±1.6 vs 2.5±1.2 and 63.3±5.4 vs 31.9±3.7,respectively)compared to preoperative values;there were no significant difference in the lumbar kyphosis angle,segment height resto-ration between preoperation(segmental lordosis,7.1°±4.7°;segmental height,64.8 mm±9.3 mm)and the values at final follow-ups(segmental lordosis,5.2°±3.5°;segmental height,69.4 mm±10.5 mm;P>0.05). All cases acquired good lumbar interbody fusion with no internal fixation failure or recurrence of tuberculosis.[Conclusions]Under systemic and routine antituberculosis chemotherapy,one-stage extreme lateral approach debridement,bone graft and internal fixation is effective and feasible for single-segmental lumbar spinal tuberculosis.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical effects of medial and lateral approach in treating terrible triad of the elbow.</p><p><b>METHODS</b>From May 2010 from May 2014, 11 patients with terrible triad of the elbow were treated through medial and lateral approach. There were 6 males and 5 females, aged from 25 to 56 years with an average of 35.2 years old. The time from injury to operation was from 1 to 13 days with an average of 5.9 days. Fracture of radial head according to Mason typing, 2 cases were type I, 7 cases were type II, 2 cases were type III. Ulnar coronoid fracture according to Regan-Morrey typing, 3 cases were type I, 7 cases were type II, 1 case was type III. Postoperative complications were observed and Mayo elbow performance score(MEPS) was used to assess the elbow joint function.</p><p><b>RESULTS</b>All patients were followed up from 6 to 24 months with an average of 15.5 months. All fractures obtained healing with an average time of 14 weeks (ranged from 10 to 18 weeks). According to Mayo to assess the results, total score was 78.2±11.7, 2 cases got excellent results, 7 good, 1 fair, 1 poor. At final follow up, the mean range of motion was (108±21)° in flexion, (12±8)° in extension, (66±13)° in pronation, (28±18)° in supination. The varus angle of the elbow ranged from 5°to 8° in 3 cases and the valgus angle was 8° in 1 case.</p><p><b>CONCLUSIONS</b>Treatment of the terrible triad of the elbow through medial and lateral approach can obtain satisfactory clinical effects, restore the elbow stability, allow early motion postoperatively, and promote the joint functional rehabilitation.</p>