Clinical effect of TESSYS technique of percutaneous transforaminal endoscopic discectomy for atypical lumbar disc herniation / 实用医学杂志

Objective To observe the clinical effect of transforaminal endoscopic surgical system (TESSYS) technique for atypical lumbar disc herniation. Methods Eighteen patients with atypical lumbar disc herniation underwent TESSYS technique under local anesthesia. Numerical rating scale (NRS) was used to evaluate the sciatica and/or back pain. The outcomes were evaluated by Oswestry disability index (ODI) and the Macnab score. Results The postoperative NRS scales were significantly lower than preoperative one (P<0.01). The postoperative ODI was lower than preoperative one (P < 0.05). Good rate of modified Macnab criteria was 88.89%. One patient occurred right hip pain and disappeared after partial closure. one patient turned to open surgery at 1 week. Conclusion The TESSYS technique was an effective method for atypical lumbar disc herniation. It has satisfactory clinical effect which is worthy of spreading for clinical application.

Effect of low stress environment on repairing of children necrotic femoral head / 中国矫形外科杂志

[Objective]To observe the change of children necrotic femoral head repairing under low stress environment and to explore the effect of low stress environment on Perthes disease.[Method]The sick coxa was supported by Coxa Multi-functional External Fixation Shoring Fixator,which decreased femoral head stress and creates a low-stress environment for the sick coxa.Meanwhile,the affected extremity was kept abduction and internal rotation in order to increase femoral head containment.The coxa could flex and extend partly on sagittal plane.Twenty-eight patients(32 hips) were followed up with mean follow-up time of 3 years and 5 months(2~7 years).The radiological characteristics of pre-and post-operation was analyzed.[Result]At 3 months postoperatively,joint space was broadened,high density necrosis shadow became little and little,the femoral head became full,height of the femoral head epiphysis increased.If epiphyseal nucleus fragmentation vaded epiphyseal plate,the big head and pachy-neck and the subluxation of coxa would finally result.[Conclusion]Under low stress environment,child necrotic femoral head could be repaired.The prognosis is related to Catterall stage of Perthes disease.On Catterall Ⅱ and Ⅲ stage,the curative effect is fairly good.But on Catterall Ⅳ stage,the curative effect is not evident.