ABSTRACT
Objective A retrospective study to determine the mid-and long-term clinical and radiological outcomes of unilateral instrumented transforaminal lumbar interbody fusion (TLIF) with bilateral decompression via unilateral paramedian incision.Methods From J ul.,2007 to J un.,2010,73 patients with single segmental lumbar stenosis were collected in this study.All of 73 patients had bilateral signs and symptoms of stenosis,and accepted the unilateral TLIF with bilateral decompression via unilateral paramedian incision.The oswestry disability index (ODI),Japanese orthopedic association scale (JOA),visual analog scale (VAS),angle of lumbar lordosis (LL) and angle of segmental lordosis (SL) were calculated and compared at pre-operation,six months after operation and last follow up.In addition,the operating time,blood loss,length of hospital stay,complications and fusion rate were also recorded.Results There were 30 males and 43 females in this study.The mean age,mean operation time,mean blood loss and mean length of hospital stay was (57.7 ± 10.1) years,(92.0 ± 26.7)minutes,(150.5 ± 130.3) mL and (12.3 ± 2.7) days,respectively.The follow up was 5 years at least and the mean follow up was (79.4 ± 11.1) months.The ODI,JOA and VAS at six months after operation and last follow up were significantly better than those at pre-operation.As for the sagittal alignment assessment,the LL and SL at six months after operation and last follow up also increased significantly compared with those at pre-operation.All of 73 patients achieved solid interbody fusion.Conclusions Unilateral instrumented TLIF with bilateral decompression via unilateral paramedian incision is an effective innovation.Compared with the traditional TLIF,it could not only reduced the surgical injury and operation cost but also achieve the same ideal effect.
ABSTRACT
Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging, which has been found to be a contributing factor for low back pain and might cause radiculopathy, myelopathy, spinal stenosis, degenerative spondylolisthesis, and herniations. Its etiology is complex and multifactorial. Although genetics influence more dominant, the occupational and mechanical influences still persist as a major risk factor. This review emphasizes up-to-date knowledge regarding etiology of disc degeneration with special consideration on occupational, lifestyle factors, and genetic polymorphisms.
Subject(s)
Humans , Intervertebral Disc Degeneration , Genetics , Life Style , Occupational DiseasesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the association between left coronary artery stenosis degree and myocardial perfusion by 64 multi-slice CT.</p><p><b>METHODS</b>A total of 223 patients underwent 64 multi-slice CT coronary artery images (CTA) were included and divided into normal group (91 cases), mild stenosis group (72 cases), moderate stenosis group (36 cases) and severe stenosis group (24 cases). Myocardial density was measured at apical, septal and lateral segments. Myocardial density in infarcted segments was compared to non-infarct segments in 11 patients with old myocardial infarction (all from severe stenosis group).</p><p><b>RESULTS</b>Myocardial density was significantly lower at apical segments [(55.8 ± 21.4) HU vs. (75.3 ± 7.5) HU], at septal segment [(87.8 ± 3.3) HU vs. (98.2 ± 5.2) HU] and at lateral segment [(86.8 ± 7.9) HU vs. (95.6 ± 11.6) HU] in severe stenosis group than in normal group (all P < 0.05). Myocardial density of patients with old myocardial infarction was significantly reduced in non-infarct segment [(70.9 ± 8.3) HU vs.(98.7 ± 7.3) HU, P < 0.01] and increased in infarct segment [(42.5 ± 15.7) HU vs. (17.8 ± 4.1) HU, P < 0.01] post contrast enhancement.</p><p><b>CONCLUSION</b>CTA could be used to evaluate the severity of the left coronary artery stenosis based on myocardial density measurement. Myocardial delayed enhancement derived from CTA could be used to identify infarct segments.</p>