ABSTRACT
BACKGROUND: Dexmedetomidine has been shown to fight against ischemia/reperfusion injury induced by tourniquets. OBJECTIVE: To study the effects of dexmedetomidine on the oxidative stress and inflammatory damage caused by tourniquet-induced ischemia/reperfusion injury. METHODS: Seventy-six patients scheduled for lower limb operation were randomized into two groups: patients in dexmedetomidine group were given the intravenous injection of 1 μg/kg dexmedetomidine for 10 minutes, followed by 0.5 μg/kg?h until the end of operation; while the controls were subjected to 0.9% saline injection at an equivalent velocity and volume. The levels of serum propanediol, lactic dehydrogenase, superoxyde dismutase, tumor necrosis factor-α, interleukin-6 and -8 were detected before tourniquet inflation, 10, 60 and 120 minutes after tourniquet release. RESULTS AND CONCLUSION: In both two groups, the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8 after tourniquet release were significantly higher and the serum superoxide dismutase level was significantly lower than those before tourniquet inflation (P < 0.05). Compared with the control group, dexmedetomidine significantly reduced the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8, and increased the serum superoxyde dismutase level after tourniquet release (P < 0.05). These results suggest that dexmedetomidine can attenuate the oxidative stress and inflammatory damage resulting from tourniquet-induced ischemia/reperfusion injury probably by up-regulating the serum superoxyde dismutase level, and down-regulating the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8.
ABSTRACT
BACKGROUND:As one of the most serious pathological types of lumbar disc herniation, the nucleus pulposus of prolapsed style lumbar intervertebral disc herniation is like a cord or mass. And the nucleus pulposus compresses nerve roots and dural sac, which brings severe low back pain and/or cauda equina injury symptoms.OBJECTIVE:To compare the clinical efficacy of simple discectomy under the Quadrant system and minimally invasive transforaminal lumbar interbody Concorde fusion (MIS-TLIF) in the treatment of prolapsed and sequestrated lumbar disc herniation.METHODS:From January 2012 to January 2015, 58 patients with prolapsed and sequestrated lumbar disc herniation were enrolled in this study, including 36 patients in simple Quadrant group and 22 patients in MIS-TLIF group.RESULTS AND CONCLUSION:Significant difference was recorded in the visual analogue scale scores and Oswestry disability index at 1 week, 3 months and 18 months postoperation compared with preoperation in the two groups (P 0.05). There were two patients with recurrent lumbar disc herniation in the simple Quadrant group. In summary, simple discectomy under the Quadrant system could achieve the similar satisfied effect as the MIS-TLIF, but the MIS-TLIF provides less low back pain.
ABSTRACT
BACKGROUND:Total hip arthroplasty is usualy taken to cure patients with ankylosing spondylitis combined with affected hip, to increase their life quality. But, its effects on sagittal balance of the spine-pelvis are not wel known. OBJECTIVE:To analyze the effects of total hip arthroplasty on sagittal balance of the spine-pelvis and life quality in patients with ankylosing spondylitis combined with affected hip. METHODS: Clinic data of 47 consecutive patients with ankylosing spondylitis combined with affected hip who had total hip arthroplasty and were folowed up for more than one year after operation from December 2008 to December 2013 were retrospectively analyzed. The spine-pelvis sagittal balancing parameters were measured. According to the SF-36 questionnaire, the dimensional scores were calculated to assess the life quality. Pearson correlation analysis was performed to analyze the correlation between the balancing parameters and SF-36 scores pre-operation, and the change of the balancing parameters and SF-36 scores pre- and post-operation were analyzed. RESULTS AND CONCLUSION:According to the data before total hip arthroplasty, sagittal vertical axis was negatively correlated with physiological function, body pain and vitality. Total kyphosis was negatively correlated with physiological function and general health. Lumbar lordosis was positively correlated with physiological function. Pelvic tilt angle was negatively correlated with the vitality and social function. Pelvic incident angle was negatively correlated with body pain, vitality and emotional role. No significant correlation was shown between sacral inclination angle and SF-36 items. After total hip arthroplasty, lumbar lordosis and sacral inclination angles were significantly increased, while sagittal vertical axis and pelvic tilt angle were significantly decreased compared with those before surgery. Total kyphosis and pelvic incident angle showed no significant differences before and after surgery. The SF-36 scores al got a statisticaly significant increase. Results showed that, sagittal vertical axis, total kyphosis, lumbar lordosis, pelvic incident angle and pelvic tilt angle are the potential factors influencing the life quality in patients with ankylosing spondylitis combined with affected hip. The total hip arthroplasty, which induces a better sagittal balance with an increased lumbar lordosis and sacral inclination angle, and a decreased sagittal vertical axis and pelvic tilt angle, can result in better life quality.