Complications and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion for the treatment of one- or two-level degenerative disc diseases of the lumbar spine in patients older than 65 years / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been successfully used to treat degenerative diseases of the lumbar spine. There are few reports comparing the complications and clinical outcomes in older patients who have undergone one- or two-level MIS-TLIF with those of younger patients. The aim of this study was to investigate the clinical outcomes of MIS-TLIF in the treatment of degenerative disc disease of lumbar spine of the patients older than 65 years, with an emphasis on perioperative complications compared to the younger patients.</p><p><b>METHODS</b>One hundred and fifty-one consecutive cases of one- or two-level degenerative disc disease of lumbar spine treated with MIS-TLIF were reviewed for the radiological and clinical outcomes. They were divided into elderly group (age ≥ 65 years old) and younger group (age < 65 years old), and were followed for at least 6 months. Radiographs were obtained before and after surgery, 3 months postoperatively, and at the final follow-up to determine the presence of fusion, hardware-related problems. The clinical outcomes were evaluated using the Oswestry Disability Index (ODI) before and after surgery, and at the final follow-up. The visual analogue scale (VAS) score of back and leg pain were evaluated as well. The intra-operative data and peri-operative complications were recorded.</p><p><b>RESULTS</b>The mean age of these patients at operation was (57.7 ± 14.2) years (range 26 - 82 years). Of 151 patients, 62 were 65 years or older. The elderly patients had more comorbidities and more porportion of lumbar canal stenosis. The overall fusion rate was 88.4% at the final follow-up, with no significant difference between younger and elderly patients. The ODI, the VAS of back pain and radicular pain of both young and elderly group were significantly improved after surgery and at the final follow-up, without significant difference between two groups. There were 16 complications with an incidence of 10.6%, including 7 major complications and 9 minor complications. There was no significant difference of the incidence of complications between two groups. The incidence of dura tear was significantly related to bilateral deompression.</p><p><b>CONCLUSIONS</b>The clinical and radiological outcomes of MIS-TLIF in the treatment of one- or two-level degenerative disc diseases of lumbar spine in the elderly patients were satisfactory. Though there are more pre-operative comorbidities, with proper patient selection, the elderly patients are not at increased risk of perioperative complications compared to younger patients. Screw malposition and dura tear, which are the most frequent complications, were more related to the surgical technique and should be avoided.</p>

Therapeutic strategy for traumatic instability of subaxial cervical spine / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A simple, safe and effective therapeutic strategy for traumatic instability of the subaxial cervical spine, as well as its prognostic assessment, is still controversial.</p><p><b>METHODS</b>The therapeutic options for 83 patients of traumatic instability of the subaxial cervical spine, whose average age was 35 years, were determined, according to the Allen-Ferguson classification, general health and concomitant traumatic conditions, neurological function, position of compression materials, concomitant traumatic disc herniation/damage, concomitant locked-facet dislocation, the involved numbers and position, and the patients' economic conditions. An anterior, posterior or combination approach was used to decompress and reconstruct the cervical spine. No operations with an anterior-posterior-anterior approach were performed.</p><p><b>RESULTS</b>The average follow-up was three years and nine months. Distraction-flexion and compression-flexion were the most frequent injury subtypes. There were 46, 28 and 9 cases of anterior, posterior and combination operations, respectively. The average score of the Japanese Orthopaedics Association, visual analog scale and American Spinal Cord Injury Association (ASIA) motor index improved from 11.2, 7.8 and 53.5, respectively, before operation, to 15.3, 2.6 and 67.8, respectively, at final follow-up. For incomplete spinal cord injury (SCI), the average ASIA neurological function scale was improved by 1-2 levels. Patients with complete SCI had no neurological recovery, but recovery of nerve root function occurred to different extents. After surgery, radiological parameters improved to different extents. Fusion was achieved in all patients and 12 developed complications.</p><p><b>CONCLUSIONS</b>The best surgical strategy should be determined by the type of subaxial cervical injury, patients' general health, local pathological anatomy and neurological function.</p>

Study on contingent negative variation in anxiety disorder / 上海第二医科大学学报

0.05)and significantly delayed reaction time,(305?109)ms vs(212?70)ms(P

Experimental Study of Mismatch Negativity in Patients with Depression / 上海第二医科大学学报

Objective To study the characteristics of mismatch negativity(MMN) in patients with depression.Methods MMN was recorded from 31 patients with depression and 28 age-matched controls. Results Compared with the controls, the patients with depression had prolonged latency ([189?22] ms vs [206?26] ms, P