ABSTRACT
Objective To investigate clinical effect of limited decompression under endoscope combined with percutaneous transpedicular screw fixation for treatment of degenerative lumbar spinal stenosis.Methods Thirty-four senile patients with lower lumbar spinal stenosis were selected as our subjects from February 2010 to August 2011,and were treated with limited decompression under endoscope combined with percutaneous transpedicular screw fixation through posterior approach.The VAS scores of all patients were collected at the four periods including pre-operation,leaving hospital,3 months after operation,and the last follow-up.The therapeutic effectiveness for the postoperative follow-up was expressed as excellent,good,ordinary,and poor according to Nakai standard.Results The VAS scores at pre-operation,leaving hospital,3 month after operation,and the last follow-up were (7.9 ± 1.6),(2.9 ± 1.4),(1.9 ± 1.9),(2.4 ± 1.5)respectively,and the difference was significant (F =13.524,P =0.036).But no significant differences of VAS scores at three sequential tests after operation were observed (P ＞ 0.05).In the last postoperative follow-up,32 cases were graded as excellent,1 cases for good and 1 case for ordinary,and the excellent rate reached to 97％.Conclusion The therapeutic effectiveness of lumbar spinal stenosis limited decompression under endoscope combined with percutaneous transpedicular screw fixation is reliable.Furthermore,no side effects on spine and back muscles are observed.
ABSTRACT
Objective-To-discuss-the-clinical-efficacy-of-limited-decompression-and-pedicle-screw-fixation-for-thoracolumbar-burst-fractures.-Methods-From-October-2005-to-October-2011,-38-patients-with-thoracolumbar-burst-fractures-were-treated-by-lumbar-pedicle-screw-fixation-combined-with-limited-decompression-.The-X-ray-measurements-and-evaluations-of-neurological-functions-before-and-after-surgery-were-reviewed-.-Results-All-the-38-cases-were-followed-up-for-36-months.The-bone-fusion-was-obtained-in-all-the-cases-,-without-pedicle-screw-breakage-,-bending-,-or-prolapse-.Evaluation-of-the-efficacy-at-36-months-after-surgery:excellent-in-36-cases,-good-in-1-case,-and-poor-in-1,-with-a-good-or-excellent-rate-of-97.4%-(37/38).The-preoperative-anterior-height-of-fractured-vertebrae-was-(14.23-±2.51)-mm,-which-was-significantly-lower-than-that-6-months-postoperatively-[(25.68-±3.95)-mm,-q=22.319,-P<0.05],-24-months-postoperatively-[(26.23-±3.15)-mm,-q=23.391,-P<0.05],-and-36-months-postoperatively-[(25.64-±2.86)-mm,-q=22.241,-P<0.05].The-preoperative-Cobb-angle-was-(24.39°±2.54°),-which-was-significantly-more-than-that-36-months-after-surgery[(15.54°±1.05°),-q=27.448,-P<0.05].The-preoperative-VAS-scores-were-(6.1-±1.1)-points,-which-were-significantly-higher-than-that-36-months-after-operation-[(1.2-±0.6)-points,-q=33.930,-P<0.05].There-were-significant-differences-in-the-Frankel-grades-before-and-after-the-operation-(Z-=-2.190,-P-=0.029).-Conclusion-Limited-decompression-and-pedicle-screw-fixation-for-thoracolumbar-burst-fractures-can-not-only-provide-instant-stability-,-but-also-have-advantages-of-high-satisfaction-rate-,-minimal-invasion-,-and-long-term-prevention-of-kyphosis-and-fixation-failure-.
ABSTRACT
Objective To study the effectiveness of limited decompression ,fixation and fusion on the patients with degenerative lumbar spinal stenosis .Methods 92 patients with degenerative lumbar spinal stenosis were ran-domly divided into two groups,the observation group(n=46 cases) who were operated through limited decompres-sion,fixation and fusion,and the control group(n=46 cases) who were operated through the lamina resection decom-pression and internal fixation and interbody fusion .Two groups were observed about surgery time ,blood loss and length of hospital stay.Follow-up for 6 months,the two groups of JOA score was compared.Results In the observation group,operative time,blood loss and length of hospital stay were shorter than that of the control group ( t=6.092, 7.114,3.714,all P0.05).After 1 month,3 months after operation,the JOA score was no significant difference between the observation group and the control group (t=0.810,0.901,P>0.05).JOA score in the observation group after 6 monthe of operation was higher (t=4.014,P<0.05).After 6 months,excellent rates were 78.3%in the observation group and 67.4%in the control group .The observation group was significantly higher than the control group (χ2 =7.210,P<0.05).Conclusion Limited decompression,fixation and fusion had a low trauma and significant effect for patients with degenerative lumbar spinal stenosis .
ABSTRACT
[Objective]To study the feasibility and clinical effect of the treatment of thoracolumbar vertebral fracture with limited decompression of neighbouring segments with internal fixation and intervertebral body fusion.[Method]Forty-three patients with thoracolumbar fractures were treated with this technique.The fusion of bone graft,reduction rate of fracture,nerve functional recovery,the loosening of rectification,subsequent low back pain,and the degeneration of adjacent segments were evaluated.[Result]All cases were followed up for 21.4 months and showed the results of strong spine bony fusion,96.1% satisfactory reduction rate without reduction lost,various differences of nerve functional improvement,a rank-sum test P