Application of back-pressurized corset in incision pressure dressing after posterior lumbar surgery / 现代临床护理

Objective To study the effect of back-pressurized corset in incision pressure dressing after posterior lumbar surgery. Methods Seventy-eight patients who received posterior lumbar surgery during December 2013 to December 2014 in our hospital, were set as the control group and treated by incision dressing using common corset. Another 80 patients receiving the same posterior lumber surgery during January to December 2015 were set as the experiment group and treated with incision pressure dressing using the pressured-corset. After surgery, the two groups were compared in terms of incisive bleeding, completeness of the dresses and waist comfort level at day 7. Results The rate of incisive bleeding in the experiment groups was significantly lower and the comfort level at the lumbar was significantly higher than that of the control group (P 0.05). Conclusion The incision pressure dressing for the patients after posterior lumbar surgery can remarkably improve the effect of compression fixation on the incision and increase comfort level.

Neurovascular distribution around the multifidus muscles in the low back and its clinical implications / 局解手术学杂志

Objective To explore the neurovascular distribution around multifidus muscles in the low back and its clinical significance via regional dissection.Methods Five cadavers were dissected in the low back.The anatomical relationships between the longissimus thoracis,iliocostalis and the start-stop,direction and position of multifidus muscles were observed.Branches,distribution and the characteristics of the erector spinae muscle,the lateral branches of spinal nerves and blood vessels were examined.Then measured the distances from the emerging point of the lateral cutaneous branches of spinal nerves to the spinous processes.Results After removed the deep fascia,the longissimus thoracis was found medially and the iliocostalis was found laterally.The muhifidus muscles located deeply to the longissimus and the iliocostalis muscles.The lateral branches of the posterior rami of the spinal nerves and the dorsal branches of lumbar blood vessels run in the multifidus muscle gaps.Conclusion The multifidus muscle gaps contain plenty of neurovascular bundles.Surgery involving the low back often takes the advantage of the gaps between multifidus muscles.Therefore,surgeons should take caution to avoid damaging the lateral branches of the posterior rami of the spinal nerves and the dorsal branches of lumbar vessels during low back surgery.