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Objective To introduce a new minimally invasive lumbar positioning system and its positioning method as well as conduct a prospective control study on the differences in positioning time,positioning frequency and radiation exposure dose between the new positioning method and the traditional positioning method.Methods 121 patients with lumbar disc herniation combined with lumbar instability and patients with thoracolumbar vertebral fracture admitted in our hospital from May 2010 to February 2013 were randomized into two groups.68 patients in Group A had undergone the traditional positioning method before and during operation.Among the 68 patients,41 were with single-segment lesion and 27 were with two-segment lesion.53 patients in Group B had undergone the new minimally invasive lumbar positioning system before and during operation.Among the 53 patients,34 were with single-segment lesion and 19 were with two-segment lesion.There were no significant differences in gender,age,course of disease and other general information between the two groups.The positioning time,positioning frequency and radiation dose of the two groups before and during operation were compared and statistically analyzed.Results The positioning time of Group A and Group B were 8.26±3.44 min and 3.51±1.82 min respectively; the positioning frequencies were 3.57 and 1.22; the accuracy were 60.8％ and 96.2％.For the patients with single-segment lesion,the positioning time before implanting two percutaneous pedicle screws during operation were 15.12±4.69 min and 5.51±1.32 min respectively and the positioning frequency were 6.47 and 2.45.For the patients with two-segment lesion,the positioning time before implanting three percutaneous pedicle screws during operation were 24.91±7.43 min and 8.84±2.32 min respectively and the positioning frequency were 11.72 and 3.69.Moreover,the radiation dose detected at neck,chest and wrist of the surgical staff in Group A were 3.09±0.24 Gy,4.23±0.71 Gy and 5.17±0.62 Gy and that detected in Group B were 1.38±0.47 Gy,2.69±0.33 Gy and 3.21±1.05 Gy.There were significant differences in positioning time,positioning frequency and radiation dose between Group A and Group B.Conclusion The minimally invasive spine positioning system and positioning method can simplify the operative procedures and largely reduce radiation exposure,which is characterized by high positioning accuracy,short positioning time,low fluoroscopy frequency and X-ray radiation dose.
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Objective To explore clinical and radiographic outcomes of unstable distal clavicle fractures (Neer ⅡB) fixed with lateral clavicle anatomic locking compression plate (LCP).Methods Between January 2009 and October 2010,eleven consecutive patients with unstable fractures of the distal clavicle (Neer ⅡB) were treated using lateral clavicle anatomic LCP.There were 9 men and 2 women,with the mean age of 37.2 years (range,23-43 years).The right shoulder was involved in 6 patients and the left in 5 patients.The interval between injuries to operation was 24-72 h (mean,48 h).After fracture reduction,the plate was place on superior of the distal clavicle.According to the distal fragment length,3 to 6 locking screws were carefully inserted,3 locking screws were used to fix proximal fractures.Coracoclavicular ligament was not repaired.Functional recovery of the shoulder joint was assessed using the American Shoulder and Elbow Surgeons (ASES) rating scale score.Plain radiographs of clavicles were used to assess bony union.Results All the patients were followed up for 9 to 12 months (mean,10.3 months).Solid bony union was eventually achieved in all patients.The mean ASES scores were 89.1 (range,84-91) on the injured side versus 96.2 (range,94-100) on the contralateral side.No implant-related fracture,fixation failure and rotator cuff injury occurred.Conclusion Lateral clavicle anatomic LCP fixation in the treatment of distal clavicular fractures is a reliable and simple technique.