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Objective To observe the clinical efficacy of modified laminoplasty with C3 laminectomy and C7 spinous process retention in the treatment of cervical ossification of the posterior longitudinal ligament(OPLL).Methods From February 2014 to March 2016,133 cases of OPLL were admitted,and 42 OPLLs were included according to the inclusion and exclusion criteria.A case-control study was conducted.Twenty-two cases were included in modified group and 20 cases in traditional group.There were 13 males and 9 females in the modified surgery group,and the average age was 56.2±9.75 years (39-77 years).Modified surgery was conducted with C3 laminectomy,C4-C6 laminoplasty,resection at the upper part of the C7 lamina and retaining the C7 spinous process.Meanwhile,there were 12 males and 8 females in the traditional surgery group,with an average age of 53.7± 8.23 years (41-75 years).Patients in the traditional surgery group were treated with standard C3-C7 laminoplasty.The mean followup was 22.9±4.5 (15-29) months.The JOA,NDI scores of the two groups were recorded preoperatively and postoperatively.The physiological curvature and activity of the cervical spine before and after operation were observed,and the incidence of axonal symptoms and postoperative complications in both groups were recorded.Results The follow-up period was 15-28 months,with an average of (23.2 ± 4.8) months.There was no significant difference between the base line of two groups before operation.At the last follow-up,the JOA and NDI scores of the two groups were significantly improved.There was no difference of JOA scores between the two groups at the last follow-up,while the NDI sores at the modified group(6.56±4.78) was superior to the traditional group(9.25±7.63).The VAS score at the first day after surgery in modified group was lower than that of the traditional group.The average cervical curvature of the patients in the modified surgery group and the standard surgery group were 12.32°±8.26° and 11.56°± 8.05°,respectively.There was no significant difference between the two groups.The postoperative range of movement (ROM) of cervical spine was 39.68°±9.52° in modified group and 33.51°± 10.39° in traditional group(P＜0.05).Eight patients (19％) had augmentation of axial symptoms,including 3 patients in the modified surgery group(13.6％) and 5 patients in the standard surgery group (30％).There was no significant difference between the two groups.During the follow-up period,there were no complications such as cerebrospinal fluid leakage,spinal cord injury,wound infection,laminar collapse,postoperative closure,internal fixation loss or fracture.Conclusion The modified laminectomy with C3 laminectomy and C7 spinous process retentionis minimally invasive,whichachieved satisfactory decompression effect,reduced the incidence of postoperative axial symptoms and maintained the cervical ROM.
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0.05). CONCLUSION:The treatment of the Tile C type pelvic fracture with the percutaneous iliosacral articulation screws and pelvis external fixation under X-ray perspective has the advantages including small wound,simple operation,reliable fixation,short operation time,quick reactivating and low operation infection rate.
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[Objective]To determine the prevalence of each type of adolescent idiopathic scoliosis in Lenke classification,and find out the relationship between Lenke classification and fusion level. [Method]Totally 154 cases of adolescent idiopathic scoliosis being treated with sugery between January 2002 and September 2007 were analyzed retrospectively in Guangdong General Hospital.All casess were classified with Lenke classification,prevalence of each type were counted.The fusion levels were compared with Lenke classification.[Result]All of 154 cases could be classified by Lenke classification,the 5 most common types were 1AN,5CN,1BN,2AN,1CN.95.5% of structural curve had been fused.[Conclusion]Lenke classification can provide effective guidance for pre-operative evaluation and choosing opertive method.The method of determining structural curve is useful.
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[Objective]To explore and design fewer time-consuming and better method in posterior lumbar approach.[Method]Totally laminectomy and reimplantation were preformed in 20 cases of lumbar degeneration patients.[Result]Laminograftomy was proved to be safe and efficacy in 20 lumbar degenerative cases in various kinds.[Conclusion]This technique,on one hand,doesn't share weak points of total or semi laminectomy,on the other hand,maintains strong points of mentioned technique.It can save time,offer broad exposure with fewer blood loss and standard and clear operational field.These allow surgeons effective and full decompression of nerve root and other manipulation such as,intervertebral fusion and vertebral reduction.As a result of laminograftomy and pedicel screw system,it can preserve the protection from posterior column bony structure for spinal canal and nerve root,and prevent scars.What's more,it enhance the reliability of facet fusion.
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[Objective]To retrospectively analyze the complications of 528 cases of scoliosis surgery,and evaluate its strategy.[Method]From January 1980 to January 2001,528 patients with scoliosis underwent correction.There were 336 females and 192 males.The average age at surgery was 14.2 years.The average preoperation Cobb's angle was 48.2?(ranged from 34? to 102?).[Result]The patients were followed up for 3~24 years,the average was 12.5 years.The postoperative Cobb's angle averaged 24?.The average correction was 50.2%.Complications included 1 case of spinal cord injury,151 cases of sympathetic nerve injury,12 cases of superior mesenteric artery syndrom,6 cases of screw fracture,13 cases of rod fracture,3 cases of steel cable breakage,25 cases of hook displacement,20 cases of wire breakage,30 cases of flatback syndrome,6 cases of crankshaft phenomenon and 9 pseudoarthroses.[Conclusion]Satisfactory results could be obtained to treat scoliosis.
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Objective To discuss clinical application of the new spinal anterior screw rod fixation system. Methods 18 patients with burst fractures of the thoracolumbar spine, 6 with spinal tuberculosis, and 2 with spinal tumor were managed with anterior decompression instrumentation and internal fixation of screw rod system. Result 26 cases were followed up for 25 to 67 months. X ray showed that the preoperative kyphotic deformity had been corrected, and all patients had bony fusion. No complications occurred. All patients had neurological improvement. Conclusion The new screw rod fixation system has reliable stabilization and can provide rigid fixation, and it is easy to handle and the cost is low.