Surgical treatment of Denis type B thoracolumbar burst fracture with neurological deficiency by paraspinal approach

We aimed to describe the surgical technique and clinical outcomes of paraspinal-approach reduction and fixation (PARF) in a group of patients with Denis type B thoracolumbar burst fracture (TLBF) with neurological deficiencies. A total of 62 patients with Denis B TLBF with neurological deficiencies were included in this study between January 2009 and December 2011. Clinical evaluations including the Frankel scale, pain visual analog scale (VAS) and radiological assessment (CT scans for fragment reduction and X-ray for the Cobb angle, adjacent superior and inferior intervertebral disc height, and vertebral canal diameter) were performed preoperatively and at 3 days, 6 months, and 1 and 2 years postoperatively. All patients underwent successful PARF, and were followed-up for at least 2 years. Average surgical time, blood loss and incision length were recorded. The sagittal vertebral canal diameter was significantly enlarged. The canal stenosis index was also improved. Kyphosis was corrected and remained at 8.6±1.4o (P>0.05) 1 year postoperatively. Adjacent disc heights remained constant. Average Frankel grades were significantly improved at the end of follow-up. All 62 patients were neurologically assessed. Pain scores decreased at 6 months postoperatively, compared to before surgery (P<0.05). PARF provided excellent reduction for traumatic segmental kyphosis, and resulted in significant spinal canal clearance, which restored and maintained the vertebral body height of patients with Denis B TLBF with neurological deficits.

Effects of Early Psychological Intervention on Activity of Daily Living of Old Stroke Patients / 中国康复理论与实践

@#Objective To study the effect of psychological intervention on activity of daily living(ADL) in old stroke patients.Methods 120 old stroke patients were divided into treatment group and control group,each including 60 cases.All the cases accepted routine neurological therapy and early rehabilitation training.The patients in the treatment group were additionally treated with psychological intervention.Before and 2,4 and 12 weeks after treatment,they were assessed with modified Bathel Index(MBI) and National Institutes of Health Stroke Scale(NIHSS).Results 4 and 12 weeks after treatment,the scores of MBI and NIHSS improved more in treatment group than in control group(P<0.05).Conclusion Psychological intervention can facilitate the recovery of neural function and ADL after stroke.