A portable spinal fixation guiding device: Design, preparation and preliminary application / 第二军医大学学报

Objective: To design a portable real-time monitoring tool for spine surgery and to preliminarily evaluate its application,so as to reduce the iatrogenic injury during the treatment of battle field spinal cord injury. Methods: A portable spine guiding device for spinal fixation was designed and prepared. The spinal specimens were randomly divided into control group (n = 10) and experimental group (n = 10). In the control group the way was cleared for the pedicle according to the doctor's experience; in the experimental group the way was cleared using our self-designed guiding device. The operation time was recorded in the two groups. After manipulation the specimens were opened along the pedicle level; the location and the depth of the needle were compared. Results;The manipulation time of a single vertebral body was (0. 5 + 0. 2) min in the control group and (0. 6 + 0. 1) min in the experimental group (P>0. 05). The edge of the puncture to the pedicle wall in the control group was significantly shorter than that in the experimental group ([1. 1 + 0. 3] vs [1. 8 + 0. 2] mm,P = 0. 037). Conclusion:The designed portable guiding device for spinal fixation is easy to carry, simple to operate; and initial in vitro application is satisfactory and can provide reliable reference for early operation.

A self-prepared field battle "Windbreaker" stretcher for fixation of spinal cord injury and its application / 第二军医大学学报

Objective: To design and prepare a field battle "Windbreaker" stretcher for fixation of spinal cord injury using macromolecular material, and to determine its application index and assess its efficacy. Methods: Using shape memory waterborne polyurethaneurea/SiO2 nano-composite, we prepared a field battle "Windbreaker" stretcher for fixation of spinal cord injury according to the physique of the Chinese. The time spent to finish the fixation procedure under different conditions (raining, cold weather, land and rivers) was recorded, and the time of solidification was also observed. Results: The weight of a complete set of the field battle "Windbreaker" stretcher was (7.5±1.4) kg. The time to complete a fixation was (2.1±0.55) min in the water, (1.9±0.35) min under dry environment. The time of solidification was(7.7±1.45) min in the water and was (6.9±1.23) min under dry environment. The maximum strength the stretcher could bear was (80±5.7) kg. Conclusion: Our self-designed "Windbreaker" stretcher can be used for rapid and simple fixation of different spinal cord injuries, and the mechanics intensity meet the requirement for fixation. The stretcher can be used for fixation of spinal cord injury under different conditions of field battle.

Cauda equina syndrome: a review of clinical progress / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the literature on the clinical progress in cauda equina syndrome (CES), including the epidemic history, pathogenesis, diagnosis, treatment policy and prognosis. Data sources All reports on CES in the literature were searched in PubMed, Ovid, Springer, Elsevier, and the Chinese Biomedical Literature Disk using the key terms "cauda equina syndrome", "diagnosis", "treatment", "prognosis" and "evidence-based medicine". Study selection Original milestone articles and critical reviews written by major pioneer investigators about the cauda equina syndrome were selected.</p><p><b>RESULTS</b>CES is rare, both atraumatically and traumatically. Males and females are equally affected. The incidence of CES is variable, depending on the etiology of the syndrome. The most common cause of CES is herniation of a lumbar intervertebral disc. CES symptoms may have sudden onset and evolve rapidly or sometimes chronic ally. Each type of CES has different typical signs and symptoms. Low back pain may be the most significant symptoms, accompanied by sciatica, lower extremities weakness, saddle or perianal hypoesthesia, sexual impotence, and sphincter dysfunction. MRI is usually the preferred investigation approach. Patients who have had CES are difficult to return to a normal status.</p><p><b>CONCLUSIONS</b>The diagnosis of CES is primarily based on a careful history inquiry and clinical examination, assisted by elective radiologic investigations. Early diagnosis and early surgical decompression are crucial for a favorable outcome in most CES cases.</p>

Evaluation of injuries first week after Wenchuan earthquake in field hospital / 上海第二医科大学学报

Objective To evaluate the injuries in Jiangyou Field Hospital first week after Wenchuan earthquake,and accumulate experience for better medical services and better-built field hospitals to meet the demands of the earthquake-stricken areas.Methods Classification was performed in 1 905 patients with emergency treatment.The medical records of those with hospital stay were retrospectively analysed,including geographical distribution,trauma type,diagnosis,initial treatment and outcomes.Results Six hundred and twenty-nine(33%)patients were hospitalized,with an average of 2 to 100 years old(median,41.2).Three hundred and eighty-four patients(61%)were admitted within the first three days after earthquake.The patients were mainly from Jiangyou City(245,39%),Beichuan County(194,31%)and Pingwu County (158,25%).The most common types of injuries were superficial lacerations(326,51.8%),fractures(202,32.1%) and soft tissue contusions/sprains(87,13.9%),among whom 15 experienced severe squeeze.There were 318 injuries to pelvis and extremities(50.6%),117 to head(18.6%)and 43 to back(6.8%),and 73 cases had multiple injuries (11.6%).Of 376 patients(59.8%)with operation,326 received debridement,21 external fixation,19 internal fixation, 11 amputation,4 laparotomy,4 fasciotomy and 2 craniotomy.The incidence of postoperative infections was 11.8%.Death occurred in 39 patients due to cerebral trauma,pelvic fracture,abdominal hemorrhage and multiple injuries.Conclusion When the earthquake has destroyed the major medical facilities,rapid organization of medical rescue teams,making full use of remaining medical resources and recovering electricity play an important role in the rescue of victims and reduction of mortality.Orthopaedic surgeons must dominate the medical teams as most of the earthquake victims suffer from injuries to the extremities.