Effect of early customized muscle strength training on postoperative rehabilitation of patients with lumbar intervertebral disc herniation / 中国实用护理杂志

Objective@#To explore the effect of early customized muscle strength training on postoperative rehabilitation of patients with lumbar intervertebral disc herniation, so as to provide a basis for better promoting postoperative rehabilitation of patients.@*Methods@#From January 2017 to June 2018, 136 patients with lumbar intervertebral disc herniation admitted to Orthopaedic Department of the Second Affiliated Hospital of Harbin Medical University were selected as the study subjects. According to the admission time, they were divided into control group (63 cases) and experimental group (64 cases). Patients in the control group received routine nursing and rehabilitation after operation, while patients in the experimental group received early customized rehabilitation training for 12 weeks on the basis of routine nursing. Oswestry dysfunction score, Japanese Orthopaedic Society (JOA) score and Visual Analogue Scale (VAS) score were compared between the two groups before and after intervention.@*Results@#The Oswestry dysfunction scores of the intervention group on the 4th and 12th weeks after operation were 26.71±4.08 and 13.66 ± 3.54, lower than those of the control group (28.34±4.25 and 16.42 ± 4.13). There were significant differences between the two groups (t=2.205, 4.046, all P < 0.05 or 0.01). The JOA scores of the intervention group on the 10th day, 4th week and 12th week after operation were 19.14 ± 2.68, 23.51 ± 2.76, 25.32 ± 2.86, and those in the control group were 17.99 ± 2.51, 21.98 ± 2.64, 23.11 ± 2.72, respectively (t=2.495, 3.192, 4.461, P < 0.05 or 0.01). The VAS scores of waist and lower limbs in intervention group were 1.39 ±0.76 and 1.32 ±0.69, lower than those in the control group (1.75± 0.88, 1.61 ±0.84), respectively. The difference between the two groups was significant (t = 2.469, 2.127, P < 0.05).@*Conclusion@#Early customized muscle strength training can improve the body function and pain degree of patients with lumbar disc herniation after operation. It is simple, easy to master, easy to accept, and has good effect. It is worthy of being popularized widely in clinic.

Progress in Vertebroplasty and Kyphoplasty for Vertebral Compression Fracture / 现代生物医学进展

The vast majority of vertebral compression fractures are caused by osteoporosis and vertebral tumor,which lead to the pain of a fracture and intervertebral height lost.In recent 20 years,the use of percutaneous vertebroplasty and percutaneous kyphoplasty,a kind of minimally invasive surgery method intended for the vertebral compression fractures,are rising up for patients with vertebral compression fractures,which can quickly relieve patients' pain and restore injured vertebral deformities.Percutaneous vertebroplasty injects bone cement into fractures through a small incision.However,percutaneous kyphoplasty injects a balloon into a fracture to make a cavity by expending and shrinking,which is filled with filler material,and then removes the balloon,and injects bone cement.This article mainly reviews development,curative effect and safety,clinical application and future aspects.of the percutaneous vertebroplasty and percutaneous kyphoplasty.

Effects of three types of fusion methods on stress of adjacent segments by finite element analysis / 实用医学杂志

Objective To study the different biomechanics surgical effects of posterolateral fusion , the transverse fusion and the interbody fusion. Method Scan CT was followed with preprocess of images. The Mimics , HyperMesh and Geomagic Studio Reverse engineering softwares were used to establish the modles of lumbar fusion , then the finite element computation was conducted by using the Abaqus finite element software. Result The EF of each lumbar modle was established , the EF of the interbody fusionwas rised evidently. After the fusion , the stress of the adjacent lumbar were also rised, among them the stress of the upper adjacent segment in tnterbody fusion was the most in extension and rotation , with statistical significance ( P 0.05). About the under adjacent sengment, in the extension and antexion, the stress of the interbody fusion was the most, and the new type of posterolateral fusion was the least, the three of them all haved statistical significance (P0.05). Conclusion After the fusion, the EF of the lumbar and the stress of the lumbar disc are all established, the interbody fusion is most, while the others are lower.

Clinical application of a novel posterior lumbar fusion method and the short-term observation of its effect / 中华外科杂志

<p><b>OBJECTIVE</b>To increase local blood supply of bone graft, a novel posterior lumbar spine fusion method with orthotopic paraspinal muscle-pediculated bone flaps was constructed, and the fusion rate and clinical effect.were observed.</p><p><b>METHODS</b>From June 2007 to December 2010, 117 patients of lumbar spinal stenosis or lumbar destabilization treated with the novel posterior lumbar fusion method were studied, 49 males and 68 females, aged from 40 to 77 years, average 61.5 years. Clinical effect was evaluated by JOA and VAS score preoperatively and postoperatively, and the fusion result was evaluated by three-dimensional CT reconstruction postoperatively.</p><p><b>RESULTS</b>Seventeen cases lost of follow up, the rest were followed up from 7 to 38 months, average 19 months. There was significant difference between pre- and postoperative JOA and VAS score (P < 0.01), the preoperative JOA score was 10.3 ± 1.9, and 25.4 ± 4.2 at the latest follow-up, the improvement rate was 81.0% ; the preoperative VAS score was 8.5 ± 0.8, and 2.3 ± 0.4 at the latest follow-up. The three-dimensional CT reconstruction showed that 126 of the 133 segments formed solid fusion in 100 patients who completed the follow-up, the fusion rate was 94.7%.</p><p><b>CONCLUSION</b>The novel posterior lumbar fusion method make the bone graft position more precise, stable and increases the fusion rate, which can effectively reduce pseudarthrosis and have a promising clinical effect.</p>

Repair of rabbit bone defect with composite of calcium phosphate bone cement and calcium phosphate cement mixed with different ratio of minimal morselized bone in vivo / 中华创伤杂志

ObjectiveTo explore the effect of the calcium phosphate cement (CPC) /calcium polyphosphate fiber (CPPF) composites mixed with different proportion of minimal morselized bone on repair of bone defect in vivo. MethodsA total of 36 New Zealand white rabbits were completely randomly designed into A, B, C, D groups and their bilateral radial bone defect model was prepared. The minimal morselized bone (300-500 μm in diameter) was made from the iliac of those rats. The CPPF and CPC were evenly mixed into CPC/CPPF composites which were divided into four groups in accordance with the CPPF weight O, 10％, 30％ and 50％ in CPC/CPPF composite. The CPC/CPPF composites of the four groups was mixed with the minimal morselized bone with ratio of 6:4 and then the mixture was implanted the bone defect of the rabbits in four groups. The gross, X-ray and histological observations were done at four and eight weeks. The biomechanical test was performed at eight weeks. Results When CPPF occupies 30％ of the CPC/CPPF composite, the maximum compressive load and bending loads were better than those in the other groups ( P ＜ 0.05 ), when the histological observation showed the most tight link between the artificial composite and the bone interface and the closest similarity between material degradation rate and the ossification rate, with the best osteogenesis and the optimal ratio.ConclusionThe repair of bone defect can attain the optimal outcome through adding a certain ratio of minimal morselized bone into the CPC/CPPF to adjust the degradation rate of composites.