Research on the correlation between surgical treatment for atlantoaxial dislocation and dredging Governor vessel / 中国骨伤

<p><b>OBJECTIVE</b>To research the correlation between surgical treatment for atlantoaxial dislocation and dredging Governor vessel.</p><p><b>METHODS</b>From June 2004 to June 2010,113 patients were reviewed, including 65 males and 48 females, with the mean age of 42.6 years (ranged, 8 to 64 years). All the patients were classified and treated by TOI clinical classification which included traction and decompression and reduction, and inter fixation fusion by surgery. The SAC (space available for the cord), Governor vessel Yuzu score, JOA score, NDI score (cervical spine dysfunction index) before treatment were compared with those of after treatment.</p><p><b>RESULTS</b>The SAC in each group before treatment were (13.34 +/- 3.21), (10.43 +/- 2.42), (7.89 +/- 3.14), (10.50 +/- 0.71) mm respectively, the last follow-up of (16.02 +/- 1.42), (15.34 +/- 1.87), (14.49 +/- 1.58), (12.50 +/- 0.71) mm; Governor vessel Yuzu score before treatment were (8.37 +/- 1.87), (6.87 +/- 1.35), (5.17 +/- 1.13), (7.50 +/- 0.71) respectively, the last follow-up of (10.59 +/- 0.94), (10.25 +/- 1.01), (8.41 +/- 1.31), (9.0 +/- 0); JOA, NDI score significantly improved compared with that of before treatment.</p><p><b>CONCLUSION</b>Atlantoaxial dislocation confirmed and treated by TOI clinical classification can effectively relieve the nerve function and Governor vessel Yuzu syndrome, and show that surgical treatment is closely related with dredging the Governor vessel.</p>

Sequential drugs treatment for central pain following spinal cord injury / 中国骨伤

<p><b>OBJECTIVE</b>To investigate methods and therapeutic effects of sequential drugs treatment for central pain following spinal cord injury.</p><p><b>METHODS</b>A total of 28 patients suffered from central pain following spinal cord injury were treated with sequential drugs from 1994 to 2008, including 23 males and 5 females, ranging in age from 25 to 59 years (mean 42 years). According to the patients' response to drugs, the therapy grade was adjusted step by step until the pain was relieved. Basing on VAS scores before and after drugs treatment, analgesic effect was evaluated. The first grade drugs: COX-2 inhibitors. The second grade drugs: Tricyclic antidepressant drugs (Amitriptyline) + COX-2 inhibitors + Carbamazepine. The third grade drugs: Tricyclic antidepressant drugs (Amitriptyline) + Gabapentin + Neurotropin/COX-2 inhibitors.</p><p><b>RESULTS</b>The pain of all of 28 patients was relieved to different extent. The VAS scores decreased by 23.3 +/- 1.2 in the first grade drugs treatment group. The VAS scores decreased by 54.5 +/- 3.8 in the second grade drugs treatment group. The VAS scores decreased by 65.8 +/- 5.1 in the third grade drugs treatment group (P<0.05).</p><p><b>CONCLUSION</b>The sequential drugs treatment for central pain following spinal cord injury has a good analgesia effect and little adverse reaction.</p>

Clinical application of atlantoaxial pedicle screw internal fixation for treatment of atlantoaxial dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effect of atlantoaxial pedicle screw internal fixation for treatment of atlantoaxial dislocation.</p><p><b>METHODS</b>Sixteen patients with atlantoaxial dislocation were treated from Dec. 2005 to June 2007, included 10 males and 6 females, aged from 38 to 45 years old (means 40.5 years). Among them 12 patients combined with nerve injury, according to ASIA grade: there were 3 cases in grade B, 5 cases in grade C, 4 cases in grade D. All patients received preoperative CT, radiograph and skull traction. Intraoperative posterior approach general spine pedicle screw-rod orthopaedics fixation system used and iliac bone block were implanted in space of posterior atlantal arch and axial vertebral plate. The outcome and complications were observed in the near future.</p><p><b>RESULTS</b>There was no vascular or neural injury found. The patients were followed up for 12 to 24 months (means 18 months). All head pain, acid storm symptoms were improved after operation. According to the Odom's clinical efficacy evaluation standard, 12 cases were excellent, 4 were good. Eleven cases of 12 with nerve injury recovered significantly. By ASIA classification: 1 cases was in grade B, 2 cases were in grade C, 5 cases were in grade D, 4 cases were in grade E. No looseness or breakage of screw occurred. Bony fusion was achieved in all cases.</p><p><b>CONCLUSION</b>Posterior approach atlantoaxial pedicle screw internal fixation have the advantages of direct screw placement, short-segment fusion, intraoperative reduction, fixation reliable, high fusion rate, and it can restablish the upper cervical vertebrae stability and help to recover the spinal cord and nerve function.</p>

Biomechanical test of the general spinal pedicle screw-rod orthopaedics fixation system in the treatment of diseases related to spinal instability / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the biomechanical performance of the spinal universal fixation system(GSPS) in treating the diseases related to spinal instability.</p><p><b>METHODS</b>Four instable models and 4 fracture models were made of fresh pig's thoracolumbar specimens (T10-L3). Self-designed GSPS were used in the simulated operation. Axial loading test and torsion test were made. The stress-strain relation of the GSPS was observed. The extracting force of link bar from elastic jig was tested.</p><p><b>RESULTS</b>The strain value of each tested point changed linearly when the axial load changed from 0 to 600 N. There was linear relation between the torsion and the torsion angle. The latter was less than 6 degrees when the former reached 300 N x cm. The minimum extracting force of the link bar from the elastic jig was more than 3 300 N.</p><p><b>CONCLUSION</b>The GSPS has high energy and high elasticity on anti-axial and anti-torsion load. It is stable to use elastic link bar.</p>

Clinical curative effect of the treatment of the disease of vertebral column by the arc-track private lock pedicle orthopaedics fixation system (ALPF II) / 中国骨伤

<p><b>OBJECTIVE</b>To approach the clinical curative effect of treatment of the disease of vertebral column by the arc-track private lock pedicle orthopedics fixation system (ALPF II).</p><p><b>METHODS</b>Eighty-six cases were treated by useing ALPF II. The average age of the cases was 36.8 years (range from 18 to 69 years),the male was 39 cases and the female was 37 cases. The results were evaluated and all the cases were followed-up.</p><p><b>RESULTS</b>All the patients were followed-up for 9 to 30 months. The amelioration of patients nerve function,spinal motion, low back pain and leg pain was 94.1%, 65.9%, 92.1% and 87.4% respectively. The height of anterior and posterior border after operation were improved greatly than that before operation (P < 0.01, P < 0.05). The X-ray films showed that the angle of kyphosis was also improved significantly (P < 0.01).</p><p><b>CONCLUSION</b>To treat spinal column disease, ALPF II is a kind of operation safety simple, easy control, reset good, curative effect credibility, the complications little of treatment method.</p>