Operative strategy of the thoracolumbar fracture dislocation / 中南大学学报(医学版)

OBJECTIVE@#To explore the operative strategy and clinical outcome of the thoracolumbar fracture dislocation.@*METHODS@#Forty-two patients with the thoracolumbar fracture dislocation were treated with anterior approach (10 patients), posterior approach (28 patients), and anterior combined with posterior approach (4 patients) in order to construct the stabilities of the spine. The ASIA grades were used to evaluate the recovery of the neurological function, and the improvement of the kyphosis deformities was evaluated by the cobb's angle post-operation.@*RESULTS@#All the patients had no complications of injury in the vascular and neurological system. The ASIA grades after the operation were superior to those of pre-operation, and the cobb's angle was rectified distinctly.@*CONCLUSION@#When appropriate operative strategies are adopted, thoracolumbar fracture dislocation can be treated with satisfactory outcome.

Pedicle screws in the posterior reconstructive operation of the lower cervical vertebra / 中南大学学报(医学版)

OBJECTIVE@#To explore the efficiency of the cervical pedicle screws in the posterior reconstructive operation of the lower cervical diseases.@*METHODS@#From November 2001 to July 2003, 31 patients suffering from the lower cervical diseases were treated with the posterior pedicle screws fixation. We put the screws in the inferior articular process of the upper centrum, the lateral of the intervertebral facet center (3 - 5 mm the medial edge of lateral mass). The angles of toe-in sagittal plane varied from 30 degrees to 45 degrees, and the screws were from 18 to 26 mm (22.3 mm) in average.@*RESULTS@#There were 193 pedicle screws in this group, and no one had spinal cord injury or vertebral artery injury. The improvement rate was 84.5%. Follow-up was from 9 to 28 months (17 months in average). The screws were fixed properly without being loose and broken, and the bone graft fusions within 9 to 12 months in the X-ray and CT scan examination were satisfactory. The Japanese orthopaedics association score (JOA) was 9.7 preoperatively, but it was raised to 16.3 postoperatively.@*CONCLUSION@#The posterior reconstructive operation with cervical pedicle screws is a good choice for patients with lower cervical diseases.

Cervical pedicle screw in the treatment of cervical fracture complicating ankylosing spondylitis / 中南大学学报(医学版)

OBJECTIVE@#To determine the effect of cervical pedicle screw in the treatment of cervical fracture complicating ankylosing spondylitis.@*METHODS@#A retrospective study was done in 5 patients of cervical fracture complicating ankylosing spondylitis who were treated with cervical pedicle screw. According to Frankel's standard, 1 patient was in Grade A, 2 patients in Grade B and 1 patient in Grade C and 1 patient in Grade D. All patients were treated with decompression, fusion and posterior fixation with cervical pedicle screw.@*RESULTS@#The average bony healing time was 3.6 months (3.1 to approximately 4.5 months). The instrumentation was not loose, pulled-out or ruptured. Only one C6 pedide was perforated and the vertebral artery was broken, but there was no new postoperative symptom. Three of the patients with neurological deficits improved postoperatively but the other two who were in Grade A were remained unchanged.@*CONCLUSION@#The good biomechanical characteristics of cervical pedicle screw help the successful treatment in the application of cervical fracture complicating ankylosing spondylitis.