RESUMO
Objective To evaluate the effectiveness of laparoscopy in anterio r lumbar interbody fusion. Methods Twenty-three laparoscopic anterior lumbar int erbody fusions were performed in the period between December 2000 and December 2 002. There were 9 males and 14 females with a mean age of 52 years (range, 46 to 66 years). In this group, there were 18 of spondylolisthesis, 3 of lumbar spina l instability and 2 of degenerative disc treated with anterior lumbar interbody fusion using Syncage and autograft with balloon-assisted endoscopic extraperiton eal gasless exposure. The main complaints were low back pain radiating to leg. 1 3 cases were fused at L4,5 and 10 at L5S1. The Oswestry Disability Index (ODI) w as recorded to evaluate the function preoperatively, and in the 2nd week, 3rd, 6 th and 12th month postoperatively. X-ray was taken to observe the fusion and the subsided cage. Results The operative time ranged from 50 to 180 min with a mean of 120 min, and the bleeding volume ranged from 50 to 300 ml with a mean of 80 ml. There were complications in 2 cases, one which was caused by laparoscopic mi sguidance, and the other was bleeding due to a small vessel injury. All the case s were followed-up from 12 to 24 months, with a mean of 16.6 months. The ODI was found with significant difference comparing preoperatively to at 2nd week, 3rd, 6th and 12th month postoperatively (P
RESUMO
Objective To review the clinical management of the radial nerve palsy (RNP) associated with humeral shaft fractures via systematically reviewing the published available articles, and develope an algorithm to guide management for RNP. Methods Using PubMed, Datastar and Cochrane Database, web based databases were searched for radial nerve palsy associated with humeral shaft fractures in the past 40 years, and manual searches of the bibliographic sections of electronically identified papers were done to identify further papers. Meticulous data extraction and meta-analysis was performed according to a preset protocol. Results In 391 citations initially identified, 35 papers, which included a total of 1045 RNP patients, met all eligibility criteria. The overall RNP incidence after humeral shaft fractures in 21 papers was 11.8% (532/4517). The incidence of RNP in middle 1/5 and middle-distal 1/5 of the humeral shaft fracture was significantly higher than that in other parts. Transverse and spiral fractures were more likely to sustain RNP than oblique and comminuted fracture patterns(P