Unilateral pedicle screw fixation combined with lumbar interbody fusion for the treatment of lumbar degenerative diseases / 中华骨科杂志

Objective To explore the feasibility and efficiency of the treatment of lumbar degenerative diseases after transforaminal lumbar interbody fusion(TLIF)and posterolateral fusion(PLF)procedures in which unilateral pedicle screw fixation was used.Methods From December 2006 to August 2008,78 cases with the lumbar degenerative diseases who received lumbar posterolateral fusion were analyzed.There were 48 cases of which underwent TLIF and PLF procedures with unilateral pedicle screw fixation(unilateral group),including 25 males and 23 females with an average of 47.6 years;and 30 cases of which underwent TLIF and PLF procedures with bilateral pedicle screw fixation(bilateral group),including 21 males and 9 females with an average of 50.5 years.The clinical effects between the two groups were evaluated with Oswestry disability index and visual analogue score(VAS)index.The operation time,blood loss,fusion rates and intervertebral collapse rates were also compared.Results Oswestry disability index,low back pain VAS index and skelalgia VAS index in both groups showed statistical significance between preoperation and 3 months,or 3 months and 1 year postoperatively.There was no difference in score improvement between the two groups.There were difference in operation time,blood loss and cost of hospitalization between unilateral and bilateral group.The former was lower.There was no difference in postoperative length of stay between the two groups.The fusion rate of unilateral group and bilateral group were 91.7%(44/48)and 93.3%(28/30),respectively.Conclusion Auto graft combined with unilateral pedicle screw fixation provids better spinal instant stability.TLIF and PLF with unilateral pedicle screw fixation was a satisfactory method in treating degenerative disease of lumbar vertebrae.

Effect of disk degeneration on development of isthmic spondylolisthesis in adults / 中国矫形外科杂志

[Objective]To analyze the correlation between disk degeneration and development of isthmic spondylolisthesis in adults.[Method]Totally 156 patients who had spoondvlolvsis and spondylolisthesis were follow-up.There were 86 males and 70 females.All patients were made radiographs for lumbar discomfort or low back pain.Spondylolysis and spondylolisthesis were discovered.According to Meyerding slip degree;68 cases were spondylolysis,88 cases were spondylolisthesis in degree Ⅰ.All patients were under conservative treatment and observed the development of the disease.According to Boxall defined the development of spondylolisthesis.There were 40 patients with development of spondylolisthesis and aggravation of dies degeneration.24 males,16 females.[Result]All the patients were followed-up for 3~9 years,with an average of 6.3 years.Lumbar vertebra slippage increased about 11%~30%(average 18.5%),the height of intervertebral disk decreased about 45%~90%(average 72%)in the level of spondylolysis.x2 test was used for statistical treatment,There was a significant positive correlation between development of isthmic spondylolisthesis in adults and aggravation of disk degeneration.[Conclusion]There are development in adults of spondylolysis and spondylolisthesis,may be correlated to the disc degeneration.

Degenerative instability in pathogensis of cervical syndrome / 中国矫形外科杂志

[Objective]To analyse the significance of degenerative instability in pathogensis of cervical syndrome.[Method]A total of 216 patients who underwent neck and shoulder pain and/or cervical spondylotic radiculopathy(CSR)were followed-up.There were 143 males and 73 females,aged from 29 to 41,with the average of 37.8.Number of patients with neck and shoulder pain were 173,with cervical spondylotic radiculopathy were 28,with neck and shoulder and CSR were 15.According to cervical degenerative instable radiology standard,instable group included 82 cases,stable group included 134 cases.All patients were treated by physiotherapy and/or local caging therapy.[Result]All the patients were followed-up for 2～7 years,with an average of 4.3 years.In the instable group,4 patients were found osteophyma at the instable vertebra,3 were intervertebral disk hernia,6 were intervertebral disk hernia and osteophyma,3 were T_2 high intensive sign(T_2 HIS)in spinal cord at the instable vertebra.In the stable group,2 were found intervertebral disk hernia at C_(4~5),2 were found osteophyma at C_5 vertebra.The incidence of cervical syndrome was 19.51% in instable group and 2.99% in stable group.There was significant statistical difference(P

An analysis of spine fractures in adolescents / 中华创伤骨科杂志

Objective To discuss the characteristics, diagnosis and therapy of the spine fractures in adolescents. Methods 15 cases were treated from 1991 to 2002 in our hospital. The causes of injuries, fracture type, treatment methods and complications were analyzed. Results All the cases were followed up from 1 to 3 years. Satisfactory recovery of fractures was found, but Harrington hook dislocation occurred in 1 case and gradual kyphosis in 2 cases postoperatively. Conclusions The injuries were mostly caused by falling. Fracture-dislocation was the most common type. The spine cord injuries were usually serious and combined with other injuries. The operation mode and internal instrument should be selected according to fracture type and age. It is very important to recover the normal spine form in therapy. Care should be taken to treat the problem of gradually increasing kyphosis after the operation.