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Objective To evaluate the characteristics and efficacy of microscope-assisted bilateral decompression via unilateral approach for the treatment of lumbar stenosis. Methods From June 2007 to June 2010, Sixty case lumbar stenosis with bilateral decompression were treated via unilateral approach under microscopy. Patients were followed up from 6 to 24 months, average (12 ± 4.7) months. Results The pain level of each patient was assessed both before and after the opeartion, using a visual analogue scale (VAS). Intermittent claudication was completely relieved in 57 out of 60 cases, moderately relieved in 3 cases. VAS score decreased from pre-operational 9.08 ± 0.76 to post-operational 2.33 ± 1.43, and there was significantly difference between them. There was no recurrent case during the whole follow-up. Conclusion Bilateral decompression via unilateral approach under microscope is proved to be an effective and safe procedure for the treatment of lumbar stenosis, and have the advantages of minimal invasion, less pain, quick recovery, better effect, little influence on the spinal stability.
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Objective To observe the therapeutic effect of minimally invasive evacuation of intracerebral hematoma in dog model of cerebral hemorrhage by using Purdy score, serum levels of neuron-specific-enolase (NSE) and numbers of perihematomal apoptotic cells. Method Twenty dogs were selected to prepoxe the model of cerebral hemorrhage, and they were randomly divided( random number) into minimally invasive treatment group and control group. Minimally invasive procedures were performed to evacuate the hematoma in minimally invasive treatment group in 6 hours after the models were established. The dogs of control group only received medical treatment. Purdy score and serum levels of neuron-specific-enolase were determined on 1,3,5,7 days after the evacuation of the hemotoma and apoptotic cells were counted after the dogs were sacrificed at 7 days after operation. All the results were compared with control group. Purdy score and serum levels of neuron-specific-enolase were compaired with variance analysis of repeated measurement design and apoptotic cells was compared with variance analysis of factorial design,the difference of the two groups showed with q test. P <0.01 showed the difference was significant. Results The Purdy scores in minimally invasive treatment group were 6.3 ± 1.702, 5.8 ± 1. 685,4.2 ± 1.762 and 4.1 ± 1.875 on 1,3,5 and 7 day after evacuation of the hematoma, significant difference was observed as compared with the control group(8.9 ± 1.632, 8.6± 1.342, 7.8±1.335, 7.9±1.468, P <0.01).The serum levels of neuron-specific-enolase were 0.632 ± 0.077, 0.721±0.771, 0.549±0.124 and 0.430 ±0.136 respectively in minimally invasive treatment group, while in the control group were 0.934 ± 0. 064, 0. 997 ±0.075, 0.986 ± 0.042, 0.874 ± 0.165, significant differences in serum levels of neuron-specific-enolase were found between the two groups(P < 0.01). The perihematomal apoptotic cells in minimally invasive treatment group(37.4 cells) was decreased significantly as compared with the control group(88.6 cells), with P < 0.01.Conclusions Minimally invasive procedures for evacuation of intracerbral hematoma might significantly reduce the neurological deficit score and decrease the serum neuron-specific enolase levels and numbers of apeptotic neurons.
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Objective To estimate the efficacy of super-early minimal invasive evacuation of hematoma via keyhole for treating hypertensive basal ganglionic hemorrhage. Methods 36 patients with hypertensive basal ganglionic hemorrhage(9 cases in grade Ⅱ, 17 in grade Ⅲ and 10 in grade Ⅳ) were treated by minimal invasive evacuation of hematoma via keyhole at super-early stage, and their efficacy was statistically compared with 35 patients with hypertensive cerebral hemorrhage underwent conservative therapy or lateral ventriculopuncture. Results In the 36 patients underwent minimal invasive evacuation of hematoma via keyhole, 22 cases had a good prognosis(61.1%), 9 had a poor prognosis(25.0%), and 5 died(13.9%). Among the 35 patients underwent conservative therapy or lateral ventriculopuncture, 5 cases had a good prognosis(14.3%), 22 had a poor prognosis(62.9%), and 8 died(22.9%). There was a significant difference in good and poor prognostic rate between the two groups(P