RESUMO
Objective:To analyze the efficacy of vertebroplasty combined with posterior decompression and internal fixation in the treatment of spinal metastases with neurological symptoms.Methods:This study was a retrospective analysis of 32 cases with neurological symptoms caused by spinal metastatic tumor in the Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University from June 2016 to January 2022. All 32 patients (20 males, 12 females) aged between 39 to 85 years were enrolled in this study, with a mean age of (64.8±11.9) years. Surgery time, bleeding volume, modified Tokuhashi score, spinal instability neoplastic score (SINS) were collected. The visual analogue score (VAS), Oswestry disability index (ODI), Karnofsky performance scale (KPS) and American spinal cord injury association (ASIA) score before surgery, 1 month after surgery, 3 months after surgery and 6 months after surgery were collected and analyzed. Measurement data with normal distribution were represented as mean±standard deviation( ± s), and the comparison before and after surgery was conducted using repeated-measures analysis of variance test. Measurement data with skewed distribution were represented as M( Q1, Q3). Results:All 32 patients were followed up for 6 months. The operation time was (209.6±49.0) min, and the blood loss was (462.9±298.3) mL. 14 patients(43.8%) were treated with blood transfusion. The modified Tokuhashi score was 8.09±2.89, and the SINS was 8.81±1.97. The VAS score before surgery, postoperative 1, 3, 6 months were 7.47±0.98, 3.87±0.87, 2.91±0.73 and 2.34±0.60, respectively. ODI score before surgery, postoperative 1, 3, 6 months were 79.13±9.50, 39.14±6.31, 34.43±6.42 and 31.08±4.80, respectively. KPS score before surgery, postoperative 1, 3, 6 months were 49.69±14.70, 64.68±15.02, 71.88±12.81 and 75.63±10.76, respectively. The ASIA grading at 6 months follow-up was improved compared to preoperative baseline. Postoperative complications occurred in 4 cases, including nerve root injury (1 case), bone cement leakage in paravertebral soft tissue (1cases), bone cement leakage in paravertebral vein(1case) and acute thoracic epidural hematoma (1case).Conclusion:Vertebroplasty combined with posterior decompression and internal fixation can effectively relieve pain, relieve the compression of spinal cord and nerve, recover nerve functions, and improve the quality of life of patients with spinal metastatic tumor.
RESUMO
Objective to investigate the efficacy of functional electrical stimulation(FES)on the postoperative treatment of lumbar disc hernia-tion. Methods Informed consents were obtained from all the subjects before the study. totally 60 patients who had remnant nervous lesion after sur-gery of lumbar disc herniation were divided into two groups:FES group and Control group. FES group received treatment since the first day after sur-gery. the parameters of therapeutic apparatus were as follows:35 Hz,0.28 ms,1 time daily and 30 min each time. the intensity of the treatment was the maximum tolerated that the patients can take. the course was 4 weeks. the control group during the study did not receive any stimulation. the myodynamia of hallux dorsiflexion and JOA score of patients were recorded and analyzed. Results After 2 weeks treatment,the myodynamia of FES group was 15.10±5.03,which was significantly larger than that of the control group at 12.03±6.30(P < 0.05). After 4 weeks treatment,the myody-namia of FES group was 20.43±5.73,which was significantly larger than that of the control group at 14.57±7.17(P < 0.05). After 4 weeks of treat-ment,the JOA score of FES group was 24.63±1.91,which was significantly higher than that of the control group at 19.87±2.33(P < 0.05). Conclu-sion After 2-4 weeks of functional electrical stimulation therapy,myodynamia of hallux dorsiflexion in FES group was significantly improved. And at the 4th week after operation,JOA score was more higher than that of the control group. Functional electrical stimulation in the treatment of remnant nervous lesion after postoperative of lumbar disc herniation has exact curative effect,which is worthy of popularization.