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Objective: To explore the safety of ultrasonic osteotome used in posterior cervical laminectomy decompression surgery and its effect on surgical outcome. Methods: A clinical data of 52 patients with ossification of posterior longitudinal ligament of cervical spine (C-OPLL) undergoing posterior cervical laminectomy decompression and fusion (PCLDF) between April 2013 and April 2017 was retrospectively analysed. The patients were divided into two groups according to whether using the ultrasonic osteotome during operation: group A (20 cases, ultrasonic osteotome group) and group B (32 cases, traditional gun-clamp decompression group). There was no significant difference in gender, age, body weight, height, preoperative hemoglobin, and Japanese Orthopedic Association (JOA) score between the two groups ( P>0.05). The operation time, intraoperative blood loss, postoperative drainage volume, hospitalization time, complications, hemoglobin at 1 day after operation, and JOA score at 6 months after operation were recorded and compared between the two groups, and the improvement rate of JOA was calculated. Results: The operation time and intraoperative blood loss in group A were significantly less than those in group B ( P0.05). The hemoglobin of group B was slightly higher than that of group A at 1 day after operation, but there was no significant difference between the two groups ( t=-1.260, P=0.214). All the patients were followed up 6-10 months (mean, 7.6 months). No serious complications such as C 5 nerve paralysis, dural tear, infection, epidural hematoma, deep venous thrombosis, pulmonary embolism, transfusion allergy, or shock occurred during and after operation. The JOA scores of the two groups were significant improved at 6 months after operation when compared with preoperative scores ( P0.05). Conclusion: Compared with the traditional gun-clamp decompression, the effectiveness of PCLDF in treatment of C-OPLL by using ultrasonic osteotome is comparable, but the latter can effectively reduce the operation time and blood loss.
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Objective To determine the relation between the graduation and type of Modic change and low back pain. Methods Ninety-seven patients with low back pain associated with Modic change were enrolled, and the data of clinical were analyzed. The degree of back pain was evaluated by visual analog score (VAS) and Oswestry disability index (ODI). The relation between Modic change and the degree of low back pain was evaluated. Results In 97 patients, the type of Modic change:28 cases (28.9%) were type Ⅰ, 37 cases (38.1%) were type Ⅱ, 11 cases (11.3%) were Ⅱ/Ⅲ, and 21 cases (21.6%) were type Ⅲ. The graduation of Modic change:39 cases (40.2%) were minimal, 34 cases (35.1%) were moderate, and 24 cases (24.7%) were severe. The VAS of type Ⅰ, type Ⅱ, typeⅡ/Ⅲand typeⅢin patients with Modic change were (3.8 ± 0.4), (2.6 ± 0.2), (1.7 ± 0.5) and (1.0 ± 0.6) scores, and there were statistical differences (P0.05). Spearman correlation analysis result showed that the graduation of Modic change had no correlation with the intensity of low back pain (r = 0.351, P>0.05). Conclusions The graduation of Modic change does not directly correlate with the low back pain, but the type of Modic lesion is more important.
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Objective To discuss the surgical effect of adult lipomatous tethered cord syndrome (TCS). Methods The clinical data of 29 patients with adult lipomatous TCS were systematically analyzed. Eleven of male and 18 of female,who ranged from 20 to 59 years. All patients were performed filum terminale release and lipoma excision, the clinical outcome after operation was analyzed according to Hoffman grading criteria and visual analog scale (VAS). Results According to Hoffman grading criteria, 9 cases were obviously improved in leg muscle weakness, including 1 case with urination disturbance improved significantly. Also the lower back pain of patients were improved obviously: (2.63 ± 1.30) scores vs. (8.67±0.30) scores, there was significant difference (P<0.05). Conclusions Filum terminale release and lipoma excision can effectively improve the symptom of lower back pain of adult lipomatous TCS patients, meanwhile the symptom of paraparesis can improve appropriate postoperatively. But urinary deficits do not show a significant change.
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AIM:Discoid meniscus is named because its width and height are abnormally increased like a disc.In this study,we observed the injury classification and special features of discoid meniscus and natural meniscus,and compare the postoperative outcome of arthroscopy comparatively.METHODS:①360 cases of meniscus injury in knee joint were selected from the First Affiliated Hospital of Anhui Medical University from June 2001 to September 2006.They were divided into natural meniscus injury group(n =300),and discoid lateral meniscus injury(n =60).People with complete clinical data before operation and following data,confirmed by arthroscopy were selected.The written informed consent was obtained from them.②Meniscus injury in 360 cases was examined by arthroscopy,and plasty,or partial excision or incomplete resection or full resection was performed according to the injury types and surgical circumstance.③All subjects were followed for 6 months to 2 years.The knee function was evaluated by the criteria of Ikeuchi.RESULTS:300 cases of natural meniscus injury and 60 of discoid lateral meniscus injury were all included in the result analysis.①Five tear types of natural meniscus were as follows:43.7% longitudinal,30% radial,12.3% horizontal,7.5% transverse,and 6.5% complex.Four tear types of discoid meniscus were as follows:68.3% horizontal,6.7% radial,3.3% longitudinal,and 21.7% complex tear.②The surgical pattern was determined by the injury types,and all patients were followed up.In 300 cases of natural meniscus,there were 62 knees with excellent function,190 with good,34 with fair and 14 with poor.The excellent and good rate was 85%.In 60 cases of discoid meniscus,there were 19 knees with excellent function,34 with good,5 with fair and 2 with poor.The excellent and good rate was 90% approximately.CONCLUSION:Discoid meniscus is different in anatomical feature and histological structure from natural meniscus;therefore the arthroscopic surgery for discoid meniscus is also different.
