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Objective To investigate clinical effect of local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis. Methods Medical records of 122 degenerative lumbar scoliosis patients were retrospectively studied. All cases were treated by selective interbody fusion,local decompression and pedicle screw fixation. Group A(L5 fusion)and group B(S1 fusion)un?derwent imaging analysis,and Suk criteria was used to evaluate the fixation,decompression,bone graft fusion. JOA scores were used to evaluate curative effect of excellent and good rate. Results There were no significant difference in operating time,blood loss and postoperative drainage volume between two groups. Follow?up period for all patients is(16.2 ± 0.8)months. X?ray revealed that Cobb′s angle on the coronal plane,the correction rate of lor?dosis and sagittal Cobb′s angle after treatment,the correction rate of lordosis in group B were better than in group A (P0.05). There was no infection or screw breakage and pulling out. The incidence rate of adjacent vertebral body disease in group A was higher than that in group B(P < 0.05). Conclusions Local decompression and selective interbody fusion with pedicle screw fixation technique for the treat?ment of degenerative lumbar scoliosis can produce satisfactory short to mid?term clinical curative effect.
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BACKGROUND:Xenogeneic ligament is readily available, which has ligament scaffold structure and is conducive to tissue ingrowth and creeping substitution. After processing, the xenogeneic ligament, with the presence of good growth scaffold function, can be completely eliminated antigenicity that can cause immune rejection. OBJECTIVE:To study the feasibility of biological xenogeneic ligament graft instead of alogeneic ligament graft for reconstruction of goat anterior cruciate ligament. METHODS: Twenty-four healthy adult goats were randomly divided into A, B, C groups, and then, the left knee joints of goats were removed to establish animal models of anterior cruciate ligament injury in the three groups. After the establishment of the tibia and femoral bone tunnel, groups A, B, C were respectively transplanted with biological xenogeneic ligament graft combined with bone marrow mesenchymal stem cels, biological xenogeneic ligament graft alone, and alogenic ligament. RESULTS AND CONCLUSION: After implantation, no rejection but good biocompatibility was found in the group A, in which, the transplanted ligament as a functional scaffold for anterior cruciate ligament reconstruction, and new tissues in-grew and replaced the scaffold under intraarticular environment to form the new ligament with good bone tendon healing. However, there were no differences in histology, immune response, biomechanical findings between groups A and C. Additionaly, in the group A, the host tissues were found to grow into the scaffold and establish a micro-circulation. These findings indicate that xenogeneic ligament combined with bone marrow mesenchymal stem cels can accelerate the establishment of micro-circulation and promote the growth of ligaments, especialy improve the ligament revascularization significantly, but has no influence on the biological characteristics of the ligament.
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To study the method and the optimal quantity of osteoblast transplantation to stimulate bone regeneration by transplanting 6～8 day old cultured osteoblasts and bFGF, together with osteoblast free calvaria of fetal rabbits into the defects of the rabbit radius. The fibroblasts were embedded in the type Ⅰcollagen in the concentrations of 10 7 ,10 6 ,10 5 , 10 4 /ml. Bone repair was evaluated by X ray, bone density,and scanning electron microscopy. Bone union ratio of the radius with transplantation of 10 7 ,10 6 ,10 5 , 10 4 /ml osteoblasts was 40%, 65%, 31 25%, 5 55% respectively at 4 weeks after transplantation, and 41 67%, 75%, 37 5%, 10% respectively at 8 weeks after transplantation. Bone density of radius defect with transplantation of 10 7 , 10 6 , 10 5 , 10 4 /ml osteoblasts was (0 112?0 018), (0 159?0 033), (0 122?0 039), (0 066?0 002) respectively at 6 weeks after transplantation and (0 150?0 059), (0 173?0 041), (0 145?0 023), (0 103?0 023) respectively at 8 weeks after transplantation, In 10 cases of bone non union, union was achieved by transplanting fetal osteoblast and basic fibroblast growth factor. This finding indicated that that transplantation of fetal osteoblasts could stimulate bone defect repair. The optimal concentration of osteoblasts implant was 10 6 cells /ml. It might be used in the treatment of bone non union.
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Objective A design of guide wire localization apparatus for the internal fixation of dens fractures. Methods From October 1999 to February 2000, 5 cases of dens fractures were treated by anterior internal fixation using cannulated compression screws; 4 cases were of Anderson typeⅡ and 1 case was typeⅢ . The guide wire localization apparatus was used for all of the patients during operations. Results The operating time was 2 to 2.5 hours, averaging 2 hours 15 minutes. The amount of bleeding was 20 to 100 ml, averaging 60 ml. The time of follow-up was 5 to 9 months, averaging 6.7 months. The locations of all the 5 cannulated compression screws were excellent, positioning in the center of the odontoid process without deviation. 4 cases healed normally and 1 had delayed bone healing. Conclusion The use of a guide wire location apparatus increased the accuracy of internal fixation of screws in dens fracture, decreased X-ray to radiation to the bodies, and reduced the possibility of pollution in operation.
