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BACKGROUND: Typically, open surgery is advocated for cauda equina patients. The goal of this study was to compare the clinical efficacy of full endoscopic lumbar discectomy and laminectomy in the treatment of cauda equina syndrome (CES) caused by lumbar disc herniation. METHODS: Forty-three patients with CES either underwent endoscopic or laminectomy surgery from May 2015 to April 2016, and data were collected and retrospectively analyzed. The patients were divided into 2 groups according to the surgical methods: the endoscopy group (with 21 patients, 14 males and 7 females, and an average age of 42.67 with a standard deviation of 9.70 years) and the laminectomy group (with 22 patients, 16 males and 6 females, and an average age of 44.55 with a standard deviation of 9.36 years). The modified Japanese Orthopaedic Association (JOA) "leg-trunk-bladder" score was used to assess the efficacy of the respective surgical methods. RESULTS: Analysis showed longer surgery time, more bleeding, and longer hospital stay in the laminectomy group than in the endoscopy group with statistical significance. The postoperative JOA scores improved in both groups when compared with those before the operation, and the differences were statistically significant. There were no significant differences in JOA scores between the 2 groups at preoperation and 6-month and 1-year follow-ups. There was 1 patient in each group whose CES symptoms worsened after endoscopy. However, immediate reoperation resulted in satisfactory outcomes. CONCLUSIONS: CES clinical symptom resolution was equal with endoscopy and laminectomy both in short-term and midterm follow-up. However, endoscopic treatment was advantageous by reducing the amount of bleeding, duration of surgery, and hospitalization days when compared to laminectomy. LEVEL OF EVIDENCE: 3. CLINICAL RELEVANCE: Feasibility study Endoscopic Decompression for Cauda Equina.
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BACKGROUND:The effect of dimethyl sulfoxide cryoprotectants has been got a lot of verification in the low-temperature medical applications. But there is no literature addressing microdialysis detection of dimethyl sulfoxide cryoprotectants. OBJECTIVE:To investigate the microdialysis relative recovery of different concentrations of dimethyl sulfoxide cryoprotectants used for limb reattachment. METHODS:In vitro linear probe relative recovery of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) was detected by retrodialysis gain and loss method. The correction in vivo experiment was done to estimate dimethyl sulfoxide relative recovery in rabbit amputated limbs. RESULTS AND CONCLUSION:The relative recoveries of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) were (49.49±3.56)%, (46.30±1.48)%, (52.66±2.54)%using retrodialysis gain method and (50.99±6.89)%, (43.86±1.35)%, (50.67±0.75)%using retrodialysis loss method. The average recoveries were (49.48±3.18)%and (48.51±4.03)%, respectively. There was no difference in the relative recovery of dimethyl sulfoxide detected using two methods. The change of dimethyl sulfoxide concentration could not influence the retrodialysis gain and loss method calibration results. The recovery was (15.45±4.8)%in vivo. These findings indicate that the microdialysis technology is suitable for dimethyl sulfoxide sampling in vivo that has no obvious influence on the relative recovery.
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Objective To observe the contribution of acute normovolemic hemodilution ( ANH) in experiment of cryopreserved dog limb replantation.Methods Sixteen healthy Beagle dogs (male:female=1:1) were divided into two groups.Dogs in the experiment group ( Group B) received ANH in the limb replantation, and dogs in the control group ( Group A) received the same amount of lactate Ringer’ s solution intravenously during the surgical operation.We recorded and compared the hemodynamic indexes, HB, HCT, the resuscitation time, the first rising head time, the first standing time and the first eating and drinking time between the two groups.Results ( 1 ) During the operation, both PaO2 and PCO2 in the two groups were normal, as well as the breathing rate.The heart rate in the group B was lower than that in the group A.Before blood transfusion, there was no statistically significant difference in HB and HCT between the two groups, but after transfusion they were significantly higher in the group B than in the group A.(2) The resuscitation time, the first rising head time, the first standing time and the first eating and drinking time of the group B were all better than those in the group A.Conclusions In cryopreserved dog limb replantation experiments, acute normovolemic hemodilution is helpful to improve the general condition and facilitate the recovery of animals after limb replantation.
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BACKGROUND:The cryopreservation of single tissue has achieved great advancement and is gradual y applied in clinics. However, the cryopreservation of complex tissue is rarely reported. OBJECTIVE:To investigate the morphological change in rabbit limb tissue after replantation through different rewarming methods, find the best rewarming methods of compound textured blood vessels, and provide theoretical basis for the feasibility of limb replantation after long-term cryopreservation. METHODS:Thirty New Zealand white rabbits were randomly divided into control group, slow freezing-slow thawing group, and slow freezing-rapid thawing group. The right posterior limbs of al the rabbits were cut off 1 cm above the knee joint. Except control group, the latter two groups were given limb replantation after thawing, and then the right posterior limb was again cut off after the replanted limbs were survived for 6 hours. For al groups, the histological changes and gross observation in aorta tissue were observed by light microscopy and transmission electron microscope, and the results were analyzed with statistical methods. RESULTS AND CONCLUSION:In the slow freezing-slow thawing, slow freezing-rapid thawing groups, the pathological changes (gross specimen, light microscope, electron microscope) of rabbit limbs 6 hours after replantation were worse than those in control group. Compared with slow freezing-rapid thawing group, better integrity of endothelial cells and less damage of the organel es were found in slow freezing-slow thawing group. Through deep cryogenic freezing-thawing process, rabbit limb blood vessels can maintain the structural integrity after replantation and survived at 6 hours. Slow freezing-slow thawing is better than slow freezing-rapid thawing for the preservation of severed limbs, providing evidences for the long-term survival fol owing a deep cry ogenic treatment after the severed limb replantation.
