The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw(3DPS)and minimally invasive reconstruction plate(MIRP)in treating sacroiliac complex injury and the surgical procedures o...The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw(3DPS)and minimally invasive reconstruction plate(MIRP)in treating sacroiliac complex injury and the surgical procedures of 3DPS were introduced.A retrospective analysis was performed on 49 patients with sacroiliac complex injury from March 2013 to May 2017.Twenty-one cases were treated by 3DPS,and 28 cases by MIRP.Intraoperative indexes as operative time,blood loss,incision length,length of hospital stay and postoperative complications were respectively documented.Quality of reduction was postoperatively evaluated by Matta radiological criteria,and clinical effect was assessed by Majeed scoring criteria at the last followup.Operative time and hospital stay were significantly shortened,and blood loss,and incision length were significantly reduced in 3DPS group as compared with those in MIRP group(P<0.05).No statistically significant difference was found between 3DPS group and MIRP group in the assessment of reduction and function(P>0.05).It was concluded that both 3DPS and MIRP can effectively treat the sacroiliac complex injury,and 3DPS can provide an accurate,safe and minimally invasive fixation with shorter operative time and hospital stay.展开更多
Objective: To study the muscle injury, inflammatory response and bone metabolism after paravertebral muscle space and minimally invasive percutaneous approach surgeries for thoracolumbar fracture. Methods: A total of ...Objective: To study the muscle injury, inflammatory response and bone metabolism after paravertebral muscle space and minimally invasive percutaneous approach surgeries for thoracolumbar fracture. Methods: A total of 92 patients with thoracolumbar fractures who were treated in Baoji Central Hospital between May 2015 and January 2017 were selected and randomly divided into paravertebral group and minimally invasive percutaneous group who accepted pedicle screw fixation under different approaches. Before operation as well as 1 d and 3 d after operation, serum was collected to determine the contents of creatase, inflammatory reaction molecules and bone metabolism indexes. Results: Serum Myo, CK, LDH, TNF-α, MCP-1, HMGB-1, CRP, IL-1β, OC, OPG, PICP and PINP levels of both groups 1 d and 3 d after operation were significantly higher than those before operation while TRACP5b, RANKL, CTX and NTX levels were significantly lower than those before operation, and serum Myo, CK, LDH, TNF-α, MCP-1, HMGB-1, CRP, IL-1β, TRACP5b, RANKL, CTX and NTX levels of paravertebral group 1 d and 3 d after operation were significantly lower than those of minimally invasive percutaneous group while OC, OPG, PICP and PINP levels were significantly higher than those of minimally invasive percutaneous group. Conclusion:Paravertebral muscle space surgery for thoracolumbar fracture is more effective than minimally invasive percutaneous surgery in reducing muscle injury and inflammatory response, and improving bone metabolism.展开更多
Objective:To study the effects of MIPO and ORIF on stress degree and bone metabolism activity in patients with middle humeral shaft fractures.Methods: Patients with middle humeral shaft fractures who received surgical...Objective:To study the effects of MIPO and ORIF on stress degree and bone metabolism activity in patients with middle humeral shaft fractures.Methods: Patients with middle humeral shaft fractures who received surgical treatment in Mianyang Orthopedic Hospital between June 2010 and October 2015 were enrolled and randomly divided into MIPO group and ORIF group who were treated with minimally invasive plate oateosynthesis and open reduction internal fixation respectively. Before surgery as well as 1 d and 3 d after surgery, serum was collected to determine the contents of stress response molecules and bone metabolism markers.Results:1 d and 3 d after surgery, serum stress molecules PGE2, CRP, NE and E as well as bone resorption markers TRACP-5B,β-CTX, RANK and RANKL contents of both groups were higher than those before surgery while bone formation markers BGP, BALP, PINP and OPG contents were lower than those before surgery;serum stress molecules PGE2, CRP, NE and E as well as bone resorption markers TRACP-5B,β-CTX, RANK and RANKL contents of MIPO group were lower than those of ORFI group while bone formation markers BGP, BALP, PINP and OPG contents were higher than those of ORFI group.Conclusion: Compared with ORIF, MIPO for middle humeral shaft fractures can reduce stress response degree and improve bone metabolism.展开更多
Study Design: Original article. Objective: Guidelines for deciding whether to perform open or percutaneous surgery in burst fractures. Summary of Background Data: The authors propose an algorithm for deciding whether ...Study Design: Original article. Objective: Guidelines for deciding whether to perform open or percutaneous surgery in burst fractures. Summary of Background Data: The authors propose an algorithm for deciding whether to perform open surgery or percutaneous surgery with short fixation in patients with fractures of the thoracolumbar junction and lumbar spine. Methods: Between July 2005 and July 2009, 72 patients underwent surgical stabilization by posterior route for fractures of the thoracolumbar junction and lumbar spine. In 44 the lesion involved the thoracolumbar junction, in 28 the lumbar spine (L2 in6 cases, L3 in15 cases, L5 in7 cases). The fractures were assessed morphologically according to Magerl’s classification (52 type A, 12 type B, 8 type C). All patients were analyzed according to the algorithm proposed, according to which patients must fulfil certain criteria: the fracture must be Magerl type A.3, it must involve one level, McCormack score must be 6 or less, invasion of the spinal canal must be 25% or less according to Hashimoto’s formula, Magnetic Resonance Imating (MRI) must confirm discoligamentous integrity. Neurologically, the patient must be ASIA E. 25 patients (17 thoracolumbar junction, 8 lumbar spine) fulfilled these criteria and were treated by percutaneous short fixation. Results: The average length of the surgical procedure was 80 minutes and the loss of blood 10 cc. All patients were dismissed without brace and were submitted to follow-upComputed Tomography CTscan 3 and 6 months after surgery. Follow-up ranged from 6 months to 4 years. In all cases CT scan confirmed fusion and there were no cases of rupture of the device. None of the patients presented neurological deficits. Conclusion: The algorithm described permits a proper selection of patients with thoracolumbar fractures who can be treated by percutaneous short fixation, thus avoiding the risks connected with failure of the stabilization system.展开更多
文摘The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw(3DPS)and minimally invasive reconstruction plate(MIRP)in treating sacroiliac complex injury and the surgical procedures of 3DPS were introduced.A retrospective analysis was performed on 49 patients with sacroiliac complex injury from March 2013 to May 2017.Twenty-one cases were treated by 3DPS,and 28 cases by MIRP.Intraoperative indexes as operative time,blood loss,incision length,length of hospital stay and postoperative complications were respectively documented.Quality of reduction was postoperatively evaluated by Matta radiological criteria,and clinical effect was assessed by Majeed scoring criteria at the last followup.Operative time and hospital stay were significantly shortened,and blood loss,and incision length were significantly reduced in 3DPS group as compared with those in MIRP group(P<0.05).No statistically significant difference was found between 3DPS group and MIRP group in the assessment of reduction and function(P>0.05).It was concluded that both 3DPS and MIRP can effectively treat the sacroiliac complex injury,and 3DPS can provide an accurate,safe and minimally invasive fixation with shorter operative time and hospital stay.
文摘Objective: To study the muscle injury, inflammatory response and bone metabolism after paravertebral muscle space and minimally invasive percutaneous approach surgeries for thoracolumbar fracture. Methods: A total of 92 patients with thoracolumbar fractures who were treated in Baoji Central Hospital between May 2015 and January 2017 were selected and randomly divided into paravertebral group and minimally invasive percutaneous group who accepted pedicle screw fixation under different approaches. Before operation as well as 1 d and 3 d after operation, serum was collected to determine the contents of creatase, inflammatory reaction molecules and bone metabolism indexes. Results: Serum Myo, CK, LDH, TNF-α, MCP-1, HMGB-1, CRP, IL-1β, OC, OPG, PICP and PINP levels of both groups 1 d and 3 d after operation were significantly higher than those before operation while TRACP5b, RANKL, CTX and NTX levels were significantly lower than those before operation, and serum Myo, CK, LDH, TNF-α, MCP-1, HMGB-1, CRP, IL-1β, TRACP5b, RANKL, CTX and NTX levels of paravertebral group 1 d and 3 d after operation were significantly lower than those of minimally invasive percutaneous group while OC, OPG, PICP and PINP levels were significantly higher than those of minimally invasive percutaneous group. Conclusion:Paravertebral muscle space surgery for thoracolumbar fracture is more effective than minimally invasive percutaneous surgery in reducing muscle injury and inflammatory response, and improving bone metabolism.
文摘Objective:To study the effects of MIPO and ORIF on stress degree and bone metabolism activity in patients with middle humeral shaft fractures.Methods: Patients with middle humeral shaft fractures who received surgical treatment in Mianyang Orthopedic Hospital between June 2010 and October 2015 were enrolled and randomly divided into MIPO group and ORIF group who were treated with minimally invasive plate oateosynthesis and open reduction internal fixation respectively. Before surgery as well as 1 d and 3 d after surgery, serum was collected to determine the contents of stress response molecules and bone metabolism markers.Results:1 d and 3 d after surgery, serum stress molecules PGE2, CRP, NE and E as well as bone resorption markers TRACP-5B,β-CTX, RANK and RANKL contents of both groups were higher than those before surgery while bone formation markers BGP, BALP, PINP and OPG contents were lower than those before surgery;serum stress molecules PGE2, CRP, NE and E as well as bone resorption markers TRACP-5B,β-CTX, RANK and RANKL contents of MIPO group were lower than those of ORFI group while bone formation markers BGP, BALP, PINP and OPG contents were higher than those of ORFI group.Conclusion: Compared with ORIF, MIPO for middle humeral shaft fractures can reduce stress response degree and improve bone metabolism.
文摘Study Design: Original article. Objective: Guidelines for deciding whether to perform open or percutaneous surgery in burst fractures. Summary of Background Data: The authors propose an algorithm for deciding whether to perform open surgery or percutaneous surgery with short fixation in patients with fractures of the thoracolumbar junction and lumbar spine. Methods: Between July 2005 and July 2009, 72 patients underwent surgical stabilization by posterior route for fractures of the thoracolumbar junction and lumbar spine. In 44 the lesion involved the thoracolumbar junction, in 28 the lumbar spine (L2 in6 cases, L3 in15 cases, L5 in7 cases). The fractures were assessed morphologically according to Magerl’s classification (52 type A, 12 type B, 8 type C). All patients were analyzed according to the algorithm proposed, according to which patients must fulfil certain criteria: the fracture must be Magerl type A.3, it must involve one level, McCormack score must be 6 or less, invasion of the spinal canal must be 25% or less according to Hashimoto’s formula, Magnetic Resonance Imating (MRI) must confirm discoligamentous integrity. Neurologically, the patient must be ASIA E. 25 patients (17 thoracolumbar junction, 8 lumbar spine) fulfilled these criteria and were treated by percutaneous short fixation. Results: The average length of the surgical procedure was 80 minutes and the loss of blood 10 cc. All patients were dismissed without brace and were submitted to follow-upComputed Tomography CTscan 3 and 6 months after surgery. Follow-up ranged from 6 months to 4 years. In all cases CT scan confirmed fusion and there were no cases of rupture of the device. None of the patients presented neurological deficits. Conclusion: The algorithm described permits a proper selection of patients with thoracolumbar fractures who can be treated by percutaneous short fixation, thus avoiding the risks connected with failure of the stabilization system.
