Thoracic spine fracture is a common orthopedic injury that is usually caused by external forces acting directly on or transmitted to the thoracic spine through other parts of the spine.Thoracic spine fractures can be ...Thoracic spine fracture is a common orthopedic injury that is usually caused by external forces acting directly on or transmitted to the thoracic spine through other parts of the spine.Thoracic spine fractures can be divided into two types:stable and unstable.An unstable fracture means that the relationship between the vertebral bodies is no longer stable,which may cause serious consequences such as spinal compression,nerve root compression,or spinal cord injury.Surgical treatment is often needed for patients with unstable fractures,nerve root compression,or spinal cord injury to restore stability and function to the thoracic spine.The probability of complications after thoracolumbar fracture surgery is high,which affects the outcome of surgical treatment.To improve postoperative rehabilitation outcomes,this article analyzed the value of nursing care based on the enhanced recovery after surgery(ERAS)concept for patients undergoing thoracolumbar fracture surgery.展开更多
To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction,short-segment pedicle screw fixation was reinforced with posterior mosel-izee bone grafting in vertebrae...To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction,short-segment pedicle screw fixation was reinforced with posterior mosel-izee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures.Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups.Fractures in group A(n=20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion,while patients group B(n=50) did not receive the morselized bone grafting for bone fusion.The two groups were compared in terms of kyphotic deformity,anterior vertebral height,instrument failure and neurological functions after the treatment.Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment.The results showed that the kyphosis correction was achieved in both group A and group B(group A:6.4 degree;group B:5.4 degree)/At the end of follow-up,kyphosis correction was maintained in group A but lost in group B(P=0.0001).Postoperatively,greater anterior height was achieved in group A than in group B(P<0.01).During follow-up study,anterior vertebral height was maintained only in Group A(P<0.001).Both group A and group B showed good Denis pain scores(P1 and P2) but group A outdid group B in terms of control of severe and constant pain(P4 and P5).By Frankel criteria,the changes in neurological functions in group A was better than those of group B(P<0.001).It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction,and it may also increase and maintain anterior vertebral height.Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures,decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.展开更多
Objective: To compare the influence of normal and degenerative discs on stress distribution of the thoracolumbar vertebrae under destructive load, explore the biomechanical background and clinical meaning and provide ...Objective: To compare the influence of normal and degenerative discs on stress distribution of the thoracolumbar vertebrae under destructive load, explore the biomechanical background and clinical meaning and provide theoretical basis for clinical diagnosis and treatment. Methods: A mechanical model of thoracolumbar motion segment of normal and degenerative discs was built with a three dimensional finite element method and three stresses of vertical compression, compressive flexion and distractive flexion were comparatively analyzed. Results: With vertical compression and compressive flexion loads, the thoracolumbar motion segment of the normal disc showed that the central part of the upper and lower end plates of the vertebrae and the central part of the trabecular bone adjacent to the end plate were loaded with the most intensive stresses, meanwhile, the postero lateral part of the annulus fibrosus was concentrated with stresses. Degenerative disc showed that the stress distribution of the trabecular bone was relatively averaged, the stresses of the central part adjacent to the end plate were low, while at the same time, the stresses of the peripheral part were elevated relatively. With distraction flexion load, the stresses of the cortex bone, trabecular bone, end plate and annulus fibrosus of the thoracolumbar vertebrae of degenerative discs were low, meanwhile, the stresses of the posterior structure of the vertebral body were relatively elevated compared with that of normal discs. Conclusions: There is difference in influence between normal and degenerative discs on the stress distribution of the thoracolumbar vertebrae with destructive load. The transferring way of load is changed after disc degeneration.展开更多
Objective:To analyze the application of vertebral pedicle screw fixation in the treatment of burst fracture of thoracolumbar vertebrae. Methods:A total of 48 cases(31 males and 17 females,aged from 18-72 years,mean:41...Objective:To analyze the application of vertebral pedicle screw fixation in the treatment of burst fracture of thoracolumbar vertebrae. Methods:A total of 48 cases(31 males and 17 females,aged from 18-72 years,mean:41.3 years)with thoracolumbar vertebrae burst fracture were treated by pedicle screw system since January 2004.According to the AO classification of thoracolumbar vertebrae fracture, there are 36 cases of Type A,9 of Type B and 3 of Type C. Results:All patients were followed up for 6-25 months(average 12 months),no secondary nerve root injury,spinal cord injury,loosening or breakage of pedicle screw were observed.The nerve function of 29 patients with cauda equina nerve injury was restored to different degrees.The vertebral body height returned to normal level and posterior process angle was rectified after operation. Conclusions:The vertebral pedicle screw internal fixation was technologically applicable,which can efficiently reposition and stablize the bursting fractured vertabrae, indirectly decompress canalis spinalis,maintain spine stablity,scatter stress of screw system,reduce the risk of loosening or breakage of screw and loss of vertebral height, and prevent the formation of posterior convex after operation.展开更多
Objective:To explore and discuss the clinical therapeutic effects of the application of cross-injury vertebral fixation and via-injury vertebrae fixation in the treatment of bone tumor with thoracolumbar spine fractur...Objective:To explore and discuss the clinical therapeutic effects of the application of cross-injury vertebral fixation and via-injury vertebrae fixation in the treatment of bone tumor with thoracolumbar spine fracture.Methods:A total of 58 patients with bone tumors and thoracolumbar spine fractures admitted to our hospital from February to February 2019 were selected as the study subjects.They were randomly divided into control group and observation group,with 29 cases in each group.The patients in the control group received cross-injury vertebral fixation treatment,while the patients in the observation group were treated with via-injury vertebral fixation.The therapeutic effects of the two groups were compared.Results:The operation time and hospitalization time of the observation group were significantly shorter than those of the control group(P<0.05),and the postoperative drainage volume of the intraoperative blood loss was significantly less than that of the control group(P<0.05).There was no significant difference in postoperative pain and spinal JOA scores between the two groups(P>0.05);there was no significant difference in the compression ratio of the injured vertebrae and the kyphosis Cobb angle between the two groups(P>0.05),after the operation,the two groups of patients were significantly reduced,and the compression ratio of the injured vertebrae and kyphosis Cobb angle of the observation group were more obvious(P<0.05);the vertebral height loss and Cobb angle loss in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:In the treatment of bone tumor with thoracolumbar spine fracture,compared with cross-injury vertebral fixation,via-injury vertebral fixation has a more significant clinical effect and is more suitable for clinical application and promotion.展开更多
To provide a new method to estimate the effectiveness of thoracolumbar vertebral finite element model. Methods: A mechanical model of human thoracolumbar vertebrae motion segment was made using three-dimensional finit...To provide a new method to estimate the effectiveness of thoracolumbar vertebral finite element model. Methods: A mechanical model of human thoracolumbar vertebrae motion segment was made using three-dimensional finite element method and the stress distribution of vertically compressed thoracolumbar vertebrae was analyzed, meanwhile, 20 patients with burst fracture of thoracolumbar vertebrae were tested by CT to calculated average CT value at ascertained different points of thoracolumbar vertebrae. The calculated results and effective stress at the same position were analyzed with straight line correlation. Results: The stress level of different position of thoracolumbar vertebrae under vertical compressive force was positively correlated with the correlative CT value, and the regressive style, Y= 214.028 + 45.268 X, r= 0.7386 , P< 0.05 (n=8) showed a statistical significance.Conclusions: To study mechanism of thoracolumbar vertebrae injuries under different forces has clinical significance.展开更多
Numbers of vertebrae is an important economic trait associated with body size and meat productivity in animals.However,the genetic basis of vertebrae number in donkey remains to be well understood.The aim of this stud...Numbers of vertebrae is an important economic trait associated with body size and meat productivity in animals.However,the genetic basis of vertebrae number in donkey remains to be well understood.The aim of this study was to identify candidate genes affecting the number of thoracic(TVn)and the number of lumbar vertebrae(LVn)in Dezhou donkey.A genome-wide association study was conducted using whole genome sequence data imputed from low-coverage genome sequencing.For TVn,we identified 38 genome-wide significant and 64 suggestive SNPs,which relate to 7 genes(NLGN1,DCC,SLC26A7,TOX,WNT7A,LOC123286078,and LOC123280142).For LVn,we identified 9 genome-wide significant and 38 suggestive SNPs,which relate to 8 genes(GABBR2,FBXO4,LOC123277146,LOC123277359,BMP7,B3GAT1,EML2,and LRP5).The genes involve in the Wnt and TGF-βsignaling pathways and may play an important role in embryonic development or bone formation and could be good candidate genes for TVn and LVn.展开更多
BACKGROUND The combined anterior/posterior approach appears to be capable of reconstructing spinal stability,correcting thoracolumbar deformity,and promoting neural recovery in severe thoracolumbar fracture dislocatio...BACKGROUND The combined anterior/posterior approach appears to be capable of reconstructing spinal stability,correcting thoracolumbar deformity,and promoting neural recovery in severe thoracolumbar fracture dislocation.However,this type of operation requires changing the body position during the procedure,resulting in a lengthy operation time.As a universal surgical robot,TINAVI robot has achieved good surgical results in clinical surgery.But to our knowledge,no reports describing TINAVI robot-assisted single lateral position anteroposterior surgery for thoracolumbar fracture dislocation.CASE SUMMARY We describe a case of a 16-year-old female patient with severe thoracolumbar fracture and dislocation underwent surgery assisted by the TINAVI robot.A onestage combined anterior and posterior operation was performed on a severe thoracolumbar fracture dislocation using the TINAVI robot,and the operation was completed in right lateral position.CONCLUSION The TINAVI robot-assisted one-stage anterior and posterior surgery in right lateral position for severe thoracolumbar fracture and dislocation is both safe and effective.展开更多
文摘Thoracic spine fracture is a common orthopedic injury that is usually caused by external forces acting directly on or transmitted to the thoracic spine through other parts of the spine.Thoracic spine fractures can be divided into two types:stable and unstable.An unstable fracture means that the relationship between the vertebral bodies is no longer stable,which may cause serious consequences such as spinal compression,nerve root compression,or spinal cord injury.Surgical treatment is often needed for patients with unstable fractures,nerve root compression,or spinal cord injury to restore stability and function to the thoracic spine.The probability of complications after thoracolumbar fracture surgery is high,which affects the outcome of surgical treatment.To improve postoperative rehabilitation outcomes,this article analyzed the value of nursing care based on the enhanced recovery after surgery(ERAS)concept for patients undergoing thoracolumbar fracture surgery.
文摘To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction,short-segment pedicle screw fixation was reinforced with posterior mosel-izee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures.Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups.Fractures in group A(n=20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion,while patients group B(n=50) did not receive the morselized bone grafting for bone fusion.The two groups were compared in terms of kyphotic deformity,anterior vertebral height,instrument failure and neurological functions after the treatment.Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment.The results showed that the kyphosis correction was achieved in both group A and group B(group A:6.4 degree;group B:5.4 degree)/At the end of follow-up,kyphosis correction was maintained in group A but lost in group B(P=0.0001).Postoperatively,greater anterior height was achieved in group A than in group B(P<0.01).During follow-up study,anterior vertebral height was maintained only in Group A(P<0.001).Both group A and group B showed good Denis pain scores(P1 and P2) but group A outdid group B in terms of control of severe and constant pain(P4 and P5).By Frankel criteria,the changes in neurological functions in group A was better than those of group B(P<0.001).It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction,and it may also increase and maintain anterior vertebral height.Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures,decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.
文摘Objective: To compare the influence of normal and degenerative discs on stress distribution of the thoracolumbar vertebrae under destructive load, explore the biomechanical background and clinical meaning and provide theoretical basis for clinical diagnosis and treatment. Methods: A mechanical model of thoracolumbar motion segment of normal and degenerative discs was built with a three dimensional finite element method and three stresses of vertical compression, compressive flexion and distractive flexion were comparatively analyzed. Results: With vertical compression and compressive flexion loads, the thoracolumbar motion segment of the normal disc showed that the central part of the upper and lower end plates of the vertebrae and the central part of the trabecular bone adjacent to the end plate were loaded with the most intensive stresses, meanwhile, the postero lateral part of the annulus fibrosus was concentrated with stresses. Degenerative disc showed that the stress distribution of the trabecular bone was relatively averaged, the stresses of the central part adjacent to the end plate were low, while at the same time, the stresses of the peripheral part were elevated relatively. With distraction flexion load, the stresses of the cortex bone, trabecular bone, end plate and annulus fibrosus of the thoracolumbar vertebrae of degenerative discs were low, meanwhile, the stresses of the posterior structure of the vertebral body were relatively elevated compared with that of normal discs. Conclusions: There is difference in influence between normal and degenerative discs on the stress distribution of the thoracolumbar vertebrae with destructive load. The transferring way of load is changed after disc degeneration.
文摘Objective:To analyze the application of vertebral pedicle screw fixation in the treatment of burst fracture of thoracolumbar vertebrae. Methods:A total of 48 cases(31 males and 17 females,aged from 18-72 years,mean:41.3 years)with thoracolumbar vertebrae burst fracture were treated by pedicle screw system since January 2004.According to the AO classification of thoracolumbar vertebrae fracture, there are 36 cases of Type A,9 of Type B and 3 of Type C. Results:All patients were followed up for 6-25 months(average 12 months),no secondary nerve root injury,spinal cord injury,loosening or breakage of pedicle screw were observed.The nerve function of 29 patients with cauda equina nerve injury was restored to different degrees.The vertebral body height returned to normal level and posterior process angle was rectified after operation. Conclusions:The vertebral pedicle screw internal fixation was technologically applicable,which can efficiently reposition and stablize the bursting fractured vertabrae, indirectly decompress canalis spinalis,maintain spine stablity,scatter stress of screw system,reduce the risk of loosening or breakage of screw and loss of vertebral height, and prevent the formation of posterior convex after operation.
文摘Objective:To explore and discuss the clinical therapeutic effects of the application of cross-injury vertebral fixation and via-injury vertebrae fixation in the treatment of bone tumor with thoracolumbar spine fracture.Methods:A total of 58 patients with bone tumors and thoracolumbar spine fractures admitted to our hospital from February to February 2019 were selected as the study subjects.They were randomly divided into control group and observation group,with 29 cases in each group.The patients in the control group received cross-injury vertebral fixation treatment,while the patients in the observation group were treated with via-injury vertebral fixation.The therapeutic effects of the two groups were compared.Results:The operation time and hospitalization time of the observation group were significantly shorter than those of the control group(P<0.05),and the postoperative drainage volume of the intraoperative blood loss was significantly less than that of the control group(P<0.05).There was no significant difference in postoperative pain and spinal JOA scores between the two groups(P>0.05);there was no significant difference in the compression ratio of the injured vertebrae and the kyphosis Cobb angle between the two groups(P>0.05),after the operation,the two groups of patients were significantly reduced,and the compression ratio of the injured vertebrae and kyphosis Cobb angle of the observation group were more obvious(P<0.05);the vertebral height loss and Cobb angle loss in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:In the treatment of bone tumor with thoracolumbar spine fracture,compared with cross-injury vertebral fixation,via-injury vertebral fixation has a more significant clinical effect and is more suitable for clinical application and promotion.
文摘To provide a new method to estimate the effectiveness of thoracolumbar vertebral finite element model. Methods: A mechanical model of human thoracolumbar vertebrae motion segment was made using three-dimensional finite element method and the stress distribution of vertically compressed thoracolumbar vertebrae was analyzed, meanwhile, 20 patients with burst fracture of thoracolumbar vertebrae were tested by CT to calculated average CT value at ascertained different points of thoracolumbar vertebrae. The calculated results and effective stress at the same position were analyzed with straight line correlation. Results: The stress level of different position of thoracolumbar vertebrae under vertical compressive force was positively correlated with the correlative CT value, and the regressive style, Y= 214.028 + 45.268 X, r= 0.7386 , P< 0.05 (n=8) showed a statistical significance.Conclusions: To study mechanism of thoracolumbar vertebrae injuries under different forces has clinical significance.
基金the Natural Science Foundation of Shandong Province,China(ZR2020MC168)。
文摘Numbers of vertebrae is an important economic trait associated with body size and meat productivity in animals.However,the genetic basis of vertebrae number in donkey remains to be well understood.The aim of this study was to identify candidate genes affecting the number of thoracic(TVn)and the number of lumbar vertebrae(LVn)in Dezhou donkey.A genome-wide association study was conducted using whole genome sequence data imputed from low-coverage genome sequencing.For TVn,we identified 38 genome-wide significant and 64 suggestive SNPs,which relate to 7 genes(NLGN1,DCC,SLC26A7,TOX,WNT7A,LOC123286078,and LOC123280142).For LVn,we identified 9 genome-wide significant and 38 suggestive SNPs,which relate to 8 genes(GABBR2,FBXO4,LOC123277146,LOC123277359,BMP7,B3GAT1,EML2,and LRP5).The genes involve in the Wnt and TGF-βsignaling pathways and may play an important role in embryonic development or bone formation and could be good candidate genes for TVn and LVn.
文摘BACKGROUND The combined anterior/posterior approach appears to be capable of reconstructing spinal stability,correcting thoracolumbar deformity,and promoting neural recovery in severe thoracolumbar fracture dislocation.However,this type of operation requires changing the body position during the procedure,resulting in a lengthy operation time.As a universal surgical robot,TINAVI robot has achieved good surgical results in clinical surgery.But to our knowledge,no reports describing TINAVI robot-assisted single lateral position anteroposterior surgery for thoracolumbar fracture dislocation.CASE SUMMARY We describe a case of a 16-year-old female patient with severe thoracolumbar fracture and dislocation underwent surgery assisted by the TINAVI robot.A onestage combined anterior and posterior operation was performed on a severe thoracolumbar fracture dislocation using the TINAVI robot,and the operation was completed in right lateral position.CONCLUSION The TINAVI robot-assisted one-stage anterior and posterior surgery in right lateral position for severe thoracolumbar fracture and dislocation is both safe and effective.
文摘目的探讨稳定型胸腰椎爆裂骨折(thoracolumbar burst fractures,TBF)非手术治疗的失败率和预测因素。方法选择2015年1月~2020年12月在该院接受非手术治疗的稳定型TBF患者资料进行回顾性分析,记录患者非手术治疗失败率。观察非手术治疗失败和非手术治疗成功患者的性别、年龄、体质量指数(body mass index,BMI)、个人史、伴随疾病、损伤原因、损伤椎体、疼痛视觉模拟评分(visual analogue scale,VAS)、椎体压缩率(vertebral body compression rate,VBCR)、椎体前缘高度压缩百分比(percentage anterior high compression,PAHC)、Cobb角、椎弓根间距(interpedicular distance,IPD)和椎管压缩程度,采用Logistic回归分析确定影响非手术治疗效果的独立因素。结果71例患者有21例非手术治疗失败,发生率29.58%。非手术治疗失败患者年龄、BMI、糖尿病、VBCR、PAHC、Cobb角、IPD、椎管压缩和VAS均高于非手术治疗成功患者(P<0.05)。多因素Logistic回归分析结果显示,年龄和IPD是影响非手术治疗效果的独立风险因素(P<0.05)。年龄预测非手术治疗失败的灵敏度、特异性、截断值和AUC分别为71.40%、86.00%、47岁、0.811,IPD预测非手术治疗失败的灵敏度、特异性、截断值和AUC分别为71.43%、88.00%、16.7%和0.771。结论年龄和IPD是影响稳定型TBF患者非手术治疗失败的风险因素,对预测手术失败具有一定临床价值。
