Study on clinical effects of pedicle screw combined with immobilized implantation bone by wirerope and hallow compression screw immobilization in treating spondylolysis of lumbar vertebra of multiple segments of adults

Objective:To observe clinical effects of pedicle screw fixation combined with cable wires and bone graft and cannulated compression screws on adult multi-segment lumbar spondylolysis.Methods:70 cases of patients with multi-segment lumbar spondylolysis were selected in our hospital.According to different surgical schemes,these patients were divided into the observation group(35 cases)and the control group(35 cases).The observation group received pedicle screw fixation combined with cable wires and bone graft and the control group received cannulated compression screw fixation.Macnab criteria were adopted to implement a therapeutic evaluation of two groups of patients to make an observation and comparison of the excellent and good rate of surgery and a series of indicators including perioperative clinical effects,intraoperative blood loss,duration of surgery,hospital length of stay(HLOS),visual analogue scale(VAS),Oswestry disability index and Japanese Orthopaedic Association(JOA)score.Results:The excellent and good rate of the observation group was 97.14%,and that of the control group was 82.86%,the difference between two groups was statistically significant(χ^(2)=6.248,p=0.012).The differences in intraoperative blood loss,duration of surgery and HLOS between two groups were statistically significant(t=-4.55,t=-4.55,t=-4.55;p<0.05).Oswestry index,VAS score and JOA score of the observation group were(2.4±0.9),(28.5±6.4)and(27.1±3.1)respectively,and these of the control group were(3.5±1.2),(37.1±7.8)and(21.3±2.7)respectively,the differences between two groups were statistically significant(t=4.338,t=5.043,t=8.347,p<0.05).Conclusions:Pedicle screw combined with immobilized implantation bone by wirerope has an excellent clinical effect on the treatment of adult multi-segment lumbar spondylolysis,and it has a series of advantages such as fast postoperative recovery,small surgical trauma and so on.In addition,this technique can also restore the stability of spinal segments and relieve pains to a greater degree.

Treatment of irreducible femoral intertrochanteric fractures using a wire-guided device

Purpose:Treatment of irreducible femoral intertrochanteric fractures often requires open reduction.However,the technique unavoidably causes patients to suffer greater trauma.As such,minimally invasive techniques should be employed to reduce the surgical-related trauma on these patients and maintain a stable reduction of the fractures.Herein,a minimally invasive wire introducer was designed and used for the treatment of femoral intertrochanteric fractures.The effectiveness of using a wireguided device to treat irreducible femoral intertrochanteric fractures was evaluated.Methods:Between 2013 and 2018,patients with femoral intertrochanteric fractures who were initially treated by intramedullary nail fixation but had difficult reduction using the traction beds were retrospectively reviewed.Decision for an additional surgery was based on the displacement of the fracture.The patients were then divided into two groups:those in the control group received an open reduction surgery while those in the observation group received a closed reduction surgery using a minimally invasive wire introducer to guide the wire that could assist in fracture reduction.The operation time,blood loss,visual analogue scale scores,angulation,reduction,neck-shaft angle,re-displacement,limb length discrepancy,and union time were then recorded and analyzed to determine the efficiency of the wire introducer technique.Categorical variables were analyzed by using Chi-square test,while continuous variables by independent t-test and the Mann-Whitney test accordingly.Results:There were 92 patients included in this study:61 in the control group and 31 in the observation group.There were no significant differences in baseline demographic factors between the two groups.All surgeries were successful with no deaths within the perioperative period.The average follow-up time for the patients was 23.8 months.However,the observation group had a significantly shorter operation time,lower visual analogue scale score,less intraoperative bleeding,and shorter fracture healing time.There were no significant differences in the angulation,reduction,neck-shaft angle,and limb length discrepancy between the two groups.Conclusion:The minimally invasive wire guide achieved a similar effect to that of open reduction in the treatment of intertrochanteric fractures with difficult reduction.Moreover,the minimally invasive wire introducer is a good technology that accurately guides the wire during reduction.Indeed,it is an effective technique and achieves good clinical outcomes in restoration of irreducible femoral intertrochanteric fractures.