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 clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures.Methods:From June 2013 to June 2014,100 patients with thoracolumbar ...Objective:To study the clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures.Methods:From June 2013 to June 2014,100 patients with thoracolumbar fractures were selected as the subjects and they were randomly divided into observation group(50 cases)and control group(50 cases).The patients in the observation group were treated with minimally invasive singlesegment reduction and internal fixation.The patients in the control group were treated with short segmental fixation.The clinical effects of the two groups were compared.Results:There was no significant difference in the compression rate and Cobb angle between the two groups before and after operation(P>0.05).For all patients who were followed up for the last time,the Cobb angle was significantly lower in the observation group than in the control group(P<0.05).The social function,affective function and physical pain score of the observation group were significantly better than the control group(P<0.05).The amount of bleeding in the observation group was(250.4±41.0)ml,which was significantly lower than that in the control group(267.5±32.8)ml.The time required for the operation was(90.2±35.4)min,which was significantly lower than that of the control group(104.5±22.6)min(P<0.05).After treatment,the prognosis was 70.00%and the excellent and good rate was 98.00%,which was significantly higher than that of the control group(46.00%)and 78.00%(P<0.05).Conclusion:Thoracolumbar fractures in patients with dilated channel minimally invasive single-segment reduction and internal fixation treatment can effectively repair the patient's vertebral height and Cobb angle and the degree of correction after surgery was significantly better,safer and worthy of clinical recommended use.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 clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures.Methods:From June 2013 to June 2014,100 patients with thoracolumbar fractures were selected as the subjects and they were randomly divided into observation group(50 cases)and control group(50 cases).The patients in the observation group were treated with minimally invasive singlesegment reduction and internal fixation.The patients in the control group were treated with short segmental fixation.The clinical effects of the two groups were compared.Results:There was no significant difference in the compression rate and Cobb angle between the two groups before and after operation(P>0.05).For all patients who were followed up for the last time,the Cobb angle was significantly lower in the observation group than in the control group(P<0.05).The social function,affective function and physical pain score of the observation group were significantly better than the control group(P<0.05).The amount of bleeding in the observation group was(250.4±41.0)ml,which was significantly lower than that in the control group(267.5±32.8)ml.The time required for the operation was(90.2±35.4)min,which was significantly lower than that of the control group(104.5±22.6)min(P<0.05).After treatment,the prognosis was 70.00%and the excellent and good rate was 98.00%,which was significantly higher than that of the control group(46.00%)and 78.00%(P<0.05).Conclusion:Thoracolumbar fractures in patients with dilated channel minimally invasive single-segment reduction and internal fixation treatment can effectively repair the patient's vertebral height and Cobb angle and the degree of correction after surgery was significantly better,safer and worthy of clinical recommended use.
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.
