Posterior lumbar interbody fusion (PLIF) is a common surgical procedure and widely used in the treatment of lumbar degenerative disc disorders. Traditionally, posterior lumbar interbody fusion is done by using the tra...Posterior lumbar interbody fusion (PLIF) is a common surgical procedure and widely used in the treatment of lumbar degenerative disc disorders. Traditionally, posterior lumbar interbody fusion is done by using the traditional pedicle screw (PS) which offers great advantages, but at the same time it has some disadvantages which include the risk of superior facet joint violation and muscle damage. Recently, an alternative method of screw insertion via cortical bone trajectory (CBT) has been invented which has less invasive process and can be placed without the drawbacks associated with the traditional pedicle screw. However, it has to remain an interest whether CBT will provide similar or greater clinical outcomes compared to PS in PLIF. So the main aim of this review is to compare the clinical outcomes of cortical bone trajectory and traditional pedicle screw fixation in posterior lumbar interbody fusion based on the articles published on this topic. Compared to the traditional pedicle screw fixation, PLIF with CBT has similar clinical outcome based on pain intensity, ODI status and JOA score, as well as similar fusion rate and radiological evaluated complication such as loosening of screw. In addition PLIF with CBT has advantages of less facet joint violation, less blood loss, less intraoperative muscle damage and perioperative pain. On the basis of this study, we can suggest that PLIF with CBT can be considered as a reasonable alternative to PS in PLIF.展开更多
Objectives: To explore the treatment and related prognosis of elderly patients with Anderson II odontoid fracture with posterior pedicle screw fixation combined with iliac bone grafting. Methods: Retrospective analysi...Objectives: To explore the treatment and related prognosis of elderly patients with Anderson II odontoid fracture with posterior pedicle screw fixation combined with iliac bone grafting. Methods: Retrospective analysis of 17 cases of elderly patients with Anderson II odontoid fracture who underwent posterior pedicle screw fixation combined with iliac bone grafting from January 2013 to December 2016. 17 patients had a history of trauma before surgery, and they all have varying degrees of atlantoaxial instability or subluxation and varying degrees of neck occipital pain and limited mobility. Result: No spinal cord or vertebral artery injury occurred during surgery. Follow-up information is complete. The follow-up period was 6 to 48 months (mean 27.4 ± 12.4 months). Postoperative imaging review prompted a good reduction of cervical spine, stable sequence;no pedicle screw loosening, fracture, iliac bone graft at the location of the situation, odontoid fracture and bone healing at the good, the patient after cervical rotation are limited to varying degrees. Conclusion: Posterior pedicle screw fixation combined with iliac bone grafting in elderly patients with Anderson II odontoid fracture can achieve good stability, and the prognosis is good, but long-term cervical rotation function may be affected to varying degrees.展开更多
目的总结和探讨后路钉棒结合改良Stoppa入路重建板治疗骨盆Tile C1型骨折的临床疗效及可推广性。方法采用后路钉棒结合改良Stoppa入路重建板治疗骨盆Tile C1型骨折23例,其中男17例,女6例;年龄18~49岁,平均36.6岁。高处坠落伤12例,车祸...目的总结和探讨后路钉棒结合改良Stoppa入路重建板治疗骨盆Tile C1型骨折的临床疗效及可推广性。方法采用后路钉棒结合改良Stoppa入路重建板治疗骨盆Tile C1型骨折23例,其中男17例,女6例;年龄18~49岁,平均36.6岁。高处坠落伤12例,车祸伤10例,重物砸伤1例。受伤至手术时间5~21 d,平均7 d。C1.2型7例,C1.3型16例。术中记录手术时间及失血量,术后记录并发症,术后1周内Matta骨折复位评价,术后1年Majeed功能疗效评价。结果所有病例均获随访,平均随访时间(14.13±2.11)个月。手术时间120~180 min,平均140 min(前路60 min,后路80 min);术中失血量100~800 m L,平均350 m L(前路120 m L,后路230 m L),所有病例未采用自体血回输,部分术后少量输血。术后1周摄片,Matta骨折复位评价:优20例,良1例,可2例,优良率91.3%。术后1年Majeed功能疗效评价,优19例,良3例,中1例,优良率95.6%。术后1年内所有骨盆骨折均愈合。结论采用后路钉棒固定结合前路改良Stoppa入路重建板固定术式使骨盆C1.2和C1.3型骨折治疗变得简单,疗效肯定,值得推广。展开更多
文摘Posterior lumbar interbody fusion (PLIF) is a common surgical procedure and widely used in the treatment of lumbar degenerative disc disorders. Traditionally, posterior lumbar interbody fusion is done by using the traditional pedicle screw (PS) which offers great advantages, but at the same time it has some disadvantages which include the risk of superior facet joint violation and muscle damage. Recently, an alternative method of screw insertion via cortical bone trajectory (CBT) has been invented which has less invasive process and can be placed without the drawbacks associated with the traditional pedicle screw. However, it has to remain an interest whether CBT will provide similar or greater clinical outcomes compared to PS in PLIF. So the main aim of this review is to compare the clinical outcomes of cortical bone trajectory and traditional pedicle screw fixation in posterior lumbar interbody fusion based on the articles published on this topic. Compared to the traditional pedicle screw fixation, PLIF with CBT has similar clinical outcome based on pain intensity, ODI status and JOA score, as well as similar fusion rate and radiological evaluated complication such as loosening of screw. In addition PLIF with CBT has advantages of less facet joint violation, less blood loss, less intraoperative muscle damage and perioperative pain. On the basis of this study, we can suggest that PLIF with CBT can be considered as a reasonable alternative to PS in PLIF.
文摘Objectives: To explore the treatment and related prognosis of elderly patients with Anderson II odontoid fracture with posterior pedicle screw fixation combined with iliac bone grafting. Methods: Retrospective analysis of 17 cases of elderly patients with Anderson II odontoid fracture who underwent posterior pedicle screw fixation combined with iliac bone grafting from January 2013 to December 2016. 17 patients had a history of trauma before surgery, and they all have varying degrees of atlantoaxial instability or subluxation and varying degrees of neck occipital pain and limited mobility. Result: No spinal cord or vertebral artery injury occurred during surgery. Follow-up information is complete. The follow-up period was 6 to 48 months (mean 27.4 ± 12.4 months). Postoperative imaging review prompted a good reduction of cervical spine, stable sequence;no pedicle screw loosening, fracture, iliac bone graft at the location of the situation, odontoid fracture and bone healing at the good, the patient after cervical rotation are limited to varying degrees. Conclusion: Posterior pedicle screw fixation combined with iliac bone grafting in elderly patients with Anderson II odontoid fracture can achieve good stability, and the prognosis is good, but long-term cervical rotation function may be affected to varying degrees.
文摘目的总结和探讨后路钉棒结合改良Stoppa入路重建板治疗骨盆Tile C1型骨折的临床疗效及可推广性。方法采用后路钉棒结合改良Stoppa入路重建板治疗骨盆Tile C1型骨折23例,其中男17例,女6例;年龄18~49岁,平均36.6岁。高处坠落伤12例,车祸伤10例,重物砸伤1例。受伤至手术时间5~21 d,平均7 d。C1.2型7例,C1.3型16例。术中记录手术时间及失血量,术后记录并发症,术后1周内Matta骨折复位评价,术后1年Majeed功能疗效评价。结果所有病例均获随访,平均随访时间(14.13±2.11)个月。手术时间120~180 min,平均140 min(前路60 min,后路80 min);术中失血量100~800 m L,平均350 m L(前路120 m L,后路230 m L),所有病例未采用自体血回输,部分术后少量输血。术后1周摄片,Matta骨折复位评价:优20例,良1例,可2例,优良率91.3%。术后1年Majeed功能疗效评价,优19例,良3例,中1例,优良率95.6%。术后1年内所有骨盆骨折均愈合。结论采用后路钉棒固定结合前路改良Stoppa入路重建板固定术式使骨盆C1.2和C1.3型骨折治疗变得简单,疗效肯定,值得推广。