Objective To evaluate surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of lower cervical spine with bilateral facet joints dislocation. Methods...Objective To evaluate surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of lower cervical spine with bilateral facet joints dislocation. Methods This展开更多
BACKGROUND Postoperative unobstructed drainage is an important measure for avoiding hematoma formation and preventing complications from anterior cervical surgery.AIM To discuss the characteristics and key points of c...BACKGROUND Postoperative unobstructed drainage is an important measure for avoiding hematoma formation and preventing complications from anterior cervical surgery.AIM To discuss the characteristics and key points of clinical management of two types of commonly used negative pressure drainage systems in clinical settings.METHODS Two types of commonly used silica gel negative pressure drainage balls and a type of gastrointestinal decompression apparatus were fully emptied and then injected with different amounts of water and air.Following this,the negative pressure values of the three devices were measured.Meanwhile,we undertook a retrospective analysis of the clinical data of 1328 patients who had been treated with different negative pressure drainage apparatuses during their anterior cervical surgery in our department between January 2007 and January 2018.RESULTS As the amount of injected air or water increased,the negative pressure of the silica gel negative pressure drainage ball decreased rapidly,dropping to zero when 150 mL of water or air was injected.In contrast,the negative pressure of gastrointestinal decompression apparatus decreased slowly,maintaining an ideal value even when 300 mL of water or air was injected.And statistical analysis demonstrated that patients who had been treated with the gastrointestinal decompression apparatus were less likely to develop severe complications than those who had been treated with the silica gel negative pressure drainage ball(P<0.05).CONCLUSION This study showed that the gastrointestinal decompression apparatus has the advantages of large suction capacity,long duration of continuous negative pressure,and good drainage effect,all of which are the favorable factors for the use of this apparatus for negative pressure drainage in anterior cervical surgery.展开更多
Objective: The authors report a rare case of ossification of the anterior longitudinal ligament in the cervical spine underlying dysphagia. Case Report: We report the case of a 50-year-old male presenting with difficu...Objective: The authors report a rare case of ossification of the anterior longitudinal ligament in the cervical spine underlying dysphagia. Case Report: We report the case of a 50-year-old male presenting with difficulty swallowing and choking. CT of the cervical spine demonstrated anterior longitudinal ligament hypertrophy with osteophytes worst at C1-C2 and C6-C7, without spinal cord compression. A videofluoroscopic swallow study revealed reduced epiglottic inversion and hyolaryngeal elevation resulting in incomplete clearance from the pharynx, as well as compression of the esophagus. Subsequently, the patient underwent osteophytectomy. There were no intraoperative or postoperative complications. Two weeks after the surgery, videofluoroscopic swallow demonstrated improved function and reduced compression. Four weeks postoperatively, the patient completely regained swallowing function without pain.展开更多
目的探讨颈椎前路术后患者吞咽困难的危险因素。方法通过计算机检索中国知网(CNKI)、中国生物医学数据库(CBM)、维普(VIP)、万方、Embase、Web of Science、CINAHL、PubMed,、Cochrane Library等中英文数据库已发表的关于颈椎前路术后...目的探讨颈椎前路术后患者吞咽困难的危险因素。方法通过计算机检索中国知网(CNKI)、中国生物医学数据库(CBM)、维普(VIP)、万方、Embase、Web of Science、CINAHL、PubMed,、Cochrane Library等中英文数据库已发表的关于颈椎前路术后患者吞咽困难危险因素的病例对照研究,检索时间从建库开始到2023年7月。经文献筛选、质量评价、数据提取后运用Reman 5.3软件对数据进行Meta分析。结果最终纳入20篇病例对照研究,包括9篇中文文献和11篇英文文献,共计4161例受试对象。Meta分析结果显示:所纳入研究共计有10个危险因素具有统计学意义,分别为女性[OR=2.34,95%CI(1.82,3.01)]、高龄[OR=2.70,95%CI(1.87,3.91)]、吸烟[OR=1.43,95%CI(1.22,1.67)]、合并糖尿病[OR=2.87,95%CI(2.33,3.53)]、手术时间>2 h[OR=1.88,95%CI(1.56,2.23)]、手术节段高于C4[OR=1.92,95%CI(1.52,2.41)]、手术节段数>2[OR=4.64,95%CI(3.07,7.03)]、病程>8个月、颈前软组织过厚[OR=2.31,95%CI(1.06,3.35)]、dC2~7角>5^(0)[OR=1.39,95%CI(1.26,1.54)]。结论女性、高龄、吸烟、糖尿病、手术时间>2 h、手术节段高于C4、手术节段数>2、病程>8个月、颈前软组织过厚、dC2~7角>5^(0)的患者更易发生术后吞咽困难。展开更多
目的:系统评价颈椎前路术后发生吞咽困难的危险因素,明确独立危险因素,为颈椎前路手术围术期并发症的防治提供指导。方法:检索万方数据库(WanFang)、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)、PubMed、Embase、Cochrane...目的:系统评价颈椎前路术后发生吞咽困难的危险因素,明确独立危险因素,为颈椎前路手术围术期并发症的防治提供指导。方法:检索万方数据库(WanFang)、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)、PubMed、Embase、Cochrane Library、Web of Science共8个数据库,检索时限从建库至2023年7月15日,搜索关于颈椎前路术后吞咽困难的危险因素的病例对照研究和队列研究,采用纽卡斯尔-渥太华质量评定量表(Newcastle-Ottawa Scale,NOS)对纳入研究进行质量评价和数据提取(包括第一作者、发表年份、研究类型、样本量、评估方式、评估时间及危险因素),通过Stata12软件进行Meta分析。结果:共纳入29篇文献,其中队列研究4篇,病例对照研究25篇,所有文献均为高质量研究,包括颈椎前路术后吞咽困难患者89571例,对照组3092967例。年龄[优势比(odds ratio,OR)=1.093,95%置信区间(confidential interval,CI):1.067~1.120]、女性(OR=2.419,95%CI:1.654~3.539)、糖尿病(OR=2.733,95%CI:2.240~3.333)、病程(OR=4.259,95%CI:2.458~7.381)、手术节段数量(OR=1.791,95%CI:1.718~1.868)、手术节段位置(OR=2.332,95%CI:1.812~3.003)、手术时间(OR=1.434,95%CI:1.110~1.852)、钢板内置物(OR=2.188,95%CI:1.413~3.175)及翻修手术(OR=2.687,95%CI:2.316-3.119)与颈椎前路术后发生吞咽困难相关,而吸烟(OR=1.323,95%CI:0.852~2.056)、高血压(OR=1.006,95%CI:0.591~1.713)、体重指数(body mass index,BMI)(OR=1.037,95%CI:0.929~1.159)、颈椎间盘置换(OR=0.577,95%CI:0.085~3.943)、C2-7角度变化(difference between postoperative and preoperative C2-C7 angle,dC2-7)>5°(OR=1.716,95%CI:0.925~3.183)等因素与其不相关。结论:女性、高龄、术前病程长、合并糖尿病、双节段或多节段手术、高位颈椎手术、手术时间长、使用钢板及翻修手术的患者颈椎前路术后更易发生吞咽困难。展开更多
文摘Objective To evaluate surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of lower cervical spine with bilateral facet joints dislocation. Methods This
基金Supported by the Multicenter Clinical Trial of hUC-MSCs in the Treatment of Late Chronic Spinal Cord Injury,No.2017YFA0105404the Key Discipline Construction Project of Pudong Health Bureau of Shanghai,No.PWZxk2017-08.
文摘BACKGROUND Postoperative unobstructed drainage is an important measure for avoiding hematoma formation and preventing complications from anterior cervical surgery.AIM To discuss the characteristics and key points of clinical management of two types of commonly used negative pressure drainage systems in clinical settings.METHODS Two types of commonly used silica gel negative pressure drainage balls and a type of gastrointestinal decompression apparatus were fully emptied and then injected with different amounts of water and air.Following this,the negative pressure values of the three devices were measured.Meanwhile,we undertook a retrospective analysis of the clinical data of 1328 patients who had been treated with different negative pressure drainage apparatuses during their anterior cervical surgery in our department between January 2007 and January 2018.RESULTS As the amount of injected air or water increased,the negative pressure of the silica gel negative pressure drainage ball decreased rapidly,dropping to zero when 150 mL of water or air was injected.In contrast,the negative pressure of gastrointestinal decompression apparatus decreased slowly,maintaining an ideal value even when 300 mL of water or air was injected.And statistical analysis demonstrated that patients who had been treated with the gastrointestinal decompression apparatus were less likely to develop severe complications than those who had been treated with the silica gel negative pressure drainage ball(P<0.05).CONCLUSION This study showed that the gastrointestinal decompression apparatus has the advantages of large suction capacity,long duration of continuous negative pressure,and good drainage effect,all of which are the favorable factors for the use of this apparatus for negative pressure drainage in anterior cervical surgery.
文摘Objective: The authors report a rare case of ossification of the anterior longitudinal ligament in the cervical spine underlying dysphagia. Case Report: We report the case of a 50-year-old male presenting with difficulty swallowing and choking. CT of the cervical spine demonstrated anterior longitudinal ligament hypertrophy with osteophytes worst at C1-C2 and C6-C7, without spinal cord compression. A videofluoroscopic swallow study revealed reduced epiglottic inversion and hyolaryngeal elevation resulting in incomplete clearance from the pharynx, as well as compression of the esophagus. Subsequently, the patient underwent osteophytectomy. There were no intraoperative or postoperative complications. Two weeks after the surgery, videofluoroscopic swallow demonstrated improved function and reduced compression. Four weeks postoperatively, the patient completely regained swallowing function without pain.
文摘目的:系统评价颈椎前路术后发生吞咽困难的危险因素,明确独立危险因素,为颈椎前路手术围术期并发症的防治提供指导。方法:检索万方数据库(WanFang)、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)、PubMed、Embase、Cochrane Library、Web of Science共8个数据库,检索时限从建库至2023年7月15日,搜索关于颈椎前路术后吞咽困难的危险因素的病例对照研究和队列研究,采用纽卡斯尔-渥太华质量评定量表(Newcastle-Ottawa Scale,NOS)对纳入研究进行质量评价和数据提取(包括第一作者、发表年份、研究类型、样本量、评估方式、评估时间及危险因素),通过Stata12软件进行Meta分析。结果:共纳入29篇文献,其中队列研究4篇,病例对照研究25篇,所有文献均为高质量研究,包括颈椎前路术后吞咽困难患者89571例,对照组3092967例。年龄[优势比(odds ratio,OR)=1.093,95%置信区间(confidential interval,CI):1.067~1.120]、女性(OR=2.419,95%CI:1.654~3.539)、糖尿病(OR=2.733,95%CI:2.240~3.333)、病程(OR=4.259,95%CI:2.458~7.381)、手术节段数量(OR=1.791,95%CI:1.718~1.868)、手术节段位置(OR=2.332,95%CI:1.812~3.003)、手术时间(OR=1.434,95%CI:1.110~1.852)、钢板内置物(OR=2.188,95%CI:1.413~3.175)及翻修手术(OR=2.687,95%CI:2.316-3.119)与颈椎前路术后发生吞咽困难相关,而吸烟(OR=1.323,95%CI:0.852~2.056)、高血压(OR=1.006,95%CI:0.591~1.713)、体重指数(body mass index,BMI)(OR=1.037,95%CI:0.929~1.159)、颈椎间盘置换(OR=0.577,95%CI:0.085~3.943)、C2-7角度变化(difference between postoperative and preoperative C2-C7 angle,dC2-7)>5°(OR=1.716,95%CI:0.925~3.183)等因素与其不相关。结论:女性、高龄、术前病程长、合并糖尿病、双节段或多节段手术、高位颈椎手术、手术时间长、使用钢板及翻修手术的患者颈椎前路术后更易发生吞咽困难。
