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Clinical Outcome of Internal Fixation and Fusion in the Treatment of Spinal Fractures by Paraspinal Muscular Space Approach
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作者 Yafei Zhao Qiushuang Ma +3 位作者 Meng Zhang Shengwang Li Yannan Li Chenguang Tian 《Journal of Clinical and Nursing Research》 2024年第7期10-15,共6页
Objective:To explore the clinical effect of internal fixation and fusion with the paraspinal muscle gap approach in the treatment of spinal fracture patients.Methods:104 spinal fracture patients admitted to Central Ho... Objective:To explore the clinical effect of internal fixation and fusion with the paraspinal muscle gap approach in the treatment of spinal fracture patients.Methods:104 spinal fracture patients admitted to Central Hospital of TCM from October 2022 to April 2024 were selected as the study subjects and were randomly divided into the control group(n=52)and the observation group(n=52)according to the random number table method.The control group was treated with the conventional approach of internal fixation surgery,and the observation group was treated with the paraspinal muscular interspace approach of internal fixation fusion.The two groups’general data,surgical indexes,pain,lumbar spine function,and postoperative complications were observed.Results:The baseline data of the two groups of patients were not statistically significant(all P>0.05)while the intraoperative bleeding,the first postoperative time getting up from bed,and the length of hospital stay of the patients in the observation group were shorter than that of the control group(all P=0.000<0.001),and the duration of the operation was longer than that of the control group(t=2.644,P=0.010<0.05);at 3 months postoperatively,the VAS scores of the patients in the observation group were significantly lower than those in the control group(t=10.768,P=0.000<0.001),and the JOA score was higher than that of the control group(t=6.498,P=0.000<0.001);the total complication rate of patients in the observation group(3/5.77%)was significantly lower than that of the control group(12/23.08%)(χ^(2)=6.310,P=0.012<0.05).Conclusion:In the treatment of spinal fracture patients,compared with the conventional approach to internal fixation surgery,the paraspinal muscular gap approach to internal fixation and fusion treatment is less traumatic,postoperative lumbar spine function recovery is faster,and can reduce the incidence of postoperative complications. 展开更多
关键词 Paraspinal muscular interspace approach Fixation and fusion spinal fracture
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Analgesic Effect of Combined Spinal-Epidural Anesthesia and its Effect on TNF-α and CRP Levels in Elderly Patients with Hip Fracture During Surgical Treatment
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作者 Jie Xu Linyan Li Ning Wang 《Journal of Clinical and Nursing Research》 2024年第3期7-11,共5页
Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our... Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion. 展开更多
关键词 Hip fracture in the elderly suRGERY Combined spinal and epidural anesthesia Analgesic effect TNF-Α CRP level
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Effectiveness and postoperative rehabilitation of one-stage combined anterior-posterior surgery for severe thoracolumbar fractures with spinal cord injury 被引量:1
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作者 Bo Zhang Jin-Chao Wang +2 位作者 Yu-Zhen Jiang Qing-Peng Song Yan An 《World Journal of Clinical Cases》 SCIE 2022年第18期6001-6008,共8页
BACKGROUND Thoracolumbar fractures are generally combined with spinal cord injury to varying degrees,which may cause deterioration of the patients’condition and increase the difficulty of clinical treatment.At presen... BACKGROUND Thoracolumbar fractures are generally combined with spinal cord injury to varying degrees,which may cause deterioration of the patients’condition and increase the difficulty of clinical treatment.At present,anterior or combined anterior-posterior surgery is preferred for severe thoracolumbar fractures.AIM To investigate the effectiveness and postoperative rehabilitation of one-stage combined anterior-posterior surgery for severe thoracolumbar fractures with spinal cord injury.METHODS One-hundred-and-twenty patients who received surgery for severe thoracolumbar fractures with spinal cord injury at our hospital from February 2018 to February 2020 were randomly enrolled.They were randomly divided into group 1(one-stage combined anterior-posterior surgery,n=60)and group 2(onestage anterior-approach surgery,n=60).Treatment efficacy was compared between the two groups.RESULTS Blood loss was greater and the operation time was longer in group 1 than in group 2,and the differences were statistically significant(P<0.05).Incision length,intraoperative X-rays,and length of hospital stay were not significantly different between the two groups(P>0.05).Preoperative function of the affected vertebrae was not significantly different between the two groups(P>0.05).In each group,the patients showed significant improvement after surgery.The anterior vertebral height ratio and the posterior vertebral height ratio in group 1 after surgery were significantly higher than those in group 2.The Cobb angle after surgery was significantly lower in group 1 than in group 2(P<0.05).The canal-occupying ratio of the affected vertebrae was not significantly different between the two groups(P>0.05).Before surgery,there was no significant difference in the quality of life scores between the two groups(P>0.05).The above indicators were significantly improved after surgery compared with before surgery in each group.In addition,these indicators were markedly better in group 1 than in group 2 after surgery(P<0.05 for each).CONCLUSION One-stage combined anterior-posterior surgery effectively improves the function of the affected vertebrae and the life quality of patients with severe thoracolumbar fractures and spinal cord injury.This surgical approach is worthy of popularization in clinical use. 展开更多
关键词 Thoracolumbar fracture spinal cord injury Combined anterior-posterior surgery Postoperative rehabilitation Quality of life
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Radiographic measurement of morphological abnormalities in thoracolumbar burst fractures: relationship with spinal cord lesion
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作者 戴力扬 《Journal of Medical Colleges of PLA(China)》 CAS 2000年第3期214-216,共3页
Objective:To investigate the relationship between morphological abnormalities and spinal cord deficit in thoracolumbar burst fractures. Methods: Seventy-eight patients with thoracolumbar burst fractures were retrospec... Objective:To investigate the relationship between morphological abnormalities and spinal cord deficit in thoracolumbar burst fractures. Methods: Seventy-eight patients with thoracolumbar burst fractures were retrospectively reviewed to calculate the stenotic ratio of spinal canal based on the midsagittal diameters and the hyphosis angle according to Cobb. The ASIA scoring of motor function of lower extremities was recorded . Results: The differences (P > 0.05) of the stenotic ratio of spinal canal and the kyphosis angle were not significant between patients without neurological deficit, with incomplete and complete lesions. No significant correlation(P > 0.05) between the stenotic ratio of spinal canal and the kyphosis angle, and ASIA scoring was noted. Conclusion:The severity of spinal cord injuries in thoracolumbar burst fractures is not predicted according to the percentage of canal stenosis or the degree of kyphesis induced by thoracolumbar burst fractures. 展开更多
关键词 spinal fractures thoracic VERTEBRAE LUMBAR VERTEBRAE spinal CANAL spinal cord injuries
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Development and validation of a predictive model for spinal fracture risk in osteoporosis patients
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作者 Xu-Miao Lin Zhi-Cai Shi 《World Journal of Clinical Cases》 SCIE 2023年第20期4824-4832,共9页
BACKGROUND Spinal osteoporosis is a prevalent health condition characterized by the thinning of bone tissues in the spine,increasing the risk of fractures.Given its high incidence,especially among older populations,it... BACKGROUND Spinal osteoporosis is a prevalent health condition characterized by the thinning of bone tissues in the spine,increasing the risk of fractures.Given its high incidence,especially among older populations,it is critical to have accurate and effective predictive models for fracture risk.Traditionally,clinicians have relied on a combination of factors such as demographics,clinical attributes,and radiological characteristics to predict fracture risk in these patients.However,these models often lack precision and fail to include all potential risk factors.There is a need for a more comprehensive,statistically robust prediction model that can better identify high-risk individuals for early intervention.AIM To construct and validate a model for forecasting fracture risk in patients with spinal osteoporosis.METHODS The medical records of 80 patients with spinal osteoporosis who were diagnosed and treated between 2019 and 2022 were retrospectively examined.The patients were selected according to strict criteria and categorized into two groups:Those with fractures(n=40)and those without fractures(n=40).Demographics,clinical attributes,biochemical indicators,bone mineral density(BMD),and radiological characteristics were collected and compared.A logistic regression analysis was employed to create an osteoporotic fracture risk-prediction model.The area under the receiver operating characteristic curve(AUROC)was used to evaluate the model’s performance.RESULTS Factors significantly associated with fracture risk included age,sex,body mass index(BMI),smoking history,BMD,vertebral trabecular alterations,and prior vertebral fractures.The final risk-prediction model was developed using the formula:(logit[P]=-3.75+0.04×age-1.15×sex+0.02×BMI+0.83×smoking history+2.25×BMD-1.12×vertebral trabecular alterations+1.83×previous vertebral fractures).The AUROC of the model was 0.93(95%CI:0.88-0.96,P<0.001),indicating strong discriminatory capabilities.CONCLUSION The fracture risk-prediction model,utilizing accessible clinical,biochemical,and radiological information,offered a precise tool for the evaluation of fracture risk in patients with spinal osteoporosis.The model has potential in the identification of high-risk individuals for early intervention and the guidance of appropriate preventive actions to reduce the impact of osteoporosis-related fractures. 展开更多
关键词 spinal osteoporosis fracture risk prediction Bone mineral density Vertebral trabecular alterations Previous vertebral fractures
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Comparative effect of intrathecal meperidine,tramadol,magnesium sulfate,and dexmedetomidine on preventing post-spinal anesthesia shivering and adverse events in hip fracture repair patients:A randomized clinical trial 被引量:1
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作者 Mansoreh Kokhaei Hesameddin Modir +1 位作者 Esmail Moshiri Mehran Azami 《Journal of Acute Disease》 2022年第6期222-227,共6页
Objective:To compare effect of intrathecal meperidine,tramadol,magnesium sulfate,and dexmedetomidine on the prevention of post-spinal anesthesia shivering and adverse events in hip fracture repair patients.Methods:In ... Objective:To compare effect of intrathecal meperidine,tramadol,magnesium sulfate,and dexmedetomidine on the prevention of post-spinal anesthesia shivering and adverse events in hip fracture repair patients.Methods:In a randomized,double-blind trial,132 patients with American Society of Anesthesiology(ASA)ⅠandⅡspinal anesthesia who needed hip fracture surgery were enrolled.Patients were stratified into 4 intervention groups based on a randomized block pattern:meperidine,tramadol,magnesium sulfate,and dexmedetomidine.Hemodynamic parameters including blood pressure,heart rate,and oxygen saturation,as well as the severity of shivering,core body temperature,Ramsay sedation score,adverse events,meperidine consumption were recorded and compared.Results:There was no statistically significant difference in the normal hemodynamic parameters,temperature,duration of surgery,meperidine consumption,and adverse events such as dizziness,hypotension,nausea,and bradycardia among groups(P>0.05).Compared to other groups,severity of shivering was the lower in the dexmedetomidine group 6 and 8 h after surgery.The Ramsay sedation scores were higher in the dexmedetomidine and meperidine groups 4 h after surgery(P=0.020).Conclusion:Dexmedetomidine acts better than the other three adjuvants in reducing complications such as shivering.Overall,these four adjuvants are helpful to prevent postoperative shivering and could be put forward as promising local anesthetics in spinal anesthesia,based on anesthesiologists’discretion and patients’general conditions.Clinical registration:The study was approved by the Research and Ethics Committee at the Valiasr Hospital(Arak,Iran)with the clinical trial code of IRCT20141209020258N153. 展开更多
关键词 DEXMEDETOMIDINE Hip fracture Intrathecal injec-tion Magnesium sulfate MEPERIDINE SHIVERING spinal TRAMADOL
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Research of the Clinical Effect of Kyphoplasty in the Treatment of Multiple Senile Osteoporotic Spinal Fractures 被引量:1
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作者 Tianhui Liu Jianmin Cui 《Journal of Clinical and Nursing Research》 2021年第1期97-100,共4页
Objective:To evaluate the clinical effect of kyphoplasty in the treatment of multiple osteoporotic vertebral fractures in the elderly.Methods:The duration of the study was selected from January 2018 to December 2020,a... Objective:To evaluate the clinical effect of kyphoplasty in the treatment of multiple osteoporotic vertebral fractures in the elderly.Methods:The duration of the study was selected from January 2018 to December 2020,and 38 patients with multiple osteoporotic spinal fractures were selected for study evaluation.All patients were treated with kyphoplasty.The clinical indicators of the two groups were compared and analyzed.Results:The total effective rate was 94.7%and the complication rate was 5.3%.The height of midline,anterior and posterior vertebral body,Cobb angle,VAS score,ODI score and ADL score of 38 patients before and after treatment were compared,which were significantly better than those before treatment(P<0.05).Conclusion:The clinical effect of kyphoplasty in the treatment of elderly patients with multiple osteoporosis is significant,which can be promoted in all levels of medical institutions. 展开更多
关键词 KYPHOPLASTY OSTEOPOROSIS spinal fracture
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Establishment and validation of standardized animal models of spinal cord injury by normal external force-caused fracture dislocation 被引量:6
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作者 Weibing Shuang Qiang Liu +1 位作者 Shoubin Jiao Yang Yang 《Neural Regeneration Research》 SCIE CAS CSCD 2011年第35期2732-2738,共7页
The duplication of animal models plays a key role in spinal cord injury research; however, there has been limited study into normal, external force-derived fracture dislocation. This study adopted experimental devices... The duplication of animal models plays a key role in spinal cord injury research; however, there has been limited study into normal, external force-derived fracture dislocation. This study adopted experimental devices, designed in-house, to construct standardized ventral and dorsal spinal cord injury animal models of 6 g and 17 g falling from a height of 2, 4, and 10 cm, and 15, 30 or 50 g transversal compression on the spinal cord. The results showed that gradual increases in the degree of histopathological injury led to decreased Tarlov and Basso, Beattie and Bresnahan scores for the behavioral test, and increased Ashworth scores for the hind limb. Furthermore, there was a gradual decline in the slope test in the rats with dorsal spinal cord injury that correlated to increases in the falling substance weight or falling height. Similar alterations were observed in the ventral spinal cord injured rats, proportional to the increase in compression weight. Our experimental findings indicate that the standardized experimental rat models of dorsal and ventral spinal cord injury are stable, reliable and reproducible. 展开更多
关键词 spinal cord injury spinal cord compression animal models external force fracture dislocation behavior HISTOPATHOLOGY
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Management of acute spinal cord injury:A summary of the evidence pertaining to the acute management,operative and non-operative management 被引量:5
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作者 Darren Sandean 《World Journal of Orthopedics》 2020年第12期573-583,共11页
Acute traumatic spinal cord injury is often a lifechanging and devastating event with considerable mortality and morbidity.Over half a million people suffer from traumatic spinal cord injury annually with the majority... Acute traumatic spinal cord injury is often a lifechanging and devastating event with considerable mortality and morbidity.Over half a million people suffer from traumatic spinal cord injury annually with the majority resulting from road traffic accidents or falls.The Individual,societal and economic costs are enormous.Initial recognition and treatment of acute traumatic spinal cord injury are crucial to limit secondary injury to the spinal cord and to provide patients with the best chance of some functional recovery.This article is an overview of the management of the acute traumatic spinal cord injury patient presenting to the emergency department.We review the initial assessment,criteria for imaging and clearing the spine,and evaluate the literature to determine the optimum timing of surgery and the role of non-surgical treatment in patients presenting with acute spinal cord injury. 展开更多
关键词 Traumatic spinal cord injury Acute management spinal fracture Vertebral fracture spinal cord transection Traumatic myelopathy
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A comparison of robot-assisted and fluoroscopy-assisted kyphoplasty in the treatment of multi-segmental osteoporotic vertebral compression fractures 被引量:4
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作者 Qingqing Li Chaoqin Wu +6 位作者 Zhenfei Huang Jiang Cao Jie Chang Guoyong Yin Lipeng Yu Xiaojian Cao Tao Sui 《The Journal of Biomedical Research》 CAS CSCD 2022年第3期208-214,共7页
Osteoporotic vertebral compression fracture(OVCF)has become a major public health issue that becomes more pressing with increasing global aging.Percutaneous kyphoplasty(PKP)is an effective treatment for OVCF.Robot-ass... Osteoporotic vertebral compression fracture(OVCF)has become a major public health issue that becomes more pressing with increasing global aging.Percutaneous kyphoplasty(PKP)is an effective treatment for OVCF.Robot-assisted PKP has been utilized in recent years to improve accuracy and reduce complications.However,the effectiveness of robot-assisted PKP in the treatment of multi-segmental OVCF has yet to be proved.This study was designed to compare the efficacy of robot-assisted and conventional fluoroscopy-assisted multi-segmental PKP.A total of 30 cases with multi-segmental OVCF between April 2019 and April 2021 were included in this study.Fifteen cases were assigned to the robot-assisted PKP group(robot group)and 15 cases to the conventional fluoroscopy-assisted PKP group(conventional fluoroscopy group).The number of fluoroscopic exposures,fluoroscopic dose,operation time,cement leakage rate,visual analog scale(VAS)score,vertebral kyphosis angle(VKA),and height of fractured vertebral body(HFV)were compared between the 2 groups.The number of fluoroscopic exposures,fluoroscopic doses,and cement leakage rates in the robot group were lower than in the conventional fluoroscopy group(P<0.05)while the operative time in the robot group was longer than in the conventional fluoroscopy group(P<0.05).VAS score and VKA were decreased and HFV was increased after surgery in both groups(P<0.05).Therefore,robot-assisted PKP for the treatment of multi-segmental OVCF can reduce the number of fluoroscopic exposures,fluoroscopic doses,and cement leakage compared to conventional treatment.As such,robot-assisted PKP has good application prospects and is potentially more effective in the treatment of multi-segmental OVCF. 展开更多
关键词 spinal fracture percutaneous kyphoplasty ROBOT-ASSISTED
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Comparison of the modified Wiltse’s approach with spinal minimally invasive system and traditional approach for the therapy of thoracolumbar fracture 被引量:7
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作者 Jie Chang Jiang Cao +3 位作者 Ziyan Huang Boyao Wang Tao Sui Xiaojian Cao 《The Journal of Biomedical Research》 CAS CSCD 2020年第5期379-386,共8页
Thoracolumbar fractures are usually treated by open posterior pedicle screw fixation.However,this procedure involves massive paraspinal muscle stripping,inflicting surgical trauma,and prolonged X-ray exposure.In this ... Thoracolumbar fractures are usually treated by open posterior pedicle screw fixation.However,this procedure involves massive paraspinal muscle stripping,inflicting surgical trauma,and prolonged X-ray exposure.In this study,we observed 127 patients with single-segment injury thoracolumbar fractures.Thirty-six patients were treated by the modified Wiltse’s paraspinal approach with minimally invasive channel system,while 91 patients were treated via traditional posterior approach.Operation time,intraoperative blood loss,intraoperative fluoroscopy frequency,screw placement accuracy,visual analogue scale score,and Cobb’s angle of two groups were compared.The X-ray exposure times were notably reduced(4.2±1.6) in the new approach group(P<0.05).The pedicle screw placement accuracy and Cobb’s angle after surgery were similar in the two groups.We conclude that modified Wiltse’s paraspinal approach w ith spinal minimally invasive channel system surgery can significantly reduce the X-ray exposure times and is an alternative therapy for the thoracolumbar fracture. 展开更多
关键词 thoracolumbar fracture Wiltse’s paraspinal approach spinal minimally invasive channel system
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THE OPERATIVE TREATMENT OF SPINAL FRACTURE-DISLOCATION WITHOUT NEUROLOGIC DEFICITS 被引量:5
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作者 仉建国 翁习生 +3 位作者 林进 赵宏 邱贵兴 任玉珠 《Chinese Medical Sciences Journal》 CAS CSCD 2000年第3期183-186,共4页
To evaluate the results of operative treatment of spinal fracture dislocation without neurologic deficits. Methods.Eighteen patients with spinal fracture dislocation were neurologically intact at the time of injury, a... To evaluate the results of operative treatment of spinal fracture dislocation without neurologic deficits. Methods.Eighteen patients with spinal fracture dislocation were neurologically intact at the time of injury, and all were treated operatively. The fracture sites were:8 cases in cervical spine, 3 cases in thoracic spine, and 7 cases in lumbar spine. Eight patients with cervical injuries had variant degrees of forward slide and kyphotic deformity. Of the 10 thoracic and lumbar fractures, one had lateral dislocation, 4 cases with kyphotic deformities, 5 cases with spinal canal compromise averaged 50% (ranging from 40% to 70%). Results.The average period of follow up was 4.4 years with a range of 11 months to 13 years. All the patients returned to full time work. No patient developed neurologic deterioration. Kyphotic deformity was corrected in the 4 cases, and no progressive kyphosis was noted. There was no operation related complication. The averaged post operative hospitalization time was 13 days. Conclusions. Despite the rare incidence of spinal fracture dislocation without neurologic deficits, we suggested that kind of fracture be considered unstable fracture because of its potential risk of delayed neurologic deterioration and kyphotic deformity, and be treated operatively to restore the sagittal alignment and the stability of the spine. 展开更多
关键词 operative treatment spinal fracture dislocation
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Effect of AXIS lateral mass screw-plate internal fixation system on functional recovery of spinal cord in fracture of lower cervical vertebrae 被引量:4
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作者 昌耘冰 尹庆水 +5 位作者 夏虹 吴增晖 徐国洲 张余 权日 章凯 《中国临床康复》 CSCD 2003年第6期998-999,T004,共3页
AIM:To evaluate the methods and results of the AXIS lateral mass screw plate system in the treating of lower cervical spine injury.METHODS:29 cases of lower cervical vertebrae injury were fixed with AXIS system.All of... AIM:To evaluate the methods and results of the AXIS lateral mass screw plate system in the treating of lower cervical spine injury.METHODS:29 cases of lower cervical vertebrae injury were fixed with AXIS system.All of them were followed up for more than 1 year.RESULTS:All cases had a good bone union without malformation.We found no complication of the injury to the vertebral arteries or nerves.There was no loosening of the plate and screw. CONCLUSION:AXIS lateral mass screw plate system has the characteristic of stable,simple and safe and is suitable for the treatment of lower cervical spine injury. 展开更多
关键词 AXIS侧板钢板螺钉 内固定系统 下颈椎骨折脱位 颈髓功能恢复
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Pressure ulcers and acute risk factors in individuals with traumatic spinal fractures with or without spinal cord injuries:A prospective analysis of the National Spinal Column/Cord Injury Registry of Iran(NSCIR-IR)data 被引量:1
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作者 Farzin Farahbakhsh Hossein Rezaei Aliabadi +5 位作者 Vali Baigi Zahra Ghodsi Mohammad Dashtkoohi Ahmad Pour-Rashid James SHarrop Vafa Rahimi-Movaghar 《Chinese Journal of Traumatology》 CAS CSCD 2023年第4期193-198,共6页
Purpose:To identify risk factors for developing pressure ulcers(PUs)in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries(SCIs).Methods:Data were collected prospectively i... Purpose:To identify risk factors for developing pressure ulcers(PUs)in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries(SCIs).Methods:Data were collected prospectively in participating the National Spinal column/Cord Injury Registry of Iran(NSCIR-IR)from individuals with traumatic spinal fractures with or without SCIs,in-clusive of the hospital stay from admission to discharge.Trained nursing staff examined the patients for the presence of PUs every 8 h during their hospital stay.The presence and grade of PUs were assessed according to the European Pressure Ulcer Advisory Panel classification.In addition to PU,following data were also extracted from the NSCIR-IR datasets during the period of 2015-2021:age,sex,Glasgow coma scale score at admission,having SCIs,marital status,surgery for a spinal fracture,American Spinal Injury Association impairment scale(AIS),urinary incontinence,level of education,admitted center,length of stay in the intensive care unit(ICU),hypertension,respiratory diseases,consumption of ciga-rettes,diabetes mellitus and length of stay in the hospital.Logistic regression models were used to es-timate the unadjusted and adjusted odds ratio(OR)with 95%confidence intervals(CI).Results:Altogether 2785 participants with traumatic spinal fractures were included.Among them,87(3.1%)developed PU during their hospital stay and 392(14.1%)had SCIs.In the SCI population,63(16.1%)developed PU during hospital stay.Univariate logistic regression for the whole sample showed that marital status,having SCIs,urinary incontinence,level of education,treating center,number of days in the ICU,age,and Glasgow coma scale score were significant predictors for PUs.However,further analysis by multiple logistic regression only revealed the significant risk factors to be the treating center,marital status,having SCIs,and the number of days in the ICU.For the subgroup of individuals with SCIs,marital status,AIS,urinary incontinence,level of education,the treating center,the number of days in the ICU and the number of days in the hospital were significant predictors for PUs by univariate analysis.After adjustment in the multivariate model,the treating center,marital status(singles vs.marrieds,OR=3.06,95%CI:1.55-6.03,p=0.001),and number of days in the ICU(OR=1.06,95%Cl:1.04-1.09,p<0.001)maintained significance.Conclusions:These data confirm that individuals with traumatic spinal fractures and SCIs,especially single young patients who suffer from urinary incontinence,grades A-D by AIS,prolonged ICU stay,and more extended hospitalization are at increased risk for PUs;as a result strategies to minimize PU development need further refinement. 展开更多
关键词 spinal fractures spinal cord injuries Pressureulcer NSCIR-IR
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Parameters Calibration of the GISSMO Failure Model for SUS301L-MT 被引量:1
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作者 Tao Zhu Haoxu Ding +4 位作者 Chao Wang Yuxin Liu Shoune Xiao Guangwu Yang Bing Yang 《Chinese Journal of Mechanical Engineering》 SCIE EI CAS CSCD 2023年第1期332-343,共12页
With the development of the rail transit industry,more attention has been paid to the passive safety of rail vehicles.Structural damage is one of the main failure behaviors in a rail vehicle collision,but it has been ... With the development of the rail transit industry,more attention has been paid to the passive safety of rail vehicles.Structural damage is one of the main failure behaviors in a rail vehicle collision,but it has been paid little attention to in past research.In this paper,the quasi-static fracture experiments of SUS301L-MT under different stress states were carried out.The mechanical fracture properties of this material were studied,and the corresponding finite element simulation accuracy was improved to guide the design of vehicle crashworthiness.Through the tests,the fracture behavior of materials with wide stress triaxiality was obtained,and each specimen’s fracture locations and fracture strains were determined.Parameters of a generalized incremental stress state dependent damage model(GISSMO)of the material were calibrated,and the model’s accuracy was verified with test results from a 45°shear specimen.The GISSMO failure model accurately reflected the fracture characteristics of the material.The mesh dependency of this model was modified and discussed.The results show that the simulation agrees well with experimental data for the force-displacement curve after correction,but the strain distribution needs to be further studied and improved. 展开更多
关键词 suS301L-MT fracture failure GISSMO model Finite element simulation Stress state
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THORACIC SPINE FRACTURES
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作者 戴力扬 《Chinese Medical Sciences Journal》 CAS CSCD 2001年第4期227-230,共4页
Objective. To investigate the unique characteristics and treatment of thoracic spine fractures. Methods. Seventy seven patients with thoracic spine fractures were retrospectively reviewed. Of these, there were 37 comp... Objective. To investigate the unique characteristics and treatment of thoracic spine fractures. Methods. Seventy seven patients with thoracic spine fractures were retrospectively reviewed. Of these, there were 37 compression fractures, 34 fracture dislocations, 3 burst fractures and 3 burst dislocations. Twenty six patients had a complete lesion of the spinal cord, 14 sustained a neurologically incomplete injury, and 37 were neurologically intact. Fifty three patients were treated nonoperatively and 24 treated operatively. Results. All patients were followed up for 2~15 years. None of the 26 patients with a complete lesion recovered any significant function. Of 37 neurologically intact patients, 13 had local pain although all of them remained normal function. Two of 14 patients with incomplete paraplegia returned to normal, 7 recovered some function and 5 did not recovered. Conclusions. Because of the unique anatomy and biomechanics of the thoracic spine, the classification commonly applied to thoracolumbar fractures is not suitable for thoracic fractures. Fusion and instrumentation are indicated when the fractures are unstable, while patients with incomplete lesion of the spinal cord may be the candidates for supplemented decompression. 展开更多
关键词 thoracic spine fractures spinal cord injuries
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Study on the Value of the Theory of Protection Motivation in the Nursing of Spinal Fracture to the Quality of Life
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作者 Jianping Fan Qi Wang 《Journal of Clinical and Nursing Research》 2021年第5期22-26,共5页
Objective:To analyze the effect of protection motivation theory on the quality of life of patients with spinal fracture.Methods:From August 2019 to September 2020,72 patients with spinal fracture were selected and ran... Objective:To analyze the effect of protection motivation theory on the quality of life of patients with spinal fracture.Methods:From August 2019 to September 2020,72 patients with spinal fracture were selected and randomly divided into two groups.The routine nursing group was the routine nursing group,and the combined nursing with the theory of protective motivation was the dynamic nursing group.Results:The hospitalization time,detumescence time,healing time and muscle strength recovery time of group A were shorter than those of group B(P<0.05).The VAS score and Barthel index score of the dynamic group were better than those of the conventional group(P<0.05);The score of SF-36 in the group A was higher than that in the group B(P<0.05).Conclusions:The application of protection motivation theory in the nursing of patients with spinal fracture can shorten the healing time of fracture,promote the recovery of muscle strength,relieve the pain of fracture,and then improve the ability of daily life and quality of life of patients. 展开更多
关键词 spinal fracture nursing Protection motivation theory Quality of life Application value
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改良后路经椎弓根截骨术治疗陈旧性胸腰椎骨折伴后凸畸形
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作者 杨棋 王达义 +3 位作者 李明 沈天宇 尚晖 郭晓鹏 《脊柱外科杂志》 2024年第4期262-266,277,共6页
创伤性脊柱骨折是临床较为常见的骨折类型,多为高处坠落、交通事故等外力冲击所致,胸腰段(T_(11)~L_(2))是脊柱骨折最常见的区域^([1])。由于骨折椎体终板及椎间隙损伤、骨质严重缺损、骨质疏松、治疗不及时、承重过早、固定不充分等原... 创伤性脊柱骨折是临床较为常见的骨折类型,多为高处坠落、交通事故等外力冲击所致,胸腰段(T_(11)~L_(2))是脊柱骨折最常见的区域^([1])。由于骨折椎体终板及椎间隙损伤、骨质严重缺损、骨质疏松、治疗不及时、承重过早、固定不充分等原因,一部分胸腰椎骨折可发展为陈旧性胸腰椎骨折伴后凸畸形^([2-3])。后凸矫形手术治疗的主要目的是通过截骨矫形及内固定技术,纠正局部后凸畸形,获得理想的胸腰段曲度,重塑脊柱的平衡及稳定性,同时减压受到压迫的脊髓或神经根^([4-5])。后路经椎弓根截骨术(PSO)经椎弓根进入椎体进行截骨,截骨面大,融合率及融合质量高,单节段可矫正30°~40°的后凸畸形^([6])。然而,PSO截骨过程中后柱切除范围较大,远期对脊柱节段稳定性有一定的影响^([7])。 展开更多
关键词 胸椎 腰椎 脊柱骨折 脊柱后凸 截骨术
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分析优质护理在经皮微创手术治疗脊柱压缩骨折患者护理中的应用效果及对睡眠质量的影响 被引量:1
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作者 杨晶 《世界睡眠医学杂志》 2024年第2期429-431,共3页
目的:分析优质护理在经皮微创手术治疗脊柱压缩骨折患者护理中的应用效果及对睡眠质量的影响。方法:选取2020年6月至2022年6月福建省厦门大学附属第一医院骨科收治的因脊柱压缩骨折入院患者110例作为研究对象,按照随机数字表法分为对照... 目的:分析优质护理在经皮微创手术治疗脊柱压缩骨折患者护理中的应用效果及对睡眠质量的影响。方法:选取2020年6月至2022年6月福建省厦门大学附属第一医院骨科收治的因脊柱压缩骨折入院患者110例作为研究对象,按照随机数字表法分为对照组和观察组,每组55例。对照组患者给予常规护理干预,观察组患者应用个案管理理念指导下的优质护理干预。采用视觉模拟评分法(VAS)比较2组患者的疼痛感受,采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后的睡眠质量,并比较2组患者不良反应的发生率。结果:术前、术后3 d及出院后1个月,观察组患者VAS、PSQI评分显著低于对照组,差异均有统计学意义(均P<0.05);住院及随访期间,2组患者不良事件发生率相近,差异无统计学意义(P>0.05),观察组患者再骨折率显著低于对照组,差异有统计学意义(P<0.05)。结论:个案管理理念指导下的优质护理用于微创手术治疗的脊柱压缩骨折患者可实现有效镇痛,提高患者的睡眠质量,加快患者的康复进程,并有效降低再骨折发生风险,建议临床推广应用。 展开更多
关键词 优质护理 微创手术 脊柱压缩骨折 睡眠质量 不良事件 骨折再发生率
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弯角椎体成形术与单侧椎体成形术治疗老年脊柱压缩骨折疗效比较
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作者 范小波 赵晨阳 +3 位作者 赵松涛 安彪 刘晖 刘睿鑫 《新乡医学院学报》 CAS 2024年第10期941-945,共5页
目的比较弯角椎体成形术与单侧椎体成形术治疗老年脊柱压缩骨折的疗效。方法选择2018年1月至2021年1月邯郸市第一医院骨科收治的122例老年脊柱压缩骨折患者为研究对象,按照手术方法将患者分为对照组和观察组,每组61例。对照组患者采用... 目的比较弯角椎体成形术与单侧椎体成形术治疗老年脊柱压缩骨折的疗效。方法选择2018年1月至2021年1月邯郸市第一医院骨科收治的122例老年脊柱压缩骨折患者为研究对象,按照手术方法将患者分为对照组和观察组,每组61例。对照组患者采用单侧椎体成形术,观察组患者采用弯角椎体成形术。比较2组患者手术时间、术中出血量和骨水泥注射量、骨水泥分布、骨水泥漏出情况、脊柱-骨盆参数、视觉模拟评分(VAS)、Barthel指数评分以及并发症发生情况。结果2组患者手术时间、术中出血量和骨水泥注射量比较差异无统计学意义(P>0.05)。2组患者Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级骨水泥分布占比比较差异无统计学意义(P>0.05);观察组患者Ⅰ级和Ⅱ级骨水泥分布总占比显著高于对照组(P<0.05)。观察组骨水泥漏出发生率显著低于对照组(P<0.05)。术前,2组患者矢状面平衡、胸椎后凸角、骨盆倾斜角、腰椎前凸角、骶骨倾斜角比较差异无统计学意义(P>0.05)。术后2组患者矢状面平衡、胸椎后凸角、骨盆倾斜角显著低于术前,且观察组患者矢状面平衡、胸椎后凸角、骨盆倾斜角显著低于对照组(P<0.05);2组患者腰椎前凸角、骶骨倾斜角显著高于术前,且观察组患者腰椎前凸角、骶骨倾斜角显著高于对照组(P<0.05)。术前,2组患者VAS评分、Barthel指数比较差异无统计学意义(P>0.05)。术后3个月,2组患者VAS评分显著低于术前,Barthel指数显著高于术前(P<0.05);观察组患者Barthel指数显著高于对照组(P<0.05),2组患者VAS评分比较差异无统计学意义(P>0.05)。治疗期间,观察组患者有1例发生椎管外血肿,并发症发生率为1.64%(1/61);对照组患者有2例发生椎管外血肿,1例发生切口感染,并发症发生率为4.92%(3/61)。2组患者的并发症发生率比较差异无统计学意义(χ^(2)=1.034,P=0.309)。结论与单侧椎体成形术比较,弯角椎体成形术用于治疗老年脊柱压缩骨折患者骨水泥分布效果较好,能够显著改善患者脊柱平衡状态,提高术后生活质量。 展开更多
关键词 脊柱 压缩骨折 弯角椎体成形术 单侧椎体成形术 脊柱-骨盆参数 骨水泥
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