Decompression is the major therapeutic strategy for acute spinal cord injury,but there is some debate about the time window for decompression following spinal cord injury.An important goal and challenge in the treatme...Decompression is the major therapeutic strategy for acute spinal cord injury,but there is some debate about the time window for decompression following spinal cord injury.An important goal and challenge in the treatment of spinal cord injury is inhibiting or reversing secondary injury.Governor Vessel electroacupuncture can improve symptoms of spinal cord injury by inhibiting cell apoptosis and improving the microenvironment of the injured spinal cord.In this study,Governor Vessel electroacupuncture combined with decompression at different time points was used to treat acute spinal cord injury.The rat models were established by inserting a balloon catheter into the atlanto-occipital space.The upper cervical spinal cord was compressed for 12 or 48 hours prior to decompression.Electroacupuncture was conducted at the acupoints Dazhui（GV14） and Baihui（GV 20）（2 Hz,15 minutes） once a day for 14 consecutive days.Compared with decompression alone,hind limb motor function recovery was superior after decompression for 12 and 48 hours combined with electroacupuncture.However,the recovery of motor function was not significantly different at 14 days after treatment in rats receiving decompression for 12 hours.Platelet-activating factor levels and caspase-9 protein expression were significantly reduced in rats receiving electroacupuncture compared with decompression alone.These findings indicate that compared with decompression alone,Governor Vessel electroacupuncture combined with delayed decompression（48 hours） is more effective in the treatment of upper cervical spinal cord injury.Governor Vessel electroacupuncture combined with early decompression（12 hours） can accelerate the recovery of nerve movement in rats with upper cervical spinal cord injury.Nevertheless,further studies are necessary to confirm whether it is possible to obtain additional benefit compared with early decompression alone.展开更多
Objective: to study and analyze the clinical value of posterolateral anterior spinal canal decompression combined with injured vertebral internal fixation in the treatment of thoracolumbar burst fracture. Methods: for...Objective: to study and analyze the clinical value of posterolateral anterior spinal canal decompression combined with injured vertebral internal fixation in the treatment of thoracolumbar burst fracture. Methods: forty patients with thoracolumbar burst fractures admitted to our hospital from April 2018 to December 2020 were randomly divided into study group and control group with 20 cases in each group. The control group was treated with short-segment minimally invasive internal fixation combined with injured vertebral bone graft, and the study group was treated with posterior approach anterior spinal canal decompression combined with injured vertebral internal fixation. The perioperative conditions, postoperative vertebral height, endplate angle and bony fusion of the two groups were evaluated and compared. Results: the operation time of the study group was shorter than that of the control group, and the amount of hemorrhage was less than that of the control group. At the stage of 12 months after operation, the height of the vertebral body in the study group was higher than that of the control group, and the endplate angle was smaller than that of the control group. The difference was statistically significant (P < 0.05). There was no significant difference in the osseous fusion between the two groups (P > 0.05). Conclusion: posterior anterolateral spinal canal decompression combined with internal fixation for thoracolumbar burst fractures has less intraoperative bleeding, which can reduce the risk of vertebral height loss and vertebral deformity on the basis of ensuring the effect of bony fusion.展开更多
Objective To study the efficiacy and safety of transfacet approach decompression to treat thoracic spinal stenosis caused by anterior compression. Methods Thirty-three patients with thoracic spinal stenosis caused by ...Objective To study the efficiacy and safety of transfacet approach decompression to treat thoracic spinal stenosis caused by anterior compression. Methods Thirty-three patients with thoracic spinal stenosis caused by anterior展开更多
Objective To investigate the surgical techniqueand efficiency of the "Cave-in" 360° circumferential decompression for thoracic spinal stenosis(TSS)with ossification of posterior longitudinal ligament(OP...Objective To investigate the surgical techniqueand efficiency of the "Cave-in" 360° circumferential decompression for thoracic spinal stenosis(TSS)with ossification of posterior longitudinal ligament(OPLL).Methods From October 2005 to展开更多
BACKGROUND Thoracic ossification of the posterior longitudinal ligament(T-OPLL)is caused by the ossified posterior longitudinal ligament occupying space in the spinal canal,which causes compression of the thoracic spi...BACKGROUND Thoracic ossification of the posterior longitudinal ligament(T-OPLL)is caused by the ossified posterior longitudinal ligament occupying space in the spinal canal,which causes compression of the thoracic spinal cord.Surgical treatment is difficult,risky and complicated;thus,clinical treatment is difficult at present.CASE SUMMARY A case of severe multi-segmental T-OPLL treated with thoracic anterior controllable antedisplacement fusion(TACAF)is reported,including the surgical procedures and analysis of the clinical data.The modified-Japanese Orthopaedic Association score in this patient was 4 before surgery,and it was raised to 9 after the operation.The symptoms of spinal canal compression were subsequently relieved.Three months after surgery,digital radiography showed good healing and recovery of limb sensory function.CONCLUSION This case report suggests that TACAF is feasible for the treatment of long-segment T-OPLL,and has the advantages of low risk and reduced trauma.However,this operation still needs to be verified by clinical research with a larger sample size.展开更多
基金supported by the Capital Characteristic Clinical Application Research Projects of Beijing Municipal Science and Technology Plan of China,No.Z16110000516009
文摘Decompression is the major therapeutic strategy for acute spinal cord injury,but there is some debate about the time window for decompression following spinal cord injury.An important goal and challenge in the treatment of spinal cord injury is inhibiting or reversing secondary injury.Governor Vessel electroacupuncture can improve symptoms of spinal cord injury by inhibiting cell apoptosis and improving the microenvironment of the injured spinal cord.In this study,Governor Vessel electroacupuncture combined with decompression at different time points was used to treat acute spinal cord injury.The rat models were established by inserting a balloon catheter into the atlanto-occipital space.The upper cervical spinal cord was compressed for 12 or 48 hours prior to decompression.Electroacupuncture was conducted at the acupoints Dazhui（GV14） and Baihui（GV 20）（2 Hz,15 minutes） once a day for 14 consecutive days.Compared with decompression alone,hind limb motor function recovery was superior after decompression for 12 and 48 hours combined with electroacupuncture.However,the recovery of motor function was not significantly different at 14 days after treatment in rats receiving decompression for 12 hours.Platelet-activating factor levels and caspase-9 protein expression were significantly reduced in rats receiving electroacupuncture compared with decompression alone.These findings indicate that compared with decompression alone,Governor Vessel electroacupuncture combined with delayed decompression（48 hours） is more effective in the treatment of upper cervical spinal cord injury.Governor Vessel electroacupuncture combined with early decompression（12 hours） can accelerate the recovery of nerve movement in rats with upper cervical spinal cord injury.Nevertheless,further studies are necessary to confirm whether it is possible to obtain additional benefit compared with early decompression alone.
文摘Objective: to study and analyze the clinical value of posterolateral anterior spinal canal decompression combined with injured vertebral internal fixation in the treatment of thoracolumbar burst fracture. Methods: forty patients with thoracolumbar burst fractures admitted to our hospital from April 2018 to December 2020 were randomly divided into study group and control group with 20 cases in each group. The control group was treated with short-segment minimally invasive internal fixation combined with injured vertebral bone graft, and the study group was treated with posterior approach anterior spinal canal decompression combined with injured vertebral internal fixation. The perioperative conditions, postoperative vertebral height, endplate angle and bony fusion of the two groups were evaluated and compared. Results: the operation time of the study group was shorter than that of the control group, and the amount of hemorrhage was less than that of the control group. At the stage of 12 months after operation, the height of the vertebral body in the study group was higher than that of the control group, and the endplate angle was smaller than that of the control group. The difference was statistically significant (P < 0.05). There was no significant difference in the osseous fusion between the two groups (P > 0.05). Conclusion: posterior anterolateral spinal canal decompression combined with internal fixation for thoracolumbar burst fractures has less intraoperative bleeding, which can reduce the risk of vertebral height loss and vertebral deformity on the basis of ensuring the effect of bony fusion.
文摘Objective To study the efficiacy and safety of transfacet approach decompression to treat thoracic spinal stenosis caused by anterior compression. Methods Thirty-three patients with thoracic spinal stenosis caused by anterior
文摘Objective To investigate the surgical techniqueand efficiency of the "Cave-in" 360° circumferential decompression for thoracic spinal stenosis(TSS)with ossification of posterior longitudinal ligament(OPLL).Methods From October 2005 to
文摘BACKGROUND Thoracic ossification of the posterior longitudinal ligament(T-OPLL)is caused by the ossified posterior longitudinal ligament occupying space in the spinal canal,which causes compression of the thoracic spinal cord.Surgical treatment is difficult,risky and complicated;thus,clinical treatment is difficult at present.CASE SUMMARY A case of severe multi-segmental T-OPLL treated with thoracic anterior controllable antedisplacement fusion(TACAF)is reported,including the surgical procedures and analysis of the clinical data.The modified-Japanese Orthopaedic Association score in this patient was 4 before surgery,and it was raised to 9 after the operation.The symptoms of spinal canal compression were subsequently relieved.Three months after surgery,digital radiography showed good healing and recovery of limb sensory function.CONCLUSION This case report suggests that TACAF is feasible for the treatment of long-segment T-OPLL,and has the advantages of low risk and reduced trauma.However,this operation still needs to be verified by clinical research with a larger sample size.
