Objective To assess the outcomes of navigationguided posterior fixation plus transpedicular vertebroplasty for thoracolumbar fractures.Methods From June,2005 through March,2009,30 patients with thoracolumbar fracture
Anterior lumbar interbody fusion （ALiF） followed by posterior pedicle screw fixation （PSF） in a second procedure is mostly used to implement lumbar spine fusion. ALIF followed by an- terior lumbar screw-plate has ...Anterior lumbar interbody fusion （ALiF） followed by posterior pedicle screw fixation （PSF） in a second procedure is mostly used to implement lumbar spine fusion. ALIF followed by an- terior lumbar screw-plate has a lot of advantages, but its biomechanical stability requires confirma- tion. This study evaluated the biomechanical stability of a novel anterior lumbar locked screw-plate （ALLSP） by comparison with posterior lumbar PSF. Twelve fresh human cadaveric lumbar speci- mens （L4-L5） were assigned to four groups： ALIF^PSF group, ALIF＋ALLSP （both fixed） group, ALIF group and an untreated control （both non-fixed） group. The first three groups received implan- tation of a rectangular titanium cage. Tests under axial compression, flexion, extension, lateral bend- ing, or rotation showed that the fixed groups had significantly stronger stability than the non-fixed groups （P=-0.000 for all）. The ALIF＋ALLSP group had significantly greater axial stiffness under ap- plied axial compression and significantly less angular displacement under rotational forces than the ALIF＋PSF group. The angular displacement of the ALIF＋ALLSP group was less under flexion than that of the ALIF＋PSF, and the angular displacement under lateral bending and extension was greater, but these differences were not statistically significant. In summary, the ALLSP conforms to the ante- rior lumbar spine and has good biomechanical stability. It is a reliable choice for enhancing the sta- bility of ALIF.展开更多
Objective: to analyze the clinical effect of posterior internal fixation and fusion in the treatment of patients with thoracolumbar fractures. The cases were selected from 64 patients with spinal thoracolumbar fractur...Objective: to analyze the clinical effect of posterior internal fixation and fusion in the treatment of patients with thoracolumbar fractures. The cases were selected from 64 patients with spinal thoracolumbar fractures who entered our hospital from April 2018 to April 2020 as the focus of this paper. Methods: the required groups were expanded by means of coin tossing. The upper part is the control group and the lower part is the observation group. Each group had 32 patients. The control group needs to use anterior internal fixation to carry out effective corresponding treatment, and the observation group needs to use posterior internal fixation to carry out targeted treatment. At the same time, observe the actual effect of patients in each group in the process of treatment, and compare the progress of surgery in reality. Results: finally, the overall effective rate of the observation group at this stage was (93.75%), which was significantly higher than that of the control group (62.50%). The difference between the data of each group was statistically significant (P < 0.05). The amount of bleeding in the observation group was better than that in the control group. After the operation, the time of hospitalization observation and the time of getting out of bed and moving were better than those in the control group. The difference was statistically significant (P < 0.05). Conclusion: posterior internal fixation and fusion is an ideal treatment for patients with thoracolumbar fractures. It can further improve the basic function of thoracolumbar spine of patients, the area of trauma is also very small, and the recovery time after operation is also short.展开更多
Purpose:Lateral compression(LC)injuries account for more than two-thirds of all pelvic fractures.The goal of surgical treatment is to provide adequate stability and early mobilization.The consensus on posterior fixati...Purpose:Lateral compression(LC)injuries account for more than two-thirds of all pelvic fractures.The goal of surgical treatment is to provide adequate stability and early mobilization.The consensus on posterior fixation of such injuries is strong in the literature;however,the necessity of anterior ring fixation is not clear.Therefore,this study was formulated to determine the practicability of posterior-only fixation in LC injuries.Methods:Between March 2015 and May 2020,all patients with LC type pelvic ring fractures who were admitted and operated upon in a single level 1 trauma center were included in this cross-sectional observational study.Demographic data,co-morbidities,treatment,types of surgical fixation,concomitant injuries and surgeries,surgical complications,length of hospital stay,injury to weight bearing duration,and follow-up period were documented.Functional outcome and quality of life were assessed using Majeed score and SF-36 questionnaire.Non-normally distributed data were presented as median(Q1,Q3)and normally distributed data were presented as mean±standard deviation(SD).Spearman's rank correlation coefficient was used for correlation analysis.Results:A total of 25 patients were included,with a mean age of 29.8 years.All patients were managed operatively with posterior-only fixation.The median Majeed score was 90(76,95).The median physical component summary score was 69.37(38.75,85.62).The median mental component summary score was 63.95(39.25,87.87).There was no significant difference compared to population norms of both physical component summary and mental component summary.Injury to weight bearing time correlated significantly(p=0.002)with Majeed score as well as SF-36 score(p=0.044).No other variable had a significant association with outcomes.Conclusion:Posterior-only fixation is sufficient for fixing LC injuries with up to 80%of cases having good to excellent functional outcomes.However,comparative studies with larger sample sizes are needed for further validation.展开更多
Purpose: Combined anterior and posterior ring (APR) fixation is classically performed in Tile B2 and C1 injuries to achieve superior biomechanical stability.However,the posterior ring (PR) is the main weight bearing p...Purpose: Combined anterior and posterior ring (APR) fixation is classically performed in Tile B2 and C1 injuries to achieve superior biomechanical stability.However,the posterior ring (PR) is the main weight bearing portion that is responsible for weight transmission from the upper parts of the body to the lower limbs through the sacrum and the linea terminalis.It is hypothesized that isolated PR fixation can achieve comparable radiological and clinical outcomes to APR fixation.Therefore,we conducted this study to compare the two fixation principles in managing Tile B2 and C1 injuries.Methods: Our study included 20 patients with Tile B2 injuries and 20 patients with Tile C1 injuries.This study was a randomized control single-blinded study via computerized random numbers with a 1:1 allocation by using random block method.The study was performed at a level one trauma center.A total of 40 patients with Tile B2 and C1 injuries underwent combined APR or isolated PR fixation (Group A and B,respectively).Matta & Tornetta radiological principles and Majeed pelvic scoring system were used for the assessment of primary outcomes and postoperative complications.Secondary outcomes included operative time,amount of blood loss,intraoperative assessment of reduction,need of another operation,length of hospital stay,ability to weight bear postoperatively and pain control metrics.We used studentt-test to compare the difference in means between two groups,and Chi-square test to compare proportions between two qualitative parameters.We set the confidence interval to 95% and the margin of error accepted to 5%.So,p ≤ 0.05 was considered statistically significant.Results: The mean follow-up duration was 18 months.The operative time (mean difference 0.575 h) and the intraoperative blood loss (mean difference 97.5 mL) were lower in Group B.Also,despite the higher frequency of rami displacement before union in the same group,there were no significant differences in terms of radiological outcome (excellent outcome withOR = 2.357),clinical outcome (excellent outcome withOR = 2.852) and postoperative complications assessment (OR = 1.556) at last follow-up.Conclusion: The authors concluded that isolated PR fixation could favorably manage Tile B2 and C1 pelvic ring injuries with Nakatani zone II pubic rami fractures and intact inguinal ligament.Its final radiological and clinical outcomes and postoperative complications were comparable to combined APR fixation,but with less morbidity (shorter operation time,lower amount of blood,and no records of postoperative wound infection).展开更多
文摘Objective To assess the outcomes of navigationguided posterior fixation plus transpedicular vertebroplasty for thoracolumbar fractures.Methods From June,2005 through March,2009,30 patients with thoracolumbar fracture
基金supported by the Chongqing Key Tech nologies R&D Program(CSTC,No.2010AB5118-4)
文摘Anterior lumbar interbody fusion （ALiF） followed by posterior pedicle screw fixation （PSF） in a second procedure is mostly used to implement lumbar spine fusion. ALIF followed by an- terior lumbar screw-plate has a lot of advantages, but its biomechanical stability requires confirma- tion. This study evaluated the biomechanical stability of a novel anterior lumbar locked screw-plate （ALLSP） by comparison with posterior lumbar PSF. Twelve fresh human cadaveric lumbar speci- mens （L4-L5） were assigned to four groups： ALIF^PSF group, ALIF＋ALLSP （both fixed） group, ALIF group and an untreated control （both non-fixed） group. The first three groups received implan- tation of a rectangular titanium cage. Tests under axial compression, flexion, extension, lateral bend- ing, or rotation showed that the fixed groups had significantly stronger stability than the non-fixed groups （P=-0.000 for all）. The ALIF＋ALLSP group had significantly greater axial stiffness under ap- plied axial compression and significantly less angular displacement under rotational forces than the ALIF＋PSF group. The angular displacement of the ALIF＋ALLSP group was less under flexion than that of the ALIF＋PSF, and the angular displacement under lateral bending and extension was greater, but these differences were not statistically significant. In summary, the ALLSP conforms to the ante- rior lumbar spine and has good biomechanical stability. It is a reliable choice for enhancing the sta- bility of ALIF.
文摘Objective: to analyze the clinical effect of posterior internal fixation and fusion in the treatment of patients with thoracolumbar fractures. The cases were selected from 64 patients with spinal thoracolumbar fractures who entered our hospital from April 2018 to April 2020 as the focus of this paper. Methods: the required groups were expanded by means of coin tossing. The upper part is the control group and the lower part is the observation group. Each group had 32 patients. The control group needs to use anterior internal fixation to carry out effective corresponding treatment, and the observation group needs to use posterior internal fixation to carry out targeted treatment. At the same time, observe the actual effect of patients in each group in the process of treatment, and compare the progress of surgery in reality. Results: finally, the overall effective rate of the observation group at this stage was (93.75%), which was significantly higher than that of the control group (62.50%). The difference between the data of each group was statistically significant (P < 0.05). The amount of bleeding in the observation group was better than that in the control group. After the operation, the time of hospitalization observation and the time of getting out of bed and moving were better than those in the control group. The difference was statistically significant (P < 0.05). Conclusion: posterior internal fixation and fusion is an ideal treatment for patients with thoracolumbar fractures. It can further improve the basic function of thoracolumbar spine of patients, the area of trauma is also very small, and the recovery time after operation is also short.
文摘Purpose:Lateral compression(LC)injuries account for more than two-thirds of all pelvic fractures.The goal of surgical treatment is to provide adequate stability and early mobilization.The consensus on posterior fixation of such injuries is strong in the literature;however,the necessity of anterior ring fixation is not clear.Therefore,this study was formulated to determine the practicability of posterior-only fixation in LC injuries.Methods:Between March 2015 and May 2020,all patients with LC type pelvic ring fractures who were admitted and operated upon in a single level 1 trauma center were included in this cross-sectional observational study.Demographic data,co-morbidities,treatment,types of surgical fixation,concomitant injuries and surgeries,surgical complications,length of hospital stay,injury to weight bearing duration,and follow-up period were documented.Functional outcome and quality of life were assessed using Majeed score and SF-36 questionnaire.Non-normally distributed data were presented as median(Q1,Q3)and normally distributed data were presented as mean±standard deviation(SD).Spearman's rank correlation coefficient was used for correlation analysis.Results:A total of 25 patients were included,with a mean age of 29.8 years.All patients were managed operatively with posterior-only fixation.The median Majeed score was 90(76,95).The median physical component summary score was 69.37(38.75,85.62).The median mental component summary score was 63.95(39.25,87.87).There was no significant difference compared to population norms of both physical component summary and mental component summary.Injury to weight bearing time correlated significantly(p=0.002)with Majeed score as well as SF-36 score(p=0.044).No other variable had a significant association with outcomes.Conclusion:Posterior-only fixation is sufficient for fixing LC injuries with up to 80%of cases having good to excellent functional outcomes.However,comparative studies with larger sample sizes are needed for further validation.
文摘Purpose: Combined anterior and posterior ring (APR) fixation is classically performed in Tile B2 and C1 injuries to achieve superior biomechanical stability.However,the posterior ring (PR) is the main weight bearing portion that is responsible for weight transmission from the upper parts of the body to the lower limbs through the sacrum and the linea terminalis.It is hypothesized that isolated PR fixation can achieve comparable radiological and clinical outcomes to APR fixation.Therefore,we conducted this study to compare the two fixation principles in managing Tile B2 and C1 injuries.Methods: Our study included 20 patients with Tile B2 injuries and 20 patients with Tile C1 injuries.This study was a randomized control single-blinded study via computerized random numbers with a 1:1 allocation by using random block method.The study was performed at a level one trauma center.A total of 40 patients with Tile B2 and C1 injuries underwent combined APR or isolated PR fixation (Group A and B,respectively).Matta & Tornetta radiological principles and Majeed pelvic scoring system were used for the assessment of primary outcomes and postoperative complications.Secondary outcomes included operative time,amount of blood loss,intraoperative assessment of reduction,need of another operation,length of hospital stay,ability to weight bear postoperatively and pain control metrics.We used studentt-test to compare the difference in means between two groups,and Chi-square test to compare proportions between two qualitative parameters.We set the confidence interval to 95% and the margin of error accepted to 5%.So,p ≤ 0.05 was considered statistically significant.Results: The mean follow-up duration was 18 months.The operative time (mean difference 0.575 h) and the intraoperative blood loss (mean difference 97.5 mL) were lower in Group B.Also,despite the higher frequency of rami displacement before union in the same group,there were no significant differences in terms of radiological outcome (excellent outcome withOR = 2.357),clinical outcome (excellent outcome withOR = 2.852) and postoperative complications assessment (OR = 1.556) at last follow-up.Conclusion: The authors concluded that isolated PR fixation could favorably manage Tile B2 and C1 pelvic ring injuries with Nakatani zone II pubic rami fractures and intact inguinal ligament.Its final radiological and clinical outcomes and postoperative complications were comparable to combined APR fixation,but with less morbidity (shorter operation time,lower amount of blood,and no records of postoperative wound infection).
