Abstract:

[Objective] To evaluate the clinical outcomes of digital-assistance percutaneous vertebroplasty (PVP) for thoracolumbar os- teoporotic vertebral compression fractures (OVCF) . [Methods] From January 2019 to August 2020, 73 patients with single-segment OVCF were enrolled in this study and divided into two groups by random number method. Among them, 36 patients underwent 3D digital modeling and data measurement before surgery, and underwent digital-assistance (DA) unilateral PVP, while the other 37 patients received the tradi- tional PVP. Perioperative, follow-up and imaging data of the two groups were compared. [Results] All the patients in both groups had opera- tion completed successfully without serious complications. The DA group proved significantly superior to the traditional group in terms of operative time, puncture time and intraoperative fluoroscopy times (P<0.05) , despite of the fact that no significant differences were found in terms of the amount of bone cement injected, the incidence of bone cement leakage, time to resume walking and the full weight-bearing ac- tivity between the two groups (P<0.05) . As time went during follow up period lasted for (19.33±4.65) months, VAS and ODI scores de- creased significantly (P<0.05) , while JOA scores increased significantly in both groups (P<0.05) . At 3 days after operation, the DA group was superior to the traditional group in VAS, ODI and JOA scores (P<0.05) . Radiographically, the anterior vertebral height increased signif- icantly (P<0.05) , whereas the local Cobb angle decreased significantly in both groups postoperatively compared with those before operation (P<0.05) . However, there were no significant differences in aforesaid radiographic items between the two groups at any corresponding time points (P>0.05) . [Conclusion] Compared with traditional PVP, the digital-assistance PVP does improve the precision of thoracolumbar percutaneous pedicle puncture, reduce the number of X-ray fluoroscopy and operation time, and has better clinical results.

Abstract:[Objective] To observe the long-term kinematic consequences, especially variation of the center of rotation (COR) of the in- volved segment, of single-segment Bryan cervical disc replacement (CDR) . [Methods] A retrospective study was conducted on 38 patients who received single-segment Bryan CDR in our hospital from January 2010 to March 2013, and had range of motion (ROM) at the affected segment ＞ 5° at the latest follow-up. Clinical and radiographic documents were analyzed. [Results] All the 38 patients had operation per- formed successfully without serious complications. The follow-up period lasted for 84 to 118 months, with a mean of (93.97±9.67) months. The symptoms related to cervical spondylosis were significantly improved at the latest follow-up. The JOA score significantly increased (P＜ 0.05) , whereas the NDI score and VAS scores for neck pain and upper limb pain significantly decreased postoperatively compared with those preoperatively (P＜0.05) . By the time of latest follow-up, no exacerbation of symptoms, readmission, or revision surgery had occurred in anyone of the patients. Radiographically, overall cervical curvature and involved segmental curvature significantly increased (P＜0.05) , whereas the overall ROM, involved segmental ROM, upper adjacent ROM and lower adjacent ROM, COR-X and COR-Y remained un- changed at the latest follow-up compared with those before operation (P＞0.05) . As correlation analysis, the COR-Y was significantly nega- tively correlated with the ROM (P＜0.05) , and the translational distance of the involved segment at the latest follow-up (P＜0.05) . In addi- tion, the ROM was significantly positively correlated with translational distance of the same segment (r=0.772, P＜0.05) . The COR-Y had no significant correlation with other clinical and imaging items (P＞0.05) , while COR-X had no correlation with any parameters (P＞0.05) . [Conclusion] The clinical and radiographic results of single-segment Bryan CDR do still be satisfactory more than 7 years after operation. The relationships between COR-Y, translational displacement and ROM of the involved segment at the last follow-up is similar to that of normal cervical segment, which is conductive to remaining motion in physiologic manner.

Abstract:[Objective] To compare the clinical efficacy and paraspinal muscles injury of unilateral biportal endoscopy (UBE) and open lumbar interlaminar fenestration decompression for the treatment of degenerative lumbar spinal stenosis (DLSS) . [Methods] A retrospec- tive study was done on a total of 68 patients who received surgical treatment for DLSS in our department from October 2019 to October 2020. Based on doctor-patient communication, 36 patients were treated with UBE, while the remaining 32 patients were treated with open lumbar interlaminar fenestration decompression. The perioperative, follow- up and imaging data were compared between the two groups. [Results] All patients in both groups had operations performed successfully without serious complications. The UBE group proved signifi- cantly superior to the open group in terms of incision length, postoperative walking and the hospital stay (P＜0.05) . In addition, the UBE group had significantly lower creatine kinase (CK) than the open group at 1 day postoperatively (P＜0.05) , whereas which became not statis- tically significant at 7 days postoperatively (P＞0.05) . The VAS and ODI scores decreased significantly (P＜0.05) , whereas the JOA score in- creased in both groups over time (P＜0.05) , which in the UBE group proved significantly superior to the open group at 7 days after opera- tion, and became not statistically significant between the two groups at 3 months after operation and latest follow-up (P＞0.05) . Radiographi- cally, although the UBE group had significantly less spinal canal area than the open group (P＜0.05) , the former had significantly greater paravertebral muscle cross-sectional area, whereas associated with significantly less paravertebral muscle atrophy than the latter at the lat- est follow up (P＜0.05) . [Conclusion] The UBE has the advantages of quite less trauma to paravertebral muscles, while faster postoperative recovery for treatment of DLSS, and achieves the similar clinical outcome as open surgery.

Abstract:[Objective] To analyze the hidden blood loss in oblique lumbar interbody fusion (OLIF) for degenerative lumbar diseases, and the factors related to it. [Methods] A retrospective analysis was performed on 45 patients who received OLIF for degenerative lumbar diseases in our hospital from May 2016 to December 2019. The hidden blood loss was calculated, and the factors related to hidden blood loss were screened out by stratification factors and multiple linear stepwise regression analysis. [Results] All patients had operation completed success- fully, with operation time of (183.36±62.53) min, the dominant blood loss of (120.78±108.31) ml. The mean total blood loss was (758.95± 393.05) ml while the hidden blood loss was (638.17±371.75) ml, accounting for (81.09±16.54) % of the total blood loss. There were no statisti- cally significant differences in hidden blood loss in terms of stratification of age, sex, BMI, number of surgical levels, diabetes, hypertension, spinal deformity, and bone graft type (P＜0.05) . However, there were statistically significant differences in hidden blood loss by stratifications of operation time, learning curve, and whether or not tranexamic acid used (P＜0.05) . As results of multiple linear stepwise regression, the learn- ing curve (number of surgical sequence) (B=-12.171, P=0.002) and the amount of tranexamic acid used (B=-246.090, P=0.015) were signifi- cantly negatively correlated with the amount of hidden blood loss. [Conclusion] There is considerable amount of hidden blood loss in OLIF for degenerative lumbar diseases, which is closely related to learning curve and tranexamic acid usage, should be paid attention to by clinicians.

Abstract:[Objective] To explore the clinical outcomes of computer-aided design and computer-aided manufacture (CAD/CAM) or- thoses for correction of adolescent idiopathic scoliosis (AIS) . [Methods] From January 2018 to December 2019, a total of 62 patients who suffered from AIS with scoliotic Cobb angle of 25°~50° were randomly divided into two groups. Among them, 31 patients were treated with CAM orthoses, while the other 31 patients were treated with plaster mold manufactured orthoses. The clinical and imaging data were com- pared between the two groups. [Results] Of the 62 patients, 60 patients were followed up for (24.90±4.26) months on an average. No compli- cations such as skin abrasion and dyspnea occurred in any patients during the wearing period of orthosis. The sitting height and SF- 36 scores increased significantly (P＜0.05) . The body height increased in both groups, but the difference in CAM group was statistically signifi- cant (P＜0.05) , while not statistically significant in plaster group (P＞0.05) . At any corresponding time points, there were no significant dif- ferences in height, sitting height and vertical offset between the two groups (P＞0.05) . However, the CAM group had significantly better SF36 score than the plaster group at 1 year after treatment and the latest follow-up (P＜0.05) . Radiographically, the scoliotic Cobb angle de- creased significantly over time in both groups (P＜0.05) . At any corresponding time points, there were no significant differences in Cobb an- gle, C7-CSVL and AVT between the two groups (P＞0.05) . [Conclusion] Both CAM and plaster mold manufactured orthoses are effective treatments for correction of adolescent idiopathic scoliosis. By comparison, the CAM orthoses are considerably superior to the plaster mold manufactured orthoses in term of fitness to patients.

Abstract:[Objective] To summarize the type and the incidence of complications of SuperPath approach for total hip arthroplasty (THA) using the method of meta-analysis for a single rate. [Methods] The databases, such as CNKI, Wanfang Database and PubMed, were searched for papers on SuperPath approach for THA published at home and abroad from January 2016 to January 2021. After strictly evalu- ating the quality of the included studies, and extracting data, a meta-analysis was conducted by using the Meta package of R software. [Results] A total of 12 articles were included，involving a total of 967 patients. The main complications of SuperPath approach for THA proved the hip dislocation (0.99%, 95%CI: 0.00~0.02) , deep vein thrombosis (1.06%, 95%CI: 0.01~0.06) , infection (2.31%, 95% CI: 0.01~0.05)，periprosthetic fracture (1.13%, 95%CI: 0.00~0.02) . [Conclusion] SuperPath approach for total hip arthroplasty has relatively less complications，including hip dislocation, deep vein thrombosis and infection, which should be paid attention to prevent.

Abstract:Subtalar arthroereisis implant is a prosthesis that is implanted into the tarsal sinus to limit the movement of subtalar joint. With the deepening of the understanding of subtalar implant, its clinical application has expanded from flexible flatfoot to subtalar joint dis- location and posterior tibial tendon dysfunction, and the operation mode has also expanded from single subtalar arthroereisis to subtalar sta- bilization. We searched the literature on subtalar arthroereisis implant and reviewed the new progress in subtalar arthroereisis implant clas- sification, biomechanics, clinical application and complications.

Abstract:To summarize the latest progress in the treatment of acute proximal fifth metatarsal fractures, in order to provide best choice for clinical treatment. The domestic and foreign literatures related to acute proximal fifth metatarsal fractures were reviewed and summa- rized to make a detailed introduction of the new conceptions and methods on the treatment. Different methods of treatment should be adopt- ed based on the different zones of fractures. The fractures involving zone I and II should be treated conservatively with rehabilitation thera- py, while the fractures involving Zone III should be treated surgically with close reduction and intramedullary screw fixation as the first choice. The treatment plans should be made alternatively according to the different fracture types and the needs of individual patients.

Abstract:Shoulder disorders that cause shoulder pain seriously affect patients' daily life and work capacity. Rotator cuff tear (RCT) is one of the most common shoulder diseases leading shoulder pain, with higher prevalence in the elderly. However, the etiology of RCT is not clear at present. Some studies have found that patients with RCT have scapular dyskinesis (SD) . In recent years, more and more studies have begun to pay attention to the relationship between SD and RCT, and therapy aiming to SD can reduce the symptoms of shoulder pain in patients with RCT and improve their function. Therefore, understanding the SD may be of great significance to the prevention, diagnosis and treatment of RCT.

Abstract:[Objective] To observe the effects of alendronate (AL) and teriparatide (TPTD) on scoliosis progression in bipedal mice. [Methods] Forty-five 4-week-old female C57BL/6J mice received bilateral forelimb amputation to establish a scoliosis model of bipedal mice. The animals were randomly divided into 3 groups with 15 mice in each group, including the control group, AL group and TPTD group, which were given normal saline, AL and TPTD respectively for 12 weeks. The imaging check and bone mineral density (BMD) assay were conducted. [Results] The Cobb angle increased significantly over time in all the 3 groups (P＜0.05) . At 8 and 12 weeks after amputation, the Cobb angle of scoliosis was ranked in descending order of control group ＞AL group ＞TPTD group with statistically significant overall dif- ference (P＞0.05) , which in the control group was significantly higher than that of AL group and TPTD group (P＜0.05) , whereas there was no significant difference between AL group and TPTD group (P＞0.05) . In addition, the BMD significantly increased over time in all three groups (P＜0.05) , which ranked from low to high at 4, 8 and 12 weeks after amputation were as follows: control group 0.05) . [Conclusion] Early administration of AL and TPTD in bipedal mice scoliosis model can effectively reduce Cobb angle and increase spinal BMD in growing mice.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of 3D microscope assisted pedicle screw fixation for atlantoaxial fracture and dislocation. [Methods] From January 2018 to June 2020, 11 patients received 3D microscope assisted pedicle screw fixation for atlantoaxial fracture and dislocation. The length and angle of pedicular screw placement were measured by PACS system before operation. After posterior atlantoaxial structures were exposed through posterior cervical approach, the operation field was ac- curately hemostatic under 3D microscope. The entry point of atlantoaxial screw was opened by grinding drill, and the pedicle screw was placed and connected with titanium rods on both sides, which were adjusted to reduce the atlantoaxial alignment under fluoroscopy. Finally, bone autografts in granule were implanted behind the atlantoaxial vertebrae. [Results] All patients had operation completed successfully with 44 pedicle screws placed totally, and 42 screws inserted in 0 and I grades with accuracy of 95.45%. The VAS score decreased signifi- cantly from (6.36±1.63) to (1.27±1.10) (P＜0.05) , whereas the JOA score increased significantly from (11.91±2.84) preoperatively to (15.55± 1.51) at 1 year after operation. [Conclusion] This 3D microscopic assisted pedicle screw fixation is an effective treatment for atlantoaxial fracture and dislocation, with improving accuracy of intraoperative screw placement and operation safety.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of a modified minimally invasive repair of acute closed Achilles tendon rupture. [Methods] From January 2018 to January 2020, 35 patients underwent modified minimally invasive repair of acute closed Achilles tendon rupture. A median longitudinal incision about 1.0~1.5 cm in length was made at the top of the broken Achilles tendon. The proximal end of Achilles tendon was pulled out with a U-shaped oval forceps and then the distal end of Achilles ten- don was pulled out at plantar flexion of the anklet. The modified Bunnell suture technique was used to repair the broken Achilles tendon, and then the torn peritendinous tissue sutured, the incision closed in layers. [Results] All the patients had operation performed smoothly with operation time of (33.14±3.51) min, total incision length of (2.33±0.44) cm, and excellent incision healing. At the latest follow up last- ed for (12.52±1.41) months, the plantar-dorsal flexion range of motion significantly increased compared with that before operation, with AO- FAS score of (92.62±2.73) . According to Amer-Lindholm criterion, the clinical outcomes were marked as excellent in 29 cases, good in 6 cases, with excellent and good rate of 100%. [Conclusion] This modified minimally invasive repair of acute closed Achilles tendon rupture has the advantages of small incision, fewer complications, good functional recovery and low treatment cost.

Abstract:[Objective] To introduce the surgical techniques and preliminary clinical results of simultaneous superficial medial collat- eral ligament (sMCL) and posterior oblique ligament (POL) reconstructions with a half peroneal tendon autograft for old medial collateral lig- ament (MCL) injuries. [Methods] A total of 14 patients had sMCL and POL reconstructed simultaneously with a half peroneal longus ten- don autograft. The anterior half of the peroneal longus tendon was harvested to prepare the graft. After establishing the femoral and tibial bone tunnels respectively, the graft was folded, pulled into the femoral tunnel and fixed with a loop plate. The shorter and longer free ends were pulled into the tibial tunnels of sMCL and POL respectively, and tightened. The two end sutures were tied and enhanced by external row screws. [Results] All the 14 patients were followed up for 6~26 months, with an average of (12.57±6.04) months, except 1 patient. At the latest follow-up, the Lysholm, IKDC and VAS scores were significantly improved compared with those preoperatively (P＜0.05) . Radio- graphically, the inner joint space at 0°and 30° flexion under valgus stress significantly decreased postoperatively compared with those pre- operatively (P＜0.05) . [Conclusion] Simultaneous sMCL and POL reconstructions with a half peroneal tendon autograft does restore the sta- bility of knee joint and considerably improve the function of the knee joint for old MCL injuries, with advantages of small incision, quick postoperative recovery and high patient satisfaction.

Abstract:[Objective] To evaluate the clinical outcomes of arthroscopic release for carpal tunnel syndrome. [Methods] A retrospec- tive study was conducted on 28 patients who received arthroscopic release for carpal tunnel syndrome, including 5 males and 23 females aged from 46 to 62 years old, with a mean of (53.15±7.89) years. The Boston carpal tunnel questionnaires (BCTQ) , including functional state (FS) and symptom severity (SS) were used to evaluate the clinical outcomes, additionally, electrophysiological examinations, involving latency (Lat) and amplitude (Amp) of motor potential and sensory conduction velocity (SCV) were conducted. [Results] All the 28 patients had surgical procedures performed smoothly in 10 min with blood loss about 1 ml, while without injuries to the blood vessels, nerves and the tendons , and were followed up for 6~12 months. As time went both BCTQ-FS and BCTQ-SS significantly decreased (P＜0.05) . Of them, 1 patient developed greater and lesser thenar muscle atrophy due to nerve entrapment for too long period. The clinical outcomes were marked as excellent in 26 cases, good in 1 case and fair in 1 case, with excellent and good rate of 96.77%. In term of electrophysiological examination, the Lat decreased significantly, whereas the Amp and SCV increased significantly at the latest follow-up compared with those preoperatively (P＜0.05) . [Conclusion] The arthroscopic release of carpal tunnel syndrome has an advantage of smaller trauma, does achieve considerably satisfactory clinical outcomes.

Abstract:[Objective] To investigate the clinical efficacy of anterior cervical discectomy and fusion (ACDF) for cervical spondylosis accompanied by vertigo, and the correlation between the vertigo and cervical imaging parameters. [Methods] A retrospective study was done on 32 patients who received ACDF for cervical spondylosis complicated with vertigo in our hospital from July 2017 to July 2019. The relationships between vertigo and imaging parameters were analyzed. [Results] All patients had surgical procedures completed successful- ly, and followed up for (28.45±2.87) months on an average. At the last follow-up, the DHI score, JOA score, and NDI score were significant- ly improved compared with those before surgery (P＜0.05) . Radiographically, C2~7 lordosis angle, intervertebral space height, and spinal ca- nal area significantly improved postoperatively compared with those before surgery (P＜0.05) , with the average distraction height of the in- tervertebral space of 119.3% compared with the baseline height. As result of correlation analysis, the pre-postoperative variation of DHI score proved significantly positively correlated to pre-postoperative variation of spinal canal area (P＜0.05) . [Conclusion] ACDF surgery does effectively treat cervical spondylosis accompanied with vertigo, with moderately expanded height of the intervertebral space, and in- creased cervical curvature. However, the improvement of vertigo symptoms is positively correlated with the increase of spinal canal area.

Abstract:[Objective] To explore the short-term outcomes of two kinds of decompression and fixation for radioulnar fractures compli- cated with early-stage compartment syndrome. [Methods] From March 2015 to June 2020, 60 patients underwent surgical treatment for ra- dioulnar fractures complicated with early-stage compartment syndrome. According to doctor-patient communication, 29 patients received decompression combined with double plate fixation (DPF group) , while the remaining 31 patients received decompression combined with radial plate and ulnar intramedullary nail fixation (the hybrid group) . The clinical and imaging data of the two groups were compared. [Results] The hybrid group proved significantly superior to the DPF in terms of incision length, operation time, periosteal dissection area, intra- operative blood loss, postoperative drainage, wound closure time and hospital stay (P＜0.05) . The VAS scores significantly decreased over time at early stage after surgery in both groups (P＜0.05) , which in the hybrid group were significantly better than those of the DPF group at 3 and 5 days after surgery (P＜0.05) . The patients were followed up for (13.18±1.63) months on an average, and the hybrid group was signifi- cantly superior to the DPF group in terms of forearm pronation-supernation range of motion (ROM) and DASH scores at 6 months after sur- gery (P＜0.05) . Radiographically, the hybrid group got fracture healing significantly earlier than the DPF group (P＜0.05) . [Conclusion] Compared with double plate, the hybrid fixation is more effective for treatment of radioulnar fractures accompanied with early-stage com- partment syndrome.

Abstract:[Objective] To evaluate the clinical outcomes of mini external fixator for fresh Monteggia fracture in children. [Methods] A total of 12 children with Monteggia fractures were enrolled in this study. Intraoperative fracture reduction and external fixation with a mini frame were conducted in all the children, additionally elbow arthrography intraoperatively was used if necessary to evaluate the reduction, followed by postoperative forearm plaster cast in supination. [Results] All the children were successfully operated without related complica- tions, and were followed up for 6~12 months. The range of motion (ROM) of the elbow flexion-extension and the ROM of forearm rotation were significantly increased at the last follow-up compared with those at 4 weeks after operation (P＜0.05) . According to the Mayo elbow score at the latest follow- up, the clinical outcomes were marked as excellent in 11 cases and good in 1 case, with excellent/good rate of 100%. Radiographically, all the 12 patients achieved satisfactory recovery of humeroradial congruence and ulna alignment after surgery, which remained unchanged until the latest follow-up (P＞0.05) . The X-ray films showed callus formation at fracture site as early as 4 weeks after the operation, with sound fracture healing time on the images ranged from 8 to 12 weeks. [Conclusion] This mini external fixator is an effective treatment for fresh Monteggia fracture in children, with benefits of simplifying operation and minimizing iatrogenic trauma.

Abstract:

[Objective] To explore how to determine whether or not to fix the inferior tibiofibular syndesmosis during open reduction and internal fixation of ankle fractures. [Methods] A total of 26 patients, including 15 males and 11 females, aged 20~67 years with a mean of (47.26±16.03) years, underwent surgical treatment for ankle fractures from February 2016 to June 2020. Intraoperative external rotation test, or fluoroscopic assessment to observe whether the medial joint space was abnormally widened were conducted. If the result was nega- tive, the inferior tibiofibular syndesmosis was not fixed with screws, whereas if positive, the inferior tibiofibular syndesmosis was fixed with screws. [Results] All the 26 patients were successfully operated on without serious complications. According to the consequences of intraop- erative judgment, 12 patients underwent tibiofibular fixation, while the remaining 14 cases did not. The fixed group had significantly greater operative time and intraoperative fluoroscopy times than the non-fixed group (P<0.05) , but there were no significant differences in incision length, intraoperative blood loss and incision healing between the two groups (P>0.05) . All the 26 patients were followed up for more than 12 months. The fixed group resumed walking and full weight-bearing activity significantly later than that of the non-fixed group (P<0.05) . The AOFAS score and dorsal extension-plantar flexion range of motion (ROM) increased significantly in both groups over time postopera- tively (P<0.05) , however there were no significant differences in AOFAS score and ROM between the two groups at corresponding postoper- ative time points (P>0.05) . In terms of radiographic evaluation, the tibiofibular overlap (TFOL) significantly increased, while the tibiofibu- lar clear space (TFCS) significantly decreased postoperatively compared with those preoperatively in both groups (P<0.05) . At the matching time points, there was no significant difference in the above indexes between the two groups (P>0.05) . [Conclusion] Intraoperative external rotation test or fluoroscopic observation of abnormal widening of medial joint space do effectively determine whether to fix the inferior tibio- fibular syndesmosis during open reduction and internal fixation of ankle fractures.

Abstract:[Objective] To evaluate the clinical outcomes of arthroscopic labrum repair for glenolabral articular disruption (GLAD) . [Methods] From January 2011 to December 2018, 12 patients who were all males and aged (21.60±5.22) years on an average underwent ar- throscopic labial repair for GLAD injury. [Results] All patients had the operations performed successfully with operation time of (28.50± 7.50) min, intraoperative blood loss of (32.30±4.20) ml. No complications, such as infection, hemoarthrosis, nerve injury and joint adhesion, happened in anyone of them. All patients were followed up for (13.60±3.65) months on average with the time to resume full weight-bearing activity of (15.70±1.50) weeks. At the last follow-up, the ASES, Constant-Murley and Rowe scores significantly improved compared with those preoperatively (P＜0.05) , but the range of motions, including shoulder forward flexion and upward lift, lateral internal rotation, as well as lateral external rotation in neutral position remained unchanged (P＞0.05) . Radiographic examination showed that the glenohumeral alignment and implants were in good position. [Conclusion] The clinical outcomes of arthroscopic debridement and repair of anterior joint capsule is satisfactory for GLAD.

Abstract:[Objective] To evaluate the clinical efficacy of microscopic resection of lumbar intradural spinal tumors. [Methods] A retro- spective study was conducted on 32 patients who received microscopic resection of lumbar intradural spinal tumors in our department from April 2016 to April 2019. The clinical and imaging data were evaluated. [Results] All the patients were successfully operated without seri- ous complications, while with operative time of (135.35±28.57) min, the intraoperative bleeding of (108.2±12.95) ml, and the postoperative hospital stay of (9.01±2.05) days. At the latest follow-up lasted for (9.03±2.01) months, all of them regained muscle strength to basically normal level, without tumor recurrence or spinal deformity. The VAS and JOA scores, as well as Frankel index for neurological function im- proved significantly over time (P＜0.05) . Radiographic checks showed that the tumors were resected completely in all the patients, and no tumor recurrence or spinal deformity was observed during the follow-up period, with good spinal stability and no significant degenerative changes of the involved spinal segment. [Conclusion] Microscopic resection of lumbar intradural tumors has the advantages of minimizing iatrogenic trauma and improving recovery, and does effectively restore spinal cord function.

Abstract:

[Objective] To compare the clinical outcomes of locking proximal humeral plate (LPHP) versus cannulated screw (CS) fixa- tion for the treatment of glenohumeral dislocation accompanied with humeral greater tuberous fracture. [Methods] From January 2016 to March 2019, 76 patients received open reduction and internal fixation for treatment of glenohumeral dislocation accompanied with humeral greater tuberosity fracture in our hospital. According to the surgical indications, 40 patients were treated with LPHP, while the other 36 pa- tients were with CS. The clinical and imaging consequences were compared between the two groups. [Results] All patients in both groups were operated on successfully without serious complications. The CS group proved significantly superior to LPHP group in terms of opera- tive time, total incision length and intraoperative blood loss (P<0.05) . All patients in both groups were followed up for (18.84±4.31) months on an average. Compared with those 3 months after surgery, the VAS score significantly decreased (P<0.05) , while the abduction and for- ward flexion range of motion (ROM) , as well as Constant-Murley score significantly increased in both groups at the latest follow up (P< 0.05) , additionally, which in the CS group was significantly superior to the LPHP group at 3 months after the operation (P<0.05) . Radio- graphically, the excellent reduction rate in the CS group (61.11%) was significantly higher than that in the LPHP group (52.50%) (P<0.05) . However, there was no significant difference in the fracture healing time between the two groups (P>0.05) . [Conclusion] Both the methods are effective treatment for glenohumeral dislocation accompanied with humeral greater tuberosity fractures, by comparison, the cannulated screw fixation has a benefit of minimizing iatrogenic trauma.