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GUWen-qi, WUCheng-lin, JIANGJian tao, SONGGuo-xun, ZHANGJie-yuan, XUEJian-feng, ZOUJian, SUYan, MEIGuo-hua, MAXin, SHIZhong-min
2025,33(8):673-680, DOI: 10.20184/j.cnki.Issn1005-8478.110463
Abstract:
[Objective] To explore the CT imaging characteristics of tarsometatarsal injuries by a clinical survey. [Methods] A retro-spective study was conducted on CT data of tarsometatarsal injuries taken from May 2017 to October 2018. In addition, the documents re-garding gender, age, classification and injury pattern, associated injuries, characteristics of injuries were recorded and summarized. [Results] A total of 307 patients (309 feet) were enrolled into this study, involving 200 males and 107 females. In term of age, the tarsometatar-sal injuries most commonly occurred in 18 to 30 years old (66/307 cases). In term of three-column classification system, the majority caseswere of three-column injuries (154/309 feet), with the middle column involved most frequently (297/309 feet). In terms of the intra-columnand inter-column sub-classification, the intra-column injury was most common, while inter-column injury had the lowest incidence. In allthe patients, the subtle injuries were seen in 11 feet, fracture-dislocation in 70 feet, pure dislocation in 2 feet, while combined cuneiformfractures were found in 239 feet, metatarsal fractures in 287 feet, cuboid fracture in 89 feet. Chopart joint involved in 15 feet and tarsometa-tarsal complex injuries in 78 feet. [Conclusion] Tarsometatarsal injury was most commonly seen in young and male patients. The CT imag-ing characteristics varies considerably, the three column and intra-column was most common with a highest rate of middle column in-volved. Furthermore, the tarsometatarsal injuries have a high incidence of associated medial cuneiform fractures, which is necessary to paya great attention during the diagnosis and treatment.
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YU Yun-fei, WU Mao, YIN Ming, HU Gang, GU Hong-cheng
2025,33(8):681-687, DOI: 10.20184/j.cnki.Issn1005-8478.110281
Abstract:
[Objective] To compare the clinical efficacy of Tightrope combined with percutaneous screw (TRPS) versus clavicular hook plate (HP) for Cho's type IIC distal clavicular fracture in the elderly. [Methods] A retrospective study was conducted on 63 elderly who had Cho's IIC distal clavicle fractures treated surgically in our department from January 2015 to January 2023. According to the doctor-patient communication, 31 patients were treated with TRPS, while other 32 patients received HP. The perioperative, follow-up and imaging data of the two groups were compared. [Results] The TRPS group proved significantly superior to the HP group in terms of operation time [(65.8± 16.7 min) vs (83.1±20.8) min, P 0.001], incision length [(1.9±0.7) cm vs (9.5±1.9) cm, P 0.001], intraoperative blood loss [(21.5±9.9) mL vs (97.5±55.8) mL, P 0.001], and hospital stay [(8.4±2.2) days vs (13.3±5.6) days, P 0.001]. All patients in both groups were followed for more than 12 months. As time went on, the VAS score, Constant-Murley score, forward elevation range of motion (ROM) and abduction elevation ROM were significantly improved in both groups (P＜0.05). The TRPS group was significantly better than the HP group in terms VAS score [(1.7±0.6) vs (2.6±1.1), P 0.001; (0.6±0.5) vs (1.5±0.9), P 0.001], Constant-Murley score [(85.0±4.0) vs (80.0±4.6), P＜0.001; (91.9±3.9) vs (88.5±4.8), P 0.001] and forward elevation ROM [(127.3±11.1)° vs (118.2±14.7)°, distal clavicular fracture, Tightrope, percutaneous screw, hook plate, acromioclavicular joint=0.008; (155.3±10.9)° vs (144.7±13.5)°, P 0.001], abduction elevation ROM [(116.5±10.0)° vs (108.1±12.9)°, P 0.001; (148.9±13.0)° vs (127.7±17.9)°, P 0.001] 3 months postoperatively and the latest follow-up. As for imaging. there was no significant difference in fracture reduction quality between the two groups (P＞0.05). The coracoclavicular distance (CC) was significantly decreased in both group after operation compared with that preoperatively (P＜0.05), whereas which was not statistically significant between the two groups at any corresponding time points (P＞0.05). [Conclusion] Both surgical techniques for the treatment of senile osteoporotic Cho's type IIC distal clavicle fracture have obtained good clinical consequence. However, the Tightrope combined with percutaneous screw takes advantages of small incision and less trauma, relieving early postoperative pain and facilitating the functional recovery over the hook plate.
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CHENG Yong-hong, ZHANG Zhi-dong, HAN Guo-song, QI Jia-long, DONG Zhou
2025,33(8):688-694, DOI: 10.20184/j.cnki.Issn1005-8478.110391
Abstract:
[Objective] To explore the clinical efficacy of percutaneous curved vertebroplasty (PCVP), by comparison with unilateral percutaneous vertebroplasty (UPVP and bilateral percutaneous vertebroplasty (BPVP) for thoracolumbar osteoporotic vertebral compression fractures (OVCF). [Methods] A retrospective study was done on 78 patients who had thoracolumbar OVCF treated surgically in our hospital from May 2018 to April 2019. Based on doctor-patient communication, 30 patients were treated with PCVP, the other 36 with UPVP, and the remaining 22 with BPVP. The documents regarding perioperative period, follow-up and auxiliary examination were compared among the three groups. [Results] The PCVP group proved significantly superior to the UPVP and BPVP in terms of operation time [(35.9±4.2) min vs (39.3±5.0) min vs (42.6±5.0) min, P 0.001], intraoperative X ray exposure times [(8.3±1.2) times vs (9.7±1.7) times vs (18.2±2.6) times, P 0.001], bone cement injection volume [(5.9±1.1) mL vs (6.7±1.4) mL vs (7.6±1.5) mL, P 0.001], intraoperative blood loss [(12.4±1.6) mL vs (25.7±2.0) mL vs (28.3±6.0) mL, P 0.001], the ambulation time [(6.5±1.1) hours vs (7.8±1.4) hours vs (8.5±0.9) hours, P 0.001], hospital stay [(5.9±1.2) days vs (8.0±2.0) days vs (8.0±1.8) days, P 0.001], hospitalization cost [(1.9±0.4) 10 k yuan vs (2.1±0.5) 10 k yuan vs (2.2± 0.4) 10 k yuan, P 0.001]. The incidences of bone cement leakage in PCVP and BPVP groups were significantly lower than that in UPVP group (0 vs 4.6% vs 26.9%, P 0.001). With time of the follow-up period lasted for (15.1±2.5) months in a mean, the VAS and ODI scores of the three groups were significantly decreased (P＜0.05). At 2 days after surgery and the last follow-up, the PCVP group was significantly better than the UPVP group and the BPVP group in terms of VAS score [(2.2±1.2) vs (2.8±0.7) vs (2.9±0.6), P 0.005; (1.3±0.6) vs (2.2±1.2) vs (1.8±0.9), P=0.007] and ODI score [(18.8±1.9) vs (20.3±2.1) vs (21.5±2.2), P＜0.001; (13.1±1.3) vs (16.3±1.6) vs (17.1±1.5),P＜0.001]. As for images, vertebral anterior height (AVH), posterior vertebral height (PVH), local kyphotic angle (LKA), thoracolumbar kyphotic angle (TLK) were significantly improved over time (P＜0.05), which in PCVP group were significantly better than those in UPVP and BPVP groups at corresponding time points after surgery (P＜0.05). [Conclusion] PCVP is effective in the treatment for thoracolumbar OVCF, which is conducive to the uniform distribution of bone cement in fractured vertebrae and better improvement of lumbar function, and has the advantages of less trauma, simple operation, short time, fewer fluoroscopy times and quick postoperative recovery
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SHI Yuan-lin, QIAO Xiaohong, GAO Xing-yi, SHANG Jin
2025,33(8):695-700, DOI: 10.20184/j.cnki.Issn1005-8478.110407
Abstract:
[Objective] To analyze the risk factors for deep vein thrombosis (DVT) in the lower extremity before surgery for femoral neck fracture. [Methods] The databases, including China Biomedical Literature Database, CNKI, Wanfang, Pubmed and Embase, were searched to May 2024, and the literature that met the standards was extracted and analyzed by RevMan5.3 software. [Results] A total of 9 studies were included, all of which were case-control studies, involving 803 patients with DVT and 3 611 patients without DVT. As results of meta-analysis, the age (MD=1.98, 95%CI: 0.28~3.68, P=0.02), interval from injury to hospitalization ＞1 day (OR=1.70, 95%CI: 1.39~ 2.08, P＜0.001), smoking history (OR=1.56, 95%CI: 1.18~2.05, P=0.002), history of hypertension (OR=1.21, 95%CI: 1.03~1.42, P=0.02), serum albumin＜35 g/L (OR=1.69, 95%CI: 1.30~2.20, P＜0.001), serum D-dimer ≥0.5 mg/L (OR=1.70, 95%CI: 1.03~2.78, P=0.04), ASA grade ≥ grade III. (OR=4.34, 95%CI: 1.42~13.26, P=0.01), whole blood platelet count ≥262×109 / L (OR=2.34, 95%CI: 1.78~3.08, P＜ 0.001) were risk factors for development of DVT in the lower extremity before surgery in patients with femoral neck fracture. [Conclusion] Age, time interval from injury to hospitalization ＞1 day, history of smoking, history of hypertension, serum albumin ＜35 g/L, serum D-dimer ≥0.5 mg/L, whole blood platelet count ≥ 262×109 /L, and ASA grade ≥ III are risk factors for preoperative lower extremity DVT in patients with femoral neck fracture, which should be given a high degree of attention to reduce the incidence of the incidence.
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ZHOU Xuana, MA Feib, LI Ying-xiana, DU Qing
2025,33(8):701-706, DOI: 10.20184/j.cnki.Issn1005-8478.110031
Abstract:
Scoliosis is a common three-dimensional deformity of the spine, which can cause serious effects on function, mobility, and quality of life if treatment is delayed. Common treatments for scoliosis include physiotherapy, specific exercise, brace therapy, and surgery. In recent years, traditional Chinese medicine has been used in combination with western medicine for scoliosis. This article reviewed traditional exercise training combined with rehabilitation treatment, Tuina combined with rehabilitation treatment, acupuncture combined with rehabilitation treatment, and Chinese medicine combined with rehabilitation treatment, in order to provide an reference for the selection of clinical treatment and future clinical research.
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2025,33(8):707-711, DOI: 10.20184/j.cnki.Issn1005-8478.100819
Abstract:
Intervertebral disc degeneration (IDD) is a key pathological process in degenerative spinal diseases, and with the aging ofthe population in society, intervertebral disc-related pathologies have become an important problem that needs to be solved urgently.Cur-rently, there are still some limitations in the study of human intervertebral disc degeneration, and there is no animal model that can compre-hensively simulate the pathological conditions and complex mechanisms of IDD, and many researches can only rely on standardized model-ling.Therefore, this paper attempts to review the current progress of intervertebral disc degeneration modelling from the level of in vivo discmodelling to the level of in vitro intervertebral disc tissue and cell culturing, and to provide a reference for researchers to select the appro-priate model for the purpose of their research.
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HAO Yu-yuan, MAN Zhen-tao, CHEN Hai-feng, LI Wei
2025,33(8):712-716, DOI: 10.20184/j.cnki.Issn1005-8478.110881
Abstract:
Periprosthetic joint infection (PJI) constitutes a severe complication subsequent to joint replacement surgery and represents one of the significant causes of joint replacement failure. Early diagnosis and intervention can enhance patient prognoses, however, an accurate and efficient early diagnostic approach is still lacking. Pathogenic microorganisms play a crucial role in the genesis and development of PJI. Thus, when PJI is suspected, the detection of pathogenic microorganisms is of great significance. In recent years, bioprobes have demonstrated considerable potential for application due to their rapid detection and high specificity. This article conducts a literature review on the diagnosis of PJI after joint replacement surgery and discusses the current application of bioprobes in pathogen detection, offering a possibility for their application in the early diagnosis of PJI.
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SUN Kai, ZHANG Yuan-zhi, LIU Ya-ou, XING Wenhua, LIU Gang, HAO Xiao-dong, ZHANG Yue-teng, CHANG Qing
2025,33(8):717-720, DOI: 10.20184/j.cnki.Issn1005-8478.110132
Abstract:
[Objective] To determine whether presence of third sacral screw channels in adults and measure the its parameter by image digital measurement. [Methods] A total of 300 healthy volunteers aged 18~60 were enrolled into this study, with a half male and a half female. The geometric boundary of the third sacral safety zone was determined by three-dimensional reconstruction of pelvic CT scan data and the optimal screw path was generated. The width at the axial "narrow point" of the optimal screw path was measured on both sides, and the length of the trans-sacral trans-iliac (TSTI) screw channel and pedicle channel of the third sacrum were measured, additionally, the projection length and projection area of the TSTI channel of the third sacrum were measured. [Results] Of the 300 volunteers, 47 (15.7%) had a fixation path that could accommodate screw 6.0 mm in diameter for the transverse sacroiliac screw of the S3 vertebra.The male proved significantly greater than the female in terms of S3 TSTI channel width [left, (5.0±1.9) mm vs (4.3±1.6) mm, P<0.001; right, (5.0±1.9) mm vs (4.4±1.6) mm, P=0.002], TST1 channel length [(111.1±8.3) mm vs (98.6±7.8) mm, P<0.001], pedicle channel length [left, (36.6±3.2) mm vs (29.1±3.0) mm, P<0.001; right, (36.6± 3.1) mm vs (28.7±2.9) mm, P=0.002], the projection length [(18.4±2.0) mm vs (16.3±1.8) mm, P< 0.001], projection minor axis length [(16.6±1.6) mm vs (11.6±1.3) mm, P<0.001], projection area [(127.0±12.4) mm2 vs (96.4±9.4) mm2 , P< 0.001]. However, there was no significant difference between the left and right sides in terms of axial S3 TSTI channel width and pedicle channel length in the same gender (P>0.05). [Conclusion] In this study, 15% of adults are found a radiological safe third sacral screw channel, which could be used for fixation with transverse sacroiliac screw.
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YAN Hao, LIU Wei-qiang, LI Jin-ge, WANG Huaibin, WANG Bing-wu
2025,33(8):721-725, DOI: 10.20184/j.cnki.Issn1005-8478.11100A
Abstract:
[Objective] To introduce the surgical technique and preliminary clinical outcome of unilateral biportal endoscopy (UBE) for cervicothoracic junction disc herniation. [Methods] A total of 8 patients received UBE discectomy for cervicothoracic disc herniation. The observation and working tubes were placed under guidance of fluoroscopy. Under the endoscopy, part of the lamina and lateral mass were removed at the lower edge of C7 and the upper edge of T1, and part of the yellow ligament was also excised to expose the protruding nucleus pulposus tissue. After the protruding disc was removed by nerve hook and forceps, the dural sac and nerve root were decompressed completely. [Results] All the 8 patients had endoscopic discectomy performed successfully without serious complications such as dural or nerve root injury, while with operation time of (152.0±18.0) minutes, intraoperative blood loss of (37.5±4.6) mL, postoperative hospital stay of (4.6±0.5) days and achieved primary wound healing. During the follow-up lasting for more than 6 months after operation, all patients had neck pain disappeared and significantly improved symptoms of limb weakness and hypoesthesia compared with those before surgery. [Conclusion] UBE technique is feasible in the treatment of cervicothoracic junction disc herniation, and has a low complication rate, and a good preliminary clinical consequence
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WU Heng, DAI Xiao, LIU Hao, XU Shuang, WANG Song
2025,33(8):726-730, DOI: 10.20184/j.cnki.Issn1005-8478.110221
Abstract:
[Objective] To introduce the surgical technique and preliminary clinical outcomes of unilateral bone cement multi-point anchoring percutaneous kyphoplasty (A-PKP) for stage I and II Kümmell's disease (KD). [Methods] A total of 31 patients received abovesaid A-PKA by transverse process-pedicle approach (TPA) for stage I and II KD. Following successful height restoration of the fractured vertebra by balloon expansion, two curved-tip Kirschner wires were prepared and introduced fractured vertebral body. If the intervertebral vacuum cleft (IVC) was close to cephalic or caudal endplate, the "Out-In" puncture was used, a curved Kirschner wire was controlled to puncture the surrounding hardening zone into IVC, while another wire was inserted opposite the endplate. If the IVC was located at the middle of the vertebral body, the "In-Out" puncture was used, a curved-tip Kirschner wire was placed towards upper endplate directly, followed by controlled puncturing from IVC to the surrounding hardened zone, and same procedure was performed with another wire towards the lower endplate from the IVC to the surrounding hardened zone. As results, multiple tiny puncture holes were created on the hardened zone surrounding the IVC. Subsequently, different periods of bone cement were injected sequentially. [Results] All patients had operation performed successfully with the average operation time of (40.6±3.6) min, and the average bone cement injected of (5.2±0.3) mL. Of them, 2 patients had bone cement paravertebral leakage, 3 patients got adjacent vertebral fracture and 1 had bone cement displacement. Compared with those before surgery, the VAS score [(8.1±0.5), (1.7±0.7), P＜0.001], the ODI score [(76.8±2.9), (14.6±2.0), P＜0.001], anterior vertebral height [(14.9±5.7) mm, (18.7±4.5) mm, P=0.006], posterior vertebral height [(22.4±4.8) mm, (25.0±4.1) mm, P=0.023) and vertebral wedge angle [(15.4±5.1)°, (12.4±3.9)°, P=0.011] were significantly improved at the last follow-up. [Conclusion] The A-PKP for the treatment of stage I and II KD is simple and feasible, with satisfactory clinical consequence and few complications.
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LIU Qibin, MA Qing-wei, CHEN Chang-jun, LI Run-ze, LONG Ke-han, YING Zhen-dong, ZHANG Lei
2025,33(8):731-735, DOI: 10.20184/j.cnki.Issn1005-8478.110437
Abstract:
[Objective] To introduce the surgical technique and preliminary clinical outcome of unilateral biportal endoscopic lumbar interbody fusion (UBE LIF) in the treatment of degenerative scoliosis complicated with spinal stenosis. [Methods] A patient received abovesaid surgical treatment for degenerative scoliosis complicated with spinal stenosis. According to the preoperative clinical menifestation and imaging data, the surgicall segments was determined. The surgical approach and body surface anatomical marks was identified by C-arm fluoroscopy, guide pins were placed under fluoroscopy. Working portals were made over the guide pins, and endoscope and surgical instruments were placed through the upper and lower channels, respectively, to expose and remove the lower edge of the upper vertebral lamina, the tip of upper facet and inner edge of the facet of the lower vertebra. Subsequently, the hypertrophic ligamentum flavum was removed, the outlet root and walking root were exposed, the adhesive tissue was separated, the intervertebral disc was removed. After the intervertebral space was treated, and fusion cage with bone autograft was placed into the space. The other segments were treated in the same manner. After all segments were treated, pedicle screws were inserted along the guide wire, and then fixed with the connecting rods. [Results] The patient successfully completed the operation with operation time of 280 min, the intraoperative blood loss of 180 mL. The patient had incision healed well, got out of bed 3 days after surgery, and followed up for 6 months. The VAS score significantly improved from 5 (low back pain) and 6 (leg pain) preoperatively to 1 at the last follow-up, additionally, the ODI improved from 51.1 to 13.3, and JOA score was from 13 to 23 correspondingly. The patient had no symptoms recurred until the last follow-up. [Conclusion] The UBE-LIF is a minimally invasive technique, and does significantly improve the clinical symptoms of degenerative scoliosis complicated with spinal stenosis, correct scoliosis, restore spinal stability, and promote rapid recovery after surgery
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WANG Mei- ling, CHEN Juan, TANG Wei, WU Gang
2025,33(8):736-739, DOI: 10.20184/j.cnki.Issn1005-8478.110873
Abstract:
[Objective] To compare the analgesic effects of ultrasound-guided adductor block with liposomal bupivacaine (LB) versus ropivacaine (ROP) in total knee arthroplasty (TKA). [Methods] A total of 98 elderly patients who were undergoing TKA from February 2024 to November 2024 were included in this study and divided into two groups by random number table method. Before operation, the ultrasound-guided adductor block was conducted with corresponding drugs. The clinical and analgesic data of the 49 patients with LB and the 49 patients with ROP were compared. [Results] TKA was successfully completed in both groups without serious complications. There was no significant difference in the incidence of perioperative adverse reactions between the two groups (P＞0.05). The LB group proved significantly superior to the ROP group in term of 30-second chair-stand test (30s-CST) 48h after surgery [(3.5±0.7) times vs (3.0±0.4) times, P 0.001], despite of the fact there was no significant difference in TUG between the two groups (P＞0.05). Regarding to analgesia, the LB group was significantly better than the ROP group in VAS scores at resting and active conditions 12 hours, 24 hours, 48 hours and 72 hours postoperatively (P＜0.05). In addition, the LB was also proved significantly superior to the ROP group in terms of time to press the analgesic pump firstly [(20.8±2.4) hours vs (10.1±1.3) hours, P 0.001] and salvage analgesic use rate 24 hours after surgery (6.1% vs 28.6%, P=0.003). [Conclusion] The LB used in ultrasound-guided adductor block is superior to ROP in terms of improving early knee function and reducing early pain in total knee arthroplasty in the elderly
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WANG Zhen, LI Xiang-yang, XUE Hua-wei, ZHU Min, MA Ji-ye, SUN Yu-yu
2025,33(8):740-743, DOI: 10.20184/j.cnki.Issn1005-8478.110630
Abstract:
[Objective] To evaluate the clinical outcome of trans-wall bone cement filling for thoracolumbar osteoporotic fracture complicated with nonunion in the elderly. [Methods] A total of 34 patients received trans-wall bone cement filling for thoracolumbar osteoporotic fracture complicated with nonunion in our department. The VAS and ODI scores were recorded, and local kyphotic angle and anterior vertebral body height (AVBH) was measured and complications were evaluated before surgery, 3 days after surgery and at the last followup. [Results] All 34 patients underwent operation successfully, and 4 of them had asymptomatic bone cement leakage in the intervertebral space. With time before surgery, 3 days postoperatively, and the latest follow-up, the VAS [(8.1±0.9), (1.9±0.6), (1.4±0.7), P＜0.001] and ODI scores [(78.8±7.9), (33.7±3.4), (32.1±3.3), P＜0.001] significantly reduced. As for imaging, the LKA [(13.1±2.8)°, (4.9±2.4)°, (5.1± 2.5)°, P＜0.001] and AVBH [(16.2±1.6) mm, (19.1±1.2) mm, (19.1±1.2) mm, P＜0.001] were significantly improved. [Conclusion] The trans-wall bone cement filling is a safe technique for thoracolumbar osteoporotic fracture with bone nonunion in elderly, and achieves satisfactory.
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ZHANG Zhen-hui, PAN Qiang-qiang, CHEN Xu-yi, MEI Wei, WANG Qing-de
2025,33(8):744-747, DOI: 10.20184/j.cnki.Issn1005-8478.110553
Abstract:
[Objective] To evaluate the value of CT/MRI fusion imaging in the diagnosis of traumatic cauda equina dural herniation in lumbar burst fractures, and its significance in determining the surgical technique. [Methods] A retrospective study was conducted on 28 patients who received surgical treatment for lumbar burst fracture combined with laminar fracture and cauda equina nerve injury in Zhengzhou Orthopaedic Hospital from June 2016 to June 2020. As thin-slice CT and MRI were performed routinely before operation, and Medraw software was used to achieve rapid registration fusion of CT and MRI 3D images. Intraoperative exploration was conducted to verify accuracy of imaging diagnosis of dural cauda equina herniation, and carried out corresponding individualized surgical treatment. [Results] On the preoperative CT/MRI fusion imaging of 28 patients, dural and cauda equina nerve herniation were found in 23 cases, accounting for 82.1%, which presented cauda equina nerve embedded in the lamina fracture gap. The intraoperative findings were completely consistent with the imaging findings, and the diagnostic accuracy of imaging was 100.0%. All patients underwent successful surgery and were followed up for 12 to 26 months (18.5±2.3). Compared with those before surgery, the VAS scores [(8.3±0.7), (2.2±0.3), P＜0.001], ODI score [(38.5± 4.3), (7.2±1.3), P＜0.001], JOA score [(12.8±0.8), (25.6±1.4), P＜0.001], and ASIA nerve function scale [A/B/C/D/E, (0/18/7/3/0), (0/0/3/5/ 20), P＜0.001] significantly improved at the last follow-up. [Conclusion] The CT/MRI fusion imaging taken before surgery for patients with lumbar fracture complicated with neurological symptoms does intuitively determine the position relationship between the dura cauda equina and the posterior lamina fractured, accurately diagnose traumatic dura cauda equina herniation, provide an important reference for accurate surgery, and obtain satisfactory clinical results.
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CAO Wen-bing, ZHANG Xing, LI Da-peng, ZOU Ya-qi
2025,33(8):748-752, DOI: 10.20184/j.cnki.Issn1005-8478.110150
Abstract:
[Objective] To evaluate the clinical consequence of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) with augmented pedicle screw for osteoporotic lumbar spondylolisthesis. [Methods] From August 2022 to August 2023, 40 patients received the abovesaid surgical treatment for osteoporosis grade I and II lumbar spondylolisthesis. The clinical and auxiliary examination documents were evaluated. [Results] All the patients were operated on smoothly, with the average operation time of (170.3±14.6) min, the average intraoperative blood loss of (123.6±10.8) mL, and the average hospital stay of (13.8±1.3) days. With time preoperatively, 6 months after surgery and at the last follow-up, the low back pain VAS [(7.6±0.7), (1.8±0.4), (1.6±0.5), P＜0.001], leg pain VAS [(8.1±0.6), (1.3±0.5), (1.2±0.4), P＜0.001] and ODI scores [(58.8±5.3), (33.3±5.1), (30.1±7.2), P＜0.001] were significantly decreased. In term of blood test, the Hb significantly decreased 1 day after surgery (P＜0.05), while CRP, ESR and CPK significantly increased (P＜0.05), whereas which all returned to normal level 3 days after surgery. In term of imaging, with time preoperatively, 6 months after surgery and at the last followup, the slippage ratio [(16.7±3.4)%, (5.1±1.5)%, (4.2±1.6)%, P＜0.001], spinal canal area [(71.4±8.3) cm2 , (115.3±6.8) cm2 , (112.6±8.4) cm2 , P＜0.001], lumbar lordotic angle [(52.8±6.3), (49.2±2.8), (46.2±4.9), P＜0.001], sagittal diameter of lateral recess [(1.8±0.4) mm, (3.6± 0.5) mm, (3.4±0.3) mm, P＜0.001] and intervertebral height [(7.4±1.6) mm, (11.4±1.2) mm, (10.6±1.7) mm, P＜0.001] significantly improved. In addition, the fusion scale [I/II/III/IV, (34/5/1/0), (37/3/0/0), P＜0.001] improved significantly at the latest followup compared with that 6 months postoperatively. [Conclusion] UBE-TLIF combined with augmented pedicle screw does effectively reduce spondylolisthesis and achieve spinal canal decompression, and get high fusion rate and satisfactory short-term clinical outcome
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JIN Dao-cheng, LIU Ke-xin, LI Zi-tao, MA Yu-bo, LI Gang
2025,33(8):753-756, DOI: 10.20184/j.cnki.Issn1005-8478.110191
Abstract:
[Objective] To explore the impact of facet symmetry on clinical consequence of percutaneous endoscopic transforaminal discectomy (PETD) for prolapsed lumbar disc herniation. [Methods] A retrospective study was conducted on 30 patients who had prolapsed lumbar disc herniation treated with PETD, including 20 patients with symmetrical bilateral facets (SBF), and 10 patients with asymmetric bilateral facets (ABF) from September 2022 to September 2023. The clinical and imaging data of the two groups were compared. [Results] There were no significant differences in operation time, intraoperative fluoroscopy times, ambulation time and hospital stay between the two groups (P＞0.05). All patients were followed up for more than 3 months. As time went on, the lower back pain VAS, leg pain VAS, ODI and JOA scores in both groups were significantly improved (P＜0.05). The SBF group proved significantly superior to the ABF group in term of lower back pain VAS scores [(2.7±1.3) vs (6.8±1.2), P＜0.001; (1.7±0.7) vs (3.8±0.6), P＜0.001] 1 day postoperatively and at the last followup. As for imaging, the intervertebral space height and vertebral canal area in both groups were significantly increased at the last follow-up compared with those preoperatively (P＜0.05). At the last follow-up, the SBF group was also significantly better than the ASF group regarding to intervertebral space height [(10.7±1.8) mm vs (7.0±1.8) mm, P＜0.001]. [Conclusion] PETD is effective treatment for prolapsed lumbar disc herniation. However, the patients with preoperative asymmetry bilateral facets will last longer postoperative symptoms of low back pain.
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NIU De-gang, ZOU Xiao-jun, GE Zhen-xin, ZANG Yun-yu, GAO Jiazhi
2025,33(8):757-760, DOI: 10.20184/j.cnki.Issn1005-8478.11103A
Abstract:
[Objective] To evaluate the clinical consequence of double-plate fixation of proximal clavicle fracture. [Methods] A retrospective study was done on 16 patients who had the proximal clavicular fractures fixed with double plates from January 2020 to January 2023. All patients underwent double-plate fixation for proximal clavicular fracture. The clinical and imaging data were evaluated. [Results] All the patients had operation performed successfully without neurovascular injury and other serious complications, while with operative time of (70.0±6.2) min and intraoperative blood loss of (71.3±10.7) mL. They were followed up for (11.6±3.5) months in a mean. With time preoperatively, 3 months postoperatively and the last follow-up, the VAS score was significantly reduced [(6.6±1.7), (1.7±0.8), (0.3±0.6), P＜ 0.001), whereas the Constant-Murley score [(42.2±9.1), (74.2±7.8), (93.8±3.5), P＜0.001], forward flexion and elevation range of motion (ROM) [(51.0±9.7)°, (120.1±15.7)°, (172.5±4.8)°, P＜0.001], abduction and elevation ROM [(58.6±11.0)°, (127.8±18.8)°, (174.5±3.1)°, P＜ 0.001], and internal-external rotation ROM [(22.0±5.6)°, (53.5±11.5)°, (73.5±2.7)°, P＜0.001] were significantly increased. At the last follow-up, the radiographs showed that the fractures in all patients were in good alignment and healed well. [Conclusion] This double-plate fixation of proximal clavicular fracture has the advantages of less postoperative complications and better shoulder function recovery.
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LIU Qing-tao, MA Wen-ru, ZHOU Lu, WANG Ya-ping
2025,33(8):761-764, DOI: 10.20184/j.cnki.Issn1005-8478.11098A
Abstract:
[Objective] To explore the relationship between postoperative depression and nutritional status in orthopedic surgery. [Methods] A total of 156 patients who were undergoing surgical treatment in Department of Traumatic Orthopedics of the 960 Hospital from October 2023 to May 2024 were selected as the study subjects. The patients were divided into the depression group and nondepression group after operation according to SDS score. The general data of the two groups were compared, and the pairwise correlation between postoperative depression and nutritional status was analyzed. In addition, binary multifactor logistic regression was used to confirm the correlation factors. [Results] There were no significant differences in smoking, drinking, education level, hypertension, diabetes, coronary heart disease, TP, TG, TC, HDL-C, LDL-C, FPG and HB between the two groups (P＞0.05). The depression group proved significantly greater than the non-depression group in terms of age [(62.4±8.1) vs (58.7±9.3), P=0.035], the female ratio [female/male, (40/29) vs (36/51), P=0.039] and BMI [(23.1±1.7) vs (22.8±2.1), P=0.030], NRS score 2002 [(2.2±0.9) vs (1.5±0.8), P=0.001], and SDS score [(57.7±4.3) vs (41.3±5.8), P= 0.001], whereas the former had significantly lower ALB level than the latter [(35.2±3.1) vs (37.4±3.5), P＜0.001]. As results of pairwise correlation, the SDS score was positively correlated with age (r= 0.257, P=0.001) and NRS2002 score (r=0.462, P=0.001), whereas negatively correlated with ALB level (r=-0.368, P=0.001). Regarding to logistic regression analysis, and high NRS2002 score (OR=1.960, P=0.005), the advanced age (OR=1.056, P=0.013), were independent risk factors for postoperative depression in orthopedic surgery. [Conclusion] There is a close correlation between depression and nutritional status in patients after orthopedic surgery, High ALB level (CR=0.867, P=0.019), is one of protective factors for postoperative depression.
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ZHAO Zhong-ting, LI Wei, LI De-min, ZHANG Zhen
2025,33(8):765-768, DOI: 10.20184/j.cnki.Issn1005-8478.100764
Abstract:
[Objective] To investigate the clinical consequence of robot-assisted short-segment pedicle screw fixation combined with the involved vertebral body bone grafting for thoracolumbar fractures. [Methods] A retrospective research was conducted on 31 patients who received robot-assisted short-segment pedicle screw fixation combined with the involved vertebral body bone grafting for thoracolumbar fractures from January 2018 to September 2022. The clinical and imaging data were evaluated. [Results] All the patients had operations completed successfully with the average operation time of (121.3±26.3) min, and the intraoperative blood loss of (78.1±31.8) mL, were followed up for (7.5±2.6) months in a mean. As time elapsed from the point preoperatively, 3 days after operation to the latest follow-up, the VAS [(7.4±1.5), (4.2±1.2), (1.1±0.7), P＜0.001], ODI [(71.4±13.6), (47.4±9.7), (24.3±6.3), P＜0.001] significantly reduced. As for imaging, the relative vertebral height [(63.2±16.0)%, (89.6±4.9)%, (88.7±5.5)%, P＜0.001] and local kyphotic angle [(17.8±8.5)°, (4.3±2.7)°, (5.2± 3.2)°, P＜0.001] significantly improved over time. [Conclusion] Robot-assisted short-segment pedicle screw fixation combined with the involved vertebral body bone grafting for thoracolumbar fractures does effectively improve clinical symptoms, restore the height of the injured vertebra and prevent the loss of vertebral height with satisfactory outcomes.
