0.05), showing that the breakage of pedicle screws had no obvious relation with material. Analysis of 4 observation indexes of two groups showed that the height of the affected intervertebral space was no correlated with the pedicle screws breakage, but the location of the pedicle screws, the degree of bony fusion and rail use were significantly related with pedicle screws breakage. CONCLUSION: Pedicle screw breakage in thoracolumbar fractures fixation are not obvious related to material; but it is correlated with pedicle screw location, degree of the bony fusion and rail use. Pedicle screw breakage is caused by interaction of multiple factors.

BACKGROUND: Both bone morphogenetic protein (BMP) and calcium phosphate cement (CPC) have excellent osteogenic capability, so, it is possible to optimize osteogenic efficiency by combing BMP, CPC and freeze-dried dura mater (FDDM). OBJECTIVE: To investigate the efficacy of combined BMP-CPC-FDDM in segmental bone defects repairing. DESIGN, TIME AND SETTING: Randomization design and control animal observation were performed at the animal laboratory of the Guangxi Medical University from July 2006 to July 2007. MATERIALS: A total of 28 healthy, adult, New Zealand white rabbits, irrespectively of genders, weighting 1.5-2.5 kg. METHODS: Four rabbits were obtained dura mater. The remained 24 rabbits were randomly divided into 2 groups, with 12animals per group. A group: bilateral 10 mm segmental bone defects were produced in the radius of rabbits. One side defect was repaired with BMP-CPC-FDDM (BMP group). The other side was served as control group. B group: one side 10 mm segmental bone defects were produced in the radius of rabbits, and were repaired with bone marrow-CPC-FDDM (BM group). MAIN OUTCOME MEASURES: X-ray examinations were performed at weeks 1, 2, 4, 6, 8, 10, and 12 after operation to observe the newly formed bone status. The samples were cut for the histology test and analysis of osteogenic area at weeks 2, 4, 8, and 12 after operation. RESULTS: The formed bone area of the BMP group was greater than the BM group at the weeks 4, 8 and 12 after operation (P < 0.05); but at the early period (week 2), the two groups had no obvious difference (P > 0.05). The osteogenic area of the BMP group and the BM group were better than the control group (P < 0.01). X-ray results demonstrated that bony callus moulding appeared obviously at weeks 10-12 in the BMP group. The pathological section revealed that maturate bone marrow could be seen at week 12 after operation, and the bone defect was connected with mature lamellar bone. CONCLUSION: The BMP-CPC-FDDMA has a good osteogenesis.

Objective To study the effect of cervical disc replacement in the treatment of cervical spondylotic myelopathy(CSM).Methods 21 patients with CSM(17 cases of spondylotic myelopathy,2 cases of radiculopathy and 2 cases of acute soft disc herniation)were treated by anterior decompression and replaced by the Bryan cervical disc prosthesis. Results All cases were: followed for 4～12 months, average 8 months. The pre-operative JOA score was 8.5 and post-operative score was 15.5 on average. There were no prosthesis, curve was good. Replaced segment achieved stability and restored partial of normal ROM. There was no subsidence of implant and no worsening of pre-operative symptoms, post-operative 21 cases remained flexion/extension movement at replaced segments at latest follow up. There was no neck stiffness and restriction of movement complained by the patients. Conclusion The Bryan cervical disc replacement for the treatment of CSM has offered an excellent early clinical outcome.

BACKGROUND:At present, it remains unclear whether delayed functional exercises after arthroscopic rotator cuff repairs could elevate the healing rate of tendon. The opportunity of functional exercises after rotator cuff repairs is stil controversial, and there is no relevant system evaluation.
OBJECTIVE:To systematical y evaluate the differences in curative effects of early and delayed functional exercises after arthroscopic rotator cuff repairs.
METHODS:We searched the Pubmed, EMBASE, Cochrane Central Register of Control ed Clinical Trials, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Infrastructure, and Chongqing VIP Database. The key words were“arthroscopy, rotator cuff, rehabilitation”. The references of the included literatures were re-retrieved. The deadline of retrieval was August 15, 2012. The included literatures were randomized control ed trials on early and delayed functional exercises after arthroscopic rotator cuff repairs. Methodological quality evaluation, screening and heterogeneous test were conducted. REVMAN5.1 software was utilized to analyze the extracted data.
RESULTS AND CONCLUSION:We included three randomized control ed trials, including 237 patients:119 in the early movement group and 118 in the delayed movement group. During fol ow-up at 1 year after operation, no significant differences in range of motion, pain degree, American Shoulder and Elbow Surgeons Scale, Simple Should Test scores and re-tear rate of rotator cuff were detected between the two groups. Results confirmed that compared with delayed functional exercises, early functional exercises after arthroscopic rotator cuff repair did not have advantages on the improvement of joint function and range of motion, but also did not negatively affect cuff healing. Postoperative rehabilitation can be modified to ensure patient’s compliance.