Objective To investigate the results of transpedicular balloon kyphoplasty for treatement of aged osteoporotic spinal compressive fractures. Methods Ten cases of aged osteoporotic spinal compressive fractures (range 57 to 72 years old), with T11 1 case, T12 4 cases, L1 5 cases were treated with kyphoplasties under “C” armed imaging guiding. The inflatable bone tamp was inserted into the fractured vertebral body transpedicularly in a minimally invasive way. The balloon was inflated, elevating the endplate and restoring vertebral body height and then confirmed by “C” armed imaging. The balloon was deflated and withdrawn, leaving a cavity within the vertebral body. The cavity was then filled with bone cement or other preferred material, creating an “internal cast” which was also confirmed by “C” armed imaging. Results The back pain disappeared immediately after the kyphoplasty in all of 10 cases. In the same day or following day after the procedure, the patients were allowed to get off bed. The height restoration of vertebral body and correction of kyphosis were confirmed by X-ray after the procedure. The average correction of kyphosis was 16?. At the time of the last follow up, all 10 cases retained the life style as before injury, there was no back pain, and deformity correction was maintained well. No complications occurred. Conclusion Kyphoplasty is a safe and effective way to treat aged osteoporotic spinal compressive fractures.

[Objective]To explore the clinical outcome of anterior cervical decompression for severe cervical spondylotic myelopathy with ossification of posterior longitudinal ligament. [Method]Thirty-three patients with severe cervical spondylotic myelopathy and continuous OPLL underwent posterior longitude ligament resection and floating in anterior cervical decompression.The intervertabral space were stabilized by autoilum graft or titanium cage and fixed with windows plates. [Result]All patients were followed up for 8 to 45 months,mean 22 months.Preoperative JOA scores were 6.7,and the postoperative JOA scores were 10.1 and 10.7(evaluated in 3 months and 12 months after surgery),the mean amelioration rate was 72.7% and 78.8%.Of these 33 patients,no severe complications such as cord or vertebral artery injury occurred. [Conclusion]Posterior longitude ligament resection and floating in anterior cervical decompression is a safe and effective treatment for severe cervical spondylotic myelopathy with ossification of posterior longitudinal ligament.

Objective To investigate the effect of intraspinal grafting of brain derived neurotrophic factor (BDNF) ex vivo transgene myoblasts cells and methylprednisolone on caspase-3 expression after spinal cord injury (SCI). Methods A total of 120 experimental rats were divided into Group A (spinal cord contusion injury group), Group B (grafting of BDNF ex vivo transgene myoblasts cells group), Group C (methylprednisolone intravenous injection group) and Group D (grafting of BDNF ex vivo transgene myoblasts cells and methylprednisolone intravenous injection group). At days 1, 3, 7, 14 and 28 respectively after SCI, the expression of caspase-3 was measured immunohistochemically for quantitative analysis via a computer image analysis system. The motion functional recovery of the rats was observed by praxiologic and electrophysiologic examination. Results Positive expression cells of caspase-3 were found in all groups, with number from the highest to the lowest in order of Group A, Group B, Group C and Group D (P

BACKGROUND:The correct method selected according to the specific type and characteristics of lumbar disc herniation can achieve satisfactory effect, but in clinic, there stil some patients have recurrence symptoms after treatment. OBJECTIVE:To investigate the recurrence factors of spinal implant internal fixation for the treatment of lumbar disc herniation, as wel as the intervention measures. METHODS:Fifty-two patients with recurrence symptoms of lumbar disc herniation after internal fixation from January 2002 to December 2007 in the Department of Orthopedics, the 306th Hospital of PLA were retrospectively analyzed, including 28 male cases and 24 female cases, the average age was 43.2 years, ranged from 25-52 years. The time form first internal fixation to the recurrence was 3-192 months, average 38 months. The patients had the symptoms of lumbar and bilateral/unilateral leg pain and numbness. Al the patients underwent the anteroposterior radiographs of lumbar spine and the hyperextension and flexion lateral X-ray films to evaluate the stability of the lumbar spine. Lumbar magnetic resonance imaging was used to observe the intervertebral disc situation of the segment treated with lumbar internal fixation as wel as the spinal stenosis and disc degeneration. RESUTLS AND CONCLUSION:Among the 52 patients, 22 cases had recurrence lumbar disc herniation on the same segment after first internal fixation;four cases had recurrence symptoms caused by the spondylodiscitis after implant internal fixation;five cases had scar adhesions caused nerve compression on the site treated with internal fixation;10 cases had the symptoms of lateral recess and nerve root canal stenosis on the site treated with internal fixation;11 cases had recurrence symptoms caused by lumbar instability after internal fixation. It has reality clinical significance to analyze the reasons of recurrence of lumbar disc herniation after internal fixation

One patient with the pedicle screw threatening the aorta was treated with adjusting the position of pedicle screw by anterolateral approach. No nervous lesion was found after adjusting. Radiograph showed the position and length of screw at T11 left pedicle of vertebral arch were good. No adverse reaction was detected after 2-years of follow-up.

BACKGROUND:Deep vein thrombosis after total knee arthroplasty has attracted increasing attention in recent years,but how to detect deep vein thrombosis in the early time in clinical practice remains unclear.Whether it is necessary to perform type-B ultrasonic or other invasive examination in lower limbs has become a hot issue.OBJECTIVE:To explore the significance of D-Dimer and fibrin degradation products in the prediction of deep vein thrombosis after total knee arthroplasty.METHODS:56 patients received total knee arthroplasty were colected from Department of Orthopedics,The 306th Hospital of Chinese PLA,between December 2012 and February 2014.The D-Dimer and fibrin degradation products were dynamicaly monitored before operation and at 1,3,5,7,10 days post-operation.Al the patients received type-B ultrasonic examination in double lower limbs at 10 days post-operation,and divided into thrombus group and non-thrombus group.The D-Dimer and fibrin degradation products in the two groups were compared.RESULTS AND CONCLUSION:Deep vein thrombosis was found in 13 cases by ultrasonic-B postoperation,D-Dimer and fibrin degradation products showed no significant difference between the two groups at 1 week after operation (P＞0.05),but the difference was significant at 10 days (P＜0.01).D-Dimer and fibrin degradation products index should be monitored dynamicaly for at least 10 days after operation,which is helpful for the earlydiagnosis of thrombosis.

BACKGROUND:Knee society score of Peking Union Medical Col ege has been promoted and used in the 306th Hospital of PLA for 2 years and we have accumulated some clinical data.
OBJECTIVE:To analyze the stability and feasibility for suitable clinical medical practice of knee society score of Peking Union Medical Col ege.
METHODS:Fifty-five patients with osteoarthritis of the knee were included, and the patients were divided into
three groups:the preoperative group;3 months postoperative fol ow-up group;6 months postoperative fol ow-up group. The measurement results obtained by the application of the scale were compared to those of the Western Ontario and McMaster Universityies Ostroarthritis Index, visual analog scale, and hospital for special surgery
score, and then knee society score goodness-of-fit analysis was performed based on the structural equation model.
RESULTS AND CONCLUSION:Knee society score performance assessment of the signs and symptoms of
osteoarthritis of the knee patients was positively correlated with the pain severity of visual analog scale score;the overal knee society score of the patients after 6-month fol ow-up was significantly improved compared with that before treatment. The knee society score after 3-and 6-month fol ow-up was significantly higher than that before treatment, and the score was quite with the hospital for special surgery score. The overal assessment of the knee society score after treated for 3 and 6 months was improved for more than grade Ⅰ, the visual analog scale
score was decreased for more than 30%. The pain assessment items and physiological functional assessment items of Western Ontario and McMaster Universityies Ostroarthritis Index after 6-month fol ow-up were
significantly better than those before treatment (P<0.05);the visual analog scale score was poor after 3-month fol ow-up, and there was significant difference in visual analog scale score before and after treatment which was related with the pain level;the score accompanied by function and joint stiffness was significantly improved. The knee society score of Peking Union Medical Col ege obtained four dimensions of 22 assessment projects, and the
goodness-of-fit analysis showed that the scale had good goodness which had scientific nature and application value.

Objective To detect the genetic toxicity of a neotype in situ polymeric injectable artificial prosthetic nucleus pulposus.Methods The artificial prosthetic nucleus pulposus was soaked for preparing the leaching liquor which was used for tests of genetic toxicity.Salmonella typhimurium reverse mutation test(Ames Test),mammalian cell chromosome aberration(CA) test utilizing Chinese hamster ovary cells(CHO),and mouse micronucleus(MN) test were performed to detect the genetic toxicity of the extraction,including the effects on DNA,chromosome aberration and genetic mutation.Results The number of reverse mutation strains,from five strains of every dosage group,was all lower than half of quantum of control group,with or without the addition of S9,in the Ames Test,which assessed as negative.In CA test,no significant difference of chromosome aberration rate existed among the high,medium and low concentration group,while the CA rate of all the three groups was lower than that of the negative group(P0.05),but significantly lower than that of the positive control group(P

BACKGROUND:It is generaly believed that the spine wil be extended, and vertebral muscle atrophy, bone loss of vertebral body, increased height and area of intervertebral disc, changes of composition of intervertebral disc wil occur in the condition of weightlessness. These are likely to be the cause of high incidence of low back pain. OBJECTIVE:To observe changes in lumbar spine bone microstructure analysis of simulated weightlessness on rhesus lumbar spine biomechanics. METHODS:Fourteen young rhesus monkeys were randomly divided into two groups: control group (n=7;free activities in the cage during the experiment), and experimental group (n=7; the use of head-down-10° on a special bed by bundle lying to simulate weightlessness). RESULTS AND CONCLUSION:(1) The results of Micro-CT examination: in the experimental group, structure model index in trabecular bone of increased. Trabecular bone changed from plate-like to the rod-like change. The intersection number of bone tissue in unit length to non-bone tissue declined. The average width of the canal between the trabecular bone increased, suggesting that there have been signs of osteoporosis in the experimental group. (2) Under an optical microscope, in the experimental group, bone hyperplasia line was disordered and irregular. Thick endplate trabecularbone became smal, shalow, and arranged substantialy perpendicular to the direction of trabecular bone and cartilage endplate. The closer the endplate surface, the smaler trabecular bone was. Compared with the control group, these smal trabecular bones were thin and curved. Bone marrow cavity was oval. The degree of the connection between the trabecular bones is poor, reflecting the structural characteristics of significant osteoporosis. (3) It is indicated that weightlessness affected the biomechanical properties of rhesus lumbar motion unit.

BACKGROUND:During ordinary plate fixation, the soft tissues around the fracture of the proximal humerus are nearly stripped to impact blood supply, and moreover, an ordinary steel plate cannot meet with the fixed requirements for severe osteoporosis, large bone defects and comminuted fractures. OBJECTIVE: To observe the functional recovery and complications in middle-aged patients with proximal humeral fractures undergoing stainless steel locking plate implantation. METHODS:From March 2011 to March 2014, 48 patients with proximal humeral fractures were treated in the 306th RESULTS AND CONCLUSION: The 48 patients were folowed up for 6-17 years, and the mean healing time was (15.3±1.2) weeks. At the last folow-up, the Neer scores were excelent in 12 cases, good in 22 cases, fair in 11 cases and poor in 3 cases, with an excelent-good rate of 71%. After internal fixation, there was one case of Hospital of PLA, including 20 males and 28 females, with an average age of 58 years. Of the 48 cases, there were 9 cases of Neer 2 fractures, 26 cases of Neer 3 fractures, and 13 cases of Neer 4 cases, al of which belonged to closed injuries. Al the patients were subject to locking plate implantation for repair of fractures of the proximal humerus, and evaluated based on Neer scores. soft tissue infection, two cases of traumatic arthritis, and no bone ununion and osteomyelitis. These findings suggest that the stainless steel locking plate implantation for repair of fractures of the proximal humerus can achieve a good anatomic reduction under minimaly invasive conditions and produce a stable rehabilitation environment for the soft tissue around the shoulder joint by internal fixation. Hence, the factures can recover faster with less complications. The stainless steel locking plate implantation can obtain good achievements in the repair of proximal humeral fractures of Neer 2, 3 as wel as Neer 4 in young patients with good bone quality.