According to the affected area, 28 patients with herpes zoster were treated. Electroacupuncture and local encircled needling method were used for the patient with the affected head and Jiaji (Ex-B 2) on the same side of pathological changes was added to puncture for the patient with the affected chest and waist. Visual analogue scale (VAS) was used to assess analgesic effect. The result showed VAS＜2 in 19 cases, VAS＜5 in 7 cases and VAS＞6 in 2 cases.

Objective To introduce the operative procedure of prosthetic disc nucleus(PDN)re-placement and investigate its clinical effectiveness in the treatment of lumbar disc herniation.Methods Nine cases of lumbar disc herniation were treated with PDN replacement from March2002to April2002.There were6males and3females,the average age of the patients was33.4years ranging from22to48years.The interval between the onset of the symptoms and the diagnosis was averagely18.4months,ranging from8months to3.6years.All of the patients were evaluated by anteroposterior and lateral radiography,computer-ized tomography and,if necessary,magnetic resonance imaging.The low back pain was predomi nant in two patients,the low back pain associated with radicular leg pain in6patients.The height of disc space became narrowed in varying grade.The operated level was at L 4-5 in6patients,L 5 S 1 in3patients.The standard pos-terior approach was used in8patients;the anterior lateral retroperitoneal approach was adopted in1patient.8cases were implanted with a single PDN,and1case with a couple of PDNs.Results All patients were followed up12to13months(average12.3months).The estimated intraoperative blood loss ranged from50to150ml (mean120ml ),and the total operation time ranged from45to120min(mean60min).The patients wore a brace for the first6weeks.Based on Oswestry low back pain and dis ability scores,the clinical successful rate was88.9%.The average percentage of the postoperative to preoperative disc height was128%.The slight displacement of PDN was observed in2patients,however there was no change of lumbar spinal mo bility.1patient had a bad recovery of back and leg pain.Conclusion PDN re placement can improve clinic symptoms,increase disc height and restore the normal lumbar motion as well.Its clinical effectiveness is excellent in short-term observation.

Objective To evaluate discuss the effect of percutaneous vertebraplasty in the treatment of compression fracture of vertebra in elderly patients with osteoporosis. Methods The clinical history of 13 elderly patients (5 male and 8 female), aged 61 to 78 years (nean 67 years), of spinal suffering from compression fracture of the vertebra, were retruspectively reviewed. Among them, 2 patients suffered compressed fracture of T11, 5 with fracture of T12, 3 with fracture of L1, 4 fracture of L2, and one suffered fracture of four vertebral bodies from T10 to L1. Percutaneous puncture were guided by C-arm X-ray or by computer navigation system, and a canal of 4.5 mm in diameter was created in the pedicle. A balloon was then introduced into the canal, and it was expanded. with radioopaque contrast medium under high pressure. The balloon was then removed after the height of the vertebral body was resumed as verified by X-ray. Bone cement in same volume and temperature was injected in the cavity which was newly formed. The treatment was completed with solidification of the bone cement. Results Low back pain disappeared in all 13 cases. Patients can be ambulatory in 6-8 hours postoperatively. The height of the vertebra body was basic recovered on postoperative X-ray, and kyphosis was rectified to a mean of 14 degrees (range10-28 degree). There was no relapse of low back pain or collapse of vertebral body after 1 to 12 months' follow up. Conclusion Percutaneous expansion of compressed vertebral body is a new kind of microsurgical, treatment for spinal compression fracture in elderly patients with osteoporosis, and it is simple and effective in relieving pain and recovering function.

BACKGROUND:Anterior cervical discectomy and intervertebral disc replacement have been extensively used in treatment of cervical degenerative disease. Its short-term therapeutic effects are encouraging, but it lacks of long-term and comprehensive evaluation.
OBJECTIVE:To observe the folow-up results of a group of cases of anterior cervical discectomy and Mobi-C intervertebral disc replacement for more than 5 years.
METHODS:A total of 25 cases of cervical spondylosis were treated in the 309 Hospital of Chinese PLA from January to September 2009. 19 of them were folowed up. Al patients received anterior cervical discectomy and Mobi-C intervertebral disc replacement. Twenty-three Mobi-C intervertebral disc prostheses were implanted. The range of motion was measured using lateral X-ray films during extension and flexion. Ectopic ossification was assessed by McAfee method. According to the cervical vertebra MRI images, the degeneration of adjacent segments was determined using Pearce classification. NDI score was used to evaluate the function of cervical spine. Pain improvement was evaluated using visual analogue scale score.
RESULTS AND CONCLUSION: A total of 19 patients were folowed up for 59-65 months, averagely 62 months. No significant difference in range of motion was detected before surgery and during final folow-up (P > 0.05). Ectopic ossification in two cases and the degeneration of adjacent segments in one case were found during final folow-up. No prosthesis loosening or displacement appeared. Visual analogue scale score and NDI score were significantly lower during final folow-up compared with that before surgery (P < 0.05). These results indicate that under the premise of reasonable choice of indications, the therapeutic effect of Mobi-C intervertebral disc replacement for degenerative cervical spondylosis was satisfactory in five-year folow-up. The range of motion was good, and the incidences of ectopic ossification and the degeneration of adjacent segments were low.

An evaluation of 16 patients with cervical spondylosis undergoing PCB (a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate,PCB) is presented. Four patients underwent surgery for cervical myelopathy and 12 for cervical radiculopathy.There were 11 males and 5 females.The average age was 46 years (ranging from 31～67 years).The time of follow up was 3～16 months after operation.Fixation at one level was performed in 12 patients,and at two levels in 4. The results revealed that the technique was easy to learn and implement,without intraoperative complications.After surgery no screw backout or device failure was identified.Symptoms improved significantly in 14 patients.Complications in donor site were rare. An external collar support was unnecessary after operation.

From July 1997 to March 2000, internal fixation of posterior transpedicular screw system and posterolateral autograft bone graft fusion procedures were used in 25 patients suffering from Pott's paraplegia in our department. 17 of them were involved in a longitudinal study and followed up for a mean of 2(1 5～4)years postoperatively. The beginning of neurologic recovery was during the first 2 to 3 weeks postoperatively in 16 patients. 9 were completely recovered,7 were partly recovered 6 months postoperatively. At final follow up, 2 of the 7 patients were completely recovered, 5 had significant improvement of one grade(2 patients) or two (3 patients) according to ASIA Grades. It is concluded that internal fixation of posterior transpedicular screw system and posterolateral autograft bone graft fusion procedures were found to be helpful in strengthening the stability of the spine in spinal tuberculosis, providing successfu recovery of paraplegia and preventing the recurrence of paraplegia.

Objective To investigate the clinical outcomes of interbody fusion with transpedicular screw fixation in the reoperation for lumbar spinal instability secondary to lumbar discectomy.Methods From May 1997 to Aug 2002, 23 patients underwent reoperation with posterior lumbar spinal decompression, removal of residual disc, transpedicular screw instrumentation and interbody fusion because of lumbar spinal instability after previous lumbar discectomy. There were 14 males and 9 females. The age of patients ranged from 28 to 64 years with an average age of 48.5 years. The time between the onset of the symptoms and the diagnosis was 18 months on average (range, 6 months to 36 years). The mean interval between the primary and revision surgery was 68 months (range, 24 months to 10 years). Lumbar discectomy had been performed in all patients as the primary surgery. All patients were evaluated by the conventional radiography, and CT or MRI if necessary. The low back pain was predominant in 8, and associated with radicular leg pain in 15. The instability of one segment was found in 17, and two segments in 6. The average follow-up was 3.6 years (range, 1 to 6.4 years). Results The lateral, AP, flexion and extension X-ray films were taken at 1, 3, 6 months and 1 year to evaluate the fusion, sliding between two vertebral bodies and internal fixation, and McGill pain questionnaire was adopted to determine the satisfaction of the patients. The intraoperative blood loss ranged from 550 to 800 ml (mean, 650 ml), and the total operative time ranged from 120 to 210 min (mean, 180 min). Based on Oswestry low back pain and disability scores, the clinical successful rate was 86.9%. The rate of patient satisfaction was 82.6%. 20 patients showed radiographic bony fusion. Pedicle screw breakage and loosening were found in 3 out of the 102 screws. 5 patients had nerve root irritation and recovered within 2 to 3 weeks. 5 patients had dural laceration. Bony nonunion was found in 3 patients. Conclusion Transpedicular screw instrumentation and interbody fusion is proved helpful in management of spinal instability secondary to decompression surgery, providing successful interbody fusion and restoration of the intervertebral stability.

0.05). Significant difference was observed between Group C+D and Group A+B(P

Objective To evaluate the clinical efficacy and the surgical treatment of spinal tuber-culosis by debridement, fusion and internal fixation to restore stability of the spine. Methods One hundred and fifty-two patients with spinal tuberculosis were treated surgically between 1996 and 2002. There were 15 in cervical spine, 67 in thoracic spine, 17 in thoracolumbar spine and 53 in lumbar spine. The lesion was of 1-3 levels without jumping lesions. The surgical procedures included: 1) anterior debridement, fusion with autograft and internal fixation with plate. 2) lateral debridement with posterior fusion and pedicle screw fix-ation. 3) posterior debridement, fusion and pedicle screw fixation. 4) anterior debridement and posterior fu-sion and fixation. All patients wore a brace for 3-5 months and chemotherapy was given for 6-9 months postoperatively. The blood test and imaging evaluation were undergone. All patients were followed for 3 to 5 years postoperatively. Results 1) The average operation time and blood loss was 4.5 hours and 650 ml for combined anterior and posterior procedure, 3.5 hours and 450 ml for anterior procedure and 3 hours and 350 ml for the other two procedures. 2) In regard to complications: major blood vessel injury in one case, temporary sinus formation in 5 and loosening and breaking of the instrumentation in 3. 3) All patients had relief of the symptoms and ambulation 1-2 weeks postoperatively. Normal daily function was recovered at 6-8 weeks and solid fusion was observed in 4-6 months postoperatively. All patients were cured of tubercu-losis lesions in spinal column or on other region, and there was no recurrence. Conclusion Effective chemotherapy and radical debridement of the lesion are the basis of success of surgical treatment of spinal tuberculosis. Fusion and internal fixation were the keys for restoration of the stability of spinal column, solid fusion and correction of the kyphotic deformity.

[Objective]To measure the feasibility and efficiency of treating vertical sacral fractures with iliac hollow screws.[Method]Sixteen patients with vertical sacral fractures were treated.10 cases of Denis type Ⅰ and 6 cases of Denis type Ⅱ.[Result]The average following-up period was 16 months. All fractures united within 3 months.Two cases showed symptoms of root L5 injuries.1 case totally recovered and 1case partly recovered by the 3nd month after operation.[Conclusion]It showed simple and easy to master for clinical applying of treating vertical sacral fractures with iliac hollow screws.