Objective to investigate the clinical efficacy of decompression and pedicle screw fixation through posterior approach for complete thoracic spine fracture dislocation.Methods The clinical data of six patients with complete thoracic spine fracture and dislocation treated from September 2002 to June 2016 were analyzed retrospectively by case series study.There were five males and one female,aged 21-67 years old (mean,47.2 years).The injury segments were T3～4 dislocation in one case,T5～6 dislocation in two cases,T6 ～7 dislocation in two cases and T8 ～9 dislocation in one case.There was one case of ASIA grade E and five cases of Grade A,and all of six cases were associated with multiple rib fractures and hemopneumothorax.The companied status was one case of sternal fracture,one case of atlantoaxial complex fractures and three cases of pulmonary contusion.The posterior median incision decompression and pedicle screw system fixation were performed,and the intervertebral bone grafting was conducted after restoration.The surgery time,bleeding volume during surgery,fracture restoration,bone grafting fusion,failure of internal fixation and other complications were recorded.The Visual Analogue Scale (VAS) and American Spinal Injury Association (ASIA) classification were used to assess the pain and neurological function improvement between the preoperative visit and final follow-up visit.Results The surgery time was 150-240 minutes (mean,205 minutes).The bleeding volume during the surgery was 700-2 100 ml (mean,1167 ml).One case was died of pulmonary infection at one week after surgery,the others were followed up for 3-14 months (mean,7.4 months).After operation,five patients were satisfied with the reduction,and the lateral displacement was partially restored in one cases.Five cases of intervertebral bone grafting all had bone fusion.There was no fixation failure.The VAS was (7.4 ± 0.6) points before surgery,(4.5 ± 1.6) points at one week after surgery and (1.8 ± 0.3) points at final visit of follow-up,which had significant difference from the preoperative status (P ＜ 0.05).One case of ASIA grade E had no postoperative aggravation and four cases of grade A had no improvement.Conclusion Posterior decompression and pedicle screw fixation system is optimal choice of treatment for complete thoracic fractures and dislocations for it can attain reduction of fracture and dislocation as well as bone fusion,provide stability for spine and relieve pain.

Objective To investigate the effect of ligustrazine on autophagy-related proteins Beclin 1,LC3 and P62 after spinal cord ischemia-reperfusion injury.Methods A total of 48 SD rats were randomly divided into sham operation group,model group,ligustrazine group and 3-MA group.The rats were intraperitoneally injected with ligustrazine injection 0.16 mg/kg in the Ligustrazine group,the rats were intraperitoneally injected with 3-methyladenine injection 0.015 mg/kg in the inhibitor group,and the rats were intraperitoneally injected with normal saline of equal volume in the sham operation group and model group.Spinal cord ischemia-reperfusion model was established in all groups except sham-operated group after administration.After molding behavioral scores were scored after 3 and 6 hours of ischemia,and the expression of Beclin 1,LC3 and P62 was detected by immunohis-tochemistry.Results After 3 and 6 hours,compared with the model group,the behavioral score (3 h:2.33 ± 0.58 vs.0.67 ± 0.58,6 h:3.33 ± 0.58 vs.1.33 ± 0.58) of the rats in ligustrazine group significantly increased (P＜0.05).Compared with the model group,the expression of Beclinl (3 h:348.00×104± 0.27×104 vs.659.00×104± 0.11×104;6 h:38.00×104± 0.19×104 vs.557.00×104± 0.26×104),LC3 (3 h:357.00×104± 0.48×104 vs.686.00×104± 0.33×104'6 h:334.00×104± 0.51×104 vs.673.00×104 ± 0.22×104),P62 (3 h:357.00×104 ± 0.48×104 vs.830.00×104 ± 0.48×104;6 h:315.00×104 ± 0.12× 104 vs.591.00× 104± 0.36× 104) in ligustrazine group were significantly decreased (P＜0.05).Conclusions The ligustrazine may regulate autophagy in two directions and protect nerve cells.

Objectives:To observe the clinical efficacy of anterior cervical V-osteotomy Y-decompression and fusion(ACVYF)for treating ossification of posterior longitudinal ligament(OPLL)in cervical spine.Meth-ods:The clinical data of 60 patients with single-segment vertebral level OPLL who underwent surgical treat ment in Luoyang Orthopedic Traumatological Hospital of He'nan Province from June 2018 to October 2022 were retrospectively analyzed.Among them,30 cases were treated with ACVYF operation(ACVYF group),in-cluding 18 men and 12 women,aged 47-65 years(61.0±6.4 years),with a body mass index(BMI)of 16.8-28.1kg/m2(23.67±2.86kg/m2)and a disease duration of 10-80 months(37.5±20.1 months),whose surgical seg-ments fell in C3 in 2 cases,C4 in 5 cases,C5 in 13 cases,C6 in 10 cases.The other 30 cases were treat-ed with anterior cervical corpectomy decompression and fusion(ACCF)operation(ACCF group),including 19 men and 11 women,aged 44-68 years(59.5±6.8 years),with a BMI of 16.6-26.4kg/m2(23.30±2.56kg/m2)and a disease duration of 13-72 months(35.8±18.8 months),whose surgical segments fell in C3 in 3 cases,C4 in 6 cases,C5 in 12 cases,C6 in 9 cases.The two groups were comparable in gender,age,BMI,disease dura-tion,surgical section and other general information with no statistical difference(P＞0.05).The operation time,intraoperative bleeding,and complications of the two groups were compared;The cervical Japanese Or-thopaedic Association(JOA)scores were recorded before operation,at 1 week,and 3,6 and 12 months after operation,and the JOA score improvement rate was calculated at postoperative 12 months;The height of the fusion area and C2-7 Cobb angle were measured on X-ray films at pre-operation,1 week,3 months,6 months and 12 months after operation.The fusion condition of implants were observed and evaluated on X-ray film or CT image at 3 months,6 months and 12 months after operation.Results:The operation was completed smoothly in both groups.The operation time and intraoperative bleeding were 88.2±19.7min and 133.3±24.4mL respectively in the ACVYF group,which were 91.5+24.1min and 137.7±29.4mL in the ACCF group,and there was no statistical difference between the two groups(P＞0.05).Three cases of dysphagia occurred in both groups after surgery,which resolved spontaneously after 1-2 weeks.No complications occurred during the follow-up period,and there was no statistically significant difference in the complication rates between the two groups(P＞0.05).The JOA scores of both groups at all time points after surgery showed significant improvement compared with those before surgery(P＜0.05),and there was no statistically significant difference between the two groups at the same time points(P＞0.05);The height of the fusion zone and C2-7 Cobb angle after operation were statistically different from those before operation(P＜0.05),and no significant difference was found between the two groups at preoperation,postoperative 1 week and 3 months(P＞0.05),while those of ACVYF group were bigger than ACCF group at postoperative 6 and 12 months(P＜0.05).The improvement rate of cervical JOA score at 12-month follow-up was(72.39±10.54)％in the ACVYF group and(75.92±10.39)％in the ACCF group,and there was no statistically significant difference between the two groups(P＞0.05).The rate of implant fusion was better in the ACVYF group at 3-month and 6-month follow-ups(70.0％and 93.3％)than in the ACCF group(40.0％and 73.3％)(P＜0.05),and both groups had osseous fusion at 12 months postoperatively(P＞0.05).Conclusions:ACVYF can effectively relieve the compression of the posterior longitudinal ligament on the spinal cord at the vertebral level and improve the neurological function of the patients;Comparing with ACCF,ACVYF can better maintain the physiological curvature of the cervical vertebrae and speed up the fusion of the implants.