Objective:To discuss the influence of posterior thoracic and lumbar titanium internal fixation system on magnetic resonance image(MRI).Methods: Twelve patients who received thoracic-lumbar posterior titanium internal fixation system were subjected to MRI scanning.The artifact characteristics of titanium internal fixator and its influence on the spinal canal structure were analyzed.Results: The artifact size was 2-3 times that of the internal fixator.The details in the spinal canal and spinal cord were clearly displayed on the sagittal T_1 and T_2 weighted images and axial T_1 weighted image.The link rod had small artifact and had influence on the images of adjacent lamina and facet,but had little influence on the observations after operation.The pedicle screw in the right position had considerable artifact,which influenced the images of lateral spinal canal,foramina,nerve root,and posterolateral herniated disc.Conclusion: Turbo spin echo sequence should be chosen for MRI scanning in patients implanted with posterior thoracic and lumbar titanium internal fixation system,with the echo time minimized.When reading the MRI images,the influence of titanium fixation system on the postoperative MRI should be considered in order to obtain the correct information of the patients.

[Objective]To discuss the influence of posterior cervical titanium internal fixation system on magnetic resonance image(MRI).[Method]Six cases that had operated in Changhai hospital with posterior cervical titanium internal fixation system performed MRI scan.The MRI system were 1.0-T or 1.5-T scanner.Patients all performed sagital T1,T2 and axial T1-weighted image scan under turbo spin echo(TSE)sequence,then the artifacts and its influence on the MRI image were analyzed.[Result]Mean artifact size ranged from 2 to 3 times of actual screw size.The artifact was similar to the primary shape of internal fixation system with low intensity signal on center and high intensity signal on the margin.The details in the spinal canal can be distinguished.The rod had small artifact,but the laminar hook had large artifact which obscured the posterior structure of spinal canal,and the artifact of pedicle screw had influence on lateral spinal canal,nerve root and vertebral artery.[Conclusion]Patients with posterior cervical titanium internal fixation system should choose Turbo spin echo(TSE)sequence for MRI scan,if the spin echo is performed,the TE should be minimized.

Objective To review and analyze the sexual function of patients with spinal fractures complicated by incomplete paraparesis. Methods A total of 73 patients with incomplete paraparesis resulted from spinal fractures were retrospectively analyzed. Frankel Grade was used to determine the neurologic function and international index of ecrectile function (IIEF) to evaluate patients' sexual function. The patients with sexual dysfunction also were examined for reflex erection and psychogenic erection function. Results There were 21 patients with sexual dysfunction. Through ?2 test, significant difference was found between Frankel grade B and grade C as well as between grade D and grade E (P

Interspinous dynamic stabilization is popular in the non-fusion spine surgery.It is characterized in the motion preservation of segmental lumbar,avoiding the stress change after fusion surgery and adjacent disc degeneration.Interspinous dynamic stabilization systems have got fast development and are widely used in the treatment of lumbar spine disease.As an innovation of traditional fusion surgery,the clinical evaluation is the focus of spine surgeon.In this paper,the recent studies of the clinical evaluation of interspinous dynamic stabilization are reviewed.

To analyze the prevention and treatment of cerebrospinal fluid leakage in spinal surgery.Methods:A retrospective analysis was taken to the 21 cases suffered from cerebrospinal fluid leakage after spinal surgery from January 1995 to May 2000.Results:Through careful treatment peri-operation,20 cases cured between 6 days and 36 days by conservative measurements,incision was applied in one case for repairing dura mater,no cerebrospinal meningitis occured;6 cases after lumbar spinal sugery had cerebrospinal fluid cysts formation after 3 months to 2 years.Conclusions:Almost all cerebrospinal fluid leakage can be cured by repairing dura mater or blocking up leakage in operation and regular conservative treatment after operation.A few cases failing to conservative treatment need reopen incision for repairing dura mater.The symptomatic and conmmunicating cerebrospinal fluid cysts can be treated by surgery.

Percutaneous endoscopic lumbar discectomy belongs to minimally invasive spine operation Its superiority includes smalleroperation wound,less bleeding,shorter hospital day,and earlier return to function,conpared with the traditional operation.At the same time,percutaneous endoscopic lumbar discectomy has complications,as the open operation.This paper reviews its common complications,diagnosis,prevention and control.

The authors analyzed current situation of teachers and students' law consciousness and proposed that we should well know the rights and obligations of the doctor and patient and improve the quality of case history.

We conducted Chinese-English bilingual education on clinical study of medical students and also discussed related problems.Chinese-English bilingual education has very good results in improving professional English study of medical students.

Objective To explore the clinical and radiographic outcomes of minimally invasive transforarninal lumbar interbody fusion (MIS-TLIF) with unilateral pedicle screw fixation in treatment of one-level lumbar degenerative disease.Methods A total of 65 patients suffered from one-level lumbar degenerative disease between October 2009 and December 2011.They were divided into 2 groups according to different fixation ways.31 patients were given MIS-TLIF with unilateral pedicle screw fixation.The other 34 patients were given MIS-TLIF with bilateral pedicle screw fixation.Microscopic tubular retractor system (METRxMD) and Sextant system were used in all the procedures of treatment.The whole lumbar lordosis (WL),the segmnental lordosis (SL),fusion level disc space angle,lumbar scoliosis angle,and segmental scoliosis angle were measured pre and post operation according to standarded X-rays.The disc height index (DI) and the lumber curvature index (LI) were also evaluated.The Oswestry disability index (ODI) score and visual analog scale (VAS) pain score data were obtained from all the patients pre-operation and during each following-up procedure.Results All the patients were well followed up 18 months to 36 months(average 26.6 months).All the 65 patients were proved to achieve bone fusion in 12 months post-operation.The ODI and VAS scores post-operation improved significantly in each group,but showed no significant difference between the 2 groups.Likewise,there were no significant differences between the 2 groups in datas of WL,SL,fusion level disc space angle,lumbar scoliosis angle,segmental scoliosis angle,DI,and LI.But there was a positive linear correlation between the LI and WL in the 2 groups.Conclusion MIS-TLIF with unilateral pedicle screw fixation is as good as MIS-TLIF with bilateral pedicle screw fixation in patients of one-level lumbar degenerative disease.

Objective:To evaluate the validity and reliability of adapted simplified Chinese Version of the Scoliosis Research Society-22(SRS-22)questionnaire.Methods:The English version of the SRS-22 was translated into simplified Chinese and was subjected to cross-culture adaptation;the final version of the simplified Chinese SRS-22 questionnaire was a consensus reached by an expert committee.Then the simplified Chinese version SRS-22 questionnaire and 36-Item Short Form Health Survey(MOS SF-36)questionnaire were used to survey 87 patients with adolescent idiopathic scoliosis who had been surgically treated;63 patients(72.4%)responded to the SRS-22 questionnaire.The average age of these patients(6 male,57 female)was(17.7?3.1)years(range,14.3-23.8 years).Fifty-six of the 63 patients returned the MOS SF-36 questionnaire.The 2 indicators of reliability were Cronbach's ? of internal consistency and intraclass correlation coefficient(ICC).Concurrent validity of the SRS-22 questionnaire was measured by comparing with domains of the SF-36 questionnaire,which was reflected by Pearson correlation coefficient(r).Results:The Cronbach ? values for 4 domains(function/activity,pain,self-image/appearance,and mental health)were all higher than 0.7;and the Cronbach ? value for satisfaction of management domain was acceptable.The intraclass correlation coefficients for function/activity,pain,self-image/appearance,mental health,and satisfaction domain were 0.74,0.78,0.86,0.81 and 0.84,respectively,demonstrating a satisfactory reproducibility.For the concurrent validity,3 domains had excellent correlation,10 had good correlation,and 21 had moderate correlation.Conclusion:The adapted simplified Chinese Version of the SRS-22 questionnaire has satisfactory reliability and concurrent validity,and might be suitable for post-operation clinical evaluation of Chinese adolescent patients with scoliosis.