ObjectiveTo introduce the design of the instrument for percutaneous posterolateral foraminoplasty and analyze long-term outcomes of percutaneous foraminoplasty and transforaminal endoscopic discectomy in the treatment of non-contained lumbar disc herniation.MethodsFifty-six patients with noncontained lumbar disc herniation confirmed by symptom,physical sign and concordant imaging underwent percutaneous foraminoplasty and transforaminal endoscopic discectomy,including 7 cases of L3-4,30 of L4-5 and 19 of L5S1.The visual analogue scales(VAS) of pre- and post-operative low back pain and sciatica were compared,and the Macnab scores were also evaluated.ResultsAll of the procedures were performed successfully,with mean operation time of 60 min(range,40-120 min),and a mean blood loss of 30 ml (range,20-50 ml).The follow-up time was more than 36 months.Postoperative VAS of low back pain and sciatica were significantly decreased compared with preoperative VAS (P＜0.01).There were 44 cases of excellent,10of good,and 2 of fair according to Macnab score system,with total successful rate (excellent and good) up to 96.4％.Only 5 cases with L5S1 disc herniation were found complicated with sun-burn syndrome,which were relieved by pulsed electro-stimulant therapy for 1 week.ConclusionPercutaneous foraminoplasty and transforaminal endoscopic discectomy is an effective and safe minimally invasive treatment alternative for non-contained lumbar disc herniation.

In this study the relation between the extent and type of disc protrusion and the clinical severity of symptoms of low back pain was observed. Our series consisted of 300 consecutive cases of lumbar disc protrusion,with their diagnosis confirmed by intraoperative observation. Preoperative pain severity was assessed using a back pain scale that combined the symptoms of back pain and sciatica. Intraoperaative pathological findings of disc were documented and comparesd with preoperative symptoms and signs. The pathological changes of disc were classified as following four subtypes: bulging disc (85 cases), protruding disc (104 cases), extruded disc (72 cases) and sequestered disc (39 cases). Our results suggest that severity of pain in patients with herniated lumbar disc is related to position of herniation rather than magnitude and exent of herniation. Inflammed intraspinal tissues are significantly associated with low back pain and sciatica.

Objective To retrospectively analyze the results of unilater al external fixators in the treatment of the distal third fractures of humeral s hafts. Methods From October 1997 to October 2002, 33 patients from 15y-70y (ave rage 31y) with the distal third fractures of humeral shafts were treated with un ilateral external fixators. They included 3 transverses fractures, 1 oblique fra cture, 9 spiral fractures and 20 comminuted fractures. 15 cases were treated wit h open reduction and fixation with external fixators and limited internal fixati on, 10 cases were treated with open reduction and fixation with external fixator s, and 9 cases were treated with closed reduction and fixation with external fix ators. 9 cases with radial nerve injury undewent nerve exploration. External fix ators were removed after bone healing. Duration of follow-up was 8 to 24 m (ave rage 18 m). Results The time of bone healing was 11 to 22 w (average 14 w). At t he latest follow-up, the function of injured radial nerves in 9 preoperative ca ses and 2 postoperative cases and the motion function of elbow were restored to normal. There were only 7 cases of superficial pin site infection which were cur ed with oral antibiotics and pin site care with mild disinfectants. Conclusion U nilateral external fixators can play special roles and have good results in the treatment of the distal third fractures of humeral shafts, combined with open re duction and limited internal fixation.

OBJECTIVETo investigate the epidemiological characteristics of lower back pain of truck drivers in plateau areas with an analysis of the causes and evaluated the effects of the protective measures.

METHODSThe self-reported lower back symptom was investigated by questionnaire in 1,132 male drivers in plateau areas. Vibration of the driver lumbar back was measured real time with or without wearing corset. Study the effect of the special corset for drivers and the massage on back by self-control design of big sample intervention experiments.

RESULTSThe prevalence of lower back pain of drivers in plateau areas was 86.1%. High level of its prevalence is due to many factors. Special corset for drivers and massage on back by themselves can reduce the degree of the pain.

CONCLUSIONDriving in plateau areas is a special occupational work with high level of prevalence of lower back pain which can be prevented.

Automobile Driving ; Humans ; Low Back Pain ; epidemiology ; etiology ; prevention & control ; Male ; Occupational Diseases ; etiology ; prevention & control ; Prevalence ; Surveys and Questionnaires