Acupuncture Therapy ; Diarrhea ; therapy ; Female ; Humans ; Young Adult

Objective To investigate the technique and clinical effects of pedicle screw fixation in treatment of unstable Hangman' s fractures in comparison with the conservative managements. Methods From January 1999 to July 2005, 36 patients with unstable Hangman' s fractures were treated in our department. Based on Levine- Edwards classification, 15 of them were treated with skull traction, and others with internal fixation with posterior pedicle screws (C2,3 fusion in 10 cases and C2- 4 fusion in 11 cases). After a posterior midline incision and clear exposure of posterior structure, the C2 screw was inserted through the center of the posterior aspect of lateral mass, inclining usually 20? to 30? towards the head of the transverse plane and 25? to 35? inwards to the medial incline of the sagittal plane. For C3,C4 screw insertion, the drilling was parallel to the joint plane of the relevant vertebra and inclined 35? to 40? outwards to the medial incline of the sagittal plane. The whole procedure was performed under the monitoring of C- arm screen for safety and accuracy. Results A mean follow- up time was 18 months (5 to 28 months). 6 cases treated by skull traction lost their anatomic reduction. Of the 21 cases treated by the pedicle screw fixation, 2 had loosened internal fixation but 19 experienced no screw loosening and their fractures were cured entirely without limited function of the cervical vertebra. Conclusions In treatment of unstable Hangman' s fractures, C2,3 or C2- 4 pedicle screw fixation is an effective method to achieve rigid reduction and early rehabilitation. However, there is no remarkable difference between C2,3 fusion and C2- 4 fusion

Purpose:To study the effect of single lung ventilation for pneumoresection on blood gas. Methods:20 patients with lung cancer whose lung function were normal or reduced slightly before the operation were divided into 2 groups (A and B),of 10 cases each.The patients in group A underwent single lung ventilation with an endobronchial tube during the operation ,and two lung ventilation with an endotracheal in group B.Blood gas analysis was measured in every patient before, during and after the operation.Results:The values of blood gas analysis during the operation in all patients were normal and no significant difference was found between the two groups during the same time. Conclusions:The patients with lung cancer whose lung function were normal or reduced slightly before the operation can receive single lung ventilation safely for pneumoresection.[

[Objective]To introduce the composion and mechanism of Iliac Bars Lever Reduction and Fixation System(IBRFS),and to evaluate the clinical efficacy of IBRFS.[Method]IBRFS was made of stainless steel composing of pedicle screw,anglar lift,reduction rod,iliac bar and screw nut A,B,C.Eighteen volunteers offered their contribution for this study.There were 6 males and 12 females with mean age of 53 years(range from 43-66 years).The classification was DS 9,IS 8,trauma 1.The slip segments were L4 6,L5 12.The reductive operation was conducted by IBRFS.Clinical efficiency was evaluated by slip ratio,slip angle,sacral slope and the height of intervertebral space.[Result]Eighteen patients were followed up from 8 to 28 months(average 14.9 months).Preoperative JOA scores ranged from-1 to 22(mean 10.7).Postoperative JOA scores ranged from 13 to 29(mean26.9).The overall recovery rate ranged from 42.9% to 98%(mean 88.3%).There was no neurologic complication.Slip ratio was improved from 20.80% to 5.01%,slip angle from 6.67?to 12? and sacral slope from 32.2? to 43.3?.The height ratio of intervertebral space was increased from 0.78 to 0.97.[Conclusion]The reduction efficiency of IBRFS is reliable.The restoration of height of intervertebral space is improved.IBRFS is an effective internal fixation.

[Objective]To present a validated two-functional spinal unit C4~7 finite element model with simulated placement of a disc prosthesis treatment to predict stresses and strains within adjacent vertebal bodies. [Methods]Two finite element models of C4~7 were generated using the CT scans taken from a male patient following placement of a disc prosthesis treatment,which were included with adjacent bodies,intervertebral discs. Simulations were conducted imposing a compression preload combined to a flexion/extension moment,a pure lateral bending moment and a pure torsion moment,and to quantify the stress levels in intervertebral discs,endplate,cancellous bone,cortical bone and adjacent bodies following placement of a disc prosthesis under clinically relevant loading conditions.[Results]The BryanTM disc prosthesis allows to correctly reproduce a physiological motion at the implanted level,and the changes in stresses and strains in levels adjacent to a placement of a disc prosthesis treatment level were minimal.[Conclusion]The artificial cervical disc prosthesis well restores the biomechanical behavior of the intact spine. Moreover,the selection of surgical indications and proper manipulations shoule bve paid more attehtion to.

[Objective]To analyze the therapeutic effects of percutaneous kyphoplasty for acute versus chronic osteoporotic vertebral compressive fracture.[Method]Percutaneous kyphoplasty was performed in 56 patients(137 vertebraes) with osteoporotic vertebral compression fracture (VCF).Based on the changes on MRI,all compression fractures were divided into 3 types:acute VCF,repairing VCF and chronic VCF.Types were examined for differences in treatment efficacy,according to the anterior/middle vertebral body height,Cobb's angle and visual analogue scale(VAS) at pre-and post-operation.[Result]All patients with the VCFs had rapid and significant improvement in back pain following percutaneous kyphoplasty.VAS was from 8.09?1.12 preoperatively to 2.31?0.91 postoperatively,and 2.26?0.88 at final follow-up.The results showed that 41 cases were Type Ⅰ on MRI,69 were Type Ⅱ and 27 were Type Ⅲ.Significant improvement was observed at the post-operative versus pre-operative assessments in Type Ⅰ and Type Ⅱ.No significant differences were observed between post-and pre-operative assessments in Type Ⅲ.[Conclusion]The curative effect of percutaneous kyphoplasty for the treatment of acute VCFs appears superior to that of chronic VCFs.After a definite diagnosis of VCFs,percutaneous kyphoplasty should be performed as early as possible in order to obtain a better therapeutic effect.

[Objective]To observe the correlation between electromyogram(EMG) combined with MRI and clinical outcome in patients with cervical spondylotic myelopathy(CSM). [Methods]Patients with CSM who were confirmed by clinical and image examination were examined by EMG.Peripheral nerve injury such as cubital tunnel syndrome and carp tunnelsyndrome were excluded.Eighty-nine cases were selected and followed-up after surgical treatment with anterior,posterior,or posterior-anterior combined surgery.Four types were classified according to EMG and MRI.Type I:EMG/MRI(-/-).Type II:EMG/MRI(-/+).Type III: EMG/MRI(+/-).Type IV:EMG/MRI(+/+).The clinical outcome were also graded according to the Japanese Orthopaedic Association(JOA) scoring system.Furthermore,the data were analyzed statistically to explore the correlation of the factors.[Results]The results showed that 36 cases were in Type Ⅰ,17 were in Type Ⅱ,10 were in Type Ⅲ and 26 were in Type Ⅳ.Clinical function was excellent in 42 patients,good in 20 patients,fair in 18 patients,and poor in 9 patients.There was a good correlation between types and the clinical outcome(Hc=30.72,P

Objective To evaluate the life quality in the elderly who underwent internal fixation with cannulated screws and bipolar hemiarthroplasty for the displaced femoral neck fractures. MethodsA retrospective study was performed on 141 cases older than 60 years treated from 1993 to 2004. All cases were followed up for mean 40.2 months to evaluate the differences in regard of pain and daily living at one and three years. Results The daily living in hemiarthroplasty group possessed better outcome than that in internal fixation group at one year, with statistical difference but without statistical difference at three years. There was no statistical differences in postoperative pain relief between both groups. Conclusions Both internal fixation and hemiarthroplasty can relieve pain and revive the life quality of the elderly.

[Objective]To verify whether or not the modified open-door laminoplasy preserving semispinalis cervicis insert into axis is effective in preventing postoperative axial symptom and maintaining postoperative cervical sagittal alignment.[Method]Since March 2002 to December 2003,forty-eight patients underwent modified open-door laminoplasy preserving semispinalis cervicis insert into Axis,among them,thirty-two patients who were followed up for more than 2 years were included in this study.Preoperative and postoperative JOA score,degree of axial symptom,ranges of neck motion,cervical curvature index were recorded and compared.[Result]Preoperative and postoperative JOA score was(9.04?2.9)and(12.5?3.1)respectively,with recovery rate as(44.9?26.9).There was significant difference between preoperative evident axil symptom rate(46.8%)and postoperative evident axil symptom rate(18.7%),while no significant difference between preoperative and postoperative ranges of neck motion,cervical curvature index was seen.[Conclusion]Modified open-door laminoplasy is less invasive to the posterior extensor mechanism especially the semispinalis cervicis than conventional open-door laminoplasy.This new procedure is effective in preventing postoperative morbidities often seen after conventional laminoplasy with adequate decompression of the spinal cord.

Objective To verify whether the modified open-door laminoplasty with C3 laminectomy is effectve in preventing postoperative axial symptom. Methods Since March 2001 to March 2005, 44 patients who underwent modified open-door laminoplasty with semispinalis cervicis insertion intact were included in this study(group A). 50 patients who underwent conventional open-door laminoplasty in the authors' department during the same period were served as control(group B). Preoperative and postoperative Japanese Orthopedic Association(JOA) scores, the degree of axial symptom, ranges of neck motion, cervical curvature index were recorded and compared. Results The average JOA recovery rate was 59.2%?11.3% for group A and 60.1%?19.5% for group B. There was no significant difference in JOA recovery rate between two groups. The rate of patients with evident axial symptoms was 22.7% in group A and 54.0% in group B, and the difference was statistically significant(P