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.

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.

Objective To explore a biodegradable drug?loaded composite scaffold and determine its bone regeneration and local long?term drug release ability. Methods In this study, RFP?loaded a novel poly (caprolactone)?b?poly (lactide?co?gly?colide)/β?TCP composite scaffold was produced using particle?leaching/freeze?drying technique. And the obtained composite scaffold was characterized by SEM, TGA, UV spectrophotometer, universal testing machine and so on. New Zealand rabbits were used to prepare bone defects, which was treated by the implantation of active artificial bone loaded with or without RFP. The blank group was untreated. Then the repairing effects of the materials were examined. Results The obtained porous scaf?fold has inter?connected and uniformly distributed pores, and the diameters of pores range from 200 μm to 300 μm. Many mi?cropores (10 μm to 50 μm) can be observed on the wall of macropores. The total porosity of the porous composite scaffold can reach as high as 83.4%; the β?TCP content of the scaffolds is 51.2%. Meanwhile, the addition of β?TCP avoided volume shrinkage compared with b?PLGC scaffold; Additionally, the porous composite scaffold has good compressive strength ( 240 kPa) and compressive modulus (1.0 MPa); And the drug loading of the scaffold was 3.2%,which could smoothly release drug for 63 days after a period of burst release for a week. All defects in the experimental groups were radiographically repaired. There were significant differences between the experimental groups and the control group. Conclusion RFP?loaded poly (cap?rolactone)?b?poly (lactide?co?glycolide)/β?TCP composite scaffold is expected to benefit in drug therapy and bone repair in the treatment of bone tuberculosis.

Objective To establish a three-dimensional finite element model and make mechanical analysis of "V"-type atlantoaxial reduction and internal fixation. Methods According to "V"-type atlantoaxial and internal fixation,based on screw-type Ⅱ design parameters,and using Pro/E 2001 and MSC.Patran 2005 software,we set up a finite element model and calculated the region containing the node scope of the force as the sites binding and 100N mechanics adding. Results The model looked realistic,geometric similarity.The deformation stress field mainly concentrated in the reset device V-tip arm bending and stability.The strength of its maximum stress was 4.78MPa,and the scope had 2794 nodes.V-type wing of the acute angle point of convergence of the premises to bear the stress intensity followed.It was 0.31MPa,and the scope had 1953 nodes.V-type wing by the end of edge was the smallest for the 1.22?10-3MPa,and there was the scope of 1730 nodes. Ⅱ-shaped fixed nail stress concentrated at the central parts of tooth and the art on both sides of teeth,with maximum stress intensity of 1.68?10-2MPa,and there was the scope of 1146 nodes. Conclusion The reduction and fixation devices to load at the time of recovery deformation forces and mechanical characteristics adapted to Ni-Ti shape memory alloy material functions and super-elasticity completely,which meets the clinical needs.

Objective To evaluate the surgical outcomes in patients with lumbar disorder treated with enlargement of the spinal canal through spinous process osteotomy. Methods Posterior central incision was used for unilateral exposure of lamina. Osteotomy was done at the base of the spinous process; complete exposure of the lamina was done by retracting the interspinous and supraspinous ligaments. Ligament flaven was resected at the superior and inferior margin of the lamina. Undermining enlargment of the central spinal canal and the neural canal were then carried out; in some cases the intervertebral disc was resected. Thirty seven patients suffered from lumbar spinal stenosis were treated with the above mentioned procedure; among them decompression of a single segment was done in 24 cases, in two segments in 13 cases. Postoperatively, Oswestry evaluation score and imaging observation were carried out. Results Thirty four cases had follow up for one year and the excellent and good results was seen in 82.4%; 27 cases had follow up of 3 years, the rate of excellent and good results was 81.5%. Both sagittal and transverse diameter of lumbar vertebrae canal were increased notably in postoperative CT scanning. 87% of osteotomized spinous processes had bony fusion. Conclusion Spinal canal plasty by spinous process osteotomy for patients with lumbar disorders affords easy performing procedure with less complications and satisfactory surgical results.

Objective To evaluate the result of anterolateral interbody fusion combined with transpedicle fixation for patients with kyphosis due to tuberculosis of the thoracic spine. Methods There were totally 17 patients, 11 male and 6 female in this study. The average age was 36.4 years, ranging from 23 to 56 years old. All tuberculous lesions were located in low thoracic spine, two vertebral bodies were involved in 9 patients and three vertebral bodies involved in 8 patients. The average kyphosis angle was 25 degrees, ranging from 15 to 34 degrees. Mild neurological function deficiency (Frankel Grade C or D) were present in 5 patients. All patients were treated with one stage posterior transpedicle fixation and anterolateral interbody fusion combined with 9 month antituberculous medication. Results All patients were followed up for 2 to 4 years postoperatively. All incisions were healed up primarily. Interbody fusion was achieved in all patients from 4 to 6 months after operation. All patients were cured and there was no recurrence within follow up period. The average kyphosic angle was 7 degree postoperatively, and the average correction of kyphosis angle was 18 degree, which was maintained well within follow up period. Patients with neurological function deficiency achieved complete recovery one year after operation. Conclusion Anterolateral interbody fusion combined with transpedicle fixation provides rigid fixation and good stability for early fusion and facilitates tuberculous kyphosis correction. This one stage procedure is effective in decreasing duration of antituberculous medication and increasing curing rate of spinal tuberculosis.

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 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.