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41.
42.
Vertebral body replacement system Synex in unstable burst fractures of the thoracic and lumbar spine
U. Vieweg 《Journal of orthopaedics and traumatology》2007,8(2):64-70
A prospective longitudinal study was performed to evaluate the vertebral body replacement system Synex associated with posterior
fixation in unstable burst fractures of the lumbar and thoracic spine. Within 24 months, we treated 28 patients (average age,
41 years; range, 22–64 years; 14 women, 14 men) with acute unstable burst fractures without osteoporosis of the thoracolumbar
region (n=16) and the thoracic (n=3) as well as the lumbar (n=9) spine in two stages (primary dorsal transpedicular stabilization and secondary vertebral body replacement). The complications
were analyzed and the postoperative follow-up result was evaluated regarding stability, bone fusion, correction loss, pain
and neurological status. One patient showed a transient irritation of the lumbosacral plexus and one patient had a superficial
wound infection (complication rate, 7.1%). At the follow-up examination (mean follow-up, 13 months) only in two cases a minimal
loss of correction (<5°) was measured. Radiologically, 27 patients showed secure bone fusions and all patients had stability
of the osteosynthesis. Most of the patients stated no or just slight pain at follow-up. Only two patients with pain to a medium
degree had to take painkillers. The vertebral body replacement system Synex seems to be a good alternative for vertebral body
replacement in unstable burst fractures of the thoracic and lumbar spine since at present follow-up it shows a high rate of
bone fusion and minimal loss of correction. 相似文献
43.
44.
目的探讨原位复发性腰椎间盘突出症再次手术的原因、手术方法及疗效。方法我院自2000年6月~2005年11月共收治17例原位复发性腰椎间盘突出症患者均采取椎板扩大开窗、椎间颗粒植骨融合、椎弓根钉内固定术,术后随访1~5年(平均19.7月),进行回顾性分析。结果椎间植骨融合率为94.1%;按Macnab疗效评定标准,优良率为88.2%。结论原位复发性腰椎间盘突出症的主要原因是髓核组织摘除不彻底,神经根粘连,并伴随不同程度的椎管狭窄和腰椎不稳。明确诊断、严格掌握手术指征、认真细致地进行手术操作,可减少或避免手术并发症,取得优良的疗效。 相似文献
45.
46.
CT导向下医疗用臭氧治疗腰椎间盘突出症 总被引:2,自引:0,他引:2
目的观察CT导向下医用臭氧治疗腰椎间盘突出症的疗效。方法30例腰椎间盘突出症患者,术前均经CT或MRI检查证实。在CT导向下行臭氧消融治疗。盘内注入浓度为60μg/ml臭氧10-20 ml,退针出纤维环至椎间孔附近,注入浓度为40μg/ml臭氧5 ml。结果随访时间1-6个月,显效7例,有效18例,无效5例,总有效率为80.3%,未发生任何明显并发症。结论CT导向下医用臭氧局部注射是治疗腰椎间盘突出症的一种有效方法。 相似文献
47.
Robert M. Levy Roman Saikovsky Evgeniya Shmidt Alexander Khokhlov Bruce P. Burnett 《Nutrition Research》2009
Flavocoxid (Limbrel), a proprietary mixture of flavonoid molecules (baicalin and catechin), was tested against a traditional nonsteroidal anti-inflammatory drug, naproxen, for the management of the signs and symptoms of moderate osteoarthritis (OA) in humans. Discomfort and global disease activity were used as the primary end points, and safety assessments were also taken for both treatments as a secondary endpoint. In this double-blind study, 103 subjects were randomly assigned to receive either flavocoxid [500 mg twice daily (BID)] or naproxen (500 mg BID) in a 1-month onset of action trial. Outcome measures included the short Western Ontario and McMaster University Osteoarthritis Index, subject Visual Analogue Scale for discomfort and global response, and investigator Visual Analogue Scale for global response and fecal occult blood. Both flavocoxid and naproxen showed significant reduction in the signs and symptoms of knee OA (P ≤ .001). There were no statistically detectable differences between the flavocoxid and naproxen groups with respect to any of the outcome variables. Similarly, there were no statistically detectable differences between the groups with respect to any adverse event, although there was a trend toward a higher incidence of edema and nonspecific musculoskeletal discomfort in the naproxen group. In this short-term pilot study, flavocoxid was as effective as naproxen in controlling the signs and symptoms of OA of the knee and would present a safe and effective option for those individuals on traditional nonsteroidal anti-inflammatory drugs or cyclooxygenase-2 inhibitors. A low incidence of adverse events was reported for both groups. 相似文献
48.
胸腰椎病变CT监视下穿刺活检路径分析 总被引:2,自引:0,他引:2
目的探讨胸腰椎病变CT监视下穿刺活检中穿刺路径的选择方法。方法141例胸腰椎病变临床诊断不清患者,其中胸椎70例,腰椎71例。根据病变位于脊椎的不同部位选择合适的穿刺路径,于CT监视下穿刺取材。穿刺路径:经椎旁路径63例,经椎弓根路径45例,经肋椎关节路径11例,其他路径22例。结果141例中共有128例诊断正确,穿刺结果诊断正确率为90.8%。无并发症发生。结论胸腰椎病变穿刺路径的选择要根据病变的位置不同具体分析。总的原则是安全、取材量多、对患者损伤小。 相似文献
49.
目的探讨应用普通股骨髓腔扩大绞刀代替专用的椎间植骨器械,进行腰椎后路椎间植骨融合术的临床经验体会,评估治疗效果。方法对我院34例应用股骨髓腔绞刀进行腰椎后路椎间植骨融合术的病例资料,进行回顾性分析。结果本组34例无围手术期硬膜及神经根损伤,无伤感染和和植骨块松脱。随访5~6年,植骨全部于6~8个月愈合,无一例植骨塌陷。按Machnab标准评定:优21例,良11例,可2例,差0例,优良率94.12%。结论改良应用股骨髓腔扩大绞刀代替专用的椎间植骨器械,作椎间植骨床的准备,效果满意,安全方便。 相似文献
50.
Anders Moller MD Ralph Hasserius PhD Inga Redlund-Johnell PhD Acke Ohlin PhD Magnus K. Karlsson PhD 《The spine journal》2007,7(6):701-707
BACKGROUND CONTEXT: Several studies report a favorable short-term outcome after nonoperatively treated two-column thoracic or lumbar burst fractures in patients without neurological deficits. Few reports have described the long-term clinical and radiological outcome after these fractures, and none have, to our knowledge, specifically evaluated the long-term outcome of the discs adjacent to the fractured vertebra, often damaged at injury and possibly at an increased risk of height reduction and degeneration with subsequent chronic back pain. PURPOSE: To evaluate the long-term clinical and radiological outcome after nonoperatively treated thoracic or lumbar burst fractures in adults, with special attention to posttraumatic radiological disc height reduction. STUDY DESIGN: Case series. PATIENT SAMPLE: Sixteen men with a mean age of 31 years (range, 19-44) and 11 women with a mean age of 40 years (range, 23-61) had sustained a thoracic or lumbar burst fracture during the years 1965 to 1973. Four had sustained a burst fracture Denis type A, 18 a Denis type B, 1 a Denis type C, and 4 a Denis type E. Seven of these patients had neurological deficits at injury, all retrospectively classified as Frankel D. OUTCOME MEASURES: The clinical outcome was evaluated subjectively with Oswestry score and questions regarding work capacity and objectively with the Frankel scale. The radiological outcome was evaluated with measurements of local kyphosis over the fractured segment, ratios of anterior and posterior vertebral body heights, adjacent disc heights, pedicle widths, sagittal width of the spinal canal, and lateral and anteroposterior displacement. METHODS: From the radiographical archives of an emergency hospital, all patients with a nonoperatively treated thoracic or lumbar burst fracture during the years 1965 to 1973 were registered. The fracture type, localization, primary treatment, and outcome were evaluated from the old radiographs, referrals, and reports. Twenty-seven individuals were clinically and radiologically evaluated a mean of 27 years (range, 23-41) after the injury. RESULTS: At follow-up, 21 former patients reported no or minimal back pain or disability (Oswestry Score mean 4; range, 0-16), whereas 6 former patients (of whom 3 were classified as Frankel D at baseline) reported moderate or severe disability (Oswestry Score mean 39; range, 26-54). Six former patients were classified as Frankel D, and the rest as Frankel E. Local kyphosis had increased by a mean of 3 degrees (p<.05), whereas the discs adjacent to the fractured vertebrae remained unchanged in height during the follow-up. CONCLUSIONS: Nonoperatively treated burst fractures of the thoracic or lumbar spine in adults with or without minor neurological deficits have a predominantly favorable long-term outcome, and there seems to be no increased risk for subsequent disc height reduction in the adjacent discs. 相似文献