不同手术方式治疗颈椎后纵韧带骨化症的并发症比较

目的探讨不同手术方式治疗颈椎后纵韧带骨化症的并发症。方法回顾性选取2011年1月~2012年12月入院经临床确诊为颈椎后纵韧带骨化症的患者60例,分为颈前路手术组和颈后路手术组各30例,分析两组的并发症发生情况。结果颈前路手术组出现并发症10例（33.33%）,其中脑脊液漏3例、植骨块滑脱2例、切口感染3例、术后血肿2例。颈后路手术组出现并发症5例（16.67%）,其中颈部疼痛3例、颈屈伸活动受限1例、脊髓损伤1例。两组并发症发生率比较,差异有统计学意义（P〈0.05）。结论颈后路手术治疗颈椎后纵韧带骨化症并发症发生率比颈前路低,可为临床工作的开展提供更好的方向。     

中西医结合治疗强直性脊柱炎的效果观察

目的 观察中西医结合治疗强直性脊柱炎的效果.方法 选取本院2010年2月～2012年6月收治的160例强直性脊柱炎患者为研究对象,将其随机分为对照组和治疗组,每组80例,对照组患者给予单纯西药治疗,治疗组在此基础上加用中药治疗,疗程结束后对比分析两组患者的疗效.结果 治疗组治疗总有效率明显高于对照组（P＜0.05）,两组患者晨僵时间、C反应蛋白（CRP）、红细胞沉降率（ESR）等临床指标和治疗前相比有明显的改善（P＜0.05）,但治疗组改善情况明显优于对照组（P＜0.05）,两组患者主要不良反应为胃肠道反应,差异无统计学意义（P＞0.05）.结论 强直性脊柱炎采用中西医结合治疗疗效确切,安全性高,可明显改善患者相关的临床症状,值得在临床上推广应用.     

改良单侧PLIF治疗腰椎间盘突出症伴腰椎不稳的疗效观察

目的比较改良单侧后路腰椎椎体间融合术(PLIF)与传统PLIF治疗腰椎间盘突出症伴腰椎不稳症的临床疗效。方法回顾性分析自2014-07—2015-06诊治的60例单节段腰椎间盘突出症伴腰椎不稳,采用改良单侧PLIF治疗30例(观察组),采用传统PLIF治疗30例(对照组)。比较2组手术时间、术中出血量、植骨融合率,术后4周及末次随访时的VAS评分、ODI指数,末次随访时的JOA评分及优良率,以及并发症情况。结果观察组手术时间、术中出血量少于对照组,差异有统计学意义(P0.05)。观察组28例获得随访,随访时间(16.81±4.27)个月;对照组26例获得随访,随访时间(15.59±4.49)个月。2组植骨融合率差异无统计学意义(P0.05)。观察组术后4周及末次随访时的VAS评分、ODI指数均低于对照组,末次随访时JOA评分优良率高于对照组,差异有统计学意义(P0.05)。结论改良单侧PLIF治疗腰椎间盘突出症伴腰椎不稳的创伤相对较小,有利于患者后期的功能恢复;同时术中能够有效减少对椎管内的干扰,减少术中出血量,有效缩短手术时间,疗效满意。     

大鼠脊髓缺血再灌注损伤后甲基强的松龙对肿瘤坏死因子－α表达的影响

目的研究大鼠脊髓缺血再灌注损伤（SCⅡ）后肿瘤坏死因子－α（TNF—d）的表达及甲基强的松龙（MP）预干预对TNF－α【表达的影响。方法健康雄性SD大鼠150只随机分成3组：对照组（n=50）仅手术暴露腹主动脉,不做进一步处理;脊髓缺血再灌注损伤纽（SCⅡ组）（n=50）建立SCⅡ模型,夹闭腹主动脉30min后松开,再灌注3h;甲基强的松龙组（MP组）（n=50）于建立SCⅡ模型前30min尾部静脉注射MP（30mg／kg）,而A组和B组于术前30min分别注入等量的生理盐水。3组均取腰段脊髓标本,观察损伤节段脊髓病理形态学变化,用免疫组织化学染色方法观察脊髓组织TNF－α的表达,并对大鼠后肢运动功能进行评分。采用SPSS10．0软件对数据进行统计学处理。结果①SCⅡ组脊髓组织内TNF—d呈高表达,与对照组相比差异有统计学意义（P〈0．05）。②MP组脊髓细胞内TNF－α表达明显降低,与SCⅡ组对比差异有统计学意义（P〈0．05）。③大鼠脊髓缺血再灌注损伤后后肢功能评分降低,MP组后肢运动功能评分提高。结论①SCⅡ后脊髓细胞TNF－α呈高表达。②预防应用MP可降低TNF－α的表达,也即预防应用MP能减轻脊髓缺血再灌注损伤,保护脊髓神经功能。     

甲泼尼龙预干预脊髓缺血再灌注损伤对热休克蛋白27和肿瘤坏死因子α表达的影响

Objective To observe the effect of methylprednisolone (MP) pre-intervention on ex-pressions of heat shock protein 27 (HSP27) and tumor necrosis factor alpha (TNF-α) in cells in rat spinal cord following ischemia-reperfusion injury. Methods One hundred and fifty male Sprague-Dawley (SD) rats were randomly divided into 3 equal groups: group A (control) in which the abdominal aorta was exposed without any treatment, group B in which the abdominal aorta was clipped for 30 minutes before reperfusion for 3 bours to establish a model of ischemia- reperfusion injury, and group C in which intravenous MP injection was conducted 30 minutes before the establishment of the ischemia-reperfusion injury model. Three hours later the spinal cords were harvested. Pathological changes of spinal cord cells were observed with HE staining and expressions of HSP27 and TNF-α in spinal cord cells were observed with immunohistochemical staining. The motor function of hind-limbs before was evaluated before sample harvest. The data were analyzed with SPSS software. Results There were significant differences between groups A and B in the expressions of TNF-α and HSP27. Compared with group B, the expression of TNF-α decreased and HSP27 increased in group C, with statistically significant differences between the 2 groups. The motor function score of hind-limbs decreased in group B but improved in group C. Conclusions Since MP can decrease the expression of TNF-α and up-regulate the expression of HSP27, it has a potency of neuro-protection. Spinal cord ischemia-reperfusion injury can be avoided or decreased after MP pre-intervention.     

甲泼尼龙预干预脊髓缺血再灌注损伤对热休克蛋白27和肿瘤坏死因子α表达的影响

Objective To observe the effect of methylprednisolone (MP) pre-intervention on ex-pressions of heat shock protein 27 (HSP27) and tumor necrosis factor alpha (TNF-α) in cells in rat spinal cord following ischemia-reperfusion injury. Methods One hundred and fifty male Sprague-Dawley (SD) rats were randomly divided into 3 equal groups: group A (control) in which the abdominal aorta was exposed without any treatment, group B in which the abdominal aorta was clipped for 30 minutes before reperfusion for 3 bours to establish a model of ischemia- reperfusion injury, and group C in which intravenous MP injection was conducted 30 minutes before the establishment of the ischemia-reperfusion injury model. Three hours later the spinal cords were harvested. Pathological changes of spinal cord cells were observed with HE staining and expressions of HSP27 and TNF-α in spinal cord cells were observed with immunohistochemical staining. The motor function of hind-limbs before was evaluated before sample harvest. The data were analyzed with SPSS software. Results There were significant differences between groups A and B in the expressions of TNF-α and HSP27. Compared with group B, the expression of TNF-α decreased and HSP27 increased in group C, with statistically significant differences between the 2 groups. The motor function score of hind-limbs decreased in group B but improved in group C. Conclusions Since MP can decrease the expression of TNF-α and up-regulate the expression of HSP27, it has a potency of neuro-protection. Spinal cord ischemia-reperfusion injury can be avoided or decreased after MP pre-intervention.     

甲泼尼龙预干预脊髓缺血再灌注损伤对热休克蛋白27和肿瘤坏死因子α表达的影响

Objective To observe the effect of methylprednisolone (MP) pre-intervention on ex-pressions of heat shock protein 27 (HSP27) and tumor necrosis factor alpha (TNF-α) in cells in rat spinal cord following ischemia-reperfusion injury. Methods One hundred and fifty male Sprague-Dawley (SD) rats were randomly divided into 3 equal groups: group A (control) in which the abdominal aorta was exposed without any treatment, group B in which the abdominal aorta was clipped for 30 minutes before reperfusion for 3 bours to establish a model of ischemia- reperfusion injury, and group C in which intravenous MP injection was conducted 30 minutes before the establishment of the ischemia-reperfusion injury model. Three hours later the spinal cords were harvested. Pathological changes of spinal cord cells were observed with HE staining and expressions of HSP27 and TNF-α in spinal cord cells were observed with immunohistochemical staining. The motor function of hind-limbs before was evaluated before sample harvest. The data were analyzed with SPSS software. Results There were significant differences between groups A and B in the expressions of TNF-α and HSP27. Compared with group B, the expression of TNF-α decreased and HSP27 increased in group C, with statistically significant differences between the 2 groups. The motor function score of hind-limbs decreased in group B but improved in group C. Conclusions Since MP can decrease the expression of TNF-α and up-regulate the expression of HSP27, it has a potency of neuro-protection. Spinal cord ischemia-reperfusion injury can be avoided or decreased after MP pre-intervention.     

探讨中药配合针刀对腰椎间盘突出症患者疼痛缓解及生活质量的影响

目的 分析中药配合针刀在缓解腰椎间盘突出症疼痛症状中的应用情况。方法 抽取入郑州市骨科医院治疗的腰椎间盘突出症患者90例作为研究对象,采用抽签法将患者随机分为两组,对照组行腰椎牵引联合中药外敷治疗,观察组采用中药内服配合针刀治疗,采用视觉模拟评分标准(VAS)和生活质量评分量表(SF-36)评估两组患者治疗前后的疼痛程度和生活质量,并观察临床疗效。结果 观察组治疗有效率95.56%较对照组77.78%高,差异具有统计学意义(P<0.05)。观察组治疗后VAS评分为(1.09±0.57)分较对照组(3.85±0.91)分低,SF-36评分为(126.98±35.66)分较对照组(90.94±30.58)分高,差异具有统计学意义(P<0.05)。结论 针刀治疗腰椎间盘的基础上,予以独活寄生汤配合治疗,能够缓解疼痛程度。     

Dynesys系统治疗腰椎退变性疾病的疗效观察

腰椎退变性疾病可引起腰椎间盘突出、椎管狭窄、滑脱、不稳等,会导致腰椎长期疼痛,影响患者的日常生活和工作,保守治疗往往无效,常常需要手术治疗。本文研究Dynesys系统治疗腰椎退变性疾病的临床疗效,现将结果报道如下。