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This article will start from two aspects of conservative treatment and surgical treatment, mainly describes the commonly used treatment methods in clinical progress and application as well as the problems faced, in order to provide a reference for the selection of clinical treatment.OBJECTIVE To investigate the clinical effect of double-door laminoplasty combined with C2 dome decompression in treatment of cervical spinal stenosis. METHODS The clinical data of 28 patients with cervical spinal stenosis who underwent double-door laminoplasty combined with C2 dome decompression from June 2016 to June 2018 were retrospectively analyzed, including 17 males and 11 females, aged 39 to 74 years with an average of (61.0±6.7) years. The clinical effects were evaluated by JOA score, axial symptoms, cervical spine activity, cervical spinal cord compression degree and so on. RESULTS All patients were followed up for 6 to12 months with an average of 10.2 months. The JOA score in the final follow-up was significantly improved (P0.05). After operation, sagittal diameter at the narrowest level of C2-C3 spinal canal was (16.20±1.82) mm, which was significantly higher than (8.38±1.16) mm before operation (P less then 0.05). There were 4 cases with axial symptoms in 24 patients with the incidence rate of 14.29% (4/24). CONCLUSION Double-door laminoplasty combined with C2 dome decompression can directly expand the volume of C2-C3 spinal canal, relieve the compression of spinal cord and nerve root, reduce the damage to the posterior cervical ligament complex as much as possible, maintain the stability of cervical spine sequence, reduce the occurrence of axial symptoms, and the operation is relatively simple, without the need of metal internal fixation.OBJECTIVE To establish a simple and reliable model of cervical vertigo in rats with hyperactivity of liver-yang syndrome, and to establish a simple and feasible method for evaluating the degree of vertigo in animals. METHODS SPF male SD rats (aged 8 weeks, weighing 280 to 320 g) were randomly divided into 4 groups (6 rats in each group). The model of cervical vertigo of hyperactivity of liver yang syndrome (joint modeling group) was established by combining local injection of lauromacrogol (hardener) and receiving fuzi decoction by gavage. The joint modeling group was compared with the hardener group, the fuzi decoction group and the blank control group. The vertigo degree of rats was measured by the time of passing through a glass tube (running time) before modeling, 2 weeks and 3 weeks after the established model. RESULTS There was no statistical difference in the running time between control group and fuzi decoction group, between joint modeling group and hardener group. The running time in the hardener group and the joint modeling group was longer than that in the control group (P0.05). CONCLUSION This method can effectively establish a rat model of cervical vertigo with hyperactivity of liver-yang syndrome, and the running time can reflect the degree of vertigo in rats to a certain extent. This experiment provides a simple and feasible animal model and detection method for research of cervical vertigo in the future.OBJECTIVE To compare the degeneration of lumbosacral multifidus muscle in patients with lumbar disc herniation. METHODS Magnetic Resonance Spectroscopy was performed on the multifidus muscle of 35 healthy volunteers and 35 patients with unilateral L4,5 lumbar disc herniation. There were 20 males and 15 females in each group, aged from 25 to 55 years old. In healthy volunteers, the mean age was (35.66±8.73) years old and the BMI was (21.85±1.94) kg/m2; in the patients, the mean age was (36.09±7.70) years old, the BMI was (21.50±1.78) kg/m2, the VAS score was (4.40±0.88) points, the course of disease was (11.2±7.14) months. The proportion of fat in the L4,5 lumbosacral multifidus muscle and the proportion of fat-suppressed cross-sectional area were observed by MRI, the differences of the observation indexes of the two groups were compared through data analysis. RESULTS In healthy volunteers, the proportion of fat on the left side of the multifidus muscle was (0.169± 0.035)%, the proportion of fat removal cross-ifidus muscular atrophy and fat infiltration.OBJECTIVE To investigate the clinical effect of One-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion for the treatment of lumbosacral tuberculosis. METHODS The clinical data of 31 patients with lumbosacral tuberculosis treated by one-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion from January 2013 to February 2018 were retrospectively analyzed. There were 18 males and 13 females, aged from 18 to 77 years old with an average of (45.9±9.1) years. The lesion segment was form L4 to S2. The preoperative ASIA grading showed that 2 cases were grade B, 17 cases were grade C, 12 were grade D. Pre- and post-operative C reactive protein (CRP), visual analogue scale (VAS), erythrocyte sedimentation rate (ESR), ASIA grade, lumbosacral angle and intervertebral space height were analyzed, the surgery complications, stability of internal fixation, bone fusion were observed. RESULTS All the 31 patients were followed up for 10 to 24 months with an averical application.OBJECTIVE To explore the influencing factors of the operative effect on cervical spinal cord injury without fracture or dislocation. METHODS The clinical data of 69 patients with cervical spinal cord injury without fracture or dislocation from November 2010 to November 2016 who received operation were retrospectively analyzed. There were 37 males and 32 females, aged from 32 to76 years with an average of (51.6±7.3) years. The clinical data of 12 factors were selected, including age, gender, ASIA grade of spine cord injury, the length of spine cord injury by MRI, Pavlov ratio, ossification of the posterior longitudinal ligament (OPLL), intervertebral disc herniation, type of spine cord injury by MRI, time from injury to operation, treatment of high-dose methylprednisolone, operation time, intraoperative bleeding volume. In order to screen the main influencing factors of above items to prognosis, the single factor and multiple factor Logistic regression analysis were used in the clinical data by SPSS 22.0 statipe with bleeding and edema, or the length of spine cord injury larger than 45 mm may be less effective, therefore, it is necessary to thoroughly communicate with the patients and their kin before surgery.OBJECTIVE To evaluate the clinical effects of debridement and bone grafting with internal fixation via anterior approach in treatment of tuberculosis of lower cervical vertebrae. METHODS The clinical data of 15 patients with tuberculosis of lower cervical vertebrae who accepted the treatment of one-stage debridement and bone grafting with internal fixation from June 2010 to December 2018 were retrospectively analyzed. There were 9 males and 6 females, aged from 39 to 72 years with an average of (54.67±10.75) years. The lesion segment was C4 to C6. Pre- and post-operative neurologic functions were evaluated by ASIA grade. All the patients underwent the X-ray films of positive and lateral of cervical spine before and after the operation and accepted the periodic review of CT to evaluate the bone grafting. RESULTS All the 15 operations were successful, no neurological or vascular injury occurred during the operation, and all patients were followed up for 18 to 52 months. The clinical symptoms improved significantly during the follow-up period and CT showed good bone grafting fusion. One patient suffered a relapse of the illness 3 years later, but was healed during the follow-up visit by strengthening the anti tuberculosis therapy. CONCLUSION For the patients with vertebral destruction and loss of cervical stability, one-stage debridement and bone grafting with internal fixation via anterior approach has definite curative effects. On the basis of standard anti tuberculosis treatment before operation, the long-term standard anti-tuberculosis treatment after operation is the key to healing the tuberculosis of lower cervical vertebrae.OBJECTIVE To explore the safety and effectivity of ultrasonic bone knife in osteotomy of degenerative kyphosis. METHODS The clinical data of 32 patients with degenerative kyphosis treated from February 2014 to May 2016 were retrospectively analyzed. There were 12 males and 20 females, aged 50 to 71 years with an average of (62.1±12.3) years. Preoperative Cobb angle was 25.3° to 36.7° with an average of (28.6±10.2) °. All patients underwent multi-segment Ponte osteotomy combined with posterior long segmental internal fixation. According to different osteotomy tools, the patients were divided into traditional tool group (group A, 18 cases) and ultrasonic bone knife group (group B, 14 cases). The operation time, laminectomy time, number of osteotomy segments, intraoperative blood loss, postoperative drainage, hospitalization time and postoperative complications were recorded.Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate clinical outcomes before and 1 month after surgery. Selleck Tyrphostin B42 RESULTS All the patients were followed up from 8 to 24 months with an average of 16.4 months. There were no significant differences in operative time and hospitalization time between two groups (P>0.05). Intraoperative single laminectomy time of group A was more than that of group B (P0.05). There were no dural, nerve and spinal cord injuries in both groups, and there were no complications such as improper operation of the instrument and nonunion of the osteotomy. CONCLUSION The use of ultrasonic bone knife for Ponte osteotomy is safe and effective. It can effectively save the time of single laminectomy while reducing the amount of intraoperative blood loss and postoperative drainage. The safety and clinical efficacy of ultrasonic bone knife are no less than traditional tools.OBJECTIVE To explore the high-risk factors of deep vein thrombosis (DVT) formation in patients after spinal cord injury (SCI) and to provide some reference value for the prevention of DVT. METHODS Eighty-five patients with spinal cord injury caused by thoracolumbar burst fracture from January 2016 to December 2017 were selected as subjects. All patients were followed up for 6 months, of which 5 cases were lost and 80 cases were finally included. According to whether there was deep vein thrombosis, the patients were divided into DVT group (35 cases) and control group (45 cases). The clinical data were statistically analyzed by SPSS 22.0 statistical software, and the high-risk factors of spinal cord injury were analyzed by multivariate Logistic regression. RESULTS Thirty-five of the 80 patients with spinal cord injury developed deep venous thrombosis (incidence rate was about 43.7%). The average age of DVT group [(47.77±10.76) years ] was higher than that of non-DVT group [(37.35±10.20) years ], and there was a significant difference between two groups (χ2=19.56, P45 years, history of diabetes, smoking history, and ASIA grade A of spinal cord injury is present, preventive measures should be taken in advance, it is of great significance to prevent the formation of deep vein thrombosis.
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