scholarly journals Comparison of the efficacy of MIS-TLIF combined with unilateral or bilateral internal fixation on single-segment lumbar degenerative diseases

2019 ◽  
Vol 17 ◽  
pp. 205873921984439
Author(s):  
Lisheng Zhao ◽  
Huijin Yu ◽  
Yan Zhang ◽  
Wenjun Zhen
Keyword(s):  
Internal Fixation ◽  
Lumbar Lordosis ◽  
Clinical Effects ◽  
Degenerative Diseases ◽  
Single Segment ◽  
Tnf Α ◽  
Significant Difference ◽  
Lumbar Degenerative Diseases ◽  
Serum Crp

In this study, to compare the efficacy of minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) combined with unilateral or bilateral internal fixation for the treatment of single-segment lumbar degenerative diseases, patients with single-segment lumbar degenerative diseases treated with MIS-TLIF combined with unilateral or bilateral internal fixation in Rehabilitation Center, Gansu Province Hospital from January 2014 to November 2015 were retrospectively enrolled, and the related data of 85 patients with 2-year follow-up were obtained. The patients were divided into unilateral group (40 cases) and bilateral group (45 cases) according to the method of internal fixation, and the Oswestry dysfunction index (ODI), visual analogue scale (VAS), lumbar lordosis angle, surgical segmental lordosis angle, lumbar scoliosis angle, surgical segmental scoliosis angle, lumbar lordosis index (LI), intervertebral height index (IHI), fusion rates, and serum inflammatory factors, including C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor alpha (TNF-α), were calculated to evaluate the efficacy of these two surgical methods. The results showed that the VAS and ODI of the two groups at 1 month, 6 months after surgery, and the last follow-up were significantly improved when compared with those before surgery ( P < 0.05). However, there were no significant differences in VAS and ODI between the two groups at preoperative, 1 month, 6 months after surgery, and the last follow-up ( P > 0.05). The lumbar lordosis and LI decreased at 1 month, 6 months, and the last follow-up ( P < 0.05), while the IHI increased when compared with that before surgery ( P < 0.05). Besides, no significant differences were observed in lumbar lordosis, LI, and IHI between the two groups at preoperative, 1 month, 6 months after surgery, and final follow-up ( P > 0.05). In addition, the fusion rates between these two groups had no significant difference ( P > 0.05). The levels of serum CRP, IL-6, and TNF-α at 12 and 24 h after operation in the two groups were higher than those before operation ( P < 0.05), but there was no significant difference in the levels of serum CRP, IL-6, and TNF-α between the two groups at 12 and 24 h after operation ( P < 0.05). In addition, none of the patients of both groups had permanent nerve injury, incision infection, and other complications. These results showed that MIS-TLIF combined with unilateral or bilateral percutaneous internal fixation technique causes less damage to the body tissues of patients with single-segment lumbar degenerative diseases, and they were considered to have similar clinical effects and imaging.

scholarly journals Clinical Analysis of Minimally Invasive Single-segment Reduction and Internal Fixation in Patients with Thoracolumbar Fractures

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Sun Xiu Chen
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Clinical Analysis ◽  
Control Group ◽  
Clinical Effects ◽  
Observation Group ◽  
Thoracolumbar Fractures ◽  
Single Segment ◽  
Significant Difference ◽  
Time Required

Objective: To study the clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures. Methods: From June 2013 to June 2014, 100 patients with thoracolumbar fractures were selected as the subjects and they were randomly divided into observation group (50 cases) and control group (50 cases). The patients in the observation group were treated with minimally invasive single-segment reduction and internal fixation. The patients in the control group were treated with short segmental fixation. The clinical effects of the two groups were compared. Results: There was no significant difference in the compression rate and Cobb angle between the two groups before and after operation (P> 0.05). For all patients who were followed up for the last time, the Cobb angle was significantly lower in the observation group than in the control group (P <0.05). The social function, affective function and physical pain score of the observation group were significantly better than the control group (P <0.05). The amount of bleeding in the observation group was (250.4 ± 41.0) ml, which was significantly lower than that in the control group (267.5 ± 32.8) ml. The time required for the operation was (90.2 ± 35.4) min, which was significantly lower than that of the control group (104.5 ± 22.6) min (P <0.05). After treatment, the prognosis was 70.00% and the excellent and good rate was 98.00%, which was significantly higher than that of the control group (46.00%) and 78.00% (P <0.05). Conclusion: Thoracolumbar fractures in patients with dilated channel minimally invasive single-segment reduction and internal fixation treatment can effectively repair the patient's vertebral height and Cobb angle and the degree of correction after surgery was significantly better, safer and worthy of clinical recommended use.

scholarly journals A Novel Capsule Lumbar Interbody Fusion (CLIF) in Treating Foot Drop due to Lumbar Degenerative Diseases: a Prospective, Observational Study

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Kaiqiang Sun ◽  
Feng Lin ◽  
Jialin Jiang ◽  
Jingchuan Sun ◽  
Jiangang Shi
Keyword(s):  
Lumbar Spine ◽  
Nerve Root ◽  
Interbody Fusion ◽  
Foot Drop ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Degenerative Diseases ◽  
Hemodynamic Parameters ◽  
Lumbar Degenerative Diseases

Objective. This present study aimed to explore the clinical effects of a novel capsule lumbar interbody fusion (CLIF) on foot drop due to lumbar degenerative diseases. Methods. Between June 2018 and January 2019, a total of 27 patients admitted to our department with lumbar degenerative diseases with associated foot drop were prospectively enrolled. Given the selection of surgical technique, patients were divided into traditional TLIF group and CLIF group. We assessed patients’ neurological status using JOA and VAS score, tibialis anterior muscle strength using MMT score, diameter and hemodynamic parameters of the L5 nerve root using intraoperative ultrasonography (IoUS), and related radiological parameters of the lumbar spine. Operation time, blood loss, and surgery-associated complications were also recorded. Results. The median duration of follow-up was 150 (6–1460) months. At the final follow-up, all patients acquired satisfactory improvement of neurological function. However, patients in the CLIF group showed better early recovery of foot drop three months after operation than those in the TLIF group, with 75% excellent rate. In addition, IoUS suggested that the diameter and hemodynamic parameters of the L5 nerve root were improved better in the CLIF group, which may suggest the correlation between the recovery of foot drop and the status of L5 nerve root. No severe complications were encountered with CLIF. Conclusions. Our preliminary study revealed that the axial tension of L5 nerve root may be involved in the pathological mechanism of foot drop. The novel technique of CLIF can shorten the lumbar spine and can be effective and safe for the treatment of foot drop due to lumbar degeneration-related diseases.

scholarly journals Revision Rates After Surgical Treatment for Femoral Neck Fractures: Results of 2-Year Follow-up

Medicina ◽  
2013 ◽  
Vol 49 (3) ◽  
pp. 22
Author(s):  
Jaunius Kurtinaitis ◽  
Narūnas Porvaneckas ◽  
Giedrius Kvederas ◽  
Tomas Butėnas ◽  
Valentinas Uvarovas
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Femoral Neck Fractures ◽  
Total Hip ◽  
Significant Difference ◽  
Surgery Rates

Background and Objective. Intracapsular fractures of the femoral neck account for a major share of fractures in the elderly. Open reduction and internal fixation has been shown to have a higher rate of revision surgery than arthroplasty. The aim of this study was to assess and compare the rates of revision surgery performed after internal fixation and primary total hip arthroplasty. Material and Methods. Between 2004 and 2006, 681 intracapsular femoral neck fractures in 679 consecutive patients were treated with internal fixation or total hip arthroplasty at our institution. Revision surgery rates were evaluated at 1-, 3-, 6-, 12-, and 24-month follow-up. Results. There was no significant difference in the ratio of internal fixation to total hip arthroplasty during 2004–2006 (P=0.31). The mean rate of total hip arthroplasty was 19.1% with a lower rate being among patients younger than 60 years. Revision surgery rates at the 2-year followup were higher in the internal fixation group compared with total hip arthroplasty group (28.9% vs. 7.0%, P<0.001). Patients who underwent internal fixation were at a 4-fold greater risk of having revision surgery at the 2-year follow-up than those who underwent total hip arthroplasty (odds ratio, 4.11; 95% CI, 1.95–8.65; P<0.001). Age was a significant risk factor for revision surgery after total hip arthroplasty (hazard ratio, 0.93; 95% CI, 0.87–0.98; P=0.02), but not significant after the internal fixation (P=0.86). Conclusions. Higher revision surgery rates after internal fixation favors arthroplasty as a primary choice of treatment for the femoral neck fractures.

CLINICAL AND RADIOLOGIC OUTCOMES OF TWO TYPES OF CAGES USED IN THE TREATMENT OF DEGENERATIVE LUMBAR DISEASES: NOVEL TITANIUM CAGES VERSUS PEEK CAGES

2020 ◽  
Vol 23 (01) ◽  
pp. 2050004
Author(s):  
Meng-Yin Yang ◽  
Hsin-Huan Chang ◽  
Shao-Ching Chao
Keyword(s):  
Transforaminal Lumbar Interbody Fusion ◽  
Neurological Status ◽  
Clinical Effects ◽  
Disc Disease ◽  
Degenerative Lumbar Diseases ◽  
Intervertebral Disc Height ◽  
Significant Difference ◽  
Vas Scores ◽  
Titanium Cages

Purpose: This study reports the clinical effects of [Formula: see text]-shaped titanium cages (ReBorn Essence Z-Brace cages) and compares the clinical outcomes between [Formula: see text]-shaped titanium cages (ZTC group) and polyetheretherketone cages (PEEK cages, PK group) for the application in transforaminal lumbar interbody fusion (TLIF). Methods: A retrospective and case control study with six patients using PEEK cages and four patients using ZTC was conducted. All patients underwent TLIF and had a 3-month follow-up. The Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) were selected to assess the pain of low back and neurological status. The intervertebral disc height (DH) and segmental angle (SA) were also measured to estimate the radiological changes. At the 3-month follow-up, the fusion and subsidence rates were evaluated. Results: There was no significant difference between the two groups regarding the ODI and VAS scores. At the 3-month follow-up, the subsidence rates were 42% and 0% for the PK and ZTC groups, respectively; the bony fusion rates were 67% and 100% for the PK and ZTC groups, respectively. Conclusion: The study has indicated that both PEEK and [Formula: see text]-shaped titanium cages can be effective options used to treat degenerative disc disease (DDD). Moreover, the higher fusion and lower subsidence rates have revealed that [Formula: see text]-shaped titanium cages may be a better choice compared to PEEK cages for lumbar reconstruction after TLIF.

scholarly journals Arthroscopic fixation of humeral greater tuberosity fracture using a W-shaped suture

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Xiaocong Lin ◽  
Xiuxi Huang ◽  
Kaibin Fang ◽  
Zhangsheng Dai
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Shoulder Arthroscopy ◽  
Healing Time ◽  
Fixation Failure ◽  
Greater Tuberosity ◽  
Vas Score ◽  
Constant Murley Score ◽  
Significant Difference

Abstract Background Patients with greater tuberosity fractures of the humerus often require surgery. Therefore, there is a need to find a minimally invasive and effective surgical procedure with great patient outcomes. Aim To evaluate the clinical outcomes of the W-shaped suture technique under shoulder arthroscopy in the treatment of greater tuberosity fractures of the humerus. Methods In this retrospective study, a total of 17 patients were included. The fractures were closed, and there was no neurovascular injury. These patients underwent arthroscopically assisted reduction and internal fixation of the greater tuberosity fractures. Fixation was performed using sighting nails combined with a W-shaped suture. The imaging data of the patients were collected, and the ASES score, Constant-Murley score, and VAS score were used to evaluate the patient’s outcome. At the last follow-up (at least 1 year), the range of motion in the affected shoulder was compared with that of the contralateral side. Results The operation was successful in all the patients. The average follow-up time was 13 months. There were no reported complications such as fracture displacement, nonunion, and internal fixation failure during the follow-up period. Post-operative X-ray examinations revealed good function recovery, with a healing time of between 10 and 12 weeks, and an average healing time of 11.5 weeks. Following the operation, patients reported reduced shoulder joint pain that no longer influenced their activity or caused discomfort in their daily life. The patient’s VAS score ranged from 0 to 3, with an average of 0.52 ± 0.73, while at the last follow-up, the Constant-Murley score ranged from 83 to 97, with an average of 92.33 ± 7.55. The ASES score ranged from 81 to 98, with an average of 93.15 ± 6.93. At the last follow-up, there was no significant difference in the overall range of motion with the unaffected limb. Conclusion This study demonstrates that the W-shaped suture can be used to effectively fix the fractures of the greater tuberosity of the humerus, by increasing the fixed area to promote healing.

scholarly journals The effect of tumour necrosis factor inhibitors on radiographic progression in axial spondyloarthritis: a systematic literature review

Rheumatology ◽  
2019 ◽  
Vol 58 (11) ◽  
pp. 1907-1922 ◽  
Author(s):  
Nadine Boers ◽  
Celia A J Michielsens ◽  
Désirée van der Heijde ◽  
Alfons A den Broeder ◽  
Paco M J Welsing
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Radiographic Progression ◽  
Axial Spondyloarthritis ◽  
Standard Dose ◽  
Tnf Α ◽  
Significant Difference ◽  
Synthetic Dmards ◽  
Necrosis Factor

Abstract The effect of TNF-α inhibitors (TNFi), with or without concomitant NSAIDs, on radiographic progression in axial SpA remains unclear. Therefore, we performed a systematic literature review up to January 2019 to determine whether longer use of standard dose TNFi is superior vs lower duration or lower dose TNFi therapy, conventional synthetic DMARDs alone, or no therapy in inhibiting radiographic progression in patients with axial SpA. Our search yielded 373 titles of which 14 full text articles and five abstracts were eligible for quantitative analysis. Studies had an overall moderate to critical risk of bias. Data could not be pooled due to clinical and methodological heterogeneity. Individual studies showed conflicting results with mainly no significant difference in radiographic progression when comparing effect of TNFi therapy to no TNFi therapy or when comparing to less TNFi therapy until 2 years of follow-up. Results that are more significant are shown after 2 years’ follow-up, mainly in subgroups with baseline syndesmophytes. Data on the additional or synergistic effect of concomitant NSAID use were inconclusive.

scholarly journals Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yicun Wang ◽  
Hui Jiang ◽  
Zhantao Deng ◽  
Jiewen Jin ◽  
Jia Meng ◽  
...  
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
Bone Defect ◽  
Fasting Blood Glucose ◽  
Bone Defects ◽  
Significant Difference ◽  
Systemic Antibiotics ◽  
Time Since Injury ◽  
Small Bone

Background. To compare the salvage rate and complication between internal fixation and external fixation in patients with small bone defects caused by chronic infectious osteomyelitis debridement. Methods. 125 patients with chronic infectious osteomyelitis of tibia fracture who underwent multiple irrigation, debridement procedure, and local/systemic antibiotics were enrolled. Bone defects, which were less than 4 cm, were treated with bone grafting using either internal fixation or monolateral external fixation. 12-month follow-up was conducted with an interval of 3 months to evaluate union of bone defect. Results. Patients who underwent monolateral external fixation had higher body mass index and fasting blood glucose, longer time since injury, and larger bone defect compared with internal fixation. No significant difference was observed in incidence of complications (23.5% versus 19.3%), surgery time (156±23 minutes versus 162±21 minutes), and time to union (11.1±3.0 months versus 10.9±3.1 months) between external fixation and internal fixation. Internal fixation had no significant influence on the occurrence of postoperation complications after multivariate adjustment when compared with external fixation. Furthermore, patients who underwent internal fixation experienced higher level of daily living scales and lower level of anxiety. Conclusions. It was relatively safe to use internal fixation for stabilization in osteomyelitis patients whose bone defects were less than 4 cm and infection was well controlled.

scholarly journals Comparison of outcomes of ORIF versus bidirectional tractor and arthroscopically assisted CRIF in the treatment of lateral tibial plateau fractures: a retrospective cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiangtian Deng ◽  
Hongzhi Hu ◽  
Yiran Zhang ◽  
Weijian Liu ◽  
Qingcheng Song ◽  
...  
Keyword(s):  
Cohort Study ◽  
Internal Fixation ◽  
Clinical Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tibial Plateau ◽  
Clinical Score ◽  
Lateral Tibial Plateau ◽  
Significant Difference

Abstract Background Lateral tibial plateau fractures (TPFs) are often treated with conventional open reduction and internal fixation (ORIF) through standard anterolateral sub-meniscal arthrotomy. There has been increasing support for “bidirectional rapid redactor” device-assisted closed reduction and internal fixation (CRIF) for treating TPFs. The aim of the present study is to compare the clinical and radiological outcomes between CRIF and ORIF procedures. Methods We performed a retrospective cohort study of 55 lateral TPF patients (Schatzker types I–III) who accepted surgical treatment at our trauma level 1 center between January 2016 and January 2018. They were divided into the CRIF group (32 patients) and the ORIF group (23 patients) based upon the different surgical protocols. The patients’ clinical outcome analysis was evaluated by using the Knee Society Score (KSS) and Rasmussen’s clinical score. For radiological assessment, changes in tibial plateau width (TPW), articular depression depth (ADD), medial proximal tibial angle (MPTA), and posterior tibial slope angle (PTSA) were evaluated using radiographs and computed tomography (CT) scan. Results The CRIF group had a mean follow-up of 28.9 months, and the ORIF group had a mean follow-up of 30.7 months (p>0.05). Furthermore, there was no statistically significant difference in terms of age, gender, injury mechanism, follow-up time, time interval from injury to surgery, and Schatzker classification in the two groups. With respect to the clinical outcomes including the KSS score and Rasmussen’s clinical score, there was also no significant difference (p>0.05). Nevertheless, the CRIF group had lower intra-operative blood loss, shorter hospitalization days, and better range of movement of the knee joint than the ORIF group (p<0.05). Furthermore, CRIF had better radiological results when compared to the ORIF group using Rasmussen’s radiological score (p<0.05), although no significant difference was observed in TPW, ADD, MPTA, and PTSA between the two groups (p>0.05). Conclusion The present study showed that CRIF could achieve comparable clinical outcomes and better radiological results for treating lateral TPFs as compared with conventional ORIF.

scholarly journals Hybrid surgery with PEEK rods for lumbar degenerative diseases: a 2-year follow-up study

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Yao Zhao ◽  
Beiyu Xu ◽  
Longtao Qi ◽  
Chunde Li ◽  
Lei Yue ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Clinical Results ◽  
Adjacent Segment ◽  
Degenerative Diseases ◽  
Hybrid Surgery ◽  
X Ray ◽  
Vas Score ◽  
Peek Rods ◽  
Lumbar Degenerative Diseases

Abstract Background Finite element analyses and biomechanical tests have shown that PEEK rods promote fusion and prevent adjacent segment degeneration. The purpose of this study was to evaluate the effects and complications of hybrid surgery with PEEK rods in lumbar degenerative diseases. Methods From January 2015-December 2017, 28 patients who underwent lumbar posterior hybrid surgery with PEEK rods were included in the study. The patients were diagnosed with lumbar disc herniation, lumbar spinal stenosis, or degenerative grade I spondylolisthesis. Before the operation and at the last follow-up, the patients completed lumbar anteroposterior and lateral X-ray, dynamic X-ray, MRI examinations. In addition, at the last follow-up the patients also completed lumbar CT examinations. The radiographic parameters, clinical visual analog scale (VAS) score and Oswestry disability index (ODI) score were compared. Results The average age of the patients was 44.8 ± 12.6 years, and the average follow-up duration was 26.4 ± 3.6 months. The VAS score improved from 6.3 ± 1.6 to 1.0 ± 0.9, and the ODI score decreased from 38.4 ± 10.8 to 6.8 ± 4.6. The fusion rate of the fused segment was 100%. There were no significant changes in the modified Pfirrmann classifications or disc height index for the nonfused segments and the upper adjacent segments from pre- to postoperatively. No cases of screw loosening, broken screws, broken rods or other mechanical complications were found. Conclusion Hybrid surgery with PEEK rods for lumbar degenerative diseases can yield good clinical results and effectively reduce the incidence of complications such as adjacent segment diseases.

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