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

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.

2019 ◽  
Vol 17 ◽  
pp. 205873921984439
Author(s):  
Lisheng Zhao ◽  
Huijin Yu ◽  
Yan Zhang ◽  
Wenjun Zhen

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.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yan Jin ◽  
Yanzheng Wang ◽  
Sai Wang ◽  
Qiongqiong Zhao ◽  
Donghua Zhang ◽  
...  

Objective. This study aimed to explore the clinical efficacy and relevant mechanism of Tripterygium glycosides combined with low molecular weight heparin calcium (LMWH) in the treatment of Henoch–Schönlein purpura nephritis (HSPN) in children. Methods. 64 cases of children patients with HSPN treated at Qilu Hospital (Qingdao) from January 2015 to May 2020 were selected and randomly divided into the control group and the observation group and 32 cases in each group. Conventional medical treatment was applied in the two groups, besides which the control group was given LMWH while the observation group was given Tripterygium glycosides based on the control group. The clinical efficacy and the indexes of clinical symptoms of the two groups were compared. Immune globulin level, fibrinogen content (FIB), prothrombin time (PT), platelet level (PLT), and activated partial thromboplastin time (APTT) level of the two groups were compared before and after the treatment. Results. The total effective rate in the observation group was significantly higher than that of the control group, and the recurrence rate in the observation group was lower than that in the control group. After treatment, urine red blood cell count and 24 h urine protein were obviously better than those of the control group. There was no statistically significant difference in PT between the two groups of children before and after treatment. The levels of PLT and FIB in the two groups of patients after treatment were significantly lower than before treatment, and the PLT levels in the observation group were lower than those in the control group. Conclusion. The combination of Tripterygium glycosides and LMWH had good clinical effects in the treatment of children with HSPN, and it could improve the clinical symptoms, the mechanism of which might be related to the increase of PT, a decrease of PLT, and the improvement of coagulation function.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Li Peng ◽  
Wei-kun Zhao ◽  
Tong-tong Xu ◽  
Qi Wu ◽  
Pan Lu ◽  
...  

Objective. To systematically evaluate the safety and efficacy of ginko-damole combined with nitroglycerin or unitary sodium nitroprusside on hypertensive cerebropathy. Methods. Four Chinese databases (VIP, CBM, Wanfang database, and CNKI database) and three English databases (Cochrane, PubMed, and EMBASE) were used to screen randomised controlled trials (RCTs) on treatments of hypertensive cerebropathy using both ginko-damole and nitroglycerin or unitary sodium nitroprusside. Outcomes included clinical effect, blood pressure after treatment, and adverse effects. These indicators were then analysed statistically using the RevMan 5.3 and Stata 12.0 software. Results. Altogether, 16 RCTs including 1507 patients with hypertensive cerebropathy were included in the present meta-analysis, of which, 755 patients treated with combined ginko-damole and nitroglycerin were included in the observation group and 752 patients treated with sodium nitroprusside were included in the control group. The curative effect of the observation group was significantly better than that of the control group (RR: 1.115 [1.077, 1.155], p<0.05). DBPs of the observation and control groups were both lower after treatment, and no significant difference was observed between the observation and control groups (MD: −1.072 [−2.578, 0.434], p>0.05). SBPs in the observation group were significantly lower than those in the control group (MD: −2.842 [−5.222, −0.462], p<0.05). The probability of adverse response in both groups did not differ significantly (RR: 0.752 [0.412, 1.374], p>0.05). Conclusion. Compared with sodium nitroprusside, the combined ginkgo-damole and nitroglycerin could better control blood pressure in patients with hypertensive cerebropathy and showed enhanced clinical effects and improved safety. However, due to poor quality of the included studies, results of the present meta-analysis should be confirmed by more stringent RCTs.


2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Huaian Li

Objective: To investigate the clinical effects of phlegm and phlegm and magnesium sulfate combined with magnesium sulfate in sea lice in Qinhuangdao City. Methods: A total of 78 patients with sea lice in Qinhuangdao City from June to May 2018 were enrolled. They were randomly divided into control group (n=39 cases) and observation group (n=39 cases). The control group was treated with magnesium sulfate. The observation group was treated with Qibai Colshi Decoction on the basisof the control group. The effect of the patients was evaluated after 5 days of treatment. The disappearance time of symptoms, inflammatory factors and adverse drug reactions were compared. Results: After treatment, the onset, pain time, skin loss, swelling time and course of treatment were shorter in the observation group than in the control group (P<0.05). The levels of inflammatory factors were lower than those before treatment (P<5). The levels of TNF-a, IL-6, HIS and 5-HT in the observation group were lower than those in the control group (P<0.05). The rash, itching, drug allergy, liver and kidney were observed in the observation group and the control group. There was no significant difference in the incidence of dysfunction and blood pressure (P>0.05). Conclusion: The combination of magnesium sulfate and magnesium sulfate in the treatment of sea lice in Qinhuangdao City can shorten the disappearance of symptoms, reduce the level of inflammatory factors, and increase the incidence of adverse drug reactions. It is worthy of popularization and application.


2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Wenxia Wang ◽  
Xiaoyong Zheng ◽  
Zuoyong Sun

Objective: To compare and analyze the clinical effects of internal fixation of minimally invasive elastic stable intramedullary nail and plate in the treatment of pediatric femoral shaft fracture. Methods: A total of 120 children with femoral shaft fractures who were admitted to our hospital from December 2016 to April 2018 were enrolled. The children were divided into an observation group and a control group by random number table, with 60 children in each group. The children in the observation group underwent internal fixation of minimally invasive elastic stable intramedullary nail, while those in the control group underwent open reduction based on internal fixation of plate. The surgical status and postoperative complications of the two groups were observed and compared, and Kolmert knee function scoring criteria were used for assessing the surgical effects of children. Results: The operation duration, intraoperative blood loss, hospitalization duration, fracture healing time and time of off-bed loaded activity of the observation group were significantly shorter than those of the control group, and the differences were statistically significant (P<0.05). The excellent and good rate of fracture healing in the observation group was 100%, which was higher than that of the control group, 83.33%, and the difference was statistically significant (P<0.05). The total incidence rate of complications in the observation group was 8.33%, which was lower than that of the control group, 10.00%, but the difference was not statistically significant (P>0.05). Conclusion: Pediatric femoral shaft fractures can be treated with internal fixation of minimally invasive elastic intramedullary nail, and it has advantages of significant curative effect, small trauma and fast postoperative recovery, which is conducive to fracture healing and worth promoting. doi: https://doi.org/10.12669/pjms.35.5.513 How to cite this:Wang W, Zheng X, Sun Z. Comparison of efficacy between internal fixation of minimally invasive elastic stable intramedullary nail and plate in the treatment of pediatric femoral shaft fracture. Pak J Med Sci. 2019;35(5):---------.   doi: https://doi.org/10.12669/pjms.35.5.513 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 7 (6) ◽  
pp. 6597-6608
Author(s):  
Rui Yao ◽  
Yongxin Huo ◽  
Yanyan Tang

Objectives: To explore the effect of comfort nursing on joint function, pain degree and Baird score after minimally invasive ankle fracture. METHODS: A total of 62 patients with minimally invasive fracture of ankle joint treated in our hospital from July 2019 to July 2020 were selected as the research subjects. According to random number method, all patients were divided into observation group and control group, with 31 cases in each group. Conventional nursing intervention was carried out in the control group and comfort nursing intervention was given in the observation group. After surgery, the recovery of bare joint function was compared between the two groups. Pain scale (VAS) was used to evaluate the degree of pain in the two groups, the Hamilton Anxiety Scale (HAMA) was used to assess patients' anxiety levels, and the comparison was made before, 3 months and 6 months after surgery. The postoperative Baird scores of the two groups were compared. The incidence of postoperative complications between the two groups was statistically analyzed and compared. The nursing satisfaction of the two groups of patients was compared. RESULTS: Compared with the control group, the number of excellent and good cases in observation group was significantly increased (P<0.05), while the number of poor cases was significantly decreased (P<0.05). There was no significant difference in the degree of pain and anxiety between the two groups before operation (P>0.05). Compared with preoperation, the pain degree, body anxiety degree and mental anxiety degree in 2 groups at 3 and 6 months after operation were significantly decreased (P<0.05); The pain score, somatic anxiety score and mental anxiety score of the observation group were significantly lower than those of the control group at 3 and 6 months after surgery (P<0.05); The pain scores of observation group at 3 months and 6 months after surgery were significantly lower than those of control group (P<0.05). Compared with the control group, the postoperative Baird score in observation group was significantly increased (P<0.05); The incidence of pressure sores, wound infection and complications of lower extremity deep vein thrombosis in the observation group was significantly lower than that in the control group (P<0.05). Compared with the control group, the nursing satisfaction of the observation group was significantly increased (P<0.05). Conclusion: The postoperative nursing of patients with minimally invasive fracture of ankle joint, taking comfortable nursing can effectively improve the joint function and nursing satisfaction of patients, relieve thepain of patients, improve their prognosis, has certain advantages, worthy of further clinical promotion and application.


2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Pengfa Tu ◽  
Chong-chao Yan ◽  
Jian-xue Hao ◽  
Shuo Cao ◽  
Chenyang Jiang

Objectives: To investigate and analyze the effect of percutaneous minimally invasive pedicle screw internal fixation in the treatment of thoracolumbar vertebral fractures and its impact on quality of life. Methods: Fifty patients with thoracolumbar vertebral fracture admitted to our hospital from January 2015 to December 2018 were selected and divided into two groups according to different treatment regimens. The observation group was treated with minimally invasive percutaneous pedicle screw internal fixation, while the control group was treated with traditional posterior approach open pedicle screw internal fixation. The surgery time, incision length, intraoperative blood loss, postoperative drainage, hospitalization time, ambulation time, fracture healing time and postoperative VAS scores were compared between the two groups. In addition, the cobb angle, the sagittal plane index, and the anterior vertebral height were compared between the two groups before and after surgery, as were the Oswestry Disability Index (ODI) at 1d, 3 months, and 6 months postoperatively. Results: The surgery time, incision length, postoperative pain level, postoperative drainage and intraoperative blood loss of the observation group were less than those of the control group (P<0.05). The postoperative Cobb angle of the two groups decreased, the sagittal plane index as well as the anterior vertebral height increased (P<0.05). The Oswestry index of the observation group was better than that of the control group at one day and three months postoperatively, with a statistical significance between the two groups (P<0.05). The complication rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusion: Percutaneous minimally invasive pedicle screw internal fixation is safer than the traditional open pedicle screw internal fixation, and it is more worthy of clinical promotion. doi: https://doi.org/10.12669/pjms.38.1.4329 How to cite this:Tu P, Yan C, Hao J, Cao S, Jiang C. Effect of percutaneous minimally invasive pedicle screw internal fixation in the treatment of thoracolumbar vertebral fractures and its impact on quality of life. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4329 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Vol 49 (3) ◽  
pp. E12
Author(s):  
Adam G. Podet ◽  
Kevin D. Morrow ◽  
Jared M. Robichaux ◽  
Jessica A. Shields ◽  
Anthony M. DiGiorgio ◽  
...  

OBJECTIVEThe need for anterior column reconstruction after thoracolumbar burst fractures remains controversial. Here, the authors present their experience with minimally invasive lateral thoracolumbar corpectomies for traumatic fractures.METHODSBetween 2012 and 2019, 59 patients with 65 thoracolumbar fractures underwent 65 minimally invasive lateral corpectomies (MIS group). This group was compared to 16 patients with single-level thoracolumbar fractures who had undergone open lateral corpectomies with the assistance of general surgery between 2007 and 2011 (open control group). Comparisons of the two groups were made with regard to operative time, estimated blood loss, time to ambulation, and fusion rates at 1 year postoperatively. The authors further analyzed the MIS group with regard to injury mechanism, fracture characteristics, neurological outcome, and complications.RESULTSPatients in the MIS group had a significantly shorter mean operative time (228.3 ± 27.9 vs 255.6 ± 34.1 minutes, p = 0.001) and significantly shorter mean time to ambulation after surgery (1.8 ± 1.1 vs 5.0 ± 0.8 days, p < 0.001) than the open corpectomy group. Mean estimated blood loss did not differ significantly between the two groups, though the MIS group did trend toward a lower mean blood loss. There was no significant difference in fusion status at 1 year between the MIS and open groups; however, this comparison was limited by poor follow-up, with only 32 of 59 patients (54.2%) in the MIS group and 8 of 16 (50%) in the open group having available imaging at 1 year. Complications in the MIS group included 1 screw misplacement requiring revision, 2 postoperative femoral neuropathies (one of which improved), 1 return to surgery for inadequate posterior decompression, 4 pneumothoraces requiring chest tube placement, and 1 posterior wound infection. The rate of revision surgery for the failure of fusion in the MIS group was 1.7% (1 of 59 patients).CONCLUSIONSThe minimally invasive lateral thoracolumbar corpectomy approach for traumatic fractures appears to be relatively safe and may result in shorter operative times and quicker mobilization as compared to those with open techniques. This should be considered as a treatment option for thoracolumbar spine fractures.


2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Chao Deng ◽  
Yuanling Ji ◽  
Wei Song ◽  
Jingfang Bi

Objectives: To explore the clinical value of minimally invasive aspiration and drainage of intracranial hematoma in the treatment of cerebral hemorrhage. Methods: Seventy-eight patients with cerebral hemorrhage who were treated in the Taian City Central Hospital and the Second Affiliated Hospital of Shandong First Medical University between June 2018 and December 2019 were selected. The patients were randomly numbered and divided into two groups by drawing lots, 39 in each group. The control group was treated with the traditional internal medicine conservative therapy, and the observation group was treated with minimally invasive intracranial hematoma aspiration and drainage. The indexes of the two groups were compared. Results: The efficacy rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). The National Institutes of Health Stroke Scale (NIHSS) score of the observation group was lower than that of the control group after treatment, and the difference was statistically significant (P<0.05). After treatment, the good recovery rate of the observation group was higher compared to the control group, and the difference had statistical significance (P<0.05). The incidence of complications in the observation group was lower than that of the control group, with a statistically significant difference (P<0.05). Conclusion: In the treatment of cerebral hemorrhage, minimally invasive intracranial hematoma aspiration and drainage facilitates the recovery of patients, promotes the improvement of neurological function, and has a high safety profile and an ideal prognostic quality. doi: https://doi.org/10.12669/pjms.38.1.4618 How to cite this:Deng C, Ji Y, Song W, Bi J. Clinical effect of minimally invasive aspiration and drainage of intracranial hematoma in the treatment of cerebral hemorrhage. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4618 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Li Sun ◽  
Xianfeng Jiang

<p><strong>Objective:</strong> To study the clinical effect of electroacupuncture combined with rehabilitation in patients with Parkinson's disease. <strong>Methods:</strong> Twenty patients with Parkinson's disease were divided into observation group and control group according to the time of admission. In each group, 10 cases were treated with electroacupuncture in the control group. The clinical effects of the two groups were compared. <strong>Results:</strong> After treatment, the Wechsler comprehensive assessment scale, Barthel index and UPDRS III score of the observation group were significantly higher than the control group (p &lt;0.05). The total effective rate was 90% in the observation group and 60% in the control group. There was significant difference in the total effective rate between the two groups (p &lt;0.05). <strong>Conclusion:</strong> Treatment of Parkinson's disease with electroacupuncture combined with rehabilitation is effective and can improve the clinical symptoms and quality of life of patients.</p>


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