Comparison of the technique of anterior cervical distraction and screw elevating-pulling reduction and conventional anterior cervical reduction technique for traumatic cervical spine fractures and dislocations
Li H.,Tongji University |
Huang Y.,Tongji University |
Cheng C.,303th Hospital of PLA |
Lin Z.,303th Hospital of PLA |
Wu D.,Tongji University
International Journal of Surgery | Year: 2017
Introduction To analyze and confirm the advantages of anterior cervical distraction and screw elevating-pulling reduction which are absent in conventional anterior cervical reduction for traumatic cervical spine fractures and dislocations. Materials and methods A retrospective study was conducted on 86 patients with traumatic cervical spine fractures and dislocations who received one-stage anterior approach treatment for a distraction-flexion injury with bilateral locked facet joints between January 2010 and June 2015. They were 54 males and 32 females with an age ranging from 20 to 73 years (average age, 40.1 ± 5.6 years). These patients were distributed into group A and group B in the sequence of visits, with 44 cases of conventional anterior cervical reduction (group A) and 42 cases of anterior cervical distraction and screw elevating-pulling reduction (group B). Comparison of intraoperative blood loss, operation duration and vertebral reduction rate was made between the two groups. The follow-up time was 12–18 months, and the clinical outcomes of surgery were evaluated according to ASIA score, VAS score and JOA score. Results Statistically significant difference was revealed between group A and group B in the surgical time and the correction rate of cervical spine dislocation (p < 0.05), with the results of group B better than those of group A. For the two groups, statistically significant difference was shown between the ASIA score, VAS score and JOA score before and after operation (p < 0.05), with the results better after operation, while no statistically significant difference was revealed in such scores between the two groups (p > 0.05), with the therapeutic effect of group A the same with that of group B. Conclusions Anterior cervical distraction and screw elevating-pulling reduction is simple with low risk, short operation duration, good effect of intraoperative vertebral reduction and well-recovered function after the operation. Meanwhile, as a safe and effective operation method for cervical spine fractures and dislocations, it can reduce postoperative complications and the risk of the iatrogenic cervical spinal cord injury caused by prying or facet joint springing during conventional reduction, having more obvious advantages compared to the conventional surgical reduction adopted by group A, with good cervical spine stability as shown in long-term follow-up. Therefore, it is suitable for clinical promotion and application. © 2017
Nong J.,303th Hospital of PLA |
Sun X.-Y.,303th Hospital of PLA |
Qin K.,303th Hospital of PLA |
Lai Y.-H.,303th Hospital of PLA |
And 7 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2013
BACKGROUND: Some scholars believe that many factors can lead to pathological changes of the lung in the process of brain-death OBJECTIVE: To observe the pathological changes of brain-death donor lung, and to investigate the feasibility of its clinical transplantation. METHODS: Twenty-three cases of brain-death donor lung received pathological biopsy, and hematoxylin-eosin staining, silver staining and PAS staining were used to observe the pathological changes of lung, and the microstructure of lung tissues was observed under electron microscope. RESULTS AND CONCLUSION: Under the light microscope, bronchial and alveolar structure was complete, and edema, necrosis and defluxion could be observed in part of epithelial cells by hematoxylin-eosin staining, silver staining and PAS staining; alveolar interval was not widened obviously, but hyperemia was visible; small amount of bleeding and scattered lymphocytes could be seen around the vessels. Under the electron microscope, the slightly edema were observed in the brain-death alveolar cells, the cell nuclear chromatin condensed along the caryotheca, some nucleus appeared abnormity, mitochondria were engorgement, but no cell necrosis could be observed. Brain-death donor lung is suitable for clinical transplantation.