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Chen X.-m.,The 306 Hospital of Chinese PLA | Ma H.-s.,The 306 Hospital of Chinese PLA | Liu Y.-z.,Capital Medical University | Zhou J.-w.,The 306 Hospital of Chinese PLA | Wang D.,The 306 Hospital of Chinese PLA
Journal of Clinical Rehabilitative Tissue Engineering Research | Year: 2011

BACKGROUND: With the in-depth understanding of foot biomechanics and calcaneal fracture, the curative effect on intra-articular calcaneal fracture continues to be improved. OBJECTIVE: To investigate the effect of nonlocking compression plates on intra-articular calcaneal fractures. METHODS: We performed 52 osteosynthesis (46 patients) of intra-articular calcaneal fractures using the standard extended lateral approach from February 2004 to October 2007. Nonlocking calcaneal plates were performed in the 46 patients. Preoperatively, all patients were checked by three-dimensional CT. According to Sander's type, there were 20 feet of II fracture, 16 of III fracture, and 16 of IV fractures. Reconstruction of the calcaneal shape was attempted. During operation, we performed Kirschner wire assisted subtalar distraction bone block and osteosynthesis with lateral-wall compression plate insertion in all cases. The patients were evaluated by the Maryland Scale. RESULTS AND CONCLUSION: All 46 patients were followed up for 1-3 years. Poor wound healing was in 2/46 cases, and traumatic arthritis in 4 cases. No patient had deep osseous infection. According to the Maryland Scale, good was in 38 feet, fair in 9 feet and poor in 3 feet, with an excellent rate of 90%. Kirschner wire assisted plate fixation plus local bone graft is satisfied in the treatment of intra-articular calcaneal fractures. Source


Ming L.,The 306 Hospital of Chinese PLA | Fishchenko V.Y.,Ukrainian Academy of Sciences | Hua-Song M.,The 306 Hospital of Chinese PLA | Ren D.-y.,The 306 Hospital of Chinese PLA | And 2 more authors.
Journal of Clinical Rehabilitative Tissue Engineering Research | Year: 2011

BACKGROUND: Establishment of a stable and effetive experimental animal model with congenital scoliosis is a precondition to lucubrate the congenital scoliosis with spinal cord injury and an efficient path to analyze the mechanism of spinal cord injury. OBJECTIVE: To assess the stability of congenital scoliosis model accompanied with complex spinal cord injury in rats. METHODS: A number of 15 model rats with no obvious spinal cord symptoms were put into special glass tubes with a diameter of 6 centimeters. The rats were kept in upright position in the tubes for 6 to 10 days to establish the congenital scoliosis model accompanied with complex spinal cord injury. RESULTS AND CONCLUSION: A total of 13 rats showed bilateral hind limb paralysis, adiaphoria of hind limbs and tail and no response to acupuncture and urination disorder. There were no obvious obstacles of defecation. The fur of bilateral hind limbs and tail in all the rats started to wither, became dull or even dropped. The mean Basso, Beattie and Bresnahen score was 7.3±2.2. Modified Tarlov scores were as follows, 0, 5 rats; 1, 2 rats; 2, 4 rats; 3, 1 rat; 4, 1 rat; 5, 0 rat. According to imaging, the congenital scoliosis were all over the spinal cord. The wedged hemivertebra and intercalated disc at the scoliosis vertex moved towards the spinal canal in some rats. According to histochemical results, there was a one-to-one relationship between the congenital defect with bone-and-spinal nourishing vessels damage and the compression in spinal cord segments caused by the bone structure damage in the corresponding segments. There were visible vascular distribution deletion regions at the malformation vertex. The vascular tissue of the venoux plexus underwent apoptosis at the scoliosis vertex. These findings indicate that the symptoms of complex spinal cord injury accompanied with the congenital scoliosis model are similar to the symptoms progress of congenital scoliosis patients. The repeat rate of the rat model is 87% (13/15). Source


Wang X.-P.,The 306 Hospital of Chinese PLA | Ma H.-S.,The 306 Hospital of Chinese PLA | Chen Z.-M.,The 306 Hospital of Chinese PLA | Yuan W.,The 306 Hospital of Chinese PLA | And 6 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: Lumbar degenerative diseases are commonly found in the elderly. Thus, surgery risk is very high. To solve this problem, some scholars put forward the concept of selective decompression. However, it is hard to identify the corresponding segment or position in some patients, so selective decompression cannot obtain perfect repair effects in many previous prospective randomized controlled studies. OBJECTIVE: To analyze the effectivity of single level decompression and fusion for multiple level lumbar disc herniation combined with lumbar spondylolisthesis. METHODS: A total of 23 cases of multiple level lumbar disc herniation with lumbar spondylolisthesis from January 2010 to December 2013 were enrolled in this study. Repair method: single level decompression and fusion. Using conventional X-ray, lumbar MRI,, disease stage and instability interval were assessed in combination with selective nerve root closed, and dynamic X-ray measurements (over-extension, over-flexion, left and right flexion). Dynamic X-ray measurements and Posner score were used to identify stability of responsible segment. Lumbar MRI was utilized to identify obvious degeneration of intervertebral discs. Selective nerve root closed was applied to identify the major responsible interspace. Low back pain visual analog scale and the Japanese Orthopaedic Association score were employed to assess patient’s repair effects. The improvement of clinical symptoms could be used as the criteria of curative effects. RESULTS AND CONCLUSION: All patients were followed up for 12-36 months. Low back pain visual analog scale and the Japanese Orthopaedic Association score were significantly improved during final follow-up. The improvement rate of the Japanese Orthopaedic Association score was 88%. The improvement rate of the visual analog scale was 93%. Nerve root irritation was not visible after surgery. Bone fusion was found in fusion segment of all patients. No loosening, fracture or pulling out appeared. No lumbar sagittal imbalance was detectable. Results indicated that it is necessary to give correct general diagnosis and evaluation according to symptoms, signs and radiological features before surgery. Decompression to responsible interspace, short level fixation, pedicle screw, connecting rods and interbody fusion can increase supporting force of pre-column. Stress on the screw and rod maintains dynamic equilibrium. Simultaneously, stable screw-rod fixation system is also conducive to the bone healing in anterior bone graft material. Frame structure formed by internal fixation significantly elevates the anti-rotation capability, forming strong three-dimensional fixation. © 2014, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved. Source


Lu M.,The 306 Hospital of Chinese PLA | Wang X.-P.,The 306 Hospital of Chinese PLA | Ma H.-S.,The 306 Hospital of Chinese PLA | Yue C.-S.,The 306 Hospital of Chinese PLA | And 6 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: The evaluation and the correction of sagittal plane balance are attributed to the good restoration effect of kyphosis deformity, and the measurement method of spinal-pelvis parameters are one of the effective method for assessing spinal imbalance. OBJECTIVE: To measure spine-pelvis parameters in stiff angular kyphosis patients treated with posterior vertebral column resection osteotomy combined with step correction, design surgical scheme, analyze postoperative biomechanical characteristics of lumber vertebra, and evaluate long-term prognosis. METHODS: Thirty-seven patients with severe angular kyphosis deformity treated with posterior vertebral column resection osteotomy, bilateral screw-rob combined with echelon tight closure for spinal cord shortening, and internal fixation in the Department of Orthopedics at the 306 Hospital of Chinese PLA. The lumbar lordosis angle, thoracic vertebrae kyphosis angle, thoracic waist kyphosis angle, pelvic tilt angle, sacrum tilt angle, pelvic index, spine-sacrum angle, saggital plane vertebral axis were measured before surgery, after surgery and at the final follow-up. The spinal kyphosis angle, spinal sagittal plane imbalance, lateral trunk shift rate, operation time, intraoperative blood loss, follow-up time, kyphosis correction angle, and correction of lateral trunk shift were recorded before and after surgery. RESULTS AND CONCLUSION: The average operation time was 326 min (212-470 min), intraoperative blood loss was 2 089 mL (1 200-6 000 mL), the number of resected vertebral bodies was 104, and the osteotomy plane was localized at T4 -L2. All the patients were followed up for 20-35 months. The average postoperative spinal kyphosis angle was 41.6° (10°-90°) and the correction rate was 65%. The average distance of C7 plumb line lateral to the posterior upper edge of S1 was 5.2 mm (-12 mm to 23 mm) after surgery, the correction rate was 73%. Two cases appeared neurological complications, accounting for 6%; and two cases appeared non-neurological complications, accounting for 6%.The anatomical parameters of the involved patients were significantly improved after surgery, compared with before surgery (P < 0.05). During the follow-ups, the osteotomy segments achieved bony fusion, no spinal cord injury and other complication were observed, and no loss of correction rate was found. Preoperative and postoperative measurement of the spine-pelvis parameters in patients with stiff spinal angular kyphosis can contribute to the understandings of spine-pelvis sequence and trunk anteroposterior balance, obtain technical parameters of osteotomy angle, achieve preoperation design, and make appropriate choice of osteotomy plane, so the restoration effect is more close to the biomechanical characteristics of human spine and lumbar vertebrae. © 2014, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved. Source


Ma H.-S.,The 306 Hospital of Chinese PLA | Wang X.-P.,The 306 Hospital of Chinese PLA | Tan R.,The 306 Hospital of Chinese PLA | Chen Z.-M.,The 306 Hospital of Chinese PLA | And 9 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: Severe spinal angular kyphosis aggravated spinal cord injury and early degeneration, even caused incomplete paralysis or complete paralysis. Surgical treatment is the only solving approaches and method, but it is difficult, exhibits high risk, and easily affects postoperative complications. OBJECTIVE: To analyze the science and effectiveness of posterior vertebral column resection osteotomy combined with step correction in treatment of stiff angular kyphosis based on biomechanical principle. METHODS: A total of 90 cases underwent posterior vertebral column resection osteotomy combined with bilateral pedicle screw spinal cord gradually shortening echelon tight closure and orthopedic fixation were selected, including 37 males and 52 females, at the average age of 47 years. Kyphotic angle, spinal sagittal imbalance, trunk side offset rate, operation time, intraoperative blood loss were compared and analyzed before and after treatment. RESULTS AND CONCLUSION: The kyphotic angles were 31°-138° (averagely 90.1°) preoperatively and 10°-90° (averagely 41.6°) postoperatively, with an improvement rate of 65%. The distance from C7 plumb line to the S1 upper edge was averagely 5.2 mm, with a correction rate of 73%. Intraoperative blood loss was 1 200-6 000 mL, averagely 2 089 mL. Operation time was 212-470 minutes, averagely 326 minutes. The patients were followed up for 20 to 35 months after the surgery. Osteotomy segments had achieved bone fusion in all patients, and no complications of spinal cord injury or orthopedic angle loss appeared. These data verified that in the accordance with cell biomechanics and spinal biomechanical principles, bilateral pedicle screw spinal cord gradually shortening echelon tight closure and orthopedic fixation protected utmost spinal cord cells against injury in the correction of thoracolumbar angular kyphosis. There is sufficient basis for cell physiology and it accorded biomechanical and physiological characteristics. During the surgery, we should pay attention to protection and release of nerve root and avoid postoperative corresponding nerve root irritation. Full fusion ensures kyphosis correction and avoids spine lateral offset, is an effective safeguard for the recovery of spinal function and postoperative orthopedic effect. © 2014 Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved. Source

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