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检索条件"任意字段=2018年浙江省医学会骨质疏松与骨矿盐疾病分会学术年会暨骨质疏松症和骨质疏松性骨折诊治进展专题研讨会"

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通道下联合固定并椎间不同融合器植骨治疗腰椎病变的对比研究

通道下联合固定并椎间不同融合器植骨治疗腰椎病变的对比研究

引用

2018年浙江省医学会骨质疏松与骨矿盐疾病分会学术年会暨骨质疏松症和骨质疏松性骨折诊治进展专题研讨会

作者：曾忠友张建乔宋永兴籍剑飞裴斐金辉韩建福宋国浩武警浙江省总队医院

目的:探讨不同融合器植骨方法在通道下联合固定并椎间融合术中的疗效比较。方法:自2015年1月～2016年12月,分别采用单枚普通融合器、双枚普通融合器或香蕉型融合器进行椎间植骨治疗腰椎病变的方式共治疗腰椎病变122例。其中,单枚融合器... 详细信息

目的:探讨不同融合器植骨方法在通道下联合固定并椎间融合术中的疗效比较。方法:自2015年1月～2016年12月,分别采用单枚普通融合器、双枚普通融合器或香蕉型融合器进行椎间植骨治疗腰椎病变的方式共治疗腰椎病变122例。其中,单枚融合器组(41例)男13例,女28例;年龄22～80岁,平均(56.6±13.25)岁;病史时间6～72个月,平均(32.7±14.1)个月。疾病类型:腰椎间盘退变22例,腰椎管狭窄症9、腰椎退行性滑脱Ⅰ°7例、巨大型腰椎间盘突出症3例。病变部位:L3/42例、L4/532例,L5S17例。双枚融合器组(41例)男16例,女25例,年龄27～84岁,平均(57.3±13.77)岁,病史时间10～66个月,平均(30.2±13.4)个月。疾病类型:腰椎间盘退变23例,腰椎管狭窄症10例、腰椎退行性滑脱Ⅰ°6例、巨大型腰椎间盘突出症2例。病变部位:L3/41例,L4/534例,L5S16例。香蕉型融合器组(40例)男15例,女25例;年龄30～81岁,平均(55.9±13.29)岁;病史时间8～84个月,平均(34.2±14.8)个月。疾病类型:腰椎间盘退变19例,腰椎管狭窄症11、腰椎退行性滑脱Ⅰ°8例、巨大型腰椎间盘突出症2例。病变部位:L3/42例,L4/534例,L5S14例。术后对比分析两者的术中出血量、手术时间、切口长度、切口愈合情况,VAS评分;ODI指数,及术中、术后并发症等。结果:均获随访,三组病例切口长度、手术时间、术中出血量和术后切口引流液量见表3,在切口长度、手术时间、术中出血量和术后切口引流液量方面,三组对比差异均无统计学意义(P> 0.05),虽然手术时间方面对比差异无统计学意义(P> 0.05),但双枚融合器组操作时间多于单枚融合器组和香蕉型融合器组。结论:三种不同的椎间融合方法,在通道下联合固定并椎间融合术中,并无明显临床差异。

关键词：联合固定椎间盘退变术中出血量植骨治疗巨大型腰椎间盘突出症手术时间椎管狭窄症椎间融合术

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双侧肌间隙入路通道下椎弓根螺钉复位固定并椎间融合治疗腰椎Ⅱ°或Ⅲ°滑脱症的可行性研究

双侧肌间隙入路通道下椎弓根螺钉复位固定并椎间融合治疗腰椎Ⅱ°...

引用

2018年浙江省医学会骨质疏松与骨矿盐疾病分会学术年会暨骨质疏松症和骨质疏松性骨折诊治进展专题研讨会

作者：曾忠友张建乔严卫锋宋永兴籍剑飞裴斐金辉宋国浩韩建福武警浙江省总队医院

目的:探讨双侧肌间隙入路通道下椎弓根螺钉复位固定并椎间融合治疗腰椎Ⅱ°或Ⅲ°滑脱症的可行性。方法:自2012年1月～2015年12月分别采用正中切口入路和双侧肌间隙入路通道下椎弓根螺钉复位固定并椎间融合器植骨治疗的腰椎Ⅱ&#... 详细信息

目的:探讨双侧肌间隙入路通道下椎弓根螺钉复位固定并椎间融合治疗腰椎Ⅱ°或Ⅲ°滑脱症的可行性。方法:自2012年1月～2015年12月分别采用正中切口入路和双侧肌间隙入路通道下椎弓根螺钉复位固定并椎间融合器植骨治疗的腰椎Ⅱ°或Ⅲ°滑脱症52例,其中,正中切口入路组27例,男9例,女18例,年龄35～70岁,平均54.1岁,病史时间12个月～15年,平均70.8个月。双侧肌间隙入路组25例男7例,女18例,年龄38～70岁,平均55.6岁;病史时间10个月～12年,平均62.4个月。术后对比分析两者的术中出血量、手术时间、切口长度、切口愈合情况,VAS评分;ODI指数,及术中、术后并发症等。结果:均获随访,两组病例手术时间、术中出血、术后切口引流液量和切口长度,两组对比差异均有统计学意义,在手术时间方面,正中切口入路组操作时间短,而在术中出血、术后切口引流液量和切口长度方面,双侧肌间隙入路组优于正中切口入路组。两组病例术中、术后均无脑脊液漏、神经损伤和椎弓根骨折,术后亦未出现神经症状加重现象;切口皮肤无坏死,切口无感染。术后72h腰部切口VAS评分:正中切口入路组2～6分,平均3.25分;双侧肌间隙入路组1～3分,平均1.62分,两者对比差异有统计学意义,即双侧肌间隙入路组术后切口疼痛轻于正中切口入路组。椎弓根螺钉位置:正中切口入路组:Ⅰ度96枚螺钉,Ⅱ度12枚螺钉,螺钉位置不良率11.1%;双侧肌间隙入路组Ⅰ度94枚螺钉,Ⅱ度6枚螺钉,螺钉位置不良率6.0%,两组对比差异有统计学意义,双侧肌间隙入路组螺钉位置优于正中切口入路组。结论:双侧肌间隙入路通道下椎弓根螺钉复位固定并椎间融合治疗腰椎Ⅱ°或Ⅲ°滑脱症,创伤小,并发症低,具有与传统手术方法相似的疗效。

关键词：肌间隙入路椎弓根螺钉复位固定椎间融合滑脱症可行性研究

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Effect of Low-frequency Pulsed Ultrasound on Drug Delivery and Bone Cement Degradation in Vancomycin-loaded Calcium Phosphate Cement

Effect of Low-frequency Pulsed Ultrasound on Drug Delivery a...

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2018年浙江省医学会骨质疏松与骨矿盐疾病分会学术年会暨骨质疏松症和骨质疏松性骨折诊治进展专题研讨会

作者：史明敏严世贵浙江大学医学院附属第二医院骨科

Background:Calcium phosphate cement(CPC) has been proved to be a biodegradable antibiotic carrier in ***,the antibiotics release and degradation rate of CPC needed further improvement in clinical *** and Methods:Vancomycin-loaded CPC columns were prepare,and eluted in stimulated body *** delivery and antibacterial efficacy of vancomycin was investigated.A low-frequency pulsed ultrasound(46.5 kHz,900 mW/cm2) was used to produce a sinusoidal wave in experimental *** percentage of residual weight was test to assess the degradation of ***:The concentration and cumulatively released percentage of vancomycin in ultrasound group were higher than that in control group at each time point(p<0.05).The duration of vancomycin concentration over the level of minimum inhibitory concentration was significantly prolonged in ultrasound group(p<0.05).Antibacterial efficacy of vancomycin in ultrasound group was significantly better than that in control group with same concentration of vancomycin(p<0.05).The percentage of residual weight in ultrasound group was significantly less than that in control group(p<0.05).Conclusion:Low-frequency pulsed ultrasound could enhance vancomycin release,prolong the duration of vancomycin concentration in high level and accelerate the degradation rate of vancomycin-loaded CPC.

关键词： Effect of Low-frequency Pulsed Ultrasound on Drug Delivery and Bone Cement Degradation in Vancomycin-loaded Calcium Phosphate Cement

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肌间隙入路通道下腰椎固定融合术的并发症

肌间隙入路通道下腰椎固定融合术的并发症

引用

2018年浙江省医学会骨质疏松与骨矿盐疾病分会学术年会暨骨质疏松症和骨质疏松性骨折诊治进展专题研讨会

作者：曾忠友宋永兴张建乔严卫锋籍剑飞裴斐金辉韩建福宋国浩武警浙江省总队医院

目的:总结、分析肌间隙入路通道下腰椎固定融合术的并发症。方法:自2012年6月～2015年12月肌间隙入路通道下固定融合术治疗的腰椎病变467例,其中肌间隙入路通道下单侧椎弓根螺钉固定并椎间融合术58例,肌间隙入路通道下单侧椎弓根螺钉联... 详细信息

目的:总结、分析肌间隙入路通道下腰椎固定融合术的并发症。方法:自2012年6月～2015年12月肌间隙入路通道下固定融合术治疗的腰椎病变467例,其中肌间隙入路通道下单侧椎弓根螺钉固定并椎间融合术58例,肌间隙入路通道下单侧椎弓根螺钉联合对侧椎板关节突螺钉固定并椎间融合术)192例,肌间隙入路通道下双侧椎弓根螺钉固定并椎间融合术217例,其中,男203例,女264例;年龄20～85岁,平均57.6岁,其中年龄<65岁有365例,年龄≥65岁102例;腰椎间盘退变195例,巨大型腰椎间盘突出症23例,极外型腰椎间盘突出症14例,腰椎间盘突出症术后原位复发27例,腰椎间盘突出伴椎管狭窄症60例,腰椎管狭窄症23例,腰椎退行性滑脱症69例,腰椎椎弓峡部断裂伴或不伴椎体滑脱56例;单节段病变415例,两节段病变52例。病变部位:T12L11例,L1/21例,L2/32例,L3/417例,L4/5298例,L5S195例,T12L1L1/21例,L2/3L3/42例,L3/4L4/527例,L4/5L5S122例。观察并记录术中出血量、血管损伤、术中和术后神经损伤、手术时间、切口长度、切口愈合情况,VAS评分;ODI指数等。术后监测影像学以评价融合率、融合器的移位或沉降、椎间融合情况,以及邻近节段的退变现象。结果:均获随访,手术时间60～180min,平均101min;术中出血量100～2000ml,平均323ml;术后切口引流液量5～360ml,平均123ml。术后72小时腰部切口疼痛VAS评分:单侧固定组0～2分,平均(0.94±0.36)分;联合固定组0～2分,平均(0.97±0.45)分;双侧固定组0～3分,平均(1.30±0.67)分。三组间VAS评分比较:单侧固定组与联合固定组相比差异无统计学意义(P> 0.05),而双侧固定组与单侧固定组,以及与联合固定组相比差异均有统计学意义(P<0.05)。结论:肌间隙入路通道下腰椎固定融合术,是一种优良的微创腰椎手术方法,但也存在一定的并发症,需要跨越学习曲线。

关键词：肌间隙入路下腰椎单侧固定椎间融合术椎间盘突出症

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Percutaneous internal fixation with PKP and simple PKP for thoracolumbar burst fractures of the aged patients:A prospective randomized controlled trial

Percutaneous internal fixation with PKP and simple PKP for t...

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2013年浙江省医学会骨质疏松与骨矿盐疾病分会学术年会暨国家级骨质疏松症和骨质疏松性骨折诊治进展专题研讨会

作者： Dengwei He Kejun Zhu Xiaoyong Sheng Ye Zhu WeiYang Yu Feijun Liu 丽水市中心医院温州医学院附属第五医院骨科

Background:The impact of percutaneous internal fixation as a supplement to percutaneous kyphoplasty(PKP) for the management of the thoracolumbar burst fractures of the aged patients is *** conducted a clinical controlled trial to define the effect of percutaneous internal fixation with PKP on thoracolumbar fractures and patientrelated functional outcomes. Method:This study included 43 patients with thoracolumbar burst fractures without nerve injuries who were elder than 65 years *** were randomly assigned to treatment with simple PKP(control group,n=22) and percutaneous short-segment pedicle screw internal fixation with PKP(treatment group,n=21).The patients were followed for at least two years postoperatively and were assessed with regard to clinical and radiological outcomes. Clinical outcomes were evaluated mainly with use of visual pain analog scale(VAS) and questionnaire score of Oswestry disability index(ODI).Radiological outcomes were assessed mainly on the basis of Cobb kyphosis angle and loss of kyphosis correction. Results:There was no significant difference between the two groups with regard to the preoperative indexes. The treatment group had better VAS values and had more postoperative improvements in ODI results as compared with the control group(P < 0.05).Postoperative kyphosis angle correction of the treatment group was superior to that of the control group,and postoperative correction loss was significant less compared with the control group(P < 0.05). In the control group,two patients postoperatively suffered refractures in the injured vertebra and one patient had refracture in the adjacent *** operation complications need managements were noted postoperatively in both groups. Conclusions:Compared with simple PKP operation,percutaneous internal fixation with PKP is one kind of more ideal surgical technique for the treatment of selected elderly thoracolumbar burst fractures.

关键词： the elderly patient thoracolumbar burst fracture percutaneous internal fixation simple PKP randomized controlled trial

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Effect of a Twelve-hour Natural Drainage Technique on Decreasing Blood Loss After Total Knee Arthroplasty:A Case-control Study

Effect of a Twelve-hour Natural Drainage Technique on Decrea...

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2018年浙江省医学会骨质疏松与骨矿盐疾病分会学术年会暨骨质疏松症和骨质疏松性骨折诊治进展专题研讨会

作者：史明敏严世贵浙江大学医学院附属第二医院骨科

Background:Different methods of drainage have been used in patients with osteoarthritis after total knee arthroplasty(TKA),but the ideal strategy is *** retrospective case-control study reported a technique of twelve-hour natural drainage and aimed to confirm its efficacy and safety in the treatment on the blood loss following *** and Methods:There were 231 patients divided into three groups who underwent TKA from Jan 2014 to July 2017:76 patients underwent twelve-hour natural drainage in Group A,80 patients underwent four-hour clamping drainage in Group B and 75 patients underwent continuous drainage in Group *** perioperative clinical data were reviewed for statistical ***:The drainage volume,serum haemoglobin and total blood loss after TKA were significantly lower in Group A than that in other two groups(p<0.05).The maximum of active motion of the knee was greater in Group C at 2 days(P<0.05).Significantly more patients in Group C required blood transfusions(p<0.05).No difference was found in complication rate among the three ***:The twelve-hour natural drainage is an effective technique on reducing blood loss for patients following *** with temporary clamping drainage and continuous negative pressure drainage,twelve-hour natural drainage decreases blood loss,reduces post-operative transfusion requirements but does not increase the risk of ***,this technique of twelve-hour natural drainage is recommended to be used in patients after TKA.

关键词： Effect of a Twelve-hour Natural Drainage Technique on Decreasing Blood Loss After Total Knee Arthroplasty:A Case-control Study TKA

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Effect of Bisphosphonates on Periprosthetic Bone Loss after Total Knee Arthroplasty:A Meta-analysis of Randomized Controlled Trials

Effect of Bisphosphonates on Periprosthetic Bone Loss after ...

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2018年浙江省医学会骨质疏松与骨矿盐疾病分会学术年会暨骨质疏松症和骨质疏松性骨折诊治进展专题研讨会

作者：史明敏严世贵浙江大学医学院附属第二医院

Background:Aseptic loosening and osteolysis are the most common indications after TKA for revision *** meta-analysis which included high-quality randomized controlled trials aimed to analyze the effect of bisphosphonates(BPs) on maintaining periprosthetic bone mineral density(BMD) after total knee ***:PubMed,AMED,EMBASE,the Cochrane library,ISI Web of Science,and China National Knowledge Infrastructure were systematically searched,five RCTs were included and the total number of participants was *** weighted mean differences with 95% confidence interval were calculated to evaluate the efficacy of BPs on total BMD of knee and the BMD of different periprosthetic regions.A descriptive review was performed for BPrelated adverse ***:The BPs group presented significantly higher total BMD in proximal part of the tibia than the control group at 3 and 6 months(P<0.05),but no significant difference at 12 months(P=0.09).The BPs group presented significantly higher BMD in the distal aspect of the femur than that in the control group at 3,6,12 *** BPs group presented significantly higher periprosthetic BMD than that in the control group at 3,6 and 12 months in R1,R2,R4,R5 and R6(p <0.05),but no significant difference for R3 at 3,6,and 12 *** of the included studies described severe or fatal adverse effects related to ***:BPs have a short-term effect on reducing periprosthetic bone loss after total knee *** with diaphyseal region,BPs are more effective on the preservation of BMD in medial lateral metaphyseal regions of proximal tibia and in anterior,central,and posterior metaphyseal region of distal femur.

关键词： Effect of Bisphosphonates on Periprosthetic Bone Loss after Total Knee Arthroplasty:A Meta-analysis of Randomized Controlled Trials BMD

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Bisphosphonates for the Preservation of Periprosthetic Bone Mineral Density after Total Joint Arthroplasty:A Meta-analysis of 25 Randomized Controlled Trials

Bisphosphonates for the Preservation of Periprosthetic Bone ...

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2018年浙江省医学会骨质疏松与骨矿盐疾病分会学术年会暨骨质疏松症和骨质疏松性骨折诊治进展专题研讨会

作者：史明敏严世贵浙江大学医学院附属第二医院骨科

The present meta-analysis aimed to evaluate the long-term efficacy of bisphosphonates(BPs) on preservation of periprosthetic bone mineral density(BMD) after joint *** confirmed the protective effect of BPs in a long-term follow-up,and found the influence factors on this *** Periprosthetic bone loss is believed to cause aseptic loosening and failed prosthetic fixation in joint *** meta-analysis which included high-quality randomized controlled trials aimed to analyze the effect of bisphosphonates on maintaining periprosthetic bone mineral density after total joint *** Twenty-five RCTs were included and the total number of participants was 1163 by computerized searches of bibliographic *** weighted mean differences with 95% confidence interval were calculated to evaluate the efficacy of BPs on total periprosthetic BMD and the BMD of different Gruen *** analyses identified the potentially influencing factors such as surgical site,cement fixation,generation of BPs,etc.A descriptive review was conducted for BP-related adverse *** The BPs group presented significantly higher total periprosthetic BMD in the BPs group than that in the control group at 3,6,12 months,2-4 years and 5-10 years after arthroplasty(P<0.05).The BPs group presented significantly higher periprosthetic BMD in femoral Gruen Zone 1 and 7 than that in the control group at 3,6,12 months,2-4 year and 5-10 years(P<0.05).The heterogeneity was minimized by dividing THA and TKA into two *** analyses revealed that the effect of BPs on preservation of BMD was significantly greater in arthroplasty with cemented component than in that with uncemented component at 12 months and 5-10 years(P<0.05),and the administration of the second and third generation BPs was significantly more effective than the first-generation BPs at6 and 12 months(P<0.05).None of the included studies described severe or fatal adverse effects

关键词： Bisphosphonates for the Preservation of Periprosthetic Bone Mineral Density after Total Joint Arthroplasty:A Meta-analysis of 25 Randomized Controlled Trials

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