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28 October 2012, Volume 16 Issue 44 Previous Issue    Next Issue

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Whether patella replacement should be performed in total knee arthroplasty Xiang Qun, Wang Si-qing, Yin Jun, Wang Dong-liang 2012, 16 (44):  8171-8177.  doi: 10.3969/j.issn.2095-4344.2012.44.001 Abstract ( 307 )   PDF (586KB) ( 354 )   Save BACKGROUND: There is consistency of conclusions on whether the patella replacement should be performed in total knee arthroplasty. OBJECTIVE: To comparatively observe whether the patella replacement should be performed in total knee arthroplasty. METHODS: A total of 56 cases (60 knees) with knee osteoarthritis were selected from Yancheng City No.1 People’s Hospital from July 2009 to April 2012, and divided into patella replacement group and non-replacement group. RESULTS AND CONCLUSION: At 3 months after total knee arthroplasty, the Hospital for Special Surgery score, patella score, activity and Q angle in patella replacement group were lower than those in the non-replacement group (P < 0.05), while there was no significant difference of postoperative anterior knee pain score and knee valgus angle between two groups (P > 0.05). Intraoperative reasonable patellar treatment can effectively improve the trajectory of the patellofemoral joint, significantly reduce the patellar complications. For the patients with patellofemoral match and a good line of force, to retain the patella in total knee arthroplasty can improve joint function recovery, and the overall effect of patella replacement is better than that of non-replacement. Related Articles | Metrics

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Total knee arthroplasty with high-flexion rotating-platform posterior stabilized artificial knee prosthesis Zhou Wei, Liu Dong-hai, Ma Guo-tao, Xu Zhen-wei, Jiang Hui-zhi, Wu Deng-ke, Zhao Shi-yang 2012, 16 (44):  8178-8181.  doi: 10.3969/j.issn.2095-4344.2012.44.002 Abstract ( 321 )   PDF (428KB) ( 483 )   Save BACKGROUND: The traditional artificial knee prosthesis has been applied successfully in clinic. Some reports have reported that there is high molecular polyethylene pad wear after high-flexion rotating-platform posterior stabilized (PFC sigma RPF) artificial knee prosthesis replacement, and the design of PFC sigma RPF artificial knee prosthesis can solve the problem effectively. OBJECTIVE: To investigate the recent clinical curative effect after PFC sigma RPF artificial knee prosthesis total knee arthroplasty. METHODS: Seventy-eighty patients (113 knees) were treated with PFC sigma RPF artificial knee prosthesis artificial knee prosthesis replacement, the prosthesis was fixed with bone cement and the patella was not treated with replacement. All the patients were followed-up for 3 years. The difference of range of motion and hospital for special knee surgery score before and after replacement were compared. RESULTS AND CONCLUSION: After 3-year follow-up, the range of motion was improved from average 110.7° preoperatively to 124° postoperatively. The mean hospital for special knee surgery score was improved from 54.2 scores preoperatively to 95.4 scores postoperatively. The excellent-good rate was 93.58%. The incidence rate of all kinds of complications was low. The recent clinical curative effect of PFC sigma RPF artificial knee prosthesis replacement is satisfactory. Persistent pain is an important cause of dissatisfaction after total knee arthroplasty. The long-term clinical curative effect still needs further observation. Related Articles | Metrics

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Effect of continuous passive motion on blood coagulation condition in patients with total knee joint replacement Luo Shu-ming, Liao Yi-ming, Chen Lin, Huang Ying, Zhou Li, Tang Jin 2012, 16 (44):  8182-8185.  doi: 10.3969/j.issn.2095-4344.2012.44.003 Abstract ( 315 )   PDF (367KB) ( 547 )   Save BACKGROUND: Preliminary studies on continuous passive motion mainly concentrated on improving the range of motion and relieving the joint swelling. OBJECTIVE: To investigate the effect of continuous passive motion on blood coagulation condition and deep vein thrombosis of the lower extremity in patients after total knee joint replacement． METHODS: Eighty patients with total knee joint replacement were randomly divided into experimental group and control group. Patients in the control group were treated only with traditional way to help the patient move the knee by the nurse and combined with active functional exercise; patients in the experimental group were treated with continuous passive motion beginning at 24 hours postoperatively, and were also treated with traditional way to help the patient move the knee by the nurse. Cruor comprehensive index and incidence rate of deep vein thrombosis of the lower extremity were recorded at 2 weeks after replacement. RESULTS AND CONCLUSION: At 2 weeks after replacement, cruor comprehensive index was 2.66±1.04 and 3.98±1.36 in the experimental group and the control group, and the incidence rate of deep vein thrombosis of the lower extremity was 2.5% and 17.5% in the experimental group and control group. The results showed that the cruor comprehensive index and incidence rate of deep vein thrombosis of the lower extremity in the experimental group were lower than those in the control group (P < 0.05). Early application of continuous passive mobilization after total knee joint replacement has obvious advantages in improving the cruor comprehensive index and blood coagulation condition, and it has positive effect on protecting the deep vein thrombosis of the lower extremity. Related Articles | Metrics

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Effects of bone cement and tourniquet on coagulation function during total knee arthroplasty Yin Jun-ping, Miao Hai-min, Qiao Guo-yong, Yi Yan-li 2012, 16 (44):  8186-8190.  doi: 10.3969/j.issn.2095-4344.2012.44.004 Abstract ( 345 )   PDF (503KB) ( 424 )   Save BACKGROUND: Studies have shown that bone cement has a great effect on the patient's hemodynamic and blood coagulation during total knee arthroplasty. OBJECTIVE: To observe the effects of bone cement and tourniquet on coagulation function during total knee arthroplasty. METHODS: Forty osteoarthritis patients who underwent single total knee arthroplasty were randomly divided into two groups with randomized control study method: the application of tourniquet and patients who did not have tourniquet. The relative parameters were observed in all patients, including prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and D-dipolymer. Coagulation function changes between two groups were compared. RESULTS AND CONCLUSION: The prothrombin time was significantly decreased at 60 and 120 minutes after cement implantation (P < 0.05), and the levels of fibrinogen and D-dipolymer were increased after implantation in all patients (P < 0.05), especially in the patients who use of tourniquet. The changes vanished at 180 minutes after bone cement implantation. There was no significant difference in activated partial thromboplastin time and prothrombin time before and after bone cement implantation. The values of prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and D-dipolymer were within the normal range. Compared with the patients who did not have tourniquet, the prothrombin time in the patients with tourniquet was shortened and the fibrinogen and D-dipolymer were increased (P < 0.05). The bone cement implantation can lead to temporal hypercoagulabale state during single total knee arthroplasty, and the tourniquet can aggravate the hypercoagulable state in patients. Related Articles | Metrics

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Cementless total hip arthroplasty for the treatment of developmental dysplasia of adult hip Lei Peng-fei, Hu Yi-he, Cai Peng-de, Yang Xu-cheng, Wang Long 2012, 16 (44):  8191-8195.  doi: 10.3969/j.issn.2095-4344.2012.44.005 Abstract ( 414 )   PDF (425KB) ( 653 )   Save BACKGROUND: Total hip arthroplasty is considered as an effective method for the treatment of hip dysplasia with advanced hip disease, but there exists many difficulties and risks. OBJECTIVE: To evaluate the short-term outcome of cementless total hip arthroplasy for the treatment of Crowe- Ⅳ developmental dysplasia of the hip. METHODS: Eighteen adult patients (22 hips) with Crowe-Ⅳdevelopmental dysplasia of the hip underwent primary total hip arthroplasty. All cases were accomplished through posterolateral approach bone cement fixation, and the greater trochanter osteotomy was performed to adjust the gluteal muscle tension. The acetabular cups were established at the level of the true acetabulum as near as possible. RESULTS AND CONCLUSION: All the patients were followed-up for more than 10 months, and the longest follow-up time was 38 months. The mean lower limb length was 4.5 cm (3.4-6.0 cm) before surgery, and it was 4.0 cm longer than that before surgery (range 3.2-4.8 cm). The mean Harris hip score at the final follow-up after surgery was 87 (range 79-91) and was significantly increased than that before surgery (P < 0.01). During the replacement, 3 cases (3 hips) suffered from fracture with femoral prosthesis stability. And these three cases were treated with wire fixation or without any special treatment, and the X-ray film at 2 months after treatment showed that the fractures were healed. One case had the symptoms of sciatic nerve palsy after replacement and 3 months later, the symptoms disappeared. There was no loosening, dislocation, infection or deep venous thrombosis in any patient. Cementless total hip arthroplasty with osteotomy of the greater trochanter for Crowe -Ⅳ developmental dysplasia of the hip was an effective procedure to establish the biomechanics and improve the function of the hip. Related Articles | Metrics

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Green Seligson Henry nails plus memory clutching internal fixator for the treatment of supracondylar femoral fractures Zhao Yan, Kang Xiong, Huo Jian-jun, Xiao-Ke-lai-ti-Maisumu, A Bu-du-sai-mai-ti, Jia Tian-peng, Bie-Ke-bo-song, A-Bu-du-ka-ha-er 2012, 16 (44):  8196-8200.  doi: 10.3969/j.issn.2095-4344.2012.44.006 Abstract ( 250 )   PDF (473KB) ( 571 )   Save BACKGROUND: The technique of internal fixation for type A supracondylar femoral fractures with combination of Green Seligson Henry nails and memory clutching internal fixator have many advantages of strong biomechanical fixation, improvement of fracture union and early exercises. OBJECTIVE: To investigate the clinical effects of Green Seligson Henry nail plus memory clutching internal fixator for the treatment of type A supracondylar femoral fractures. METHODS: Nineteen cases of type A supracondylar femoral fractures were treated with Green Seligson Henry nails plus memory clutching internal fixator. There were 11 cases of type 33A1, 6 cases of type 33A2 and 2 cases of type 33A3 according to AO/ASIF classification. The demography of the 19 cases was as follows: 12 males and 7 females, ranging from 17 to 68 years old (a mean of 37.2 years old). All cases were treated with Green Seligson Henry nails plus memory clutching internal fixator. RESULTS AND CONCLUSION: Seventeen out of 19 cases were followed-up with a mean period of 8 months (4 to 24 months). The time for fracture union averaged 14 weeks (12-18 weeks). No implant loosening or breaking, knee joint infection, deformity and nonunion were observed. Two cases of infected incision, 2 cases of postoperative traumatic arthrits,1 cases of temporary aggravation of pre-existing osteoarthritis were documented as postoperative complication. For the 17 cases, 12 cases score excellent under the HSS score, 3 good and 2 average (12%). The excellent and good rate was 88%. Internal fixator with combination of Green Seligson Henry nail and memory clutching has better characteristics of stability mechanism in treating type A supracondylar femoral fractures. The stability and integrity of type A supracondylar femoral fractures can be recovered. This method has many advantages such as stable fixation, improvement of fracture union and early exercises. Related Articles | Metrics

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Comparison of retrograde intramedullary nail and plate implantation for internal fixation for the treatment of distal femur fractures Maimaitiaili·Niyazi1, Aihemaiti·Wumair2, Maierdan·Maimaiti1, Jin Ge-le1, Tian Juan1 2012, 16 (44):  8201-8205.  doi: 10.3969/j.issn.2095-4344.2012.44.007 Abstract ( 282 )   PDF (485KB) ( 513 )   Save BACKGROUND: Center fixation method based on the intramedullary nail is more consistent with the bio-mechanical characteristics of the femur. OBJECTIVE: To compare the clinical effects of femoral condyle retrograde intramedullary nail and anatomical distal femur plate fixation for the treatment of distal femoral fractures. METHODS: Thirty-five patients with distal femur fractures were treated with retrograde intramedullary nail fixation and 31 patients were treated with plate fixation, all the patients were followed-up for more than 1 year, and then the recovery of motion of knee joints and the time of bone healing were evaluated by Neer knee society function score criteria. RESULTS AND CONCLUSION: All the patients were followed-up for 1 year. According to Neer knee society function score criteria, in the retrograde intramedullary nail group, 24 cases were excellent (69%), good in 9 cases (26%) and fair in 2 cases (6%); the excellent and good rate was 94%. The average bone healing time was 4.8 months. In the anatomical distal femur plate group, excellent in 21 cases (68%), good in 5 cases (16%), fair in 3 cases (10%), poor in 2 cases (6%), and the excellent and good rate was 84%, the average bone healing time was 6.5 months. The results show that retrograde interlocking intramedullary nail fixation is helpful for early ambulation, while the distal femur plate, with wide indication has relatively light damage to the articular surface and is conducive to the recovery of knee function. All the two internal fixation methods have good medical effects; we should select the compatible fixation according to the classification of distal femoral fractures. Related Articles | Metrics

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Proximal humeral locking plate for the treatment of four-part proximal humeral fracture Sun Xiang-xiang, Heng Li-song, Ma Jian-bing, Zhao Guang-hui, Zhang Kun, Li Hui, Jiang Yong 2012, 16 (44):  8206-8211.  doi: 10.3969/j.issn.2095-4344.2012.44.008 Abstract ( 207 )   PDF (449KB) ( 420 )   Save BACKGROUND: Non-locking anatomical plate is commonly used for open reduction and internal fixation for the treatment of four-part proximal humeral fracture, but it has the high probability of fracture re-displacement and humeral head necrosis after fixation. OBJECTIVE: To observe the clinical results of proximal humeral locking plates fixation for the treatment of four-part proximal humeral fracture. METHODS: Seventy-two patients with four-part proximal humeral fracture were included, 32 patients with dislocation of the humeral head and the other 40 patients without, and all patients were treated with open reduction and fixation with proximal humeral locking plates. Shoulder’s movement was restricted within 3 weeks after surgery, and then gradually began to perform the functional exercise. All patients were followed-up regularly and Neer scores were recorded to evaluate the function of shoulder after union of fractures. RESULTS AND CONCLUSION: At the time of final followed-up, 6 patients were followed-up for 3 months, 13 patients were followed-up for 6 months, 31 patients for 9 months, 9 patients for 12 months, 8 patients for 18 months and 5 patients for at least 24 months. Fifty-three patients were followed-up for at least 9 months, the rate of fracture union was 98% (52/53), Neer scores with intermediate and above the intermediate level was 85% (45/53), humeral head osteonecrosis was 6% (3/53), and all the 3 patients were preoperative humeral head dislocation, subacromial impingement syndrome was 9% (5/53), and no screw loosing or fracture occured. There were no significant differences of Neer score and humeral head necrosis between patients with and without preoperative humeral head dislocation. The application of proximal humeral locking plate for the treatment of four-part proximal humeral fracture is helpful to the reduction of four-part fractured fragments and its fixation is stable. The recovery of postoperative shoulder functions is satisfactory and low rate of complications can be obtained following locking plate treatment of four-part fracture. Related Articles | Metrics

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Three-dimensional finite element analysis on different implant fixation for L1 segment burst fracture Liang Ning, Kang Yi-jun, Chen Fei 2012, 16 (44):  8212-8217.  doi: 10.3969/j.issn.2095-4344.2012.44.009 Abstract ( 228 )   PDF (605KB) ( 497 )   Save BACKGROUND: Thoracolumbar burst fracture is a common injury in clinic. Inner fixation surgery through anterior and posterior approach is the commonly used method to rebuild the stability. The stress distribution has not been reported in literature. OBJECTIVE: To investigate the stress distribution of internal fixation materials in titanium mesh reconstruction screw-rods system fixation and posterior approach screw-rods system fixation for the treatment of L1 segment burst fracture by three-dimensional finite element analysis, and to compare the stability of these two methods. METHODS: One healthy male volunteer was selected to establish the T12-L2 segment three-dimensional finite element model through CT scan and finite element software. The L1 segment burst fracture was simulated on the effective finite element model to establish the anterior approach L1 segment titanium mesh reconstruction combine screw-rods system fixation (model A) and posterior approach short segment screw-rods system fixation (model B), the load was applied on the models in order to observe the stress distribution and compare the stability. RESULTS AND CONCLUSION: A T12-L2 segment three-dimensional finite element model was established. In the loading experiment, the stress of model A was mainly in the titanium mesh area and the stress of model B was mainly concentrated in the screw-rod junction. Both model A and model B could gain valid stability in reconstruction of L1 segment burst fracture, and the former was better than later. Mean stress in T12 plane of model A was less than that of model B, and the difference was statistically significant (P < 0.01). Titanium mesh deposition after anterior approach and screw-rod fracture after posterior approach may relate with local stress concentration. The anterior approach titanium mesh reconstruction combine screw-rods system fixation has the better stability than posterior approach screw-rods system fixation. Related Articles | Metrics

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Three-dimensional digital reconstruction for the morphological research of proximal tibia of Chinese population Xu Bo-xing, Wang Wei, Zhang Li 2012, 16 (44):  8218-8222.  doi: 10.3969/j.issn.2095-4344.2012.44.010 Abstract ( 293 )   PDF (430KB) ( 550 )   Save BACKGROUND: During China knee prosthesis design and total knee replacement, not only the anatomical characteristics of the proximal tibia of the Chinese population and the differences in geometry should be considered, but also should pay attention to the differences between the different individuals. OBJECTIVE: To analyze the changes of morphology reference value of normal proximal tibia of the Chinese population by digital technology. METHODS: We collected the original CT scan images of knee joints in both sides of the Chinese population, and the three-dimensional digital model of knee joint was established with Mimics 10.1 software. The simulation osteotomy of proximal tibial model was performed and the relevant linear parameters of tibia section were measured. RESULTS AND CONCLUSION: In addition to the anteroposterior diameter of the lateral tibial plateau/anteroposterior diameter of the medial tibial plateau and the difference between anteroposterior diameter of the lateral tibial plateau and anteroposterior diameter of the medial tibiale plateau, the transverse diameter and anteroposterior diameter of male patients were bigger than those of the female patients, there was significant difference of proximal tibial osteotomy nominal value between most of the male patients and female patients (P < 0.01). With the increasing of body mass index, the anteroposterior diameter of the medial tibial plateau and the transverse diameter of the tibial plateau were also increased. It indicates that there is difference among the proximal tibia morphology of normal Chinese people in gender and body mass index, reflecting in: ①The data measured by different measurement methods can fully reflect the morphological characteristics of the proximal tibia. ②The ration of anteroposterior diameter of the tibial plateau /transverse diameter of the tibial plateau of female patients is higher than that of the male patients. Related Articles | Metrics

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Influence of distractor diameter on initial stability of implantal distraction: A three-dimensional finite element analysis Hui Guang-yan, Li Tao, Qiu Min, Jia Wen-min 2012, 16 (44):  8223-8227.  doi: 10.3969/j.issn.2095-4344.2012.44.011 Abstract ( 309 )   PDF (453KB) ( 374 )   Save BACKGROUND: Finite element analysis can be applied to imitate orthopedic operations and biomechanics analysis of orthopedic model. Finite element analysis has been considered as an important method in surgery for orthopedic biomechanics research. OBJECTIVE: To evaluate the influence of the distractor diameter on the initial stability of implantal distraction. METHODS: Models with different distractor diameters were made by three-dimensional finite element methods. The stress distribution on the surface of distractor and the maximum deformation of the transport bone segment and the distractor were analyzed. RESULTS AND CONCLUSION: For the alveolar ridge with good bone quality, over-expanded the diameter of the distractor might lead to the bone stress increasing on transportation section; for the atrophic alveolar ridge with poor bone quality, increasing the distractor diameter was conducive to improve the stress distribution of the bone-distractor complex. Distractor diameter had a major influence on the stress distribution of bone-distractor complex. Appropriate diameter of distractor should be chosen according to both requirement of implant and distraction. Related Articles | Metrics

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Meta analysis on the treatment of acute patellar dislocation by surgical versus conservative treatment Tian Wen, Wang Fu-ming, Huang Jian, Chen Lu-yao, Hu Shi-qiang, Peng Ai-ping 2012, 16 (44):  8228-8234.  doi: 10.3969/j.issn.2095-4344.2012.44.012 Abstract ( 620 )   PDF (440KB) ( 530 )   Save BACKGROUND: Acute patellar dislocation is more common in clinic, but there is controversial about surgical treatment and conservative treatment. OBJECTIVE: To compare the clinical therapeutic effects of surgical versus conservative treatment method for acute patellar dislocation and to guide the selection of clinical treatment options. METHODS: The Coehrane Library (Issue 4, 2012), MEDLINE (from 1966 to April 2012), EMBase (from 1966 to April 2012), CBM database (from January 1979 to April 2012), PubMed database (from June 1966 to 2012) and Wangfang database (from beginning to April 2012) were searched with computer and the Chinese orthopedic journals were searched by hand for the randomized controlled trials and clinical trials on comparison of surgical versus conservative treatment method for acute patellar dislocation. Meta analysis was conducted using the Cachrane Collaboration’s RevMan 5.1 software. The risk of recurrent dislocation, Kujala scores after operation, the excellent and good rate based on Kujala scores and re-operation rate during follow-up were observed after treated with surgical and conservative treatment methods. RESULTS AND CONCLUSION: Only six randomized controlled trials were included involving 380 patients (203 patients in surgical group and 117 patients in conservative group) met the criteria of the present study. Meta analysis results showed that there was no significant difference between surgical and conservative group of acute patellar dislocation in the risk of recurrent dislocation [relative risk (RR)=0.54, 95% confidence interval (CI): 0.28-1.07], Kujala scores [weighted mean difference (WMD)=5.50, 95%CI: -4.46-15.45], excellent and good rate based on Kujala scores (RR=2.53, 95%CI: 0.47-13.56) and re-operation rate during follow-up (RR=1.09, 95%CI: 0.72-1.65) (P > 0.05). Further analysis was performed between the short-term 2-5 years follow-up group and long-term 5-7 years follow-up group, and found that only in the short-term 2-5 years follow-up group, the Kujala scores of surgical group were better than that of the conservative group (WMD=15.52, 95%CI: 5.67-25.38, P < 0.05). For patients with acute patellar dislocation, the surgical treatment result is equivalent to conservative treatment, but the short-term recovery knee function after surgical treatment is superior to conservative treatment. Related Articles | Metrics

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Acupotomy versus acupuncture for knee osteoarthritis: A Meta-analysis of randomized controlled trials Liu Fu-shui, Jin De-zhong, Wu Xiang 2012, 16 (44):  8235-8239.  doi: 10.3969/j.issn.2095-4344.2012.44.013 Abstract ( 556 )   PDF (377KB) ( 659 )   Save BACKGROUND: Acupotomy and acupuncture are widely used in the clinical treatment of knee osteoarthritis in recent years. However, there remains no systematic review to assess the clinical effect. OBJECTIVE: To professionally assess the different effects of acupotomy versus acupuncture for knee osteoarthritis. METHODS: A computer-based search was conducted on the CNKI database, VIP database, Wanfang database, PubMed database and Cochrane Central Register of Controlled Trials (Issue 3, 2011). The time limitation ran from the commencement of each database to September 15, 2011. Randomized controlled trials of acupotomy in the treatment group and acupuncture in the control group were included. Data were extracted and evaluated by two reviewers independently. RevMan5.1 software was used for Meta analysis after the literatures were evaluated. RESULTS AND CONCLUSION: A total of 8 trials involving 654 patients were included. The Meta analysis showed that both curative rate and total effective rate of acupotomy for the treatment of knee osteoarthritis are higher than those of acupuncture in short term. It showed effects as follows respectively: OR=4.27, 95%CI (2.32-7.85); OR=3.01, 95%CI (1.77-5.14). Acupotomy is more effective than acupuncture in the treatment of knee osteoarthritis in short term. However, due to low quality of included studies and there are no reports on the adverse events, further well-designed randomized controlled trials with high quality are still needed to evaluate the beneficial effects of acupotomy. Related Articles | Metrics

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Meta analysis of robotic Nissen fundoplication for the treatment of gastroesophageal reflux disease Fan Yong-gang, Yao Guo-liang, Liu Ke-feng 2012, 16 (44):  8240-8245.  doi: 10.3969/j.issn.2095-4344.2012.44.014 Abstract ( 672 )   PDF (380KB) ( 494 )   Save BACKGROUND: Compared with conventional laparoscopic techniques, robot-assisted surgery, especially the Da Vinci Surgical System, can provide a good three-dimensional imaging, better human bioengineering design and more sophisticated operations. OBJECTIVE: To evaluate the efficacy and feasibility of robotic Nissen fundoplication for the treatment of gastroesophageal reflux disease through Meta-analysis. METHODS: A comprehensive search of PubMed database, Embase database and OVID database was performed by computer to determine all published research papers on the comparison of robotic versus conventional laparoscopic Nissen fundoplication for the treatment of gastroesophageal reflux disease. The inverse-variance method and Mantel-Haenszel method were used for the analysis depending on the data type with fixed effect model or random effect model according to the heterogeneity. RESULTS AND CONCLUSION: Five studies met the criteria finally, which included 160 patients. Meta analysis showed that except the intraoperative and postoperative complications, statistical differences were not observed in the other outcomes between conventional laparoscopic group and robotic Nissen fundoplication group, including total operating interval, effective operating interval, postoperative dysphagia, conversions, re-operation rate, hospital stay and in-hospital costs (P > 0.05). It indicates that the robotic Nissen fundoplication is not superior to the traditional laparoscopic surgery in the treatment of gastroesophageal reflux disease. Therefore, we should select the indications carefully. Related Articles | Metrics

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Identification for digital orthopantomography of adult Chinese Han population in Shenzhen Area Wang Yao, Zhang Yan-fu, Xu Zhen-bo, Zhang Fu, Yin Xiao-jun, Lai Yue 2012, 16 (44):  8246-8250.  doi: 10.3969/j.issn.2095-4344.2012.44.015 Abstract ( 345 )   PDF (554KB) ( 460 )   Save BACKGROUND: To date, we have reached a consensus of forensic dental identification according to physiological and anatomical characteristics and pathological changes of the teeth, jaw bones and its adjacent structures, as well as the individual identification of various treatments for teeth. However, with the growing of awareness of oral health and the development of dental treatment method, dental problems are gradually reducing. Thus, identification only depends on dental disease and treatment characteristics cannot meet the current situation. OBJECTIVE: To investigate the distribution frequency of surveying indexes of mandibular teeth and mandible in segment assignment section for the digital panoramic tomography of Chinese Han population in Shenzhen with oral lesions and trauma, and to evaluate its value in individual identification. METHODS: The digital dental orthopantomograms of 200 adults in Shenzhen were accurately measured with E-film Workstation2.12 software. And the data were statistically analyzed with Microsoft Office Excel 2003 and SPSS 16.0 software. RESULTS AND CONCLUSION: The frequency of each observed index was different. The maximal one was 96.5%. The maximal matching probability of the section-numbers between two homologous dental orthopantomograms was 77.53% and the minimal was 69.66%. While the maximal matching probability of the section-numbers between two non-homologous dental orthopantomograms was 42.70％. The distribution frequencies surveying indexes of mandibular teeth and mandible in segment assignment section on dental orthopantomograms are polymorphic, and the method is suitable for forensic identification. Related Articles | Metrics

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Detection of mental fatigue state using pulse sensor measurement values and principal component analysis Ren Ya-li 2012, 16 (44):  8251-8255.  doi: 10.3969/j.issn.2095-4344.2012.44.016 Abstract ( 359 )   PDF (494KB) ( 553 )   Save BACKGROUND: With the development of science and technology, there are more and more objective methods to research fatigue, and physiological indexes intervene makes it a medical, cognitive science and psychology research hotspot. However, the detection of mental fatigue is still lack of objective physiological indexes. OBJECTIVE: To propose a novel sub-health state recognition method based on principal component analysis and pulse signal features is presented in order to evaluate mental fatigue state. METHODS: Firstly, wavelet transform was used to de-noise the pulse signal. Secondly, the peak value of power spectrum, features of corresponding frequency, center of gravity and gravity frequency of power spectrum were extracted. Thirdly, the extracted features were performed with principal component analysis. Finally, an improved linear discriminant analysis was applied to classification and pattern recognition. The results demonstrated that the recognition ratio of the principal component was up to 100%. RESULTS AND CONCLUSION: This method possessed many attractive characters such as simpler calculated process, better stability, and could get higher recognition rate, which provides a certain reference value for achieving detection of mental fatigue state. Related Articles | Metrics

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Effect of meditation training on heart rate variability based on permutation entropy Shen Zi-wei, Shen Yun-hai, Bian Chun-hua, Ma Qian-li 2012, 16 (44):  8256-8260.  doi: 10.3969/j.issn.2095-4344.2012.44.017 Abstract ( 395 )   PDF (452KB) ( 616 )   Save BACKGROUND: Meditation trainings are helpful for keeping physical and mental health. Regulating the heartbeat rhythm via autonomic nerve system may be the possible factor. The investigation of the relationship between training and heartbeat rhythm will deepen our understanding on the regulation rules of cardiovascular system and healthy training. OBJECTIVE: To investigate the regulation of heartbeat rhythm during meditation training from the aspect of complexity. METHODS: The heart rate variability series were obtained from meditation training database of PhysioNet. Permutation entropy was applied to analyze the data before and during Chi and yoga training. The effects of these two training methods on the complexity of heartbeat rhythm were investigated. RESULTS AND CONCLUSION: The permutation entropy of heart rate variability series during training was significantly smaller than that before meditation training; it indicated that both Chi and yoga training can reduce the complexity of heartbeat rhythm. Previous study on healthy young, healthy elderly and congestion heart failure subjects by permutation entropy showed that aging and disease could increase the value of permutation entropy. Thus, the regulation of the heartbeat rhythm via autonomic nerve system could be an important reason. Related Articles | Metrics

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Autogenous bone, allogeneic bone and bone morphogenic protein micromorselized bone for the treatment of lumbar fracture Shan Fu-yan 2012, 16 (44):  8261-8264.  doi: 10.3969/j.issn.2095-4344.2012.44.018 Abstract ( 353 )   PDF (360KB) ( 449 )   Save BACKGROUND: Bone morphogenic protein micromorselized bone is a new type of bone graft materials which has been gradually applied in clinic, but the reports about the effect of bone graft fusion on the lumbar fracture are rare. OBJECTIVE: To compare the clinical effect of autogenous bone, allogeneic bone and bone morphogenic protein micromorselized bone for the treatment of lumbar fracture. METHODS: This study retrospectively collected 78 patients with lumbar spinal fracture in First Affiliated Hospital of Nanyang Medical College from March 2005 to March 2009, and the 78 patients were randomly divided into three groups, and the autogenous bone, allogeneic bone and bone morphogenic protein micromorselized bone were implanted respectively. RESULTS AND CONCLUSION: All the 78 patients were followed-up for 24 months. There was a significant difference of Japanese Orthopaedic Association score at 24 months after grafting, the Japanese Orthopaedic Association score in bone morphogenic protein group was 90% > autogenous bone group 85% > allogeneic bone group 70% (P < 0.05); at 12 and 24 months after grafting, the Cobb angle in the allogeneic bone group was larger than that in the other two groups at 12 and 24 months after grafting, and also larger than that in the allogeneic bone group at 6 months after grafting (P < 0.05), but smaller than that before grafting (P < 0.05), and there was significant difference between autogenous bone group and bone morphogenic protein group (P > 0.05); the bone fusion rate at different time points in the autogenous bone group was lower than that in the other two groups (P < 0.05). Bone morphogenic protein micromorselized bone is equivalent to autogenous bone graft in treating lumbar fracture, both are superior to allogeneic bone transplantation, and bone morphogenic protein micromorselized bone can facilitate the bone fusion with good effect and to be recommended in the clinical application. Related Articles | Metrics

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Blood inflammatory markers for the diagnosis of joint prosthesis infection Xie Qiang, Lei Guang-hua 2012, 16 (44):  8271-8278.  doi: 10.3969/j.issn.2095-4344.2012.44.020 Abstract ( 300 )   PDF (745KB) ( 434 )   Save BACKGROUND: Artificial joint replacement as a proven treatment method is now widely used at home and abroad, and the joint prosthesis infection is one of the serious complications of artificial joint replacement surgery. Once the infection occurred, patients will have serious consequences. At present, there is no clinical or laboratory tests that people is satisfied at the sensitivity, specificity and accuracy. OBJECTIVE: To discuss and summarize the blood inflammatory markers diagnostic methods of prosthesis infection after artificial joint replacement. METHODS: First author searched the literature from CNKI database (2002/2012) and PubMed database (2002/2012) with the key words of “joint replacement, prosthesis infection, diagnosis, laboratory tests” in Chinese or English. The introduction and summary literatures that related to clinical manifestation and diagnosis of prosthesis infection after joint replacement were searched. A total of 153 literatures were screened out, and 30 literatures were included according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION: The results showed that serum interleukin-6 levels have the highest accuracy for the diagnosis of joint prosthesis infection, followed by C-reactive protein, erythrocyte sedimentation rate, leukocyte count. However, the routine examination of interleukin-6 is limited, to further assess the accuracy of interleukin-6 and other cytokines for the diagnosis of joint prosthesis infection in different patients also need more in-depth research. Related Articles | Metrics

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Latest information of the establishment of an animal model of femoral head necrosis Feng Jin-zhu, Wang Rui, Zhao Jian-ning 2012, 16 (44):  8279-8282.  doi: 10.3969/j.issn.2095-4344.2012.44.021 Abstract ( 249 )   PDF (591KB) ( 354 )   Save BACKGROUND: In clinical orthopedic research, a variety of femoral head necrosis animal models have emerged in order to study the etiology and pathogenesis of femoral head necrosis and give a fundamental treatment. OBJECTIVE: To give a review to the variety of femoral head necrosis improved model established by scholars in recent years, and to analyze the pros and cons of various models, in order to help to study the osteonecrosis pathogenesis or evaluate the clinical value of a new treatment. METHODS: The CNKI database and PubMed database (2005-01/2011-12) were used to retrieve the articles on the establishment of femoral head necrosis animal models with the key words of “femoral head necrosis, animal model” in English and Chinese. A total of 136 articles were obtained and finally 16 articles were included to review according to the inclusion criteria. RESULTS AND CONCLUSION: The improved methods of steroid-induced are most used in modeling approach currently, but different modeling approach has its own advantages and disadvantages. Each method should be closely linked with its experimental purpose. And no matter for the study of the etiology and pathogenesis, or the evaluation of treatment, the methods to establish the animal model still needs further improvement. Related Articles | Metrics

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Vascularized greater trochanter bone flap combined with bone grafting for the treatment of femoral head necrosis Zhu Shao-ling, Zeng Yi-rong 2012, 16 (44):  8283-8290.  doi: 10.3969/j.issn.2095-4344.2012.44.022 Abstract ( 484 )   PDF (369KB) ( 464 )   Save BACKGROUND: The vascular pedicled greater trochanter bone flap combined with bone grafting developed from the application of microsurgical technique in the treatment of femoral head necrosis is one of the important methods for the treatment of young and middle aged osteonecrosis of the femoral head. OBJECTIVE: To investigate the greater trochanter bone flap transplantation from different aspects through retrospectively analyzing the related clinical and basic research on greater trochanter bone flap transplantation for the treatment of osteonecrosis of the femoral head. METHODS: The PubMed database (1972-01/2011-10) was searched with the key words of “osteonecrosis femoral head, greater trochanter bone flap” or “osteonecrosis femoral head, bone flap” or “osteonecrosis femoral head, finite element analysis” in English; the CNKI database (1979-01/2011-10) was also searched with the key words of “femoral head necrosis, greater trochanter bone flap” in Chinese. The articles that related to the greater trochanter bone flap transplantation for the treatment of femoral head necrosis were selected, and for the articles in the same filed, those published recently or in the authorized journals were preferred. Finally, a total of 46 articles were included for review according to the inclusion criteria. RESULTS AND CONCLUSION: The reports on the commonly used focal cleaning+great trochanter bone flap with the pedicle of the transverse branch of lateral femoral circumflex artery combined with bone grafting+free iliac crest and bone grafting for the treatment of osteonecrosis of the femoral head are rare. This technique can keep the balance between the blood supply and mechanical reconstruction, and can achieve the physiological reconstruction of femoral head with the advantages, such as the biomechanical advantages of the cortical bone and the good blood supply conditions provided by great trochanter bone flap with the pedicle of transverse branch of lateral femoral circumflex artery plus cancellous. Related Articles | Metrics

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Clinical features of cervical spinal cord whiplash injury without fracture or dislocation Zhu Wen-gang, Wu Qiang 2012, 16 (44):  8291-8297.  doi: 10.3969/j.issn.2095-4344.2012.44.023 Abstract ( 198 )   PDF (748KB) ( 555 )   Save BACKGROUND: Spinal cord whiplash injury without fracture or dislocation belongs to special cervical vertebra and spinal cord damage, the causes and mechanism of the damage have been controversial, the recognition of pathogenesis provides important theoretical basis for clinical diagnosis and treatment. OBJECTIVE: To review the domestic and foreign pathogenesis of spinal cord whiplash injury without fracture and dislocation and the clinical study conditions of diagnosis and treatment method. METHODS: Computer was used for reviewing articles in China biological medical literature database, Chinese science and technology journal full-text database (1975-01/2011-05) and PubMed database (1950-01/2011-05) about spinal cord whiplash injury without fracture or dislocation, the key words were “spinal cord whiplash injury, nosogenesis, imaging, treatment” in English and Chinese, and the language in the article was limited into Chinese and English. The articles that related to the definition, pathogenesis, imaging manifestations, treatment and prognosis of spinal cord whiplash injury without fracture or dislocation, the repetitive articles were excluded. RESULTS AND CONCLUSION: A total of 90 related articles were collected, 38 articles in line with the standards were included. The spinal cord whiplash injury without fracture or dislocation belongs to a kind of special cervical vertebra and spinal cord injury, and is mainly caused by hyperextension and flexion injury. Further study on spinal cord whiplash injury without fracture or dislocation in recent years discovered that definition, pathogenesis, imaging manifestations and treatment standards had differences. Conventional X-ray and CT examination has no positive discovery; MRI examination is the best inspection methods which can reduce the misdiagnosis rate of spinal cord whiplash injury without fracture or dislocation. According to the damage mechanism, the anterior approach, posterior approach and combined surgery of anterior approach and posterior approach can be selected for the treatment. Related Articles | Metrics

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CT evaluation on thoracic pedicle screw placement: Based on the analysis of the literatures from SCI database Zeng Xian-chun, He Bo, Han Dan 2012, 16 (44):  8298-8307.  doi: 10.3969/j.issn.2095-4344.2012.44.024 Abstract ( 252 )   PDF (733KB) ( 330 )   Save BACKGROUND: CT evaluation and scanning before and after thoracic pedicle screw implantation can improve the accuracy of screw placement, and can avoid the serious complications caused by nerve and blood vessel injury during screw implantation. OBJECTIVE: To in-depth analyze CT evaluation and application for thoracic pedicle screw implantation, and to provide relevant reference information for improving pedicle screw implantation technology as well as the research and application of CT scans in the field. METHODS: The SCI database from 2002 to 2011 was searched for the articles on the CT evaluation for thoracic pedicle screw implantation, and the bibliometric analysis and experimental research and analysis were performed on these articles. We analyzed the author, institute and the countries of the articles in order to clear the research on this field worldwide. The feasibility, accuracy, risk of structure anatomy and the clinical application of CT evaluation for thoracic pedicle screw implantation were analyzed, and the application range of CT scanning for thoracic pedicle screw implantation was indentified. RESULTS AND CONCLUSION: The CT scan evaluation for thoracic pedicle screw implantation has a high accuracy. The CT scanning for the thoracic pedicle and adjacent structures around the screw placement before implantation can evaluate the morphology of the thoracic pedicle and the structural relationship with the surrounding tissue, improve the accuracy of screw implantation and avoid the complications caused by neurovascular injury. The CT scanning for the thoracic pedicle and screw system after implantation can evaluate the effect and satisfaction of screw implantation, in order to provide the assistance for developing follow-up treatment programs. Related Articles | Metrics

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The pedicle screw implantation for thoracolumbar fractures Liang Wei-zhi, Zhang Hai-bo, Jia Jun-feng, Gao Jin-wei, Fu Lei, Cui Xiao-hu 2012, 16 (44):  8308-8315.  doi: 10.3969/j.issn.2095-4344.2012.44.025 Abstract ( 194 )   PDF (739KB) ( 490 )   Save BACKGROUND: With the development of diagnostic radiology, biomechanics, a variety of new fixation devices and methods emerged in recent years, the growing number of thoracolumbar fractures can be treated through surgery. OBJECTIVE: To study the pedicle screw implantation for thoracolumbar fractures. METHODS: A computer online retrieval was performed to search papers regarding the pedicle screw implantation for thoracolumbar fractures, using key words of “thoracolumbar fracture, internal fixation, pedicle, screw, pedicle screws” in both Chinese and English. We summarized thoracolumbar injury severity score, clinical application of pedicle screw, and the characteristics of pedicle screw internal fixation, and analyzed pedicle screw internal fixation for thoracolumbar fractures. RESULTS AND CONCLUSION: Pedicle screw fixation is an effective thoracolumbar fixation technique, which can be used for various reasons-induced thoracic and lumbar instability, in particular the treatment for thoracolumbar fractures. Pedicle screw fixation provides rigid internal fixation, which can correct deformity and maintain the spine three-dimensional position, and provides better biomechanical stability. Pedicle screw fixation system can effectively rebuild vertebral height, restore physiological curvature, relieve spinal cord nerve oppression, restore the diameter of the damaged spinal canal, and reconstruct spinal stability, correct kyphosis. Pedicle screw fixation with fewer traumas, satisfactory reduction, fixed and strong, easy to operate and other advantages has been widely used in clinic. Related Articles | Metrics

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Adjacent segment disease after posterior pedicle screw internal fixation and lumbosacral fusion Shao Shui-lin, Wu Ji-gong, Ji Yong, Zhang Le-le, Gao Bo, Li Hai-xia, Tao You-ping, Cao Shen, Ma Hua-song 2012, 16 (44):  8316-8323.  doi: 10.3969/j.issn.2095-4344.2012.44.026 Abstract ( 297 )   PDF (914KB) ( 529 )   Save BACKGROUND: Pedicle screw internal fixation and lumbosacral fusion has become the main treatment method for various spinal diseases, and the postoperative complications have attracted more and more attention of the scholars, while the adjacent segment disease is the main complication which seriously affects the efficacy of interbody fusion and internal fixation. OBJECTIVE: To investigate the course and treatment efficacy of adjacent segment disease after posterior pedicle screw internal fixation and lumbosacral fusion. METHODS: A retrospective analysis was performed on 536 patients (male 341, female 195, age 34-71, average in 51.3 years old) treated with posterior pedicle screw internal fixation and fusion in the cervical vertebrae fusion cage from April 1998 to December 2011. Among the patients, 412 cases experienced single segment fusion and 124 cases with multi-segment fusion. The patients with adjacent segment disease received lateral lumbar spine X-ray examination, over flexion-extension position X-ray examination and magnetic resonance image examination of the lumbar spine, and the changes of adjacent intervertebral angle and the slip distance and changes of upper vertebral were measured on the X-ray film, then the treatment effect was evaluated according to the Japanese Orthopaedic Association sores and Oswestry disability index. We investigated the causes, incidence rate, the potential risks and the treatment of adjacent segment disease according to the statistical analysis. RESULTS AND CONCLUSION: Among the 536 patients treated with posterior pedicle screw internal fixation and lumbosacral fusion, 31 cases of patients with adjacent segment disease symptom, 18 cases with single segment fusion, 13 cases with multi-segment fusion, 6 cases has lumbar disc herniation, 13 cases has lumbar instability 9 cases affected lumbar spondylolis thesis and 3 cases has lumbar spinal stenosis. All the patients were followed-up for 9-64 months, average in 26.7 months. According to the Japanese Orthopaedic Association sores, excellent in 4 cases, good in 11 cases, average in 3 cases, poor in 1 case, and the excellent and good rate was 78.94%. The Oswestry disability index was reduced by an average of 33.8 (8.5-42.3), the improvement rate was 79.91%. Statistical t-test showed that there was significant difference of average age, ration of fusion segments, Japanese Orthopaedic Association sores and the Oswestry disability index among the patients with adjacent segment disease (P < 0.05). There was adjacent segment disease after treated with posterior pedicle screw internal fixation and lumbosacral fusion, the incidence may related with the biomechanics changes of the adjacent vertebral. Majority of adjacent segment disease patients achieved the good results after reoperation; early consideration of the pathogenic potential factors is the main means to prevent the incidence of adjacent segment disease. Related Articles | Metrics

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Internal fixation for the treatment of lumbar degenerative scoliosis Lu Ming, Ma Hua-song, Wang Xiao-ping, Niu Jing, Ren Dong-yun, Zheng Rui, Zhang Jing 2012, 16 (44):  8324-8331.  doi: 10.3969/j.issn.2095-4344.2012.44.027 Abstract ( 383 )   PDF (824KB) ( 468 )   Save BACKGROUND: Lumbar degenerative disease is one of the common orthopedic diseases, and there is controversy on the methods of operation and whether the operation should be preformed. OBJECTIVE: To analyze the effect of internal fixation on the treatment of lumbar degenerative scoliosis, to assess the development of the patient’s symptoms, lumbar renegade segment and imaging, and to systematic review the literatures related degenerative diseases. METHODS: A total of 61 patients (30 cases in male and 31 cases in female, the age ranged 42-78, average in 59.02) with lumbar degenerative scoliosis were selected from Department of Orthopedics, the 306th Hospital of PLA during March 2010 to August 2012. Among the 61 patients, 32 patients treated with lumbar posterior decompression and internal fixation and fusion; 29 patients treated with lumbar posterior dynamic system. The postoperative follow-up time was 6-29 months, and average in 16 months. Visual Analogue Scale, Oswestry disability Index and Japanese Orthopaedic Association Scores were used for the preoperative, postoperative and follow-up assessment. The literatures on the treatment of lumbar degenerative scoliosis by internal fixation were screened out, and the experimental methods and the results in the literatures were analyzed in-depth. RESULTS AND CONCLUSION: The gender and age of the patients were consistent with the incidence of lumbar degenerative scoliosis and age reported in the literatures. Visual Analogue Scale, Oswestry disability Index and Japanese Orthopaedic Association Scores showed that that there was no statistically significant difference at 1 and 3 months postoperation (P > 0.05); at 1 year postoperation, there was statistically significant difference of Visual Analogue Scale, Oswestry disability Index and Japanese Orthopaedic Association Scores (P < 0.05). Lumbar posterior decompression and internal fixation has the advantages of wide adaptation range, longer clinical application time and higher familiarity degree, it has the disadvantages of poor compliance, heavier degeneration degree of adjacent segments and higher incidence of complications. Dynamic fixation system can not only ensure the stability of internal fixation, but also better play the internal fixation characteristics, and the long-term follow-up showed better compliance for the dynamic fixation, therefore had the therapeutic effect, and retained the activities of the patient's lumbar. Related Articles | Metrics

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Internal fixation implants for the treatment of degenerative lumbar disease Ma Hua-song 2012, 16 (44):  8332-8339.  doi: 10.3969/j.issn.2095-4344.2012.44.028 Abstract ( 289 )   PDF (722KB) ( 588 )   Save BACKGROUND: Lumbar degenerative disease and frequently-occurring disease are the common diseases in the spinal surgery, and with the increasing of the age, the incidence will increase which has seriously affected the life quality of the patients. OBJECTIVE: To analyze the internal fixation for the treatment of lumbar degenerative disease, such as the lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis and lumbar scoliosis disease, in order to improve the clinical treatment effect and provide the research information for improving the life quality of the patients. METHODS: The research articles on the internal fixation for the treatment of lumbar degenerative disease were screened, and the articles on the internal fixation for the treatment of lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis and lumbar scoliosis disease were comprehensively and in-depth analyzed from the aspects of experimental methods, experimental results and experimental conclusion. RESULTS AND CONCLUSION: The lumbar degenerative disease includes the lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis and lumbar scoliosis disease, the disease causes influence each other, and they often occur at the same time. Usage of internal fixation decompression and the implant fixation fusion strictly according to the surgical indications in clinic can obtain good therapeutic effect. Related Articles | Metrics

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Single segmental decompression plus pedicle screw system internal fixation for the treatment of lumbar disc herniation Wang Xiao-ping, Lu Ming, Ma Hua-song, Niu Jing, Ren Dong-yun, Zheng Rui, Zhang Jing 2012, 16 (44):  8340-8347.  doi: 10.3969/j.issn.2095-4344.2012.44.029 Abstract ( 262 )   PDF (923KB) ( 655 )   Save BACKGROUND: The patients with lumbar disc herniation who have no relief after conservative treatment, sensorimotor dysfunction, cauda equina syndrome, unbearable pain and have impact on the work and life should be treated with operation. OBJECTIVE: To analyze the effect of internal fixation on the treatment of lumbar disc herniation, in-depth explore the clinical examination method of lumbar disc herniation, and to review the literatures on the treatment of lumbar disc herniation with internal fixation. METHODS: Twenty-three patients with lumbar disc herniation and L5/S1 spondylolisthesis were selected from the Department of Orthopedics, the 306th Hospital of PLA during 29 December 2010 to 27 January 2011, and the patients received posterior lumbar canal decompression and interbody fusion plus pedicle screw system internal fixation after general anesthesia, the Japanese Orthopaedic Association Scores was used to assess before and after operation, and the clinical improvement degree was considered as the surgical treatment criteria. The literatures on the treatment of lumbar disc herniation with internal fixation were screened out, and the experimental methods and results were in-depth analyzed. RESULTS AND CONCLUSION: The patients treated with short-segment pedicle screw system internal fixation have the advantages of little surgical trauma, more safety and small functional limitation as it just fix single segment. The follow-up results at 6 months after operation showed that improvement rate of Japanese Orthopaedic Association Scores was 80.3%. Related Articles | Metrics

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The application of digital medical technology in spinal surgery Yang Bo, He Jie-min, Fang Shi-bing, Song Lei, Yin Biao, Wang Le, Xie Jing-kai, Wan Sheng-yu 2012, 16 (44):  8348-8355.  doi: 10.3969/j.issn.2095-4344.2012.44.030 Abstract ( 332 )   PDF (772KB) ( 470 )   Save BACKGROUND: With the rapid development of modern science and technology, especially computer technology and medical technology, modern spinal surgery has entered a new era, showing trends of digitization, personalization, microsurgery, precision and artificial intelligence. OBJECTIVE: To explore the application of digitization in spinal surgery. METHODS: A computer online retrieval was performed by the first author in CNKI and Wanfang database to search papers regarding the application of digitization technology in spinal surgery, using key words of “spine, lumbar, cervical, digitization, spinal surgery, digital orthopedics, the finite element model, computer assisted design, minimally invasive technology, three dimensions reconstruction or 3D, CT, MRI, computer emulation, endoscope, intervertebral disc, percutaneous endoscopic laser-assisted discectomy or PELD”. According to inclusion criteria, papers about the finite element model, computer navigation technology, minimally invasive technology, and medical imaging in spinal surgery were included for further analysis to explore the characteristics of digitized spine surgery, clinical efficacy and safety. RESULTS AND CONCLUSION: The digitization establishes the method of unique digitized spine surgery and widely uses in clinical orthopedics on the basis of the finite element model, computer navigation, minimally invasive technology, medical imaging and other areas of research progress. The biggest advantage of the finite element model is that it can reflect the collective internal stress changes. The analysis of finite element used in medical biomechanics, made a lot of progress and development. Computer navigation technology works using digital image information through the medium of the body to enter a computer workstation. The reconstruction of three-dimensional model of the image after operation processing and related software through high-resolution display observed from all directions to the surgical approach as well as a variety of parameters completed the minimally invasive surgery. Minimally invasive spinal surgery uses a tiny incision or puncture channel, with special equipment or device in imaging instrument under the surveillance. The analysis of medical image as information science and technology-based cross-disciplinary research, clinical diagnosis and observation of spinal surgery has a reference value. Digital medicine with high-efficiency, high-precision, three-dimensional understanding of the distribution of the disease, the morphology, structure, minimizing surgical trauma, spinal has broad prospects. Related Articles | Metrics

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Total hip arthroplasty for the treatment of ankylosing spondylitis-caused hip ankylosis deformity Hu Ru-yin, Tian Xiao-bin, Sun Li, Han Wei, Yang Xian-teng, Li Bo 2012, 16 (44):  8356-8360.  doi: 10.3969/j.issn.2095-4344.2012.44.031 Abstract ( 339 )   PDF (597KB) ( 562 )   Save BACKGROUND: To data, total hip arthroplasty is the best treatment method of advanced disease of hip tonic deformity, but the prosthesis loosening has been a thorny issue after replacement, which mainly related with the stress at the interface of the prosthesis and bonding strength of prosthesis interface. OBJECTIVE: To summarize the effect and the mechanism of total hip arthrplasty for the treatment of ankylosing spondylitis-caused hip ankylosis deformity. METHODS: A computer-based online search was performed in CNKI database, Wangfang database, PubMed database and Springer Link database for the articles on the treatment of ankylosing spondylitis caused hip ankylosis deformity with total hip arthroplasty that published between 1980 and December 2011. The clinical cases and the relevant reviews were concluded. The key words of “hip joint, hip ankylosis deformity, total hip arthroplasty, prosthesis loosening, complications” were used to analyze the research progress of ankylosing spondylitis caused hip ankylosis deformity treated with total hip arthroplasty and the relevant complications after hip implantation. RESULTS AND CONCLUSION: The assessment before and after replacement was performed based on the patient’s own situation, choose the right model, prepare the prosthesis with different specifications and to analyze the promotion effect on the treatment of ankylosing spondylitis caused hip ankylosis deformity. Young patients with advanced ankylosing spondylitis caused hip ankylosis deformity have bone hyperplasia and the new bone can grows into the surface micropores of prosthesis, so the uncemented prosthesis shows unique advantages. With the advances in biological prosthesis design, especially the artificial hip joint with various coatings and metal microporous surface has the characteristics of multi-site weight-bearing and closely matching, and also make it more reliable than other prosthesis over past during the initial fixation. A great progress has made recent years, but the prosthesis loosening and periprosthetic joint infection after replacement is still plague the orthopedic surgeons and patients. Related Articles | Metrics