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27 August 2010, Volume 14 Issue 35 Previous Issue    Next Issue

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Biomechanical effects of percutaneous kyphoplasty on adjacent vertebrae: A finite element analysis Fei Qi, Wang Bing-qiang, Yang Yong, Li Dong, Tang Hai, Li Jin-jun 2010, 14 (35):  6461-6465.  doi: 10.3969/j.issn.1673-8225.2010.35.001 Abstract ( 75 )   PDF (320KB) ( 350 )   Save BACKGROUND: Kyphoplasty has obtained favorable clinical effects, but adjacent vertebral fracture has been reported. Therefore, it is important to analyze the possible reasons for adjacent vertebral fracture based on biomechanics. OBJECTIVE: To explore the biomechanical effectsof percutaneous kyphoplasty (PKP) on adjacent vertebrae and analyze causes for adjacent vertebral fracture. METHODS: T 10-L2 segment data were obtained from CT scans of a female with single T12 compressed fracture who underwent PKP. A three-dimensional finite element model of thoracolumbar Spine (T 10-L2) was built in the MIMICS and the ABAQUS software. The stress on the annulus fiber, nucleus pulposus, endplate and facet joints under axial pressure (0.3, 1.0, and 4.0 MPa) were analyzed to evaluate the influence of PKP on the vertebrae adjacent to fractures. RESULTS AND CONCLUSION: The 3D finite element models before and after PKP were successfully established. The stresses were increased with increasing axial pressure. In the model after PKP, the stress augmentation scope on adjacent end plates (T 11 low plate and L1 top plate) and intervertebral disc (T11-12 and T12-L1) increased. The maximum Von Mises stress on adjacent vertebrae (T11 and L1) increased, but the maximum Von Mises stress on end vertebrae (T10 and L2) decreased. Postoperative adjacent vertebral fracture after PKP may be related to the changes of biomechanical effects on adjacent vertebrae. Related Articles | Metrics

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Frameless Spinal Navigation Surgery Robot Guide-wire Placement in the lumbar spine with pedicle standard axis view  Zhang Chun-lin, Zhao Yu-guo, Zhang Chang-sheng, Wang Zheng, Cui Feng 2010, 14 (35):  6466-6470.  doi: 2010-35-6466 Abstract ( 133 )   PDF (450KB) ( 388 )   Save BACKGROUND: Pedicle screw fixation, as a commonly used technique, can provide super bio-mechanical effect. Various guiding methods have been employed including computer aided surgery navigation system (CASNS). However, none of them can ensure absolute accuracy, and malpositioning may result in disastrous consequence. OBJECTIVE: To perform pedicle guide-wire placement with pedicle standard axis view (PSAV) using Frameless Spinal Navigation Surgery Robot (FSNSR) so as to explore a high accurate and easily tackled transpedicular placement technique. METHODS: A total of 6 human lumbar spines vertebras (L1 to L5) were used. All specimens underwent pre-intervention CT scanning, and the angle (α) between pedicle centre axis and vertebra body sagittal plane (m plane) and the angle (β) between the axis and superior surface of vertebra body (s plane) were measured, respectively. During the operation, a standard posterior-anterior fluoroscopic image of target vertebra was obtained; the PSAV was acquired via C-arm rotation according to α and β; the guide-wire was inserted into the centre of approximate circular projection of pedicle by teleoperating FSNSR. After surgery, each vertebra underwent vertebra body axial and lateral radiographs as well as CT scans to assess guide-wire trajectory and excursion between post/preoperative α and β. RESULTS AND CONCLUSION: A total of 60 guide-wires were successfully inserted. All guide-wires were confirmed in the core of the pedicle by axial and lateral X-ray, as well as CT scanning. None of the guide-wire trajectory was found to contract or perforate the pedicle wall. FSNSR guide-wire placement with PSAV is a novel, safe and accurate transpedicular placement technique, which can reduce or prevent radiation exposure. Related Articles | Metrics

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Computer aided design and exact foundry of individualized titanium-alloy implant for reconstruction of cranial defects Xia De-lin, Zhou Hang-yu, Fu Guang-xin, Chen Jun-liang, Ma Zheng 2010, 14 (35):  6471-6474.  doi: 10.3969/j.issn.1673-8225.2010.35.003 Abstract ( 132 )   PDF (299KB) ( 405 )   Save BACKGROUND: Modern cranioplasty should consider appearance and function, recovering integrity of the cranial cavity, and reconstruction of surface anatomy of cranial vault. Conventional methods exist many disadvantaged, especially in reconstructing huge and complex defect of craniofacial areas. OBJECTIVE: To explore the method of prefabricated and individualized implant for reconstruction of cranial defect by the techniques of CT data, computer imaging processing, rapid prototyping and exact foundry of titanium. METHODS: The animal model of cranial defect was established by the adult goat. The raw data was obtained from continuous thin-layer volume computer tomography scanning. Three-dimensional curved model of implant was designed by in situ fully fit and interactive screen method through a serial disposal of CT imaging. The data of three-dimensional curved model was transmitted to rapid prototyping machine, the prototyping was finished. The individualized implant was prefabricated by exact foundry of titanium alloy. RESULTS AND CONCLUSION: The prefabricated individualized cranial implant was finished by a series of CT data processing, computer aided designing, rapid prototyping and titanium casting. The implant is well fitting with defect area. The results showed that the technique that prefabricated and individualized implant basing on CT data, computer aided design and rapid prototyping provides an effective method for reconstruction of cranial defect and resolves clinical difficulty of custom-made implant for patient. Moreover, this method has advantages of reduced operation time, simple operation-step, high accuracy of their fitting and satisfied function and aesthetic result restoring. Related Articles | Metrics

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Inverse dynamics-based platform for human muscle force estimation Tang Gang, Wang Hong-sheng, Zhang Xi-an, Wang Cheng-tao 2010, 14 (35):  6475-6478.  doi: 10.3969/j.issn.1673-8225.2010.35.004 Abstract ( 207 )   PDF (360KB) ( 647 )   Save BACKGROUND: The foreign business software mainly includes SIMM, Visual 3-D (C-Motion Inc.), Anybody (Anybody Technology) and Adams (MSC Software Corporation); open source software mainly includes OpenSim. Domestic development of such software is slow. Muscle force estimation plays an important role in studying neuromuscular coordination and analyzing athletic performance. It can also be used to identify the sources of pathological movement and establish a scientific basis for treatment planning. OBJECTIVE: From a new perspective, a perfect platform was built based on inverse dynamics for the human muscle force estimation. METHODS: This paper describes the developed process of the platform for muscle force estimation (MFE-2) which based on the optimization algorithm. This platform can analyze muscle force in the state of various human movements. In addition, with a normal gait as an example, muscle force of the major muscles of upper limb was analyzed. RESULTS AND CONCLUSION: Two typical muscles (triceps brachii lateral and biceps brachii short) of a health subject in gait were analyzed, and the calculated result was basically consistent with the relevant references. Related Articles | Metrics

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Software design of a force-feedback virtual driving tele-rehabilitation system Wang Yue-jiao, Song Ai-guo 2010, 14 (35):  6479-6482.  doi: 10.3969/j.issn.1673-8225.2010.35.005 Abstract ( 111 )   PDF (355KB) ( 424 )   Save BACKGROUND: With the aging of population in China, demands for available rehabilitation are increasing. Rehabilitation robot which combined robotics technology with medicine theory and network communication technology can effectively solve the shortcomings of traditional methods. OBJECTIVE: To develop a force-feedback virtual driving tele-rehabilitation software system according to the demands of stroke survivors and people with upper-limb deformity. METHODS: The WSAAsyncSelect socket model was used for a secure network communication environment; ADO database management technology was introduced into information management. Virtual reality technology was applied to create a virtual driving environment. Data base administration technique rather than traditional document-based data processing was used to improve information management. Virtual driving environment can increase interests of rehabilitation, which also has clear data and video display interface. RESULTS AND CONCLUSION: The system enjoys clear and intuitive, real-time video and data display interface, efficient data management techniques, and an interesting virtual driving environment. This system lays a foundation for future clinical application. Related Articles | Metrics

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Total hip replacement versus femoral head replacement in treatment of elderly femoral neck fracture: Meta analysis of efficacy and safety Chen Guang-dong, Wang Zhen-bin, Chen Jian-chang, Lu Lan-hong, Li Xiu-qing, Wang Hui-cai 2010, 14 (35):  6483-6496.  doi: 10.3969/j.issn.1673-8225.2010.35.006 Abstract ( 182 )   PDF (254KB) ( 427 )   Save OBJECTIVE: To compare the clinical outcomes and safety between total hip replacement and femoral head replacement in treatment of elderly patients with femoral neck fracture based on Meat analysis of large samples. METHODS: A computer-based online search of CBM (2010-04), CNKI (2010-04) and VIP (2010-04) was performed for clinical randomized trials regarding total hip replacement and femoral head replacement in treatment of elderly patients with femoral neck fracture. Meta analysis was used to analyze prosthesis function, operation time, bleeding, complication and hip pain. RESULTS: A total of 7 clinical control studies were included, involving 624 patients aged > 60 years, including 329 patients undergoing total hip replacement (experimental group) and 295 undergoing femoral head replacement (control group). Meta analysis showed that the efficacy of total hip replacement was better than femoral head replacement [OR=2.88, 95% confidence interval (1.84, 4.49), P < 0.05]. The operation time of experimental group was longer than control group [WMD=43.35, 95% confidence interval (23.96, 62.74), P < 0.05]. The bleeding volume of experimental group was greater than control group [WMD=336.36, 95% confidence interval (196.34, 476.37), P < 0.05]. There were no significant differences in complications between two groups [OR=0.54, 95% confidence interval (0.29, 1.02), P > 0.05]. The hip joint pain of experimental group was less than control group [OR=0.30, 95% confidence interval (0.18, 0.50), P < 0.05]. CONCLUSION: Total hip replacement exhibited better long-term clinical outcomes compared with femoral head replacement in treatment of elderly femoral head fracture, in particular for primary hip disease and for patients with strong activity. However, the operation time and bleeding volume were greater than femoral head replacement. Large sample, randomized, controlled studies are required for further validation. Related Articles | Metrics

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Small splint external fixation versus internal fixation implants for the treatment of closed humeral shaft fracture: A Meta-analysis Yang Zheng, Yuan Meng-lang, Qiu You-bo, Zhang Xiao 2010, 14 (35):  6487-6490.  doi: 10.3969/j.issn.1673-8225.2010.35.007 Abstract ( 107 )   PDF (246KB) ( 349 )   Save BACKGROUND: The humeral shaft fractures are commonly treated with small splints, plaster, functional scaffold external fixation and internal fixation of plates and screws, intramedullary nails and so on. But each treatment approach to the biological mechanisms of bone healing is different. Therefore, each has its unique clinical indications. OBJECTIVE: To compare efficacy between small splint external fixation and internal fixation of plates and screws, intramedullary nails and kirschner wires for the treatment of closed humeral shaft fracture by using Meta-analysis. METHODS: Computer-based online search of Medline, CBM, CNKI, EMCC, and VIP  databases was performed to collect related articles with the test group treated with small splint external fixation, while control group with internal fixation of plates and screws, intramedullary nails and kirschner wires. Differences in efficacy and evaluation indicators were odds ratio (OR), weighted mean difference and 95% confidence interval (CI). RESULTS: A total of 7 clinically controlled studies were included in the final analysis containing 1 390 patients. Among the patients, 1 007 cases were treated with small splint external fixation and 383 with internal fixation. All the 7 controls were performed with Meta-analysis. ①Fracture reduction excellent rate, fracture union tie, nonunion rate of experimental group were less than control [OR=0.20, 95%CI (0.03,1.20), P=0.08; OR=-33.69, 95%CI (-44.67, -22.72), P < 0.000 01; OR=0.31, 95%CI (0.16,0.60), P=0.000 5]. ②Fractures normal union rate and functional of shoulder and elbow joints excellent rate of experimental group were greater than control [OR=3.04, 95%CI(1.95,4.75), P < 0.000 01, OR=8.02,95%CI (2.68,24.04), P=0.000 2]. Meta-analysis results demonstrated that small splint external fixation is safe and effective. Additionally, clinical efficacy of small splint external fixation was superior to that of internal fixation of plates and screws, intramedullary nails and kirschner wires. Related Articles | Metrics

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Lumbar disc replacement versus fusion for treatment of lumbar degenerative disc disease: A Meta-analysis Chen Ling-yun, Tang Wen, Liu Zhi-li, Shu Yong 2010, 14 (35):  6491-6495.  doi: 10.3969/j.issn.1673-8225.2010.35.008 Abstract ( 102 )   PDF (542KB) ( 297 )   Save BACKGROUND: The new artificial disc replacement concept was proposed in 1960’s, which attempted to simulate normal human inter-vertebral disc artificial disc to avoid the negative effects of inter-vertebral fusion. However, it remains controversial in term of the efficacy and safety for the two treatments of lumbar degenerative disc disease (DDD). OBJECTIVE: To assess the effect and the safety of lumbar disc replacement versus fusion for the treatment of DDD. METHODS: Cochrane Back Group, the Cochrane library (Number 12, 2009), additional electronic database including Medline (1966/2009-12), Embase (1966/2009-12), CBM, CNKI were retrieved for articles of well designed clinical trials related to lumbar disc replacement versus fusion for the treatment of DDD. Chinese Journals were manually searched. Data were extracted and evaluated by two reviewers independently of each other. Among the literature, the test group was treated with artificial disc replacement, while the control group with fusion; The Cochrane Collaboration’s RevMan 4.2.2 software was used for data analyses. RESULTS AND CONCLUSION: A total of 7 studies were included involving 936 patients. Meta-analysis indicated that no difference was found in mean blood loss mean operation time or re-operation rate between two groups (P > 0.05), but the disc replacement group had lower rate of the complication, better VAS scores and ODI score compared with fusion group (P < 0.05). The disc replacement group show superior clinic efficacy at the immediate postoperative time. However, there is no difference between two groups in safety. More randomized controlled trials with long time and high quality are required for further validation. Related Articles | Metrics

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Osteolysis cytokine in limiting membrane of joint prosthesis aseptic loosening Liu Tian-sheng, Wang Yu-qiang, Wang Jing-gui, Su Bin 2010, 14 (35):  6496-6499.  doi: 10.3969/j.issn.1673-8225.2010.35.009 Abstract ( 158 )   PDF (282KB) ( 301 )   Save BACKGROUND: Artificial joint aseptic loosening is a process of osteolysis, in which osteolysis cytokines play important roles. However, only tumor necrosis factor and prostaglandin E2 have been reported. OBJECTIVE: To detect the osteolysis cytokine expression in limiting membrane of joint prosthesis aseptic loosening. METHODS: A total of 54 patients who had joint prosthesis aseptic loosening and underwent revision in Affiliated Hospital of Medical College of Chinese People’s Armed Police Force and Union Hospital from March 2006 to December 2008 were served as observation group and to the limiting membrane in the operation was collected. In addition, 56 patients with fixator removal were served as control group, and the scar tissues were collected. Interleukin-1 (IL-1), IL-6, IL-11, and macrophage colony-stimulating factor (M-CSF) were detected by immunohistochemisty method, and cytokine mRNA expression was detected by RT-PCR. RESULTS AND CONCLUSION: IL-1, IL-6, IL-11, and M-CSF expression was greater in limiting membrane of joint prosthesis loosening patients than the control group (P < 0.05). Results suggested that IL-1, IL-6, IL-11, and M-CSF play an important role in the joint prosthesis loosening, and blocking this pathological process may effectively delay and prevent joint aseptic loosening. Related Articles | Metrics

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Nonlinear finite element analysis of the breakage in pubic connection plate after pelvic reconstruction with modular hemipelvic endoprosthesis Ji Tao, Guo Wei, Tang Shun, Li Da-sen 2010, 14 (35):  6500-6503.  doi: 10.3969/j.issn.1673-8225.2010.35.010 Abstract ( 66 )   PDF (291KB) ( 296 )   Save BACKGROUND: Finite element method has been used in studies regarding orthopedics-related biomechanics under static loading, evaluation of stress peak and stress distribution. However, due to fatigue calculation and complex in vivo mechanical environment, clinic-related biomechanics is difficult to identify. OBJECTIVE: To investigate the biomechanical basis of breakage of pubic connection plate after reconstruction of periacetabular defect by finite element method. METHODS: The three-dimensional pelvic ring finite element model was reconstructed, and type Ⅱ+Ⅲ resection was simulated. The three-dimensional modular hemipelvic endoprosthesis was reconstructed with CAD software. Finite element model of the reconstructed pelvis was established. The stress distribution of the pubic connection plate was analyzed in simple standing and gait cycle. The position and value of peak stress was analyzed. RESULTS AND CONCLUSION: The results of finite element analysis showed the peak von Mises stress was 3.5 MPa in the middle of the plate, and the peak stress during the gait cycle was 273.0 MPa located at the junction of plate and artificial acetabulum. The stress concentration position was the same as that of breakage during follow-up. The reason for breakage of the pubic connection plate was attributed to the fatigue fracture during high cycle of gait load. Related Articles | Metrics

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Biomechanical analysis of human mandible reconstructed with titanium-plate  Liu Feng, Huang Di-yan, Ma Jie, Zhao Wei-xia 2010, 14 (35):  6504-6507.  doi: 10.3969/j.issn.1673-8225.2010.35.011 Abstract ( 105 )   PDF (302KB) ( 466 )   Save BACKGROUND: Mandibular reconstruction plate is the most commonly used metals. Titanium plate titanium screw fracture and loosening leads to surgical failure. Studies show that the causes for titanium plate titanium screw fracture and loosening include overload, occlusal force, plate length, number of titanium screw, and mechanical injury. OBJECTIVE: To establish normal mandible and mandibular defect reconstruction plate finite element model, and analyze its biomechanics. METHODS: Based on the original CT scan image data of 1 male volunteer with normal occlusion relationship, using high-performance computer and reverse engineering software Mimics, normal mandible and mandibular reconstruction plate three-dimensional model and three-dimensional finite element model were established to simulate the vertical and oblique teeth together state, normal plate reconstruction of the mandible and the mandibular stress distribution. RESULTS AND CONCLUSION: Three-dimensional finite element model was obtained. The normal mandible comprised of 80 044 nodes and 431 899 modules; mandibular defects (SS type) titanium mandibular reconstruction was composed of 68 400 nodes and 247 379 units. Under normal mandibular teeth in the combined posterior vertical large area, the von Mises stress was distributed in the mandibular ramus front 20.15 MPa, mandibular angle and condylar neck 19.45 MPa 15.35 MPa. von Mises stress of titanium plate mandibular reconstruction model under vertical teeth together was ascending branch of the maximum front 19.34 Mpa, condylar neck 10.21 Mpa, mandibular angle 18.56 Mpa, titanium central 24.58 MPa, screws 18.35 MPa. Simulated oblique 45° teeth together under the maximum von Mises stress distribution, the reconstruction of mandibular titanium condylar neck and ramus on the right front was 19.34 MPa, right condyle neck 10.21 Mpa, mandibular angle 18.56 MPa, titanium 24.58 MPa titanium nail 18.35 MPa. Stress of reconstruction of mandibular stress distribution plate is focused on the titanium plate, titanium screw, which is distributed unevenly compared with the normal stresses, thereby affecting stability of titanium plate reconstruction of mandibular defects. Related Articles | Metrics

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Establishment of a three-dimensional finite element model of rapid canine movement through reducing resistance and distraction osteogenesis  Jumanjiang•Maimaiti, Mi Cong-bo, Zhao Xi, Qian Ya-jing, Nie Jing, Wang Wei 2010, 14 (35):  6508-6511.  doi: 10.3969/j.issn.1673-8225.2010.35.012 Abstract ( 149 )   PDF (319KB) ( 371 )   Save BACKGROUND: Animal experimental model of the rapid tooth movement has been established through distraction osteogenesis domestically, based mainly on basic research. It has not been reported about the biomechanical mechanism of the rapid tooth movement through distraction osteogenesis. OBJECTIVE: To establish three-dimensional finite element model (3-D FEM) with high geometric and mechanical similarity of rapid canine movement through reducing resistance and distraction osteogenesis, and to set up a flexible platform for analyzing the biomechanics of rapid canine movement through reducing resistance and distraction osteogenesis, optimization design and selecting the method for surgery. METHODS: By the scanning of spiral CT with 64 rows, the sectional image data in DICOM of maxillary and upper teeth were obtained. With the help of Mimics, Geomagic Studio 8.0, Unigraphics NX and Ansys 11.0 software, the 3-D FEM of rapid canine movement was established through reducing resistance and distraction osteogenesis, including maxillary, upper teeth and periodontal ligament. RESULTS AND CONCLUSION: A 3-D FEM of rapid canine movement through reducing resistance and distraction osteogenesis was established, which consisted of 43 477 elements and 83 577 nodes, which could add or delete the framework according to different research needs. The 3-D FEM with high geometric and mechanical similarity provided a favorable platform for analyzing the biomechanics behavior of rapid canine movement through reducing resistance and distraction osteogenesis, which provide theory bases for clinical application generally. Related Articles | Metrics

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Biomechanical optimization of diameter and length of parameterization three-dimensional finite element model of human maxillary central incisor with post-and-core Gao Jian-yong, Wang Da-lin, Kong Liang, Tian Gang 2010, 14 (35):  6512-6516.  doi: 10.3969/j.issn.1673-8225.2010.35.013 Abstract ( 146 )   PDF (275KB) ( 377 )   Save BACKGROUND: In the past 3D finite element analysis of post-and-core crown, length and diameter of post were almost analyzed by straggling and combinatorial method that could not precisely reflect their status of continuous variation. OBJECTIVE: To determine the residual roots stress variation affected by continuous variation of length and diameter of post by Ansys Workbench-DesignXplorer. METHODS: Parameterization 3-D finite element model of human maxillary central incisor with post-And-Core was created. The range of the post diameter (D) and length (L) were set from 1.0 mm to 4.1 mm and from 3.0 mm to 8.0 mm, respectively by Ansys Workbench.  Influence of the maximum Von Mises stresses in dental tissue by continuous variation of length and diameter of post and sensitivity to D and L were evaluated． RESULTS AND CONCLUSION: With increasing L, EQV of nickel-chromium alloy post decreased 28.9%, and EQV of carbon fiber post decreased 13.1%; with increasing D, EQV of nickel-chromium alloy post decreased 33.9%, and EQV of carbon fiber post decreased 9.6%. When 5.16 < L < 8.00 and 1.62 < D < 2.02 (nickel-chromium alloy post), 4.75 < L < 8 and 1.68 < D < 2.2 (carbon fiber post), the response curve curvatures of maximum Von Mises stresses to L and D in dentin ranged from -1 to +1. The result has shown that the dentin stress of nickel-chromium alloy post is more sensitive to variation of length and diameter than that of carbon fiber post. diameter of nickel-chromium alloy post have more important influence than length, however, and length of carbon fiber post have more important influence than diameter. Biomechanical natures of different materials should be considered, and the suitable length of nickel-chromium alloy post is 5.16-8.00 mm, and the suitable diameter is 1.62-2.02 mm; the suitable length of carbon fiber post is 4.75-8.00 mm, and the suitable diameter is 1.68-2.20 mm. Related Articles | Metrics

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Force bearing of lifters’ lumbar segment during preparation to lift barbell: A finite element analysis   Bao Chun-yu, Meng Qing-hua 2010, 14 (35):  6517-6519.  doi: 10.3969/j.issn.1673-8225.2010.35.014 Abstract ( 100 )   PDF (275KB) ( 317 )   Save BACKGROUND: Studies have explore the biomechanical properties of the lumbar spine, but because of the complexity of spinal anatomy and limitations of research methods, the prevention of waist injuries in lifters requires investigation. OBJECTIVE: To establish the finite element model of complete human lumbar spine to analyze the lumbar motion segment loading characteristics when lifters are ready to lift barbell. METHODS: The three-dimensional, comprehensive and realistic finite element model of the lumbar spine (L1-5) was established using datum of Dicom based on opinion of “assembled construction”, and the biomechanics of a lumbar motion segment during preparing lifting barbell was simulated. RESULTS AND CONCLUSION: During preparation of lifting barbell the equivalent stress on the anterior-lower location of vertebral body was greater than the other sites, and stress on pedicle of vertebral arch was higher. The equivalent stress of intervertebral disc was observed at middle-anterior location of exterior annulus fibrosus, especial anterior location in flexion. The equivalent stress on the vertebral body and intervertebral disc showed gradually ascending trend from up to low sites. The stress on the vertebral body was 4-5 times higher than the below intervertebral disc’s. The three-dimensional finite element model could be used for studying the biomechanics of the lumbar spine. Related Articles | Metrics

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Test-retest reliability of position sense and muscle force sense of the ankle joint Zhang Qiu-xia, Zhang Lin 2010, 14 (35):  6520-6524.  doi: 10.3969/j.issn.1673-8225.2010.35.015 Abstract ( 176 )   PDF (435KB) ( 482 )   Save BACKGROUND: There was no criterion for proprioception test of the sagittal plane of the ankle joint. OBJECTIVE: To explore the test-retest reliability of the ankle joint position sense (JPS) and muscle force sense (MFS). METHODS: The target angle of the ankle passively reposition was 5° of plantar flexion to measure JPS. The target force of the muscle was 25% maximal voluntary isometric contraction to measure MFS. Consistency degree of the repeated measures was evaluated by intra-class correlation (ICC) and standard error of measurement (SEM). RESULTS AND CONCLUSION: Interclass correlation coefficients of variable errors and absolute errors in JPS and MFS were more than 0.75, and SEM of them were less. ICCs of constant error of them are less than 0.75, and SEMs of them are greater. The test-retest reliability for variable errors and absolute errors of JPS and MFS was better than constant error of them. Related Articles | Metrics

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Short-term precision differences in hip skeleton at different conditions: Determination by using dual-energy X-ray absorptionmetry Kang Hou-sheng, Zhao Yu, Dai Xiao-si, Ren Ling-li, Qiu Ping, Liu Lin, Peng Yi-hua, Sun Kun 2010, 14 (35):  6525-6528.  doi: 10.3969/j.issn.1673-8225.2010.35.016 Abstract ( 160 )   PDF (236KB) ( 313 )   Save BACKGROUND: There are many methods for measuring bone density, but no study reports quality control of measurements in different degrees of osteoporosis. OBJECTIVE: To compare short-tem precision of DPX-MD dual-energy X-ray absorptionmetry in measuring hip of different degree osteoporosis. METHODS: According to osteoporosis degree, 20 patients were divided into normal, decreased bone mass, osteoporosis, and severe osteoporosis groups. One hip with soft tissues from corpse was provided by Laboratory of Anatomy, North Sichuan Medical College. Hip bone density of each subject was measured using DPX-MD dual-energy X-ray absorptionmetry, once a day for 5 days. The bone density was expressed as Mean±SD, and coefficient of variation was obtained by mean of different bone densities dividing standard deviation. RESULTS AND CONCLUSION: Among femoral neck, Ward’s triangle, greater trochanter, inner zone of greater trochanter, and entire hip, the coefficient of variation of the entire hip was the smallest in all subjects, suggesting the best short-term precision of the entire hip, followed by femoral neck. The coefficient of variation of Ward’s triangle was the largest. The coefficient of variation of normal group was less than decreased bone mass, osteoporosis, and severe osteoporosis groups, but normal group exhibited the best short-term precision. The coefficient of variation of corpse at each region was greater than the four groups, suggesting the worst short-term precision. Results show that there are differences in short-term precision among hip skeleton. Therefore, the entire hip region and femoral neck with little influence can be used for bone density detection during observation of clinical drug effects. Related Articles | Metrics

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Application of three-dimensional reconstruction images of spiral CT in pelvis fractures Zhang Jun, Liao Wen-bo 2010, 14 (35):  6529-6531.  doi: 10.3969/j.issn.1673-8225.2010.35.017 Abstract ( 152 )   PDF (223KB) ( 335 )   Save BACKGROUND: The technology of three-dimensional (3-D) construction of spiral CT can offer intuitionistic 3-D images. These images can be rotated randomly to allow the displacement of pelvis fracture observed from any visual angles thus clear and direct impression of fracture can be acquired by doctor. OBJECTIVE: To observe the clinical effectiveness of 3-D reconstruction images of spiral CT in the pelvic fractures. METHODS: From November 2007 to March 2009, 42 patients with pelvic fractures from Department of Orthopedics, Affiliated Hospital of Zunyi Medical College were selected, including 30 males and 12 females. They underwent X-ray and spiral CT scanning respectively. 3-D reconstruction was performed with surface shaded display and multi-planar reconstruction with 3-D imaging software simultaneously. These images which displayed best results of fracture were selected to store and photographed. The observation effects were compared with two scanning methods. RESULTS AND CONCLUSION: All patients had shown fractures with spiral CT 3-D imaging radiography. The bone fragments were shown more accurately with 3-D reconstruction images. The display effect of 3-D images was better than X-ray radiography (P < 0.05). The 3-D spiral CT imaging has a very important value in the diagnosis of pelvic fractures. It can show the fracture situation of pelvis more accurately and provide evidence for the choice of treatment. Related Articles | Metrics

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CT measurement of lower cervical vertebra pedicle  Zhou Shan 2010, 14 (35):  6532-6535.  doi: 10.3969/j.issn.1673-8225.2010.35.018 Abstract ( 106 )   PDF (406KB) ( 379 )   Save BACKGROUND: Because of small perimeter, different heights, complex anatomic structures of pedicle of cervical vertebra, the pedicular implantation may damage spinal cord, vertebral artery or nerve root. Correct understanding of pedicle and surrounding anatomic structures facilitate improvement of safety of transpedicular screw fixation. OBJECTIVE: To evaluate clinical significances of CT measurement of cervical vertebra pedicle in transpedicular screw fixation. METHODS: The cervical segments of 81 health adult vertebrae were measured by CT. The measured indexes included 13 items: pedicle height, pedicle width, lateral, internal, inferior and superior cortical thicknesses, spongy bone height and width, total pedicular length, pedicular length1, pedicular length2, pedicular transect angle and pedicular sagittal angle. RESULTS AND CONCLUSION: The pedicle width was smaller than corresponding height, and pedicle size was the smallest at C3 and C4 levels; the spongy bone diameter was small and cortical bone was high. The lateral cortical thickness was the thinnest among the internal, inferior and superior cortical thicknesses. The total pedicular length, the pedicular length1 and the pedicular length2 remained unchanged in C3 to C7, but there were some differences with the pedicular transect angel and the pedicular sagittal angle. CT can display internal morphology of lower cervical pedicle clearly and provide radiology data for transpedicular screw fixation. Related Articles | Metrics

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Application of 64-slice CT imaging in the evaluation of basic fibroblast growth factor on angiogenesis in myocardial ischemia rabbits Long Kai-lin, Zhou Pan 2010, 14 (35):  6536-6539.  doi: 10.3969/j.issn.1673-8225.2010.35.019 Abstract ( 114 )   PDF (367KB) ( 288 )   Save BACKGROUND: 64-slice spiral CT provides noninvasive approach that can potentially expand the utility of coronary angiography. However, there are few reports concerning 64-slice spiral CT in evaluating therapeutic effect of gene therapy. OBJECTIVE: To evaluate the effect of basic fibroblast growth factor (bFGF) on angiogenesis in myocardial ischemia using 64-slice spiral CT. METHODS: New Zealand rabbits with acute myocardial ischemia were randomly assigned to the bFGF group and control group. Totally 200 μL buffer phosphate containing polyamidoamine carrying bFGF cDNA nano-carriers or buffer phosphate only was injected into ischemia myocardia. Four weeks after injection, 64-slice spiral CT imaging and immunohistochemistry were applied to examine the region of ischemia myocardial and increased density of capillaries. RESULTS AND CONCLUSION: 64-slice spiral CT imaging demonstrated that, the percentage of ischemia myocardial region in the treatment group was obviously smaller than that of the control group (P < 0.05). Furthermore, density of capillaries and arteries were increased in the myocardial section of the treatment group (P < 0.05). The findings indicated that, gene therapy with PAMAM-bFGF induces arteriogenesis in the region of myocardial ischemia. 64-slice spiral CT can evaluate therapeutic efficacy of gene therapy for myocardial ischemia. Related Articles | Metrics

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Multi-slice spiral CT and virtual endoscopy in reconstruction of pig intestinal tract Zhang Bin, Zhu Ming, Qiu Hai-sheng 2010, 14 (35):  6540-6543.  doi: 10.3969/j.issn.1673-8225.2010.35.020 Abstract ( 144 )   PDF (232KB) ( 315 )   Save BACKGROUND: Appropriate reduction of CT scanning dose while not influencing examination is the trend in future. Low dose CT intestinal tract reconstruction has become a focus in recent studies. OBJECTIVE: To explore the feasibility of low dose multi-slice CT (MSCT) scan in reconstruction of intestinal tract. METHODS: Fresh colons of pigs were made into 36 polyps moulds and randomly divided into 150 mA, 100 mA and 50 mA groups. All pieces of colon underwent MSCT scanning with the angle of 0°, 45° and 90° to the gantry. Intestinal tract was reconstructed using virtual endoscopy and the sensitivity was calculated. RESULTS AND CONCLUSION: The number of polyps that was detected by low dose MSCT were 36 polyps for 150 mA group, 35 polyps for 100 mA group and 33 polyps for 50 mA group with diagnostic sensitivity 100%, 97.2% and 91.7% (P=0.162). The number of detection was 34 polyps for 0° group, 34 polyps for 45° group and 36 polyps for 90° group with diagnostic sensitivity 94.4%, 94.4% and 100% (P=0.354). The reconstruction of low dose MSCT could offer sufficient information for diagnosis and satisfy the diagnose requirement of colon polypous. Tube current of 50 mA follows the principle of legalisation and optimizing shelter of X ray and establish balance between radiation dosage and picture quality. Related Articles | Metrics

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Segmentation of interesting targets in liver cancer image Shi Yan-xin 2010, 14 (35):  6544-6546.  doi: 10.3969/j.issn.1673-8225.2010.35.021 Abstract ( 145 )   PDF (307KB) ( 350 )   Save BACKGROUND: Snake model is a new approach for medical image segmentation, which can overcome the defects of the traditional medical image segmentation. OBJECTIVE: To propose an improved B-spline Snake model for image segmentation based on the features of liver cancer CT images. METHEDS: The abdominal CT image was preprocessed to obtain initial outline of liver cancer parts, and then, closed B-spline Snake model was constructed. Finally, deformed model image of accurate segmentation was obtained using the MMSE to minisize extemal force. RESULTS AND CONCLUSION: The improved B-Snake segmentation algorithm not only reduces noises, but also converge the Snake curve to target contour edge. It is an effective method for segmenting the interesting target of liver CT images. Related Articles | Metrics

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Feasibility of drilling pinhole on pulp chamber based on digital radiographs data Mao Xiao-quan, Zheng Tong-wen, Xing Lie, Xu Pu, Xing Li, Hong Rui-e 2010, 14 (35):  6547-6550.  doi: 10.3969/j.issn.1673-8225.2010.35.022 Abstract ( 100 )   PDF (320KB) ( 341 )   Save BACKGROUND: Clinical methods for pulpitis always devitalize pulp vitality and destroy a great quantity of tooth tissues, resulting in tooth fracture. However, studies have indicated that pulp tissue has self-defense and self-recovery potentiality. Therefore, it is appropriate to preserve vital pulp considerging biology. OBJECTIVE: To investigate feasibility of drilling pinhole on pulp chamber in digital radiographs. METHODS: A total of 60 clear radiographs from VixWin PRO were selected, and pulp chamber height and pulp chamber width were measured (pulp chamber height: distance from roof of pulp chamber to midpoint of bilateral socket ridge line in the anterior teeth and premolars, or distance from midpoint of roof of pulp chamber to midpoint of floor of pulp chamber in the molars; pulp chamber width: distance from mesiwall to distal wall of pulp chamber. Height and width of pulp chamber was measured with electronic gage in VixWin PRO. Mean was calculated respectively. The pulp chambers were observed whether they were contained two transfusion needles. RESULTS AND CONCLUSION: The smallest mean height was 3.43 mm, width 0.80 mm in front teeth and premolars, and height 1.80 mm, width 2.35 mm in molars. The pulp chambers could contain two transfusion needles (No. 5.5). It is feasible to drill two pinholes on pulp chamber. Related Articles | Metrics

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X-ray enhancement based on gray-contrast and adaptive wavelet transform  Shi Li, Chen Xin-xin 2010, 14 (35):  6551-6554.  doi: 10.3969/j.issn.1673-8225.2010.35.023 Abstract ( 121 )   PDF (465KB) ( 452 )   Save BACKGROUND: As a routine way of checking, X-ray examination has been widely used, but because of the limitations of existing technology, X-ray images have disadvantages of low intensity contrast, and noise. Therefore, nowadays the X-ray images are often not meet medical requirements. OBJECTIVE: To enhance and denoise X-ray images with low intensity contrast and noise, to achieve the purpose of medical understanding and recognition. METHODS: Due to the shortage of image enhancement algorithm in the spatial domain and transform domain, an algorithm based on gray-contrast and adaptive wavelet transform was addressed. First, gray-scale ranges needed to strengthen or weaken were selected. The algorithm of eight neighborhood gray-scale contrast enhancement was used to enhance the X-ray image, and algorithm of median filtering was used to smooth the image. Second, the X-ray image was decomposed using wavelet decomposition algorithm, and the size of the correlation coefficients between adjacent layers were used to determine the details and noise of the image. RESULTS AND CONCLUSION: The algorithm based on gray-contrast and adaptive wavelet transform integrates methods based on space domain enhancement or transform domain, which is better than enhancement method alone. The results show that this method achieved a good enhancement and denoising effect. Compared with the results of only contrast and modified the wavelet coefficients, this method obtains a better enhancement and denoising effect. Related Articles | Metrics

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MRI imaging of the ischemic penumbra in rat models of acute cerebral ischemia/reperfusion: An analysis based on mathematical model Gao Wei, Yang Kun, Ling Xiao-zheng, Yang Jing, Zhang Xue-jun, Hao Rui-sheng 2010, 14 (35):  6555-6558.  doi: 10.3969/j.issn.1673-8225.2010.35.024 Abstract ( 156 )   PDF (317KB) ( 348 )   Save BACKGROUND: Most scholars believe that generalized ischemic penumbra (IP) was located in the hypoperfusion area next to severe ischemic region, and is a dynamic state. It is a key point for therapy to successfully remedy IP. MRI can observe area of brain ischemia, but the data cannot directly reflect changing rules between ischemia duration and infarct area.  OBJECTIVE: To observe the effect of mathematical model in MRI imaging of rat models with acute cerebral ischemia/reperfusion. METHODS: The model of ischemia was established by obstructing middle cerebral artery occlusion. The model rats were divided into ischemia and neuroprotective agent groups (breviscapine injection following ischemia). DWI was performed in 0.5-48 hours. Apparent diffusion coefficient (ADC) in different areas of ischemic focus was measured and relative magnitude of ischemic areas and opposite side areas were calculated. Data processing was performed by using least square method, and the results of functional relation formula between ischemic time and infarct size was concluded, followed by linear analysis. RESULTS AND CONCLUSION: Ischemic time (X) was negatively correlated with relative ADC (Y) during 9-21 hours in points 3 and 4 in rat models of acute cerebral ischemia/reperfusion, and there was significant linear correlation. Those regression equations were following as: y=1.458 153-0.042 770 333x, y=1.510 346-0.037 141 333x. There was significant linear correlation during 1-6 hours in all points of neuroprotective agent group (r > 0, P < 0.05). From 24 to 48 hours, the rADC of all points was increased with time. Results showed that 1-6 hours is an important period for neuroprotection in rat models of acute cerebral ischemia/reperfusion. Related Articles | Metrics

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Estimation of Gibbs field prior parameter applied in medical image segmentation  Li Bin, Liu Tong, Chen Wu-fan 2010, 14 (35):  6559-6562.  doi: 10.3969/j.issn.1673-8225.2010.35.025 Abstract ( 139 )   PDF (436KB) ( 286 )   Save BACKGROUND: The method based on Markov random field model is an important segmentation algorithm for medical images. The prior parameters of Gibbs field can severely affect the accuracy of image segmentation. OBJECTIVE: Based on the properties of medical images, to explore the estimation method of Gibbs field prior parameter to improve the accuracy of segmentation. METHODS: The relation between the variance of Gauss noises and the optimal Gibbs field prior parameters for brain MR images was obtained by a statistical method. In the image segmentation iterative steps, the Gibbs field prior parameters were estimated by means of interpolation using the estimation of image variance. RESULTS AND CONCLUSION: Simulated brain MR images with different noise levels and real brain MR images are presented in the experiments. The results show that the proposed estimation method is easy in practical implementation, faster in computational speed, and is capable of achieving finer and adaptive segmentation compared with conventional methods. Related Articles | Metrics

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Anatomical validation of the left ventricular apical thinning in Chinese people measured by three-dimensional CT imaging  Li Fang-zhi, Zhang Ping, He Hong-wei, Wang Ze-en, Lin Qing-chi, Duan Shao-yin 2010, 14 (35):  6563-6566.  doi: 10.3969/j.issn.1673-8225.2010.35.026 Abstract ( 134 )   PDF (300KB) ( 258 )   Save BACKGROUND: In the application of heart three-dimensional CT imaging, the imaging sign of left ventricular apical thinning is observed in Chinese people. There is no any report in domestic literatures. To understand the anatomical and imaging features of the left ventricular apical thinning provides the basis for clinical applications and researches. OBJECTIVE: To confirm the left ventricular apical thinning in Chinese people, and to measure its thickness and location. METHODS: A total of 12 heart specimens of cadavers were observed, and the thickness of the left ventricular apical thinning was measured, as well as the thickest myocardium. 3D CT data of 69 cases without heart diseases were collected from PACS of Zhongshan Hospital of Xiamen University, the left ventricular apical thinning was shown with the techniques of 3D imaging, and the left ventricular apical thinning was measured, as well as the thickest myocardium and the distance between the left ventricular apical thinning and the anterior descending branch of the left coronary artery. RESULTS AND CONCLUSION: The anatomical methods clearly showed the left ventricular apical thinning, with thickness of (1.74±0.32) mm. The thickest myocardium of left ventricle was (13.07±1.48) mm. 3D CT also showed clearly the left ventricular apical thinning, with thickness of (1.27±0.31) mm, and the thickest myocardium was (12.02±1.66) mm. The distance between the left ventricular apical thinning and the left ventricular was (13.70±3.78) mm. There was significant difference between the thickness of apical thin point and thickest myocardium of the left ventricle (P < 0.05). This study proves that there is left ventricular apical thinning, which is normal anatomy in Chinese people showed on both anatomy and 3D-CT. Related Articles | Metrics

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Acquisition of complete locating points on 2-D Panoramagram for registration of functional fascicular groups of the peripheral nerve Zhang Yi, Lu Hao, He Cai-feng, Qi Jian, Luo Peng, Liu Xiao-lin 2010, 14 (35):  6567-6572.  doi: 10.3969/j.issn.1673-8225.2010.35.027 Abstract ( 134 )   PDF (456KB) ( 412 )   Save BACKGROUND: Computer automatic registration of 2-D images is a key step for 3-D reconstruction. The software development of nerve cross section requires 4 complete locating points. OBJECTIVE: To explore the key technology to capture the complete locating points on 2-D Panoramagram for registration of the functional fascicular 3-D visualization of peripheral nerve. METHODS: A segment donating fresh adult sciatic nerve with 4 piece of woman’s hairs fixed around the nerve was serially horizontally sliced into 100 slices, 10 µm thick. According to the different adhesion glass (polylysine coated silicification glass and ordinary glass) and the different ways of staining (hematoxylin-eosin and Karnovsky-Roots AChE staining). The 2-D panorama images of nerve section slice before and after staining were obtained by OLYMPUS-Z61 micro digital photography device. The counts of hair locating pots of each image were compared between pro and post staining. The slices of a segment donating fresh adult ulnar nerve of upper arm were stained with AchE, 2-D panorama images of the same slice were captured before and after AchE staining. Using the layer processing technique of Photoshop CS, the recomposition images including complete 4 location pots were obtained. RESULTS AND CONCLUSION: The missing of hair locating pots was serious after staining. The remaining hair location points on the glass had no significant differences among the groups (P > 0.05); the rate of complete adhesion of 100 image was 1%, with a total adhesion rate of 22.5%. The hair locating pots adhesion rate of frozen slices of peripheral nerve is low after staining. Staining did not affect adhesion rate: the rate of complete adhesion and the rate of total adhesion before staining were 98.0% and 99.50% respectively. The position of the pots before staining was accurate. The outline of the merging 2-D panorama images has fine goodness of fit，the 4 locating points of is accurate, the whole procedure is simple and fast. Based on the two-time imaging technique of the same slice before and after AChE staining and the photoshop layer processing technique, the 2-D panorama images with complete locating points can be obtained. Related Articles | Metrics

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Cilostazol treats rabbit iliac artery restenosis by regulating nuclear factor kappaB pathway to inhibit inflammatory factors  Zeng Zhi-huan, Dong Yu-Gang, Zhao Yan-qun, Huang Rui-miao, Zhang Wei, Wang Wei 2010, 14 (35):  6573-6577.  doi: 10.3969/j.issn.1673-8225.2010.35.028 Abstract ( 123 )   PDF (506KB) ( 287 )   Save BACKGROUND: Restenosis after angioplasty frequently occurs. Inflammatory response is the initiating factor of restenosis. Therefore, to effectively suppress inflammation and reduce smooth muscle cell migration and proliferation is the key to reducing restenosis. Studies have demonstrated that cilostazol significantly reduces restenosis after angioplasty, but the mechanism remains unclear. OBJECTIVE: To investigate the efficacy and mechanism of the cilostazol treatment of rabbit iliac artery restenosis. METHODS: The white rabbits were randomly divided into 6 groups (blank control, vascular stenosis, vascular restenosis, cilostazol 25, 50 and 100 mg/kg groups), and fed with high fat food. Iliac artery stenosis model was established in all groups except blank control group. Percutaneous transluminal angioplasty was performed at stenosis site of vascular restenosis and cilostazol groups. Angiography was performed to determine blood lipid and cytokine mass concentration. Nuclear factor-κB expression was observed by immunohistochemistry, and vascular stenosis was analyzed using imaging work station. RESULTS AND CONCLUSION: Compared with the restenosis group, the blood lipids and cytokines concentration was significantly decreased following cilostazol treatment (P < 0.05). Immunohistochemistry showed that the nuclear factor-κB expression in restenosis group was significantly greater than the blank control and cilostazol groups, but the expression was decreased with increasing cilostazol dose (P < 0.05). Angiography confirmed that vessel area stenosis rate and rates of diameter stenosis were significantly decreased in cilostazol group compared with the restenosis group (P < 0.01). Results showed that cilostazol can inhibit the rabbit iliac artery restenosis, possibly by regulating nuclear factor-κB and inhibiting various inflammatory factors. Related Articles | Metrics

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Morphology of adolescent cervical spinous process: A comparison with adult dried specimens Zhang Shao-jie, Shi Jun, Liu Sa-ri-na, Wang Xing, Li Zhi-jun, Li Xiao-he, Ma Shi-feng, Liu Hong-wei, Wu Yan 2010, 14 (35):  6578-6580.  doi: 10.3969/j.issn.1673-8225.2010.35.029 Abstract ( 140 )   PDF (252KB) ( 442 )   Save BACKGROUND: In recent years, the incidence of cervical spondylosis is increased in the young. However, previous studies regarding cervical spinous morphology have been conducted in adults. OBJECTIVE: To explore the morphological characteristics of juvenile cervical spinous process. METHODS: In original complete specimens of cervical vertebra of adolescents aged 14 to 19 years, the spinous process bifurcation on the length, angle, and the incidence, type and other morphological features of gross anatomy were observed. And the results were compared with adult dehydration specimens. RESULTS AND CONCLUSION: Young C2-C6 spinous process bifurcation length was (7.73 ± 1.82), (5.33 ± 1.43), (5.62 ± 1.57), (5.22 ± 1.99) and (5.36 ± 0.98) mm, respectively; bifurcation incidence rate was 100.0%, 80.0%, 73.3%, 80.0% and 46.7%, respectively, of which the highest rate occurred in C2 bifurcation, and the bifurcation was significantly different between C2 and other segments (P < 0.05), but there was no bifurcation in C7. Bifurcation angle ranged from C2-C6 was (63.07 ± 26.00)°, (70.42 ± 31.43)°, (84.09 ± 31.51)°, (46.17 ± 16.78)°, (59.00 ± 16.90)°. The shape of the end was inverted "U" or "V" shaped, and some was M-typed. The basic morphological characteristics and above parameters of spinous process were consistent with the adult control group. Results showed that C2 and C7 spinous process morphology of adolescents aged 14 to 19 years was similar to the adults, and can be used as location marks of neck massage, Chinese medicine therapy and surgery. Related Articles | Metrics

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Acetabular wear following artificial femoral head replacement Yin Hui 2010, 14 (35):  6583-6886.  doi: 10.3969/j.issn.1673-8225.2010.35.031 Abstract ( 155 )   PDF (300KB) ( 452 )   Save OBJECTIVE: To investigate the clinical features of artificial femoral head, influencing factors and treatment for acetabular wear following femoral head replacement. METHODS: Literatures concerning acetabular wear following artificial femoral head replacement published between 1998 and 2010 were retrieved from Wanfang database and China Academic Journal databases using key words “artificial femoral head replacement, total hip replacement, acetabular wear, clinical significance, revision skill”. The repetitive studies or old literatures were excluded. RESULTS: Totally 24 documents were included in the final analysis according to inclusive and exclusive criteria. The commonly used artificial femoral head comprised metal alloy and ceramic femoral heads. The metal alloy femoral head was characterized by low price, anti-corrosion, and easy implantation, however, it accompanied by server complications. Though the ceramic femoral head are good in safety and effectiveness, it is hard to apply due to high cost. In clinical results, the occurrence of acetabular wear caused by ceramic femoral head was notably lower than that of metal alloy. Selection of biological material, implant design, surgical techniques influence acetabular wear after replacement. Revision hip arthroplasty was the end solution for acetabular wear, and skills need pay more attention in hip revision.  CONCLUSION: Ceramic femoral head is more suitable for femoral head replacement with low incidence of acetabular wear. Revision total hip replacement is the end solution for acetabular wear, which receives good results in near and mid-term, but the long-term effectiveness needs further exploration. Related Articles | Metrics

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Artificial knee replacement: Technique development as well as clinical application and evaluation Wang Shi-he 2010, 14 (35):  6587-6590.  doi: 10.3969/j.issn.1673-8225.2010.35.032 Abstract ( 136 )   PDF (328KB) ( 521 )   Save OBJECTIVE: To review and evaluate development and application of artificial knee replacement. METHODS: With “artificial knee joint, replacement, prosthesis, transplantation reconstruction” as Chinese key words and “total knee arthroplasty, prosthesis” as English key words, a computer-based online search was performed for articles published between January 1993 and October 2009. Articles related to application of total knee replacement in knee injury repair were selected. Repetitive studies or Meta analysis was excluded. A total of 28 articles were included, which discussed material selection and application, postoperative announcements and issues following total knee arthroplasty. RESULTS: Joint replacement includes total hip and semi-hip replacement, total knee arthroplasty, single condyle replacement, condyle replacement, total shoulder, elbow replacement, and artificial hand and foot replacement. Artificial joint prosthesis is implanted in human body, therefore, the material design, surface processing, selection, manufacture technology and package are important. Indications of different knee prostheses depend on knee joint bone and soft tissue conditions, ligament quality and state, joint deformity and articular cartilage impairment degree. CONCLUSION: High-quality prosthesis, development and application their assembled apparatus are important for total knee replacement development. Related Articles | Metrics

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Application of different internal fixation implants in treating thoracolumbar tuberculosis Shi Xiang-chun 2010, 14 (35):  6591-6595.  doi: 10.3969/j.issn.1673-8225.2010.35.033 Abstract ( 89 )   PDF (354KB) ( 439 )   Save OBJECTIVE: To explore the clinical effect of anterior or posterior internal fixation following focus debridement on thoracolumbar tuberculosis. METHODS: A computer-based online search was performed with the key words “thoracolumbar spinal tuberculosis; internal fixation; titanium mesh; autogenous bone; cement; anterior and posterior” in Chinese and English, respectively for articles published from January 2007 to May 2010. Meta analysis or repetitive studies were excluded. A total of 30 articles were included to discuss the clinical outcomes of different implant internal fixations for thoracolumbar tuberculosis. RESULTS: Titanium alloy as internal fixation materials plus anterior or posterior bone grafting fusion has become main method for treating thoracolumbar tuberculosis. It has advantages that titanium alloy has histocompatibility and corrosivity resistance. Pyrenomycetes formed poloysaccharide on metal surface is relatively few and antituberculosis drugs and patient autoimmunity are effective, therefore, implant-induced infection rate is low. However, long-term implantation of implants for internal fixation stimulates blood vessels and induces fixtor loosening or shedding. CONCLUSION: With developing internal fixation materials, increasing clinical applications have demonstrated the safety and efficacy of internal fixation in spinal tuberculosis patients. Moreover, reconstruction of spinal stability is important to improve operation efficacy. Internal fixator with low wearing but high compatibility can significantly improve treatment and prolong prosthesis lifespan. Related Articles | Metrics

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Biological properties of “Lantern skeleton-shaped” memory alloy vertebroplasty frame  Chang Min, Jiang Bo, Liu Wei-tong 2010, 14 (35):  6596-6600.  doi: 10.3969/j.issn.1673-8225.2010.35.034 Abstract ( 100 )   PDF (454KB) ( 318 )   Save OBJECTIVE: To introduce development concept and biological characteristics of the “lantern skeleton-shaped” memory alloy vertebroplasty frame to treat thoracolumbar vertebral compression fractures. METHODS: A computer-based online search of Wanfang, VIP and CMB databases was performed for articles published between January 1999 and December 2009 related to osteoporotic thoracolumbar vertebral compression fracture in the elderly with key words “thoracolumbar vertebral compression fracture, biomaterial, kyphoplasty”. Insufficiency in the material and conditions in the osteoporotic thoracolumbar vertebral compression fracture in the elderly was analyzed, and an ideal novel material should be designed. RESULTS: A total of 60 relevant literatures were collected, and 31 were included. Results show that ideal material should be non-toxic and can be minimally invasive implanted, with security, uniform expansion, sufficient expansion force and compression support force. According to the above conditions, “Lantern skeleton-shaped” memory alloy vertebroplasty frame was developed based on Chinese thoracolumbar sagittal diameter. Moreover, it is improved according to observation experimental effects. The small, medium and large (length 22 mm, 26 mm and 30 mm) “Duckbill-shaped” memory alloy vertebroplasty frame can be able to meet treatment requirements of the Chinese thoracolumbar compression fracture. CONCLUSION: “Lantern Skeleton-shaped” memory alloy vertebroplasty frame has advantages such as minimal invasion implantation through pedicle, security, uniform expansion, with sufficient expansion force and compression support force. It can meet requirement of spinal biological properties because of early elastic fixation and later biological fixation through artificial bone and vertebral fusion. Moreover, it can avoid some percutaneous kyphoplasies complications such as bone cement leakage and has better clinical application development prospects. Related Articles | Metrics

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Models and techniques of image data mining Yu Xin-xing, Li Ming-qi, Duan Zhu 2010, 14 (35):  6601-6603.  doi: 10.3969/j.issn.1673-8225.2010.35.035 Abstract ( 141 )   PDF (265KB) ( 780 )   Save OBJECTIVE: To introduce models and core techniques of image data mining. METHODS: Original images cannot be directly used for image data mining, which must be pretreated to generate image feature libraries for high layer mining. An image mining system should include functions of image storage, preprocessing, retrieval, mining, display, etc. It is mainly related to image data mining models and image data mining techniques. RESULTS: MultiMediaMiner is an image data mining system developed based on DBMiner system and C-BIRD system, which is a typical feature-driven model. In information-driven model, pixel layers and object layers mainly process images, recognize objects, extract features. Semantic concept layers and mode knowledge layers mainly execute image data mining and knowledge integration. Information-driven model not only can execute mining in high layer of image, but also can be extended to allow mining at every layer and different layers. The core techniques of data mining based on images are related to: image processing techniques, such as removing noise, contrast enhancement, image segmentation, etc.; feature extraction and optimization techniques; classification, rule extraction, forecasting, clustering, etc. CONCLUSION: Image data mining is a branch of data mining in theory, but because of the complexity of mining objects, image data mining is not a simple application and extension of traditional data mining theories and techniques in image data. Image data mining is a new field of research which has its own distinctive research contents, theories and technical frameworks. Related Articles | Metrics

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Research advances and clinical application of lower limb gait rehabilitation robots Ding Min, Li Jian-min, Wu Qing-wen, Shen Hai-tao 2010, 14 (35):  6604-6607.  doi: 10.3969/j.issn.1673-8225.2010.35.036 Abstract ( 193 )   PDF (294KB) ( 1035 )   Save BACKGROUND: Safe, quantitative, effect and repetitive new techniques are required in rehabilitation training. Rehabilitation robots can solve these problems to certain degree. OBJECTIVE: To explore how to enhance and restore musculoskeletal function and to improve coordination capacity by rehabilitation robots, and to analyze the influence of rehabilitation and limitation about the new development, and the challenges. METHODS: With the key words of “stroke, gait, biofeedback, rehabilitation, treadmill training, rehabilitation robotics” databases of Pubmed and Medline and Chinese Journal Full-text Database was searched for articles published between April 1992 and December 2009. Lower limb gait rehabilitation robot was used as the evaluation index. Articles related to lower limb gait rehabilitation robot were included, and repeat studies were excluded. RESULTS AND CONCLUSION: Lower limb gait rehabilitation robot completes walking by guide thing and leg coordinate swing. Sole gait rehabilitation robot performs gait training by simulating angle joint movement track, which solves many clinical issues to certain degree. Application of rehabilitation robot for stroke patients shows that robot provides rehabilitation opportunities to improve the quality of life of the disabled. Related Articles | Metrics

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Analysis of domestic electrical stimulation for swallowing disorders after stroke Yang Yong-hong, Yang Lin 2010, 14 (35):  6608-6611.  doi: 10.3969/j.issn.1673-8225.2010.35.037 Abstract ( 161 )   PDF (299KB) ( 441 )   Save BACKGROUND: Dysphagia after stroke is a common clinical problem. Electrical stimulation treatment is a new method for swallowing disorders after stroke. OBJECTIVE: To understand the domestic electrical stimulation on swallowing impairment of post-stroke condition by comparison with overseas research. METHODS: A computer-based online search of CKNI, Wanfang database and VIP database was performed for related articles published between January 1989 and April 2010 with the key words “stroke/cerebrovascular accident, dysphgia, electrical stimulation/electrical therapy ”, and the retrieval strategy was connected with “and”. RESULTS AND CONCLUSION: A total of 47 articles were collected, and the earliest published paper occurred in March 2003. Analysis shows that the research level about treating dysphgia with electrical stimulation was less in China compared with international studying level, which mainly involved clinical application. Therefore, researches with high quality and extended area are required to explore electrical stimulation treatment for swallowing disorders after stroke. Related Articles | Metrics

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Total knee arthroplasty for knee arthritis in 126 middle-aged and elderly patients Zhang Jun, Guo Ke-bin, Xiong Yuan-bo 2010, 14 (35):  6612-6615.  doi: 10.3969/j.issn.1673-8225.2010.35.038 Abstract ( 99 )   PDF (301KB) ( 360 )   Save BACKGROUND: With the investigation and development of knee joint disease, total knee arthroplasty has increasingly become the optimal strategy of treating severe knee arthritis in middle-aged and elderly patients. OBJECTIVE: To evaluate the clinical effect of total knee arthroplasty for treatment of knee arthritis in middle-aged and elderly patients. METHODS: From January 2000 to July 2008, 126 patients with arthritis were treated in Department of Orthopedic Surgery, Xiangyang People’s Hospital, including 74 males and 52 females, aged 63.9 years (51-83 years), 92 cases of severe osteoarthritis, 19 of traumatic arthritis, and 15 of rheumatoid arthritis. All patients underwent total knee arthroplasty, and the effect was evaluated using HSS scores. The complications were also observed. RESULTS AND CONCLUSION: All patients were followed up from 1 year to 7 years. Among 126 patients, excellent  results  were achieved in 118 knees (77%), good in 30 knees (20%), fair in 5 knees (3%), with an excellent and good rate of 97%. The artificial knee joint could meet the daily requirements and patient quality of life was significantly improved. In addition, 5 cases developed deep venous thrombosis and cured by treatment; 9 cases had knee joint pain within 3 months post-surgery, with no swelling but normal range of motion, and relieved by femoral nerve blocking and medication. Results showed that total knee arthroplasty obtained good clinical outcomes in treating knee arthritis in middle-aged and elderly patients. Related Articles | Metrics

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Custom-made rotating hinge artificial total knee replacement for the treatment of bone tumors surrounding the knee in 19 cases Xiao Wen-feng, Li Kang-hua, Lei Guang-hua, Hu Yi-he, Liao Qian-de, Zhu Yong, Li Ren-jie, Long Hai-tao 2010, 14 (35):  6616-6619.  doi: 10.3969/j.issn.1673-8225.2010.35.039 Abstract ( 130 )   PDF (349KB) ( 294 )   Save BACKGROUND: The former fixed-hinge design artificial knees have been gradually replaced by rotating-hinge artificial knees due to the high risk of revision. The custom-made rotating hinge artificial total knee can better match the patients’ anatomy and achieve mechanical multiformity and individualized anatomy. OBJECTIVE: To investigate the clinical effects of custom-made rotating hinge artificial total knee replacement for benignant or malignant bone tumors around the knee. METHODS: Rotating hinge prosthesis replacement was performed in 19 patients with benignant or malignant bone tumors around the knee, including 13 males and 6 females, aged 19-51 years. There were 6 cases of benignant tumors, 13 of malignant tumors, 15 cases involving distal femur and 4 cases in proximal tibia. Enneking Functional Score was used to evaluate the post-operation functions. Radiographs were shot on the postoperative visit to evaluate the prosthesis conditions and tumor relapse. RESULTS AND CONCLUSION: The average operating time was (3.64±0.89) hours (range 2.5-5.3 hours) and the average intraoperative blood loss was (452.63±135.88) mL (range 300-800 mL). All the patients were followed-up with an average time of (30.45±21.44) months (range 3-64 months). Local relapse was observed in one patient, and one survived with the presence of lung metastasis. The extension and flexion of knee activity was respectively 0° and 95°-140° (124.47±12.89)°. The excellent and good rate was 89%. Custom-made rotating hinge artificial total knee replacement is an efficacious limb salvage method for the treatment of benignant or malignant bone tumors around the knee. Related Articles | Metrics

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Technical points of artificial humeral head replacement for the treatment of comminuted fracture of the proximal humerus in elderly patients Pan Zhao-xun, Qu Lian-jun, Yang Xiao-ming, Zhang Hong-xin, Cui Yan, Sun Chao 2010, 14 (35):  6620-6623.  doi: 10.3969/j.issn.1673-8225.2010.35.040 Abstract ( 134 )   PDF (257KB) ( 387 )   Save BACKGROUND: Function of shoulder joint can quickly recover using artificial humeral head replacement for comminuted fracture in elderly patients. However, how to reconstruct and recover the equilibrium of surrounding soft tissues during artificial humeral head replacement needs to be explored. OBJECTIVE: To investigate treatment effectiveness and technical points of the artificial humeral head replacement for treating comminuted fractures of the proximal humerus in elderly patients. METHODS: Totally 13 patients with comminuted fractures of the proximal humerus were treated by artificial humeral head replacements at the Department of Joint Surgery, the 89 Hospital of PLA, from June 1999 to January 2009 were analyzed, including 4 males and 9 females, aged 69.2 (63-78) years. Intraoperatively, greater tubercle and lesser tubercle were accurately reduced and fixed and prostheses implanted precisely, rotator cuff repaired. Rehabilitation training was begun in proper strength postoperatively. The treatment effectiveness was evaluated by the Neer’s score criteria. RESULTS AND CONCLUSION: All the thirteen patients were followed up 51 (9-112) months. According to Neer score criteria, the treatment effectiveness was excellent in six cases, good in five cases, mean in two cases and bad in none. The excellent and good rate was 85%. No dislocation of joint and loosening or ruptures of the prothses were showed on radiograph. All patients could fulfill the daily activities, among them, ten patients were satisfied subjectively. Degree of the subjective satisfaction was 77%. The artificial humeral head replacement can quickly restored satisfactory function of the shoulder joints in the elderly patients with comminuted fractures of the proximal humerus on condition of grasp operative indication, follow the technical points, and perform rehabilitation training. Related Articles | Metrics

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Periprosthetic femoral fractures in 9 cases following hip arthroplasty Ruan Zhi, Sun Jian-hua, Shi Chen-hui, Dong Jin-bo, Wang Yong-ming 2010, 14 (35):  6624-6626.  doi: 10.3969/j.issn.1673-8225.2010.35.041 Abstract ( 88 )   PDF (188KB) ( 410 )   Save BACKGROUND: The treatment for the periprosthetic femoral fracture following hip arthroplasty is difficult because of the metal prosthesis and the quality of local bone loss, and the appropriate treatment remains controversial. OBJECTIVE: To discuss an accurate preoperative planning and clinical effects according to the periprosthetic femoral fracture following hip arthroplasty. METHODS: A total of 9 patients with periporsthetic femoral fractures were treated in First Department of Orthopedics, First Affiliated Hospital of Xinjiang Shihezi University Medical School from February 2001 to June 2009 and were retrospectively reviewed. The patients were classified by Vancouver classification, including 1 case of A-type fracture, 3 of B1-type fracture, 4 of B2-type fracture and 1 of C-type fracture. The option of treatments included the conservative treatment, open reduction with internal fixation of wire or plate, long stem revision with wire, and the clinical effects and complications of those treatments were observed. RESULTS AND CONCLUSION: All the patients were followed for 1.1-4.5 years with a mean follow-up of 2.5 years; 6 patients received postoperative fracture healing and the average healing time was 6 months. Two B2-type fracture cases of long stem revision with wire and one C-type fracture case with internal fixation of plate were not healed. The key of the treatments applied for periprosthetic fractures is to select the appropriate therapy according to the site of fracture, stability of implant and quality of bone and prevention of the blood circulation of fracture. Related Articles | Metrics

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Anatomical plate versus dynamic hip screw internal fixation for the treatment of femoral intertrochanteric fractures Li Jian, Zhang Zhen-shan, Zhao Hong-pu, Zhang Ping, Pan Yong-qian, Wu Yi-feng 2010, 14 (35):  6627-6631.  doi: 10.3969/j.issn.1673-8225.2010.35.042 Abstract ( 124 )   PDF (317KB) ( 614 )   Save BACKGROUND: Dynamic hip screw (DHS), Gamma nail, and femoral proximal interlocking intramedullary nail have been used in internal fixation of femoral intertrochanteric fractures. Anatomical plate has been recently used for the treatment of femoral intertrochanteric fractures. OBJECTIVE: To compare the therapeutic results of internal fixation by anatomical plate and DHS for treatment of femoral intertrochanteric fractures. METHODS: Between May 2007 and June 2009, 48 consecutive patients with femoral intertrochanteric fractures were randomly assigned to anatomical plate fixation and control group (DHS fixation) with 24 cases in each group. The operative time, blood loss, walking time and hip function scores were recorded. RESULTS AND CONCLUSION: All patients were followed up for 12.6 (range 5 to 18 months). The wound drainage and walking time was similar in two groups (P > 0.05). The mean operative time and blood loss in the experimental group were significantly lower than the control group (P < 0.05). Preoperative Harris hip score of the two groups were significantly improved postoperatively, and good and excellent was better in experimental group, but there was no significant difference between two groups (P > 0.05). Results demonstrated that internal fixation by anatomical plate is a better treatment for femoral intertrochanteric fractures compared with the traditional DHS due to its easier operation, less bleeding and similar effect. Related Articles | Metrics

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Intervertebral bone fusion after posterior lumbar interbody fusion using the Cage impacted with laminar and processus spinosus bone chips in the treatment of degenerative diseases of the lumbar spine in 63 cases Xing Wen-hua, Jia Lian-shun, Huo Hong-jun, Yang Xue-jun 2010, 14 (35):  6632-6635.  doi: 10.3969/j.issn.1673-8225.2010.35.043 Abstract ( 96 )   PDF (242KB) ( 459 )   Save BACKGROUND: There are many clinical reports about application of posterior lumbar interbody fusion (PLIF) with the Cage used autologous iliac bone particles in treatment of degenerative lumbar disease. But few studies reports state of fusion in different time and fusion rate of long-term follow-up using cages impacted with laminar and processus spinosus bone chips. OBJECTIVE: To investigate the radiologic changes and clinical efficacy in the interbody bone fusion site in patients who had received PLIF using cages impacted with autoallergic laminar and processus spinosus bone chips. METHODS: A total of 63 patients with degenerative lumbar disease were selected, including 24 males and 39 females, aged 46 years (rang 35-72 years). All cases were one level. The decompressed autologous vertebral plate and processus spinosus bone chips were soaked in gentamycin and filled in Cage. The autologous iliac bone particles were filled in the anterior diastema of Cage, and the Cage was implanted. The patients were followed up for 53 months (range 37–62 months). Anteroposterior and lateral radiograph films were taken from all patients after bone fusion at 1 week, 3, 6 and 12 months after surgery and at follow-up. The extent of the bone fusion was observed in different time. RESULTS AND CONCLUSION: Of the 63 fusion levels, successful bone fusion was observed in 51 levels (81%). All the successful fusions occurred inside and anterior to the cages. Successful fusion time was 6 to 12 months after surgery. The pain in the lumbar spine and lower limb disappeared or alleviated obviously. Lumbar interbody fusion was good, and the height of lumbar intervertebral space was not lost significantly. PLIF using cages impacted with autoallergic laminar and processus spinosus bone chips is a useful method when considering the time required for surgery and the morbidity of the autograft donor sites. Related Articles | Metrics

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Deep venous thrombosis in the lower limbs and unilateral total hip replacement in the elderly Pang Ling, Hai De-jing, Wang Rui, Zong Min-ru, Yu Min-hua, Yang Yu-hui 2010, 14 (35):  6636-6638.  doi: 10.3969/j.issn.1673-8225.2010.35.044 Abstract ( 89 )   PDF (174KB) ( 321 )   Save BACKGROUND: Deep vein thrombosis (DVT) of the lower limbs is one of the severe complications of total hip replacement (THR) during the perioperative period. The incidence rate was high. The effect of primary disease on the DVT after THR in the elderly remains poorly understood. OBJECTIVE: To explore the effect of primary disease on DVT after THR in the elderly. METHODS: 147 cases with unilateral THR aged 64-93 years, were included and divided into two groups. Fracture group contained 68 cases, which of them were all traumatic femoral neck fracture ones. Osteopathia group contained 79 cases, and they had no traumatic injury. We selected total hip prostheses according to their physiological age, preoperative socialization ability, substantia ossea and life expectancy. Biological prosthesis in 5 cases and mixed prosthesis in 12 cases were used, while the others used bone cement prosthesis. If the patient had pain and/or swelling on the injured limb, with or without Homans/Neuhofs sign, we did the pressurized ultrasonic Doppler to examine whether the patient had got DVT. RESULTS AND CONCLUSION: In the fracture group, 32 cases had swelling in the injured limbs, and 20 cases with pain, 15 cases with Homans/Neuhofs sign, and 29 DVT cases were confirmed by the pressurized ultrasonic Doppler. One femoral neck fracture case of THR had no DVT clinical signs and was dead 17 days later. The autopsy found that it was an mixed type combined of pulmonary embolism; Osteopathia group: 20 cases had swelling in the injured limbs, and 11 cases of pain, 9 cases of Homans / Neuhofs sign, 20 DVT cases were confirmed by the pressurized ultrasonic Doppler. The blood coagulation state was greater, and the incidence rate of DVT in the lower limbs was greater in the fracture group compared with osteopathia group (P < 0.05). These indicated that femoral neck fracture is a high risk factor for DVT development in lower limb after THR in the elderly. Related Articles | Metrics

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Computer-assisted design of individualized femoral prosthesis according to 3D reconstruction of CT images Zhu Jian-wei, Liu Fan, Dong Qi-rong, Xu Wei-wei, Bai En-zhong, Huang Xi 2010, 14 (35):  6639-6642.  doi: 10.3969/j.issn.1673-8225.2010.35.045 Abstract ( 92 )   PDF (224KB) ( 453 )   Save BACKGROUND: Due to individual characteristics of human body, it is difficult to well match between standard prosthesis and patient skeleton. Computer-assisted design and manufacture of individualized prosthesis can effectively prolong artificial joint lifespan and quality and reduce revision rate. However, related studies are few in China. OBJECTIVE: To explore computer-assisted design for individualized femoral head prosthesis according to three-dimensional (3D) reconstruction of CT images for improving prosthesis and affected skeleton matching. METHODS: The CT scanning image of one healthy male volunteer, with no hip joint disease, was used. His femur was scanned with GE Speed Light CT with 3.0 mm thick cross-section slices. CT 2D images were transmitted to a computer. The medical image format was translated from DICOM into bmp. Inner and external bone contours were drawn automatically or by hand and processed digitally, and then these data were downloaded into 3D Mimics8.1, and Rapidform2004 software. The 3D femoral canal model was rendered. Femur canal contours curve was downloaded into the Solidworks2004 software in the form of dxf. Femoral prosthesis was designed on the base of femoral canal contours curve. RESULTS AND CONCLUSION: The CT image was transmitted in the form of vector by a set of self-made medical image processing software. The accurate 3D femoral internal/external outline model was obtained by CT 2D image and reverse technique. Suitable femoral prosthesis was designed by means of image reverse engineering and norientation CAD. Reverse engineering and CAD provide an effective way to develop individualized prosthesis, improve the matching of prosthesis and affected skeleton, prevent prosthesis loosening and improve long-term stability. Related Articles | Metrics

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Treatment of cervical spondylotic myelopathy by anchoring polyetheretherketone cage filled with nano-artificial bone Department of Orthopedics, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China 2010, 14 (35):  6643-6646.  doi: 10.3969/j.issn.1673-8225.2010.35.046 Abstract ( 163 )   PDF (246KB) ( 428 )   Save BACKGROUND: In vivo and in vitro experiments have demonstrated that polyetheretherketone (PEEK) polymer is the best cervical fusion cage material due to its good biocompatibility, elastic modulus similar to human bone, and satisfactory plasticity and hardness.  OBJECTIVE: To assess the outcomes of polyetheretherketone (PEEK) cage filled with nano-artificial bone following anterior cervical discectomy and fusion (ACDF) in patients with cervical spondylotic myelopathy. METHODS: In total 17 patients with cervical spondylotic myelopathy were collected from the Department of Orthopedics, First Affiliated Hospital of Harbin Medical University between May 2007 and September 2009. There were 12 males and 5 females, averaging 55 (range 42-67) years of age. All patients underwent ACDF using PEEK cage filled with nano-artificial bone. Patients’ neurological functions were assessed on the basis of Japanese Orthopaedic Association (JOA) scoring system. The distance between the midpoint of the upper end plate and lower end plate was measured as interboby height. Radiographs with the neck in lateral flexion and extension were obtained to evaluate fusion results. RESULTS AND CONCLUSIONS: Seventeen patients with cervical spondylotic myelopathy participated in the final analysis. Almost all patients had symptomatic improvement. Within postoperative several days, muscle strength of lower limb was increased, and limb was more flexible after surgery than prior to surgery. At 3 months after surgery, JOA scores were significantly increased compared to prior to surgery, the operated segments were stable and disc space height was satisfactory. In addition, no complications were found, and all cases achieved solid fusion, as confirmed by radiographs. These findings suggest that the immediate stability of the operated segments can be obtained by anchoring PEEK cage, and the nano-artificial bone-filled PEEK cage is safe, simple, and with relatively few complications. It is therefore a good choice for patients with cervical spondylotic myelopathy. Related Articles | Metrics

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Construction of a three-dimensional skull model using spiral computer tomography data Gong Zhen-yu, Li Guo-hua, Liu Yan-pu, He Li-sheng, Zhou Shu-xia 2010, 14 (35):  6647-6650.  doi: 10.3969/j.issn.1673-8225.2010.35.047 Abstract ( 140 )   PDF (387KB) ( 315 )   Save BACKGROUND: A three-dimensional spiral computer tomography can display stereoscopic pictures with multi angles on films or computer screens. However, it is hard to display complex three-dimensional anatomical morphology on two-dimensional films or computer screens. Thus, three-dimensional models are needed in craniomaxillofacial surgery simulation or conceptual design. OBJECTIVE: To establish a three-dimensional skull model using spiral computer tomography data and to explore its application in craniofacial surgery. METHODS: Skull of the patient was scanned with Picker 6000 spiral computer tomography with 2.0 slice thickness and 1.0 pitch, and the obtained data were treated in Voxel Q image workstation for three-dimensional reconstruction with volume rendering technique. After having been downloaded to personal computer at 0.1 mm interval, the transaxial two-dimensional image data were converted into two-dimensional digitized contour data by using image processing software developed by the experimental team. The wire frame and solid images of craniofacial triangular facets could be reconstructed when the digitized data were inputted into image processing software of Surfacer 9.0. RESULTS AND CONCLUSION: The three-dimensional wire frame and solid image of skull was reconstructed and computer aided design for plastic operation was accomplished on it. Then the simulacrum of underlay was obtained by rapid prototyping technology. A three-dimensional skull model could be established using spiral computer tomography data. It might play an important role in the diagnosis and treatment of tumors, injuries and abnormality in craniofacial surgery. Related Articles | Metrics