【Abstract】 Objective To summarize the current development of the correction of severe and rigid scol iosis. Methods Recent l iterature concerning the correction of severe and rigid scol iosis at home and abroad was extensively reviewed, and current developments of the correction of severe and rigid scol iosis were summarized. Results The correction of severe and rigid scol iosis shows developments as follows: the application of Halo-gravity traction increase and Halo-femoral traction is applied in posterior correction surgery. Fixation and correction technique with all pedicle screws was gradually popularized. The applications of posterior vertebral column resection, one-stage anterior and posterior surgery, and posterior-only correction surgery increase. Conclusion The developments of all kinds of correction techniques improve the correction effects of severe and rigid scol iosis. Now there is no standardized treatment protocol for severe and rigid scol iosis. Greater development can be expected in the future.
Objective To elucidate the new development and effects of three-dimensional correction techniques of idiopathic scol iosis (IS). Methods The related home and abroad l iterature concerning three-dimensional correction techniques of IS was extensively reviewed. Results With more and more attention to three-dimensional correction of IS, all kinds of surgery and developed techniques of correction are applied to the correction of IS. The effects of three-dimensional correction of IS are satisfied. Conclusion With more knowledge about IS and more developed theory of correction, more safe and effective techniques of correction is therefore the hot spot for future study.
Objective To investigate the stability and the stress distributions of L3-5 fused with three different approaches (interbody, posterolateral and circumferential fusions) and to investigate degeneration of thesegment adjacent to the fused functional spinal unit. Methods A detailed L3-5 three-dimensional nonlinear finite element model of a normal man aged 32 was established and validated. Based on the model, the destabilized model, the interbody, posterolateral and circumferential fusions models of L4-5 were established. After the loadings were placed on all the models, we recorded the angular motions of the fused segment and the Von Mises stress of the adjacent intervertebral disc. Results The circumferential fusion was most stable than the others, and the interbody fusion was more stable than the posterolateral fusion. The maximal Von Mises stress of the adjacent L3,4 intervertebral disc in all the models was ranked descendingly as flexion,lateral bending,torsion and extension. For the three kinds of fusions, the stress increment of the L3,4 intervertebral disc was ranked ascendingly as interbody fusion,posterolateral fusion and circumferential fusion. Conclusion After destabilization of the L4,5 segment, the stability of the circumferential fusionis better than that of the others, particularly under the flexional or extensional loading. The stability of the interbody fusion is better than that of the posterolateral fusion, except for under the flexional loading. The feasibility of adjacent segment degeneration can be ranked descendingly as: circumferential fusion,posterolateral fusion and interbody fusion.
Objective To explore the techenique of fusing the reconstructed titanic plate, the C2 pedical screws, and the autogenous granulated cancellous bone graft in the occipitocervical region. Methods From April 2002 to January 2005, 19 patients aged 31-67 years with occipitocervical instability underwent the occipitocervical fusion using the reconstructed plate, C2 pedical screws, and autogenous granulated cancellous bone graft. Of the patients, 8 had complex occipitocervical deformity，8 had old atlantoaxial fracture and dislocation，2 had rheumatoid arthritis and anterior dislocation of the atlantoaxial joint, and 1 had cancer of the dentoid process of the axis． Results No complication occurred during and after operation．The follow-up for an average of 16 months in 19 patients showed that all the patients achieved solid bony fusion in the occipitocervical region．There was no broken plate, broken screw, looseness of the internal fixation or neurovascular injury. Conclusion The fixation of the C2 pedical screws with the reconstructed titanic plate is reliable, the insertion is easy, and the autogenous granulated cancellous bone graft has a high fusion rate, thus resulting in a satisfactory effect in the occipitocervical fusion.
Objective To summarize the function of fibula in stability of ankle joints.Methods Recent original articles were extensively reviewed, which were related to the physiological function and biomechanical properties of fibula, the influence of fibular fracture on stability of ankle joints and mechanism of osteoarthritis of ankle joints. Results The fibula had the function of weightbearing; and it was generally agreed that discontinued fibula could lead to intra articular disorder of ankle joint in children; but there were various viewpoints regarding the influence of fibular fracture on the ankle joint in adults. Conclusion Fibula may play an important role in stability of ankle joint.