ObjectiveTo observe the therapeutic effect of the Tizanidine hydroehloride combined with non-steroidal anti-inflammatory drugs (NSAIDs) on fibromyalgia syndrome. MethodsA total of 166 patients collected from August 2011 to January 2013 were randomly divided into control group and treatment group (with 83 cases in each group), the NSAIDs was used for control group, and for the other group, the Tizanidine hydroehloride combined with NSAIDs was used. The patients in two groups were continuously treated for 2 weeks. And the first and second week after treatment, the psychological evaluation,visual analogue pain, activities of daily living were detected. During the treatment period, the average follow-up duration was 3 months. ResultsThe clinical efficacy was better after treatment in both of the two groups. The clinical efficacy was more significant in treatment group than that in the control group, and the occurrence of gastrointestinal discomfort were less in the treatment group than that in the control group. ConclusionTizanidine hydroehloride combined with NSAIDs is effective on fibromyalgia syndrome. And the Tizanidine hydroehloride can protect the gastrointestine from being injured.
ObjectiveTo investigate the effectiveness of pedicle screw internal fixation for the atlantoaxial instability of children. MethodsBetween July 2005 and January 2012, 19 cases of atlantoaxial instability were treated, included 10 boys and 9 girls with an average age of 7.5 years (range, 4-15 years). The X-ray films, CT, and MRI examinations of the cervical spine showed craniocervical malformation in 9 cases, congenital os odontoideum in 3 cases, odontoid fracture (type Ⅱ) in 1 case, disruption of transverse ligament in 2 cases, atlantoaxial fracture and dislocation in 4 cases; and spinal cord injury in 8 cases, according to the American Spinal Cord Injury Association (ASIA) impairment scale, 1 case was rated as grade B, 2 as grade C, and 5 as grade D. Preoperative skull traction was performed routinely on all cases, and complete reduction was achieved in 17 cases, no reduction in 2 cases. In 17 patients who achieved complete reduction, pedicle screw internal fixation was used through posterior approach, including occipitocervical fusion and fixation in 5 cases, and atlantoaxial fusion and fixation in 12 cases; in 2 patients with no reduction, pedicle screw internal fixation was used through posterior approach (atlantoaxial fusion and fixation) after release by transoral approach. ResultsThe operation was successfully performed in all patients. The mean operation time was 89 minutes; the mean intraoperative blood loss was 95 mL; the mean postoperative drainage volume was 73 mL; and the mean hospitalization days were 14 days. The patients were followed up 6-27 months (mean, 18.3 months). Satisfactory atlantoaxial fusion was obtained, and bone fusion was obtained at 3-7 months after operation (mean, 4.5 months). No breakage of screw or rods and re-dislocation occurred during follow-up. At last follow-up, the cervical range of motion (CROM) of the left and right rotation were (62.0±5.9)°and (63.9±3.8)°respectively in 5 patients receiving occipitocervical fusion and fixation, showing significant difference when compared with the values of normal children[(72.3±7.0)°and (74.1±7.6)°, respectively] at the same age (t=-3.915, P=0.018; t=-5.954, P=0.004). The CROM of the left and right rotation were (70.5±5.8)°and (72.7±4.9)°respectively in 14 patients receiving atlantoaxial fusion and fixation, showing no significant difference when compared with normal children at the same age (t=-1.417, P=0.180; t=-1.021, P=0.323). The visual analogue scale (VAS) score was significantly decreased from 7.8±1.1 at pre-operation to 3.5±0.8 at last follow-up (t=17.267, P=0.000). In 8 cases having spinal cord injury, 2 cases were rated as grade C, 1 case as grade D, and 5 cases as grade E according to ASIA impairment scale. ConclusionTechnique of pedicle screw internal fixation has been proven to be an effective treatment for the atlantoaxial instability of children. It plays an important part in relieving pain and limitation of the cervical region.