经骨折椎体椎弓根螺钉短节段固定治疗胸腰段骨折疗效

目的:评估和分析经骨折椎体椎弓根螺钉短节段固定治疗胸腰段单椎体粉碎性骨折的临床疗效。方法:选取胸腰段单椎体粉碎性骨折30例患者,分为两组,甲组20例,采用经骨折椎体椎弓根螺钉短节段固定治疗,均行骨折椎体及骨折椎体上下相邻椎体的椎弓根螺钉+双侧连接杆固定;乙组10例,只行骨折椎体的上下相邻椎体的椎弓根螺钉+连接杆固定术。术后随访。测定两组患者手术前后的椎体后凸畸形角和骨折椎体前方高度,评估其临床疗效。结果:术前平均后凸畸形角纠正:甲组15°,乙组11°,P0.05。术后骨折椎体前方的平均高度(和正常椎体前方高度比):甲组89%,乙组81%,P0.05;术后3个月随访:平均后凸畸形角纠正丢失,甲组2°,乙组6°,P0.05;骨折椎体前方的平均高度(和正常椎体前方高度比):甲组87%,乙组73%,P0.05。结论:经骨折椎体椎弓根螺钉短节段固定治疗胸腰段单椎体粉碎性骨折能提供更好的生物力学稳定性,更有利于骨折的复位和后凸畸形的纠正。     

浮选剂丁基黄原酸钠对草鱼早期发育阶段的毒性效应

丁基黄原酸钠是一种金属矿的浮选剂.作者研究了它对草鱼早期发育阶段(孵化、存活、生长、畸形等)的毒性效应.结果表明,丁基黄原酸钠对草鱼胚胎96h的半致死浓度为17.8mg/L,致畸半效应浓度为8.85mg/L,当浓度为24mg/L时,其胚胎的孵化率仅为38.8%,对生长有影响的浓度为5.6-10.0mg/L,浓度在5.6mg/L就可诱发畸形.丁基黄原酸钠对草鱼胚胎具有强烈的致崎作用,崎形的主要症状为弯体和体表瘤状赘生物.       

Halo-vest辅助下前路手术治疗严重颈椎结核伴后凸畸形

目的：探讨使用halo-vest支具牵引复位并通过前路手术治疗严重颈椎结核并后凸畸形的方法和疗效。方法：通过对2004年10月至2010年9月在我科住院治疗的14例严重颈椎结核并后凸畸形的患者进行回顾性研究。本组患者中男8例,女6例,术前颈椎后凸Cobb角24-42°,平均34°。术前使用四联抗结核药物治疗2-4周,通过Halo-vest支具牵引复位。纠正颈椎后凸畸形后,采用一期前路手术治疗。手术处理包括：结核病灶清除、自体髂骨植骨或钛网植入、颈前路钢板内固定。术后继续抗结核治疗12-24个月。结果：术后随访12-48个月,平均26个月。所有颈椎结核并后凸畸形的患者都能通过halo-vest支具牵引恢复基本的颈椎序列,并能很好地耐受手术。术后患者局部疼痛和全身结核中毒症状明显缓解,神经功能均较术前有所恢复,后凸畸形得到矫正。术后3-6个月植骨融合,无内固定及伤口并发症,无严重halo-vest支具相关并发症,无结核复发。结论：对于严重颈椎结核并后凸畸形的患者,术前通过halo-vest支具牵引复位,可矫正畸形,恢复颈椎正常生理序列,为后期手术治疗创造条件并降低术中复位可能引起的脊髓损伤风险。Halo-vest辅助下的前路手术是治疗严重颈椎结核伴后凸畸形的有效手段。     

Change in kyphosis does not affect the risk of falling in postmenopausal osteopenic and osteoporotic women

Objectives:To examine the influence of the annual change in kyphosis on the risk of falling in postmenopausal osteopenic and osteoporotic women.Methods:This prospective observational study included 498 postmenopausal Greek women over the age of 50, suffering from either osteoporosis or osteopenia. Data on age, height, weight, and self-reported falls were collected. Additionally, we evaluated the degree of the kyphosis angle, the balance, the mobility, the functionality and the handgrip strength on both hands of each subject using the Debrunner kyphometer, the Berg Balance Scale, the Timed-Up-and-Go test, the 30 Seconds Sit-to-Stand test and the Jamar Hydraulic Hand Dynamometer, respectively. All the above data were recorded at the baseline visit and the 12-month follow-up visit for each participant.Results:All examined variables presented a statistically significant change at the 12-month follow-up visit. Nevertheless, the annual change in kyphosis did not show any association with the risk of falling.Conclusion:No association was shown between the annual change in kyphosis and the risk of falling in postmenopausal osteopenic and osteoporotic women, nor bears any substantial prognostic value for future falls.     

The shape and mobility of the thoracic spine in asymptomatic adults – A systematic review of in vivo studies

A comprehensive knowledge of the thoracic shape and kinematics is essential for effective risk prevention, diagnose and proper management of thoracic disorders and assessment of treatment or rehabilitation strategies as well as for in silico and in vitro models for realistic applications of boundary conditions.After an extensive search of the existing literature, this study summarizes 45 studies on in vivo thoracic kyphosis and kinematics and creates a systematic and detailed database. The thoracic kyphosis over T1–12 determined using non-radiological devices (34°) was relatively less than measured using radiological devices (40°) during standing. The majority of kinematical measurements are based on non-radiological devices. The thoracic range of motion (RoM) was greatest during axial rotation (40°), followed by lateral bending (26°), and flexion (21°) when determined using non-radiological devices during standing. The smallest RoM was identified during extension (13°). The lower thoracic level (T8–12) contributed more to the RoM than the upper (T1–4) and middle (T4–8) levels during flexion and lateral bending. During axial rotation and extension, the middle level (T4–8) contributed the most. Coupled motion was evident, mostly during lateral bending and axial rotation. With aging, the thoracic kyphosis increased by about 3° per decade, whereas the RoM decreased by about 5° per decade for all load directions. These changes with aging mainly occurred in the lower region (T6–12). The influence of sex on thoracic kyphosis and the RoM has been described as partly contradictory. Obesity was found to decrease the thoracic RoM. Studies comparing standing, sitting and lying reported the effect of posture as significant.