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Sample records for fixated posterior chamber

  1. Anterior chamber fixation of a posterior chamber intraocular lens: A novel technique

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    A Sahap Kükner

    2014-01-01

    Full Text Available We aimed to evaluate the implantation of a posterior chamber intraocular lens (IOL in the anterior chamber (AC with the haptics passing through two iridectomies to the posterior chamber. A total of 33 eyes of 33 patients with inadequate posterior capsular support due to either previous aphakia or posterior capsular rupture during cataract extraction were included in the study. A double iridectomy was performed on all patients using a vitrectomy probe on the midperiphery of the iris. IOLs were implanted in the AC, and the haptics were passed through the iridectomies to the posterior chamber. The mean follow-up time was 25.3 months. AC hemorrhage occurred in five patients during the iridectomy procedure. Corneal edema was detected in eight of 14 patients with primary IOL insertions. Haptic dislocation was detected in only one patient. This technique may be a good alternative to scleral-fixated IOL implantation in eyes with aphakia.

  2. A knotless, one-haptic fixation of posterior chamber intraocular lenses: one-year results

    Institute of Scientific and Technical Information of China (English)

    Pipat; Kongsap

    2015-01-01

    AIM: To assess the results of a modified technique for scleral fixation of a posterior chamber intraocular lens(IOL) in eyes which had deficient of posterior capsular support.METHODS: This retrospective study was comprised of ten patients with deficient posterior capsular support who underwent one-haptic fixation of posterior chamber IOLs, between February 2010 and October 2011. IOL as implanted with one haptic supported on the capsular remnant and the other haptic drawn into the sulcus by anchoring suture without a knot. All patients were evaluated for pre- and postoperative visual acuity, lens centration, intra-and postoperative complications.RESULTS: A knotless, one-haptic fixation of posterior chamber IOLs has successfully been performed on ten eyes. All cases had inadequate capsular support(i.e. a capsular tear ranged from 5 to 7 clock hours). The average age was 74.25 ±8.87y(SD). The average postoperative uncorrected visual acuity was 0.51 log MAR.Complications included hyphema in one eye, a mild inflammatory reaction in the anterior chamber in two eyes, and a transient rise in IOP in one eye. Neither IOL tilt nor dislocation was observed and there were no later complications.CONCLUSION: In the presence of insufficient capsular support, a knotless, one-haptic fixation of posterior chamber IOLs is a safe and viable option which reduces the operation time, and minimizes postoperative suture-related complications.

  3. A knotless, one-haptic fixation of posterior chamber intraocular lenses: one-year results.

    Science.gov (United States)

    Kongsap, Pipat

    2015-01-01

    To assess the results of a modified technique for scleral fixation of a posterior chamber intraocular lens (IOL) in eyes which had deficient of posterior capsular support. This retrospective study was comprised of ten patients with deficient posterior capsular support who underwent one-haptic fixation of posterior chamber IOLs, between February 2010 and October 2011. IOL as implanted with one haptic supported on the capsular remnant and the other haptic drawn into the sulcus by anchoring suture without a knot. All patients were evaluated for pre- and postoperative visual acuity, lens centration, intra-and postoperative complications. A knotless, one-haptic fixation of posterior chamber IOLs has successfully been performed on ten eyes. All cases had inadequate capsular support (i.e. a capsular tear ranged from 5 to 7 clock hours). The average age was 74.25±8.87y (SD). The average postoperative uncorrected visual acuity was 0.51 logMAR. Complications included hyphema in one eye, a mild inflammatory reaction in the anterior chamber in two eyes, and a transient rise in IOP in one eye. Neither IOL tilt nor dislocation was observed and there were no later complications. In the presence of insufficient capsular support, a knotless, one-haptic fixation of posterior chamber IOLs is a safe and viable option which reduces the operation time, and minimizes postoperative suture-related complications.

  4. Evaluation of pars plana sclera fixation of posterior chamber intraocular lens

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    Fangju Han

    2014-01-01

    Full Text Available Purpose: The purpose of this study was to evaluate the clinical efficacy and safety of modified posterior chamber intraocular lens (PCIOL implantation with transscleral fixation. Design and Setting: This is a study, which is conducted at Department of Ophthalmology, Jinan Eye Hospital, Jinan Second People′s Hospital. Materials and Methods: A total of 82 patients who were scheduled for sutured PCIOL were divided randomly into modified and conventional groups. The former underwent PCIOL through pars plana fixation with knot buried and without scleral flap and the latter underwent transscleral fixation of PCIOL in the ciliary sulcus. The main outcome measures included operative time, postoperative visual acuity, and postoperative complications. Results: The mean operative time of the modified group was 39.95 ± 5.87 min, which was significantly less than that of the conventional group (45.77 ± 5.21 min; P < 0.05. No difference was found in postoperative visual acuity between the two groups. There were no significant postoperative complications, including knot exposure, endophthalmitis, and retinal detachment in either group. The optical clamping of PCIOL was prone to occur in the conventional group. Conclusion: Modified sutured PCIOL implantation is a safe, effective, and feasible technique for the correction of aphakia in eyes without adequate posterior capsular support.

  5. Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration

    OpenAIRE

    Ertugrul Can; Nurullah Koçak; Özlem Eski Yücel; Adem Gül; Hilal Eser Öztürk; Osman Sayin

    2016-01-01

    Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL). Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postope...

  6. Iris-fixated anterior chamber phakic intraocular lens for myopia moves posteriorly with mydriasis.

    NARCIS (Netherlands)

    Cruysberg, L.P.J.; Doors, M.; Berendschot, T.T.; Brabander, J. De; Webers, C.A.; Nuijts, R.M.

    2009-01-01

    PURPOSE: To elucidate the physiological characteristics of eyes implanted with iris-fixated anterior chamber phakic intraocular lenses (pIOLs), which are increasingly being used for the correction of higher myopic and hyperopic refractive errors. METHODS: In a case series of 20 patients (39 eyes), t

  7. Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration

    Science.gov (United States)

    Can, Ertuğrul; Koçak, Nurullah; Yücel, Özlem Eşki; Gül, Adem; Öztürk, Hilal Eser; Sayın, Osman

    2016-01-01

    Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL). Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postoperatively. Corrected distant and near visual acuities of the patients were improved. There was no significant postoperative complication. In the follow-up period of 1 year, no evidence of suture erosion was found. Conclusions: Ab-interno scleral suture loop fixation with hitch-cow knot in the eye was effective in repositioning decentered or subluxated PC IOLs with excellent postoperative centered lenses and visual outcomes. PMID:27050346

  8. Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration

    Directory of Open Access Journals (Sweden)

    Ertugrul Can

    2016-01-01

    Full Text Available Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL. Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postoperatively. Corrected distant and near visual acuities of the patients were improved. There was no significant postoperative complication. In the follow-up period of 1 year, no evidence of suture erosion was found. Conclusions: Ab-interno scleral suture loop fixation with hitch-cow knot in the eye was effective in repositioning decentered or subluxated PC IOLs with excellent postoperative centered lenses and visual outcomes.

  9. Primary and secondary implantation of scleral-fixated posterior chamber intraocular lenses in adult patients

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    Zuleyha Yalniz-Akkaya

    2014-01-01

    Conclusion: Both primary and secondary scleral-fixated PCIOL implantations can provide favorable visual outcomes with lower complication rates. An important consideration is the appropriate timing for scleral fixation, taking into account the patient′s characteristics and the course of the operation.

  10. [Iris suture fixation of posterior-chamber elastic intraocular lens in ligament apparatus laxity].

    Science.gov (United States)

    Pashtaev, N P; Bat'kov, E N; Zotov, V V

    2010-01-01

    An original MIOL-23 multifocal elastic intraocular lens (IOL) was used to operate 5 eyes with acquired lens dislocation and traumatic cataract. By making self-sealing tunnel incision, ILO was implanted into the capsular sac and sutured to the iris. MIOL-23 implantation caused an increase in mean visual acuity. The IOL took up a correct position. Elastic IOL implantation with iris suture fixation is an efficient and safe mode of additional ILO support.

  11. [Endoscopically controlled optimization of trans-scleral suture fixation of posterior chamber lenses in the ciliary sulcus].

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    Althaus, C; Sundmacher, R

    1993-08-01

    Two technical difficulties have to be overcome in transscleral suture fixation of posterior chamber intraocular lenses (PCL) in the ciliary sulcus: first, exact needle penetration through the sulcus, and second, exact positioning of the PCL haptics in the sulcus. Incongruence of the two may lead to long-term complications by compression or even strangulation of ciliary processes. Intraocular endoscopy was used intraoperatively to visualize the site of needle penetration and the final location of the haptics in patients. It turned out that with our previously described standard techniques the precision was far less than anticipated. Thus, new technical ways had to be sought to improve the precision of positioning. In secondary implantation without perforating keratoplasty we achieved the best results when the needle was passed ab externo before opening the eye and before anterior vitrectomy, taking advantage of a precisely prepared sclerocorneal zone. Passing the needle ab externo in an already hypotonic eyeball gives much less precise results. In combination with perforating keratoplasty with an open-sky approach, needle penetration ab interno is reliable. Correct positioning of the PCL haptics is at least as difficult as correct needle penetration, a fact which up to now has mostly been ignored. In 33 consecutively operated eyes the technique of implantation and PCL design was varied under endoscopical control.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Simulation of airbag impact on eyes with different axial lengths after transsclerally fixated posterior chamber intraocular lens by using finite element analysis

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    Huang J

    2015-02-01

    Full Text Available Jane Huang,1 Eiichi Uchio,1 Satoru Goto2 1Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, 2Nihon ESI KK Technical Division, Tokyo, Japan Purpose: To determine the biomechanical response of an impacting airbag on eyes with different axial lengths with transsclerally fixated posterior chamber intraocular lens (PC IOL.Materials and methods: Simulations in a model human eye were performed with a computer using a finite element analysis program created by Nihon, ESI Group. The airbag was set to be deployed at five different velocities and to impact on eyes with three different axial lengths. These eyes were set to have transsclerally fixated PC IOL by a 10-0 polypropylene possessing a tensile force limit of 0.16 N according to the United States Pharmacopeia XXII.Results: The corneoscleral opening was observed at a speed of 40 m/second or more in all model eyes. Eyes with the longest axial length of 25.85 mm had the greatest extent of deformity at any given impact velocity. The impact force exceeded the tensile force of 10-0 polypropylene at an impact velocity of 60 m/second in all eyes, causing breakage of the suture. Conclusion: Eyes with transsclerally fixated PC IOL could rupture from airbag impact at high velocities. Eyes with long axial lengths experienced a greater deformity upon airbag impact due to a thinner eye wall. Further basic research on the biomechanical response for assessing eye injuries could help in developing a better airbag and in the further understanding of ocular traumas. Keywords: airbag, ocular trauma, computer simulation, transsclerally fixated posterior chamber intraocular lens, finite element analysis

  13. Fixação iriana de lentes de câmara posterior para o tratamento da afacia Iris fixation of posterior chamber intraocular lenses for the treatment of aphakia

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    Ana Luiza Lise Ferreira

    2009-10-01

    Full Text Available OBJETIVO: avaliar os resultados de uma série de casos de fixação iriana de lentes intra-oculares de câmara posterior para correção de afacia, realizados no setor de catarata da disciplina de Oftalmologia da Faculdade de Medicina do ABC e compará-los a literatura existente. MÉTODOS: estudo prospectivo de oito pacientes afácicos, que apresentavam ausência de suporte capsular adequado e foram submetidos à cirurgia para implante secundário de LIO de câmara posterior com fixação iriana seguindo a técnica modificada de McCannel. RESULTADOS: sete dos oito pacientes (87,5% que não tiveram complicações cirúrgicas obtiveram melhora na acuidade visual corrigida. Um paciente (12,5% apresentou complicação intra-operatória, evoluindo com ceratopatia bolhosa do pseudofácico. Um paciente (12,5% apresentou glaucoma secundário à dispersão pigmentar. CONCLUSÃO: em nosso estudo a técnica de fixação iriana de câmara posterior se mostrou eficaz e segura para o tratamento da afacia, em concordância com os dados da literatura.PURPOSE: evaluate the results of a case series of iris-sutured posterior chamber IOLs for the correction of aphakia in the cataract sector of the department of Ophthalmology of the ABC School of Medicine and compare them with the existing data. METHODS: prospective study of eight patients who underwent foldable IOL implantation using modified McCannel iris suture fixation for aphakia in the absence of capsule support. RESULTS: seven of eight patients (87,5% without surgical complications improved their best corrected visual acuity. One patient (12,5% with surgical complication developed pseudophakic bullous keratopathy. One patient (12,5% developed secondary glaucoma caused by dispersion syndrome. CONCLUSION: in our study the iris-sutured posterior chamber IOLs prove to be safe and effective in the treatment of aphakia, in accordance with existing data.

  14. Posterior transodontoid fixation: A new fixation (Kotil technique

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    Kadir Kotil

    2011-01-01

    Full Text Available Anterior odontoid screw fixation or posterior C1-2 fusion techniques are routinely used in the treatment of Type II odontoid fractures, but these techniques may be inadequate in some types of odontoid fractures. In this new technique (Kotil technique, through a posterior bilateral approach, transarticular screw fixation was performed at the non-dominant vertebral artery (VA side and posterior transodontoid fixation technique was performed at the dominant VA side. C1-2 complex fusion was aimed with unilateral transarticular fixation and odontoid fixation with posterior transodontoid screw fixation. Cervical spinal computed tomography (CT of a 40-year-old male patient involved in a motor vehicle accident revealed an anteriorly dislocated Type II oblique dens fracture, not reducible by closed traction. Before the operation, the patient was found to have a dominant right VA with Doppler ultrasound. He was operated through a posterior approach. At first, transarticular screw fixation was performed at the non-dominant (left side, and then fixation of the odontoid fracture was achieved by directing the contralateral screw (supplemental screw medially and toward the apex. Cancellous autograft was scattered for fusion without the need for structural bone graft or wiring. Postoperative cervical spinal CT of the patient revealed that stabilization was maintained with transarticular screw fixation and reduction and fixation of the odontoid process was achieved completely by posterior transodontoid screw fixation. The patient is at the sixth month of follow-up and complete fusion has developed. With this new surgical technique, C1-2 fusion is maintained with transarticular screw fixation and odontoid process is fixed by concomitant contralateral posterior transodontoid screw (supplemental screw fixation; thus, this technique both stabilizes the C1-2 complex and fixes the odontoid process and the corpus in atypical odontoid fractures, appearing as an

  15. Nueva variante de abordaje al surco ciliar en la fijación transescleral de lentes de cámara posterior New variant of approach to the ciliary sulcus in the transcleral fixation of posterior chamber lens

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    Ileana Vila Dópico

    2002-06-01

    Full Text Available Se expone una variante de abordaje al surco ciliar para la fijación del lente intraocular de cámara posterior, que está a nuestro alcance, en pacientes en que no existe soporte capsular o este es insuficiente. Se describe la técnica. Se realizó en 17 pacientes de los que se obtuvo mejoría visual en todos los casos (20/50-20/20 con un seguimiento promedio de 12 meses. Esta variante tiene la ventaja de evitar el paso de la aguja por el surco ciliar a ciegas, pues se utiliza el abordaje a través de la esclera y con ello evitamos dañar estructuras oculares aledañas evitando el riesgo de complicaciones por lo que se logra la recuperación anatómica y funcional en todos los casos.A variant to approach the ciliary sulcus for fixating the posterior chamber intraocular lens, which is within our reach, in patients with insufficient or no capsular support, is explained. The technique is described here and it was applied to 17 patients. Visual improvement was obtained in all cases (20/50-20/20 with an average follow-up of 12 months. This variant allows to prevent the blind passage of the needle through the ciliary sulcus, since it is approached via the sclera, avoiding to damage adjoining ocular structures and to have complications, and making possible the anatomic and functional recovery of all patients.

  16. Primary Posterior Chamber Intraocular Lens Implantation in Traumatic Cataract With Posterior Capsule Breaks

    Institute of Scientific and Technical Information of China (English)

    YupingZou; WenhuiYang

    1995-01-01

    Background:In patients with incomplete posterior capsule support,posterior chamber intraocular lenses(PC-IOLs)were implanted with both haptics transs-cleral fixation.This causes more damage to the eye and may result in more com-plications,In patients with small posterior breaks,non-fixation or single haptic fixation may be adequate.Methods:Thiry-two consecutive patients of traumatic cataract with posterior capsule breaks caused by penetrating eye trauma were retospected.Posterior chamber intraocular lenses were implanted in all these patients with three tech-niques,ie,without fixation,with single haptic fixation and with both haptics fixation .The selection of the technique was based on the position and size of the posterior capsule.The follow-up period was 21days to 28months(mean,15.2months).Results:Intra-operative problems included ciliary body bleeding(Two patents,6.25%)and enlargement of posterior capsule breaks(2patients,6.25).Postoperative visual acuity was0.5or better(Corrected)in28case(87.5%)and 0.1-0.4in four patients(12.5%),Postoperative complications included hyphema(6eyes,18.8%),transient intraocular pressure elevation(6eyes,18.8%),transient hypotention(7eyes,21.8%).Postoperative IOL position were good except one case of IOL tilt.No pupillary capture or endophthalmitis was found.Conclusions:Not all PC-IOLs have to be fixed by two haptics.In patients with small posterior capsule breaks,PC-IOLmay not be fixed or fixed by only one haptics.Eye Science1995;11:140-142.

  17. Finite element analysis of posterior cervical fixation.

    Science.gov (United States)

    Duan, Y; Wang, H H; Jin, A M; Zhang, L; Min, S X; Liu, C L; Qiu, S J; Shu, X Q

    2015-02-01

    Despite largely, used in the past, biomechanical test, to investigate the fixation techniques of subaxial cervical spine, information is lacking about the internal structural response to external loading. It is not yet clear which technique represents the best choice and whether stabilization devices can be efficient and beneficial for three-column injuries (TCI). The different posterior cervical fixation techniques (pedicle screw PS, lateral mass screw LS, and transarticular screw TS) have respective indications. A detailed, geometrically accurate, nonlinear C3-C7 finite element model (FEM) had been successfully developed and validated. Then three FEMs were reconstructed from different fixation techniques after C4-C6 TCI. A compressive preload of 74N combined with a pure moment of 1.8 Nm in flexion, extension, left-right lateral bending, and left-right axial rotation was applied to the FEMs. The ROM results showed that there were obvious significant differences when comparing the different fixation techniques. PS and TS techniques can provide better immediate stabilization, compared to LS technique. The stress results showed that the variability of von Mises stress in the TS fixation device was minimum and LS fixation device was maximum. Furthermore, the screws inserted by TS technique had high stress concentration at the middle part of the screws. Screw inserted by PS and LS techniques had higher stress concentration at the actual cap-rod-screw interface. The research considers that spinal surgeon should first consider using the TS technique to treat cervical TCI. If PS technique is used, we should eventually prolong the need for external bracing in order to reduce the higher risk of fracture on fixation devices. If LS technique is used, we should add anterior cervical operation for acquire a better immediate stabilization. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Posterior Chamber Hemorrhage during Fluorescein Angiography

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    Manuel A. P. Vilela

    2015-01-01

    Full Text Available This paper provides the first reported case of acute posterior chamber hemorrhage during fluorescein angiography (FA. This is a case review with serial color photographs of the anterior segment. A 76-year-old male was referred for angiographic control of age-related macular degeneration. He was pseudophakic OU, BCVA 20/40 OU. He had mild hypertension, but not diabetes. He had had two previous angiograms without adverse effects. Difficulty was experienced in obtaining the images owing to a progressive reduction in the transparency of the media. A dense hemorrhage in the posterior chamber of the right eye was found, involving the visual axis. Thorough biomicroscopy, gonioscopy, and ultrasonic biomicroscopy showed that part of one of the haptics of the right intraocular lens (IOL was touching and tearing the posterior face of the iris, without any visible synechiae, iris, or angle neovascularization. Anterior segment FA and posterior ultrasonography were normal. No similar case has been described in the literature involving dense progressive bleeding located in the capsular bag and posterior chamber, without any detectable triggering ocular event other than mydriasis and fluorescein injection. Contact of the iris or sulcus with part of the intraocular lens, aggravated by the intense use of mydriatics during the FA procedure, probably caused bleeding to happen.

  19. Pars plana cicatrization of sewn-in posterior chamber intraocular lens haptics.

    Science.gov (United States)

    McDermott, M L; Puklin, J E

    1997-03-01

    The authors describe the unexpected finding of cicatrization of posterior chamber lens haptics to the pars plana. This was found during removal of a secondary, transscleral sewn-in pseudophakos during a retinal reattachment procedure. Ophthalmic history and intraoperative photography revealed pars plana cicatrization of haptics. Despite removal of trans-scleral prolene fixation sutures and application of gentle traction, the posterior chamber lens haptics remained firmly adherent to pars plana retina. The haptics were amputated to prevent significant chorioretinal damage. The conventional belief that all sewn-in posterior chamber intraocular lenses cause little or no scarring response around the haptics may be unfounded.

  20. 小切口三片式折叠人工晶状体睫状沟悬吊术疗效观察%Small-incision transscleral sulcus fixation of posterior chamber intraocular three pieces of types lens implantation

    Institute of Scientific and Technical Information of China (English)

    白华; 黄耀辉; 何涛

    2011-01-01

    Objective To study and assessment the effectiveness and feasibility of small-incision transscleral sulcus fixation with posterior chamber intraocular three pieces of types lens.Methods Forty-three patients ( 43 eyes ) with zonule abnormity or posterior capsule rupture were performed intraocular lens implantation through corneal incision, and pre-fixed with polypropylene suture followed by three pieces of type lens foldable intraocular fixed in sulcus by injector.Results The uncorrected visual acuity of all operated eyes were improved.After 1 week, there were 12 eyes in 1.0, 16 eyes in 0.6 ~ 0.8,15 eyes in 0.4 ~ 0.6, and there were 16 eyes in 1.0, 18 eyes in 0.6 ~ 0.8, 9 eyes in 0.4 ~ 0.6 after 3 months.The mean astigmatism was 1.15D ± 0.75D ( 1 week ) and 0.75D ± 0.35D ( 3 months ) respectively, with the eye pressure was ( 16 ± 3 )mmHg( 1 week ) and ( 18 ± 8 )mmHg( 3 months ), and no statistical significant compared with pre-operation( P > 0.05 ).Besides, there were no significant severely complications intra-and post-operation.Conclusion It demonstrated that the smallincision transscleral sulcus fixation with posterior chamber intraocular three pieces of types lens had less complications, small astigmatism, which proved the potential to be widely applied.%目的 探讨小切口植入三片式折叠人工晶状体,并悬吊于睫状沟的有效性和实用性.方法 选择因晶状体后囊破裂或悬韧带断裂不能正常植入后房型人工晶状体的患者43例(43只眼),利用推注器系统,通过透明角膜小切口,把襻预扎了聚丙烯缝线的三片式折叠人工晶状体植入后房,由缝线固定于睫状沟.结果 所有患者术后裸眼视力均提高,术后1周12只眼1.0,16只眼0.6~0.8,15只眼0.4~0.6;术后3个月16只眼1.0,18只眼0.6~0.8,9只眼0.4~0.6.术后1周及3个月平均散光分别为1.15D+0.75D和0.75D±0.35D,眼压分别为(16±3)mmHg和(18±8)mmHg,与术前比较均无统计学意义(P>0.05),术中

  1. Fixação iriana de lentes de câmara posterior para o tratamento da afacia Iris fixation of posterior chamber intraocular lenses for the treatment of aphakia

    OpenAIRE

    Ana Luiza Lise Ferreira; Leonardo Verri Paulino; Jose Ricardo Carvalho Lima Rehder

    2009-01-01

    OBJETIVO: avaliar os resultados de uma série de casos de fixação iriana de lentes intra-oculares de câmara posterior para correção de afacia, realizados no setor de catarata da disciplina de Oftalmologia da Faculdade de Medicina do ABC e compará-los a literatura existente. MÉTODOS: estudo prospectivo de oito pacientes afácicos, que apresentavam ausência de suporte capsular adequado e foram submetidos à cirurgia para implante secundário de LIO de câmara posterior com fixação iriana seguindo a ...

  2. Pupillary block glaucoma following implantation of a posterior chamber pseudophakos in the anterior chamber.

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    Mandal Anil

    2002-01-01

    Full Text Available Pupillary block glaucoma is a common complication of cataract surgery, especially following anterior chamber intraocular lens implantation. We report a case of pupillary block glaucoma with a posterior chamber IOL that was implanted in the anterior chamber following a complicated extracapsular cataract extraction. The case was successfully managed by explantation of the posterior chamber lens, anterior vitrectomy, peripheral iridectomy and secondary anterior chamber intraocular lens implantation. The intraocular pressure was controlled with a single topical antiglaucoma medication.

  3. Posterior fixation suture and convergence excess esotropia.

    Science.gov (United States)

    Steffen; Auffarth; Kolling

    1998-09-01

    The present study investigates the results of Cuppers' 'Fadenoperation' in patients with non-accommodative convergence excess esotropia. Particular attention is given to postoperative eye alignment at distance fixation. Group 1 (n=96) included patients with a 'normal' convergence excess. The manifest near angles (mean ET 16.73 degrees +/- 6.33 degrees, range 4 degrees -33 degrees ) were roughly twice the size of the distance angles (mean ET 6.50 degrees +/- 3.62 degrees, range 0 degrees -14 degrees ). These patients were treated with a bilateral fadenoperation of the medial recti without additional eye muscle surgery. Three months after surgery, the mean postoperative angles were XT 0.5 degrees +/- 3.3 degrees (range XT 11 degrees -ET 5 degrees ) for distance fixation, and ET 2.7 degrees +/- 3.6 degrees (range XT 5 degrees -ET 14 degrees ) for near fixation, respectively. Postoperative convergent angles at near fixation >ET 10 degrees were present in two patients (1.9%). Group 2 (n=21) included patients with a mean preoperative distance angle of ET 9.2 degrees +/- 3.7 degrees (range 6 degrees -16 degrees ) and a mean preoperative near angle of ET 23.4 degrees +/- 3.1 degrees (range 16 degrees -31 degrees ). These patients were operated on with a bilateral fadenoperation of the medial recti and a simultaneous recession of one or both medial rectus muscles. Mean postoperative angles were XT 0.5 degrees +/- 4.6 degrees (range XT 12 degrees -ET 7 degrees ) for distance fixation and ET 1.4 degrees +/- 4.5 degrees (range XT 8 degrees -ET 13 degrees ) for near fixation, respectively. In this group, 2 patients (10.6%) had a postoperative exotropia >XT 5 degrees at distance fixation, and two patients had residual esotropia>ET 10 degrees at near fixation. Group 3 (n=17) included patients with a pronounced non-accommodative convergence excess. Near angle values (mean of 17.8 degrees +/- 5.3 degrees, range ET 7 degrees -26 degrees ) were several times higher than the distance

  4. Posterior Chamber IOL Implantation in Traumatic Cataract with Injured Complications

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications were discussed.Seventy-two percent of patients have the correctvision over 20/40.It is suggested that the posterior chamber IOL can be im-planted in traumatic cataract with some injured complications.EYE SCIENCE1992;8:111-112.

  5. The Relation of the Location of Haptics of Posterior Chamber Intraocular Lenses and Peripheral Anterior Synechia

    Institute of Scientific and Technical Information of China (English)

    RuiduanLiao; ShaozhenLi

    1995-01-01

    Purpose:To investigate the occurrence,outcome and influencial factors of the pe-ripheral anterior synechia(PAS)following implantation of posterior chamber in-traocular lenses for finding a way to reduce thePAS.Subjects;40 eyes of 38senile cataract patients with normal chamber angle and in-traocular pressue(IOP)preoperatively were examined.Methods:Extracapsular cataract extraction was performed under microscope with insertion of a posterior chamber lens implant vaulted anteriorly by 10°.Go-nioscopy and slit-lamp examination and photography of the operated eyes were performed 3to 6months postoperatively.Results:PAS were found in 20(50%)of the 40eyes.Among the 20eyes with PAS the locations of 23haptics in17eyes corresponded with those of the PAS.PAS were seen more frequently with vertically sulcus-fixated haptics than with the horizontally capsular-fixated haptics.showing a significant difference(P<0.05).88%of the eyes withPAS had pupillary edformation,but their visual acuities and IOP were not affected.Conclusions:PAS is more likely to occur with vertically sulcus-fixated IOL.Rotat-ing the capsular-fixated haptics to the horizontal position may reduce the inci-dence of PAS.Gonioscopy should be a routine follow-up examination.

  6. Abnormalities of fixation, saccade and pursuit in posterior cortical atrophy.

    Science.gov (United States)

    Shakespeare, Timothy J; Kaski, Diego; Yong, Keir X X; Paterson, Ross W; Slattery, Catherine F; Ryan, Natalie S; Schott, Jonathan M; Crutch, Sebastian J

    2015-07-01

    The clinico-neuroradiological syndrome posterior cortical atrophy is the cardinal 'visual dementia' and most common atypical Alzheimer's disease phenotype, offering insights into mechanisms underlying clinical heterogeneity, pathological propagation and basic visual phenomena (e.g. visual crowding). Given the extensive attention paid to patients' (higher order) perceptual function, it is surprising that there have been no systematic analyses of basic oculomotor function in this population. Here 20 patients with posterior cortical atrophy, 17 patients with typical Alzheimer's disease and 22 healthy controls completed tests of fixation, saccade (including fixation/target gap and overlap conditions) and smooth pursuit eye movements using an infrared pupil-tracking system. Participants underwent detailed neuropsychological and neurological examinations, with a proportion also undertaking brain imaging and analysis of molecular pathology. In contrast to informal clinical evaluations of oculomotor dysfunction frequency (previous studies: 38%, current clinical examination: 33%), detailed eyetracking investigations revealed eye movement abnormalities in 80% of patients with posterior cortical atrophy (compared to 17% typical Alzheimer's disease, 5% controls). The greatest differences between posterior cortical atrophy and typical Alzheimer's disease were seen in saccadic performance. Patients with posterior cortical atrophy made significantly shorter saccades especially for distant targets. They also exhibited a significant exacerbation of the normal gap/overlap effect, consistent with 'sticky fixation'. Time to reach saccadic targets was significantly associated with parietal and occipital cortical thickness measures. On fixation stability tasks, patients with typical Alzheimer's disease showed more square wave jerks whose frequency was associated with lower cerebellar grey matter volume, while patients with posterior cortical atrophy showed large saccadic intrusions

  7. [Intraocular lenses for the correction of refraction errors. Part II. Phakic posterior chamber lenses and refractive lens exchange with posterior chamber lens implantation].

    Science.gov (United States)

    Kohnen, T; Kasper, T; Terzi, E

    2005-11-01

    In this overview, the current status of intraocular lens surgery to correct refractive error is reviewed. The interventions are divided into additive surgery with intraocular lens implantation without extraction of the crystalline lens (phakic intraocular lens, PIOL) or removal of the crystalline lens with implantation of an IOL (refractive lens exchange, RLE). Phakic IOLs are constructed as angle-supported or iris-fixated anterior chamber lenses and posterior chamber lenses which are fixated in the ciliary sulcus. The implantation of phakic IOLs has been demonstrated to be an effective, safe, predictable and stable procedure to correct higher refractive errors. Complications are rare and differ for the three types of PIOL; for posterior chamber lenses these are mainly cataract formation and pigment dispersion. RLE is preferable in cases of high ametropia in which the natural lens has lost its accommodative effect. The main complications for myopic RLA include retinal detachment, while hyperopic refractive lens exchange may be associated with surgical problems in the narrower anterior eye segment.

  8. Implantation of foldable posterior chamber intraocular lens in aphakic vitrectomized eyes without capsular support

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    Gurkan Erdogan

    2016-06-01

    Full Text Available ABSTRACT Purpose: To evaluate the outcomes of three different surgical techniques for foldable posterior chamber intraocular lens (PCIOL implantation in vitrectomized eyes without capsular support. Methods: A total of 60 patients with aphakic and vitrectomized eyes without capsular support were enrolled. All patients underwent three-piece foldable PCIOL implantation into the posterior chamber through a small corneal incision. Transscleral fixation (TSF, iris fixation (IF, and intrascleral tunnel fixation (ISF surgical techniques were performed. Results: Postoperative PCIOL subluxation or dislocation occurred in one case in the TSF group and two cases in the ISF group. Intraoperative PCIOL dislocation occurred in two patients in the IF group. The incidence of temporary postoperative complications, such as mild intraocular hemorrhage and cystoid macular edema, was higher in the ISF group. No statistically significant difference in PCIOL-related astigmatism was observed between groups. Visual acuity improved in all groups. Conclusions: Postoperative outcomes were comparable between TSF, IF, and ISF for PCIOL in vitrectomized eyes without capsular support.

  9. Posterior atlantoaxial transpedicle screw fixation for traumatic atlatoaxial instability

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    Zheng-lei WANG

    2015-10-01

    Full Text Available Objective To explore the clinical efficacy of posterior atlantoaxial pedicle screw fixation for traumatic atlantoaxial instability. Methods From September 2009 to March 2013, 17 patients with atlantoaxial instability received posterior atlantoaxial pedicle screw fixation. There were 12 males and 5 females, with a mean age of 42 years old (ranged from 19 to 63 years old. Transpedicle screw fixation was employed in 8 patients with atlantoaxial fracture and dislocation, in 2 with traumatic disruption of transverse atlantal ligament, and in 7 with odontoid fracture. The Japanese Orthopaedic Association (JOA score before operation was from 5 to 14, with a mean of 11.2. Preoperative CT, MRI and radiographs, as well as intraoperative screw placement and bone graft were administered in all the patients. Results In all the patients, complete reduction was achieved without injury to the vertebral artery, spinal cord or never root, and they started to be ambulatory on the first day after the operation. The patients were followed up for 6-36 months (mean 21 months, and clinical symptoms were seen to be improved significantly. Imaging reexamination 6 months after the surgery showed satisfactory healing of implanted bone and position of all the screws without loosening of the implant. The mean JOA scores was 15.5(11.0-17.0 twelve months after the operation. Conclusion Atlantoaxial pedicle screw fixation for traumatic atlantoaxial instability is safe and reliable with a favorable clinical result. DOI: 10.11855/j.issn.0577-7402.2015.09.14

  10. 晶状体半脱位白内障术中两类折叠型 lOL做悬吊术的疗效比较%Observation of two types of foldable scleral - fixated posterior chamber intraocular lens to treat cataract dislocation

    Institute of Scientific and Technical Information of China (English)

    邓芳祝; 邝国平

    2014-01-01

    AlM:To observe the clinical efficacy of two types of scleral-fixated posterior chamber intraocular lens ( lOL ) combined intra-capsule lens extraction to treat cataract dislocation. METHODS: After intra - capsule lens extraction of dislocated cataract, two types of lOL were used as scleral-fixated posterior chamber lOL . First group was with four seal loops, the second group was with two open loops. All 21 patients (23 eyes) took the examination of the best corrected visual acuity, intraocular pressure, fundus, and lOL decentration using camera system attached to slit - lamp ophthalmoscope and lOL tilted using ultrasound biomicroscopy (UBM) at 6mo after surgery.RESULTS: After 6mo, all patients had improved eye sight. There was significant difference in the mean lOL decentration between the two groups ( 0. 57mm vs 0. 79mm, P CONCLUSlON: lOL with four loops are more appropriate as scleral-fixated posterior chamber lOL with less tiltness and dicentration.%目的:探讨囊内摘除联合两类人工晶状体( intraocular lens,IOL)做悬吊术治疗晶状体半脱位白内障的临床疗效。  方法:晶状体半脱位患者21例23眼,行晶状体囊内摘除前部玻璃体切割联合IOL悬吊术,依植入IOL类别分为四个闭合襻IOL组和两个C襻IOL组,术后观察视力、眼压、综合验光、眼底,6mo时裂隙灯眼前节摄像系统拍照确定 IOL 偏心值,超声生物显微镜( ultrasound biomicroscopy,UBM)检查确定IOL的倾斜度检查。  结果:所有患眼术后视力均有不同程度的提高。四襻组IOL平均偏心为0.57mm,两襻组平均偏心0.79mm;四襻组IOL平均倾斜度为6°,两襻组平均倾斜度11°,两组间差异均有统计学意义(P  结论:晶状体半脱位术中四个闭合襻IOL做悬吊术后居中性更好,IOL倾斜度更小。

  11. Posterior Iris Fixated Intraocular Lens for Pediatric Traumatic Cataract

    Science.gov (United States)

    Kavitha, V.; Balasubramanian, Preethi; Heralgi, Mallikarjun M.

    2016-01-01

    Purpose: To evaluate the postoperative visual outcomes and complications of posterior iris fixated intraocular lens (IFIOL) implantation for pediatric traumatic cataract. Methods: A retrospective clinical audit was performed of all the pediatric traumatic cataract patients who underwent lens removal and iris fixated lens implantation due to inadequate capsular support with or without corneal tear repair between January 2009 and December 2013. Data were collected and analyzed on the preoperative and postoperative visual outcomes and complications. Results: Twenty-five children (25 eyes; 21 males and 4 females) were enrolled with the mean age of 11 ± 4.0 years. There were 72% of eyes that underwent primary cataract removal with IFIOL implantation. Twenty-eight percent of eyes underwent corneal tear repair prior to intraocular lens (IOL) implantation. Preoperative best corrected visual acuity (BCVA) was hand motion in 32% eyes, counting fingers in 24%, and perception of light in 44%. Postoperative BCVA of 0-0.2 logarithm of minimum angle of resolution was reported in the 64% of eyes. One eye developed secondary glaucoma, one eye underwent re-enclavation, and none developed retinal complications. Conclusion: Posterior IFIOL implantation resulted in an improved visual outcome, low incidence of postoperative complications, and is a good alternative to other IOL, in the cases of pediatric traumatic cataract without adequate capsular support. PMID:27162456

  12. Posterior chamber phakic intraocular lens implantation for high myopia

    Institute of Scientific and Technical Information of China (English)

    沈晔; 杜持新; 顾扬顺; 王竞

    2003-01-01

    Objective To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens (PIOLs) implantation for the correction of high myopia.Methods Thirty-nine eyes of twenty patients with high myopia (between-11.75 and-25.75 diopters) had a posterior chamber PIOL (Staar ICL) implanted. During 6-48 months' follow-up, visual acuity, refraction, intraocular pressure (IOP), corneal reaction and space between crystal lens and intraocular lens (IOLs) were tested.Results Successful implantation was achieved in all patients. Visual acuity without correction greater than 0.5 was found in 34 eyes at 1 day and 3 months postoperatively. Thirty-five eyes maintained a low negative power of refraction (-1.42±1.32 doipters), which did not prevent the patients from most of their daily activities. During 3-48 months' follow-up, refraction was stable and no cornea edema and glaucoma was found. Two eyes of one patient had corticosteroid glaucoma and another eye showed cataractogenesis under anterior capsular membrane.Conclusion Posterior chamber PIOL implantation is predictable, safe, and effective in the correction of high myopia, and its indications should be carefully selected.

  13. [Posterior atlantoaxial fixation using vertex multiaxial screw system].

    Science.gov (United States)

    Zhong, Dejun; Song, Yueming

    2007-06-01

    This study aims to assess the effectiveness and advantages of Vertex multiaxial screw system in use for stabilizing the atlanto-axial junction. The entry point of the atlas was located 18-20 mm lateral to the midline and 2.0 mm superior to the inferior border of posterior arch, and the direction of screw was chosen to be about 10 degrees medial to the sagittal plane and about 5 degrees cephalad to the transverse plane. In odontoid vertebra (C2), the direction of the drill bit was guided directly by the medial and superior aspect of the individual C2 pedicle. All screws were placed properly without incidence of nerve or blood vessel injury, and no complication appeared in operation and after surgery. All cases were followed up for an average of 9 months, all cases achieved well reposition and fixation of atlantoaxial joint, average JOA grade was 9.6 before preoperation and 15.9 after operation. Fixation of the atlantoaxial complex using Vertex multiaxial screw system seemed to be a reliable technique and should be considered a good alternative in atlantoaxial fusion. The technique could be used in young patiens.

  14. Kestenbaum procedure with posterior fixation suture for anomalous head posture in infantile nystagmus

    OpenAIRE

    2009-01-01

    Background The purpose of this study was to report the effect of combining the Kestenbaum procedure with posterior fixation suture for infantile horizontal nystagmus with anomalous head posture (AHP) in children. Methods Nine consecutive patients who underwent combined Kestenbaum procedure plus posterior fixation suture to the recessed muscles at the same time were retrospectively studied. All patients were orthotropic before surgery and were followed for at least 6 months. Pre- and postopera...

  15. Step-by-step external fixation of unstable pelvis with separate anterior and posterior modules

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    Ivan Viktorovich Borozda

    2016-02-01

    Conclusions: The modular approach applied is the advantage of the transosseous osteosynthesis allowing for a separate anterior (anti-shock fixation and final posterior reposition of the pelvic ring preceded by the stabilization of vital functions. The above mentioned method gives an opportunity to increase the amount of techniques applied for the pelvic external fixation in polytrauma cases.

  16. Results of Posterior Chamber Lens Implantation for Correction of Myopia

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    Pınar Sorgun Evcili

    2012-10-01

    Full Text Available Pur po se: To evaluate the results of posterior chamber phakic intraocular lens implantation in myopic patients. Ma te ri al and Met hod: Posterior chamber phakic intraocular lens (STAAR ICL implantation was performed in 58 eyes of 33 patients with mean spherical equivalent of -13.12±5.31 diopters (D (-2.5 - -24.75 D between August 2007 and October 2010 at Dr. Lütfi Kırdar Kartal Training and Research Hospital, Second Eye Clinic. The mean age of the patients was 32.84 ± 9.95 years (18-55 years - 24 (72.7% were male and 9 (27.3% were female. The study was designed as prospective case series. The patients were evaluated regarding visual acuity, refraction, endothelial cell count, and complications in postoperative period. Re sults: The mean follow-up time was 21.5±4.9 (12-24 months months. The mean spherical equivalent was -1.29±1.53 D (-5.6 D - +2.60 D at the last postoperative follow-up visit. Visual acuity was better or equal to preoperative best-corrected value in 42 (72.4% of eyes at the last follow-up visit postoperatively. Mean spherical equivalent was regressed to -1.13±1.59D at 1-month and -1.39±1.53D at 24-month postoperative follow-up visit. Pupillary-block glaucoma in 1 eye (1.7%, anterior subcapsular opacification not affecting the vision in 4 eyes, and retinal detachment in 1 eye were detected at follow-up visits. Dis cus si on: ICL implantation was observed to be an effective and safe method for correction of myopia in two-year follow-up. As possible retinal complications may develop, the patients must be followed carefully during the preoperative and postoperative period. (Turk J Ophthalmol 2012; 42: 349-54

  17. Posterior chamber phakic intraocular lens implantation for high myopia

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    Yan Ju

    2013-12-01

    Full Text Available AIM:To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia.METHODS: Retrospective case review of 82 eyes (43 patients undergoing implantable Collamer lens (ICL placement by a single surgeon (Xiao-Wei Gao to correct preoperative mean spherical equivalents between -9.00 diopter (D and -23.00D. Main outcome measures included uncorrected visual acuity (UCVA, refraction, best spectacle-corrected visual acuity (BSCVA, endothelial cell density (ECD, intraocular pressure (IOP, lens transparency, postoperative uveitis. Visante anterior segment optical coherence tomography (AS-OCT was used to measure anterior chamber depth (ACD and the position of ICL.RESULTS:Mean follow-up was 6.54±3.26 months (range 3-12 months. Predictability of the manifest spherical equivalent (SE refraction to within ±1.00D was achieved in 88% of eyes and ±0.50D in 72.5% of eyes. The mean postoperative manifest SE refraction was -1.85±0.72D, with 96.34% of eyes maintaining or gaining ≥1 line(s of BSCVA. The mean 3-month postoperative ECD decreased but had no statistically difference compared with the preoperative ECD. Of the 7 eyes (8.54% with a mild transient increase in intraocular pressure (up to 30mmHg, none required a second surgical procedure or prolonged topical medication. There was no loss of lens transparency. Pigmented precipitates were observed in 5 eyes (6.09%. The mean preoperative ACD measured with AS-OCT was 3.28±0.14mm, three months after surgery, the mean ACD was 2.45±0.22mm. Anterior chamber depth showed a statistically significant reduction. One eye (1.22% had ICL spontaneous rotation, 81 eyes (98.78% of the lens remained correctly centered.CONCLUSION: The implantation of ICL is an effective surgical option for the management of high myopia. But its long time effect and safety still need more time to prove.

  18. Does prone repositioning before posterior fixation produce greater lordosis in lateral lumbar interbody fusion (LLIF)?

    Science.gov (United States)

    Yson, Sharon C; Sembrano, Jonathan N; Santos, Edward R G; Luna, Jeffrey T P; Polly, David W

    2014-10-01

    Retrospective comparative radiographic review. To determine if lateral to prone repositioning before posterior fixation confers additional operative level lordosis in lateral lumbar interbody fusion (LLIF) procedures. In a review of 56 consecutive patients who underwent LLIF, there was no statistically significant change in segmental lordosis from lateral to prone once a cage is in place. The greatest lordosis increase was observed after cage insertion. We reviewed 56 consecutive patients who underwent LLIF in the lateral position followed by posterior fixation in the prone position. Eighty-eight levels were fused. Disk space angle was measured on intraoperative C-arm images, and change in operative level segmental lordosis brought about by each of the following was determined: (1) cage insertion, (2) prone repositioning, and (3) posterior instrumentation. Paired t test was used to determine significance (α=0.05). Mean lordosis improvement brought about by cage insertion was 2.6 degrees (P=0.00005). There was a 0.1 degree mean lordosis change brought about by lateral to prone positioning (P=0.47). Mean lordosis improvement brought about by posterior fixation, including rod compression, was 1.0 degree (P=0.03). In LLIF procedures, the largest increase in operative level segmental lordosis is brought about by cage insertion. Further lordosis may be gained by placing posterior fixation, including compressive maneuvers. Prone repositioning after cage placement does not produce any incremental lordosis change. Therefore, posterior fixation may be performed in the lateral position without compromising operative level sagittal alignment.

  19. Outcomes of C1 and C2 posterior screw fixation for upper cervical spine fusion.

    Science.gov (United States)

    De Iure, F; Donthineni, R; Boriani, S

    2009-06-01

    To achieve stable fixation of the upper cervical spine in posterior fusions, the occiput is often included. With the newer techniques, excluding fixation to the occiput will retain the occiput-cervical motion, while still allowing a stable fixation. Harms's technique has been adapted at our institution and its effectiveness for indications such as C2 complex fractures and tumors using C1 or C2 as endpoints of a posterior fixation are reviewed. Fourteen cases were identified, consisting of one os odontoideum; four acute fractures and four non-unions of the odontoid; three tumors and two complex fractures of C2 vertebral body, and one C2-C3 post-traumatic instability. One misplaced screw without clinical consequences was the only complication recorded. Screw loosening or migration was not observed at follow-up, showing a stable fixation.

  20. NEGLECTED POSTERIOR KNEE DISLOCATION TREATED WITH CLOSED MANIPULATION AND UNIPLANAR EXTERNAL FIXATOR : A CASE REPORT

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    Manikumar

    2015-06-01

    Full Text Available Neglected traumatic posterior knee dislocations were rare in orthopaedic literature more so after a surgical intervention . Majority of the injuries are associated with vascular trauma and distal or proximal fractures and complete disruption of anterior and posterior cruciate ligaments and nerve traction injuries. Traumatic knee dislocations are therefore treated as an orthopaedic emergency. There were no definitive guide lines to open reduction as well as conservative methods of treatment. The end results of functional recovery are still controversial with residual posterior subluxation. Here we present a case of neglected posterior knee dislocation treated with closed manipulation and uni planar external fixator

  1. Adult Case of Atlantoaxial Rotatory Fixation Treated with In Situ Fixation Using an Unusual Posterior Instrumentation Construct.

    Science.gov (United States)

    Miyao, Yasuyoshi; Sasaki, Manabu; Umegaki, Masao; Yonenobu, Kazuo

    2017-07-01

    Atlantoaxial rotatory fixation (AARF) occurs commonly in children who have undergone trauma. It is usually corrected with conservative therapy. In this report, however, the patient was an adult with AARF who was treated surgically. A 64-year-old woman presented with a 1-year history of spastic gait and hand clumsiness. Imaging studies revealed the presence of AARF, os odontoideum, and severe spinal cord compression at that spinal level. As the AARF had not been responded to head traction with a halo device, we decided to treat the patient with in situ posterior fixation. Because the rigid dislocation was present between the atlas and the axis, we were forced to make an unusual instrumentation construct. Neurological symptoms other than hand numbness diminished after the surgery, and arthrodesis was obtained between the occiput and the axis. It should be noted that surgical planning for posterior instrumentation construct is required when rigid AARF is treated surgically.

  2. Posterior capsular opacification and intraocular lens decentration. Part I: Comparison of various posterior chamber lens designs implanted in the rabbit model.

    Science.gov (United States)

    Hansen, S O; Solomon, K D; McKnight, G T; Wilbrandt, T H; Gwin, T D; O'Morchoe, D J; Tetz, M R; Apple, D J

    1988-11-01

    Experimental phacoemulsification procedures were performed in 54 Rex rabbits. In 96 eyes, posterior chamber intraocular lenses (IOLs) were implanted in the capsular sac, and 12 eyes served as controls with no lens implantation. The IOLs were divided into eight groups consisting of both one-piece and three-piece styles with various optic designs. Each lens was evaluated for the relative effect on posterior capsular opacification (PCO) and optic decentration, two of the most common complications of modern cataract surgery and IOL implantation. Optics with a convex-anterior, plano-posterior design (the type of IOL optic most frequently implanted today) had the highest incidence of PCO. With capsular fixated IOLs, the features that have a statistically significant impact on reducing PCO include (1) one-piece, all-polymethylmethacrylate (PMMA) IOL styles, (2) a biconvex or posterior convex optic design, and (3) angulated loops. Lens decentration was not affected by the optic design, but statistical analysis showed that one-piece, all-PMMA IOL construction provided the most consistent centration.

  3. Treatment of neuromuscular scoliosis with posterior-only pedicle screw fixation

    OpenAIRE

    Fernandez Harry M; Song Hae-Ryong; Suh Seung-Woo; Modi Hitesh N; Yang Jae-Hyuk

    2008-01-01

    Abstract Background To determine whether posterior-only approach using pedicle screws in neuromuscular scoliosis population adequately addresses the correction of scoliosis and maintains the correction over time. Methods Between 2003 and 2006, 26 consecutive patients (7 cerebral palsy, 10 Duchenne muscular dystrophy, 5 spinal muscular atrophy and 4 others) with neuromuscular scoliosis underwent posterior pedicle screw fixation for the deformity. Preoperative, immediate postoperative and final...

  4. Bilateral spontaneous dislocation of posterior chamber intraocular lens in a patient with gyrate atrophy

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    Michael Kinori

    2012-01-01

    Full Text Available We report a patient with gyrate atrophy, a rare metabolic disease, who had bilateral late spontaneous posterior dislocation of in-the-bag posterior chamber intraocular lens (PCIOL. He underwent pars plana vitrectomy, PCIOL retrieval and anterior chamber intraocular lens implantation in both eyes. This report may imply that patients with gyrate atrophy are at risk for spontaneous dislocation of intraocular lenses.

  5. Phacolytic glaucoma-its treatment by planned extracapsular cataract extraction with posterior chamber intraocular lens implantation

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    Singh Gurdeep

    1994-01-01

    Full Text Available Phacolytic glaucoma has traditionally been treated with intracapsular lens extraction to avoid any anaphylaxis. Various mechanisms have been described for the rise of intraocular pressure in these cases. The present study was undertaken to evaluate the response of extracapsular cataract extraction (ECCE with posterior chamber intraocular lens implantation (PC IOL in five cases of phacolytic glaucoma that occurred between March 1989 and August 1990. A planned extracapsular cataract extraction with can-opener capsulectomy was done in all the cases with placement of a sulcus-fixated modified J-loop Sinskey design intraocular lens. With a mean follow-up period of two years, all patients (100% maintained a normal postoperative intraocular pressure of less than 20 mm Hg without any additional medical therapy. The final best-corrected visual acuity in 4 cases (80% was 6/12 or better, while in one case it was 6/24 due to a senile maculopathy. These results show that ECCE with PC IOL implantation is a safe and efficacious method of visual rehabilitation in cases of phacolytic glaucoma

  6. Cubitus varus in adults correction with lateral closing wedge osteotomy and fixation with posterior plating

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    S Pandey

    2012-09-01

    Full Text Available To share the result of lateral closing wedge osteotomy and fixation with posterior reconstruction plate in correction of cubitus varus in adults. It is a retrospective case analysis of 8 cases of cubitus varus in adult treated with lateral closing wedge osteotomy through posterior triceps retracting approach. Internal fixation was done with two posterior reconstruction plates. All cases were from 15 to 29 years of age (mean 22.3 with 3 female and 5 male. All had cubitus varus ranging from 15- 28 deg (mean 20.16 deg due to childhood malunited supracondylar fracture of humerus. Indication for operation was cosmetic reason only. Follow up duration was 4-22 months (mean 12.5 months. All the osteotomy united clinically in mean duration of 9 weeks ( range 8-12 weeks with mean carrying angle 8.33 degree in postoperative phase. There was no loss of motion, no loss of fixation, no surgical site infection, nonunion or neurovascular deficit. Lateral closing wedge corrective osteotomy and fixation with posterior reconstruction plate is easy technique with satisfactory result in correction of cubitus varus in adults. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-2, 49-53 DOI: http://dx.doi.org/10.3126/jcmsn.v8i2.6839

  7. The flying buttress construct for posterior spinopelvic fixation: a technical note

    Science.gov (United States)

    2011-01-01

    Background Posterior fusion of the spine to the pelvis in paediatric and adult spinal deformity is still challenging. Especially assembling of the posterior rod construct to the iliac screw is considered technically difficult. A variety of spinopelvic fixation techniques have been developed. However, extreme bending of the longitudinal rods or the use of 90-degree lateral offset connectors proved to be difficult, because the angle between the rod and the iliac screw varies from patient to patient. Methods We adopted a new spinopelvic fixation system, in which iliac screws are side-to-side connected to the posterior thoracolumbar rod construct, independent of the angle between the rod and the iliac screw. Open angled parallel connectors are used to connect short iliac rods from the posterior rod construct to the iliac screws at both sides. The construct resembles in form and function an architectural Flying Buttress, or lateral support arches, used in Gothic cathedrals. Results and discussion Three different cases that illustrate the Flying Buttress construct for spinopelvic fixation are reported here with the clinical details, radiographic findings and surgical technique used. Conclusion The Flying Buttress construct may offer an alternative surgical option for spinopelvic fixation in circumstances wherein coronal or sagittal balance cannot be achieved, for example in cases with significant residual pelvic obliquity, or in revision spinal surgery for failed lumbosacral fusion. PMID:21489256

  8. The flying buttress construct for posterior spinopelvic fixation: a technical note

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    van Ooij Bas

    2011-04-01

    Full Text Available Abstract Background Posterior fusion of the spine to the pelvis in paediatric and adult spinal deformity is still challenging. Especially assembling of the posterior rod construct to the iliac screw is considered technically difficult. A variety of spinopelvic fixation techniques have been developed. However, extreme bending of the longitudinal rods or the use of 90-degree lateral offset connectors proved to be difficult, because the angle between the rod and the iliac screw varies from patient to patient. Methods We adopted a new spinopelvic fixation system, in which iliac screws are side-to-side connected to the posterior thoracolumbar rod construct, independent of the angle between the rod and the iliac screw. Open angled parallel connectors are used to connect short iliac rods from the posterior rod construct to the iliac screws at both sides. The construct resembles in form and function an architectural Flying Buttress, or lateral support arches, used in Gothic cathedrals. Results and discussion Three different cases that illustrate the Flying Buttress construct for spinopelvic fixation are reported here with the clinical details, radiographic findings and surgical technique used. Conclusion The Flying Buttress construct may offer an alternative surgical option for spinopelvic fixation in circumstances wherein coronal or sagittal balance cannot be achieved, for example in cases with significant residual pelvic obliquity, or in revision spinal surgery for failed lumbosacral fusion.

  9. Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study.

    Science.gov (United States)

    Sakaura, Hironobu; Miwa, Toshitada; Yamashita, Tomoya; Kuroda, Yusuke; Ohwada, Tetsuo

    2016-11-01

    OBJECTIVE Several biomechanical studies have demonstrated the favorable mechanical properties of the cortical bone trajectory (CBT) screw. However, no reports have examined surgical outcomes of posterior lumbar interbody fusion (PLIF) with CBT screw fixation for degenerative spondylolisthesis (DS) compared with those after PLIF using traditional pedicle screw (PS) fixation. The purposes of this study were thus to elucidate surgical outcomes after PLIF with CBT screw fixation for DS and to compare these results with those after PLIF using traditional PS fixation. METHODS Ninety-five consecutive patients underwent PLIF with CBT screw fixation for DS (CBT group; mean followup 35 months). A historical control group consisted of 82 consecutive patients who underwent PLIF with traditional PS fixation (PS group; mean follow-up 40 months). Clinical status was assessed using the Japanese Orthopaedic Association (JOA) scale score. Fusion status was assessed by dynamic plain radiographs and CT. The need for additional surgery and surgery-related complications was also evaluated. RESULTS The mean JOA score improved significantly from 13.7 points before surgery to 23.3 points at the latest follow-up in the CBT group (mean recovery rate 64.4%), compared with 14.4 points preoperatively to 22.7 points at final follow-up in the PS group (mean recovery rate 55.8%; p fusion was achieved in 84 patients from the CBT group (88.4%) and in 79 patients from the PS group (96.3%, p > 0.05). Symptomatic adjacent-segment disease developed in 3 patients from the CBT group (3.2%) compared with 9 patients from the PS group (11.0%, p fusion rate tended to be lower in the CBT group than in the PS group, although the difference was not statistically significant between the 2 groups.

  10. New Management of Malignant Glaucoma by Phacoemulsification with Posterior Chamber Foldable Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    GeJian; GuoY

    1999-01-01

    Objective:To investigate the feasibility of phacoemulsification with posterior chamber foldable intraocular lens implantation in the management of malignant glaucoma. Patients and Methods:Fourteen patients with malignant glaucoma diagnosed in the Department of Glaucoma were enrolled in the study.12 patients developed malignant glaucoma after filtration surgery.1 developed after peripheral iridectomy.1 patient developed malignant glaucoma without any clear cause.Cataract phacoemulsification was performed.Posterior chamber intraocular foldable lens was implanted in 10 cases of patients.Results:All 14 patients were cured wiht normal intraocular pressure,normal anterior chamber depth and increased visual acuity.Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation is a good alternative in treating malignant glaucoma.

  11. Finite element analysis of the stability of combined plate internal fixation in posterior wall fractures of acetabulum.

    Science.gov (United States)

    Liu, Xi-Ming; Pan, Chang-Wu; Wang, Guo-Dong; Cai, Xian-Hua; Chen, Lei; Meng, Cheng-Fei; Huang, Jin-Cheng

    2015-01-01

    This study aims to explore the mechanical stability of combined plate internal fixation in posterior wall fractures of the acetabulum. The fracture and internal fixation models were established in this study and they were divided into four kinds of internal fixation models, finite element analysis was performed. The four groups were 2 mini-plates and 1 reconstruction plate fixation (A), Reconstruction plate internal fixation group (B), 2 screws internal fixation group (C) and mini-plates internal fixation group (D). The displacement of each node was measured and evaluated. There was no distortion in the geometric shape of the finite element model. The results of stress showed that it was less in the anterior pelvic ring and distributed uniform in labrum acetabulare; the stress was bigger in the upper and middle of sacroiliac joint and sciatic notch in sitting position. Combined plate internal fixation for posterior wall fractures of acetabular were stable and reliable, it is better than the other three methods.

  12. Step-by-step external fixation of unstable pelvis with separate anterior and posterior modules

    Institute of Scientific and Technical Information of China (English)

    Ivan Viktorovich Borozda; Nikolay Alexandrovich Ganzhurov; Alexander Alexandrovich Kapustyansky; Roman Valerievich Nikolaev; Kirill Sergeevich Golokhvast

    2016-01-01

    Objective: To evaluate the treatment outcomes of patients with pelvic ring injury by applying step-by-step external pelvic fixation and circular external fixation device.Methods: A total of 28 patients suffering from disintegrated pelvic ring injury are involved in the study. Fourteen patients(the treatment group) underwent step-by-step external pelvic fixation by applying anterior(anti-shock) and posterior modules. For the rest 14 patients(the experimental group), the osteosynthesis were conducted by means of a circular external fixation device. The long-term outcomes were evaluated in a year after the injury.Results: The residual deformity of 5(4–7) mm was observed in 10 patients(71.4%) from the experimental group. In the treatment group, the residual deformity was evident only in 4(28.6%) cases being 2.5(2–3) mm(P = 0.000 319) on the average. The functional result(according to the Majeed scale) was statistically better in the treatment group(P = 0.000 319). Nine(64.3%) and five(35.7%) patients in treatment group showed excellent and positive results, respectively. The excellent result was demonstrated by 3patients(21.4%) of the experimental group, the positive outcomes were observed in 6 cases(42.9%) and the unsatisfactory one was displayed by 1 patient(7.1%) of the same group.Conclusions: The modular approach applied is the advantage of the transosseous osteosynthesis allowing for a separate anterior(anti-shock) fixation and final posterior reposition of the pelvic ring preceded by the stabilization of vital functions. The above mentioned method gives an opportunity to increase the amount of techniques applied for the pelvic external fixation in polytrauma cases.

  13. Posterior acetabular column and quadrilateral plate fractures: fixation with tension band principles.

    Science.gov (United States)

    Aly, Tarek A; Hamed, Hany

    2013-07-01

    Acetabular fractures can be classified into 5 simple and 5 associated fracture patterns. A significant amount of variation and complexity exists in these fractures patterns. Fractures of the posterior wall are the most common acetabular fractures. Comminution of the quadrilateral plate adds to fracture instability, and more rigid and stable internal fixation is mandatory. The goal of this study was to assess the results of reconstruction of comminuted posterior wall fractures of the acetabulum associated with quadrilateral plate fractures using the tension band technique. Twelve patients (9 men and 3 women) were included in the study. Mean patient age was 38.6 years (range, 24-47 years). Minimum follow-up was more than 2 years postoperatively. Reconstruction of the fracture included anatomic reduction of the fracture and fixation with a buttress plate for the posterior column and a prebent one-third tubular plate for the quadrilateral plate fracture. Clinical results were excellent in 58% of patients and good in 17% of patients. Radiologic results were excellent in 50% of patients and good in 17% of patients. Radiologically, based on the fracture gap postoperatively, 8 (66%) patients showed anatomic reduction, 2 (17%) showed good reduction, and 2 (17%) showed poor reduction. The study confirms that this method of reconstruction facilitates accurate and firm reduction of displaced posterior wall fractures of the acetabulum.

  14. Biomechanical evaluation of DTRAX® posterior cervical cage stabilization with and without lateral mass fixation

    Science.gov (United States)

    Voronov, Leonard I; Siemionow, Krzysztof B; Havey, Robert M; Carandang, Gerard; Patwardhan, Avinash G

    2016-01-01

    Introduction Lateral mass screw (LMS) fixation with plates or rods is the current standard procedure for posterior cervical fusion. Recently, implants placed between the facet joints have become available as an alternative to LMS or transfacet screws for patients with cervical spondylotic radiculopathy. The purpose of this study was to evaluate the biomechanical stability of the DTRAX® cervical cage for single- and two-level fusion and compare this to the stability achieved with LMS fixation with rods in a two-level construct. Methods Six cadaveric cervical spine (C3–C7) specimens were tested in flexion–extension, lateral bending, and axial rotation to ±1.5 Nm moment without preload (0 N) in the following conditions: 1) intact (C3–C7), 2) LMS and rods at C4–C5 and C5–C6, 3) removal of all rods (LMS retained) and placement of bilateral posterior cages at C5–C6, 4) bilateral posterior cages at C4–C5 and C5–C6 (without LMS and rods), and 5) C4–C5 and C5–C6 bilateral posterior cages at C4–C5 and C5–C6 with rods reinserted. Results Bilateral posterior cervical cages significantly reduced range of motion in all tested directions in both single- and multilevel constructs (P<0.05). Similar stability was achieved with bilateral posterior cages and LMS in a two-level construct: 0.6°±0.3° vs 1.2°±0.4° in flexion–extension (P=0.001), (5.0°±2.6° vs 3.1°±1.3°) in lateral bending (P=0.053), (1.3°±1.0° vs 2.2°±0.9°) in axial rotation (P=0.091) for posterior cages and LMS, respectively. Posterior cages, when placed as an adjunct to LMS, further reduced range of motion in a multilevel construct (P<0.05). Conclusion Bilateral posterior cages provide similar cervical segmental stability compared with a LMS and rod construct and may be an alternative surgical option for select patients. Furthermore, supplementation of a lateral mass construct with posterior cages increases cervical spine stability in single- and multilevel conditions. PMID

  15. Posterior fixation and fusion with atlas pedicle screw system for upper cervical diseases

    Institute of Scientific and Technical Information of China (English)

    LI Lei; ZHOU Feng-hua; WANG Huan; CUI Shao-qian

    2008-01-01

    Objective: To evaluate the feasibility, safety and efficacy of atlas pedicle screws system fixation and fusion for the treatment of upper cervical diseases. Methods: Twenty-three consecutive patients with up-per cervical disorders requiring stabilization, including 19 cases of atlantoaxial dislocation (4 congenital odontoid disconnections, 6 old odontoid fractures, 4 fresh odontoid fractures of Aderson Ⅱ C, 3 ruptures of the C1 transverse ligament, and 2 fractures ofC1), 2 cases ofC2 tumor (instability after the resection of the tumors), and 2 giant neurilemomas of C2-C3(instability after resection of the tumors), were treated by posterior fixation and fusion with the atlas pedicle screw system, in which the screws were inserted through the posterior arch of Cr The operative time, bleeding volume and complications were reported. All patients were immobilized without external fixation or with rigid cervical collars for 1-3 months. All patients were followed up and evaluated with radiographs and CT. Results: In the 23 patients, 46 C1 pedicle screws, 42 C2 pedicle screws and 6 lower cervical lateral mass screws and 2 lower cervical pedicle screws were placed. The mean operative time and bleeding volume was 2.7 hours and 490 ml respectively. No intraoperative complications were directly related to surgical technique. No neurological, vascular or infective complications were encountered. All patients were followed up for 3-36 months (average 15 months). Firm bony fusion was documented in all patients after 3-6 months. One patient with atlas fracture showed anterior occipitocervical fusion. There was no implant failure. Conclusions: Posterior fixation and fusion of the atlas pedicle screw system is feasible and safe for the treatment of upper cervical diseases, and may be applicable to a larger number of patients.

  16. Spontaneous fracture of an implanted posterior chamber polyimide intraocular lens haptic: A case report

    Directory of Open Access Journals (Sweden)

    Haemin Kang

    2014-01-01

    Full Text Available A 57-year-old male patient visited our clinic for decreased visual acuity in the right eye for 10 days. He denied any trauma history, but recalled that the symptom developed after straining. He had undergone uncomplicated phacoemulsification and posterior chamber intraocular lens (IOL implantation in the bag of the right eye 11 years ago. The IOL was a three-piece silicone polyimide-haptics design. On slit-lamp examination, the IOL optic and proximal part of nasal fractured haptic were found in the anterior chamber. The distal part of fractured haptic was observed in the capsular bag. He underwent IOL exchange. The fracture site of the haptic was near the optic-haptic junction. This is the unique case report of a spontaneous fracture of an implanted posterior chamber polyimide IOL haptic, which implies the possibility of IOL haptic fracture in various haptic materials.

  17. Posterior Fixation with Unilateral Same Segment Pedicle Fixation and Contralateral Hook in Surgical Treatment of Thoracolumbar Burst Fractures

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    Farzad Omidi-Kashani

    2016-06-01

    Full Text Available Background In surgical treatment of thoracolumbar burst fractures, most authors try to lower the number of vertebrae involved during the surgery. Objectives The aim of this study was to evaluate the outcome of a medium-segment posterior spinal fixation in these patients. Patients and Methods We retrospectively reviewed 27 patients (18 male, 9 female with mean age of 39.4 ± 15.0 years old in a before-and-after study. The mean follow-up period was 38.4 ± 15.6 months. We involved 2 intact above vertebrae and one intact below vertebra, inserting a pedicular screw at the fractured level and supplemented the construct with contralateral infralaminar hook. Clinical and radiologic characteristics were assessed with American spinal injury association (ASIA scale, oswestry disability index (ODI, visual analogue scale (VAS, and plain radiography. Data analysis was carried out by SPSS version 11.5 software. Results Mean post traumatic kyphosis was + 15.7° ± 3.3° that was changed to - 8.5° ± 4.3° and +1° ± 4.4° at immediate and last visit after surgery, respectively. Mean loss of correction (LOC was 9.5° ± 1.9° (P < 0.001. At the most recent follow-up visit, mean ODI and VAS were 15.0 ± 14.4 and 2.4 ± 2.5, respectively and 24 cases (88.9% declared excellent or good clinical results. At the last follow-up visit, LOC had no significant correlation neither with VAS nor ODI. Conclusions In surgical treatment of thoracolumbar burst fractures, a medium-segment posterior spinal fixation, although cannot maintain the radiologic reduction of the fractured vertebrae efficiently, is not only associated with acceptable clinical outcome but also spare one lower intact lumbar segment and therefore recommended.

  18. Combined vitrectomy and endoscopy-guided posterior chamber intraocular lens transscleral fixation in ocular trauma%玻璃体切除联合内窥镜引导人工晶状体固定在眼外伤治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    徐哲; 邹玉平; 邹秀兰; 陈京霞; 张楚; 王泳; 林振德

    2013-01-01

    目的 探讨玻璃体切除(PPV)联合内窥镜引导人工晶状体(IOL)固定术对伴有晶状体位置异常的外伤性玻璃体积血的治疗效果.方法 11例(11眼)行PPV联合内窥镜辅助IOL固定术.9例采用折叠式IOL缝线固定于睫状沟,2例伴有虹膜大部脱失者采取带虹膜隔IOL缝线固定于前平坦部.对照组选取我院常规方法处理的白内障术中后囊破裂坠核的3例.观察指标包括:术后视力、前房炎症反应、眼压及超声生物显微镜检查(UBM)等.结果 随访1~9个月,裸眼视力>0.5者7眼,0.2 ~0.4者3眼,0.1者1眼.UBM显示,对照组1例IOL一侧襻位置靠后接近睫状体平坦部导致体部偏位,而内窥镜辅助手术IOL全部位置准确;裂隙灯显微镜检查所有IOL位置正常.影响术后视力恢复主要由于不规则角膜散光、黄斑水肿和视神经挫伤.结论 PPV联合内窥镜下IOL同定术是治疗严重眼外伤伴晶状体位置异常的安全有效的方法.%Objective To determine the effect of combined pars plana vitrectomy (PPV) and transscleral intraocular lens (IOL) fixation under endoscope guidance in the management of traumatic vitreous hemorrhage with dislocation of the lens or IOL.Methods Endoscope-assisted PPV and transscleral IOL fixation were performed in 11 eyes of 11 patients.The foldable IOLs were fixed in ciliary sulcus in nine cases,and an aniridia IOL was fixed in anterior pars plana in the other two cases with iris loss.3 patients with dropped nucleus in phacoemulsification process who sustained regular treatment were taken as control.Observed items included post-surgery vision,anterior chamber inflammation,intraocular pressure,ultrasound biomicroscope(UBM) examination.Results Follow-up ranged from 1 month to 9 months (4.1±2.3) months.Postoperatively,uncorrected visual acuities were 0.5 or better in 7 cases,0.2-0.4 in 3 cases,0.1 in one case.UBM results indicated that all IOL position fixed under endoscope-guidance were

  19. Thoracolumbar spinal fractures : radiological results of transpedicular fixation combined with transpedicular cancellous bone graft and posterior fusion in 183 patients

    NARCIS (Netherlands)

    Leferink, VJM; Zimmerman, KW; Veldhuis, EFM; ten Vergert, EM; ten Duis, HJ

    2001-01-01

    In internal posterior fixation of thoracolumbar fractures combined with transpedicular cancellous bone graft and posterior fusion of the intervertebral facet joints at the level of the destroyed end plate it is still uncertain as to whether significant vertebral body collapse and loss of correction

  20. Posterior interbody fusion using a diagonal cage with unilateral transpedicular screw fixation for lumbar stenosis.

    Science.gov (United States)

    Zhao, Jian; Zhang, Feng; Chen, Xiaoqing; Yao, Yu

    2011-03-01

    Few reports have described the combined use of unilateral pedicle screw fixation and interbody fusion for lumbar stenosis. We retrospectively reviewed 79 patients with lumbar stenosis. The rationale and effectiveness of unilateral pedicle screw fixation were studied from biomechanical and clinical perspectives, aiming to reduce stiffness of the implant. All patients were operated with posterior interbody fusion using a diagonal cage in combination with unilateral transpedicular screw fixation and had reached the 3-year follow-up interval after operation. The mean operating time was 115 minutes (range=95-150 min) and the mean estimated blood loss was 150 mL (range=100-200 mL). The mean duration of hospital stay was 10 days (range=7-15 days). Clinical outcomes were assessed prior to surgery and reassessed at intervals using Denis' pain and work scales. Fusion status was determined from X-rays and CT scans. At the final follow-up, the clinical results were satisfactory and patients showed significantly improved scores (pdiagonal cage with unilateral transpedicular fixation is an effective treatment for decompressive surgery for lumbar stenosis.

  1. Staged Fixation of Tibial Plateau Fractures: Strategies for the Posterior Approach.

    Science.gov (United States)

    Kottmeier, Stephen A; Watson, J Tracy; Row, Elliot; Jones, Clifford B

    2016-01-01

    A critical assessment of radiographic and clinical outcomes after complex articular fractures of the proximal tibia demonstrates several aspects worthy of reevaluation and potential modification. These include a refined understanding of fracture pathoanatomy, injury classification, operative exposure, surgical timing, and preferred fixation constructs in addition to implant design modifications. Evolving trends include increasing appreciation of the importance of the fracture morphology in the axial plane and the role that the fracture pattern has on the choice of surgical approach. This focused review will highlight the attributes and limitations of classification schemes (both conventional and contemporary) as well as the role that posterior surgical approaches performed in the prone position may offer in select clinical scenarios. The merits of staged fixation (prone followed by supine patient positioning), its technique, indications, and potential liabilities are described and case examples offered. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. Posterior approach for subtalar joint distraction arthrodesis by compact external fixation: a technique guide.

    Science.gov (United States)

    Laporta, Guido; Bock, Felicia; Ghate, Nihar

    2013-01-01

    Subtalar joint arthrodesis is a commonly used surgical procedure for the management of rearfoot pathologic features. We present a technique guide for a posterior incisional approach to subtalar joint arthrodesis for correction of a calcaneal deformity secondary to calcaneal fracture malunion. This technique uses a monolateral external fixation device for controlled distraction and intercallary allograft placement. In contrast to a standard lateral approach, this incision provides better visualization of the joint space, and the use of a distractor enhances access to the joint surfaces for fusion preparation and maintains alignment while internal fixation is applied. A 44-year-old male underwent isolated subtalar joint arthrodesis to repair a malunion of a nonsurgically managed calcaneal fracture sustained 1 year before the surgical intervention. Controlled distraction was applied using a Hoffmann(®) Compact™ MRI external fixation device. This device maintained distraction and tibial-calcaneal alignment until placement of the allograft-bone marrow aspirate. The use of external fixation is a viable option for distraction arthrodesis in subtalar joint fusions. It facilitates frontal plane deformity correction. We have described the surgical technique and presented a case in which the posterior approach with distraction was successfully used in subtalar joint arthrodesis. At 12 weeks postoperatively, serial radiographs displayed incorporation of the graft, with distraction maintained at the subtalar joint arthrodesis site. At the 3-month follow-up visit, the patient had successfully transitioned to weightbearing in a CAM walker without any complications. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Surgical complications in neuromuscular scoliosis operated with posterior- only approach using pedicle screw fixation

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    Singh Surya Udai

    2009-05-01

    Full Text Available Abstract Background There are no reports describing complications with posterior spinal fusion (PSF with segmental spinal instrumentation (SSI using pedicle screw fixation in patients with neuromuscular scoliosis. Methods Fifty neuromuscular patients (18 cerebral palsy, 18 Duchenne muscular dystrophy, 8 spinal muscular atrophy and 6 others were divided in two groups according to severity of curves; group I ( 90°. All underwent PSF and SSI with pedicle screw fixation. There were no anterior procedures. Perioperative (within three months of surgery and postoperative (after three months of surgery complications were retrospectively reviewed. Results There were fifty (37 perioperative, 13 postoperative complications. Hemo/pneumothorax, pleural effusion, pulmonary edema requiring ICU care, complete spinal cord injury, deep wound infection and death were major complications; while atelectesis, pneumonia, mild pleural effusion, UTI, ileus, vomiting, gastritis, tingling sensation or radiating pain in lower limb, superficial infection and wound dehiscence were minor complications. Regarding perioperative complications, 34(68% patients had at least one major or one minor complication. There were 16 patients with pulmonary, 14 with abdominal, 3 with wound related, 2 with neurological and 1 cardiovascular complications, respectively. There were two deaths, one due to cardiac arrest and other due to hypovolemic shock. Regarding postoperative complications 7 patients had coccygodynia, 3 had screw head prominence, 2 had bed sore and 1 had implant loosening, respectively. There was a significant relationship between age and increased intraoperative blood loss (p = 0.024. However it did not increased complications or need for ICU care. Similarly intraoperative blood loss > 3500 ml, severity of curve or need of pelvic fixation did not increase the complication rate or need for ICU. DMD patients had higher chances of coccygodynia postoperatively. Conclusion

  4. [Analysis of reason and strategy for the failure of posterior pedicle screw short-segment internal fixation on thoracolumbar fractures].

    Science.gov (United States)

    Xing, Jin-Ming; Peng, Wen-Ming; Shi, Chu-Yun; Xu, Lei; Pan, Qi-Huao

    2013-03-01

    To analyze the reason and strategy for failure of posterior pedicle screw short-segment internal fixation on thoracolumbar fractures. From March 2008 to December 2010,the clinical data of 18 patients with thoracolumbar fracture failed in posterior pedicle screw short-segment internal fixation were retrospectively analyzed. There were 11 males and 7 females with an average age of 37.2 years (ranged, 19 to 63). The time from the first operation to complication occurrence was from 6 to 44 months with an average of 14.3 months. Of them,fusion failure was in 7 cases (combined with screw breakage in 4 cases), the progressive neuro-dysfunction was in 5 cases,the progressive lumbodorsal pain was in 6 cases. All 18 patients with kyphosis were treated with anterior internal fixation remaining posterior fixation (9 cases) and anterior internal fixation after posterior fixation removal (9 cases). All the patients were followed up from 18 to 50 months with an average of 30.5 months. No intetnal fixation loosening and breakage were found, moreover, X-ray and lamellar CT showed bone healing well. Preoperative, postoperative at 3 months and at final follow-up, ODI score was respectively 31.6+/-5.1, 8.6+/-5.7, 8.3+/-3.2; VAS score was respectively 7.2+/-2.3, 2.3+/-0.7, 2.1+/-1.1; kyphosis angle was respectively (-21.2/-+7.8 degreeso, (-5.3+/-6.8 degrees ), (-5.8+/-7.8 )degrees. Compared with preoperative data ,above-listed items had obviously ameliorated(Pinternal fixation may result in the complications such as bone nonunion ,internal fixation breakage and progressive kyphosis. Anterior reconstruction may be a good strategy for the failure of posterior operation.

  5. The Clinical Analysis of Secondary Glaucoma Following Posterior Chamber Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    We present 14 patients with secondary gluacoma following the implantation of a posterior chamber intraocular lens (lOLs). All patients were u-nilateral gluacoma , which developed within 1 month following the IOL implantation in 10 cases, and from 1 to 3 years in 4 cases. The angle of anterior chamber was open in 8 patients, and close in 6 ones. Seven patients required treatment of antiglaucomatous medicine; 4 patients underwent laser indecto-my and 3 patients required antiglaucoma surgery. The results s...

  6. Biomechanical evaluation of DTRAX® posterior cervical cage stabilization with and without lateral mass fixation

    Directory of Open Access Journals (Sweden)

    Voronov LI

    2016-08-01

    Full Text Available Leonard I Voronov,1,2 Krzysztof B Siemionow,3 Robert M Havey,1,2 Gerard Carandang,2 Avinash G Patwardhan1,2 1Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, Maywood, 2Musculoskeletal Biomechanics Laboratory, Edward Hines Jr. VA Hospital, Hines, 3Department of Orthopaedics, University of Illinois College of Medicine at Chicago, Chicago, IL, USA Introduction: Lateral mass screw (LMS fixation with plates or rods is the current standard procedure for posterior cervical fusion. Recently, implants placed between the facet joints have become available as an alternative to LMS or transfacet screws for patients with cervical spondylotic radiculopathy. The purpose of this study was to evaluate the biomechanical stability of the DTRAX® cervical cage for single- and two-level fusion and compare this to the stability achieved with LMS fixation with rods in a two-level construct.Methods: Seven cadaveric cervical spine (C3–C7 specimens were tested in flexion–extension, lateral bending, and axial rotation to ±1.5 Nm moment without preload (0 N in the following conditions: 1 intact (C3–C7, 2 LMS and rods at C4–C5 and C5–C6, 3 removal of all rods (LMS retained and placement of bilateral posterior cages at C5–C6, 4 bilateral posterior cages at C4–C5 and C5–C6 (without LMS and rods, and 5 C4–C5 and C5–C6 bilateral posterior cages at C4–C5 and C5–C6 with rods reinserted.Results: Bilateral posterior cervical cages significantly reduced range of motion in all tested directions in both single- and multilevel constructs (P<0.05. Similar stability was achieved with bilateral posterior cages and LMS in a two-level construct: 0.6°±0.3° vs 1.2°±0.4° in flexion–­extension (P=0.001, (5.0°±2.6° vs 3.1°±1.3° in lateral bending (P=0.053, (1.3°±1.0° vs 2.2°±0.9° in axial rotation (P=0.091 for posterior cages and LMS, respectively. Posterior cages, when placed as an adjunct to LMS, further reduced

  7. New Management of Angle-closure Glaucoma by Phacoemulsification with Foldable Posterior Chamber Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    Jian Ge; Yan Guo; Yizhi Liu; Mingkai Lin; Yehong Zhuo; Bing Chen; Xiuqi Chen

    2000-01-01

    Objective: To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens (PC-IOL) implantation. Design: Retrospective, noncontrolled interventional case series.Participants: In 36 eyes with angle-closure glaucoma (ACG), there were 18 eyes with primary acute angle-closure glaucoma (PACG), 14 eyes with primary chronic angle-closure glaucoma (PCCG), 3 eyes with secondary acute angle-closure glaucoma (SACG) and 1 eye with secondary chronic angle-closure glaucoma (SCCG).Intervention: Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures: Postoperative visual acuity, IOP, axial anterior chamber depth.Results: After a mean postoperative follow-up time of 8.81 ± 7.45 months, intraocular pressure was reduced from a preoperative mean of 23.81 ± 17.84 mmHg to a postoperative mean of 12.54 ± 4. 73 mmHg ( P = 0. 001 ). Mean anterior chamber depth was 1.75 ± 0.48 mm preoperatively and 2.29 ± 0.38 mm postoperatively ( P = 0. 000).Best spectacle-corrected visual acuity in 36 eyes ranged from 0. 01 to 0. 7 (20/200 to 20/30) postoperatively, which was better than preoperative VA ranging from hand movement to 0.4 (20/50) ( P= 0. 000).Conclusion: Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma. Eye Science 2000; 16:22 ~ 28.

  8. New Management of Angle-closure Glaucoma by Phacoemulsification with Folable Posterior Chamber Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    JianGE; YanGuo; 等

    2002-01-01

    Objective:To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens (PC-IOIL)implantation.Design:Retrospective,noncontrolled interventional case series.Participants:In 36 eyes with angle -closure glaucoma(ACG).there were 18eyes with primary acute angle-closure glaucoma(PACG),14 eyes with primary chonic angle -closure glaucoma(PCCG),3 eyes with secondary acute angle-closure glaucoma (SACG) and 1 eye with secondary chronic angle -closure glaucoma(SCCG).Intervention:Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures:Postoperative visual acuity,IOP,axial anterior chamber depth.Results:After a mean postoperative follow -time of 8.81±7.45 months,intraocular pressure was reduced from a preoperative mean of 23.81±17.84 mmHg to a postoperative mean of 12.54±4.73mmHg(P=0.001).Mean anterior chamber depth was 1.75±0.48 mm preoiperatively and 2.29±0.38mm postoperatively(P-0.000).Best spectacle-corrected visual acuity in 36 eyes ranged from 0.01 to 0.7(20/200 to 20/30)postoperatively,which was better than preoperative VA ranging from hand movement to 0.4(20/50)(P=0.000).Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma.Eye Science2000;16:22-28.

  9. Tibial inlay press-fit fixation versus interference screw in posterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Max Ettinger

    2013-11-01

    Full Text Available Reconstruction of the posterior cruciate ligament (PCL by a tibial press-fit fixation of the patellar tendon with an accessory bone plug is a promising approach because no foreign materials are required. Until today, there is no data about the biomechanical properties of such press-fit fixations. The aim of this study was to compare the biomechanical qualities of a bone plug tibial inlay technique with the commonly applied interference screw of patellar tendon PCL grafts. Twenty patellar tendons including a bone block were harvested from ten human cadavers. The grafts were implanted into twenty legs of adult German country pigs. In group P, the grafts were attached in a press-fit technique with accessory bone plug. In group S, the grafts were fixed with an interference screw. Each group consisted of 10 specimens. The constructs were biomechanically analyzed in cyclic loading between 60 and 250 N for 500 cycles recording elongation. Finally, ultimate failure load and failure mode were analyzed. Ultimate failure load was 598.6±36.3 N in group P and 653.7±39.8 N in group S (not significant, P>0.05. Elongation during cyclic loading between the 1st and the 20th cycle was 3.4±0.9 mm for group P and 3.1±1 mm for group S. Between the 20th and the 500th cycle, elongation was 4.2±2.3 mm in group P and 2.5±0.9 mm in group S (not significant, P>0.05. This is the first study investigating the biomechanical properties of tibial press-fit fixation of the patellar tendon with accessory bone plug in posterior cruciate ligament reconstruction. The implant-free tibial inlay technique shows equal biomechanical characteristics compared to an interference screw fixation. Further in vivo studies are desirable to compare the biological behavior and clinical relevance of this fixation device.

  10. Treatment of neuromuscular scoliosis with posterior-only pedicle screw fixation.

    Science.gov (United States)

    Modi, Hitesh N; Suh, Seung-Woo; Song, Hae-Ryong; Fernandez, Harry M; Yang, Jae-Hyuk

    2008-06-10

    To determine whether posterior-only approach using pedicle screws in neuromuscular scoliosis population adequately addresses the correction of scoliosis and maintains the correction over time. Between 2003 and 2006, 26 consecutive patients (7 cerebral palsy, 10 Duchenne muscular dystrophy, 5 spinal muscular atrophy and 4 others) with neuromuscular scoliosis underwent posterior pedicle screw fixation for the deformity. Preoperative, immediate postoperative and final follow-up Cobb's angle and pelvic obliquity were analyzed on radiographs. The average age of the patients was 17.5 years (range, 8-44 years) and the average follow-up was 25 months (18-52 months). Average Cobb's angle was 78.53 degrees before surgery, 30.70 degrees after surgery (60.9% correction), and 33.06 degrees at final follow-up (57.9% correction) showing significant correction (p vertebral column resection due to the presence of a rigid curve. The average spinal-pelvic obliquity was 16.27 degrees before surgery, 8.96 degrees after surgery, and 9.27 degrees at final follow-up exhibited significant correction (p maintained with posterior-only pedicle screw instrumentation without anterior release procedure.

  11. Treatment of neuromuscular scoliosis with posterior-only pedicle screw fixation

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    Fernandez Harry M

    2008-06-01

    Full Text Available Abstract Background To determine whether posterior-only approach using pedicle screws in neuromuscular scoliosis population adequately addresses the correction of scoliosis and maintains the correction over time. Methods Between 2003 and 2006, 26 consecutive patients (7 cerebral palsy, 10 Duchenne muscular dystrophy, 5 spinal muscular atrophy and 4 others with neuromuscular scoliosis underwent posterior pedicle screw fixation for the deformity. Preoperative, immediate postoperative and final follow-up Cobb's angle and pelvic obliquity were analyzed on radiographs. The average age of the patients was 17.5 years (range, 8–44 years and the average follow-up was 25 months (18–52 months. Results Average Cobb's angle was 78.53° before surgery, 30.70° after surgery (60.9% correction, and 33.06° at final follow-up (57.9% correction showing significant correction (p Conclusion Results indicate that in patients with neuromuscular scoliosis, acceptable amounts of curve correction can be achieved and maintained with posterior-only pedicle screw instrumentation without anterior release procedure.

  12. Posterior lumbar interbody fusion using one diagonal fusion cage with transpedicular screw/rod fixation.

    Science.gov (United States)

    Zhao, Jie; Hou, Tiesheng; Wang, Xinwei; Ma, Shengzhong

    2003-04-01

    Posterior lumbar interbody fusion (PLIF) using threaded cages has gained wide popularity for lumbosacral spinal disease. Our biomechanical tests showed that PLIF using a single diagonal cage with unilateral facetectomy does add a little to spinal stability and provides equal or even higher postoperative stability than PLIF using two posterior cages with bilateral facetectomy. Studies also demonstrated that cages placed using a posterior approach did not cause the same increase in spinal stiffness seen with pedicle screw instrumentation, and we concluded that cages should not be used posteriorly without other forms of fixation. On the other hand, placement of two cages using a posterior approach does have the disadvantage of risk to the bilateral nerve roots. We therefore performed a prospective study to determine whether PLIF can be accomplished by utilizing a single diagonal fusion cage with the application of supplemental transpedicular screw/rod instrumentation. Twenty-seven patients underwent a PLIF using one single fusion cage (BAK, Sulzer Spine-Tech, Minneapolis, MN, USA) inserted posterolaterally and oriented anteromedially on the symptomatic side with unilateral facetectomy and at the same level supplemental fixation with a transpedicular screw/rod system. The internal fixation systems included 12 SOCON spinal systems (Aesculap AG, Germany) and 15 TSRH spinal systems (Medtronic Sofamor Danek, USA). The inclusion criteria were grade 1 to 2 lumbar isthmic spondylolisthesis, lumbar degenerative spondylolisthesis, and recurrent lumbar disc herniations with instability. Patients had at least 1 year of low back pain and/or unilateral sciatica and a severely restricted functional ability in individuals aged 28-55 years. Patients with more than grade 2 spondylolisthesis or adjacent-level degeneration were excluded from the study. Patients were clinically assessed prior to surgery by an independent assessor; they were then reassessed at 1, 3, 6, 12, 18, and 24

  13. Design of three-dimensional visualization based on the posterior lumbar pedicle screw fixation

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    Kai XU

    2011-09-01

    Full Text Available Objective To establish a three-dimensional visualization model of posterior lumbar pedicle screw fixation.Methods A patient with lumbar intervertebral disc hernia and another patient with compression fracture of lumbar vertebra were involved in the present study.Both patients underwent multi-slice spiral CT scan before and after lumbar pedicle screw fixation.The degree of preoperative vertebral compression,vertebral morphology before and after surgery,postoperative pedicle screw position,and decompression effects were observed.The original data of the multi-slice spiral CT were inputted into the computer.The three-dimensional reconstructed images of the lumbar and implanted screws were obtained using the software Amira 4.1 to show the three-dimensional shape of the lumbar vertebrae before and after surgery and the location of the implanted screws.Results The morphology and structure of the lumbar vertebrae before and after surgery and of the implanted screws were reconstructed using the digital navigation platform.The reconstructed 3D images could be displayed in multicolor,transparent,or arbitrary combinations.In the 3D surface reconstruction images,the location and structure of the implanted screws could be clearly observed,and the decompression of the spinal cord or nerve roots and the severity of the fracture and the compression of lumbar vertebrae could be fully evaluated.The reconstructed images before operation revealed the position of the vertebral pedicles and provided reference for intraoperative localization.Conclusions The three-dimensional computerized reconstructions of lumbar pedicle screw fixation may be valuable in basic research,clinical experiment,and surgical planning.The software Amira is one of the bases of three-dimensional reconstruction.

  14. [Iritis with destabilization of the intraocular pressure due to dislocation of a posterior chamber intraocular lens].

    Science.gov (United States)

    Handzel, D M

    2012-04-01

    This report concerns the case of a 67-year-old male patient who underwent uncomplicated phacoemulsification with implantation of a posterior chamber intraocular lens (IOL). After an interval of 2 months the patient developed iritis together with an uncontrollable increase in intraocular pressure. After a detailed examination a dislocated haptic of the IOL was identified as the cause of the symptoms. The dislocation had led to uveitis-glaucoma-hyphema syndrome although no hemorrhage was observed. In addition to this complication the haptic had arroded the zonular complex which made implantation of an anterior chamber lens necessary. Although improvements in operating techniques, lens materials and designs have been made uveitis-glaucoma-hyphema syndrome has to be kept in mind. Surgical intervention is the only therapeutic option.

  15. Rigid Posterior Lumbopelvic Fixation Without Formal Debridement for Pyogenic Vertebral Diskitis and Osteomyelitis Involving the Lumbosacral Junction: Technical Report

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    Marcus D Mazur

    2015-09-01

    Full Text Available Background: Pelvic fixation with S2-alar-iliac (S2AI screws can increase the rigidity of a lumbosacral construct, which may promote bone healing, improve antibiotic delivery to infected tissues, and avoid L5-S1 pseudarthrosis. Purpose: To describe the use of single-stage posterior fixation without debridement for the treatment of pyogenic vertebral diskitis and osteomyelitis (PVDO at the lumbosacral junction. Study Design: Technical reportMethods: We describe the management of PVDO at the lumbosacral junction in which the infection invaded the endplates, disc space, vertebrae, prevertebral soft tissues, and epidural space. Pedicle involvement precluded screw fixation at L5. Surgical management consisted of a single-stage posterior operation with rigid lumbopelvic fixation augmented with S2-alar-iliac screws and without formal debridement of the infected area, followed by long-term antibiotic treatment. Results: At 2-year follow-up, successful fusion and eradication of the infection were achieved.Conclusions: PVDO at the lumbosacral junction may be treated successfully using rigid posterior-only fixation without formal debridement combined with antibiotic therapy.

  16. Scleral Fixation of Posteriorly Dislocated Intraocular Lenses by 23-Gauge Vitrectomy without Anterior Segment Approach

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    Jeroni Nadal

    2015-01-01

    Full Text Available Background. To evaluate visual outcomes, corneal changes, intraocular lens (IOL stability, and complications after repositioning posteriorly dislocated IOLs and sulcus fixation with polyester sutures. Design. Prospective consecutive case series. Setting. Institut Universitari Barraquer. Participants. 25 eyes of 25 patients with posteriorly dislocated IOL. Methods. The patients underwent 23-gauge vitrectomy via the sulcus to rescue dislocated IOLs and fix them to the scleral wall with a previously looped nonabsorbable polyester suture. Main Outcome Measures. Best corrected visual acuity (BCVA LogMAR, corneal astigmatism, endothelial cell count, IOL stability, and postoperative complications. Results. Mean follow-up time was 18.8 ± 10.9 months. Mean surgery time was 33 ± 2 minutes. Mean BCVA improved from 0.30 ± 0.48 before surgery to 0.18 ± 0.60 (p=0.015 at 1 month, which persisted to 12 months (0.18 ± 0.60. Neither corneal astigmatism nor endothelial cell count showed alterations 1 year after surgery. Complications included IOL subluxation in 1 eye (4%, vitreous hemorrhage in 2 eyes (8%, transient hypotony in 2 eyes (8%, and cystic macular edema in 1 eye (4%. No patients presented retinal detachment. Conclusion. This surgical technique proved successful in the management of dislocated IOL. Functional results were good and the complications were easily resolved.

  17. Long-term change in intraocular pressure after extracapsular cataract extraction with posterior chamber intraocular lens implantation versus phacoemulsification with posterior chamber intraocular lens implantation in Indians.

    Science.gov (United States)

    Pal, Virendra K; Agrawal, Ajai; Suman, Suwarna; Pratap, V B

    2013-01-01

    The purpose of the study is to evaluate the long-term changes in intraocular pressure (IOP) after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation versus phacoemulsification with PCIOL implantation in otherwise normal cataract patients in India. The study was conducted in the Department of Ophthalmology, King George's Medical College, Lucknow between August 2000 and August 2001. One hundred and seventeen eyes of 115 patients were included in the study. 84 patients were randomly selected for ECCE with PCIOL implantation (ECCE group) and 31 patients were selected for phacoemulsification with PCIOL implantation (Phaco group). IOP was measured pre-operatively and post-operatively, from the 1(st) month to the 12(th) month. Statistical significance was indicated by P > 0.05. There was a mean fall in IOP of 2.70 mm Hg (19.74%) in the ECCE group and 2.74 mm Hg (20.57%) in the phaco group. The decrease in the mean post-operative IOP from baseline was statistically significant (P > 0.01) at the end of 2 months in both groups. There was no statistically significant difference in post-operative IOP at any visit between groups (P ECCE or phacoemulsification with IOL implantation. The lowering of IOP became statistically significant at about 2 months post-operatively, but became almost stable after the 4(th) month.

  18. Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    Science.gov (United States)

    Ang, Marcus; Evans, Jennifer R; Mehta, Jod S

    2014-11-18

    Age-related cataract is the opacification of the lens, which occurs as a result of denaturation of lens proteins. Age-related cataract remains the leading cause of blindness globally, except in the most developed countries. A key question is what is the best way of removing the lens, especially in lower income settings. To compare two different techniques of lens removal in cataract surgery: manual small incision surgery (MSICS) and extracapsular cataract extraction (ECCE). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 8), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to September 2014), EMBASE (January 1980 to September 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to September 2014), Web of Science Conference Proceedings Citation Index- Science (CPCI-S), (January 1990 to September 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 23 September 2014. We included randomised controlled trials (RCTs) only. Participants in the trials were people with age-related cataract. We included trials where MSICS with a posterior chamber intraocular lens (IOL) implant was compared to ECCE with a posterior chamber IOL implant. Data were collected independently by two authors. We aimed to collect data on presenting visual acuity 6/12 or better and best-corrected visual acuity of less than 6/60 at three months and one year after surgery. Other outcomes included intraoperative complications, long-term complications (one year or more after surgery), quality of life, and cost

  19. Anatomic and radiological study on posterior pedicle screw fixation in the atlantoaxial vertebrae of children

    Institute of Scientific and Technical Information of China (English)

    DENG Xiong-wei; MIN Zhi-hai; LIN Bin; ZHANG Fa-hui

    2010-01-01

    Objective: To investigate the feasibility of posterior fixation with 3.5-mm pedicle screws in the atlantoaxial vertebrae of children.Methods: In this study, atlantoaxial vertebrae specimens were obtained from 10 cadavers of children aged 6-8 years. We measured the height and width of the C1 pedicle and the midportion of C1 lateral mass; the width of C1 posterior arch under the vertebral artery groove and the height of the external and internal one-third of this part; the external,internal height and the superior, middle, inferior width of the C2 pedicle (transverse foramen). Furthermore, computed tomography (CT) axial scan was performed on 20 agematched volunteers to obtain relative data of their atlantoaxial vertebrae. We measured the length and width of the C1 and C2 pedicles in the atlantoaxial cross-sectional plane. On CT workstation, we also measured the angles between the longitudinal axes of the atlantoaxial pedicles and the midsagittal plane.Results: For the cadaveric specimen group, the height and width of the C1 pedicle were (5.26±0.44) mm and (6.26±0.75) mm respectively. The height of the medial one-third of the C1 posterior arch under the vertebral artery groove was (4.07±0.24) mm. The external, internal height and superior,middle, inferior width of the C2 pedicle was (6.86±0.48) mm,(6.67±0.49) mm, (6.63 ±0.61 ) mm, (5.41±0.39) mm and (3.71±0.30) mm, respectively. For the volunteer group measured by CT scan, the height and width of the Ct pedicle were (5.47±0.34) mm and (6.63±0.54) mm respectively, while (6.59±0.51) mm and (5.13±0.42) mm of the C2 pedicle. The angles between the atlas, axis pedicles and the midsagittal plane were (9.60±1.32)° and (27.80±2.22)° respectively.Conclusion: It is feasible to place a 3.5-mm pedicle screw in the C1 and C2 pedicles of children aged 6-8 years old.

  20. Movement of a posterior chamber lens in phakic eyes assessed with partial coherence interferometry

    CERN Document Server

    Koeppl, C M

    2001-01-01

    Purpose: the implantable contact lens (ICL sup T sup M , STAAR Surgical), a posterior chamber phakic IOL, provides an effective refraction correction among high myopic and hypermetropic patients. However, the cause of cataract formation in some of these patients is still unclear. Mechanical contact between the ICL and the crystalline lens and inadequate aqueous circulation in the prelenticular space may cause subcapsular opacification. To get a better understanding of the pathogenesis of cataract formation after ICL implantation the distance changes between the ICL and the crystalline lens under different conditions were investigated. Methods: in an open pilot study, 13 eyes of 11 myopic and 2 hyperopic patients with a mean age of 38 years (range: 19 to 53 years) were examined at least 6 months after ICL implantation. Using a non-invasive, high resolution biometry technique, partial coherence interferometry (PCI), which has unprecedented precision in the micrometer region, distance changes between the ICL and...

  1. Location and composition of haptics of posterior chamber intraocular lenses. Histopathologic study of postmortem eyes.

    Science.gov (United States)

    McDonnell, P J; Champion, R; Green, W R

    1987-02-01

    Of 110 eyes with posterior chamber intraocular lenses (IOLs) examined postmortem, 37% had both haptics outside of the capsular bag; 57% had one haptic in the capsular bag and the other haptic outside of the bag. Typically, these optics were decentered by 1 to 2 mm. Only six eyes (5%) had both haptics within the capsular bag. Erosion into the ciliary sulcus produced obliteration of the major arterial circle of the iris in 12 eyes (11%). The local tissue response to eroding haptics was similar for haptics composed of polypropylene and haptics composed of polymethylmethacrylate (PMMA). The authors found considerable discrepancy between the actual location of haptics and the surgeon's desired location (i.e., capsular bag or ciliary sulcus). Most of these cases were clinically successful.

  2. CLINICAL STUDY OF POSTERIOR CHAMBER PHAKIC IOL PLACEMENT IN MYOPIC PATIENTS

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    Ashok Kumar P

    2017-02-01

    Full Text Available BACKGROUND The aim of this study was to determine the safety and efficacy of posterior chamber phakic IOL in Myopic patients. MATERIALS AND METHODS This prospective interventional study included 50 eyes of 50 patients with myopia. Patients of age more than 18 yrs. Stable refraction, Myopia, Mild to Moderate keratoconus and absence of any ocular pathology and any history of ocular surgeries were included in this study. Prior to starting treatment certain parameters like visual acuity, AC depth, Iridocorneal Angle Aperture, Endothelial cell count, Central corneal thickness and IOP were considered. Intervention- Implantation of the phakic IOL. Main outcome Measures- Uncorrected Visual Acuity (UCVA, best spectacle corrected visual acuity (BSCVA, AS OCT AC depthbetween endothelium and phakic IOL, IOP and Endothelial cell count were recorded. RESULTS Postoperative examinations conducted at day 1, day 3, after 1 week, 1 month and after 3 months .out of 50 patients, 4 patients had striate keratopathy, 2 patients had shallow ac during immediate post-operative period. During the postoperative follow up 10 patients had BCVA of 6/9-6/6 (20%, 14 patients had 6/9-6/12 (28%, 24 patients had 6/12-6/24(48% and remaining 2 patients had <6/24 which was better than their preoperative uncorrected visual acuity. CONCLUSION Based on this prospective clinical study and on comparison with other clinical studies posterior chamber phakic IOL corrective procedures are safe and effective for treatment of myopia. It also shows that it can provide sharp and clear vision in 96% of our study population. It does not induce dry eye syndrome as in other refractive surgeries. Short term complications like endothelial damage, angle closure glaucoma, iritis, anterior capsule injury/lens changes were not encountered during our study. But still long term follow up is required to confirm long term safety of the implant.

  3. Interlenticular opacification: clinicopathological correlation of a complication of posterior chamber piggyback intraocular lenses.

    Science.gov (United States)

    Gayton, J L; Apple, D J; Peng, Q; Visessook, N; Sanders, V; Werner, L; Pandey, S K; Escobar-Gomez, M; Hoddinott, D S; Van Der Karr, M

    2000-03-01

    To present a clinicopathological correlation of 2 pairs of piggyback posterior chamber intraocular lenses (PC IOLs) explanted because of opacification between the lens optics. Gayton Health Center, Eyesight Associates of Middle Georgia, Warner Robins, Georgia, and Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. Two pairs of piggyback AcrySof lenses were explanted from 2 patients with significant visual loss related to opacification between the optics. They were submitted for pathological analysis. Gross and histopathological examinations were performed, and photomicroscopy was used to document the results. Gross examination showed accumulation of a membrane-like white material between the lenses. Histopathological examination revealed that the tissue consisted of retained/proliferative lens epithelial cells (bladder cells or pearls) mixed with lens cortical material. Piggyback PC IOLs were explanted in 2 cases because of a newly described complication, interlenticular opacification. Three surgical means may help prevent this complication: meticulous cortical cleanup, especially in the equatorial region; creation of a relatively large continuous curvilinear capsulorhexis to sequester retained cells peripheral to the IOL optic within the equatorial fornix; insertion of the posterior IOL in the capsular bag and the anterior IOL in the ciliary sulcus to isolate retained cells from the interlenticular space.

  4. Pseudophakic hyperopia in nanophthalmic eyes managed by a posterior chamber implantable collamer lens

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    Kothari Kulin

    2011-01-01

    Full Text Available We report a case of a bilateral posterior chamber implantable collamer lens (ICL implantation post-clear lens extraction, to reduce the residual hyperopia, in a patient with nanophthalmic eyes. A 30-year-old female patient, keen to reduce her dependency on glasses and contact lenses, came to our refractive surgery department. Her refractive error was +12.0 and +12.5 diopters in the right and left eye, respectively, with steep corneas on keratometry and a shallow anterior chamber depth. She underwent clear lens extraction with implantation of +35.0 D and +40.0 D IOL in the right eye and left eye, respectively. Her post-operative best-corrected visual acuity was 20/30 with +8.5 D in the right eye and +6 D in the left. She underwent bilateral ICL implantation. Postoperatively after 6 months, her unaided visual acuity was 20/30 in both eyes. In conclusion, ICL implantation can be considered to correct residual hypermetropic ametropia in pseudophakic eyes when other options have limitations.

  5. ASTM F1717 standard for the preclinical evaluation of posterior spinal fixators: can we improve it?

    Science.gov (United States)

    La Barbera, Luigi; Galbusera, Fabio; Villa, Tomaso; Costa, Francesco; Wilke, Hans-Joachim

    2014-10-01

    Preclinical evaluation of spinal implants is a necessary step to ensure their reliability and safety before implantation. The American Society for Testing and Materials reapproved F1717 standard for the assessment of mechanical properties of posterior spinal fixators, which simulates a vertebrectomy model and recommends mimicking vertebral bodies using polyethylene blocks. This set-up should represent the clinical use, but available data in the literature are few. Anatomical parameters depending on the spinal level were compared to published data or measurements on biplanar stereoradiography on 13 patients. Other mechanical variables, describing implant design were considered, and all parameters were investigated using a numerical parametric finite element model. Stress values were calculated by considering either the combination of the average values for each parameter or their worst-case combination depending on the spinal level. The standard set-up represents quite well the anatomy of an instrumented average thoracolumbar segment. The stress on the pedicular screw is significantly influenced by the lever arm of the applied load, the unsupported screw length, the position of the centre of rotation of the functional spine unit and the pedicular inclination with respect to the sagittal plane. The worst-case combination of parameters demonstrates that devices implanted below T5 could potentially undergo higher stresses than those described in the standard suggestions (maximum increase of 22.2% at L1). We propose to revise F1717 in order to describe the anatomical worst case condition we found at L1 level: this will guarantee higher safety of the implant for a wider population of patients.

  6. Flexion-distraction injury of the L1 vertebra treated with short-segment posterior fixation and Optimesh.

    Science.gov (United States)

    Inamasu, Joji; Guiot, Bernard H; Uribe, Juan S

    2008-02-01

    We report a patient with a flexion-distraction injury of the L1 vertebra treated with a combination of short-segment posterior fixation and Optimesh (Spineology Inc., St. Paul, MN, USA), a flexible balloon-shaped mesh that is deployed into the fractured vertebra together with allograft. The patient, a 47-year-old man, was admitted after sustaining a motor vehicle accident. Imaging studies showed an L1 compression fracture. The patient had no neurologic deficits and was treated conservatively. However, intense back pain persisted and significant kyphosis was noted when he mobilized. Review of the imaging studies strongly suggested disruption of the posterior spinal ligaments. Surgical intervention was performed to address both restoration of the posterior tension band and anterior column height simultaneously. The combined procedure consisted of short-segment posterior fixation from T12 to L2, and placement of Optimesh filled with allograft into the L1 vertebral body. The anterior column height was restored and spinal alignment was corrected by the procedure, and the patient's back pain subsided soon after the procedure. The role of minimally invasive procedures for reconstruction of the vertebral column height, including the Optimesh system, in patients with thoracolumbar compression fracture seems promising. However, the long-term efficacy of these new techniques is unknown. It also remains to be seen how the delivery of allograft into the fractured vertebra via Optimesh affects remodeling, and whether the restored vertebral height is maintained.

  7. Posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia

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    HU Peng

    2012-08-01

    Full Text Available Background Chiari malformation type Ⅰ(CM-Ⅰ is one of the soft tissue anomalies in craniovertebral junction (CVJ. This kind of soft tissue anomaly usually develops with bone anomaly, such as atlantoaxial subluxation, basilar invagination, platybasia, C1 assimilation, etc. For these complex combined anomalies, the treatment remains unaddressed. This study was performed to evaluate the effect of posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia. Methods Patients with basilar invagination and atlantoaxial subluxation treated from July 2004 to September 2011 were reviewed. Including criterions were made to screen matching patients. Including patients were retrospectively analyzed on both clinical outcomes and radiographical results. Japanese Orthopaedic Association (JOA score was used to evaluate the clinical outcomes, while the syrinx maximum size was measured on transverse view of MRI T2 image. The results were analyzed by SPSS 17.0 using t -text. Significant difference was considered when P ≤ 0.05. Results Fourteen patients met the including criterions, including 4 male patients and 10 female patients, with a mean age of 31.86 ± 11.36 (standard deviation, range: 17-51 years. Mean JOA score preoperatively of 14 patients was 13.07 ± 1.59 (standard deviation, while that was 15.57 ± 1.02 (standard deviation postoperatively (t = 9.946, P = 0.000. The mean syrinx size was (7.05 ± 1.98 mm (standard deviation, while that was (2.21 ± 1.91 mm (standard deviation postoperatively (t = 7.271, P = 0.000. There were no procedure-related morbidity or mortality happened. Conclusion Direct posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression can obviously improve the clinical outcomes and shrink syrinx for patients suffered from Chiari malformation typeⅠ with

  8. Biomechanical comparison of anterior Caspar plate and three-level posterior fixation techniques in a human cadaveric model.

    Science.gov (United States)

    Traynelis, V C; Donaher, P A; Roach, R M; Kojimoto, H; Goel, V K

    1993-07-01

    Traumatic cervical spine injuries have been successfully stabilized with plates applied to the anterior vertebral bodies. Previous biomechanical studies suggest, however, that these devices may not provide adequate stability if the posterior ligaments are disrupted. To study this problem, the authors simulated a C-5 teardrop fracture with posterior ligamentous instability in human cadaveric spines. This model was used to compare the immediate biomechanical stability of anterior cervical plating, from C-4 to C-6, to that provided by a posterior wiring construct over the same levels. Stability was tested in six modes of motion: flexion, extension, right and left lateral bending, and right and left axial rotation. The injured/plate-stabilized spines were more stable than the intact specimens in all modes of testing. The injured/posterior-wired specimens were more stable than the intact spines in axial rotation and flexion. They were not as stable as the intact specimens in the lateral bending or extension testing modes. The data were normalized with respect to the motion of the uninjured spine and compared using repeated measures of analysis of variance, the results of which indicate that anterior plating provides significantly more stability in extension and lateral bending than does posterior wiring. The plate was more stable than the posterior construct in flexion loading; however, the difference was not statistically significant. The two constructs provide similar stability in axial rotation. This study provides biomechanical support for the continued use of bicortical anterior plate fixation in the setting of traumatic cervical spine instability.

  9. Membrane Formation on the Surface of implanted Posterior Chamber Intraocular Lenses

    Institute of Scientific and Technical Information of China (English)

    FangyaoYang; GuijunWu

    1995-01-01

    Purpose:To study the prevention and treatment of the membrane formation on the lens surface after extracapsular cataract extraction(ECCE)with posterior chamber intraocular lens(PCIOL)implantation.Methods:We reviewed the records of 312 cataractous patients that had undergone ECCEwith PCIOLimplantation between1989and1993,Postoperatively all pa-tients were examined under slit-lamp microscopy.The membrane formation on the surface of PCIOLin pupilar area was divided into four grades.Two mem-branes of surgical removal were observed under a transmission electrom mi-croscopy.One PCIOLof surgical removal was observed under a scanning electron microscopy.Results;Of312 patients,21 had the membrane formation on the surface of the PCIOL postoperatively.The incidence of the membrane formation was6.7%.Comparisone with cases of senile cataract showed the incidence to be significantly the highest among;1.patients who had traumatic cataract(P<0.05);2.pa-tients with complicated cataract(P<0.05).Interoperatively residual lens corten and rupture of posterior capsule,interval time betwwen the first and second eye operations less than 1month are the main factors of menbrane formation.The ultrastructure in membrane and cytology on the lens surface showed that the membrane on the surface of PCIOLs is usually composed of acellular protein film and cellular elements,including macrophages.fibroblast-like cells,epithelioid cells,giant cells,fibroblasts and collagen fibrils,etc.Conclusions:The cellular response on the surface of an implanted PCIOLis a chonic foreign-body inflammatory reaction and the membrane of the surfaceof implanted PCIOL is a reactive membrane of the foreign-body.Eye Science1995;11:131-135.

  10. Posteromedial approach of gastrocnemius for reduction and internal fixation of avulsed tibial attachment of posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-li; XU Hu; LI Ming-quan

    2006-01-01

    Objective:To introduce a posteromedial approach through the medial border of the medial head of gastrocnemius for reduction and reattachment of bony avulsion of the posterior cruciate ligament (PCL) from the tibia.Methods: Eleven patients with avulsed tibial attachment of the PCL underwent an operative reduction and internal fixation through the posteromedial approach of the gastrocnemius in our department from February 1998 to March 2000. The skin incision was reversed L-shaped along the medial border of the medial head of the gastrocnemius and the posterior capsule was exposed by dissecting the medial border and lateral retraction, avoiding the damage of the popliteal neurovascular structures. After that, the posterior capsule was vertically dissected a little medially to the posterior intercondylar sulcus and just on the posterior medial tibial eminence positioned by finger palpation. Then the PCL and its tibial attachment were easily accessible. In the delayed cases, PCL peripheral releasing was necessary to overcome the ligament retraction and to refresh the fracture bed for optimal reduction and bony healing. At last, one or two biodegradable screws were used to fix the avulsed bone segment and 30° flexion knee plaster cast immobilization was regularly applied after the wound was closed. The evaluation included X-ray, posterior sag sign and posterior drawer test compared with the contralateral side. The functional assessment of the low limbs was not available because of concomitant injuries.Results: The posteromedial approach of the gastrocnemius used in repair of tibial attachment avulsed injury of the PCL could provide benefit of clear anatomical exposure, few blood loss (20 ml on average), no need for detachment or reattachment of any structure. The patients were followed up for 11 months on an average (ranging from 6 months to 2 years ). It demonstrated that bony healing was achieved within 4-6 weeks in cases of fresh injury and 7-9 weeks in cases of

  11. Posterior Titanium Screw Fixation without Debridement of Infected Tissue for the Treatment of Thoracolumbar Spontaneous Pyogenic Spondylodiscitis

    Science.gov (United States)

    Iacoangeli, Maurizio; Nasi, Davide; Nocchi, Niccolo; Di Rienzo, Alessandro; di Somma, Lucia; Colasanti, Roberto; Vaira, Carmela; Benigni, Roberta; Liverotti, Valentina; Scerrati, Massimo

    2016-01-01

    Study Design Retrospective study. Purpose The aim of our study was to analyze the safety and effectiveness of posterior pedicle screw fixation for treatment of pyogenic spondylodiscitis (PSD) without formal debridement of the infected tissue. Overview of Literature Posterior titanium screw fixation without formal debridement of the infected tissue and anterior column reconstruction for the treatment of PSD is still controversial. Methods From March 2008 to June 2013, 18 patients with PSD underwent posterior titanium fixation with or without decompression, according to their neurological deficit. Postero-lateral fusion with allograft transplantation alone or bone graft with both the allogenic bone and the autologous bone was also performed. The outcome was assessed using the visual analogue scale (VAS) for pain and the Frankel grading system for neurological status. Normalization both of C-reactive protein (CRP) and erythrocyte sedimentation rate was adopted as criterion for discontinuation of antibiotic therapy and infection healing. Segmental instability and fusion were also analyzed. Results At the mean follow-up time of 30.16 months (range, 24–53 months), resolution of spinal infection was achieved in all patients. The mean CRP before surgery was 14.32±7.9 mg/dL, and at the final follow-up, the mean CRP decreased to 0.5±0.33 mg/dL (p <0.005). Follow-up computed tomography scan at 12 months after surgery revealed solid fusion in all patients. The VAS before surgery was 9.16±1.29 and at the final follow-up, it improved to 1.38±2.03, which was statistically significant (p <0.05). Eleven patients out of eighteen (61.11%) with initial neurological impairment had an average improvement of 1.27 grades at the final follow-up documented with the Frankel grading system. Conclusions Posterior screw fixation with titanium instrumentation was safe and effective in terms of stability and restoration of neurological impairment. Fixation also rapidly reduced back pain

  12. One-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion for the treatment of unstable hangman's fracture.

    Science.gov (United States)

    Liu, Jingchen; Li, Ye; Wu, Yuntao

    2013-03-01

    The present study aimed to evaluate the effect of using one-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion in the treatment of unstable hangman's fracture. A total of 13 patients with unstable hangman's fractures underwent C2 and C3 pedicle screw fixation, lamina interbody fusion or combined anterior C2-C3 fusion and imaging examinations to evaluate the fracture fixation and healing condition at three days and three months following surgery. Postoperative X-ray and computed tomography (CT) results showed high fracture reduction, good internal fixation position and reliable fracture fixation. The three-month postoperative CT showed good vertebral fracture healing. C2 and C3 pedicle screw fixation has a good curative effect in the treatment of unstable hangman's fracture. The direct fixation of the fracture enables early ambulation by the patients.

  13. Out-of-the-bag intraocular lens dislocation: outcomes of posterior chamber intraocular lens exchange, risk factors, and prevention

    Institute of Scientific and Technical Information of China (English)

    ZHENG Dan-ying; CHEN Li-na; SUN Yi; SHAO Ying-feng; LIANG Jing-li; LIU Yi-zhi

    2010-01-01

    Background Dislocation of posterior chamber intraocular lens is one of the most common complications of intraocular lens implantation. Lens exchange is an effective solution to this unsatisfactory status. This study was conducted to analyze the possible predisposing factors for out-of-the-bag posterior chamber intraocular lens dislocation and to study the outcomes of lens exchange surgery.Methods Thirty-six consecutive patients (36 eyes) with out-of-the-bag intraocular lens dislocation who underwent posterior chamber intraocular lens exchange in Zhongshan Ophthalmic Center of Sun Yat-sen University (Guangdong,China) from January 2003 to October 2009 were included. A 6-month follow-up was completed. The causes for out-of-the-bag intraocular lens dislocation and visual outcomes of posterior chamber intraocular lens exchange were analyzed. The out-of-the-bag intraocular lens dislocation was diagnosed on the basis of the findings from slit-lamp microscope and B-ultrasound. The dislocated intraocular lens was explanted. Reimplantation of a new posterior chamber intraocular lens was performed in each case using standardized surgical procedures.Results In this study, a total of thirty-six consecutive patients (36 eyes) with out-of-the-bag intraocular lens dislocation underwent posterior chamber intraocular lens exchange surgery. Causes for out-of-the-bag intraocular lens dislocation included posterior capsule rupture during the initial cataract extraction procedure (23 eyes, 63.8%), trauma (5 eyes,13.9%), neodymium-doped yttrium aluminium garnet (Nd:YAG) laser-induced dislocation (2 eyes, 5.6%), the status after vitrectomy (2 eyes, 5.6%) and unidentifiable etiology (4 eyes, 11.1%). Symptoms of these patients mainly included decrease in visual acuity (17 cases, 47.2%), blurred vision (16 cases, 44.4%), glare (1 case, 2.8%), diplopia (1 case,2.8%), and halo (1 case, 2.8%). Intraocular lens dislocation into the posterior vitreous cavity (29 eyes, 80.5%), anterior chamber (1

  14. Ruptura del ligamento cruzado posterior. Fijacion cortical retrógrada. [Rupture of posterior cruciate ligament. Retrograde cortical tibial fixation

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    Rodolfo Horacio Alonso

    2015-11-01

    Full Text Available Introducción Presentamos las dificultades propias de cada una de las técnicas empleadas en la reconstrucción del Ligamento Cruzado Posterior (LCP, el objetivo es analizar retrospectivamente si hemos mejorado el resultado final con la técnica actual de fijación cortical tibial retrógrada. Material y Método Sobre 106 pacientes operados con distintas técnicas de fijación artroscópica en rupturas del LCP, tipo II y III se incluyen 96 reconstrucciones en las cuales evaluamos retrospectivamente el cajón posterior (CP radiográfico al alta.   Se excluyeron 8 pacientes que no están de alta o se perdieron durante el tratamiento y dos pacientes operados con injerto de tendón cuadricipital, que por el escaso número no tienen relevancia estadística y cuyo CP al alta fue similar a nuestras primeras cirugías. Resultados El CP radiográfico al alta tuvo diferencias estadísticamente significativas entre la técnica actual y las otras realizadas anteriormente. Conclusión La reconstrucción del LCP con esta técnica, objetivamente ha mejorado el CP final radiográfico.

  15. The effect of posterior spinal fixation with acrylic cement on the vertebral growth plate and intervertebral disc in dogs.

    Science.gov (United States)

    Moon, M S; Ok, I Y; Ha, K Y

    1986-01-01

    We have attempted to clarify the serial histological changes in the growing spine of dogs following posterior fixation with acrylic cement. Twenty-four male mongrel dogs aged 8 weeks were used for the study. The lumbar spine from L.3 to L.5 was fixed posteriorly with acrylic cement. Three dogs were then sacrificed every four weeks up to 32 weeks, and the histological changes of the vertebral disc, growth plate and vertebral bodies were observed by light microscopy. Thinning of the growth plate and distortion of the cartilage columns has been demonstrated, but premature fusion of the growth plate did not result and vertebral body growth continued. Anterior wedging of the intervertebral disc was seen with some thinning of the bony trabeculae of the vertebral body. Degeneration of the nucleus pulposus resulted, with replacement by fibrous tissue. The normal horizontal arrangement of the fibres of the annulus fibrosus altered to a vertical configuration by 32 weeks.

  16. A finite element modeling of posterior atlantoaxial fixation and biomechanical analysis of C2 intralaminar screw fixation

    Institute of Scientific and Technical Information of China (English)

    Ma Xuexiao; Peng Xianbo; Xiang Hongfei; Zhang Yan; Zhang Guoqing; Chen Bohua

    2014-01-01

    Background The objective of this study was to use three-dimensional finite element (FE) models to analyze the stability and the biomechanics of two upper cervical fixation methods:the C2 intralaminar screw method and the C2 pedicle screw method.Methods From computed tomography images,a nonlinear three-dimensional FE model from C0 (occiput) to C3 was developed with anatomic detail.The C2 intralaminar screw and the C2 pedicle screw systems were added to the model,in parallel to establish the interlaminar model and the pedicle model.The two models were operated with all possible states of motion and physiological loads to simulate normal movement.Results Both the C2 intralaminar screw method and the C2 pedicle screw method significantly reduced motion compared with the intact model.There were no statistically significant differences between the two methods.The Von Mises stresses of the internal and external laminar walls were similar between the two methods.Stability was also similar.Conclusions The C2 intralaminar screw method can complement but cannot completely replace the C2 pedicle screw method.Clinicians would need to assess and decide which approach to adopt for the best therapeutic effect.

  17. Comparison of the effect of posterior lumbar interbody fusion with pedicle screw fixation and interspinous fixation on the stiffness of adjacent segments

    Institute of Scientific and Technical Information of China (English)

    LI Chun-de; SUN Hao-lin; LU Hong-zhang

    2013-01-01

    Background Adjacent segment degeneration could seriously affect the long-term prognosis of lumbar fusion.Dynamicfixation such as the interspinous fixation,which is characterized by retaining the motion function of the spinal segment,has obtained satisfactory short-term effects in the clinical setting.But there are few reports about the biomechanicalexperiments on whether dynamic fixation could prevent adjacent segment degeneration.Methods The surgical segments of all 23 patients were L4/5.Thirteen patients with disc herniation of L4/5 underwentWallis implantation surgery,and 10 patients with spinal stenosis of L4/5 underwent posterior lumbar interbody fusion(PLIF).L3-S1 segmental stiffness and displacement were measured by a spine stiffness gauge (SSG) device duringsurgery when the vertebral plate was exposed or during spinal decompression or internal fixation.Five fresh,frozencadavers were used in the self control experiment,which was carried out in four steps:exposure of the vertebral plate,decompression of the spinal canal,implantation of a Wallis fixing device,and PLIF of L4/5 after removing the Wallis fixingdevice.Then,L3-S1 segment stiffness was measured by an SSG device.Results The experiments showed that the average stiffness of the L4/5 segment was (37.1±8.9) N/mm after exposure of the vertebral plate,while after spinal decompression,the average stiffness fell to (26.2±7.1) N/mm,decreasing by 25.8% (P <0.05).For the adjacent segments L3/4 and L5/S1,their stiffness showed no significant difference between the L4/5 segment decompression and the exposure of the vertebral plate (P >0.05).After Wallis implantation of L4/5,the stiffness of the cephalic adjacent segment L3/4 was (45.8±10.7) N/mm,which was 20.5% more than that after the exposure of the vertebral plate (P <0.05); after L4/5 PLIF surgery,the stiffness of L3/4 was (35.3±10.7) N/mm and was decreased by 12.4% more than that after the exposure of the vertebral plate (P <0.05).The

  18. Comparison between Bilateral C2 Pedicle Screwing and Unilateral C2 Pedicle Screwing, Combined with Contralateral C2 Laminar Screwing, for Atlantoaxial Posterior Fixation

    OpenAIRE

    Miyakoshi, Naohisa; HONGO, MICHIO; Kobayashi, Takashi; Suzuki, Tetsuya; Abe, Eiji; Shimada, Yoichi

    2014-01-01

    Study Design A retrospective study. Purpose To compare clinical and radiological outcomes between bilateral C2 pedicle screwing (C2PS) and unilateral C2PS, combined with contralateral C2 laminar screwing (LS), for posterior atlantoaxial fixation. Overview of Literature Posterior fixation with C1 lateral mass screwing (C1LMS) and C2PS (C1LMS-C2PS method) is an accepted procedure for rigid atlantoaxial stabilization. However, conventional bilateral C2PS is not always allowed in this method due ...

  19. [Percutaneous fluoroscopic and arthroscopic controlled screw fixation of posterior facet fractures of the calcaneus].

    Science.gov (United States)

    Nehme, A; Chaminade, B; Chiron, P; Fabie, F; Tricoire, J-L; Puget, J

    2004-05-01

    We describe a new technique for reduction and percutaneous osteosynthesis of displaced posterior facet fractures of the calcaneus which appears to overcome the problems encountered with other percutaneous methods described for this type of surgery. The method relies on the use of traction which allows automatic reduction of the greater tubersosity. The patient is installed on an orthopedic traction table. Pin traction provides anatomic reduction of the posterior articular surface and restitution of Böhler's angle under fluoroscopic and arthroscopic control. We used this technique in thirteen patients with fifteen displaced posterior facet fractures of the calcaneum. Mean patient age was 50.4 Years. Mean follow-up was twenty Months. We did not have any cutaneous or infectious complications in this short series. In the majority of the cases, the overall functional and physical results were excellent or good. The mean Böhler's angle was 27 degrees, corresponding to 83% correction compared with the healthy side. These preliminary results are encouraging. We were able to restitute calcaneum anatomy, shorten hospital stay, and avoid all skin complications. Indications for this percutaneous technique could be widened. It is a valid alternative to open treatment of posterior facet fractures of the calcaneum.

  20. Phacoemulsification with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    Science.gov (United States)

    de Silva, Samantha R; Riaz, Yasmin; Evans, Jennifer R

    2014-01-29

    ). Studies varied in visual acuity assessment methods and time frames at which outcomes were reported. Participants in the phacoemulsification group were more likely to achieve UCVA of 6/12 or more at three months (risk ratio (RR) 1.81, 95% confidence interval (CI) 1.36 to 2.41, two studies, 492 participants) and one year (RR 1.99, 95% CI 1.45 to 2.73, one study, 439 participants). People in the phacoemulsification group were also more likely to achieve BCVA of 6/12 or more at three months (RR 1.12, 95% CI 1.03 to 1.22, four studies, 645 participants) and one year (RR 1.06, 95% CI 0.99 to 1.14, one study, 439 participants), but the difference between the two groups was smaller. No trials reported BCVA less than 6/60 but three trials reported BCVA worse than 6/9 and 6/18: there were fewer events of this outcome in the phacoemulsification group than the ECCE group at both the three-month (RR 0.33, 95% CI 0.20 to 0.55, three studies, 604 participants) and 12-month time points (RR 0.62, 95% CI 0.36 to 1.05, one study, 439 participants). Three trials reported posterior capsule rupture: this occurred more commonly in the ECCE group than the phacoemulsification group but small numbers of events mean the true effect is uncertain (Peto odds ratio (OR) 0.56, 95% CI 0.26 to 1.22, three studies, 688 participants). Iris prolapse, cystoid macular oedema and posterior capsular opacification were also higher in the ECCE group than the phacoemulsification group. Phacoemulsification surgical costs were higher than ECCE in two studies. A third study reported similar costs for phacoemulsification and ECCE up to six weeks postoperatively, but following this time point ECCE incurred additional costs due to additional visits, spectacles and laser treatment to achieve a similar outcome. Removing cataract by phacoemulsification may result in a better visual acuity compared to ECCE, with a lower complication rate. The review is currently underpowered to detect differences for rarer outcomes

  1. Bilateral posterior cervical cages provide biomechanical stability: assessment of stand-alone and supplemental fixation for anterior cervical discectomy and fusion

    Directory of Open Access Journals (Sweden)

    Voronov LI

    2016-07-01

    Full Text Available Leonard I Voronov,1,2 Krzysztof B Siemionow,3 Robert M Havey,1,2 Gerard Carandang,1,2 Frank M Phillips,4 Avinash G Patwardhan1,2 1Musculoskeletal Biomechanics Laboratory, Department of Research, Edward Hines Jr VA Hospital, Hines, IL, USA; 2Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, Maywood, IL, USA; 3College of Medicine at Chicago, University of Illinois, Chicago, IL, USA; 4Midwest Orthopedics at Rush, Rush University Medical Center, Chicago, IL, USA Introduction: Supplemental posterior instrumentation has been widely used to enhance stability and improve fusion rates in higher risk patients undergoing anterior cervical discectomy and fusion (ACDF. These typically involve posterior lateral mass or pedicle screw fixation with significant inherent risks and morbidities. More recently, cervical cages placed bilaterally between the facet joints (posterior cervical cages have been used as a less disruptive alternative for posterior fixation. The purpose of this study was to compare the stability achieved by both posterior cages and ACDF at a single motion segment and determine the stability achieved with posterior cervical cages used as an adjunct to single- and multilevel ACDF.Methods: Seven cadaveric cervical spine (C2–T1 specimens were tested in the following sequence: intact, C5–C6 bilateral posterior cages, C6–C7 plated ACDF with and without posterior cages, and C3–C5 plated ACDF with and without posterior cages. Range of motion in flexion–extension, lateral bending, and axial rotation was measured for each condition under moment loading up to ±1.5 Nm.Results: All fusion constructs significantly reduced the range of motion compared to intact in flexion–extension, lateral bending, and axial rotation (P<0.05. Similar stability was achieved with bilateral posterior cages and plated ACDF at a single level. Posterior cages, when placed as an adjunct to ACDF, further reduced range of motion in both

  2. Comparison of results and complications following combined ECCE-trabeculectomy versus small-incision-trabeculectomy and posterior chamber lens implantation.

    Science.gov (United States)

    Wedrich, A; Menapace, R; Hirsch, U; Papapanos, P; Derbolav, A; Ries, E

    To compare the efficacy and complication rate of two standard cataract extraction techniques with different incision lengths when combined with trabeculectomy. 54 eyes after combined ECCE, posterior chamber lens implantation and trabeculectomy (ECCE-group) are compared with 49 eyes following phacoemulsification, trabeculectomy and implantation of a folded flexible posterior chamber lens (small-incision group). Minimum follow-up was 24 months. Glaucoma control was achieved in all eyes of both groups. There was a tendency towards a higher number of patients without therapy in the small-incision group (82% versus 65%, p = 0.07). Final mean IOP (14.2 +/- 3.0 mmHg versus 15.5 +/- 2.7 mmHg, p = 0.02) and mean therapy index (0.2 +/- 0.5 versus 0.4 +/- 0.6, p = 0.03) were significantly lower in the small-incision group. Postoperative complications such as severe fibrin effusion (41% versus 18%, p = 0.018), early postoperative IOP rises > 25 mmHg (18% versus 2%, p = 0.009), filtering bleb scarring (63% versus 8%, p ECCE-group. With the decrease of the incision size necessary for the cataract extraction a reduction of postoperative complications and better functional results are achieved in combined cataract/glaucoma surgery.

  3. Anterior Chamber Angle Evaluation following Phakic Posterior Chamber Collamer Lens with CentraFLOW and Its Correlation with ICL Vault and Intraocular Pressure

    Science.gov (United States)

    El-Deeb, Mohamed W. A.

    2016-01-01

    Purpose. To assess intraocular pressure (IOP), lens vaulting, and anterior chamber (AC) angle width, following V4C implantable Collamer lens (ICL) procedure for myopic refractive error. Methods. A prospective case series that enrolled 54 eyes of 27 patients that were evaluated before and after V4C phakic posterior chamber Collamer lens implantation for correction of myopic refractive error. Preoperative measurement of IOP was done using Goldmann applanation tonometer and anterior chamber angle width using both Van Herick slit lamp grading system and Scheimpflug tomography imaging (Oculus Pentacam). Follow-up of the aforementioned variables was at 1, 6, and 18 months postoperatively, together with ICL vault measurements. Results. The mean baseline IOP of 11.69 ± 2.15 showed a statistically significant (P = 0.002) increase after 1 month that remained unchanged at 6 and 18 months postoperatively, with mean value of 16.07 ± 4.12, 16.07 ± 4.10, and 16.07 ± 4.13, respectively. Pentacam AC angle width showed a statistically significant decrease at 1 (P = 0.025), 6 (P = 0.016), and 18 (P = 0.010) months postoperatively, with mean preoperative value of 40.14 ± 5.49 that decreased to 25.28 ± 5.33, 25.46 ± 5.44, and 25.49 ± 5.38, at 1, 6, and 18 months, respectively. Mean ICL vault showed moderate correlation with Pentacam AC angle width at 1 (r = −0.435) and 6 (r = −0.424) months. Conclusion. V4C ICL implantation resulted in decrease in AC angle width and increase in IOP, within acceptable physiological values at all time points. PMID:28053776

  4. Posterior Cruciate Ligament Tibial Avulsion treated with Open Reduction and Internal Fixation through the Burks and Schaffer Approach

    Directory of Open Access Journals (Sweden)

    Khatri K

    2015-07-01

    Full Text Available Objective: To report functional outcome in Posterior Cruciate Ligament (PCL tibial avulsion fractures treated with open reduction and internal fixation through Burks and Schaffer approach. The patient specific functional outcome measures like IKDC grading together with objective grading with stress radiographs have rarely been used to assess PCL tibial avulsion fractures. Material and Methods: Twenty seven patients (21 males and 6 females were included in the study. The mean follow up duration was 22.30±6.82 months. They were assessed using international knee documentation committee (IKDC grades, Lysholm scoring and stress radiography. The injury severity scores (ISS of the patients were also recorded. Results: The mean Lysholm scores at the time of last follow up was 90.85±5.58. The IKDC grades achieved were normal in 20 patients, near normal in five and abnormal in two. The PCL laxity determined on active hamstring contraction stress radiography was grade I in 20 cases and grade II in seven cases. All patients had achieved bony union of tibial avulsion fractures at the time of last follow up. Statistically significant association was found between higher ISS and lower Lysholm scores. (t=3.455, p=0.0019. Good IKDC grades were associated with higher Lysholm scores (analysis of variance, F=32.51, p<.0001.There was no correlation between PCL laxity and functional outcome (t=.857, p =0.399. Conclusion: PCL tibial avulsion fractures treated through Burk and Schaffer approach with open reduction and internal fixation produces good results. The early rehabilitation without cast immobilisation prevents arthrofibrosis.

  5. Lente fácica de câmara posterior para correção da miopia Posterior chamber phakic lens for the correction of myopia

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    Ricardo Queiroz Guimarães

    2001-02-01

    Full Text Available Objetivo: Avaliar a eficácia, previsibilidade e segurança do implante de lente intra-ocular de câmara posterior em pacientes com miopia moderada e elevada. Métodos: Analisamos os resultados das cirurgias realizadas em 93 olhos de 54 pacientes para implante de lente fácica de câmara posterior com a finalidade de corrigir miopia moderada e elevada. O objetivo da cirurgia era a emetropia. O acompanhamento médio foi de 9 meses, variando de 1 a 38 meses (desvio padrão 10,45. Resultados: O equivalente esférico médio pré-operatório era -13,56 D (variando de -5,75 a -20,38 D e o equivalente esférico médio pós-operatório no último exame foi -0,92 D (variando de -3,88 a +1,00 D. No último exame, 39 olhos (41,9% se encontravam entre ±0,50 D da emetropia, 64 olhos (68,8% estavam entre ±1,00 D e 88 olhos (94,6% estavam entre ±2,00 D da emetropia. Um ganho de duas ou mais linhas de visão foi observado em 45,17% (42 olhos. Em 15 olhos (16,1% ocorreu algum tipo de complicação: em 2 olhos (2,2% houve perda de células endoteliais, em 2 olhos (2,2% ocorreu bloqueio pupilar e em 11 olhos (11,8% houve alterações de transparência lenticular, assintomática em 5 olhos (5,4% e sintomática em 6 olhos (6,5%. Conclusão: O implante de lente fácica de câmara posterior para correção de miopia moderada e alta é um método eficaz, previsível e seguro. O significativo ganho de linhas de visão é uma observação freqüente nesta técnica. Um acompanhamento pós-operatório mais prolongado em um maior número de pacientes é necessário para confirmar a estabilidade dos resultados a longo prazo.Purpose: To examine the efficacy, predictability and safety of posterior chamber phakic intraocular lens implantation in patients with moderate and high myopia. Methods: We analyzed the results of 93 eyes of 54 patients who were submitted to the implantation of a posterior chamber phakic lens for the correction of their myopia. The target postoperative

  6. 螺钉置入内固定修复后踝骨折的适应证%Indications for screw fixation of posterior malleolas fractures

    Institute of Scientific and Technical Information of China (English)

    程渊; 高仕长; 倪卫东; 梁安霖

    2015-01-01

    BACKGROUND:Posterior maleolar fractures are often accompanied by ankle joint instability,if the stability of ankle joint is not recovered,it is prone to traumatic arthritis of the ankle.However,the indications of internal fixation of posterior maleolar fractures remain controversial.OBJECTIVE:To explore the indications for internal fixation of posterior maleolar fractures by comparing the clinical effects of posterior maleolar fractures treated with internal fixation or not.METHODS:42 patients with maleolar fractures involving posterior ankle were recruited from the First Affiliated Hospital of Chongqing Medical University from January 2007 to January 2012.According to preoperative CT scans of ankle joint,42 cases were divided into the internal fixation group and the non-fixation group.27 cases in the fixation group had posterior maleolar fractures in more than 10%of the distal tibial articular surface and/or dislocation of the posterior maleolar fractures greater than 2 mm,and were treated with screws.15 cases in the non-fixation group had posterior maleolar fractures in less than 10%of the distal tibial articular surface anddislocation of the posterior maleolar fractures less than 2 mm,and were treated with non-operation.The average healing time of posterior maleolar fractures,postoperative complications,ankle-hindfoot scores of American Orthopedic Foot and Ankle Society were compared during the folow-up postoperatively.RESULTS AND CONCLUSION:Al of 42 patients with ankle fractures achieved bony union within 6 months.In the fixation group,1 case had postoperative superficial infection of the wounds in the medial ankle and lateral ankle,and the wound got healed completely with anti-infection therapy.One case in each group had postoperative superficial necrosis in the incisional edges,and got healed by dress changing.For the other cases,there was no wound infection,internal fixation loosening,breakage or failure and other adverse events during the folow

  7. Long-term outcome of medial rectus recession and pulley posterior fixation in esotropia with high AC/A ratio.

    Science.gov (United States)

    Wabulembo, Geoffrey; Demer, Joseph L

    2012-09-01

    Medial rectus (MR) recession with pulley posterior fixation (PF) can be used to treatesotropia (ET) with a high accommodative convergence to accommodation (AC/A) ratio as effectively in the short term as MR recession with scleral PF. This study provides a novel examination of the long-term results of MR recession with pulley PF (PPF). In 21 children we performed bilateral MR recession and pulley PF for ET greater at near than distance (high AC/A). Mean follow-up was 3.5 ± 2.5 (standard deviation [SD]) years. Mean age at presentation was 2.7 ± 1.8 and at surgery 4.3 ± 1.6 years. Fourteen (67%) children had amblyopia. Distance and near pre-operative ET averaged 19.6Δ ± 10.5Δ and 36.9Δ ±18.9Δ, respectively. Mean near-distance (N-D) disparity was 16.4Δ ± 12.3Δ. The MR recession averaged 4.4 ± 0.9 mm. Early mean postoperative ET was 1.3 ± 3.3Δ at distance and 2.8Δ ± 5.2Δ at near. Mean late postoperative ET was 0.1Δ ± 5.8Δ and 1.0Δ ± 6.2Δ at distance and near, respectively. At the final postoperative examination, mean N-D disparity was reduced to 0.9Δ ± 3.6Δ. MR recession with PPF has a high long-term effectiveness, even in patients with amblyopia and autism. Since no posterior scleral suturing is required, it minimizes the perforation risk associated with scleral PF. MR recession with PPF is a safe and highly effective long-term treatment for ET with high AC/A ratio. Long-term results may surpass those of alternate procedures.

  8. A STUDY OF POSTERIOR LUMBAR INTERBODY FUSION WITH LOCALLY HARVESTED SPINOLAMINECTOMY BONE GRAFT AND PEDICLE SCREW FIXATION IN SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Pardhasaradhi M

    2017-08-01

    Full Text Available BACKGROUND Posterior Lumbar Interbody Fusion (PLIF and Transforaminal Lumbar Interbody Fusion (TLIF create intervertebral fusion by means of a posterior approach. Successful results have been reported with allograft, various cages (for interbody support, autograft and recombinant human bone morphogenetic protein‐2. Interbody fusion techniques facilitate reduction and enhance fusion. Corticocancellous laminectomy bone chips alone can be used as a means of spinal fusion in patients with single level instrumented PLIF. This has got a good fusion rate. PLIF with cage gives better fusion on radiology than PLIF with iliac bone graft, but no statistical difference in the clinical outcome. Cage use precludes complications associated with iliac bone harvesting. The reported adjacent segment degeneration was 40.5% and reoperation was 8.1% after 10 years of follow up. MATERIALS AND METHODS 30 cases of spondylolisthesis who attended the Orthopaedic Outpatient Department of Andhra Medical College, Visakhapatnam, from 2014 to 2016 were taken up for study. All the cases were examined clinically and confirmed radiologically. The patient’s age, sex, symptoms and duration were noted and were examined clinically for the status of the spine. Straight leg raising test was done and neurological examination of the lower limbs performed. All the patients were subjected to the radiological examination of the lumbosacral spine by taking anteroposterior, lateral (flexion and extension views, oblique views to demonstrate spondylolysis and spondylolisthesis. MRI and x-rays studies were done in all the cases to facilitate evaluation of the root compression disk changes and spinal cord changes. RESULTS In our study, we followed all the 30 patients after the surgery following procedure of removal of loose lamina, spinous process and fibrocartilaginous mass, PLIF with only the laminectomy bone mass and CD screw system fixation up to 2 years. 12 patients (40% had excellent

  9. The Use of Posterior Short Segment Screw Fixation and Balloon Kyphoplasty in the Surgical Treatment of Traumatic Vertebral Fracture: A Case Report

    Directory of Open Access Journals (Sweden)

    Sevim Ondul

    2012-04-01

    Full Text Available Surgical treatments for the fracture of the spine are frequently used in clinical practice. Posterior spine stabilization with transpedicular screw fixation is one of the surgical treatment methods in the surgical treatment of spinal fractures. A 48-year old male patient was admitted to our hospital with a diagnosis of the L1 compression fracture resulting from traumatic injury. Posterior transpedicular screws were placed at one level above and one level below of the fractured vertebrate. Anterior column of the fractured vertebrate was strengthened with balloon kyphoplasty application. The system was completed with the placement of transverse rods. Fusion with allograft was performed. According to the ASIA neurological grading system, the patient was assessed as Grade E. 10 cm skin and fascia incision was done. Operation time of about 70 minutes and blood loss was less than 100 cc. The patient was mobilized on the first day of surgery and was discharged from the hospital on the third day after the surgery. Short segment transpedicular fixation on the one level above and one level below of the fractured vertebrate together with balloon kyphoplasty on the corpus of the fractured vertebrate may be used as a minimally invasive surgical treatment in such kind of injuries. The advantages are short duration of hospital stay, less blood loss, providing early mobilization, and a reliable method for fixation and stabilization. In this article, a case with traumatic fracture that fixed and stabilized with short segment transpedicular screw placement and balloon kyphoplasty application was presented.

  10. Surveying of Pressure in Posterior Chamber and Pressure Difference Between Anterior and Posterior Chambers of Rabbit Eye in Vivo%正常兔眼后房压强及前后房压强差值的在体监测

    Institute of Scientific and Technical Information of China (English)

    宋红芳; 杨红玉; 刘志成

    2011-01-01

    目的 寻求一种眼后房穿刺方法,并在体测量兔眼的前、后房压强差.方法 利用高精度压力传感器与空气差压传感器,采用"从角巩膜缘外周1~1.5mm处进针穿透巩膜,使针水平滑行于虹膜下而进入后房"的扎针方法,实现在体连续监测正常兔眼麻醉状态下的后房压强与前后房压强差值.结果 麻醉状态下兔眼后房压强的范围在839.93~2662.48Pa;前、后房压强差范围是46.15~85.52Pa,均值为59.73Pa,变化周期为11.17min.结论 扎针方法测量兔眼后房压强及前后房压强差值对眼球损伤较小,监测到的正常兔眼后房压强及前后房压强差值均在合理可信的范围内.监测方法的可行性为青光眼前后房压强差值的在体监测提供了新的思路.%Objective To find a proper method of puncturing into the posterior chamber of the rabbit eye and to measure the pressure in posterior chamber and the pressure difference between anterior and posterior chambers in vivo. Methods With the help of the high-accuracy pressure and pressure difference sensors, the pressure in posterior chamber and the pressure difference between anterior and posterior chambers were measured continuously in normal rabbit eyes with anesthesia in vivo. The needle directly punctured into the posterior chamber at 1 to 1.5 millimeters away from the cornea-sclera limbus, penetrated the sclera, and then slided horizontally the needle underneath the iris. Results The pressure value in posterior chamber was from 839. 93 Pa to 2662. 48 Pa, while the pressure difference between anterior and posterior chambers was from 46. 15 Pa to 85. 52 Pa with its average value 59. 73 Pa and the wave period was about 11. 17 min. Conclusions The puncture method for surveying the pressure of rabbit ' s chambers does less hurt to the eye-ball and the experimental data of the pressures in posterior chamber and pressure difference between anterior and posterior chambers. are authentic and

  11. Pediatric Patient with Incidental Os Odontoideum Safely Treated with Posterior Fixation Using Rod-Hook System and Preoperative Planning Using 3D Printer: A Case Report.

    Science.gov (United States)

    Sakai, Toshinori; Tezuka, Fumitake; Abe, Mitsunobu; Yamashita, Kazuta; Takata, Yoichiro; Higashino, Kosaku; Nagamachi, Akihiro; Sairyo, Koichi

    2017-05-01

    Os odontoideum is often found incidentally. Surgical treatment is recommended for patients with atlantoaxial instability or neurologic deficits. Although various techniques have been used for C1-C2 fusion in adults, the use of these procedures in children is not widely accepted. We present a 12-year-old boy with incidental os odontoideum and obvious C1-C2 instability, in which bony union was achieved safely and successfully by posterior fixation using a rod-hook system and perioperative planning using a three-dimensional printer. At the 2-year follow-up, bone formation around the gap of the dens, which has been generally considered as pseudoarthrosis, was obtained after union of the posterior element of C1-C2. Georg Thieme Verlag KG Stuttgart · New York.

  12. Posterior chamber collagen copolymer phakic intraocular lens with a central hole for moderate-to-high myopia

    Science.gov (United States)

    Cao, Xinfang; Wu, Weiliang; Wang, Yang; Xie, Chen; Tong, Jianping; Shen, Ye

    2016-01-01

    Abstract The purpose of this article is to evaluate the clinical outcomes of a posterior chamber phakic intraocular lens (pIOL) (Visian Implantable Collamer Lens V4c) for the correction of moderate to high myopia in Chinese eyes. The article is designed as a retrospective case series. This study included the first consecutive eyes that had implantation of a new pIOL design with a central hole, at our department by the same surgeon. The safety, efficacy, predictability, stability, and adverse events of the surgery were evaluated over 6 months. The study enrolled 63 eyes (32 patients). The mean spherical equivalent decreased from −12.81 ± 3.11 diopters (D) preoperatively to −0.05 ± 0.27 D 6 months postoperatively; 96.8% of eyes were within ±0.50 D of the target and 100% of eyes were within ±1.00 D. All eyes had a decimal uncorrected distance visual acuity of 0.5 (20/40) or better at every follow-up visit. The safety and efficacy indices were 1.42 ± 0.34 and 1.11 ± 0.19, respectively. Postoperatively, the intraocular pressure (IOP) remained stable over time. No significant rises in IOP (including pupillary block) and no secondary cataract were found. After 6 months, the mean vault was 505.2 ± 258.9 μm (range 120–990 μm), and the mean endothelial cell loss was 2.0%. Implantation of the pIOL was safe, effective, predictable, and stable in the correction of moderate-to-high myopia in Han Chinese patients, even without peripheral iridectomy. PMID:27603356

  13. Visual outcome of conventional extracapsular cataract extraction with posterior chamber intraocular lens implantation versus manual small-incision cataract surgery.

    Science.gov (United States)

    Gurung, A; Karki, D B; Shrestha, S; Rijal, A P

    2009-01-01

    an effective method for cataract surgery should be identified to combat cataract blindness. to study the surgical outcome of conventional extracapsular cataract extraction versus manual small-incision cataract surgery. a randomized clinical trial was carried out including one hundred eyes (88 patients) which were divided into two groups using systematic randomization: groups of conventional extracapsular cataract extractionwith posterior chamber intraocular lens (ECCE with PCIOL) implantation and manual small-incision cataract surgery (MSICS). The postoperative parameters/variables studied were the unaided and best-corrected visual acuity and astigmatism. epi info 2000 version statistical software was used for data analysis and calculation of relative risk, 95% CI and p value. The p value of less than 0.05 was considered as significant. in the immediate postoperative period, unaided visual acuity of =or> 6/18 was achieved in 24 subjects in MSICS group versus 7 in ECCE with PCIOL group (RR=2.05, 95% CI= 1.44 - 2.94, p = 0.0002), whereas the same at 6 - 8 weeks postoperatively was found in 28 and 22 subjects in those groups respectively (RR=1l.27, 95% CI=0.86-1.89, p=0.23). The astigmatism of =or> 2 at6 - 8 weeks was found in 35 and 17 subjects from the conventional and MSICS groups respectively ( R=2.28, 95% CI= 1.39-3.73, p=0.0002). both MSICS and conventional ECCE with PCIOL are safe and effective techniques for treatment of cataract patients. A more rapid recovery of good vision can be achieved with MSICS than with conventional ECCE with PCIOL in the immediate postoperative period.

  14. Corneal Endothelial Cell Changes Due to Combined Phacoemulsification-Posterior Chamber Intraocular Lens Implantation and Transpupillary Silicone Oil Removal

    Directory of Open Access Journals (Sweden)

    Mehmet Hanifi Alp

    2014-12-01

    Full Text Available Objectives: The aim of this study was to evaluate the effects of combined phacoemulsification-posterior chamber intraocular lens (PCIOL implantation and removal of transpupillary silicone oil on the corneal endothelial cell layer. Materials and Methods: In this study, we included seven eyes of 7 patients who had intravitreal hemorrhage resulting from retinal detachment or tractional retinal detachment due to proliferative diabetic retinopathy and who underwent pars plana vitrectomy and silicone oil injection. Complicated cataract developed, and phacoemulsification-PC-IOL implantation combined with transpupillary silicon oil removal were performed. Preoperative and postoperative corneal endothelial cell count values were taken by Topcon SP-2000P automatic non-contact specular microscopy and were assessed by IMAGEnet 2000 Endothelial Cell Analysis. The results were compared with the findings in the literature. Results: The mean endothelial cell density (ECD was 2461 cell/mm2 preoperatively. The silicone oil removal was performed after an average of 10±3.5 months (range 5-14 months, and then endothelial cells were counted after a mean of 17±21.2 months (range 1-49 months of the combined surgery. The mean ECD was determined as 1906 cell/mm2 postoperatively. While mean endothelial cell loss was found to be 32% in two patients with diabetes mellitus, five non-diabetic patients had 19% cell loss. Corneal decompensation was not observed in any patient during the follow-up period. Conclusion: After combined phacoemulsification-PC-IOL implantation and transpupillary silicone oil removal, significant reduction in endothelial cells was observed. We detected that this reduction was greater in diabetics. (Turk J Ophthalmol 2014; 44: 424-7

  15. Fijación posterior monosegmentaria en fracturas de la columna toracolumbar Fixação posterior monossegmentar nas fraturas da coluna toracolombar Posterior monosegmental fixation in thoracolumbar spine fractures

    Directory of Open Access Journals (Sweden)

    José Fleiderman Valenzuela

    2011-01-01

    return to work. RESULTS: 4 patients (14% presented radiological treatment failure. 3 suffered acute complications, and had 2 delayed complications. 92.8% of the patients returned to their jobs, with a mean postoperative time out of work of 3.4 months. no statistically significant differences were detected among the different evaluated variables evaluated and the levels of treatment failure. CONCLUSION: Posterior monosegmental fixation has good results in the treatment of thoracolumbar fractures. In our series we had good clinical results in 93% and radiological results in 86% of the patients. We did not find any variable that could be correlated with treatment failure, although the cases considered failures according to the radiological exams had a major preoperative kyphosis and a greater postoperative kyphosis correction than those who did not.

  16. Different types of fixation for posterior pilon fractures%不同内固定方式治疗胫骨后pilon骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    王浩; 李连华; 彭城; 郭永智; 刘智

    2016-01-01

    Objective To explore the mechanisms of posterior pilon fractures and evaluate the curative effects of different types of fixation on the treatment of posterior pilon fractures.Methods We included in this retrospective study 20 patients with posterior pilon fracture who had been treated from January 2012 to January 2015 at our department.They were 10 men and 10 women,from 23 to 77 years of age (average,50.6 years).According to the classification by Yu Guangrong,5 cases belonged to type Ⅰ,3 to type Ⅱa,4 to type Ⅱb,and 7 to type Ⅲ.One was not indentified because of lacking CT examination.The mechanisms included ground level fall in 2 cases,motor vehicle accident in 7,fall off stairs in 5,sport injury in 2,fall from a bike in one and fall from a height in 3.More than 25% of the articular surface was involved in 13 patients.Syndesmosis injury was identified in 6 patients by Cotton test during operation.Internal fixation varied accordingly.We recorded the mechanism,classification,proportion of the articular surface involved (more or less than 25%),and syndesmosis injury to figure out the characteristics of posterior pilon fractures.We used the Burwell-Charnley radiographic criteria to assess the postoperative reduction of the articular surface,and the Olerud-Molander scoring scale and visual analogue scale (VAS) to assess the ankle function.The curative effects of different types of fixation on the treatment of posterior pilon fractures were compared.Results Of the 20 patients,17 were available for follow-up for 6 to 36 months (average,17.8 months).Two patients received reoperation because of implant failure after cannulated screw fixation from anterior to posterior.The Burwell-Charnley radiographic evaluation revealed 12 anatoinical reducations and 8 fair reductions.The mean Olerud-Molander score for the 17 patients at the final follow-ups was 81.5 (range,from 35 to 100) and the mean walking VAS was 1 (from 0 to 3).Conclusions Posterior pilon fractures are

  17. Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis: A retrospective case-control study.

    Science.gov (United States)

    Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

    2017-07-01

    The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery.In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared.The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively.PELD operation was superior in terms of operation time, bleeding volume, recovery period, and financial

  18. Application EPSTR Technique in Acetabulum Posterior Wall Fracture Fixation%EPSTR技术在髋臼后壁骨折固定中的应用

    Institute of Scientific and Technical Information of China (English)

    张功林; 甄平; 陈克明; 安勇; 朱雄; 赵来绪; 杨军林; 周建华

    2014-01-01

    目的:报告EPSTR技术在髋臼后壁骨折固定中的临床应用结果。方法自2006年1月至2011年1月,对46例髋臼后壁骨折患者行内固定后应用EPSTR技术修复髋关节后侧软组织,其中男36例,女10例;年龄25~55岁,平均42.5岁,伤后手术时间2~7 d,平均5 d。髋关节后侧软组织采用“T”形切开,行髋臼内固定后,关节囊和外旋短肌作为一层再次附着到大粗隆。结果术后随访2.5~6.0年,平均4.5年。随访期间没有发生髋关节脱位和股骨头缺血性坏死,有2例发生骨关节炎,没有出现与本项技术相关的并发症。按Harris评定标准进行疗效评定,优良率为93.5%,取得了满意的效果。结论髋臼后壁骨折固定后采用EPSTR技术,有利于术后功能恢复和加强髋关节稳定性。%Objective To report clinical results of application EPSTR technique after the acetabulum posterior wall frac-ture fixation. Methods From January 2006 to January 2011,46 patients(36 men,10 women)after acetabulum posterior wall fracture fixation underwent posterior soft tissue repair of the hip joint. They ranged in age from 25 to 55 years( mean 42. 5 yeras). Operative time after injury was 3 to 9 days( mean 7 days). Posterior soft tissue of the hip joint was opened through a T-shaped incision. The posterior capsule and short external rotators was attached to the greater trochanter. Results Follow-up period ranged from 2. 5 to 6 years( mean,4. 5 years)postoperatively. There were no dislocation of the hip joint and avascular necrosis of the femoral head in this series. Two patients had osteoarthritis. No apparent complications related to the technique. The recovery rate was accessed with Harris scores. The rates of excellent and good were 93%. Satisfactory clinical results were obtained in this series. Conclusion The acetabulum posterior wall fracture fixation used EPSTR technique help the postopera-tive functional recovery and strengthen

  19. One-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion for the treatment of unstable hangman’s fracture

    OpenAIRE

    Liu, Jingchen; Li, Ye; Wu, Yuntao

    2013-01-01

    The present study aimed to evaluate the effect of using one-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion in the treatment of unstable hangman’s fracture. A total of 13 patients with unstable hangman’s fractures underwent C2 and C3 pedicle screw fixation, lamina interbody fusion or combined anterior C2-C3 fusion and imaging examinations to evaluate the fracture fixation and healing condition at three days and three months following surgery. Postoperative X...

  20. Fixação das fraturas do platô tibial com placas pela via de acesso posterior - relato preliminar de 12 casos Tibial plateau fractures fixation using posterior approaches - preliminary results of 12 cases

    Directory of Open Access Journals (Sweden)

    André Wajnsztejn

    2011-01-01

    Full Text Available OBJETIVO: Apresentar os resultados preliminares com técnicas de abordagem posterior para fraturas do platô tibial, com traço de cisalhamento no plano sagital. MÉTODOS: Doze pacientes com fraturas do platô tibial tratados cirurgicamente através de um acesso posterior direto foram incluídos no estudo. Foram revisados os prontuários, as radiografias e tomografias dos pacientes bem como as avaliações clínicas. Todos os casos foram acompanhados até o momento da consolidação óssea, definido como aquele em que o paciente apresentava sinais radiográficos compatíveis sendo capaz de apoiar carga total sobre o membro sem referir dor. RESULTADOS: Entre julho de 2009 e abril de 2010, foram atendidos em nosso serviço 89 pacientes com fraturas da extremidade proximal da tíbia. Desses, 80 (89,9% foram tratados cirurgicamente. Doze pacientes (13,6% apresentavam uma fratura com um componente de cisalhamento posterior e, portanto, foram submetidos a abordagens posteriores para redução e fixação da fratura. Em três destes casos associou-se uma abordagem antero-lateral. A média de idades dos pacientes foi de 35 anos. O acompanhamento médio foi de 12 meses (entre 8 e 23 meses. As fraturas foram classificadas de acordo com o sistema AO/OTA: cinco como 41 B1, quatro como 41 B3, duas como 41 C1 e uma como 41 C3. Dentre as complicações, tivemos uma deiscência de sutura, tratada com curativos, e uma perda de redução que necessitou de uma reoperação. Em nenhum caso ocorreu lesão neurovascular, retarde de consolidação, pseudartrose ou instabilidade articular residual. Em 4 casos a redução foi considerada ruim (> 2mm de degrau articular, em 5 casos foi considerada imperfeita (OBJECTIVE: To describe our preliminary results of posterior shearing tibia plateau fractures treated by a direct dorsal approach and plate fixation. METHODS: A consecutive series of twelve patients with tibia plateau fractures treated by direct posterior approach

  1. The effect of Nd:YAG laser treatment of posterior capsule opacification on anterior chamber depth and refraction in pseudophakic eyes.

    Science.gov (United States)

    Khambhiphant, Bharkbhum; Liumsirijarern, Chayata; Saehout, Piyada

    2015-01-01

    This was a prospective descriptive study to determine the changes in intraocular lens (IOL) position after neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy by measuring anterior chamber depth (ACD) and refraction, including the spherical equivalent (SE) and cylinder. Forty-seven pseudophakic eyes with posterior capsule opacification of 29 patients were included. Nd:YAG laser posterior capsulotomy was performed. Patients' ACD and refraction were measured before the treatment, as well as after the treatment at 1 week and 3 months. IOLMaster(®) and an automated refractometer were used at the Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. There were no statistically significant differences in ACD and SE before and after laser treatment at 1 week and 3 months (repeated analysis of variance, P=0.582 and P=0.269, respectively). Both backward IOL movement (number [n]=29) and forward IOL movement (n=18) were found. Some changes in cylindrical refraction were found at 1 week, but decreased at 3 months after capsulotomy (baseline cylinder: -1.16; cylinder at 1 week and 3 months: -1.00 and -1.14, respectively; P=0.012). These changes were the same with one-piece and three-piece IOLs. Nd:YAG laser posterior capsulotomy did not significantly change ACD and SE. It led to cylinder change at 1 week after laser, but the effect decreased at 3 months. This effect was small and may not be clinically significant.

  2. Percutaneous cannulated screw fixation of sacral fractures and sacroiliac joint disruptions with CT-controlled guidewires performed by interventionalists: Single center experience in treating posterior pelvic instability

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Sebastian, E-mail: sebastian.fischer@kgu.de [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Vogl, Thomas J. [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Marzi, Ingo [Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Zangos, Stephan; Wichmann, Julian L.; Scholtz, Jan-Erik; Mack, Martin G. [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Schmidt, Sven [Orthopaedic University Hospital Friedrichsheim, Marienburgstraße, 260528 Frankfurt (Germany); Eichler, Katrin [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany)

    2015-02-15

    Highlights: • Minimally invasive sacroiliac screw fixation can be performed under CT-imaging. • Guidewires help in precise placement of cannulated sacroiliac screw. • Only a diminishing rate of misplacements can be seen. • The method appears to be a safe and very accurate procedure. - Abstract: Objective: The purpose of our study was to evaluate minimally invasive sacroiliac screw fixation for treatment of posterior pelvic instability with the help of CT controlled guidewires, assess its accuracy, safety and effectiveness, and discuss potential pitfalls. Methods: 100 guidewires and hollow titan screws were inserted in 38 patients (49.6 ± 19.5 years) suffering from 35 sacral fractures and/or 16 sacroiliac joint disruptions due to 33 (poly-)traumatic, 2 osteoporotic and 1 post-infectious conditions. The guidewire and screw positions were analyzed in multiplanar reconstructions. Results: The mean minimal distance between guidewire and adjacent neural foramina was 4.5 ± 2.01 mm, with a distinctly higher precision in S1 than S2. Eight guidewires showed cortical contacts, resulting in a total of 2% mismatched screws with subsequent wall violation. The fracture gaps were reduced from 3.6 ± 0.53 mm to 1.2 ± 0.54 mm. During follow-up 3 cases of minor iatrogenic sacral impaction (<5 mm) due to the bolting and 2 cases of screw loosening were observed. Interventional time was 84.0 min with a mean of 2.63 screws per patient whilst acquiring a mean of 93.7 interventional CT-images (DLP 336.7 mGy cm). Conclusions: The treatment of posterior pelvic instability with a guidewire-based screw insertion technique under CT-imaging results in a very high accuracy and efficacy with a low complication rate. Careful attention should be drawn to radiation levels.

  3. Truly simultaneous SS-OCT of the anterior and posterior human eye with full anterior chamber and 50° retinal field of views (Conference Presentation)

    Science.gov (United States)

    McNabb, Ryan P.; Viehland, Christian; Keller, Brenton; Vann, Robin R.; Izatt, Joseph A.; Kuo, Anthony N.

    2017-02-01

    Optical coherence tomography (OCT) has revolutionized clinical observation of the eye and is an indispensable part of the modern ophthalmic practice. Unlike many other ophthalmic imaging techniques, OCT provides three-dimensional information about the imaged eye. However, conventional clinical OCT systems image only the anterior or the posterior eye during a single acquisition. Newer OCT systems have begun to image both during the same acquisition but with compromises such as limited field of view in the posterior eye or requiring rapid switching between the anterior and posterior eye during the scan. We describe here the development and demonstration of an OCT system with truly simultaneous imaging of both the anterior and posterior eye capable of imaging the full anterior chamber width and 50° on the retina (macula, optic nerve, and arcades). The whole eye OCT system was developed using custom optics and optomechanics. Polarization was utilized to separate the imaging channels. We utilized a 200kHz swept-source laser (Axsun Technologies) centered at 1040±50nm of bandwidth. The clock signal generated by the laser was interpolated 4x to generate 5504 samples per laser sweep. With the whole eye OCT system, we simultaneously acquired anterior and posterior segments with repeated B-scans as well as three-dimensional volumes from seven healthy volunteers (other than refractive error). On three of these volunteers, whole eye OCT and partial coherence interferometry (LenStar PCI, Haag-Streit) were used to measure axial eye length. We measured a mean repeatability of ±47µm with whole eye OCT and a mean difference from PCI of -68µm.

  4. Comparative analysis of international standards for the fatigue testing of posterior spinal fixation systems: the importance of preload in ISO 12189.

    Science.gov (United States)

    La Barbera, Luigi; Ottardi, Claudia; Villa, Tomaso

    2015-10-01

    compared with the previous model where the precompression was not considered. Neglecting the initial preload due to the assembly of the overall construct according to ISO 12189 standard could lead to an overestimation of the stress on the rods up to 50%. To correctly describe the state of stress on the posterior spinal fixator, tested according to the ISO procedure, it is important to take into account the initial preload due to the assembly of the overall construct. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Open reduction and internal fixation via a posterior approach for posterior fractures of tibial plateau%后方入路治疗胫骨平台后方骨折

    Institute of Scientific and Technical Information of China (English)

    陈成帷; 陈雷; 番哲尔; 杨胜武

    2012-01-01

    目的:探讨后方入路治疗胫骨平台后方骨折的骨折类型、手术方法和临床疗效.方法:回顾性分析自2008年6月至2011年2月采用后方入路治疗且随访完整的8例胫骨平台后方骨折,男5例,女3例;年龄23~55岁,平均41.1岁.致伤原因:车祸伤5例,高处坠落伤3例.2例胫骨平台后方冠状面骨折伴后交叉韧带撕脱和1例后外侧平台劈裂伴塌陷骨折采用正后方“S”形入路,2例后内侧平台骨折采用后内侧倒“L”型入路,3例同时累及胫骨平台前后侧及胫骨干骺端骨折者采用后内侧倒“L”形入路联合前外侧入路行钢板螺钉内固定.关节面塌陷者采用同种异体骨或自体髂骨植骨术.结果:所有患者获得随访,时间8~39个月,平均20个月.全部病例获得影像学上的骨性愈合,愈合时间11~21周,平均14.5周.术中未出现血管、神经损伤,术后无一例出现切口感染、内固定松动及断裂.所有患者术后即刻与术后6个月胫骨平台内翻角(TPA)、内外侧平台后倾角(PA)度数均无统计学差异.术后末次随访Rasmussen 膝关节功能评分为19~29分,平均25.60分,其中优4例,良3例,可1例.术后末次随访Rasmussen放射学评分14~18分,平均17.25分,其中优6例,良2例.结论:胫骨平台骨折以后侧为主时,后方入路能得到很好的骨折端暴露,有利于直视下复位固定,术后近期疗效满意.%Objective: To discuss the fracture patterns, operative procedures and clinical results of open reduction and internal fixation via a posterior approach to treat posterior fractures of tibial plateau. Methods: From June 2008 to February 2011,8 patients with posterior tibial plateau fractures treated with posterior approach,were reviewed retrospectively. There were 5 males and 3 females,with an average of 41.1 years ranging from 23 to 55. Of the 8 cases,5 cases were caused by traffic accidents, 3 caused by fall. Two cases of posterior coronal fractures

  6. One-off surgery of posterior reduction and fixation for the treatment of basilar invagination with atlantoaxial dislocation

    Directory of Open Access Journals (Sweden)

    LIU Jia-gang

    2012-08-01

    Full Text Available Objective To investigate the surgical treatment and clinical results for the primary basilar invagination (BI with atlantoaxial dislocation (AAD. Methods A retrospective study was performed. The study included 89 patients who had primary BI and AAD were surgically treated in our hospital from January 2008 to December 2011. There were 28 males and 61 females, aged between 10 and 69 years (mean 45.42 years. All patients were treated by the same 3-step surgical method. The first step, reduction of the AAD was performed by homemade odontoid repositor intraoperatively through posterior approach; the second step, AO stainless steel plates were fixed between the occiput and C2, 3 lateral mass screws; and the third step, occipitocervical fusion were completed by autologous iliac crest graft. Operation effect was recorded during follow-up period. Results Follow-up period was 6 to 48 months. Clinical symptoms were improved in 82.93% patients after the surgery. Japanse Orthopaedic Association (JOA score increased from preoperative (8.80 ± 1.36 points to postoperative (15.35 ± 1.47 points (t = 17.225, P = 0.001. In general, satisfactory decompression and bony fusion were shown on postoperative radiological examinations for all patients. Compared with pretreatment data, the postoperative imaging measurement showed that the mean data of atlanto-dental interval (ADI, 9.22 mm vs 3.72 mm and vertical dimension from the top of odontoid process to Chamberlain line (10.41 mm vs 3.23 mm were all reduced, and the cervicomedullary angle (130° vs 150° and space available of spinal cord (SAC, 11.13 mm vs 15.54 mm were all improved. Conclusion The one-off surgery of posterior reduction technique and fixing between occiput and C2, 3 lateral mass screws is a safe, easy, and effective treatment for patients with p

  7. Management of posteriorly dislocated crystalline lens with perfluorocarbon liquid and fibrin glue-assisted scleral-fixated intraocular lens implantation.

    Science.gov (United States)

    Lee, Soo Jung; Kim, In Geun; Park, Jung Min

    2013-03-01

    We describe a technique that uses a 23-gauge transconjunctival sutureless vitrectomy with perfluorocarbon liquid (PFCL) and phacoemulsification to manage a dropped nucleus. The PFCL is injected into the vitreous space until the dislocated lens reaches the iris plane and is then removed using phacoemulsification in the anterior chamber. After intraocular lens (IOL) implantation, a 23-gauge forceps is passed through the sclerotomy to grasp the IOL haptic, which is pulled onto the ocular surface. Tunnels are made at the edge of the flap with a 26-gauge needle into which the 2 haptics are tucked for additional stability. The scleral flaps and conjunctiva are then glued using biological glue. Perfluorocarbon liquid reduces lens repulsion and blocks the transmission of the ultrasound stream to the retina. The fibrin glue-assisted sutureless IOL implantation technique could reduce complications and suture-related problems.

  8. 后路内固定融合术治疗脊柱胸腰段骨折的效果分析%The Analysis in Arthrodesis Posterior Internal Fixation for the Treatment of Thoracic Lumbar Spine Fracture

    Institute of Scientific and Technical Information of China (English)

    丁鑫

    2015-01-01

    目的:分析脊柱胸腰段骨折的后路内固定融合术临床效果。方法选取80例脊柱胸腰段骨折患者,其中对照组采取前路手术内固定,观察组采取后路内固定融合术,对比两组临床疗效。结果观察组有效率、手术时间、失血量以及住院时间等明显优于对照组(P<0.05)。结论后路内固定融合术手术时间短、出血量少,疗效显著,具有临床应用价值。%Objective To analyze the clinical result of thoracolumbar spine fractures within posterior fixation and fusion.MethodsChoose 80 cases of thoracolumbar spine fractures patients,which control group take anterior fixation,the observation group taking posterior fixation and fusion, compared to clinical efficacy.Results The effective rate,operative time,blood loss and hospital stay in observation group was significantly better than the control group(P<0.05).Conclusion Posterior fixation and fusion surgery a short time,less blood loss,a significant effect,with clinical applications.

  9. Therapeutic efficacy of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting for tuberculosis of lumbar vertebra

    Directory of Open Access Journals (Sweden)

    Jia-ming LIU

    2015-11-01

    Full Text Available Objective To evaluate the efficacy and safety of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting in the treatment of tuberculosis of mono-segmental lumbar vertebra. Methods From January 2010 to April 2013, 21 patients (9 males and 12 females with an average age of 49.1 years with mono-segmental tuberculosis of lumbar vertebra underwent surgery in our hospital were included. Eight patients had neurological deficit. The focus of tuberculosis was located on one side of the vertebral body, and all the patients had obvious signs of bone destruction on CT and MRI. All the patients were given anti-tuberculosis chemotherapy for 2-3 weeks before surgery. The local bone chips and autologous iliac cancellous bone were used as the intervertebral bone graft. Postoperative plain radiographs and CT were obtained to evaluate the fusion rate and degree of lumbar lordosis. The visual analogue scale score (VAS, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP before and after operation, and at final follow-up date were recorded. Results All the patients were followed up for 25.3±4.2 months. The mean operation time was 157±39 minutes, and the average blood loss was 470±143ml. The fusion rate of the interbody bone graft was 95.2%, with an average fusion period of 6.1±2.5 months. The neurological function was improved by 100%, and no severe complication or neurological injury occured. The preoperative and postoperative lordosis angles of the lumbar spine were 21.4°±5.7° and 33.6°±3.1°, respectively, and it was 31.3°±2.7° at the final follow up. The preoperative and postoperative VAS scores were 7.8±2.6 and 2.4±1.7 respectively, and it was 0.9±0.7 at the final follow up. The ESR and CRP were significantly decreased 3 months after surgery, and they became normal at 6 months. Conclusion Pedicle screw-rod internal fixation after one-stage posterior

  10. Combined anterior and posterior decompression and short segment fixation for unstable burst fractures in the dorso lumbar region.

    Directory of Open Access Journals (Sweden)

    Ramani P

    2002-07-01

    Full Text Available The dorso lumbar segment of spine (D10 to L2 is an unstable zone between fixed dorsal and mobile lumbar spine. A combined anterior and posterior approach with short segment stabilization was found most appropriate. Thirty cases were treated over a period of 4 years and 6 months. There were 26 male and 4 female patients with mean age of 32.6 years. L1 vertebra was fractured in 17 cases, D1 in 8 cases, D11 in 4 cases and D10 in one case. 14 cases had total neurological deficit, 9 cases had partial and 7 had no neurological deficit. We have used three column classification of Denis to assess the cases. Seven patients returned to regular physical work, 5 had restricted physical work, 5 remained in full time light job and 9 patients were unable to return to original job but did some work. Most had flaccid paraplegia but 4 patients were completely disabled due to spastic paraplegia. Neurological recovery occurred in all the patients with partial paralysis, and appeared to be dependent on initial kyphosis. The overall recovery rate varied from 50% to 90%. There is no correlation between canal compromise and severity of injury. Neurological injury occured at the time of trauma, rather than as a result of pressure of fragment in the canal. No strong conclusion could be drawn to say that the results of surgery were superior to non-operative treatment.

  11. Implante de lentes intra-oculares de câmara posterior em olhos fácicos para correção de hipermetropia Implantation of posterior chamber intraocular lens in phakic eyes for the correction of hyperopia

    Directory of Open Access Journals (Sweden)

    Cristina Moreira Salera

    2003-12-01

    Full Text Available OBJETIVOS: Avaliar a eficácia, a previsibilidade e a segurança do implante da lente fácica de câmara posterior para a correção da hipermetropia. MÉTODOS: Analisamos, retrospectivamente, os prontuários de 16 pacientes (31 olhos submetidos à implantação de lente fácica de câmara posterior para correção da hipermetropia. RESULTADOS: O equivalente esférico médio pré-operatório na refração dinâmica era +5,39 D (variando de +1,25 a +10,50 D e na refração estática era +6,44 D (variando de +3,25 a +10,75 D. O equivalente esférico médio da refração dinâmica do último exame pós-operatório era de -0,45 D (variando de -2,75 a +1,25 D. Observa-se que em três olhos (9,7% ocorreu perda de uma linha de visão e 19 olhos (61,3% mantiveram a mesma acuidade visual pré-operatória com correção. Em seis olhos (19,3% houve ganho de uma linha de visão e em três olhos (9,7% ocorreu ganho de duas linhas de visão. Quanto às complicações, em 13 (41,9% olhos foi observada a presença de depósito de pigmentos finos sobre a lente e três pacientes (18,7% queixaram-se de "glare". CONCLUSÃO: O implante de lente fácica de câmara posterior para correção de hipermetropia moderada e elevada se mostrou método eficaz, previsível e seguro. É necessário acompanhamento pós-operatório mais prolongado para melhor avaliação da estabilidade e do surgimento de complicações tardias.PURPOSE: To examine the efficacy, predictability and safety of posterior chamber phakic intra-ocular lens implantation in patients with hyperopia. METHODS: The authors analyzed retrospectively 16 patients (31 eyes submitted to the implantation of a posterior chamber phakic lens for the correction of hyperopia. RESULTS: The mean preoperative spherical equivalent manifest refraction was +5.39D (ranging from +1.25 to +10.50D and cycloplegia refraction was +6.44D (ranging from +3.25 to +10.75D. The mean postoperative spherical equivalent at the last visit was

  12. A new Open Top Chamber designed to test in situ effects of climatic and atmospheric changes on nitrogen fixation in boreal forest floor mosses

    Science.gov (United States)

    Bringuier, Charline; Bradley, Robert; Bellenger, Jean-Philippe; Morin, Hubert; Lindo, Zoë

    2014-05-01

    Biological nitrogen fixation (BNF) by cyanobacteria dwelling in forest floor moss layers is an important determinant of boreal black spruce forest productivity. Recent studies have suggested that these BNF rates may increase with increasing atmospheric CO2 and increasing temperature, as predicted by current weather models. This potential increase in BNF may be offset, however, by increasing atmospheric deposition of nitrogen, or by increasing demands for phosphorus (i.e. driving nodular ATP content) and for micronutrients such as Mo, Va and Fe (i.e. co-factors of nitrogenase enzyme). In order to study the relative and interactive effects of these factors controlling in situ BNF rates in boreal forest floor moss layers, a new Open Top Chamber (OTC) was developed in summer of 2013. The chambers measure 1.60 cm dia. × 60 cm height, and are equipped with an automated CO2 delivery system designed to maintain atmospheric daytime CO2 concentrations at 800 ppm, as well as buried heating coils that increase soil temperature by 4 ° C for 3 weeks in springtime. These 2 experimental factors are crossed in a full factorial (2 × 2) design that is replicated in 4 complete blocks. Each of the 16 OTCs is divided into 4 compartments, each of which are assigned 1 of 4 sub-plot factors. These include chronic additions of either atmospheric nitrogen, phosphorus, micronutrients or a non-amended control. Staring in summer 2014, a series of measurements will be made to assess the effects of treatments on BNF rates, cyanobacterial colonization and soil nitrogen cycling. Our poster will describe in detail the design and operation of the OTCs, as well as their construction and maintenance costs.

  13. Biomechanical study on the posterior screw fixation in the lower cervical spine%下颈椎后路螺钉固定的生物力学研究进展

    Institute of Scientific and Technical Information of China (English)

    林华杰; 徐荣明; 刘观燚

    2011-01-01

    So far,the fixation in the lower cervical spine through posterior approach technology has commonly been used,besides the lateral screw and pedicle screw techniques,transarticular screw and laminar screw techniques have being paid more attention recently. This article introduced four screw fixation ways in the lower cervical spine through posterior approach and reviewed the recent biomechanics studies of four screw fixation techniques. The biomechanics study includes stabilization,pollout strength, insertion technique, and screw characteristic and so on. Lateral screw and pedicle screw techniques have become an effective internal fixation way for the lower cervical spine instability because of their superior stabilization and higher pollout strength. Transarticular screw fixation has become a new way to fix the lower cervical spine through posterior approach,which has widely surgical indications. Besides, this technique is relatively safe, simple and has achieved favorable curative effect in clinic. Laminar screw fixation technique is rarely used in clinic, but the study of anatomy and biomechanics confirmed that this technique can be applied as a salvage technique in clinic. Above four techniques of the screw fixation in the lower cervical spine through posterior approach have advantages and disadvantages, respectively, and the application in clinic is different. Through the biomechanics study of these techniques will contribute to the development of the techniques of the screw fixation in the lower cervical spine through posterior approach and guide the clinical work effectively.%目前,下颈椎后路螺钉固定除侧块螺钉和椎弓根螺钉技术已普遍应用外,经关节螺钉和经椎板螺钉固定技术也逐渐被重视.本文就此介绍下颈椎后路4种螺钉固定方式,并对各自固定技术的生物力学研究现状进行综述.生物力学研究内容包括三维稳定性、抗拔出力、置钉技术和螺钉特点等.侧块螺钉和椎

  14. 创伤性颈椎不稳后路钉棒固定重建稳定%Stability reconstruction of traumatic cervical vertebra by screw-rod fixation through posterior approach

    Institute of Scientific and Technical Information of China (English)

    周章彦; 朱轶; 谢彬; 林义文

    2012-01-01

    Objective To explore the therapeutic effect on treatment of traumatic instability of cervical vertebra by pedicel screw through posterior approach or screw-rod fixation in lateral mass. Methods 30 patients of traumatic cervical vertebra instability were treated with grafting in cervical spinal lamina or between small joints by posterior transpedicular screw through posterior approach or screw-rod fixation in lateral mass. Results All cervical symptoms disappeared after operation and the damaged neurological function of cervical spinal cord were significantly improved. No complication was found in the follow up visits for 3 ~ 52 ( 10 ± 3. 2 ) months. The recovered cervical vertebra of all patients was of well fused and stable without looseness, fracture of interior fixation or displacement of grafting bone; the fracture was well healing and grafting bone was gradually fused with flexion range of extensible i05°±i0.5°, lateral 80° ±7. 2°, and axial rotation 96° ±9. 3°. Conclusions The treatment of the traumatic cervical vertebra by posterior transpedicular screw through posterior approach or screw-rod fixation in lateral mass reveals good reconstructed stability.%目的 探讨颈后路椎弓根钉或侧块螺钉-棒内固定治疗颈椎创伤性不稳临床效果.方法 对30例创伤性颈椎不稳患者行后路椎弓根钉或侧块螺钉-棒内固定,椎板或小关节间植骨.结果 术后颈部症状完全消失,受损颈髓神经功能明显改善.30例均获随访,时间3~52(10±3.2)个月,未发生并发症.颈椎复位良好,序列稳定;无内固定松动、断裂、植骨块移位;骨折愈合好,植骨渐进融合.颈椎伸屈角度105°±10.5°,侧屈角度80°±7.2°,轴向旋转功能96°±9.3°.结论 颈椎创伤性不稳采用经后路椎弓根钉或侧块螺钉-棒内固定治疗能够达到良好的稳定效果.

  15. Posterior chamber phakic intraocular lens dislocation after ocular trauma%后房型有晶状体眼人工晶状体外伤性脱位

    Institute of Scientific and Technical Information of China (English)

    赫天耕; 孙智勇; 颜华

    2014-01-01

    Objective To study the clinical features and treatment principles of posterior chamber phakic intraocular lens (PC-PIOL) dislocation after ocular trauma.Methods Eighty eyes of 42 cases had undergone PC-PIOL implantation for the correction of high myopia,in which two cases were found PC-PIOL dislocation after ocular trauma.One case who received implantable collamer lens (ICL) implantation 8 months ago was diagnosed ICL subluxation into the anterior chamber after ocular blunt trauma.Another case who received posterior chamber phakic refractive lens (PC-PRL) implantation 3 months ago was found dislocation into anterior chamber after trauma.The operations for PC-PIOL reposition were performed 1 and 3 days respectively after the trauma.The endothelial cell density (ECD) count was documented and compared.The two cases were followed-up for 6 months.Results The clinical features of PC-PIOL dislocation after ocular trauma included mild discomfort,visual acuity decrease,aqueous flare,pupil deformation and pupillary capture of IOL.The uncorrected visual acuity (UCVA) of ICL subluxation eye decreased to 0.2 after trauma,and it was recovered to 0.3 after repositionsurgery.The UCVA for PC-PRL dislocation eye decreased to 0.3 after trauma,and regained to 1.0 after reposition surgery.Neither of the two cases had best corrected visual acuity (BCVA) loss.There was no complications such as traumatic cataract occurred.The ECD count of the two cases dropped to 1941/ram2 and 1889/mm2 respectively.It continuously dropped to 1883/mm2 and 1746/mm2 at one week after the reposition surgery,but it went upward to 1911/mm2 and 1845/mm2 at 6 months postoperatively.Conclusion PC-PIOL for high myopia could be subluxated or dislocated into anterior chamber after ocular trauma,led to aqueous flare,pupil deformation and ECD loss.The immediate PC-PIOL reposition was safe and effective,and long term ECD follow-up was suggested.%目的 研究后房型有晶状体眼人工晶状体(PC-PIOL)植入术后

  16. Posterior chamber collagen copolymer phakic intraocular lens with a central hole for moderate-to-high myopia: First experience in China.

    Science.gov (United States)

    Cao, Xinfang; Wu, Weiliang; Wang, Yang; Xie, Chen; Tong, Jianping; Shen, Ye

    2016-09-01

    The purpose of this article is to evaluate the clinical outcomes of a posterior chamber phakic intraocular lens (pIOL) (Visian Implantable Collamer Lens V4c) for the correction of moderate to high myopia in Chinese eyes.The article is designed as a retrospective case series.This study included the first consecutive eyes that had implantation of a new pIOL design with a central hole, at our department by the same surgeon. The safety, efficacy, predictability, stability, and adverse events of the surgery were evaluated over 6 months.The study enrolled 63 eyes (32 patients). The mean spherical equivalent decreased from -12.81 ± 3.11 diopters (D) preoperatively to -0.05 ± 0.27 D 6 months postoperatively; 96.8% of eyes were within ±0.50 D of the target and 100% of eyes were within ±1.00 D. All eyes had a decimal uncorrected distance visual acuity of 0.5 (20/40) or better at every follow-up visit. The safety and efficacy indices were 1.42 ± 0.34 and 1.11 ± 0.19, respectively. Postoperatively, the intraocular pressure (IOP) remained stable over time. No significant rises in IOP (including pupillary block) and no secondary cataract were found. After 6 months, the mean vault was 505.2 ± 258.9 μm (range 120-990 μm), and the mean endothelial cell loss was 2.0%.Implantation of the pIOL was safe, effective, predictable, and stable in the correction of moderate-to-high myopia in Han Chinese patients, even without peripheral iridectomy.

  17. 3D打印模型辅助后路内固定治疗儿童颈椎畸形%Individualized 3-dimensional printing model-assisted posterior screw fixation in the treatment of cervical deformity of children

    Institute of Scientific and Technical Information of China (English)

    李浩; 李承鑫; 张学军; 郭东; 范敬一; 刘虎; 孙记航; 潘少川

    2015-01-01

    Objective To explore the method and efficacy of individualized 3-dimensional (3D) printing model-assisted posterior screw fixation for the treatment of cervical deformity of children.Methods A total of 29 surgical patients with cervical deformity associated with upper cervical instability as diagnosed by computed tomography (CT) were retrospectively analyzed.For 22 cases,3D printing cervical model was establisged by 3D printing technology.And screw insertion and fixation were simulated for assisting actual operations.At last implemented one-stage posterior orthomorphia plus internal fixation.Results Among them,22 patients with cervical deformity successfully underwent posterior screw fixation assisted by individual 3D printing model.Without injury to vertebral artery or nerve root,there was no internal fixation loosening or fracture.The average followup period was 13.5 (3-23) months.Postoperative atlantodens interval (ADI) significantly decreased,cervicomedullary angle (CMA) increased markedly while ventral compression of medulla oblongata diminished or even disappeared.There was no operative mortality.The procedures included secondary fusion of bone graft (n =1),sternocleidomastoid muscle amputationlysis (n =1),foramen magnum decompression (n =1) and posterior arch of atlas decompression (n =1).Conclusions Posterior screw fixation operation assisted by individualized 3D printing model can improve the success rate and safety of screw insertion and effectively protect vertebral artery and nerve root.And it is particularly suitable for children with cervical deformity.%目的 研究个体化3D打印模型辅助后路内固定治疗儿童颈椎畸形的方法和效果.方法 对北京儿童医院骨科2012年9月至2014年5月CT确诊并手术的29例颈椎畸形伴上颈椎不稳患儿的临床资料进行回顾性分析.其中22例采用3D打印技术建立颈椎个体化3D打印模型,在模型上进行模拟置钉及内固定手术,获得个体化置钉数据,再

  18. A new measurement for posterior tilt predicts reoperation in undisplaced femoral neck fractures: 113 consecutive patients treated by internal fixation and followed for 1 year

    DEFF Research Database (Denmark)

    Palm, Henrik; Gosvig, Kasper; Krasheninnikoff, Michael

    2009-01-01

    BACKGROUND AND PURPOSE: Preoperative posterior tilt in undisplaced (Garden I-II) femoral neck fractures is thought to influence rates of reoperation. However, an exact method for its measurement has not yet been presented. We designed a new measurement for posterior tilt on preoperative lateral......, and rate of reoperation within the first year. In a subgroup of 50 randomly selected patients, reliability tests for measurement of posterior tilt were performed. RESULTS: Intra- and interclass coefficients for the new measurement were > or = 0.94. 23% (26/113) of patients were reoperated and increased...... score, time from admission to operation, surgeon's expertise, postoperative reduction, and implant positioning, a preoperative posterior tilt of > or = 20 degrees was the only significant predictor of reoperation (p measurement for posterior tilt appears to be reliable...

  19. Biomechanical characteristics of posterior fixation for repairing atlantoaxial instability%后路内固定系统修复寰枢椎不稳的生物力学特征

    Institute of Scientific and Technical Information of China (English)

    王诗军; 李钰婷; 李淳德

    2015-01-01

    BACKGROUND:With the development of atlantoaxial morphology, applied anatomy and biomechanics, pathogenesis, diagnosis and treatment of atlantoaxial instability have attracted more and more attention. However, the development of effective fixation for atlantoaxial instability is relatively late, so scholars al over the world have made numerous studies. OBJECTIVE:To compare biomechanical functions of different fixations through atlantoaxial posterior approach, and to assess its stability. METHODS:We retrieved recent studies on comparative biomechanical evaluation and its primary clinical application of different posterior approaches in repair of atlantoaxial instability, and conducted a retrospective analysis by measuring the three-dimensional range of movement in normal atlantoaxial complex and atlantoaxial instability models. This analysis evaluated the stability of different fixations under normal three-dimensional atlantoaxial movement, and provided a biomechanical basis for reasonable fixator selection. RESULTS AND CONCLUSION:Atlantoaxial posterior fixation included Gal ie wire fixation, Brooks fixation, Apofix and Halifax vertebral plate hook fixation, screw fixation through joint and atlantoaxial pedicle nail/rod fixation. Gal ie technique contributes to the reduction of anterior semiluxation, but its mechanical stability is poor. Brooks technique has strong rotation and stretch forces. Apofix and Halifix vertebral plate hook device provides strong anti-rotation and anti-antelocation strength, and is more stable than Gal ie technique in mechanics. The biomechanics of screw fixation through joint was better than wire technique and Halifax. The screw fixation avoids occipitocervical fusion, and has a high requirement to instal ation. When an internal fixator was selected, immediate cervical vertebra stability should be provided to protect spinal cord functions. Upper neck functions should be maintained to reach reduction and maintenance of occipital bone, atlas

  20. 后路内固定融合术治疗脊柱胸腰段骨折的疗效观察%The curative effect observation on arthrodesis posterior internal fixation used in thoracic lumbar spine fractures

    Institute of Scientific and Technical Information of China (English)

    林建新; 林建民; 肖胜捷

    2014-01-01

    目的:探讨胸腰椎段骨折采用后路内固定融合术治疗的效果。方法选取胸腰椎段骨折患者90例,研究组(50例)采用后路内固定融合术治疗,对照组(40例)采用前路内固定术治疗,对比两组术前术后神经功能与伤椎情况,手术效果以及不良情况。结果研究组的神经功能与伤椎情况改善均更显著;研究组总有效率为94.0%;对照组为82.5%;研究组不良情况率为2.0%,对照组为10.0%;研究组手术效果明显更优( P<0.05)。结论胸腰椎段骨折采用后路内固定融合术治疗,效果显著,安全性高,值得临床推广应用。%Objective To discuss the curative effect of arthrodesis posterior internal fixation used in thoracic lumbar spine fractures. Methods 90 cases of patients with thoracic lumbar spine fractures were selected,the research group(50cases) were cured by arthrodesis posterior internal fixation,the control group(40cases)were cured by anterior fixation,then compared the situation of nerve function and injured vertebral before and after operation,surgical effect and adverse conditions. Results After the operation,the situation of nerve function and injured vertebral of the research group all improved more apparently;the total effective rate of the research group was 94.0%,and the rate of the control group was 82.5%;the rate of adverse situation of the research group was 2.0%.and the rate of the control group was 10.0%;the surgical effect of the research group was significantly better(P < 0.05). Conclusion The curative effect on arthrodesis posterior internal fixation used in thoracic lumbar spine fractures is significant,and there has high safety,it is worth promoting.

  1. Clinical observation of posterior internal fixation with vertebral pedicle screw and rod system on thoracolumbar spine fractures%椎弓根钉棒系统在胸腰椎骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    黎华茂; 李敬中; 向峥; 林晓岗

    2012-01-01

    Objective To observe the clinical efficacy of posterior internal fixation of vertebral pedicle screw and rod system for thoracolumbar spine fractures. Methods Totally 59 patients with thoracic or lumbar vertebral fractures were treated with internal fixation of vertebral pedicle screw and rod system. The Frankel scale combined with X ray and CT images was used for the judgment of efficacy. Results Radiographic parameters were significantly improved after the experiment, the Frankel degree of cases with nerve injury symptoms was improved 2-4 degrees after surgery. Conclusions Internal fixation of vertebral pedicle screw and rod system is efficient for thoraco lumbar spine fractures.%目的 观察椎弓根钉棒系统内固定治疗胸腰椎骨折的临床疗效.方法 应用椎弓根钉棒系统内固定治疗胸腰椎骨折59例,采用Frankel分级结合X线片、CT影像表现判断疗效.结果 术后各项影像学指标均有明显改善,患者术后神经功能Frankel分级大多数都有2~4级提高.结论 椎弓根钉棒系统内固定是治疗胸腰椎骨折的一种有效方法,值得临床推广应用.

  2. Preservative Therapy of the Posterior Teeth with Longitudinal Fracture by Plastic Crown Temporary Fixation%塑料冠暂时固定纵折后牙的保存治疗

    Institute of Scientific and Technical Information of China (English)

    符起亚

    2001-01-01

    To study the curative effect of the posterior teeth with longitudinal fracture by temporary fixation of plastic crown,the posterior teeth with longitudinal fracture was fixed with instant crown of selfcuring crylic resin, following root canal treatment and then replaced with cast crown.All of cases were followed up 1~3 years. 24 of 28 cases(85.71%) treated by this method were satisfactary.The results showed that the curative effect of the posterior teeth with longitudinal fracture fixed by the plastic crown was better than that by the tiny steel wire,and the method is simple.%为探讨塑料冠暂时固定纵折后牙的疗效,采用自凝塑料冠固定纵折后牙,牙合面钻孔行根管治疗后铸造金属全冠修复.结果表明:28颗患牙中有26颗经治疗后铸造全冠修复,成功24例,成功率达85.71%.塑料冠固定纵折后牙比单纯金属丝固定效果好,且制作简便.

  3. Análise radiográfica do tratamento cirúrgico da fratura cervical baixa por via posterior Evaluación radiográfica de la fijación posterior de la fractura de la columna cervical baja Radiographic evaluation of the posterior fixation in the subaxial cervical spine injury

    Directory of Open Access Journals (Sweden)

    Nelson Astur Neto

    2012-01-01

    érdida de la reducción, la cifosis segmentaria, la degeneración de nivel adyacente y la pseudoartrosis. RESULTADOS: En comparación con el método de síntesis, 60,8% de los pacientes se sometieron a fijación por cableado interespinoso, 26% a la placa con tornillos de masa lateral y 13% a la barra con tornillos de masa lateral. De los pacientes sometidos a fijación con tornillos, ninguno presentó complicaciones radiográficas y 35,7% de los pacientes sometidos a la fusión con el cableado interespinoso presentaron complicaciones, siendo la cifosis segmentaria la más frecuente. CONCLUSIÓN: Las lesiones de columna cervical sometidas a la fusión con el tornillo de masa lateral presentaron una evolución radiográfica mejor que las de quienesfueron sometidos a fijación con cableado interespinoso, esta última presentó una mayor incidencia de complicaciones en la artrodesis.OBJECTIVE: To perform a radiographic evaluation of the cervical spine injury treated with posterior fixation techniques only. METHODS: From 2000 to 2008, twenty three patients were included in the study, of which 91,3% were men, with a mean age of thirty-four years and four months. The mean follow-up time was 82 months. The type of implant used, the radiographic arthrodesis consolidation, implant failure, lost of reduction, segmental kyphosis and pseudarthrosis were evaluatedin the preoperative period, the immediate postoperative period and after six months of evolution, based on the patients records. RESULTS: When it comes to the type of implant used, there were 60,8% of the patients who underwent interspinous wire fixation, 26% with lateral mass screws and plate and 13% with lateral mass screws and rods. Of the lateral mass screws patients, none had radiographic complications and 35,7% of the interspinous wire patients had complications being the segmental kyphosis the most frequent of them. CONCLUSIONS: The cervical spine injuries that underwent lateral mass screw fixation showed better

  4. 有晶状体眼后房型人工晶状体植入术后前房及前房角的超声活体显微镜观察%Observation on changes of anterior chamber and chamber angle structures after posterior chamber phakic intraocular lens implantation by ultrasound biomicroscopy

    Institute of Scientific and Technical Information of China (English)

    汪晓宇; 沈晔; 杜持新; 李毓敏; 董映

    2009-01-01

    Objective To study the changes of anterior chamber and chamber angle structures after implantable contact lens (ICL) implantation in high myopia by using ultrasound biomicroscopy (UBM).Methods A prospective series case study was conducted on 15 high myopia patients (30 eyes) treated with ICL implant.These patients were followed for one year postoperatively.Intraocular pressure (IOP) was measured by Goldmann applanation tonometer after surgery.All eyes were examined by UBM one year after the surgery.Central anterior chamber depth (ACD), trabecular-iris angle (TIA), the distance between the posterior surface of ICL and the lens and the distance between peripheral surface of ICL and the lens were measured.Nonparametric test was used to compare TIA.One-way ANOVA was used to assess the distance between peripheral surface of ICL and the lens.Repeated Measure ANOVA and Bonferroni test was performed to compare the IOP level before and after surgery.Paired t-test was used to compare ACD.Results Intraocular pressure changed from (13.75±2.27) mm Hg(1 mm Hg=0.133 kPa) preoperatively to (14.27±1.70), (14.70±2.07), (14.07±2.24), (14.00±2.69) and (13.97±2.95) mm Hg at 1 week, 1,3, 6 and 12 months after the surgery, respectively.There was a statistically significant increase of the IOP one month after the surgery, which was normalized completely at 3 months after surgery.The distances between central posterior surface of the cornea to the ICL and the lens were (2.24±0.21 ) and (2.97±0.11) mm, respectively.There was significant difference between these two data (t=20.63, P30°,ICL周边部与晶状体之间的距离在钟表位12:00、3:00、6:00、9:00位差异无统计学意义.ICL后表面与晶状体之间的距离为(0.63±0.16)mm,ICL与晶状体无接触.结论 ICL植入术后ICL位于晶状体前,致使术后中央ACD变浅、部分手术眼前房角宽度变窄.ICL与晶状体无接触,与虹膜后表面接触.

  5. Clinical observation of posterior internal fixation with vertebral pedicle screw and rod system on thoracolumbar spine fracture%采用后路椎弓根钉棒系统治疗胸腰椎骨折疗效观察

    Institute of Scientific and Technical Information of China (English)

    王洽君

    2013-01-01

    目的 观察后路椎弓根钉棒系统治疗胸腰椎骨折的临床疗效.方法 回顾性分析32例采用后路椎弓根钉棒系统治疗胸腰椎骨折患者的临床资料,术后最长获得2年随访,分析椎体高度、椎体序列和Cobb角的改变.结果 32例患者获得6~ 48个月随访,平均15.8个月.术后椎体前、后缘高度分别为(96.85±14.33)%、(97.44±12.38)%,明显大于术前的(46.67±11.25)%、(76.76±12.62)%(均P<0.05);术后Cobb角为(7.45±2.12)°,显著小于术前的(20.56±7.51).(P<0.05).术后患者Frankel分级均有改善.结论 应用椎弓根钉棒系统治疗胸腰椎骨折能取得良好的临床疗效.%Objective To observe the clinical effect of posterior internal fixation with vertebral pedicle screw and rod system on thoracolumbar spine fracture.Methods The clinical data of 32 patients diagnosed as thoracolumbar spine fracture in our hospital who treated with posterior internal fixation with vertebral pedicle screw and rod system were retrospectively analyzed.The Frankel scale combined with X-ray and CT images were used for the judgment of efficacy.Results The vertebral Height and Cobb angles were improved significantly after the operations (P <0.05).And the Frankel degree of cases with nerve symptoms was also improved.Conclusion Posterior internal fixation with vertebral pedicle screw and rod system is effective in treating patients with thoracolumbar spine fracture.

  6. Posterior C1-C2 Fixation Using Absorbable Suture for Type II Odontoid Fracture in 2-Year-Old Child: Description of a New Technique and Literature Review.

    Science.gov (United States)

    Labbe, Jean L; Peres, Olivier; Leclair, Olivier; Goulon, Renaud; Scemama, Patrice; Jourdel, François; Bertrou, Véronique; Murgier, Jerome

    2016-12-01

    Odontoid synchondrosis fractures are rare in children, even though they are the more common cervical fracture in children less than 7 years old. Nonoperative treatment with external orthosis immobilization is the treatment of choice for stable undisplaced or minimally displaced injuries. In unstable fractures, when reduction cannot be achieved or maintained, surgical fixation is recommended. We report a 2-year-old boy with an unstable fracture of the odontoid treated surgically using an absorbable monofilament suture for C1-C2 interlaminar fixation without bone grafting. This suture was strong enough to provide the stability necessary to allow healing of the synchondrosis and the delayed resorption of the suture was followed by complete restoration of the mobility between C1 and C2. This case illustrates that surgical stabilization using an absorbable suture in young children with an unstable odontoid fracture is a safe and effective alternative to other surgical techniques.

  7. [Intraocular lenses for the correction of refraction errors. Part 1: phakic anterior chamber lenses].

    Science.gov (United States)

    Kohnen, T; Baumeister, M; Cichocki, M

    2005-10-01

    In this overview, the current status of intraocular lens surgery to correct refractive error is reviewed. The interventions are divided into additive surgery with intraocular lens implantation without extraction of the crystalline lens (phakic intraocular lens, PIOL) or the removal of the crystalline lens with implantation of an IOL (refractive lens exchange, RLE). Phakic IOLs are constructed as angle-supported or iris-fixated anterior chamber lenses and posterior chamber lenses that are fixated in the ciliary sulcus. The implantation of phakic IOLs has been demonstrated to be an effective, safe, predictable and stable procedure to correct higher refractive errors. Complications are rare and differ for the three types of PIOL; for anterior chamber lenses these are mainly pupil ovalization and endothelial cell loss.

  8. Simultaneous anterior and posterior screw fixations confined to the axis for stabilization of a 3-part fracture of the axis (odontoid, dens, and hangman fractures): report of 2 cases.

    Science.gov (United States)

    Shinbo, Jun; Sameda, Hiroaki; Ikenoue, Sumio; Takase, Kan; Yamaguchi, Takeshi; Hashimoto, Eiko; Enomoto, Takahiro; Kanazuka, Aya; Mimura, Masaya

    2014-03-01

    Fractures of the axis are considered to be one of the most common injuries to the cervical spine, accounting for more than 20% of all cervical spine fractures. Multiple fractures of the axis are much rarer, accounting for 1% of all cervical fractures. Management of such complex fractures is still challenging, and there is no strong consensus for the treatment. The authors describe the cases of 2 patients who presented with 3-part fractures of the axis consisting of an odontoid Type II fracture and a Levine-Edwards Type IA fracture, which were treated with concurrent insertion of an anterior odontoid screw and bilateral posterior pedicle screws. The cases presented were characterized by 1) a Type II odontoid fracture; 2) a Type IA traumatic spondylolisthesis with no or a little translation and angulation of C-2 on C-3 in a ring fracture of the axis; and 3) no disorders at the C2-3 disc on MR images. Therefore, the authors performed surgery confined to the axis by concurrently inserting an anterior odontoid screw and posterior bilateral pedicle screws without arthrodesis of C2-3. This was followed with cervical soft collar fixation for only 1-2 weeks. The outcomes were favorable, including good osteosynthesis, high primary stability, early patient mobilization, and preserved range of motion of the cervical spine at C2-3 as well as at C1-2.

  9. Axis系统治疗下颈椎不稳的解剖研究和临床应用%Axis posterior cervical internal fixation system in lower cervical spine instability

    Institute of Scientific and Technical Information of China (English)

    尹庆水; 张余; 刘景发; 曹正霖; 夏虹; 权日

    2001-01-01

    Objective:To study the anatomical features of lateral mass in lower cervical spine and evaluate the clinical application of Axis posterior cervical internal fixation system.Method:Anatomical morphology of 16 lower cervical spine specimens were observed.Ameliorative method of the screw prick point,angle and depth was measured and defined.18 cases of lower cervical spine instability of various reasons were treated with Axis posterior cervical internal fixation system.Result:The screw prick point was defined in the medial and lower 1~2mm of the mass center.The arrow angle,horizontal angle and depth of internal fixation screw were 45 degree,29 degree and 13.2~16.4mm respectively.18 patients were followed-up for an average of 8 months.There was no complication of artery and nerve injury,and no loosening of the plate and the screw.15 cases obtained bony fusion.Spine injury had recovered partly.Conclusion:The ameliorative prick method is more suitable for Chinese.Axis posterior internal fixation system is suitable for the treatment of lower cervical spine instability.%目的:研究下颈椎侧块的解剖特点,评估Axis颈椎后路内固定系统的应用价值。方法:选16具成人正常下颈椎防腐标本,观察解剖特点,探查并测量改良Magerl法进针点和进针角度、深度以及与血管、神经的关系。临床应用Axis系统治疗下颈椎不稳18例。结果:改良Magerl法进针点选在术中可视侧块中点内下1~2mm处,深度13.2~16.4mm,进针角度分别为矢状面角度45°,水平面角度29°。距动脉和神经根的距离分别约为4.1mm和1.9mm。临床应用18例,平均随访8个月,无并发症,15例获骨性融合,脊髓功能除1例无改善外,余均有不同程度恢复。结论:改良进针法更适合于国人。Axis系统适用于各种原因引起的需后路减压的下颈椎不稳。侧块固定有一定风险,但只要熟悉解剖特点,规范操作,使用是安全的。

  10. Spinal Arthrodesis Posterior Internal Fixation in Thoracic Lumbar Fracture Analysis of the Application Effect%脊柱胸腰段骨折中后路内固定融合术的应用效果分析

    Institute of Scientific and Technical Information of China (English)

    余建

    2015-01-01

    目的:探讨脊柱胸腰段骨折中后路内固定融合术的应用效果.方法:采用回顾性方法分析,选取我院自2011年2月~2013年2月以来收治的63例脊柱胸腰段骨折患者的临床资料,随机将其分为对照组(31例)和观察组(32例) ,对照组给予前路内固定融合术治疗,观察组给予后路内固定融合术治疗,比较2组患者治疗效果.结果:2组患者手术成功率、并发症、术中出血量、上、下床活动时间等均有显著差异(P<0.05);术后随访1年,2组椎体前缘、后缘高度、后凸Cobb角及椎管占位率均无明显差异(P>0.05).结论:后路内固定融合术治疗脊柱胸腰段骨折具有显著疗效,可有效减少并发症,提高患者生活质量,值得临床推广应用.%Objective:To investigate the thoracic lumbar spine fractures in the application effect of internal fixation posterior arthrode-sis.Methods:A retrospective method to analyze and select our hospital from February 2011 to February 2013 has been treated, 63 cases of thoracic lumbar spine fractures in patients with clinical data, its randomly divided into control group (31 cases) and observation group (32 cases) and control group given anterior internal fixation fusion treatment, observation group was given arthrodesis posterior internal fixation treatment, compared two groups of patients with therapeutic effect.Results: Two groups of patients with surgical success rate, complications, intraoperative blood loss, ambulation time had significant difference (P <0.05);Postoperative follow-up of 1 year, fan-terior edge, trailing edge height, the two groups of the protruding after Cobb Angle and vertebral canal placeholder rate had no obvious difference (P >0.05).Conclusion:Lumbar arthrodesis posterior internal fixation treatment of thoracic spine fractures with significant curative effect, can effectively reduce the complications and improve patient quality of life, worthy of clinical popularization and

  11. Application of Posture Nursing Intervention in Posterior Pedicle Screw Internal Fixation%体位护理干预在脊柱后路椎弓根钉内固定术中的应用

    Institute of Scientific and Technical Information of China (English)

    马永玲

    2016-01-01

    Objective Application of posture nursing intervention in posterior pedicle screw internal fixation. Methods From October 2014 to October 2014, 100 cases of patients with posterior pedicle screw ifxation,divided into two groups:observation group (50 cases with patients treated with posture nursing intervention) and control group (50 cases of patients treated with conventional nursing intervention), compare the application effect of the two groups. Results After the intervention, the observation group nursing satisfaction is 98.0% better than the control group 86.0%(P<0.05). Conclusion The posture nursing intervention in the application of spinal posterior pedicle screw ifxation effect is good, which can improve patients' quality of life.%目的:体位护理干预在脊柱后路椎弓根钉内固定术中的应用。方法选取我院2014年10月~2015年10月收治的后路椎弓根钉内固定术患者100例,分成两组:观察组(n=50,施以体位护理干预),对照组(n=50,施以常规护理干预),对两组应用效果进行对照。结果干预后,观察组护理满意度为98.0%优于对照组86.0%(P<0.05)。结论体位护理干预在脊柱后路椎弓根钉内固定术中的应用效果良好,能提升患者生活质量。

  12. Comparative finite element analysis of fixations for posterior malleolar fracture%后踝骨折内固定方法的有限元模拟比较研究

    Institute of Scientific and Technical Information of China (English)

    金丹; 付苏; 梅刚; 邹振吕; 刘松; 王尚冲; 刘军

    2014-01-01

    Objective To compare the tube plate,T-plate and screws in fixation of posterior malleolar fracture in terms of biomechanical stability.Methods The CT data of the ankle obtained from a normal male volunteer was used to make a three-dimensional reconstruction by software mimics 14.0 and geomagic 2012.After we built a three-dimensional finite element model of the ankle along with its stimulated ligaments in software ANSYS,the validity of the model was verified.The model of posterior malleolar fracture was cut from the posteromedial point of the tibia to the one-fourth point of the distance from the posterior to the anterior margin in the software Solidworks 2012.Models of screws,1/4 tube plate and T-plate were also constructed in Solidworks 2012.According to the established method in the literature,2 screws,a 1/4 tube plate and a T-plate were applied respectively.Under the same neutral weight bearing,the flexion and external loadings,the fragmental displacement,the stresses of fracture and fixation were calculated by finite element analysis.Results Under neutral or external loading,T-plate fixation caused the smallest fragmental displacement compared with the other 2 fixations and the 2 plate fixations caused a smaller displacement in Z-axis under neutral loading than screws fixation.However,similar displacements were identified in all fixations under flexion loading.Under all loading conditions,excessive concentration of the stress was not observed.Conclusions T-plate shows a better biomechanical stability than 1/4 tube-plate and screws while plating reduces the upward displacement than screws.All the 3 fixations show no obvious excessive concentration of the stress.%目的 使用有限元法分析比较螺钉、管型钢板、3孔T型钢板固定治疗后踝骨折的生物力学稳定性.方法 取1名23岁男性健康志愿者的足踝CT数据进行三维重建,建立带有周围韧带的踝关节有限元模型并进行有效性验证,将模型导入Solidworks软

  13. Ultrasound Biomicroscopy Comparison of Ab Interno and Ab Externo Intraocular Lens Scleral Fixation

    Science.gov (United States)

    Horiguchi, Lie; Garcia, Patricia Novita; Malavazzi, Gustavo Ricci; Allemann, Norma

    2016-01-01

    Purpose. To compare ab interno and ab externo scleral fixation of posterior chamber intraocular lenses (PCIOL) using ultrasound biomicroscopy (UBM). Methods. Randomized patients underwent ab externo or ab interno scleral fixation of a PCIOL. Ultrasound biomicroscopy was performed 3 to 6 months postoperatively, to determine PCIOL centration, IOL distance to the iris at 12, 3, 6, and 9 hours, and haptics placement in relation to the ciliary sulcus. Results. Fifteen patients were enrolled in the study. The ab externo technique was used in 7 eyes (46.6%) and the ab interno in 8 eyes (53.3%). In the ab externo technique, 14 haptics were located: 4 (28.57%) in the ciliary sulcus; 2 (14.28%) anterior to the sulcus; and 8 (57.14%) posterior to the sulcus, 6 in the ciliary body and 2 posterior to the ciliary body. In the ab interno group, 4 haptics (25.0%) were in the ciliary sulcus, 2 (12.50%) anterior to the sulcus, and 10 (75.0%) posterior to the sulcus, 4 in the ciliary body and 6 posterior to the ciliary body. Conclusions. Ab externo and ab interno scleral fixation techniques presented similar results in haptic placement. Ab externo technique presented higher vertical tilt when compared to the ab interno. PMID:27293878

  14. Ultrasound Biomicroscopy Comparison of Ab Interno and Ab Externo Intraocular Lens Scleral Fixation.

    Science.gov (United States)

    Horiguchi, Lie; Garcia, Patricia Novita; Malavazzi, Gustavo Ricci; Allemann, Norma; Gomes, Rachel L R

    2016-01-01

    Purpose. To compare ab interno and ab externo scleral fixation of posterior chamber intraocular lenses (PCIOL) using ultrasound biomicroscopy (UBM). Methods. Randomized patients underwent ab externo or ab interno scleral fixation of a PCIOL. Ultrasound biomicroscopy was performed 3 to 6 months postoperatively, to determine PCIOL centration, IOL distance to the iris at 12, 3, 6, and 9 hours, and haptics placement in relation to the ciliary sulcus. Results. Fifteen patients were enrolled in the study. The ab externo technique was used in 7 eyes (46.6%) and the ab interno in 8 eyes (53.3%). In the ab externo technique, 14 haptics were located: 4 (28.57%) in the ciliary sulcus; 2 (14.28%) anterior to the sulcus; and 8 (57.14%) posterior to the sulcus, 6 in the ciliary body and 2 posterior to the ciliary body. In the ab interno group, 4 haptics (25.0%) were in the ciliary sulcus, 2 (12.50%) anterior to the sulcus, and 10 (75.0%) posterior to the sulcus, 4 in the ciliary body and 6 posterior to the ciliary body. Conclusions. Ab externo and ab interno scleral fixation techniques presented similar results in haptic placement. Ab externo technique presented higher vertical tilt when compared to the ab interno.

  15. Ultrasound Biomicroscopy Comparison of Ab Interno and Ab Externo Intraocular Lens Scleral Fixation

    Directory of Open Access Journals (Sweden)

    Lie Horiguchi

    2016-01-01

    Full Text Available Purpose. To compare ab interno and ab externo scleral fixation of posterior chamber intraocular lenses (PCIOL using ultrasound biomicroscopy (UBM. Methods. Randomized patients underwent ab externo or ab interno scleral fixation of a PCIOL. Ultrasound biomicroscopy was performed 3 to 6 months postoperatively, to determine PCIOL centration, IOL distance to the iris at 12, 3, 6, and 9 hours, and haptics placement in relation to the ciliary sulcus. Results. Fifteen patients were enrolled in the study. The ab externo technique was used in 7 eyes (46.6% and the ab interno in 8 eyes (53.3%. In the ab externo technique, 14 haptics were located: 4 (28.57% in the ciliary sulcus; 2 (14.28% anterior to the sulcus; and 8 (57.14% posterior to the sulcus, 6 in the ciliary body and 2 posterior to the ciliary body. In the ab interno group, 4 haptics (25.0% were in the ciliary sulcus, 2 (12.50% anterior to the sulcus, and 10 (75.0% posterior to the sulcus, 4 in the ciliary body and 6 posterior to the ciliary body. Conclusions. Ab externo and ab interno scleral fixation techniques presented similar results in haptic placement. Ab externo technique presented higher vertical tilt when compared to the ab interno.

  16. A 10-year follow-up of transpedicular screw fixation and intervertebral autogenous posterior iliac crest bone graft or intervertebral B-Twin system in failed back surgery syndrome

    Science.gov (United States)

    Cincu, Rafael; Lorente, Francisco de Asis; Gomez, Joaquin; Eiras, Jose; Agrawal, Amit

    2015-01-01

    Background: The spine surgeons have been combining anterior and posterolateral fusion (circumferential fusion) as the final solution to treat spinal disorders and many have been using it to treat failed back surgery syndrome (FBSS). In present study, we analyzed and compared the clinical and radiological outcomes in patients with transpedicular screw fixation and intervertebral autogenous posterior iliac crest bone graft or in patients with transpedicular screw fixation and intervertebral B-Twin system for FBSS with a follow-up period of 10 years after the surgery. Materials and Methods: This study was a retrospective case study performed on 55 patients with FBSS. Clinical and radiological changes were compared between the two groups of patients on the basis of improvement of back pain, radicular pain, and work capacity. Outcome was measured in terms of Oswestry Low Back Pain Disability Index, and the changes in pain and function were documented every year from before surgery until 2012. We analyzed the evolution of 55 cases of FBSS those underwent segmental circumferential posterior fusions from June 2001 to February 2003, operated by a single surgeon and followed up during 10 years until February 2012. The patients were divided into 2 groups: In 25 patients, posterolateral fusions with Legacy™ (Medtronic, Inc. NYSE: MDT) screws and intersomatic autogenous posterior iliac crest bone graft was performed, and, in 30 patients, posterolateral fusions with the same screws and intersomatic fusion B-Twin (Biomet Spain Orthopaedics, S.L.) system was performed. In all cases, we used posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) approach for intervertebral graft, and the artrodesis was supplemented at intertransverse level with Autologus Growth Factor (AGF-MBA INCORPORADO, S.A.). The outcome was measured in terms of Oswestry Low Back Pain Disability Index, and the changes in pain and function were documented every year and compared

  17. A 10-year follow-up of transpedicular screw fixation and intervertebral autogenous posterior iliac crest bone graft or intervertebral B-Twin system in failed back surgery syndrome.

    Science.gov (United States)

    Cincu, Rafael; Lorente, Francisco de Asis; Gomez, Joaquin; Eiras, Jose; Agrawal, Amit

    2015-01-01

    The spine surgeons have been combining anterior and posterolateral fusion (circumferential fusion) as the final solution to treat spinal disorders and many have been using it to treat failed back surgery syndrome (FBSS). In present study, we analyzed and compared the clinical and radiological outcomes in patients with transpedicular screw fixation and intervertebral autogenous posterior iliac crest bone graft or in patients with transpedicular screw fixation and intervertebral B-Twin system for FBSS with a follow-up period of 10 years after the surgery. This study was a retrospective case study performed on 55 patients with FBSS. Clinical and radiological changes were compared between the two groups of patients on the basis of improvement of back pain, radicular pain, and work capacity. Outcome was measured in terms of Oswestry Low Back Pain Disability Index, and the changes in pain and function were documented every year from before surgery until 2012. We analyzed the evolution of 55 cases of FBSS those underwent segmental circumferential posterior fusions from June 2001 to February 2003, operated by a single surgeon and followed up during 10 years until February 2012. The patients were divided into 2 groups: In 25 patients, posterolateral fusions with Legacy™ (Medtronic, Inc. NYSE: MDT) screws and intersomatic autogenous posterior iliac crest bone graft was performed, and, in 30 patients, posterolateral fusions with the same screws and intersomatic fusion B-Twin (Biomet Spain Orthopaedics, S.L.) system was performed. In all cases, we used posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) approach for intervertebral graft, and the artrodesis was supplemented at intertransverse level with Autologus Growth Factor (AGF-MBA INCORPORADO, S.A.). The outcome was measured in terms of Oswestry Low Back Pain Disability Index, and the changes in pain and function were documented every year and compared from before surgery to the final

  18. Basis椎弓根螺钉固定加环形植骨融合治疗腰椎滑脱%Basis pedicle screw fixation and posterior instrumented circumferential fusion for the treatment of lumbar spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    董福龙; 申才良; 张建湘; 汤健; 杨庆国; 江曙

    2011-01-01

    Objective To summarize curative effects of the decompressive laminectomy by posterior approach, reduc tion of spondylolisthesis fixed with Basis pedicle screw and posterior instrumented circumferential fusion in the treat ment of lumbar spondylolisthesis. Methods Thirty-two patients with lumbar spondylolisthesis treated with posterior instrumented circumferential fusion were studied retrospectively. Results All the patients received follow-up for 4 ~ 25 months. Symptoms were disappeared after operations in all the patients. The postoperative X-ray films showed that 29 patients obtained complete reduction,3 partly reduction. This surgical methods produced satisfactory outcomes with the 100% osseous fusion. All the bone grafts were fusion, without screws loosening or breakage or internal fixation loosing was found. Based on Hou Shu-xun Criteria for therapeutical evalution, the efficacy was as follows: excellent in 23 cases,good in 7,and fair in 2,the rate of excellent and good was 94%. Conclusions Posterior instrumented cir cumferential fusion with Basis pedicle screw is an effective method for treating severe lumbar spondylolisthesis.%目的 探讨后路腰椎管减压、Basis椎弓根螺钉系统复位固定加环形植骨融合治疗腰椎滑脱症的疗效.方法 对32例腰椎滑脱症患者行后路腰椎管减压Basis椎弓根螺钉复位固定加环形植骨融合术.结果 32例均获随访,时间4~25个月.患者术后症状均消失,X线片示29例滑脱完全复位,3例部分复位.所有患者均达骨性融合,无椎弓根钉松动、断裂及再滑脱现象.根据侯树勋等疗效评定标准评定:优23例,良7例,可2例,优良率94%.结论 Basis椎弓根固定系统复位固定加环形植骨融合治疗腰椎滑脱症临床疗效满意,可作为治疗严重腰椎滑脱的首选方法.

  19. Individualized posterior atlantoaxial short-segmental fixation for upper cervical injury%寰枢椎后路短节段个体化内固定治疗上颈椎损伤

    Institute of Scientific and Technical Information of China (English)

    李菊根; 黄彦; 杨进顺; 黄文铎; 史群伟; 谢楚海

    2013-01-01

    目的 探讨寰枢椎椎弓根或侧块螺钉棒后路短节段内固定治疗上颈椎损伤的个体化置钉及其临床疗效. 方法 23例上颈椎损伤患者术前常规行颅骨牵引复位,个体化手术方案依据患者寰枢椎CT扫描及三维重建结果决定行椎弓根螺钉或侧块螺钉内固定以及螺钉的直径、长度和进钉点位置、方向、角度. 结果 术前Frankel分级C级6例、D级8例,术后均恢复至E级.随访6~36个月,所有患者内固定牢固,植骨均获得骨性愈合,其中3例年轻患者及1例寰椎左侧椎弓根螺钉偏外侧穿出骨皮质患者骨性愈合后取出内固定,临床效果均满意. 结论 个体化后路寰枢椎椎弓根螺钉或侧块螺钉钉棒固定系统是治疗上颈椎损伤的有效方法,具有三维固定牢固、固定节段短和术后并发症少等优点.%Objective To observe the individualized insertion choice in treatment of upper cervical injury with posterior atlantoaxial short-segmental pedicle screws or lateral mass screws and the relevant clinical outcome.Methods A total of 23 cases of upper cervical injuries received skull traction preoperatively.Individual surgery plan including internal fixation using pedicle screws or lateral mass screws as well as diameter,length,entry point,direction,and angle of screws was determined according to their atlantoaxial CT scan and three-dimensional reconstruction results.Results Six cases of Frankel grade C and eight of grade D were all recovered to grade E after operation.All cases presented rigid fixation and bony fusion in the follow-up of 6 to 36 months.Besides,screws were removed after bony fusion for three young cases and one case with left atlas pedicle screws emerged laterally out of cortex.Clinical outcome was all satisfactory.Conclusion Individualized posterior atlantoaxial fixation using pedicle screws or lateral mass screws is an effective way to treat upper cervical injury and gains advantages of stable

  20. Microbiology research and drug sensitive situation of infections after posterior internal fixation in thoracolumbar spines%胸腰椎体后路内固定术后切口感染的病原学与药敏分析

    Institute of Scientific and Technical Information of China (English)

    曹海云; 李志伟; 邹吉锋; 王芳芳; 李红九

    2015-01-01

    目的:对医院胸腰椎体后路内固定患者术后深部切口感染的病原学和药敏状况进行分析,为临床治疗提供参考依据。方法选择2010年5月-2015年4月医院胸腰部位椎体后路内固定术后切口感染的96例患者进行回顾性研究,选取术中可疑标本做病原培养,分析病原菌种类及药敏结果,数据采用SPSS 17.0软件进行统计分析。结果96例切口感染患者送检标本共分离出病原菌96株,以革兰阳性菌为主,共73株占76.04%;革兰阳性菌中主要为耐甲氧西林葡萄糖球菌,占33.33%;耐甲氧西林凝固酶阴性葡萄球菌对替考拉宁、左氧氟沙星敏感率为100.00%。结论胸腰部位椎体后路内固定术后深部外科切口感染的患者中,革兰阳性菌检出率最高,预防性用药应选择万古霉素、左氧氟沙星或亚胺培南;并根据药敏试验的结果合理选择抗菌药物。%OBJECTIVE To analyze the etiology and drug sensitivity condition of deep incision infections in patients after posterior internal fixation of thoracolumbar spine so as to provide references for clinical treatments . METHODS Totally 96 cases with incision infections after posterior internal fixation of thoracolumbar spine from May 2012 to Apr .2015 were researched retrospectively .The suspicious samples were chosen for pathogen cul‐tures .The pathogen types and drug sensitivity results were statistically analyzed by SPSS 17 .0 .RESULTS In 96 cases of the objects ,96 strains of pathogens were isolated from the samples ,dominating by gram‐positive bacteri‐a ,with 73 strains accounting for 76 .04% .In those gram‐positive bacteria ,33% were methicillin‐resistant Staph‐ylococcus ,and all the methicillin‐resistant coagulase negative Staphylococcus were totally sensitive to teicoplanin and levofloxacin .CONCLUSION Gram‐positive bacteria are the main cause for incision infections in patients after posterior internal

  1. Treatment of senile thoracolumbar kyphotic deformity by posterior pedicle subtraction osteotomy and internal fixation%经后路椎弓根截骨内固定治疗老年严重脊柱后凸畸形

    Institute of Scientific and Technical Information of China (English)

    陈建梅; 姚晓东; 黄丽花; 徐皓

    2013-01-01

    目的 探讨后路经椎弓根截骨治疗老年严重脊柱后凸畸形的临床疗效.方法 对18例老年严重脊柱后凸畸形患者采用后路经椎弓根截骨矫形内固定治疗,分别于术后2周、3个月、12个月通过X线片、VAS评分、Cobb角、神经功能恢复情况评估临床疗效.结果 18例均获随访,时间14~37个月.VAS评分:术前8.4分±1.3分,术后2周、3个月、12个月分别为1.1分±0.3分、1.1分±0.2分、1.2分±0.3分,与术前比较差异均有统计学意义(P<0.05).Cobb角:术前为78.3°±5.9°,术后2周、3个月、12个月分别为42.7°±8.4°、42.9°±5.7°、44.2°±6.9°,与术前比较差异均有统计学意义(P<0.05).有2例发生硬脊膜撕裂,1例直接缝合,1例行脑膜片修补,未发生脑脊液漏.无内固定松动、断裂及截骨面假关节形成.结论 后路经椎弓根截骨矫形内固定可以有效矫正老年性脊柱后凸畸形,临床疗效良好.%Objective To evaluate the effect of posterior pedicle subtraction osteotomy and internal fixation for senile thoracolumbar kyphotic deformity.Methods 18 cases of senile thoracolumbar kyphotic deformity treated in our hospital were retrospectively analyzed.All cases were treated with posterior pedicle subtractiou osteotomy and internal fixation.Clinical effects were evaluated by X-ray,VAS score,Cobb's angle,nerve functional rehabilitation.Results The follow-up period was 14 ~ 37 months.The VAS score was 8.4 ± 1.3 preoperatively,and was 1.1 ± 0.3,1.1 ±0.2,1.2 ± 0.3 at 2 weeks,3months,1 year postoperatively respectively.The difference was significant between preoperation and postoperation(P < 0.05).The Cobb's angle was 78.3° ± 5.9° preoperatively,and was 42.7° ± 8.4°,42.9° ± 5.7°,44.2° ± 6.9° at 2 weeks,3months,1 year postoperatively respectively.The difference was significant between preoperation and postoperation(P < 0.05).Spinal dura matter tearing occurred in 2 patients and was repaired during

  2. 内直肌后固定术治疗集合过强型内斜视的临床观察%Medial Rectus Posterior Fixation Sture for Convergence Excess Esotropia

    Institute of Scientific and Technical Information of China (English)

    殷小龙; 彭小维; 邓燕; 杨洋; 于春红; 廖瑜俊; 鄢涛

    2009-01-01

    目的 观察内直肌后固定术治疗集合过强型内斜视的临床效果.方法 回顾性分析2006年2月到2007年5月行内直肌后固定术治疗的17例集合过强型内斜视的临床资料.结果 17例患者中,术前平均看远内斜度为8.8△、平均看近内斜度为24.2△、平均AC/A比率为10.7.术前有12例无舣眼单视功能,仅5例具有远立体视.术后平均随访12.6月(9~15月),平均看远内斜度为2.8△、平均看近内斜度为3.9△、平均AC/A比率为5.9,其中看近内斜度较术前平均下降20.2△,AC/A比率均达到正常.术后有13例具有双眼单视功能.结论 内直肌后固定术可以减少看近的内斜视度数,降低AC/A比率,是一种治疗集合过强型内斜视的安全有效的方法.%Objective To observe the surgical effectiveness of convergence excess esotropia performed with medial rectus posterior fixation suture.Methods Retrospectively analyzed the clinical data of 17 cases convergence excess esotropia performed with medial rectus posterior fixation suture from 2003 to 2007.Results In 17 patients,the preoperative mean distance deviation was 8.8 prism diopter(PD)of esotropia and the mean near deviation was 24.2PD.The mean accommodative convergence/accommodation(AC/A)ratio preoperatively was 10.7.Except 5 eases,others without distance stereopsis in preoperation.Average follow-up was 12.6 months(ranged 9 to 15 months).Postoperatively the mean distance deviation was 2.SPD and the mean near deviation was 3.9PD.The mean decrease in the near deviation was 20.2PD.The mean postoperative AC/A ratio was 5.9 and all of the patients normalized.The 13 cases attained binocular single vision postoperation.Conclusions The medial rectus posterior fixation suture appears to be useful in convergence excess esotropia by reducing the near deviation and the AC/A ratio,so it is a safe and effective method.

  3. Percutaneous internal fixation using sacroiliac screw in dorsal position for treatment of pelvic posterior ring injuries%仰卧位经皮骶髂置钉固定术治疗骨盆后环损伤

    Institute of Scientific and Technical Information of China (English)

    王亮; 藏卫东; 甄相周; 李付彬; 徐向峰; 杨彦亭

    2009-01-01

    Objective To explore the feasibility, operative procedure and the result for the tech-nique of sacroiliac percutaneous screws fixation in dorsal position for treatment of pelvic posterior ring in-juries. Methods From October 2004 to October 2007, 14 patients with the pelvic posterior ring injuries were treated with width 7.2 mm sacroiliac cannulated screws fixation under monitoring of "C"-arm, which in-cluded 7 males and 7 females, with the mean age of 41.6 years (range, 28-75 years). According to the Tile classification, there were 4 cases for type B, 10 for type C. During the operation, the patients were kept on domal position. The inserting point was the intersection point of anterior 2 cm of superior iliac spine and posterior axillary line, or the posterior-middle 1/3 point of the line between anterior superior iliac spine and posterior superior iliac spine. The screw inclined anterior 20°~30°, 5°~15° toward foot. The pelvic preceding ring injuries and the other bone joint damages were dealt with at the same time. After the operation, screen the X-ray polished section of the pelvic A-P position and the lumbar vertebrae lateral position, and scan pelvic posterior ring by CT, watch the screw entering position in S1 centrum. Results All 14 patients were available at follow up with mean duration of 16 months (range, 6-36 months). All cases attained bone union in 3 months. Fifteen hollow titanium screws inserted into 14 patients. There were no nerve injuries and breakage or loosening of the screws, and no pelvic deformities and pain of sacroiliac. According to Majeed e-valuation, the excellent and good rate was 92.9%. Conclusion To use two ways to decide position on per-cutaneous internal fixation using sacroiliac screw in dorsal position for treatment of pelvic posterior ring in-juries is safe, convenient and feasible.%目的 探讨仰卧位经皮骶髂置钉固定术治疗骨盆后环损伤的可行性、手术方法及疗效.方法 在10

  4. Efficacy of posterior fixation comparison in the treatment of thoracolumbar fractures with paraplegia by%后路内固定治疗胸腰椎骨折合并截瘫的疗效比较

    Institute of Scientific and Technical Information of China (English)

    乔崇巍

    2012-01-01

    Objective To evaluate the clinical efficacy of pedicle screw fixation system (AF) in the treatment of thoracolumbar fractures with paraplegia. Methods Analysis and compare Forty — two patients with thoracolumbar fractures who received posterior Luque + Harrington and AF fixation were analyzed. The change of anterior vertebral height, the degree of correction of the Cobb' angle and the paraplegia index were compared. Results AF is better in improving anterior vertebral height change and the degree of correction of the Cobb' angle than Luque + Harrington. And it had good long— term effect for recovery of neurological function. Conclusion The AF system is a good method in the treatment of thoracolumbar fractures complicated with nerve injury%目的 评价椎弓根螺钉内固定系统(AF系统)治疗胸腰椎骨折合并截瘫临床效果.方法 通过分析42例应用后路Luque+ Harrington、AF内固定治疗胸腰椎骨折合并截瘫患者术前、术后及随访的椎体前缘高度变化、Cobb'角的纠正程度及截瘫指数恢复程度相比较.结果 AF系统在改善椎体高度、Cobb'角的纠正程度优于Luque+ Harrington.神经功能恢复远期效果好.结论 AF系统是治疗胸腰椎骨折合并神经损伤的一种理想方法.

  5. 颈椎后路单开门结合钛板内固定治疗脊髓型颈椎病%Clinical observation of posterior cervical single door joint titanium plate fixation treatment for cervical myelopathy

    Institute of Scientific and Technical Information of China (English)

    李水胜; 黄黎

    2014-01-01

    目的:探讨分析颈椎后路单开门结合钛板内固定治疗脊髓型颈椎病的临床疗效。方法回顾性分析2009年5月至2012年6月间在我院进行治疗的46例脊髓型颈椎病患者的临床记录资料。结果治疗后,治疗组的优良率为82.61%,高于对照组的52.17%,具有显著性差异(P ﹤0.05);治疗组的 JOA 评分高于对照组,ROM、颈椎屈曲、后伸角度均低于对照组,均具有显著性差异(P ﹤0.05)。结论颈椎后路单开门结合钛板内固定治疗脊髓型颈椎病的临床疗效显著,值得临床推广应用。%Objective:To investigate clinical effect of posterior cervical single door joint titanium plate fixation in treat-ment for cervical myelopathy. Methods:The clinical records of 46 patients with cervical myelopathy in our hospital from May 2009 to June 2012 were reviewed. Results:After treatment,the excellent rate of treatment group( 82. 61% )were sig-nificantly higher than that of the control group(52. 17% )(P ﹤ 0. 05). The JOA score of the treatment group was signifi-cantly higher than that of the control group and ROM,cervical flexion ,extension angles of the treatment group were lower than that of the control group( P ﹤ 0. 05 ). Conclusion:Clinical efficacy of posterior cervical single door joint titanium plate fixation in treatment for cervical myelopathy is remarkable and worthy of clinical application.

  6. Effects of Lordotic Angle of a Cage on Sagittal Alignment and Clinical Outcome in One Level Posterior Lumbar Interbody Fusion with Pedicle Screw Fixation

    Directory of Open Access Journals (Sweden)

    Ji-Ho Lee

    2015-01-01

    Full Text Available This study aims to assess the differences in the radiological and clinical results depending on the lordotic angles of the cage in posterior lumbar interbody fusion (PLIF. We reviewed 185 segments which underwent PLIF using two different lordotic angles of 4° and 8° of a polyetheretherketone (PEEK cage. The segmental lordosis and total lumbar lordosis of the 4° and 8° cage groups were compared preoperatively, as well as on the first postoperative day, 6th and 12th months postoperatively. Clinical assessment was performed using the ODI and the VAS of low back pain. The pre- and immediate postoperative segmental lordosis angles were 12.9° and 12.6° in the 4° group and 12° and 12.0° in the 8° group. Both groups exhibited no significant different segmental lordosis angle and total lumbar lordosis over period and time. However, the total lumbar lordosis significantly increased from six months postoperatively compared with the immediate postoperative day in the 8° group. The ODI and the VAS in both groups had no differences. Cages with different lordotic angles of 4° and 8° showed insignificant results clinically and radiologically in short-level PLIF surgery. Clinical improvements and sagittal alignment recovery were significantly observed in both groups.

  7. Posterior fusion versus posterior interbody fusion in segmental spinal fixation for aged spondylolisthesis%椎弓根钉固定的侧后方植骨融合和径后路椎体间融合治疗老年人腰椎滑脱症的效果评价

    Institute of Scientific and Technical Information of China (English)

    赵庆华; 田纪伟; 王雷; 董双海; 吴振凯; 王震; 贾连顺

    2009-01-01

    目的 观察应用椎弓根螺钉内固定技术,并分别结合侧后方融合(PLF)和经后路椎体间融合(PLY)两种方法 治疗老年人腰椎滑脱症的临床效果.方法 应用枢法模公司生产的TSRH-3D腰椎后路内固定系统治疗30例腰椎滑脱症患者,其中14例患者实施TSRH-3D内固定加侧后方植骨融合(PLF);16例患者行TSBH-3D内固定加经后路椎体问融合(PLIF),进行术前术后功能、症状评分.结果 30例患者均达到良好的融合效果;实施PLF患者,Prolo功能和症状评分分别为1.25和1.64;术前腰椎滑脱角为48.6%,术后恢复至17.5%.实施PLIF患者,Prolo功能和症状评分分别为1.18和1.39;术前腰椎滑脱角为44.2%,术后恢复至20.3%.结论 治疗成人腰椎滑脱症,应用TSBH-3D腰椎后路内固定系统可以获得牢固稳定,在保持腰椎术后功能恢复方面,PLIF优于PLF,但临床结果 尚无明显差异.%Objective Clinical and radiographic results in 30 consecutive patients undergoing posterior lumbar fixation and posterior facet joint or posterior interbody fusion for Meyerding Grade Ⅱ/Ⅲ spendylolisthesis were assessed: (1) to address the suitability of a dynamic stabilization; and (2) to investigate whether there are differences in terms of clinical and functional results between these two types of arthrodesis. Methods Fourteen patients underwent posterior inteffacet fusion (PLF) and implantation of TSRH-3D system. Posterior lumbar interbody fusion (PLIF) and placement of the same system were performed in 16 patients. Clinical, economic, functional and radiographic data were recorded both pre- and postoperatively. Results The average changes in Prolo Scale of economic and functional scores were 1.25 and 1.64 respectively, in patients undergoing posterior fusion; the average measured vertebral slippage was 48.6% (range 32% -65%) preoperatively and 17. 5% (range 15% -25%) postoperatively. In patients undergoing PLIF, the average changes in economic and

  8. 术中即时牵引与后路复位枕颈固定治疗原发性颅底凹陷症%Intraoperative traction combined with posterior occipitocervical reduction and fixation for primary basilar invagination

    Institute of Scientific and Technical Information of China (English)

    黄伦海; 涂洪波; 刘鹏; 赵建华

    2011-01-01

    目的 评价术中即时牵引与后路钉-棒系统枕颈固定治疗颅底凹陷症的疗效.方法 2009年7月至2010年6月共收治5例颅底凹陷症患者,男1例,女4例,平均年龄45.2岁.患者均有明显神经功能损害症状,JOA评分平均10.6分.寰齿前距平均7.86 mm.齿突尖超McGregor线(腭枕线)平均15.12 mm.1例合并难复性寰枢关节脱位.全麻后头高脚低位均行(体重的1/6重量)颅骨牵引维持15 min.4例寰齿前距减小(小于4 mm),1例无明显复位征象患者即行前路经口腔松解后寰齿前距减小至2.7 mm.轴性翻身后经后路钉-棒系统枕颈固定.术后均给予费城颈托固定3个月.结果齿状突均有较好的复位,术后寰齿前距平均3.44 mm,齿突尖超McGregor线平均6.4 mm.无术中、术后并发症.平均随访8个月,均固定满意并坚固融合,末次随访时所有患者神经功能均有较好恢复,JOA评分平均15.8分,改善率为81.25%.结论 术中即时牵引与后路钉-棒系统枕颈固定是治疗原发性颅底凹陷症安全、有效的方法.%Objective To evatuate the ctinicat efficacy of intraoperative traction combined with posterior occipitocervicat reduction and fixation using screw-rod system in treatment of basitar invagination. Methods Totatty five patients with primary basitar invagination were ad-mitted to our department form Juty 2009 to June 2010,inctuding four femates and one mate with an average age of 45. 2 years otd. Att the five patients had obvious symptoms of neurotogicat functionat damage, the average Japanese orthopaedic association score ( JOA score) was 10. 6 points. The average attantoodontoid intervat was 7. 86 mm and the odontoid tip went 15. 12 mm beyond the McGregor tine (chambertain tine). One case was compticated with irreducibte attantoaxiat distocation. Under generat anesthesia,att patients were accepted skutt traction for 15 minutes. The attantoodontoid distances of four patients were diminished ( <4 mm) . One patient with

  9. 一期后路病灶清除植骨融合内固定治疗胸椎结核%ONE-STAGE POSTERIOR DEBRIDEMENT, BONE GRAFT, AND INTERNAL FIXATION FOR THORACIC TUBERCULOSIS

    Institute of Scientific and Technical Information of China (English)

    陈宣维; 林建华; 陈雷; 陈飞; 许卫红; 韦超

    2011-01-01

    Objective To evaluate the clinical effectiveness and advantages of one-stage posterior debridement, bone graft, and internal fixation for thoracic tuberculosis. Methods The data were retrospectively analysed, from 21 cases of thoracic tuberculosis undergoing one-stage posterior debridement, bone graft, and internal fixation between June 2007 and November 2009. There were 16 males and 5 females with an average age of 42.2 years (range, 22-73 years). The average disease duration was 13.2 months (range, 7-21 months). The lesions were located at the level of T5,6 (1 case), T6,7 (1 case), T8,9 (4 cases), T9,10 (3 cases), Tio, n (5 cases), Tn, 12 (6 cases), and T9-11 (1 case). According to the Frankel grading criterion, the neurological function was rated as grade B in 2 cases, grade C in 6 cases, grade D in 10 cases, and grade E in 3 cases. The preoperative Cobb angle was (26.3 ± 9.2)°. The erythrocyte sedimentation rate (ESR) was (35.9 ± 11.2) mm/1 hour. Results Thoracic tuberculosis was confirmed in postoperative pathological examination in all 21 cases. All incisions healed primarily without fistules formation. The average follow-up time for 21 patients was 16.2 months (range, 1-3 years). Bony fusion was achieved within 7-12 months (mean, 9 months) without pseudoarthrosis. No loosening and breakage of internal fixation were found, and no local recurrence occurred. The ESR decreased to (25.1 ± 8.9) mm/1 hour at 1 week postoperatively, showing significant difference when compared with preoperative value (t=5.935, P < 0.01); it decreased to (14.1± 4.6) mm/1 hour at 3 months postoperatively. According to Frankel grade, the neurological function was significantly improved at 1 year after operation (x2=13.689, P=0.003). The average Cobb angle was (17.1 ± 4.5)° at 1 years postoperatively, showing significant difference when compared with preoperative value (t=7.476, P < 0.01). Conclusion One-stage posterior debridement, bone graft, and internal fixation has a

  10. 经后路寰枢椎椎弓根螺钉固定融合术治疗寰枢椎失稳%Atlanto-axial pedicle screw fixation through posterior approach for treatment of atlanto-axial joint instability

    Institute of Scientific and Technical Information of China (English)

    左春光; 刘夏君; 王新虎; 王建顺

    2013-01-01

    Objective:To discuss the therapeutic effects of the atlantoaxial pedicle screw system fixation in treatment of atlantoaxial instability. Methods:From June 2003 to March 2010,32 patients with atlantoaxial instability were treated by atlantoaxial pedicle screw system fixation, included 21 males and 11 females wiht an average age of 42.5 years old ranging from 28 to 66 years. Among them, 18 cases were odontoid process fractures,7 were congenital dissociate odontoid process,4 were Jefferson fracture combined with odontoid fracture, 3 were rheumatic arthritis causing atlantoaxial instability. All patients suffered from the atlantoaxial subluxation and atlantoaxial instability. The JOA score ranged from 4 to 14 (means 9.1±0.3) before operation. The patients had some image examination including the X-ray of cervical vertebrae (include of dynamic position film) ,spiral CT 3D reconstruction and/or MRI. The position of pedicle screw system implantation,the angle of pedicle screw system implantation and screw length were measured. Operating skull traction. Operation undewent general anesthesia, implanted the pedicle screw, reduction and bone fusion under direct vision. The bone was fixated between posterior arch of atlas and lamina of axis by the lateral combination bended to posterior. Results:One hundred and twenty-eight atlantoaxial pedicle screws were implanted in 32 patients. No patient had the injure of spinal cord,nerve root and vertebral artery. All patients were followed-up from 6 to 48 months (averaged 16 months). After operation,the JOA score ranged from 11 to 17 (averaged 15.9± 0.2) ,improvement rate was 86.1%. The fracture of odontoid process were healing completely. All fusion bone were combinated. The internal fixation wasn't loosening and breaking. Conclussion:The atlantoaxial pedicle screw system fixation was effective method to treat atlantoaxial instability. The method had many advantages, such as provide rigid and short segment fixation, safe and simple

  11. CLINICAL SIGNIFICANCE OF POSTERIOR INTERNAL FIXATION FOR REGULATION OF SPINAL CURVATURE IN THORACOLUMBAR COMPRESSION FRACTURES%胸腰椎压缩骨折复位术中伤椎植钉曲度矫正的临床意义

    Institute of Scientific and Technical Information of China (English)

    李鹏飞; 房根强; 李华; 靳宪辉; 张庆胜; 丁文元; 张为; 崔胜杰

    2013-01-01

    Objective To investigate the clinical significance of applicating posterior internal fixation for regulating spinal curvature in thoracolumbar compression fractures. Methods Between May 2006 and May 2009, 63 patients with thoracolumbar compression fractures were treated, and the clinical data were retrospectively analyzed. Among them, 33 patients received traditional posterior internal fixation in control group; 30 patients underwent posterior internal fixation with spinal curvature correction under C-arm X-ray device in trial group. There was no significant difference in age, gender, cause of injury, injured segment, grade of fracture, and time from injury to operation between 2 groups (P > 0.05). The Cobb angle, height of injured vertebral body, and disc height were measured by X-ray examination; loosening and breakage of internal fixation were observed and compared between 2 groups. The recovery rate was calculated according to pre- and post-operative visual analogue scale (VAS) and Oswestry disability index (ODI) scores for each patient. Results All cases were followed up 20-45 months (mean, 31 months). The postoperative VAS score, ODI, Cobb angle, height of injured vertebral body, and disc height were improved significantly when compared with preoperative values in 2 groups (P < 0.05). At last follow-up, VAS and ODI scores of trial group were significantly better than those of control group (P < 0.05); loss of Cobb angle was (2.1 ± 1.7)° in trial group and (4.2 ± 3.2)° in control group, showing significant difference (t=1.457, P=0.000); loss of disc height was (1.4 ± 1.2) mm in trial group and (3.4 ± 2.3) mm in control group, showing significant difference ((=9.336, P= 0.000); loss of height of injured vertebral body was 1.8% ± 0.6% in trial group and 5.4% + 2.1% in control group, showing significant difference (t=3.435, P=0.000). Broken screw and loosening screw occurred in 1 case of control group, respectively (6.1%), but no broken or loosening screw

  12. 前弓切除联合后路固定治疗齿突骨折畸形愈合%Anterior arch resection combined with posterior fixation for odontoid malunion

    Institute of Scientific and Technical Information of China (English)

    高延征; 高坤; 余正红; 陈书连; 王红强; 张广泉; 张敬乙; 曹臣

    2015-01-01

    目的 探讨经口前路寰椎前弓切除、寰枢椎侧块关节松解联合后路复位内固定融合术治疗齿突骨折畸形愈合伴难复性寰枢椎脱位的疗效.方法 2007年2月至2012年2月共收治6例齿突骨折畸形愈合伴难复性寰枢椎脱位患者,均有外伤史,均存在脊髓损伤表现.男5例,女1例;年龄36~57岁,平均45.5岁.术前日本骨科协会(Japanese Orthopaedic Association,JOA)评分为4~10分,平均(7.5±2.2)分;脊髓有效空间(space available for cord,SAC)为5~11 mm,平均(8.1±2.5) mm.采用经口前路寰椎前弓切除、寰枢椎侧块关节松解联合后路枕颈复位固定融合术,术后颈托外固定3个月.术后观察神经功能改善情况,行X线、CT检查观察寰枢椎复位及融合情况.结果 6例患者均获得随访,随访时间12~20个月,平均16个月.寰枢椎术中得到较好复位,术后3个月获得骨性融合,随访期间内固定无松动.6例患者神经功能末次随访时JOA评分为10~15分,平均(14.7±2.1)分,较术前明显提高(差异有统计学意义),神经功能改善率75.5%.末次随访时SAC为11~17 mm,平均(13.5±2.6)mm,较术前明显增大,差异有统计学意义.1例术后第5天出现后路切口渗液,督促患者采取侧卧位,避免切口受压,3周后切口愈合.1例术后第3天出现神智淡漠,化验室检查显示低钠、低钾血症,经及时补液,1d后神智恢复正常.结论 经口前路寰椎前弓切除、寰枢关节松解联合后路复位固定融合术是治疗齿突骨折畸形愈合伴难复性寰枢椎脱位的安全、有效方法,临床效果满意.%Objective To study the clinic efficacy of anterior arch resection,atlantoaxial joint release combined with posterior fixation and fusion for odontoid malunion associated with irreducible atlantoaxial dislocation.Methods From February 2007 to February 2012,6 patients (5 males,1 female) were diagnosed with odontoid malunion associated with irreducible atlantoaxial

  13. Application of three-dimensional CT angiography of cervical part in posterior atlas fixation%颈部三维CT血管成像在寰椎后路固定术中的应用

    Institute of Scientific and Technical Information of China (English)

    张志; 王亭; 张金锋; 李书忠

    2012-01-01

    BACKGROUND: Posterior atlantoaxial fusion with internal fixation is a common treatment method for the treatment of upper cervical lesions. Some cases of vertebral artery injuries have been reported since complex and variable anatomical structure here. OBJECTIVE: To observe normal three-dimensional CT angiograph images of the upper cervical spine and to study the anatomy of atlantal posterior arch and the accompanying vertebral artery journey in order to provide the basis of microvascular anatomy for clinical treatment.METHODS: Four hundred cases without pathological lesions of atlantoaxial joint were selected. All the three-dimensional CT images were formed with volume rendering together with the techniques of separating, fusing, opacifying and false-coloring, On the three-dimensional CT images, the courses and variations of vertebral artery were observed, and the posterior screw-related data of the atlantal posterior arch were measured.RESULTS AND CONCLUSION: All the three-dimensional CT angiography images of head and neck were in high quality and up to our requirements. The courses of vertebral artery accompanied with the atlas were curved. There were 385 cases with typical itinerary. Variations were found in 15 cases, a total of 18 sides. There were 11 sides of persistent first intersegmental artery, 6 sides of fenestrated vertebral artery, 1 side of abnormal posterior inferior cerebellar artery respectively. 48 cases of posterior ponticulus were found, and 10 cases were bilateral, a total of 58 sides. The bottom of the vertebral artery's groove was the weakest part of the posterior arch, and there was no significant difference between left and right (P > 0.05). The shape of the atlantal posterior arch and the vicinal vertebral artery are polytropic which bright the uncertain factors for the atlas posterior screw. Therefore, the three-dimensional CT angiography image clearly shows the anatomical structures. Full understanding of these data before operation can

  14. Pseudo-aneurisma de artéria tibial posterior pós-tratamento de fratura de perna com fixador externo: relato de caso e revisão da literatura Pseudoaneurysm of the posterior tibial artery after external fixation for leg fracture: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Domingos de Morais Filho

    2007-06-01

    Full Text Available Este trabalho descreve um caso de pseudo-aneurisma da artéria tibial posterior devido ao uso de fixador externo para tratamento de fratura dos ossos da perna (técnica de Ilizarov, bem como as técnicas utilizadas para seu tratamento. A compressão guiada por ultra-som e a injeção de trombina guiada por ultra-som foram realizadas, sem sucesso. O tratamento definitivo do pseudo-aneurisma e reconstrução arterial foi conseguido através do tratamento cirúrgico clássico, usando enxerto interposto de veia safena magna homóloga invertida. As indicações, vantagens e desvantagens das técnicas de tratamento não invasivo (compressão guiada por ultra-som e injeção de trombina guiada por ultra-som e as possíveis causas de sua incapacidade na obliteração do pseudo-aneurisma são discutidas. Também foi realizada a revisão de casos de pseudo-aneurisma da artéria tibial posterior na literatura médica, encontrando-se apenas um caso semelhante, entre 24 publicados.We describe a case of pseudoaneurysm in the posterior tibial artery following treatment for tibial and fibula fractures using external fixation (Ilizarov technique, as well as the techniques used for its treatment. Ultrasound-guided compression and ultrasound-guided thrombin injection were unsuccessfully performed. Definite treatment of pseudoaneurysm and arterial reconstruction was achieved through the traditional surgical treatment, using interposed graft of inverted homologous great saphenous vein. Indications, advantages and disadvantages of noninvasive treatment techniques (ultrasound-guided compression and ultrasound-guided thrombin injection and the possible causes of their inability in obliterating the pseudoaneurysm are discussed. A literature review of pseudoaneurysms of the posterior tibial artery was also carried out, resulting in only one similar case out of 24 published cases.

  15. 个体化后路寰枢椎融合内固定治疗寰枢椎不稳%Management of atlantoaxial instability with individualized posterior atlantoaxial fixation and fusion

    Institute of Scientific and Technical Information of China (English)

    周凤金; 倪斌; 谢宁; 卢旭华; 郭翔; 郭群峰; 陈金水; 杨军

    2014-01-01

    目的:探讨后路寰枢椎融合治疗寰枢椎不稳的个体化方案。方法回顾分析2006年10月~2011年6月治疗的各种原因导致的寰枢椎不稳98例,男57例,女41例。年龄4~71岁,平均37.2岁。其中,先天发育性34例,外伤性51例,类风湿性关节炎8例,强直性脊柱炎5例。所有病例均行手术复位内固定、自体髂骨移植植骨融合术,其中,采用双侧寰椎椎板钩及枢椎椎弓根螺钉内固定24例,采用双侧C1/C2关节间隙螺钉及寰椎椎板钩28例,双侧C1/C2关节间隙螺钉加改良Gallie法5例。双侧C1侧块螺钉加C2椎弓根螺钉内固定16例,双侧C1侧块螺钉加C2椎板螺钉7例,组合钉棒内固定18例。根据病情、内固定的稳定情况决定术后是否行外固定及制动时间。其中,89例存在不同程度的脊髓压迫症状。治疗前美国脊髓损伤协会( American Spinal Injury Association , ASIA)脊髓神经功能分级:B级12例,C级48例,D级29例,E级9例。结果随访时间12~60个月,平均32个月。所有病例枕颈部症状得到很大改善,91例获得骨性融合,7例发生延迟愈合。术后ASIA脊髓神经功能分级:B级1例,C级12例,D级32例,E级53例。手术操作无椎动脉及脊髓神经损伤病例。无内固定脱落、断裂、退钉等并发症。结论完善的术前准备,个体化选择合适的固定融合术式,是减少手术并发症、提高疗效的有效途径。%Objective To evaluation the treatment of atlantoaxial instability by using individualized posterior atlantoaxial fixation and fusion.Methods A total of 98 patients (57 males and 41 females) with atlantoaxial instability from October 2006 to June 2011 were retrospectively analyzed, and the mean age was 37.2 years old (range, 4 to 71 years), and among them, 34 patients with congenital deformity , 51 patients had a definite history of neck injury , rheumatoid arthritis in 8 cases and

  16. The Postoperative Application of Percutanous Dilatational Tracheostomy for Patients with Serious Cervical Spinal Cord Injury Undergoing Anterior or Combined Anterior-posterior Cervical Spine Fixation%经皮扩张气管切开术在重度颈髓损伤颈椎前路或前后路联合手术后人工气道中的应用

    Institute of Scientific and Technical Information of China (English)

    李强; 安卫红; 白宇; 刘飞; 么改琦; 朱曦

    2013-01-01

    Objective To investigate the feasibility of percutanous dilatational tracheostomy on patients undergoing anterior and anterior-posterior cervical spine fixation.Methods A retrospective analysis was done on 17 patients with cervical spinal cord injury who were admitted to ICU of Peking University Third Hospital from January 2012 to March 2013,including 12 cases of anterior and 5 cases of combined anterior-posterior cervical spine fixation.All patients received percutanous dilatational tracheostomy after anterior or anterior-posterior cervical spine fixation.The duration between the percutanous dilatational tracheostomy and the anterior/anterior-posterior cervical spine fixation were 5 to 11 days.Results The procedure of percutanous dilatational tracheostomy was smooth in all 17 cases,with no intraoperative impairment to the vital organs,no postoperative heavy blood loss and no fistula infection.No concurrent anterior and anterior-posterior cervical incision infection occurred.Conclusions Percutanous dilatational tracheostomy is a safe and efficient way of building the artificial airway 5 days after the anterior and anterior-posterior cervical spine fixation.%目的 探讨颈椎前路和颈椎前后路联合颈椎切开复位内固定手术后行经皮扩张气管切开术的安全性. 方法 回顾性分析2012年1月~2013年3月颈脊髓损伤17例,行颈前路(12例)或颈前后路(5例)切开复位内固定手术,术后5 ~11d行经皮扩张气管切开术. 结果 17例经皮扩张气管切开术均过程顺利,无颈前部重要器官损伤、术后局部大量出血、造瘘区域感染、颈前路手术切口及切口深层感染. 结论 颈前路手术5日后行经皮扩张气管切开术是安全高效的建立人工气道的方法.

  17. Posterior atlas limited internal fixation for atlas unstable fractures%后路寰椎有限内固定治疗寰椎不稳定性骨折

    Institute of Scientific and Technical Information of China (English)

    徐荣明; 赵红勇; 胡勇; 马维虎; 顾勇杰; 袁振山

    2012-01-01

    cervical alignment was maintained with no instrument failure and Cl-2 recurrent instability. Conclusions: In the premise of strictly select surgical indications, posterior Cl screw-rod fixation system is a better way for treatment of Cl unstable fractures, which can preserve the function of the craniocervical junction.%目的:探讨后路寰椎钉棒系统有限内固定治疗寰椎不稳定性骨折的疗效.方法:2008年4月~2010年10月采用后路寰椎钉棒系统内固定治疗寰椎不稳定性骨折10例,男7例,女3例;年龄20~60岁,平均37.5岁.患者均有不同程度的枕颈部疼痛、僵硬和颈部活动受限,均无神经损伤表现.双侧寰椎后弓并单侧寰椎前弓骨折(后3/4 Jefferson骨折,LandellsⅡ型)6例,单侧寰椎前后弓骨折(半环Jefferson骨折,LandellsⅡ型)4例;横韧带完整7例,横韧带附着处骨折和撕脱(DickmanⅡ型)3例.术前均行颅骨牵引稳定骨折块.结果:共置入螺钉20枚,其中1例在置入寰椎椎弓根螺钉时后弓破裂,1例术前进钉点处后弓破裂,直接将螺钉固定在侧块上;1例患者寰椎后弓进钉点处的高度小于4mm,无法行椎弓根螺钉固定而改为侧块螺钉固定;其余7例均行寰椎椎弓根螺钉固定.手术时间为60~90min,平均70.5min;术中出血量为100~300ml,平均150ml.术中1例患者在剥离寰椎后弓下缘时损伤静脉丛,用明胶海绵压迫止血;未发生脊髓和椎动脉损伤.术后X线片及CT示1例一侧寰椎椎弓根螺钉部分进入椎动脉孔,1例一侧螺钉偏内致椎弓根内侧皮质破裂,但均无血管神经损伤症状,未处理;其余螺钉位置良好.随访12~36个月,平均20.2个月,术后3~6个月枕颈部疼痛缓解,颈部活动范围基本接近伤前水平;术后6个月复查骨折断端达到骨性融合;随访期间颈椎序列良好,未见内固定松动、断裂,无C1-2失稳.结论:在严格选择适应证的前提下,寰椎后路钉棒系统有限内固定是治疗

  18. 脊柱前路内固定器系统与脊柱后路椎弓根钉棒系统治疗腰椎爆裂性骨折的疗效比较%Effect of anterior internal fixation and posterior pedicle screw fixation in the treatment of lumbar burst fractures

    Institute of Scientific and Technical Information of China (English)

    张建新; 李玉明; 张苏斌; 吕曦

    2016-01-01

    Objective To compare the effect of anterior internal fixation and posterior pedicle screw fixa-tion in the treatment of lumbar burst fractures.Methods Thirty-three patients( the anterior group) with burst frac-ture of lumbar spine treated by anterior internal fixation system in our hospital from Feb.2012 to Dec.2013 were se-lected.Fifty-four patients ( the posterior group) treated by posterior pedicle screw rod system fixation were also ret-rospectively analyzed.The differences in operation time, intraoperative blood loss,loss of Cobb' s angle,Japanese Orthopaedic Association ( JOA) Scores,anterior height ratio of the vertebral body and score by American Spinal In-jury Association (ASIA) between the two groups were compared.Results The operation time of (178.8 ±55.2) min and the intraoperative blood loss of ( 750.9 ± 85.2 ) mL in the anterior group were both significantly higher than those of the posterior group[(149.3 ±38.6)min,(414.3 ±67.8)mL] and the difference was statistically sig-nificant(P0.05).After 1 year of operation,the JOA scores of the two groups were significantly improved and the difference was statistically significant(P0.05) .Conclusion The results of the two methods in the treatment of lumbar burst frac-ture are both satisfactory.The disadvantage of the posterior group is the large loss of Cobb angle correction and the disadvantage of the anterior group is the surgical trauma.Individualized consideration should be given to the factors such as patients' surgical tolerance.%目的 研究对比脊柱前路内固定器系统内固定及脊柱后路椎弓根钉棒系统内固定治疗腰椎爆裂性骨折的效果差异.方法 笔者选取2012年2月~2013年12月采用前路内固定器系统内固定治疗的33例腰椎爆裂性骨折患者(前路组)、后路椎弓根钉棒系统内固定治疗的54例患者(后路组)进行回顾性分析,对比两组患者的手术时间、术中出血量、Cobb角丢失、日本矫形外科协会(JOA)评分

  19. Comparação entre os resultados pós-operatórios de pacientes submetidos ao procedimento tríplice e transplante de córnea combinado a fixação secundária de lente intra-ocular Comparison between the postoperative results of triple procedure and combined penetrating keratoplasty/ transsclerally sutured posterior chamber lens implantation

    Directory of Open Access Journals (Sweden)

    Daniela Maggioni Pereira Leão

    2006-08-01

    Full Text Available OBJETIVO: Comparar os resultados pós-operatórios de 2 grupos de pacientes submetidos a transplante de córnea com técnicas e tempo cirúrgico diferentes, em relação à abordagem do cristalino e/ou lente intra-ocular. MÉTODOS: Neste estudo retrospectivo foram analisados 37 olhos de pacientes divididos em 2 grupos: extração de catarata, implante de lentes intra-oculares (LIO e transplante de córnea no mesmo tempo cirúrgico - grupo 1 (G1 e extração de catarata sem implante de lentes intra-oculares no primeiro tempo cirúrgico e fixação secundária de lentes intra-oculares associada a transplante de córnea no segundo tempo cirúrgico - grupo 2 (G2. As variáveis estudadas foram: acuidade visual, pressão intra-ocular (PIO, astigmatismo refracional, astigmatismo ceratométrico e complicações pós-operatórias. RESULTADOS: Foi observado melhora da acuidade visual nos 2 grupos (G1 pPURPOSE: To compare the outcomes of two surgical techniques of penetrating keratoplasty with different surgical time, regarding the crystalline and the intraocular lens. METHODS: This retrospective study included 37 patients' eyes divided into 2 groups: extracapsular cataract extraction, posterior chamber intraocular lens implantation and penetrating keratoplasty (Group 1, G1 and transscleral fixation of posterior chamber lens and penetrating keratoplasty (Group 2, G2. The following parameters were recorded: visual acuity, intraocular pressure, refractive astigmatism, complication and keratometric astigmatism. RESULTS: Visual acuity improved in the two groups (G1 p<0.001 and G2 p=0.008. In G2 a significant change for the worse of intraocular pressure outcome was observed when compared with the other group (p=0.014. Regarding refractive and keratometric astigmatism no significant differences between the groups were found. The follow-up was 11 months. CONCLUSION: The most important negative prognostic factor affecting visual acuity was the postkeratoplasty

  20. 下颈椎前路内固定联合后路经关节金属螺钉置入固定的生物力学稳定性%Biomechanical stability of the lower cervical spine inter-fixation by anterior approach combined with posterior articular screws

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    康建平; 冯大雄; 王清; 钟德君; 李骏; 叶飞; 王松

    2011-01-01

    BACKGROUND: A simple anterior corpectomy or discectomy, or simple posterior open canal to expand a single trip cannot fully complete three-column spinal cord decompression and spinal stabilization in patients with degenerative cervical stenosis.OBJECTIVE: To study the biomechanical stability of the lower cervical spine inter-fixation by anterior approach combined with posterior srticular screws.METHODS: Ten cervical spine specimens were gained from cadavers. Every specimen was managed via two methods sequentially: The first method was by posterior C3-C7 open-door laminoplasty combined with posterior articular screw fixation andby anterior C5 subtotal corpectomy with bone granule graft in the titanium mesh and ORION fixation (test group); The second method was by posterior C3-C7 open-door laminoplasty and by anterior C5 subtotal corpectomy with bone granule graft in thetitanium mesh and ORION fixation (control group).RESULTS AND CONCLUSION: Compared with the control group, displacement angles of flexion, extension, left/right lateroflexion left/right rotation in the test group were lower (P < 0.001). The findings indicated that: ①The lower spine gained the excellent biomechanical stability in flexion, extension, lateroflexion and rotation via the treatment of anterior fixation combined posterior articular screw fixation. ②The treatment of anterior fixation combined with posterior articular screw fixation provided significant biomechanical stability to the lower cervi cal spine in flexion position.%背景:对退变性颈椎管狭窄单纯采用前路椎体次全切除或椎间盘切除或单纯后路单开门椎管扩大成行均不能彻底完成脊髓减压和脊柱三柱稳定.目的:探讨下颈椎前路固定联合后路经关节螺钉固定的生物力学稳定性.方法:正常成人尸体颈椎标本,每具分别制作以下两种模型:①经后路C3~C7单开门和下颈椎前路C5椎体次全切除钛网支撑植骨、ORION内固定

  1. 颈后路多节段椎弓根螺钉内固定术与颈前路钢板内固定术治疗Hangman骨折疗效对比分析%The Efficacy Comparison of Internal Fixation by Multilevel Pedicle Screw in Posterior and Internal Fixation by Steel Plate in Anterior on Treating ;Hangman Fracture

    Institute of Scientific and Technical Information of China (English)

    李军

    2014-01-01

    目的:观察比较Hangman骨折采用颈后路多节段椎弓根螺钉内固定术与颈前路钢板内固定术的疗效。方法:选取笔者所在医院2010年6月-2013年6月收治的Hangman骨折患者45例,按照随机数字表法分成颈后路组23例和颈前路组22例。比较两组患者手术时间及术中出血量,手术治疗产生的并发症,术后骨折的痊愈程度及恢复脊髓功能的情况。结果:两组患者手术时间、术中出血量、术后骨折痊愈的程度及恢复脊髓功能的情况比较差异均无统计学意义(P>0.05)。颈后路组的并发症总发生率(4.35%)明显低于颈前路组的并发症总发生率(31.82%),两组比较差异有统计学意义(P0.05).The overall incidence of complications in posterior group(4.35%) was significantly lower than anterior group(31.82%),and the difference between the two groups was statistically significant(P<0.05).Conclusion:The ideal method for treating Hangman fracture is internal fixation by multilevel pedicle screw in posterior.

  2. 有晶状体眼后房型人工晶状体植入术治疗高度近视临床观察%Clinical Observation of Posterior Chamber Phakic Intraocular Lens Implantation for High Myopia

    Institute of Scientific and Technical Information of China (English)

    岳军; 李红; 王平; 覃光海; 赵婷; 丁熊; 郑姣; 龚晋; 简岩

    2012-01-01

    目的:评价有晶状体眼后房型人工晶状体(ICL)植入术治疗高度近视的有效性和安全性.方法:对7例(14只眼)高度近视患者行有晶状体眼ICL植入术.术后随访3-9个月,观察手术前后裸眼视力、最佳矫正视力、屈光度、眼压、内皮细胞计数等.结果:所有患者成功植入ICL,14只眼手术前后平均屈光度分别为(-14.52±-6.43)D,(-0.01±0.28)D;裸眼视力分别为0.08±0.06,0.6±0.3;最佳矫正视力分别为0.5±0.2,0.7±0.2;术后裸眼视力和最佳矫正视力均明显好于术前(P<0.05).术前平均眼压为(16.21±2.84)mmHg,术后平均眼压为(17.03±1.95)mmHg;内皮细胞计数术前为(3 028±289)个/mm2,术后为(2 912±2 51)个/mm2;前房深度术前平均为(3.69±0.31)mm,术后为(3.57±0.29)mm,差异均无统计学意义(P>0.05).结论:ICL矫正高度近视近期临床效果有效、可靠,临床观察未发现手术并发症,远期效果需进一步观察.%Objective: To evaluate the efficacy and safety of the surgical correction of high myopia using an implantation of posterior chamber intraocular lens. Methods: Posterior chamber phakic intraocular lens (ICL) implantation was performed in 14 eyes of 7 patients with high myopia. After follow-up for 3 to 9 months, the clinical ocular examinations were performed including uncorrect-ed visual acuity (UCVA), best corrected visual acuity (BCVA) retraction, intraocular pressure (IOP), slit-lamp findings, cornea topography and cornea endothelial cell density before and after surgery. Results: Posterior chamber phakic intraocular lens were implanted successfully in all the operative eyes. The mean preoperative diopter was —14. 52 ± 6. 43 D, and postoperative diopter was —0. 01±0. 28 D. The UCVA and BCVA were 0. 08 ± 0. 06 and 0. 5 ± 0. 2 respectively before operation versus 0. 6 ±0. 3 and 0. 7 ± 0. 2 respectively after operation. It is obvious that postoperative UCVA and BCVA were better than the preoperative ones

  3. Posterior chamber implantable contact lens for 18 cases of high myopia%有晶状体眼后房型可植入式接触镜矫正高度近视患者18例

    Institute of Scientific and Technical Information of China (English)

    张淑萍; 叶子隆; 刘旭姣; 高岩; 史彩霞; 谢淑丽; 高海音

    2009-01-01

    Objective To investigate the efficacy and safety of posterior chamber implantable contact lens (ICL) implantation to correct high myopia in phakic eyes. Methods Under topical anesthesia 18 cases (32 eyes) of high myopia were treated with posterior chamber intraocular lens implantation. Comparisons between post-operative uncorrected visual acuity and pre-operative best corrected visual acuity, between post-operative refraction and pre-operative refraction, and between post-operative intraocular pressure and pre-operative pressure were carried out. ICL's location and complications such as cataract and secondary glaucoma were observed. Results Post-operative uncorrected visual acuity reached or exceeded the preoperative best corrected visual acuity in 18 cases (32 eyes). Except that 2 cases (2 eyes) had a transient high intraocular pressure 2 hours after the operation and 1 case had a high intraocular pressure 10 days after the operation, others were controlled normally. UBM showed that there was a certain gap between ICL and the lens. During the follow-up period, visual acuity, refraction, and intraocular pressure were stable. No complicated cataract, secondary glaucoma, retinal detachment or chronic meningitis, such as uvitis happened. Conclusion ICL posterior chamber intraocular lens implantation in eyes is safe and reliable.%目的 探讨有晶状体眼后房型可植入式接触镜(ICL)植入术矫正高度近视的有效性及安全性.方法 表面麻醉下对18例(32眼)高度近视患者行有晶状体眼后房型ICL植入术,将术后裸眼视力与术前最佳矫正视力对比.术后屈光度、眼压与术前屈光度、眼压进行对比.观察ICL在眼内的位置及有无并发性白内障、继发性青光眼等并发症的发生.结果 18例(32眼)术后裸眼视力均达到或超过术前最佳矫正视力,除两例(2眼)术后2 h出现一过性高眼压,1例(1眼)术后10d出现眼压升高,经局部降眼压对症治疗及停用激素眼药治疗

  4. 后路椎弓根钉棒复位内固定+经伤椎椎弓根植骨治疗胸腰椎骨折%Posterior transpedicle vertebral bone grafting and screw fixation for thoracolumbar vertebral fracture

    Institute of Scientific and Technical Information of China (English)

    曹杰; 于海洋; 梁成民; 焦伟

    2016-01-01

    背景:胸腰椎骨折临床上常见,传统手术方案是后路椎弓根钉棒复位内固定+自体髂骨植骨,但术后胸腰段活动度受影响,且远期伤椎椎体前部仍会有椎体体积25%大小的骨缺损,即所谓的"蛋壳"效应,导致远期伤椎局部后凸再次增大、矫正丢失等并发症.后路椎弓根钉棒复位内固定+经伤椎椎弓根植骨可恢复椎体前中柱的抗压性,因而备受关注.目的:探讨后路椎弓根钉棒复位内固定+经伤椎椎弓根植骨治疗胸腰椎骨折的临床疗效.方法:2014年1月至2016年1月收治无需减压的胸腰椎骨折患者42例,男31例,女11例;年龄20~52岁,平均37.3±1.2岁;按Denis分型:DenisⅠ型(压缩型)31例,Ⅱ型(爆裂型)11例.分为2组,伤椎椎体后壁完整入选非融合组,后壁破损入选融合组,非融合组21例后路椎弓根钉棒复位内固定后在"C"型臂X线机透视引导下应用硫酸钙经伤椎椎弓根椎体内植骨治疗;融合组21例后路椎弓根钉棒复位内固定后取髂骨植骨融合治疗.比较两组患者的临床参数和影像学指标.结果:2组患者均顺利完成手术,术中未发生大出血、损伤神经等手术并发症,获得12~36个月随访,平均(23.5±1.8)个月.非融合组的术后胸腰段Cobb角(过屈位/过伸位)比值优于融合组(P<0.05),非融合组伤椎椎体的骨容量优于融合组,且非融合组术后伤椎均未出现"蛋壳"效应.结论:后路椎弓根钉棒复位内固定+经伤椎椎弓根植骨治疗胸腰椎骨折手术安全可靠,矫正效果满意,术后恢复快,不影响腰椎活动度,并有效防止伤椎出现"蛋壳"效应,能即时增加伤椎椎体的骨容量及前柱的抗压稳定性.%Background:Thoracolumbar fractures are common in clinic. The traditional operation scheme is posterior pedi-cle screw reduction and internal fixation plus iliac bone grafting, but thoracolumbar range of motion may be affected and there is still bone defect in anterior involved

  5. 经后路内固定植骨融合治疗游离齿突小骨伴寰枢椎脱位%Posterior fixation and fusion for treatment of Os odontoideum complicated by atlantoaxial dislocation

    Institute of Scientific and Technical Information of China (English)

    张辉; 靳安民; 张力; 周治来; 段扬; 闵少雄

    2012-01-01

    Objecfive To summarize the techniques and evaluate the therapeutic effect of posterior fixation and fusion in the treatment of Os odontoideum complicated by atlantoaxial dislocation. Methods From March, 2007 to October, 2010,10 patients with Os odontoideum (including 6 male and 4 female patients aged from 20 to 65 years, mean 39.8 years) were treated in our hospital. Before and after the operation, the patients underwent X ray, CT and MRI examinations to measure and evaluate the degree of dislocation and neural compression. After preoperative traction for 1-2 weeks, all the 10 patients showed reductible atlantoaxial dislocation. Through a posterior approach, Atlantoaxial pedicle screws fixation were performed in 9 cases, and C2/ 3 pedicle-Occiput screw fixation was performed in 1 case. All the patients wore cervical collars as external support for 3 months after the operation. Results The mean operative time was 3 h in these patients with a mean intraoperative blood loss of 420 ml. The symptoms were relieved after the surgery in all the patients, who showed no neck pain or neurological defects. The patients were followed up for 6 to 52 months (mean 22 months), and bony fusion was observed in all the 10 cases within 6 to 8 months without such complications as internal fixation failure or redislocation of the atlas. Conclusion Patients with Os odontoideum complicated by atlantoaxial dislocation should undergo surgical stabilization to avoid severe neurological injury. Pedicle screw instrument in the atlas allows restoration of the spinal stability, short-segment fusion, and maximal preservation of the mobility of the neck.%目的 探讨后路复位内固定治疗游离齿突小骨伴寰枢椎脱位的方法及疗效.方法 2007年3月~2010年10月,收治10例游离齿突小骨伴寰枢椎脱位患者,男6例,女4例;年龄20~65岁,平均39.8岁,术前摄颈椎正侧位X片,CT及MRI检查,评价脱位及脊髓受压程度.术前经1~2周牵引,10

  6. Clinical research of phakic posterior chamber intraocular lens implantation for high myopia%有晶状体眼后房型人工晶状体植入术治疗高度近视的临床研究

    Institute of Scientific and Technical Information of China (English)

    卢苇; 邵彦; 贡雅洁

    2010-01-01

    Objective To investigate the clinical efficacy and safety of phakic posterior chamber intraocular lens (ICL) implantation for high myopia. Methods Twenty-four eyes of 12 patients with high myopia were treated with ICL implantation. The best corrected visual acuity, intraocular pressure and lens changes shape between post-operative and pre-operative were compared. Results Successful implantations were done in all patients. All eyes had a significant increase in uncorrected visual acuity. Exactly improved visual function in patients with high myopia status. The intraocular pressure was ( 14.26 ± 2.13) mm Hg(1 mm Hg = 0.133 kPa) of pre-operative , and was ( 14.79 ± 2.77) mm Hg at 1 year after post-operative, the intraocular pressure was stability after the operation. UBM showed that there was a certain gap between ICL and the lens. During the follow-up period,no complications such as cataract,chronic uveal infusion were found. Conclusion Phakic posterior chamber ICL implantation is effective,safe and reliable method for the correction of high myopia.%目的 探讨有晶状体眼后房型人工晶状体(ICL)植入术治疗高度近视的临床效果.方法 对12例24眼接受ICL植入术的患者资料进行总结和分析,比较其手术前后最佳矫正视力、眼压及透明晶状体性状的改变.结果 12例24眼术后最佳矫正视力均达到或超过术前最佳矫正视力,改善了高度近视患者的视功能状况,术前眼压(14.26±2.13)mm Hg(1 mmHg=0.133 kPa),术后1年眼压(14.79±2.77)mm Hg(P>0.05),术后眼压稳定,术后ICL与透明晶状体存在裂隙,随访期间未见并发性白内障、慢性色素膜炎等并发症.结论 ICL植入术治疗高度近视手术效果确切,预测性好,安全性高.

  7. SURGICAL OUTCOME OF TRIPLE PROCEDURE AS PENETRATING KERATOPLASTY WITH EXTRACAPSULAR CATARACT EXTRACTION WITH POSTERIOR CHAMBER INTRAOCULAR LENS IMPLANTATION IN PATIENTS WITH BOTH CENTRAL CORNEAL OPACITY AND ADVANCED CATARACT AT RURAL SET UP

    Directory of Open Access Journals (Sweden)

    Shubhangi Nigwekar, Kishor Badhe, Neeta Misra, Surekha Bangal

    2015-10-01

    Full Text Available Purpose: To study the surgical outcome of triple procedure as penetrating keratoplasty (PKP with conventional extra capsular cataract extraction (ECCE with posterior chamber intraocular lens (PCIOL implantation in patients with both central corneal opacity and advanced cataract at rural set up. Introduction: When corneal opacity and cataract present together then well-established and effective triple procedure is indicated. Prognosis for a clear graft is good in triple, as graft endothelium does not touch the hard nucleus which may occur in two steps or sequential surgery. It provides faster visual rehabilitation. Being single step procedure it reduces patient’s hospital stay, postoperative care and follows up visits. Methodology: In this hospital based observational , three years longitudinal study, we studied the surgical outcome of relatively rare one step triple procedure as PKP with conventional ECCE with PCIOL implantation in sulcus or in bag, in patients with both central corneal opacity and advanced cataract at rural set up. The outcome measures included graft clarity on slit lamp, postoperative unaided visual acuity with Snellen’s chart and the occurrence of postoperative complications after taking IEC permission and informed written consent in local language from study patients. Results: Out of 13 study patients mean age was 61.15yrs (Range50-80yrs. Follow up range was 9-34 months. At final follow up 9 patients (69.23% had clear grafts and 61.52% patients gained visual acuity >6/24. Graft failure was the most common post operative complication in 30.76% followed by Posterior capsular opacification (PCO in 15.38% patients which was treated well with YAG laser capsulotomy. Conclusion: Triple procedure gives good results in respect to graft clarity, unaided vision, and faster rehabilitation.

  8. 特发性脊柱侧弯后路矫形植骨融合内固定围术期护理%Perioperative nursing on posterior fusion and fixation for idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    夏同霞; 袁发孝; 杨晓群; 周芬; 谢文婷; 李媛媛

    2011-01-01

    Objective To probe into the perioperative nursing method during osterior fusion and fmation for idiopathic scoliosis. Methods The study involved 31 patients with idiopathic scoliosis treated with posterior correction nails and selective spinal fusion with hook-rod system fixation.The severe patients were treated with extensive posterior release or anterior correction and fusion posterior to release.Before the operation,the patients were administrated with mental nursing,lung function exercise,self-elongation exercise,wake-up pilot training,self-image appraisement and bed and life skills exercise.After the operation,an observation was done on the change of nervous system,propor turning the body over best clinostatism,drainage tube care,respiratory passage care,functional exercise instruction and discharge instruction. Results The operation was accomplished successfully in all the patients,which showed that the body height was increased 2-15 cm.There found no complications including loosening or breakage of the nails or sticks,nervous system injury,incisional wound infection or press~e sore. Conclusion Preoperative sufficient preparation and fine postoperative nursing are important guarantee to successful operation and fast rehabilitation.%目的 探讨脊柱侧弯后路矫形植骨融合内固定术围术期的护理方法.方法 对31例特发性脊柱侧弯患者采用后路矫形钉、钩棒系统内固定选择性脊柱融合术,对于重度患者采用广泛后路松解或前路松解后矫形融合治疗;术前给予心理护理、肺功能训练、自我伸长训练、唤醒试验训练、自我形象鉴定、床上生活能力训练;术后密切观察神经系统变化,正确搬运和翻身,给予最佳卧位,加强引流管护理、呼吸道护理、功能锻炼指导和出院指导.结果 31例患者均顺利完成手术.术后身高增加2~15 cm.本组未发生螺钉及棒的松动、断裂及神经系统损伤、切口感染,压疮等.结论 术前充

  9. Modified posterior-assisted levitation with intraocular lens scaffold and glued IOL for sinking nucleus in eyes with inadequate sulcus support.

    Science.gov (United States)

    Narang, Priya; Agarwal, Amar

    2017-07-01

    Posterior-assisted levitation is used to retrieve and levitate a sinking nucleus in cataract surgery associated with posterior capsule rupture. After the nucleus is levitated in the anterior chamber, the intraocular lens (IOL) scaffold procedure helps emulsify the nuclear remnants with the phacoemulsification probe and glue-assisted intrascleral haptic fixation (glued IOL) enables appropriate placement of an IOL in cases with insufficient capsule support. We describe a triumvirate procedure for a sinking nucleus in the absence of capsule support that combines modified posterior-assisted levitation, in which the nucleus is levitated from the existing sclerotomy sites of glued IOL surgery, with the IOL scaffold technique, enabling a closed-chamber approach when performed concurrently. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  10. Clinical research on the implantation of posterior chamber phakic intraocular lens for high myopia%有晶状体眼后房型人工晶状体植入术矫治高度近视

    Institute of Scientific and Technical Information of China (English)

    吴敬明; 冯琛; 陈艳路; 王弘媛; 赵周婷

    2012-01-01

    Objective To evaluate the efficacy, safety and stability of the implantation of posterior chamber phakic intraocular lens for high myopia. Design Retrospective case series. Participants Seventy three eyes of 38 cases with high myopia (-6.00—24.00 D) who were implanted with posterior chamber phakic intraocular lens in 211 Hospital of the People's Liberation Army, Haerbin from July 2009 to March 2012. Methods The patients were implanted with posterior chamber phakic intraocular lens, 48 eyes with im-plantable contact lens-myopia (ICM) and and 25 eyes with Toric implantable contact lens (TICL). The follow-up was 6 months. Main Outcome Measures Visual acuity, refraction, inraocular pressure (IOP), cornea, and space between crystals. Results The uncorrected visual acuity (UCVA) after surgery varied from 0.15 to 1.0, and was found in 40 eyes ≥0.8 (54.79%). The UCVA of 72 eyes (98.63%) after surgery was better than the best corrected visual acuity (BCVA) before surgery. The post-operation UCVA exceeded pre-operation BCVA one row on visual chart in 33 eyes (45.21%), two rows in 13 eyes (17.81%) and three rows in 8 eyes (10.96%). The post-operation spherical refractive error was within ±1.00 D of expected diopters in 54 eyes (73.97%), within ±0.50D in 12 eyes (16.44%). The post-operation cylindrical refractive error was within ±0.50 D of expected diopters in 19 eyes (76%). The post-operation IOP was not significantly different from pre-operation IOP (P=0.197). A transient IOP elevation was found in seven patients (10 eyes) within two hours after surgery. There were 6 eyes (8.22%) had halo at night. There was no axial deviation of TICL and cataractogenesis in any patients. Conclusion Posterior chamber phakic intraocular lens implantation can significantly improve visual acuity in high myopia. It is an effective, safe and reliable method for correction of high myopia with a wide range of suitable diopters.%目的 观察有晶状体眼后房型人工晶状体植入术

  11. 单切口植入有晶状体眼后房型人工晶状体治疗高度近视%Implantation of phakic posterior chamber intraocularlens for high myopia by a single incision

    Institute of Scientific and Technical Information of China (English)

    赵婷; 王平; 岳军; 郑姣; 丁熊; 周杜娟; 危晓青

    2014-01-01

    AIM:To evaluate the efficacy and safety of implantation of phakic posterior chamber intraocular lens for high myopia by a single incision. METHODS: Phakic posterior chamber intraocular lens implantation surgery by a single incision was performed in 9 patients ( 18 eyes ) with high myopia.All patients were followed up for 3 to 9 months to record the clinical ocular data including uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA ) , diopter, astigmatism, intraocular pressure, the number of endothelial cell etc.before and after surgery. RESULTS: Phakic posterior chamber intraocular lens were implanted successfully in all the operative eyes.The mean preoperative diopter was (-13.38 ±-5.32) D, and postoperative diopter was (-0.25±0.38)D.All eyes of the preoperative and postoperative uncorrected visual acuity ( UCVA ) and the best corrected visual acuity ( BCVA ) were 0.06±0.04, 0.6±0.2, 0.5±0.2, 0.7±0.3 respectively. It was obvious that postoperative UCVA and BCVA were better than the preoperative UCVA and BCVA (P0.05).CONCLUSION: Phakic posterior chamber intraocular lens implantation for high myopia by a single incision is a reliable and effective method with low risk, small ocular surface injury, low cost and small astigmatism induced by surgery.It can be a suitable operation method.%目的:评价单切口有晶状体眼后房型人工晶状体植入术治疗高度近视的有效性和安全性。  方法:对9例18眼高度近视患者行有晶状体眼后房型人工晶状体植入术。术后随访3~9mo,观察手术前后裸眼视力、最佳矫正视力、屈光度、散光变化、眼压、内皮细胞计数等。  结果:所有患者成功植入眼内接触镜( implantable contact lens,ICL),18眼手术前后平均屈光度分别为-13.38±-5.32,-0.25±0.38D;手术前后裸眼视力分别为0.06±0.04,0.6±0.2;最佳矫正视力分别为0.5±0.3,0.7±0.3;术后裸

  12. 后路椎弓根螺钉内固定融合术治疗创伤性寰枢椎不稳%Treatment of traumatic atlantoaxial instability via posterior internal fixation and fusion plus atlantoaxial pedicle screw

    Institute of Scientific and Technical Information of China (English)

    王守国; 徐用亿; 谢跃; 费昊东; 季峰; 赵庆华; 田纪伟

    2011-01-01

    [ Objective ] To study the therapeutic effect of posterior fixation and fusion plus pedicle screw in treatment of traumatic atlantoaxial instability. [ Method] A retrospective analysis was done on twenty patients (14 male and 6 female,mean age of 39.6 years old) with traumatic atlantoaxial instability treated via atlantoaxial pedicle screw system from March 2008 to October 2010,included 4 cases with Jefferson fracture,5 cases with type- II Dens fracture,3 cases with Dens fracture combined with atlantoaxial dislocation, 1 case with Jefferson fracture combined with Dens fracture,7 cases with atlantoaxial dislocation. The post-operative effect was evaluated with JOA (Japanese Orthopaedic Association)scores and VAS( visual analogue scale). [ Result]Operative time were 138.75 ±20.06 min,and blood loss were 338. 80 ± 100. 10 ml. All patients received the follow-up( range from 12 to 25 months,mean 15.6 months). All atlantoaxial joint came to bony fusion by the last follow-up without complication due to instrumentation. There was significant difference on VAS scores between pre-operation(7. 25 ± 1. 52) and post-operation (2. 13 ± 1.75) (P<0.01). There was significant difference on JOA scores between pre-operation( 8.65 ±3.49) and post-operation (13. 05 ±4. 88) (P <0. 01), and improvement rate was 58. 01 ± 20. 15%. [ Conclusion] Posterior fixation and fusion plus pedicle screw has the advantages of strong fixation,direct screw placement,and high fusion rate in traumatic atlantoaxial instability. So it is a better alternative for traumatic atlantoaxial instability.%[目的]探讨经后路椎弓根螺钉系统内固定融合术治疗创伤性寰枢椎不稳的临床疗效.[方法]回顾2008年3月~2010年10月,采用后路椎弓根钉系统固定融合治疗创伤性寰枢椎不稳20例,男14例,女6例;平均年龄39.6岁;Jefferson骨折4例,Ⅱ型齿状突骨折5例,齿状突骨折合并寰枢椎脱位3例,Jefferson骨折合并齿状突骨折1例,寰枢椎脱位7

  13. Clinical analysis of early deep wound infection after posterior thoracolumbar spinal fixation%胸腰椎后路内固定术后伤口早期深部感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    王林峰; 张静涛; 雷涛; 申勇

    2016-01-01

    背景:胸腰椎内固定术后手术部位感染是一种严重的并发症,对手术疗效起至关重要的作用。目的:探讨胸腰椎后路内固定术后伤口早期深部感染的临床特点。方法:回顾性分析2006年1月至2011年1月我院脊柱外科1100例胸腰椎后路内固定手术患者的临床资料。术后伤口早期感染患者65例,其中浅表感染40例,深部感染25例。深部感染患者中进行一次清创患者14例,多次清创患者11例;移除内固定患者9例,保留内固定患者16例。记录所有患者年龄、性别、BMI、病原菌种类、糖尿病、营养状况、激素使用、融合节段数、手术时间、出血量、异体输血及远处感染等情况。结果:与浅表感染患者相比,深部感染患者合并糖尿病及发生多重细菌感染的比率较高。多次清创患者中,耐甲氧西林金黄色葡萄球菌感染及远处感染的发生率高于一次清创者。内固定移除患者中,营养不足的比率高于内固定保留者。结论:深部感染患者常合并糖尿病及发生多重细菌感染,耐甲氧西林金黄色葡萄球菌感染及远处感染常需多次清创,营养不足可能是内固定保留失败的危险因素。%Background:Surgical site infection after thoracolumbar fixation is a serious complication, which can significant-ly affect clinical outcomes. Objective:To investigate the characteristics of early deep wound infection after posterior thora-columbar spinal fixation. Methods: Clinical data of 1100 patients who underwent posterior thoracolumbar fixation from Januray 2006 to January 2011 was analyzed retrospectively. Postoperative early wound infection developed in 65 patients of them. There were 40 cases with superficial infection and 25 with deep infection. Of the 25 cases with deep infection, 14 cas-es underwent debridement one time and 11 cases underwent multiple debridements;implants were preserved in 16 cases and removed

  14. Surgical treatment of thoracolumbar fractures by using the posterior short segment pedicle screw fixation%后路短节段固定联合伤椎置钉治疗胸腰椎骨折

    Institute of Scientific and Technical Information of China (English)

    胡力丰; 张志成; 王晓凯; 孙天胜

    2012-01-01

    Objective To evaluate the efficacy,indications and clinical outcomes of the treatment of thoracolumbar fractures by short segmental pedicle screws fixation at the level of the fracture.Methods Thirtytwo patients with thoracolumbar fracture,who underwent surgical procedure of short segmental pedicle screws fixation at the level of the fracture from 2007 to 2010,were followed up.X rays were performed preoperatively and postoperatively to locate the injured vertebral segment height and fractured kyphosis vertebral (Cobb angle).Frankel standard was used to assess the spinal cord function.Results All patients were followed up for 12 to 20 months and were in satisfying condition in the reduction of fracture.After surgery,the height of fractured vertebral body leading edge recovered from preoperative (32.4% ~69.3%,averaged (51.6 ± 17.8)% ) to (85.6% ~99.2%,averaged (92.8 ±6.2)% ) after two weeks and (90.6% ~97.8%,averaged (93.8 ±3.6)% ) at the last follow-up.Fractured vertebral Cobb angle was recovered from the preoperative ( 12.8 ° ~ 30.5 °,averaged [20.8±9.1] °) to (0° ~7.8 °,averaged [4.9 ±3.2] °) two weeks later and (2.0° ~ 12.0°,averaged [ 6.2 ± 4.6 ] o at the last follow-up.Cobb angle of the injured vertebral segment and the extend of vertebral compression were significantly improved after the angle was corrected ( P <0.01 ).Conclusion Using reduction and short segment pedicle screw fixation at the fracture level would be helpful to correct kyphotic vertebral compression and restore the height of injured vertebrate,which was also of benefit to increase the stability of short-segment posterior fixation system and reduce the loss of correction in a long run.%目的 观察经伤椎椎弓根置钉复位固定治疗胸腰椎骨折的可行性、适应证及临床疗效.方法 我院2007年1月至2010年1月收治的胸腰椎骨折采用经伤椎椎弓根置钉复位固定治疗,共随访32例,对患者术前及术后伤椎

  15. 后路寰枢椎固定融合术患者围术期的护理%Perioperative nursing of posterior internal fixation and fusion for atlanto-axial instability

    Institute of Scientific and Technical Information of China (English)

    王文慧

    2012-01-01

    目的 探讨上颈椎不稳患者经后路寰枢椎椎弓根钉棒固定融合术围术期的护理方法.方法 对12例上颈椎不稳患者术前做好心理护理,保持有效的颅骨牵引及头-胸环固定牵引,术后严密监测生命体征,预防脊髓水肿,观察切口及引流情况,保持正确体位和正确穿戴头颈胸支具,鼓励早期离床活动,重视并发症观察和出院指导.结果 12例患者均顺利度过围术期,未出现术后并发症,患者临床症状缓解或消失,且均能较早下床活动.结论 精心的围术期护理是手术成功的重要保障,可改善患者术后的生活质量.%Objective To study the peri-operative nursing care method in patients with upper cervical spine instability with posterior atlanto-axial pedicle screw-rod fixation and fusion. Methods 12 patients were give preoperative psychological nursing of upper cervical instability, mintain effective chest and head-skull traction collar traction, vital signs was closely monitored after surgery to prevent spinal cord edema, incision and drainage were observed, the correct posture and correct wearing of head and neck chest brace were mintained, the early off-bed activities were encouraged and complications and discharge instructions were attented. Results 12 cases patients were navigated the perioperative without postoperative complications, clinical symptoms eased or disappeared, and were able to out of bed activity early. Conclusion Perioperative nursing care of carefully is important guarantee of successful operation, which can improve the quality of life in postoperative patients.

  16. 有晶状体眼后房型人工晶状体植入术治疗高度近视术后UBM观察%Ultrasound biomicroscopy examination of posterior chamber phakic intraocular lens for high myopia

    Institute of Scientific and Technical Information of China (English)

    马波; 陈莉; 王从毅; 杨新光

    2011-01-01

    Objective To observe the position of posterior chamber phakic intraocular lens and its relationship to the iris and the crystalline in vivo through UBM. Methods There were 33 eyes with high myopia who accepted surgery treatment All surgeries were performed using topical anesthesia and clear corneal incision. The posterior chamber phakic intraocular lens manufactured with STAAR collamer was implanted between transparent lens and iris. During the course of the surgery, iridectomy was done at one clock. Each eye was examined carefully before and after surgery. The position of ICL was observed at 1, 3 and 6 months. Result All eyes of preoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA)were 0.04± 0.06, 0.5± 0.3 respectively and postoperative were 0.5± 0.2, 0.8± 0.2 respectively. At sixth month of postoperative the anterior chamber depth was 2802± 297 m and ICL central vault was 329 m. UBM verified the contact between ICL and iris. Both haptics were supported by zonula in 22 eyes; one haptic was supported by zonula and other haptic by ciliary body in 7 eyes; Both haptics were supported by ciliary body in 4eyes. The extreme tip of two haptic was at sulcus in 20 eyes. In 6 eyes, rotation of the lens was observed. Conelusions Thephakic IOLs are a safety and effective treatment for the correction of high myopia. It is important that looking for a new and accurate method to measure sulcus diameter in order to reduce complication resulted by inaccurate ICL vault.%目的 通过UBM在活体状态下观察有晶状体眼后房型人工晶状体(posterior chamber phakic intraocularlens,PCPIOL)植入术后PCPIOL与虹膜、睫状体和晶状体的位置的关系及变化.方法 取高度近视患者33只眼接受有晶状体眼后房型人工晶状体植入及术后检查,手术在表面麻醉下进行,作透明角膜隧道式切口,可植入式接触镜(implantablecontactlens,ICL)置于透明晶状体与虹膜之间,术中1点位作虹膜周

  17. Posterior bicondylar tibial plateau fractures.

    Science.gov (United States)

    Carlson, DuWayne A

    2005-02-01

    To present a case series of patients with posterior bicondylar tibial plateau fractures treated by direct fracture exposure and fixation through dual incisions. Retrospective clinical study. Level 1 trauma centers. Eight patients were identified that had posterior bicondylar tibial plateau fractures. Two patients had depressed posterolateral tibial plateau fractures with contained defects and did not have direct fracture exposure. One patient died of medical problems leaving 5 patients who underwent direct fracture exposure, reduction, and fixation. Posteromedial followed by posterolateral open reduction and internal fixation of posterior bicondylar tibial plateau fractures. At 6 to 24 months follow-up (mean 13 months), all patients returned to near full activities, each with aching after prolonged standing (8-hour shift). Range of motion averaged 2 degrees to 121 degrees of flexion. Three of 5 returned to manual labor jobs; the others were not employed at the time of injury. Posterior bicondylar tibial plateau fractures have a high association with lateral meniscal pathology and can be associated with anterior cruciate ligament injury. Reduction of the posterior plateau condyles is easiest with the knee in full extension. Flexion contractures can be a problem, and patients should be encouraged to regain/maintain knee extension. The dual-incision approach to these challenging fractures can result in good to excellent knee function for these patients.

  18. Biomechanical Study of Acetabunlum Transverse and Posterior Wall Fractures Treated by Internal Fixation with Locking Reconstruction Plate%锁定重建接骨板治疗髋臼横行伴后壁骨折的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    付久洋; 吴啸波

    2015-01-01

    Objective To evaluate the stability of 3 different internal fixation methods for transverse and posterior wall fractures of the acetabulum. Methods Seighteen acetabula of 9 whole pelvises were divided into 3 groups randomly. Models of transverse and posterior wall fracturesof acetabulum were established and then fixed with one of following three internal fixation methods:(Group A)posterior column locking reconstruction plate group,(Group B)posterior column common reconstruction plate withposterior wall 2 lag screwsgroup ,(Group C)anterior column lag screw and posterior column common reconstruction plate with posterior wall2 lag screws group. biomechanical tests are conducted in a single leg stance tomeasurethe maximal loads in the three groups and the displacements of the posterior wall fractures when the stress were loaded to 2 200 N on the three groups. Results The maximal loads in Groups A,B,C were as follows:(2243. 74 ± 116. 36)N,(2769. 05 ± 131. 42) N,(2832. 87 ± 137. 93)N. When the stress was loaded to 2 200 N on the three groups,the displacements of the posterior wall fractures were as follows:(2. 15 ± 0. 26)mm,(0. 45 ± 0. 05)mm,(0. 53 ± 0. 07)mm. We found there was no significant difference between the Group B and the Group C(P > 0. 05). There was significant difference between Groups B,C and Groups A,(P 0.05)。B、C 两组数据与 A 组比较,差异均有统计学意义(P <0.05,P <0.01)。结论锁定重建接骨板固定髋臼横行伴后壁骨折固定可靠,能够满足患者早期功能锻炼的要求,具有较大临床应用价值。

  19. Atlantoaxial stabilization using multiaxial C-1 posterior arch screws.

    Science.gov (United States)

    Donnellan, Michael B; Sergides, Ioannis G; Sears, William R

    2008-12-01

    The authors present a novel technique of atlantoaxial fixation using multiaxial C-1 posterior arch screws. The technique involves the insertion of bilateral multiaxial C-1 posterior arch screws, which are connected by crosslinked rods to bilateral multiaxial C-2 pars screws. The clinical results are presented in 3 patients in whom anomalies of the vertebral arteries, C-1 lateral masses, and/or posterior arch of C-1 presented difficulty using existing fixation techniques with transarticular screws, C-1 lateral mass screws, or posterior wiring. The C-1 posterior arch screws achieved solid fixation and their insertion appeared to be technically less demanding than that of transarticular or C-1 lateral mass screws. This technique may reduce the risk of complications compared with existing techniques, especially in patients with anatomical variants of the vertebral artery, C-1 lateral masses, or C-1 posterior arch. This technique may prove to be an attractive fixation option in patients with normal anatomy.

  20. 探讨后路椎间盘摘除椎弓根钉内固定结合Cage植骨治疗腰椎间盘突出症的临床效果%Clinical Effect of Posterior Lumbar Interbody Fusion and Pedicle Screw Fixation Combined With Cage Bone Graft in the Treatment of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    梁涛

    2016-01-01

    Objective To explore the feasibility of posterior lumbar interbody fusion and pedicle screw fixation combined with Cage bone graft in the treatment of lumbar disc herniation. Methods 86 patients with lumbar disc herniation were col ected. The patients in the study group were treated with posterior lumbar interbody fusion and pedicle screw fixation combined with Cage bone graft. The control group was treated with simple bone graft. Results There were significant differences in the treatment effect of the two groups after 6 months. Conclusion The treatment of lumbar disc herniation by posterior lumbar interbody fusion with pedicle screw fixation combined with Cage bone graft is effective and safe.%目的:探究腰椎间盘突出症使用后路椎间盘摘除椎弓根钉内固定结合 Cage 植骨治疗的可行性。方法收集腰椎间盘突出症患者86名,研究组使用后路椎间盘摘除椎弓根钉内固定结合 Cage 植骨治疗方案,对照组使用单纯植骨治疗方案。结果术后6个月两组患者治疗效果的差异具有统计学意义。结论腰椎间盘突出症使用后路椎间盘摘除椎弓根钉内固定结合 Cage 植骨治疗,具有较高的有效率和安全性。

  1. Analysis of 23 cases of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation%张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折23例分析

    Institute of Scientific and Technical Information of China (English)

    张朝凯; 吴莉; 丁晶; 刘庆波; 李迎辉; 吴明贵; 俞超

    2013-01-01

    目的 探讨张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折的效果.方法 23例膝关节后交叉韧带止点撕脱骨折患者,采用张力带钢丝复位固定,并对关节腔进行修整;采用Lysholm膝关节评分法评价疗效.结果 23例患者随访6个月~2年,22例(95.7%)术后膝关节功能恢复良好,1例老年患者术前即有骨性关节炎,关节间隙狭窄,术后仍有慢性疼痛及曲伸功能障碍.结论 张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折简单、经济、有效.%Objective To investigate the outcomes of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation. Methods Twenty-three patients with avulsion fractures of posterior cruciate ligament of knee joint were treated with tension band wire fixation, and the outcomes were evaluated by Lysholm knee joint scoring. Results All the patients were followed up for 6 months to 2 years. Favorable function recovery was achieved in 22 (95.7%) patients. The other senior patient suffered from osteoarthritis and narrow joint space before operation, and there still existed chronic pain and flexion-extension dysfunction after operation. Conclusion Treatment of avulsion fractures of posterior cruciate ligament of knee joint by tension band wire fixation is simple, economical and effective.

  2. 有晶状体眼后房型人工晶状体植入治疗高度近视临床观察%Clinical study for the implantation of posterior chamber phakic implantable contact lens in high myopia

    Institute of Scientific and Technical Information of China (English)

    刘欣华; 贺温玲; 周薇薇

    2013-01-01

    Objective To assess the clinical outcome of phakic posterior chamber intraocullar lens (ICL) implantation for high myopia. Methods One hundred sixty-two eyes Of 82 patients with high myopia were treated with ICL implantation from Feb 2009 to Feb 2011. The preoperative mean spherical equivalent was 13.65 ± 4.25 D, the mean cylindrical equivalent was 2.65 ±0.75 D. All subjects were followed for 6 months up to 2 years. Unconnected and best corrected visual acuity, refraction, intraocular pressure, endothelial cell morphometry, and adverse complications were analyzed. Results The range of unconnected visual acuity after operation was 0.5 ±1.0, with mean of 0.78 ±0.32. The range of preoperative best corrected visual acuity was 0.3±1.0, with mean of 0.59 ± 0.36. The mean best corrected visual acuity after operation was 0.79 ±0.30. The uncorrected visual acuity was better than preoperative best corrected visual acuity in 68 out of 160 eyes. The mean spherical equivalent after operation was - 0.75 ± 0. 65 D, the mean cylindrical equivalent was 0.55 ±0.25 D. Comeal endothelium counting had no significant changes after the surgery. No serious complications have been reported during the follow-up period. Conclusion The implantation of phakic posterior chamber ICL for high myopia is safe and effective. It is an appropriate treatment for high myopia.%目的 评价有晶状体眼后房型人工晶状体(ICL)植入术矫治高度近视的临床效果.方法 自2009年2月至2011年2月接受ICL植入的高度近视患者82例(160只眼),术前平均屈光度球镜(-13.65±4.25)D,柱镜(-2.65 ±0.75)D.观察术后裸眼视力、最佳矫正视力、屈光度、内皮细胞计数等情况,分析并发症的发生情况.结果 术后裸眼视力:0.5~1.0,平均0.78 ±0.32.术前最佳矫正视力:0.3 ~1.0,平均0.59±0.36,术后最佳矫正视力0.79±0.30.达到术前矫正视力92只眼(57.5%),超过术前最佳矫正视力68只眼(42.5%),随访6个月至2年,无

  3. 有晶体眼后房型人工晶体植入治疗高度近视及散光%Clinical research of the implantation of phakic posterior chamber intraocular lens (ICL) for high myopia with astigmatism

    Institute of Scientific and Technical Information of China (English)

    廖荣丰; 汪永; 周艳峰; 刘伦; 刘兴华; 封利霞

    2009-01-01

    目的 观察和探讨后房型有晶体眼人工晶体植入术治疗高度近视及散光的效果及安全性.方法 后房型有晶体眼人工晶体植入术治疗高度近视及散光28例56眼.术前屈光度(等效球镜)为-7.0~-22.50D,平均(-12.42±3.50)D.散光0.37~6.5D,平均(1.92±1.32)D.所有患者随访3~24个月.术后检查视力、眼压,裂隙灯检查眼前部情况.结果 术后3个月,所有病例术后达到或超过术前最佳矫正视力.等值球镜,0.25~1.50D,平均(0.534±0.408)D.散光度0.25~1.50D,平均(0.564±0.289)D.术后并发症:4例7眼术后早期眼压升高,经降眼甩治疗,3~4天后眼压正常.结论 后房型有晶体眼人工晶体植入术治疗高度近视及散光效果确切,预测性好,手术安全.高度近视,尤其是超高度近视以及角膜薄不适合准分子激光矫正的患者是理想的治疗对象.%Objective To observe and investigate the efficacy and safety of the implantation of phakic posterior chamber intraocular lens (ICL) for high myopia with or without astigmatism. Methods 56 eyes of 28 patients with high myopia were treated with ICL implanta-tion. The range of preoperative myopia diopters was-7.0 to-22. 5D, mean-12.42±3.50 D. Astigmatism ranges 0.37 to 6.5D, mean 1.92±1.32D. All of 56 eyes were implanted ICL successfully and have been followed up for 3 to 24 months. The follow up examination included visual acu-ity, refraction, tonometer, slit lamp examination ,and space between crystal lens and IOL. Results Three months after operation, the uncor-rected visual acuity of every eye was same or better than the pre-operative best corrected visual acuity (BCVA). The refractive diopters were from 0.25 to 1.50D, mean 0.534±0.408D. Astigmatism were 0.25 to 1.50D, mean 0.564±0.289D.complications were secondary glaucoma. 7 eyes of 4 patients had increased intraocular pressure shortly after surgery. After treatment, the intraocular pressure became normal in 3 to 4 days. Con

  4. 腰椎椎弓根螺钉内固定术三维可视化设计%Design of three-dimensional visualization based on the posterior lumbar pedicle screw fixation

    Institute of Scientific and Technical Information of China (English)

    徐凯; 陈春; 黄山东; 章莹; 尹庆水

    2011-01-01

    目的 建立腰椎椎弓根内固定术后的三维可视化数字模型.方法 选择1名腰椎间盘突出和1名腰椎压缩性骨折患者,在腰椎内固定术前及术后行多排螺旋CT扫描,观测术前椎体压缩程度、手术前后腰椎结构形态,术后钉棒的位置及椎板减压情况,利用Amira 4.1软件,经剪切、分割、表面重建及绘制等步骤,对腰椎结构及内植物进行三维重建,获得立体形态的腰椎手术前后改变及内置物位置结构.结果 借助数字化导航平台,重建了手术前后的腰椎和内置物形态结构.重建的三维结构可以多彩色、透明或任意组合显示.经不同角度观察,重建的三维结构显示清晰、实体感强.在三维表面重建的图像中可清楚地观察到内固定物的位置形态,特别是可以充分评估脊髓或神经根的减压程度及椎体骨折和压缩程度.术前重建图像可以清晰显示椎弓根的位置,为术中精确定位提供参考.结论腰椎椎弓根内固定术的三维重建对基础研究、临床试验及手术规划具有重要价值,应用Amira软件可为三维建模提供基础.%Objective To establish a three-dimensional visualization model of posterior lumbar pedicle screw fixation. Methods A patient with lumbar intervertebral disc hernia and another patient with compression fracture of lumbar vertebra were involved in the present study. Both patients underwent multi-slice spiral CT scan before and after lumbar pedicle screw fixation. The degree of preoperative vertebral compression, vertebral morphology before and after surgery, postoperative pedicle screw position, and decompression effects were observed. The original data of the multi-slice spiral CT were inputted into the computer. The three-dimensional reconstructed images of the lumbar and implanted screws were obtained using the software Amira 4.1 to show the three-dimensional shape of the lumbar vertebrae before and after surgery and the location of the

  5. 有晶状体眼后房型人工晶状体植入术治疗高度近视效果观察%Phakic posterior chamber intraocular lens for high myopia

    Institute of Scientific and Technical Information of China (English)

    陈莉; 马波; 王从毅

    2010-01-01

    Objective To evaluate the efficacy and safety of the surgical correction of high myopia using a phakic posterior chamber intraocular lens (PCPIOL).Methods Thirty-four eyes of 18 patients with high myopia who accepted surgery treatment.Each eye was examined before and after surgery.The examination included visual acuity,refraction,tonometry,kerameter,pachometer,anterior chamber depth,horizontal corneal diameter (white to white),and posterior segment evaluation after indirect ophthalmolscope examination.All surgeries were performed using topical anesthesia and clear corneal incision.The posterior chamber phakic intraocular lens manufactured with STAAR collamer was implanted between transparent lens and iris.Results All eyes of preoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were 0.08±0.06,0.5±0.3 respectively and postoperative were 0.5±0.2,0.7±0.2 respectively.The mean preoperative SE was -19.9±5.4D and postoperative SE was -1.5±1.5D.The mean preoperative ECD was 3249.6±337.1/mm~2 and postoperative ECD was 3103.4±305.5/mm~2 and the percentage of loss was 4.5%.The mean preoperative IOP was 15.5±2.7 mmHg and postoperative IOP at first day was 19.4±7.3 mmHg.UBM showed that preoperative ACD was 3.20±0.30 mm and postoperative ACD reduced 2.99±0.19 mm.Conclusions The phakic IOLs were an effective treatment for the correction of high myopia and have significant advantages such as reversibility,immediate correction,stability,and relative simplicity.However,long-term studies are necessary to assess the potential risks.%目的 评价有晶状体眼后房型人工晶状体植入术治疗高度近视的安全性和有效性.方法 高度近视患者18例(34只眼)接受有晶状体眼后房型人工晶状体植入,每只眼术前及术后进行眼部检查,包括:裸眼视力、矫正视力、睫状肌麻痹验光、角膜曲率、裂隙灯检查、眼压测量、角膜地形图、角膜厚度、角膜内皮细胞计数、UBM

  6. Phakic posterior chamber intraocular lens implantation in high myopia with astigmatism%后房型有晶状体眼人工晶状体植入术治疗高度近视及散光

    Institute of Scientific and Technical Information of China (English)

    刘莉; 陈自新; 陈茂盛; 马金花; 陈荥培

    2011-01-01

    目的 探讨后房型有晶状体眼人工晶状体植入术治疗高度近视及散光的安全性和疗效性.方法 后房型有晶状体眼人工晶状体植人术治疗高度近视及散光22例39只眼.术前屈光度(等效球镜)为-7.0~-24.0D,平均(-14.50D±3.50)0;散光-0.50~-4.50D,平均(-2.25±1.32)D.术后检查视力、眼压、裂隙灯显微镜,前房角,前房深度,人工晶状体拱高,角膜内皮细胞计数.随访3-18个月.结果 术后3个月,38只眼视力达到或超过术前矫正视力.等效球境-0.50~-2.25D,平均(-0.75±0.38)D,散光度0.25~2.75D,平均(1.03±0.23)D,术后7只眼早期(2h后观察)眼压升高,经降眼压处理,24h内恢复正常.无一例出现青光眼、白内障、人工晶状体偏移及网脱等并发症.结论 后房型有晶状体眼人工晶状体植入术治疗高度近视及散光保留了生理性调节、并发症少、安全有效,是临床矫正高度近视散光比较理想的一种方法.%Objective To valuate the efficacy, safety stability and predictability of implanting a posterior chamber phakic intraocular lens to correct high myopia with astigmatism. Methods Thirty-nine eyes of 22 patients with high myopia were treated with ICL implantation. The range of preop-erative myopia diopters was -7.0 D to -24.0 D, mean -14.50 D±3.50 D, astigmatism ranges -0.50 D to -4.50 D, mean 2.25±1.32 D. All of 39 eyes were implanted ICL successful and had been followed up for 3 to 18 months. The follow up examination included visual acuity, refraction tonometer, slit lamp examination, chamber depth, chamber angle and space between crystal lens and IOL. Results One week after operation, the uncorrected visual acuity of 38 eyes were same or better than the pre-operative best corrected visual acuity (BCVA). The refractive diopters were from -0.50 to -2.25 D,mean -0.75±0.38 D. Astigmatism was 0.25 to 2.75 D, mean 1.03±0.23 D. Complications were seen in 7 eyes of 6 patients who had increased intraocular

  7. Posterior Isobar non-fusion internal fixation system in repair of lumbar disc herniation:more advantages in restoring range of motion of lumbar spine%后路Isobar非融合内固定系统修复腰椎间盘突出症:恢复腰椎活动度更具优势

    Institute of Scientific and Technical Information of China (English)

    刘彦斌; 付强

    2015-01-01

    背景:对于腰椎间盘突出症患者采取后路内固定治疗,可以常规选择后路椎间融合钉棒系统内固定的方式,近年来Isobar非融合内固定系统作为一种半坚强内固定腰椎后路动态钉棒固定系统开始逐渐应用在临床,成为患者的治疗选择方式之一。目的:临床对比观察研究分析采取后路Isobar非融合内固定系统和传统椎间融合钉棒系统内固定治疗腰椎间盘突出症的临床疗效。方法:对2011年9月至2012年9月收治解放军第二军医大学附属长海医院骨科进行手术治疗的腰椎间盘突出症患者40例,分为Isobar组和坚强内固定组,各20例,分别采用后路Isobar非融合内固定系统和传统椎间融合钉棒系统内固定进行治疗。结果与结论:两组患者均顺利完成手术,并完成至少2年以上随访,无脱落。与内固定前相比,两组患者内固定后腰腿痛目测类比评分、Oswestry功能障碍指数功能指数均显著改善;且与坚强内固定组相比,Isobar组患者治疗后腰椎活动度较大,而两组患者腰腿痛目测类比评分和Oswestry功能障碍指数接近。说明采用后路Isobar非融合内固定治疗能够获得传统治疗相同的治疗效果,且在腰椎活动度方面更具有优势。%BACKGROUND:The patients with lumbar intervertebral disc protrusion can be treated with internal fixation of posterior surgery way. We can choose the conventional posterior intervertebral fusion nail stick system internal fixation. Isobar non-fusion internal fixation system was used in recent years. As a kind of a strong internal fixation of lumbar posterior dynamic screw rod fixation system, it has been gradual y applied in clinic, and has been one of patient’s treatment options. OBJECTIVE:To compare and analyze the clinical efficacy of Isobar non-fusion internal fixation system and traditional intervertebral fusion nail rod system internal fixation operation

  8. Stability of posterior dynamic stabilization system fixation for the treatment of lumbar disc herniation%后路动态稳定系统内固定治疗腰椎间盘突出症的稳定性评价☆

    Institute of Scientific and Technical Information of China (English)

    丁立祥; 陈迎春; 张亘瑷; 姚琦; 侯宇

    2013-01-01

    BACKGROUND: Posterior dynamic stabilization system can be used to maintain the vertebral motion segment and reduce the degeneration of vertebral body adjacent segment. OBJECTIVE: To investigate the efficacy and stability of posterior dynamic stabilization system for the treatment of lumbar disc herniation. METHODS: Eighteen patients with degenerative lumbar disease and treated with posterior decompression and posterior dynamic stabilization system internal fixation in the Department of Orthopedics, Beijing Shijitan Hospital Affiliated to Capital Medical University from February 2009 to June 2011 were selected, included 11 male patients and seven female patients, the age was 32-67 years old and averaged in 45 years old. The visual analogue scale score was used for pain assessment and the Oswestry disability index was used for clinical evaluation, the flexion and hyperextension X-ray films were used to measure the activity of lumbar intervertebral disc and the adjacent intervertebral disc after posterior dynamic stabilization system fixation. RESULTS AND CONCLUSION: Al the patients were fol owed-up for 20-45 months, averaged in 38 months. The visual analogue scale score before posterior dynamic stabilization system fixation was 7.1-9.4 points, and averaged 8.3 points, the postoperative score was 0-3.1 points, averaged 1.5 points, the improvement rate of visual analogue scale score was 81.5%. The Oswestry disability index before posterior dynamic stabilization system fixation was 35-81 points (average 60 points) and 0-45 points after fixation (average 22 points), and the improvement rate of Oswestry disability index was 63.3%. There was one case of loosening after posterior dynamic stabilization system fixation, one case had lower extremity nerve symptoms transient increasing and relieved after 3 months. The average range of motion after fixation was 5.3°. The posterior dynamic stabilization system for the treatment of lumbar disc herniation can maintain the range of

  9. Biomechanical comparison of three posterior fixation techniques for thoracolumbar burst fractures%胸腰椎爆裂骨折三种后路内固定方法的稳定性生物力学研究

    Institute of Scientific and Technical Information of China (English)

    刘传安; 曾至立; 程黎明

    2012-01-01

    [Objective] To compare the biomechanical stability of the three types of contemporary posterior spinal instrumentation in a fractured spine model,namely long - segment pedicle instrumentation( LSPI) .short-segment pedicle instrumentation (SSPI) and short-segment pedicle instrumentation combined with vertebroplasty (SSPI + VP). [ Method ] Thoracolumbar spines ( T9 ~ L5 ) from 6 donors were tested in pure moment loading in flexion - extension, lateral bending and axial rotation. Thoracolumbar burst fractures were induced at L, ,and testing was repeated sequentially for each of the following state: fractured specimens,LSPI,SSPI and SSPI + VP. Primary 3D motions were measured and calculated across the instrumented site (Tl2 -Lj) ,and then compared between groups. [ Result]The ROMs of the fractured model became obviously larger than thoBe in the intact specimens (P 0.05). [ Conclusion ] The stability of SSPI model can be enhanced by longer segments fixation or additional vertebroplasty. SSPI + VP model can achieve the same biomechanical stability as LSPI model in flexion and lateral bending.%[目的]比较长节段固定术、短节段固定术和短节段结合椎体成形固定术治疗胸腰椎爆裂骨折的稳定性.[方法]收集6具新鲜尸体的脊柱(T9~L5)标本,对每一具标本依次按完整状态、骨折状态、长节段固定、短节段固定和短节段结合椎体成形的顺序进行测试,计算其在屈曲、背伸、左右侧弯和左右旋转6个方向的运动范围,比较各组间差异.[结果]骨折后脊柱在6个方向上的运动范围均增加(P<0.05);各内固定组的运动范围均小于完整组(P<0.05);长节段固定和短节段结合椎体成形固定的运动范围小于单纯短节段固定组(P<0.05);短节段结合椎体成形固定在屈曲和左右侧屈方向上的运动范围与长节段固定无差别(P>0.05),而在背伸和左右旋转方向上的运动范围短节段结合椎体成形固

  10. Treatment of the thoracolumbar spine fracture with posterior monosegment pedicle fixation and transpedicular impacted bone graft at injured level%单节段椎弓根固定椎体内打压植骨治疗胸腰椎压缩骨折

    Institute of Scientific and Technical Information of China (English)

    邢飞; 樊道斌; 陈宏赋; 张林胜; 朱敏

    2012-01-01

    Objective To explore the clinical effects of posterior monosegmental pedicle screw fixation in selective treatment of thoracolumbar vertebral fractures. Methods 15 patients with thoracolumbar fractures were treated with posterior monosegmental pedicle screw fixation and transpedicle impacted bone graft. The Cobb's angle and reduction of injured vertebral body height were observed. Results All cases were followed up for 6 ~ 18months. Clinical evaluation revealed that 11 cases had no pain, 4 cases with occasional pain but required no medication and all patients had a high level of satisfaction with the final results. Radiographic evaluation revealed reduction rate of the injured vertebral height was 95%. The Cobb's angle was restored from 14° ~25° to 3° ~8°. There was no implant breakage, and no signs of pseudoarthrosis were observed. Conclusions Posterior monosegmental fixation might be an adequate and effective procedure to be used in specific types of thoracolumbar spine fractures. Transpedicular impacted grafting after bone loss calculation combined with pedicle fixation has better biomechanical properties.%目的 探讨单节段椎弓根固定结合伤椎打压植骨治疗胸腰椎屈曲压缩骨折的疗效.方法 对15例胸腰椎压缩性骨折(Denis B型)患者行后路单节段经伤椎复位固定、经椎弓根伤椎打压植骨手术.测量术前术后Cobb角,计算伤椎高度恢复率,进行ODI评分,分析疗效.结果 15例患者均获随访,时间6~18个月.伤椎高度矫正率约95%,Cobb角由术前的14°~25°改善为术后的3°~8°.未出现内固定断裂、神经损伤等并发症.结论 单节段椎弓根固定椎体内植骨治疗胸腰椎压缩性骨折手术创伤小,仅固定1个运动节段;椎体内打压植骨有效解决椎体复位后产生的椎体内骨缺损.

  11. A feasibility study of upper thoracic vertebral plate screw fixation through posterior approach%上胸椎后路椎板螺钉固定的可行性研究

    Institute of Scientific and Technical Information of China (English)

    钟熙强; 何少奇; 董伊隆; 刘良乐; 黄益奖; 戴鸣海; 汤呈宣

    2016-01-01

    Objective:To study the anatomical parameters of upper thoracic vertebral plate of Chinese adults and explore the feasibility of upper thoracic vertebral plate screw fixation through posterior approach in Chinese adults.Methods:The cadaveric T1 -4 specimens of 40 Chinese adults were selected and the anatomical parameters that related to the upper thoracic vertebral plate screw fixation technique were measured by using vernier caliper and conimeter.The anatomical parameters included the thickness of upper,middle and lower part of vertebral plate,the height of vertebral plate,the screw path length and the included angle between vertebral plate axis and sagittal plane. Results:There was no statistical difference in the thickness of the middle part of T4 vertebral plate and the included angle between T1 -4 vertebral plate axis and sagittal plane axis between 20 females and 20 males(5.94 +/-0.1 3 vs 6.00 +/-0.22 mm,t =1 .609,P =0.1 1 2;46.00 +/-1 .1 0 vs 46.50 +/-1 .1 0 degrees,t =1 .955,P =0.054;46.30 +/-0.80 vs 46.60 +/-1 .1 0 degrees,t =1 .383,P =0.1 71 ;45.40 +/-1 .40 vs 45.30 +/-1 .40 degrees,t =0.404,P =0.688;45.20 +/-1 .40 vs 45.30 +/-1 .40 degrees,t =0.41 0,P =0.683).The thickness of the middle part of T1 -3 vertebral plate were less in adult female cadavers compared to adult male cadavers(5.86 +/-0.1 0 vs 5.93 +/-0.1 8 mm,t =2.083,P =0.040;5.88 +/-0.1 1 vs 5.97 +/-0.20 mm,t =2.581 ,P =0.01 2;5.90 +/-0.09 vs 6.00 +/-0.1 9 mm,t =2.885,P =0.006).Such parameters of T1 -4 were less in adult female cadavers compared to adult female cadavers as thick-ness of upper part of vertebral plate(5.39 +/-0.1 2 vs 5.51 +/-0.1 3 mm,t =4.202,P =0.000;5.43 +/-0.09 vs 5.52 +/-0.1 1 mm,t =4.1 84,P =0.000;5.43 +/-0.1 0 vs 5.53 +/-0.1 0 mm,t =4.279,P =0.000;5.41 +/-0.08 vs 5.53 +/-0.07 mm,t =7.557,P =0.000),thickness of lower part of vertebral plate(5.43 +/-0.1 2 vs 5.55 +/-0.1 2 mm,t =4.51 3,P =0.000;5.43 +/-0.07 vs 5.57 +/-0.1 0 mm,t =7.068,P =0.000;5.44 +/-0.08 vs 5.57 +/-0.1 1 mm

  12. Posterior pedicle screw fixation and interbody fusion in the treatment of recurrent lumbar disc herniation:an evaluation of vertebral stability%后路钉棒内固定椎间融合治疗复发性腰椎间盘突出症:椎体稳定性评价

    Institute of Scientific and Technical Information of China (English)

    刘凤松; 王凯; 景成伟; 张亮; 刘宾; 杨亚林

    2014-01-01

    BACKGROUND:Discectomy is an important therapy for lumbar disc herniation, but a smal number of patients undergoing discectomy wil relapse. OBJECTIVE:To investigate the spinal stability fol owing posterior pedicle screw fixation combined with interbody fusion cage for treatment of recurrent lumbar disc herniation. METHODS:Twenty-six patients with recurrent lumbar disc herniation from January 2007 to December 2011 were enrol ed and subjected to posterior pedicle screw fixation combined with interbody fusion cage. Pain relief and lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after posterior pedicle screw fixation combined with interbody fusion cage depending on literature search. RESULTS AND CONCLUSION:Al the 26 patients were fol owed up for 12-36 months. After treatment, al patients effectively al eviated the symptoms of low back pain, and lumbar interbody fusion was good, with a good rate of 96.2%. There was no pedicle screw loosening, broken, non-fusion phenomenon. Posterior decompression and interbody fusion cage combined with posterior pedicle screw fixation for recurrent lumbar disc herniation, characterized as fast symptom relief, strong fixation, exact interbody fusion exact, is an ideal treatment for recurrent lumbar disc herniation.%背景:腰椎间盘突出症治疗的重要方法是椎间盘切除,但有少部分患者会出现复发现象。  目的:探讨后路椎弓根钉棒内固定联合cage植入椎间融合治疗复发性腰椎间盘突出症后的脊柱稳定性。  方法:选择2007年1月至2011年12月复发性腰椎间盘突出症患者26例,应用后路减压cage植入椎间融合加钉棒系统内固定治疗复发性腰椎间盘突出症进行再手术治疗,观察患者治疗后疼痛症状缓解情况以及腰椎稳定性。通过数据库文献检索的方法分析后路钉棒内固定椎间融合治疗复发性腰椎间盘突出症的椎

  13. Clinical Curative Effect Observation of Posterior Chamber Iol Implantation in Treatment of Adult Amblyopia%后房型人工晶体植入术治疗成人弱视临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    徐珊容; 李元朝

    2015-01-01

    目的:探讨有晶体眼成人屈光不正(弱视)患者植入后房型人工晶体术后的临床疗效。方法:15例(28只眼)成人高度近视弱视眼患者(屈光度球镜-8.50~21.5 D,柱镜-1.00~2.50 D),表面麻醉后行后房型人工晶体植入术,术后3个月随访观察。结果:术前角膜内皮计数(3121±135)个/mm2,眼压(15.0±4.5)mm Hg,术后角膜内皮计数(3100±151)个/mm2,眼压(20.0±2.5)mm Hg。100%术眼的最佳矫正视力保持不变或增加≥1行,术后裸眼视力≥1.0者为7.14%(1例,2只眼),术后裸眼视力较术前最佳矫正视力提高2行以上者为64.29%(18只眼),术后裸眼视力等同术前最佳矫正视力者为28.57%(5例,8只眼)。结论:后房型有晶体眼人工晶体植入是一种安全、有效的治疗成人高度近视弱视眼的手术方法。%Objective:To investigate clinical efficacy of implanted posterior chamber intraocular lens surgery in treatment of the adult phakic refractive errors(amblyopia).Method:15 cases(28 eyes)adult amblyopia patients with high myopia(spherical diopter-8.50-21.5 D,cylinder-1.00-2.50 D)were given intraocular lens implantation after topical anesthesia ,then followed up three months.Result:Preoperative corneal endothelial count was(3121±135)/mm2,intraocular pressure was(15.0±4.5)mm Hg, corneal endothelial count was(3100±151)/mm2,intraocular pressure was(20.0±2.5)mm Hg.100%best corrected visual acuity eye surgery remain unchanged or increase≥1 line,postoperative uncorrected visual acuity≥1.0 were 7.14%(n=1,2 eyes), postoperative uncorrected visual acuity compared with preoperative best corrected visual acuity improved 2 those above the line for 64.29%(18 eyes),postoperative uncorrected visual acuity before surgery best corrected visual acuity equal to 28.57%(5 cases, 8 eyes). Conclusion:Chamber phakic intraocular lens implantation is a safe and effective surgical method for treating high

  14. Long-Term Comparison of Posterior Chamber Phakic Intraocular Lens With and Without a Central Hole (Hole ICL and Conventional ICL) Implantation for Moderate to High Myopia and Myopic Astigmatism

    Science.gov (United States)

    Shimizu, Kimiya; Kamiya, Kazutaka; Igarashi, Akihito; Kobashi, Hidenaga

    2016-01-01

    Abstract The study shows a promising next-generation surgical option for the correction of moderate to high ametropia. Hole implantable collamer lens (ICL), STAAR Surgical, is a posterior chamber phakic intraocular lens with a central artificial hole. As yet, however, no long-term comparison of the clinical results of the implantation of ICLs with and without such a hole has hitherto been conducted. A prospective, randomized, controlled trial was carried out in order to compare the long-term clinical outcomes of the implantation, in such eyes, of ICLs with and without a central artificial hole. Examinations were conducted of the 64 eyes of 32 consecutive patients with spherical equivalents of −7.53 ± 2.39 diopters (D) (mean ± standard deviation) in whom implantation of a Hole ICL was performed in 1 eye, and that of a conventional ICL was carried out in the other, by randomized assignment. Before 1, 3, and 6 months, and 1, 3, and 5 years after surgery, the safety, efficacy, predictability, stability, intraocular pressure, endothelial cell density, and adverse events of the 2 surgical techniques were assessed and compared over time. The measurements of LogMAR uncorrected and corrected distance visual acuity 5 years postoperatively were −0.17 ± 0.14 and −0.24 ± 0.08 in the Hole ICL group, and −0.16 ± 0.10 and −0.25 ± 0.08 in the conventional ICL group. In these 2 groups, 96% and 100% of eyes, respectively, were within 1.0 D of the targeted correction 5 years postoperatively. Manifest refraction changed by −0.17 ± 0.41 D and −0.10 ± 0.26 D occurred in from 1 month to 5 years in the Hole and conventional ICL groups, respectively. Only 1 eye (3.1%), which was in the conventional ICL group, developed an asymptomatic anterior subcapsular cataract. Both Hole and conventional ICLs corrected of ametropia successfully throughout the 5-year observation period. It appears likely that the presence of the central hole does not

  15. Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel

    Directory of Open Access Journals (Sweden)

    Kawaji T

    2016-01-01

    Full Text Available Takahiro Kawaji,1,2 Tomoki Sato,2 Hidenobu Tanihara11Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, 2Sato Eye & Internal Medicine Clinic, Kumamoto, JapanPurpose: To report the results of sutureless scleral fixation of a posterior chamber intraocular lens (IOL by using our developed simple technique.Methods: We retrospectively reviewed the medical records of 48 eyes of 47 patients who underwent sutureless intrascleral IOL fixation by using our modified technique. A 25-gauge microvitreoretinal knife was used to perform sclerotomies and create limbus-parallel scleral tunnels with lamellar dissection in which the haptics were fixed.Results: The IOLs were fixed and centered well. The mean follow-up period was 26.7 months. Postoperative complications included smooth vitreous hemorrhage in four eyes (8.3%, cystoid macular edema in two eyes (4.2%, and iris capture of the IOL in two eyes (4.2%. No other complications, such as breakage of the IOL, spontaneous IOL dislocation, or retinal detachment, were detected during the follow-up period.Conclusion: The lamellar dissection of the limbus-parallel scleral tunnel can simplify the forceps-assisted introduction of the haptics into the scleral tunnel, and this technique seemed to be safe.Keywords: intraocular lenses, ophthalmologic surgical procedures, intrascleral fixation, sutureless fixation

  16. The comparison of clinical effects of arthroscopic fixation with sutures versus screws for posterior cruciate ligament tibial avulsion fractures%关节镜下缝线与螺钉固定后十字韧带胫骨止点撕脱骨折的疗效比较

    Institute of Scientific and Technical Information of China (English)

    李亦丞; 孙学斌; 刘阳; 李纲; 尼加提; 张克远

    2017-01-01

    Objective To compare the clinical effects between arthroscopic suture and screw fixation for posterior cruciate ligament (PCL)tibial avulsion fractures.Methods From February 2013 to January 2016,29 cases with PCL tibial avulsion fracture diagnosed at our department were selected,in which 15 cases of the suture fixation group and 14 cases of the screw fixation group were separated.Operation time, Lysholm score,IKDC score and knee range of motion (ROM)were compared after operation.Results The operation time for the suture fixation group (48.3±1.5)min was significantly longer than that for the screw fixation group (36.4±1.5)min (P<0.05).During the follow-up period,there were no incision in-fection and loosening of the fixation device.The X-ray films showed that all fractures were healed in the first post-operative year.There was a case with synarthrophysis in each group,and the knee function of them returned to normal after rehabilitation training.There were no significant differences between the two groups regarding the Lysholm score (89.9±1.3)for the suture fixation group vs (88.9±1.5)for the screw fixation group),the IKDC score (89.2±1.6)for the suture fixation group vs (89.8±1.5)for the screw fixation group),and the ROM (129.6°±2.8°)for the suture fixation group vs (127.7°±3.2°)for the screw fixation group.Conclusion Arthroscopic fixation with suture vs screw for posterior cruciate ligament tibial avulsion fractures can achieve satisfactory effects,but the operation time of screw fixation has more advantages.%目的:比较关节镜下缝线与螺钉固定后十字韧带(PCL)胫骨止点撕脱性骨折的疗效。方法选择2013年2月—2016年1月新疆医科大学第一附属医院收治的29例PCL胫骨止点撕脱骨折患者,其中术中采用缝线固定15例(缝线固定组)、螺钉固定14例(螺钉固定组),比较两组患者的手术时间、Lysholm评分、IKDC评分及膝关节活动度(ROM)情况。结果缝线

  17. spark chamber

    CERN Multimedia

    A few cosmic rays pass through your body every second of every day, no matter where you are. Look at the spark chamber to your right – every flash is the track made by a cosmic ray from outer space. The spark chamber is filled with a special gas mixture. Cosmic rays knock electrons out of the atoms in the gas. These electrons accelerate towards high voltage metal strips layered throughout the chamber, creating sparks like little bolts of lightning.

  18. spark chamber

    CERN Multimedia

    A few cosmic rays pass through your body every second of every day, no matter where you are. Look at the spark chamber to your right – every flash is the track made by a cosmic ray from outer space. The spark chamber is filled with a special gas mixture. Cosmic rays knock electrons out of the atoms in the gas. These electrons accelerate towards high voltage metal strips layered throughout the chamber, creating sparks like little bolts of lightning.

  19. The effect of suture-button fixation on simulated syndesmotic malreduction: a cadaveric study.

    Science.gov (United States)

    Westermann, Robert W; Rungprai, Chamnanni; Goetz, Jessica E; Femino, John; Amendola, Annunziato; Phisitkul, Phinit

    2014-10-15

    The accuracy of reduction of distal tibiofibular syndesmosis disruptions has been associated with the clinical outcome. Suture-button fixation of the syndesmosis is a dynamic alternative mode of fixation. We hypothesized that with deliberate clamp-induced malreduction, suture-button fixation of the syndesmosis would allow a more anatomic post-fixation position compared with screw fixation. Forty-eight syndesmotic fixations were performed on twelve through-knee cadaveric specimens. The syndesmosis was destabilized and off-axis clamping was used to produce both anterior and posterior malreduction patterns. In twelve scenarios (six anterior and six posterior malreductions), syndesmotic screw fixation was used, followed by computed tomography. With tenacula holding the malreduction, the syndesmosis screws were exchanged for a suture-button construct and the specimens underwent a subsequent computed tomography scan. In the other twelve scenarios, the suture-button fixation was achieved first, followed by screw fixation. Standardized measurements of anterior-posterior and medial-lateral fibular displacement were performed by two observers blinded to the method of fixation. With anterior off-axis clamping, the mean sagittal malreduction was 2.7 ± 2.0 mm with screw fixation and 1.0 ± 1.0 mm with suture-button fixation (p = 0.02). With posterior off-axis clamping, the sagittal malreduction was 7.2 ± 2.3 mm with screw fixation and 0.5 ± 1.4 mm with suture-button fixation (p button fixation of the syndesmosis results in less post-fixation displacement compared with screw fixation. The suture button's ability to allow for natural correction of deliberate malreduction was greatest with posterior off-axis clamping. Although the clinical relevance is unknown, dynamic syndesmotic fixation may mitigate clamp-induced malreduction. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  20. Complications and treatment in early time of posterior chamber phakic intraocular contact lens implantation%有晶体眼后房型人工晶体植入术早期并发症观察及其处理

    Institute of Scientific and Technical Information of China (English)

    吴燕; 罗涛; 蒋炜; 邱敏

    2014-01-01

    目的:观察有晶体眼后房型人工晶体( ICL)植入治疗高度近视早期的并发症及处理情况,并探讨其原因。方法观察在我院行ICL/TICL植入术的患者46例(92眼),在虹膜周切手术和ICL植入手术中及术后半年出现的并发症,记录并发症处理方法以及处理后的情况。结果无1例瞳孔阻滞性青光眼发生,术前虹膜周切后有8眼眼压升高,ICL植入术后有7眼眼压升高,均未超过28 mmHg,未做特殊处理;术前 YAG 激光虹膜周切组虹膜出血及色素播散的发生率明显高于手术虹膜周切组(P<0.05),术中晶体损伤2眼,1眼行透明晶体摘除及人工晶体植入;术后TICL旋转2眼,术后视觉干扰主要表现阴影及眩光各1例,术后视觉心理改变1例。结论 ICL植入治疗高度近视早期并发症少,基本可预防和控制,术后患者满意度极高,该手术方式值得大力推广。%Objective To investigate the complications and outcomes of the treatments in the early time of posterior chamber phakic in-traocular contact lens ( ICL) implantation for the treatment of high myopia, and to analyze the causes. Methods Forty-six patients ( 92 eyes) who underwent ICL/TICL implantations were enrolled in this study. The intraoperative and the postoperative complications in 6 months were observed,at the same time also the treatments and the outcomes were observed. Results None of the patients had a pupillary block. Only 8 eyes in all the patients had an elevated IOP after peripheral iridectomy ( PI) ,and 7 eyes after the ICL implantation,the highest IOP in which was 28 mmHg. No medication was given for treatment. In the YAG PI group,the incidence rate of iris bleeding and pigment dispersion were all higher than that in the YAG PI group (P<0. 05);2 crystalline lens of different patient were damaged intraoperation. Rotation of TICL was observed in 2 eyes. Only 2 individuals of all the patients in this study had complained visual disturbances,which was

  1. Binocular vision changes after phakic posterior chamber implantable collamer lens implantation%有晶状体眼后房型人工晶状体植入术后双眼视觉的变化

    Institute of Scientific and Technical Information of China (English)

    王晓贞; 付晶; 王京辉; 赵世强

    2015-01-01

    目的 评价有晶状体眼后房型人工晶状体(PPC-ICL)植入治疗高度近视术后患者双眼视觉的变化.方法 自身对照研究.行PPC-ICL植入术治疗高度近视患者42例,分别于术前和术后6个月行同视机的同时视、双眼融合、远立体视检查,采用颜少明《立体视觉检查图》检测近立体视锐度.采用Fisher's精确概率法对术前和术后6个月以上各参数进行统计分析.结果 术后6个月同时视功能与术前相比差异无统计学意义.远融合范围与远立体视锐度较术前有明显改善,差异有统计学意义(x2=0.357,P<0.01;x2=0.276,P<0.05).术后6个月与术前相比中心凹立体视功能和周边立体视功能较前改善,但差异无统计学意义.立体视盲者术后6个月较术前明显减少,差异有统计学意义(x2=0.279,P<0.05).结论 PPC-ICL植入术后患者同时视、双眼融合、远立体视功能及近立体视功能较术前明显改善.%Objective To evaluate the changes in binocular vision after phakic posterior chamber implantable collamer lens (PPC-ICL) implantation for high myopia.Methods This self-control study included 84 eyes of 42 patients with high myopia who underwent PPC-ICL implantation surgery.Simultaneous perception,fusion range,and distance and near stereopsis were tested before and 6 months after surgery with a synoptophore and stereogram designed by Yan Shaoming.Results There was no significant difference in simultaneous perception before surgery compared to 6 months after surgery,while the differences in fusion range and distance stereopsis were statistically significant (x2=0.357,P<0.01 and x2=0.276,P<0.05).There were no significant differences in foveal stereopsis and peripheral stereopsis before surgery compared to 6 months after surgery,but there was a significant difference in stereo blindness (x2=0.279,P<0.05).Conclusion Simultaneous perception,fusion range,and distance and near stereopsis after PPC-ICL implantation

  2. 后房型人工晶状体眼视网膜脱离临床分析%Clinical analysis of pseudophakic retinal detachment after implantation of posterior chamber intraocular lens

    Institute of Scientific and Technical Information of China (English)

    董卫红; 毕宏生; 王兴荣; 张建华

    2001-01-01

    Objective:To approach the clinical characteristics andtherapeutic methods for pseudophakie retinal detachment(RD)after posterior chamber intraocular lens(PCIOL) inplantation.Methods:Data of 12 patients with pseudophakic RD after PCIOL implantation treated with conventional retinal detachment surgery or combined with vitreo-retinal surgery from 1996 to 1998 were reviewed retrospetively.Results:Of the 12 patients(12 eyes),7 patients were treated with conventional retinal detachment surgery,5 patients with micro vitreo-retinal surgery.The retinas were completely reattached in 10 eyes(83.3%),partially reattached in 1 eye.The total reattachment rate was 91.7%.Conclusion:Pseudophakic RD after PCIOL implantation is more severe than general RD.If diagnosed early and treated early with proper surgery,better result can be obtained.%目的:探讨后房型人工晶状体眼视网膜脱离的临床特点及治疗方法。方法:对我院1996年至1998年3年间经常规视网膜脱离复位术及显微玻璃体视网膜联合术治疗的12例(12只眼)后房型人工晶状体眼视网膜脱离的临床资料作回顾性分析。结果:行常规视网膜脱离复位术(巩膜外加压术、巩膜环扎术、巩膜环扎加外加压术)7只眼;玻璃体切除、眼内填充联合巩膜环扎术5只眼。随访半年至3年,视网膜完全复位10只眼(均为一次手术复位,占83.3%),部分复位1只眼,总复位率达91.7%。术后视力提高9只眼,不变2只眼,下降1只眼。12只眼均未行人工晶状体取出。结论:人工晶状体眼视网膜脱离具有发病早、发展迅速、眼内病变复杂、易致严重PVR、诊断及治疗难度加大等特点。一旦发现视网膜脱离,即根据不同的情况选择相应的手术方式、施行手术治疗,仍可取得较好疗效。

  3. 角膜塑形镜对角膜前后表面曲率半径和前房深度的影响%The affect of orthokeratology lens to the anterior and posterior corneal surface and anterior chamber depth

    Institute of Scientific and Technical Information of China (English)

    陈蛟; 肖满意; 王华; 郭颖卓; 何书喜

    2013-01-01

      目的:探讨角膜塑形镜对角膜前后表面曲率半径和前房深度的影响。方法:用Orbscan-Ⅱ角膜地形图,检查17例31眼配戴角膜塑形镜3个月后角膜前后表面曲率半径和前房深度的变化。结果:配戴角膜塑形镜3个月后所有患者屈光度下降,裸眼视力上升(P0.05)。结论:角膜塑形镜主要通过改变角膜前表面的曲率,压平角膜前表面达到矫正近视的目的,对角膜后表面与前房深度无明显影响。%Objective To find out the affect of orthokeratology lens to the anterior and posterior corneal sur-face and anterior chamber depth.Methods 17 patients ,31eyes, after 3 months orthokeratology wearing, corneal topography examination with Orbscan-Ⅱ,record the changes of the anterior and posterior corneal surface radius and anterior chamber depth.Results After 3 months orthokeratology wearing, the refraction diopter decline, uncor-rected visual acuity increased (P0.05).Conclusion Orthokeratology lens mainly affects the shape of the anterior corneal surface , flatten the anteri-or corneal surface, rather than change of the posterior corneal surface radius and anterior chamber depth to achieve the effect of reducing refraction.

  4. Posterior cruciate ligament and posterolateral corner reconstruction.

    Science.gov (United States)

    Fanelli, Gregory C; Edson, Craig J; Reinheimer, Kristin N; Garofalo, Raffaele

    2007-12-01

    The keys to successful posterior cruciate ligament reconstruction are to identify and treat all pathology, use strong graft material, accurately place tunnels in anatomic insertion sites, minimize graft bending, use a mechanical graft-tensioning device, use primary and backup graft fixation, and employ the appropriate postoperative rehabilitation program. Adherence to these technical points results in successful single and double bundle arthroscopic transtibial tunnel posterior cruciate ligament reconstruction documented with stress radiography, arthrometer, knee ligament rating scales, and patient satisfaction measurements.

  5. Clinical effects of phakic posterior chamber intraocular lens implantation for very high myopia%有晶状体眼后房型人工晶状体植入术治疗超高度近视的临床研究

    Institute of Scientific and Technical Information of China (English)

    产竹林; 邹召中; 崔俐; 余红莲

    2014-01-01

    观察分析有晶状体眼后房型人工晶状体植入术( ICL)治疗超高度近视的临床疗效。方法选择分析我院2011年6月至2013年6月行有晶状体眼后房型人工晶状体植入术治疗超高度近视患者14例(25只眼)。术前常规检查视力、最佳矫正视力,进行各项检查后,行单眼或者双眼有晶状体眼后房型人工晶状体植入术,术后观察视力、眼压及内皮细胞计数变化情况。结果术后视力0.3~1.0。术后2例(3只眼)出现早期眼压升高,经降眼压治疗,3~4 d后眼压正常。结论有晶状体眼后房型人工晶状体植入术治疗超高度近视及散光疗效确切,患者满意度好,预测性好,手术安全。%Objective To analyse the clinical efficacy of phakic posterior chamber intraocular lens implantation (ICL) for treatment of very high myopia .Methods Totally 14 patients ( 25 eyes) with phakic posterior chamber intraoc-ular lens implantation were analysed from June 2011 to June 2013.Routine visual acuity ,best-corrected visual acuity and various important examinations were performed preoperatively for phakic posterior chamber intraocular lens implantation . Results Postoperative visual acuity was 0.3 to 1.0.Complications were secondary glaucoma .3 eyes of 2 patients had in-creased intraocular pressure shortly after surgery .After treatment, the intraocular pressure became normal in 3 to 4 days. Conclusion The phakic posterior chamber IOL was efficacious , predictable and safe .

  6. 桩钉辅助玻璃离子粘结固定冠根纵折后牙再植治疗临床观察%Clinical observation on replantation of vertical fractured posterior teeth after bonding with glass ionomer cement and fixation with metal post

    Institute of Scientific and Technical Information of China (English)

    黎石坚; 陈燕; 陆兆威; 罗菊芬; 李民东

    2012-01-01

    Objective To investigate the therapeutic results on replantation of vertical fractured posterior teeth after bonding with glass ionomer cement and fixation with metal post. Methods A total of 40 vertical fractured posterior teeth were treated by extraction,root canal therapy,bonding with glass ionomer cement.fixation with metal post, replantation and coronal restoration. 36 of the 40 posterior teeth were completely followed up for 2 years and evaluated. Results Among 36 vertical fractured posterior teeth observed,the the successful reserved rate of 6 months was 100.00% (36/36),one year was 88.89% (32/36),two years was 80.56% (29/36) There were statistical significant differences of the reserved rate in difference period after therapy, the reserved rate became lower with observation time became longer. Conclusion The therapeutic results were satisfied with a 2-year reserved rate, and the method can be worth of clinical application.%目的:对桩钉辅助玻璃离子粘结固定冠根纵折的后牙行再植术并行冠修复的临床效果进行观察、评价.方法:选择40例牙体相对完好、牙周情况良好的纵裂的后牙,拔牙后即刻体外完成根管治疗,用玻璃离子粘固剂粘结并复位,冠部横向钻通,插入并粘结根管桩钉辅助固定,再植入牙槽窝,2个月后行全冠或连冠修复,随访2年,观察疗效.结果:除失访4例外,6个月的成功保存率为100.00%(36/36),1年的保存率为88.89%(32/36),2年的保存率为80.56%(29/36),成功率随术后时间延长而下降.结论:正确选择适应证,对桩钉辅助玻璃离子粘结固定冠根纵折的后牙再植治疗,可获得一定的效果满意,为临床保存治疗提供多一种选择.

  7. Application of C2 Transpedicular Screw Fixation Combined with C3 Lateral Mass Screw Plate Fixation in Posterior Treatment of Old Hangman's Fracture%经后路C2椎弓根C3侧块短节段固定治疗陈旧性枢椎椎弓骨折

    Institute of Scientific and Technical Information of China (English)

    曹成刚; 梁益建; 何睿; 石化洋; 曾勇; 陈伶

    2012-01-01

    Objective To approach the therapeutic effect of C2 transpedicular screw fixation combined with C3 lateral mass screw plate fixation on old Hangman' s fracture. Methods Nine patients with old Hangman' s fracture were treated with C2 transpedicular screw fixation combined with C3 lateral mass screw plate fixation as well as bone gr'aft fusion in our hospital from 2002. Results A mean follow-up time was 8 months(6 to 15 months). All cases got bony union. No infection, neurological deficits, or other complications were found. Conclusion It can be an effective and simple way to treat old Hangman' s fracture with C2 transpedicular screw fixation combined with C3 lateral mass screw plate fixation, which can ultimately preserve the cervical function.%目的 探讨经后路C2椎弓根C3侧块短节段内固定治疗陈旧性枢椎椎弓骨折(Hangman骨折)的疗效.方法 2002年以来9例陈旧性Hangman骨折采用经后路C2椎弓根C3侧块短节段固定,植骨融合治疗.结果 所有患者随访6~15个月,平均8个月.所有患者均骨性愈合,未出现感染、神经损伤等并发症.结论 经后路C2椎弓根C3侧块短节段内固定治疗陈旧性Hangman骨折是一种安全有效并能最大程度保留患者颈部功能的方法.

  8. The clinical research of posterior transpedicular screw fixation combined with intervertebral bone grafting fusion in the treatment of Ⅱ degree and Ⅲ degree lumbar spondylolisthesis%后路椎弓根螺钉内固定联合椎间植骨融合治疗Ⅱ、Ⅲ度腰椎滑脱的临床研究

    Institute of Scientific and Technical Information of China (English)

    宁凯; 车立新; 王志刚; 李坤; 吉喆

    2012-01-01

    目的 探讨后路椎弓根螺钉内固定联合椎间植骨融合治疗Ⅱ、Ⅲ度腰椎滑脱临床疗效.方法 回顾性分析我院2009年1月~2011年1月收治入院的30例腰椎滑脱症患者临床资料,所有病例均为Ⅱ、Ⅲ度腰椎滑脱.患者均采用后路椎弓根螺钉内固定联合椎间植骨融合治疗,观察手术前后临床症状及滑脱恢复情况、术后复位、疗效评价、材料生物相容性、术后椎间隙高度及BFS评分.结果 30例患者术前均为Ⅱ、Ⅲ度腰椎滑脱,其中,19例行椎管、神经根管减压、复位固定、植骨融合治疗,11例只行复位固定、植骨融合治疗.获得随访30例,均超过12个月.30例椎间植骨全部融合,融合率为100%.BFS评分优良率达90.0%.结论 后路椎弓根螺钉内固定联合椎间植骨融合治疗Ⅱ、Ⅲ度腰椎滑脱,操作简便、固定可靠,是临床治疗中的一种值得推广的方法.%Objective To explore the curative effect of posterior transpedicular screw fixation combined with intervertebral bone grafting fusion in the treatment of Ⅱ degree and Ⅲ degree lumbar spondylolisthesis. Methods The clinical data of 30 patients with lumbar spondylolisthesis from January 2009 to January 2011 in our hospital were analyzed retrospectively. All cases were suffered with Ⅱ degree or Ⅲ degree lumbar spondylolisthesis. All patients were adopted posterior transpedicular screw fixation combined with intervertebral bone grafting fusion treatment. The clinical symptoms, slippage recovery condition before and after operation, postoperative restoration, therapeutic effect evaluation, material biocompatibility, postoperative intervertebral height and BFS score were observed. Results 30 patients all suffered with Ⅱ degree or Ⅲ degree lumbar spondylolisthesis before surgery, among whom 19 cases were treated with canalis vertebralis and nerve root canal decompression, reduction and fixation and bone graft fusion. Other 11 cases were

  9. wire chamber

    CERN Multimedia

    Proportional multi-wire chamber. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle. Proportional wire chambers allow a much quicker reading than the optical or magnetoscriptive readout wire chambers.

  10. 特发性脊柱侧弯后路钉棒置入内固定:谁是影响效果的因素?%Posterior screw-rod fixation for idiopathic scoliosis:factors affecting the results

    Institute of Scientific and Technical Information of China (English)

    毕中普; 夏磊; 徐静磊; 周亚旗; 柯广水; 桑亮

    2014-01-01

    背景:特发性脊柱侧弯在脊柱侧弯中最常见,有时还伴有神经、内分泌系统以及营养代谢的异常,但保守治疗效果欠佳,通常需要进行手术治疗。畸形矫正是一个极其复杂的过程,对特发性脊柱侧弯治疗、转归等进行深入研究意义巨大,但目前缺少相近研究。  目的:观察后路钉棒内固定置入治疗特发性脊柱侧弯的矫正效果,探讨影响其效果的相关因素。  方法:回顾性分析近4年80例接受后路钉棒内固定置入治疗的特发性脊柱侧弯患者的病例资料,记录研究患者年龄、性别、病程、治疗前后X射线平片测量的冠状面Cobb's角、躯干偏移度等观察指标,并进行统计学分析。  结果与结论:单因素分析显示患者性别和患者病程均与内固定后矫正效果无明显相关(P>0.05);而患者年龄分布、侧凸的位置、侧凸的柔韧性均与内固定疗效相关(P OBJECTIVE:To observe the correction effect of posterior screw-rod fixation for idiopathic scoliosis, and explore the relevant factors influencing its effectiveness. METHODS:We retrospectively analyzed 80 cases receiving pedicle screw fixation in the treatment of idiopathic scoliosis in the latest four years. Age, gender, disease duration, preoperative and postoperative X-ray measurement of coronal Cobb’s angle, and trunk deviation were recorded, and statistical y analyzed. RESULTS AND CONCLUSION:Univariate analysis showed that gender and disease duration were not significantly correlated with postoperative correction results (P>0.05). However, the age distribution of patients, the location of scoliosis, and scoliosis flexibility were associated with curative effects of internal fixation (P<0.05). Posterior screw-rod fixation for idiopathic scoliosis can achieve significant effects. The patient’s age, location and flexibility of scoliosis have a significant effect on the effects of fixation. The

  11. Sacroiliac screw fixation: A mini review of surgical technique

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2014-01-01

    Full Text Available The sacral percutaneous fixation has many advantages but can be associated with a significant exposure to X-ray radiation. Currently, sacroiliac screw fixation represents the only minimally invasive technique to stabilize the posterior pelvic ring. It is a technique that should be used by experienced surgeons. We present a practical review of important aspects of this technique.

  12. Sacroiliac screw fixation: A mini review of surgical technique

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Farid-Escorcia, Hector; Alcalá-Cerra, Gabriel; Castellar-Leones, Sandra Milena; Moscote-Salazar, Luis Rafael

    2014-01-01

    The sacral percutaneous fixation has many advantages but can be associated with a significant exposure to X-ray radiation. Currently, sacroiliac screw fixation represents the only minimally invasive technique to stabilize the posterior pelvic ring. It is a technique that should be used by experienced surgeons. We present a practical review of important aspects of this technique. PMID:25336831

  13. Wire Chamber

    CERN Multimedia

    Magnetoscriptive readout wire chamber. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  14. wire chamber

    CERN Multimedia

    1967-01-01

    Magnetoscriptive readout wire chamber.Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  15. 有晶状体眼后房型人工晶状体总长度选择的回顾性分析%Selection of the posterior chamber phakic intraocular lens length

    Institute of Scientific and Technical Information of China (English)

    曹信芳; 汪阳; 沈晔; 童剑萍; 夏建华; 周天安; 叶蓓

    2013-01-01

    .虹膜-ICL接触距离为(0.85 ±0.46) mm.ICL中央拱高(ICL中央部与自身晶状体之间的距离)平均为(0.47±0.25)mm,与角膜水平直径的相关系数r=0.11,与睫状沟间距的相关系数r=0.16,与前房深度的相关系数r=0.04,与ICL长度的相关系数r=0.19,均无统计学意义(P>0.05).ICL周边拱高(ICL周边部与自身晶状体之间的距离)为0~1.23 mm,平均为(0.25±0.20) mm.结论 根据角膜水平直径选择的ICL,其长度适宜,术后并发症少,ICL拱高理想,为ICL植入术良好的安全性、有效性和可预测性提供了有力保障.%Objective To evaluate the efficacy,safety and clinical value of calculating the posterior chamber phakic intraocular lens (ICL) length according to the corneal horizontal diameter.Methods This was a retrospective study.A Staar Visian implantable contact lens (ICL) was implanted in 32 patients (64 eyes) with high myopia in the Department of Ophthalmology,the First Affiliated Hospital,College of Medicine,Zhejiang University between November 15,2005 and January 15,2011.The lens length was calculated according to the corneal horizontal diameter measured by Orbscan Ⅱ.Patients were followed up postoperatively at 1 day,1 week,1,3,6 and 12 months and every 6 months thereafter.The evaluations included visual acuity,manifest refraction,applanation tonometry,endothelial cell count,slit-lamp microscopy to detect cataract,and UBM to assess the degree of ICL tilt and distances between the corneal endothelium,the ICL,and the crystalline lens.All of the preoperative and 12-month follow-up observations were analyzed using SPSS 16.0 software.Results No anterior subcapsular cataracts were found in any of the eyes after surgery.Pigmentary dispersion was observed on the anterior and posterior surface of the ICL,but the difference was not statistically significant (x2 =2.24,P =0.13).The intraocular pressure changed from (15.67 ± 3.23) mm Hg(1 mm Hg =0.133 kPa) to (15.78 ± 3.23)mm Hg,but the difference was not significant (t =0

  16. 后路椎间融合加椎弓根螺钉固定术治疗退行性腰椎间盘病变%Posterior lumbar interbody fusion combined with pedicle screw fixation in treatment of degenerative diseases of lumbar intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    黄占柱; 仇小华; 张如意

    2011-01-01

    Objective To investigate the clinical effect of treating the patients suffering from degenerative diseases of lumbar intervertebral disc with posterior lumbar interbody fusion (PLIF) combined with pedicle screw fixation.Methods This study was based on 100 cases suffering from degenerative diseases of lumbar intervertebral disc who underwent PLIF combined with pedicle screw fixation.All the patients were followed by 1 - 2 years.The shape and the function of spinal column were both estimated before and after the operation,and they were also estimated during the following of the patients after the operation.The datas in the formal 3 stages were multiply compared.Results Between the preoperative and postoperative datas,there were statistically significant differences in the JOA scores and the angle of scoliosis and kyphosis (P < 0.05 ).And so do the preoperative datas and the datas during the following (P <0.05).But no similar result was detected between the postoperative data and the data during the following (P > 0.05).Conclusions Posterior lumbar interbody fusion (PLIF) combined with pedicle screw fixation has a significant effect in treating degenerative diseases of lumbar intervertebral disc,deserving further study and clinical popularization.%目的 探讨后路椎间融合加椎弓根螺钉固定术治疗退行性腰椎间盘病变的临床疗效.方法 对100例退行性腰椎间盘病变患者采取后路椎间融合加椎弓根螺钉固定术,术后予1~2年随访,并比较术前、术后及随访时脊柱形态、功能恢复情况(JOA评分).结果 术后与术前患者脊柱后凸、侧凸角度和JOA评分比较差异均有统计学意义(P均<0.05),随访时与术前比较差异也有统计学意义(P<0.05),随访时与术后比较差异无统计学意义(P>0.05).结论 后路椎体间融合术治疗退行性腰椎间盘病变效果显著,有进一步研究和推广价值.

  17. Wire Chamber

    CERN Multimedia

    1986-01-01

    Two wire chambers made originally for the R807 Experiment at CERN's Intersecting Storage Rings. In 1986 they were used for the PS 201 experiment (Obelix Experiment) at LEAR, the Low Energy Antiproton Ring. The group of researchers from Turin, using the chambers at that time, changed the acquisition system using for the first time 8 bit (10 bit non linear) analog to digital conversion for incoming signals from the chambers. The acquisition system was controlled by 54 CPU and 80 digital signal processors. The power required for all the electronics was 40 kW. For the period, this system was one of the most powerful on-line apparatus in the world. The Obelix Experiment was closed in 1996. To find more about how a wire chamber works, see the description for object CERN-OBJ-DE-038.

  18. Comparison of short-term effect of two kinds of posterior internal fixation combined with ex-pansive open-door laminoplasty in the treatment of multilevel cervical myelopathy%两种后路内固定结合单开门手术治疗多节段脊髓型颈椎病的近期疗效比较

    Institute of Scientific and Technical Information of China (English)

    唐少龙; 黄庆华; 吴罗根; 周文华; 曹华敏; 陈大勇; 袁野

    2016-01-01

    目的:比较后路颈椎板成形术钉棒固定与微型钛板固定治疗多节段脊髓型颈椎病的近期疗效。方法将47例多节段脊髓型颈椎病患者随机分为两组:23例行后路颈椎板成形微型钛板固定术(微型钛板组),24例行后路颈椎板成形钉棒固定术(钉棒组)。比较两组手术时间、术中出血量、JOA评分、VAS评分、术后椎管矢状径、颈椎曲度、术后活动度影响及手术并发症等,评价两种手术方式的临床疗效。结果患者均获得随访,微型钛板组为(23.8±8.1)个月,钉棒组为(23.6±8.0)个月。两组手术时间、术中出血量、手术并发症比较差异无统计学意义(P>0.05)。 JOA评分:两组手术后均较术前显著升高(P<0.05),两组间比较差异无统计学意义(P>0.05)。颈痛VAS评分:术前钉棒组显著高于微型钛板组(P<0.05),术后两组评分均较术前显著降低(P<0.05),两组间比较差异无统计学意义(P>0.05)。颈椎矢状径:两组术后3 d和未次随访时均较术前明显改善(P<0.05),两组间比较差异无统计学意义(P>0.05)。术后3 d和末次随访时微型钛板组颈椎曲度改善明显优于钉棒组(P<0.05)。末次随访时两组活动度均较术前减少(P<0.05),钉棒组减少的度数明显大于微型钛板组( P<0.05)。结论后路颈椎板成形术钉棒固定与微型钛板固定治疗多节段脊髓颈椎病神经功能改善相似,微型钛板对颈椎的活动度影响较少。%Objective To compare the short-term clinical effect of posterior vertebral plate internal fixation combined with expansive open-door laminoplasty and posterior screw rod system fixation combined with expansive open -door laminoplasty in the treatment of multilevel cervical myelopathy .Methods Forty-seven cases with cervical spondylot-ic myelopathy were randomly divided into two groups:23 cases

  19. 3D 打印模型辅助后路内固定治疗儿童颈椎畸形%Individualized 3D printing model-assisted posterior screw fixation for the treatment of the cervical de-formity of children

    Institute of Scientific and Technical Information of China (English)

    李浩; 李承鑫; 张学军; 郭东; 范敬一; 刘虎; 孙记航; 潘少川

    2016-01-01

    Objetive To study the method and effect of individualized 3D printing model—assisted pos-terior screw fixation for the treatment of the cervical deformity of children.Methods 22 patients with cervical deformity associated with upper cervical instability diagnosed by CT were retrospectively analyzed in Department of Orthopedics at Beijing Children’s Hospital.First,a 3D printing model of cervical was made with 3D printing technology,then simulated screw insertion and fixation operation on the model to obtain the individual screw in-sertion data to assist the real operation.At last implemented one-stage posterior orthomorphia combined with in-ternal fixation.Results 22 patients with cervical deformity successfully underwent the posterior screw fixation operation assisted by individual 3D printing models,without injury to the vertebral artery and nerve root,without internal fixation loosening and fracture,postoperative follow-up time ranged from 3 to 23 months,average 13.5 months.Postoperative ADI was significantly reduced,CMA increased significantly,the medulla oblongata ventral compression significantly reduced or disappeared,no death in operation,1 case with two times the fusion of bone graft,1 case underwent sternocleidomastoid muscle amputation lysis,1 case of foramen magnum decompression, 1 cases of posterior arch of atlas decompression. Conclusions Posterior screw fixation operation assisted by individualized 3D printing model can improve the success rate and safety of screw insertion,and effectively pro-tect the vertebral artery and nerve root avoiding damage,especially is of great help to the treatment of children with cervical deformity.%目的:研究个体化3D 打印模型辅助后路内固定治疗儿童颈椎畸形的方法和效果。方法对北京儿童医院骨科 CT 确诊的22例颈椎畸形伴上颈椎不稳患儿进行回顾性分析。采用3D 打印技术建立颈椎个体化3D 打印模型,在模型上进行模拟置钉及内固定手

  20. 后房型有晶状体眼人工晶状体植入对眼轴测量的影响%Effects of posterior chamber phakic intraocular lens on axial length measurements

    Institute of Scientific and Technical Information of China (English)

    俞阿勇; 郑林燕; 王勤美; 朱双倩; 薛安全; 苏炎峰; 潘蕊

    2015-01-01

    目的 探讨后房型有晶状体眼人工晶状体(PIOL)植入对眼轴测量的影响,以及日后若行白内障摘除及人工晶状体植入术时计算人工晶状体度数采用校正系数的必要性.方法 收录行PIOL植入术的高度近视眼患者,其中有晶状体眼屈光镜(PRL)组22例(39只眼),等效球镜度数(-19.00±4.03)D,植入后房悬浮型PIOL;可植入式接触镜(ICL)组24例(40只眼),等效球镜度数(-13.10±2.53)D,植入睫状沟支撑型PIOL.采用相干光生物测量仪(IOLMaster)测量手术前后的眼轴长度并进行比较.PIOL植入术前后的参数,如等效球镜、最佳矫正视力、眼轴等的比较采用配对t检验.手术前后眼轴测量值之间的数量关系分析采用直线回归方法.结果 手术前后眼轴PRL组分别为(30.87±2.18)、(30.94±2.16) mm(t=-2.64,P=0.012),ICL组分别为(28.35±1.20)、(28.45±1.22) mm(t=-3.97,P<0.001).直线回归分析示PRL组:术前眼轴=1.01×术后眼轴-0.24(R2 =0.99,P<0.001),术后眼轴-术前眼轴=0.24-0.005 5×术后眼轴,手术前后眼轴差异平均为0.075 mm;ICL组:术前眼轴=0.96×术后眼轴+1.17(R2 =0.99,P<0.001),术后眼轴-术前眼轴=0.015 4 ×术后眼轴-0.376 3,手术前后眼轴差异平均为0.054 mm.结论 根据SRK公式,小于0.1 mm的眼轴误差导致的人工晶状体度数误差不超过0.25 D,相当于在框架眼镜平面不超过0.20 D.因此后房型PIOL矫治高度近视术后,若日后行白内障摘除及人工晶状体植入术时,眼内的PIOL对眼轴测量影响不大,且PRL误差随着眼轴的延长而缩小,计算人工晶状体度数采用校正系数的必要性不大.%Objective To study the effects of posterior chamber phakic intraocular lens (IOL) on axial length (AL) measurements and whether a correction factor for later IOL power calculation before cataract surgery is necessary.Methods Twenty-two high myopic patients (39 eyes) with mean spherical equivalent-19.00 ± 4.03 D received phakic

  1. 后房型有晶状体眼人工晶状体植入术治疗高度近视%Posterior chamber phakic intraocular lens implants for high myopia

    Institute of Scientific and Technical Information of China (English)

    罗岩; 胡六梅; 徐婧; 李莹

    2012-01-01

    目的 评价后房型有晶状体眼人工晶状体(ICL)植入术治疗高度近视术后1年的有效性和安全性.方法 回顾性病例研究.高度近视患者149例(290眼)接受ICL植入手术.其中男107眼,女183眼,平均年龄(29.0±6.5)岁.术前平均等效球镜度(-13.2±5.6)D.随诊时检查视力、眼压、屈光度和其他副作用.结果 所有眼睛的术后裸眼视力都有提高,接近术前最佳矫正视力.最后一次随访时199眼(68.6%)术后裸眼视力高于术前最佳矫正视力1行以上,无最佳矫正视力下降的病例.术后3 h内32眼眼压超过35 mmHg,其中13眼为瞳孔阻滞,19眼考虑为黏弹剂残留.术后随诊时发现3眼眼压在21~25 mmHg之间.2眼术后3个月以后发生黄斑区出血,3个月后出血吸收.3眼(2例)因为术后光晕干扰视物不适而取出ICL.12眼因为术后拱高欠佳而进行了人工晶状体置换术.结论 随诊1年显示ICL植入治疗高度近视是一种安全、有效而并发症少的治疗方法.%Objective To evaluate the efficacy,safety,and biocompatibility of a posterior chamber phakic intraocular lens (PCPIOL) to correct high myopia within 1 year.Methods In a retrospective case series study,an implantable intraocular lens was implanted in 290 eyes of 149 patients with a mean age of 29.0±6.5 years (range 20 to 49 years).There were 107 eyes from males and 183 eyes from females.Mean preoperative myopia was-13.2±5.6 D (range-6.0 to-32.0 D).The follow-up included tests for visual acuity,intraocular pressure,manifest refraction,and adverse reactions.Results Postoperatively,all eyes had a significant increase in uncorrected visual acuity (UCVA).Best corrected visual acuity (BCVA) had improved by 1 or more lines in 199 eyes (68.6%)at 1 year.No eye lost BCVA.Thirty-two eyes developed intraocular pressure (IOP) more than 35 mmHg within 3 hours after the implatation.Pupillary blockage caused an increase in IOP in 13 eyes and insufficient removal of viscoelastic

  2. The mid - and long - term clinical outcomes of open reduction and internal fixation for dislocation of hip joint combined with posterior wall or/and column fractures of acetabulum%髋关节后脱位并髋臼后壁(柱)骨折手术治疗结果分析

    Institute of Scientific and Technical Information of China (English)

    何长街; 刘志礼; 舒勇; 黄山虎

    2011-01-01

    目的 探讨髋臼后壁(柱)骨折伴髋关节脱位手术治疗的中远期疗效.方法 回顾性分析21例髋关节脱位伴髋臼骨折患者临床资料,其中20例髋臼脱位行闭合复位,1例行急诊切开复位内固定;所有合并的髋臼骨折均采用开放复位内固定术治疗.结果 完整随访19例,失访 2例,随访时间29~86个月.按髋关节功能恢复情况评分:优13例,良3例,可2例,差1例,优良率84.2%.结论 髋关节脱位伴髋臼骨折应尽早诊断,应尽快行髋关节复位,骨折应尽早开放复位内固定,早期功能锻炼,避免过早负重.%Objectives To investigate the mid - and long - term clinical outcomes of open reduction and internal fixation(ORIF) for treating the dislocation of hip joint with posterior wall or/and column fractures of acetabulum. Methods The clinic data of 21 patients with dislocation of hip joint and posterior wall fracture of acetabulum who were given close reduction( n = 20)or open reduction and internal fixation(ORIF) ( n = 1 ) for disclocation of hip joint and then were treated with ORIF for the fracture of acetabulum were retrospectively analyzed. Results A total of 19 patients were followed up for 29 to 86 mon. According to Letournel E's hip joint functional scoring system, clinical outcome was excellent in 13 patients,good in 3 patients,fair in 2 patients,and poor in one patient. The ratio of fineness of the midand long - term clinical outcomes was 84. 2%. Conclusion The dislocation of hip joint combined with posterior wall fracture of acetabulum should be diagnosed early, and reduction of the hip joint and ORIF should be performed as soon as possible. The positive functional exercise is necessary and the premature weight bearing on the hip joint should be avoided at early time.

  3. Tram-Track Suture Technique for Pupillary Capture of a Scleral Fixated Intraocular Lens

    Science.gov (United States)

    Kim, Sung In; Kim, Kiseok

    2016-01-01

    Purpose To report a new technique using tram-track suture for pupillary capture of a scleral fixated posterior chamber intraocular lens (PC-IOL) to reposition the tilted IOL. Methods In this prospective interventional case series, we describe a tram-track suture for pupillary capture of a scleral fixated PC-IOL. A long straight needle with double-armed 10-0 polypropylene is passed behind the iris and just above the optic portion (tilted forward) of the IOL. The other straight needle with double-armed 10-0 polypropylene is passed just below the optic portion (tilted backward) of the IOL. After the IOL is repositioned properly, the polypropylene sutures are gently pulled and tied. Results Four eyes of 4 patients underwent tram-track suture for pupillary capture of a scleral fixated PC-IOL. No intra- or postoperative complications were noted, and no pupillary captures were detected during the follow-up period. Conclusions The tram-track suture technique provides good centration and stability of a PC-IOL. This technique is an easy and effective way to reposition pupillary capture of an IOL. Further, it is also minimally invasive as it maintains a closed system. PMID:27462257

  4. Ⅰ期手术经后路病灶清除内固定治疗儿童胸椎结核%One-stage debridement and bone grafting with internal fixation via posterior approach for treatment of children thoracic spine tuberculosis

    Institute of Scientific and Technical Information of China (English)

    蓝旭; 许建中; 罗飞; 刘雪梅; 葛宝丰

    2013-01-01

    目的:探讨Ⅰ期手术经后路结核病灶清除植骨融合内固定治疗儿童胸椎结核的效果.方法:2005年6月至2010年12月采用病灶清除植骨融合内固定治疗儿童胸椎结核9例,其中男7例,女2例;年龄3~12岁,平均7岁;病史3个月~1年,平均6个月.患儿均有不同程度胸背痛、肋间神经痛以及脊柱后凸畸形,同时伴有低热、盗汗、消瘦等全身症状.术前X线片、CT、MRI检查提示病变部位多发生于T4-T9节段.胸段后凸角35°~72°,平均48.2°.术前脊髓功能ASIA分级:B级2例,C级5例,D级2例.术后定期复查X线片了解后凸角变化和椎间植骨融合情况,采用ASIA分级评定术后脊髓功能恢复情况.结果:术中无大血管或脊髓损伤,术后随访16~38个月,平均24个月.所有患儿结核症状消失,无结核复发、切口感染、窦道形成或内固定失败等并发症,复查血沉正常.术后4~8个月复查X线片提示椎间植骨均获骨性愈合,内固定位置正常.最后随访后凸角12°~30°,平均19.5°,脊髓功能ASIA分级:C级2例,D级2例,E级5例.脊髓功能均有不同程度改善.结论:Ⅰ期经后路清除胸椎结核病灶彻底,椎管减压可靠,矫形效果显著,行自体或同种异体骨植骨钉棒系统内固定可有效重建胸段脊柱的稳定性.%Objective:To investigate the outcome of the children with thoracic spine tuberculosis who underwent radical debridement,reconstruction with bone autograft or allograft and internal fixation via posterior approach. Methods: From June 2005 to December 2010,9 children with thoracic spine tuberculosis underwent radical debridement,reconstruction with bone autograft or allograft and internal fixation via posterior approach including 7 males and 2 females with an average age of 7 years old ranging from 3 to 12 years. The course of the disease ranged from 3 months to 1 year (averaged 6 months). All the patients had continuous thoracic and back pain

  5. wire chamber

    CERN Multimedia

    Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  6. wire chamber

    CERN Multimedia

    Was used in ISR (Intersecting Storage Ring) split field magnet experiment. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  7. Wire chamber

    CERN Multimedia

    Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  8. wire chamber

    CERN Multimedia

    1985-01-01

    Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  9. Pedicle screw fixation and posterior lumbar interbody fusion in treatment of lumbar spondylolisthesis%椎弓根固定加椎间植骨治疗腰椎滑脱症

    Institute of Scientific and Technical Information of China (English)

    李源

    2008-01-01

    目的 探讨经后路椎弓根螺钉复位固定加椎体间植骨融合治疗腰椎滑脱的疗效.方法 采用椎弓根内固定系统,手术复位固定后,从两侧进入椎间隙取出椎间盘及纤维环,取髂骨块植骨融合.结果 29例患者获得随访,平均随访时间16个月(9~26个月).26例症状完全消失或缓解,优良率89.6%.结论 椎弓根固定系统加椎间植骨治疗腰椎滑脱症效果满意.%Objective To discuss the efficacy of reduction and fixation by pedicle screw system and iliac dowel graft placement in the treatment of lumbar spondylolisthesis.Methods From January 2003 to Decmber 2006.29 cases with lumbar spondylolisthesis were treated with pedicle screw system and iliac dowel graft placement.Results Twenty-nine patients were followed up from 9-26 months(16 months On average).26 cases were healed or alleviated.The excellent rate was 89.6%.Conclusion This technique has been found to be a safe,rapid effective procedure for lumbar spondylolisthesis and satisfaction.

  10. 关节镜下钢丝固定治疗后交叉韧带胫骨止点撕脱骨折的临床疗效%Anatomic Fixation Under Athroscopy for Posterior Cruciate Ligament Tibial Avulsion Fractures Using Kirschnerwires

    Institute of Scientific and Technical Information of China (English)

    李明亮; 姜鑫

    2015-01-01

    Objective To investigate the operation methods and clinical ef ect of anatomic fixation under athroscopy for Posterior cruciate ligament ( PCL) tibial avulsion fractures using Kirschner wires.Methods From Jan 2012 to Jan 2013 20 patients with isolated PCL tibial avulsion fractures underwent anatomic fixation under athroscopy treated at our institutionwere selected,in which 14 men, 6women aged 19~35years old, an average of 27 ,8 cases of sports injury history , and 12 cases of traf ic accident injury history. Patients had varying degrees of the symptoms of knee pain,pain arc positive and restricted activitie . Preoperative X-ray and MRI images showed PCL tibial avulsion fractures .Al patients were treated with arthroscopic surgery. The clinical examination, preoperative anterior drawer test, gravity drawer teat was fol owed-up,the knee-joint function was evaluated with Lysholm score,KT-1000 and the ef ectswere analyzed. Results The fol ow-up of 12 months, Lysholm score,KT-1000 have significantly improved relative to preoperative.Conclusion Athroscopy assisted anatomic fixation for Posterior anterior cruciate ligament ( PCL) tibial avulsion fractures using Kirschner wires has the advantages of lit le trauma,firm fixation,early rehabilitation and lit le complications,and the ef ect is satisfactory,more close to the anatomical biomechanical tibial insertion of PCL.%目的:探讨关节镜下钢丝解剖固定治疗后交叉韧带( PCL)胫骨止点撕脱骨折的临床疗效。方法2012年1月~2013年1月对20例后交叉韧带胫骨止点撕脱骨折患者行关节镜下钢丝解剖固定,其中男14例,女6例;年龄19~35岁(平均27岁);左膝9例,右膝11例。8例为运动伤,12例为车祸伤。所有患者均有不程度的膝关节疼痛、肿胀、活动受限,后抽屉试验及重力实验阳性,术前X射线片、MRI检查可见胫骨髁间窝后方撕脱骨折块。全部行关节镜下钢丝固定骨折块治疗。术前及末次随访一般情况、

  11. MAST QUADRANT 可扩张管下单侧椎弓根钉置入与椎体间融合治疗腰椎退变性疾病%Recent clinical observation in treatment of lumbar degenerative diseases with posterior lumbar interbody fusion cage and pedicle screw fixation under MAST QUADRANT expansive pipe

    Institute of Scientific and Technical Information of China (English)

    孙郁雨; 崔志明; 保国锋; 李卫东; 徐冠华; 王玲玲; 崔颖; 储惊蛰

    2011-01-01

    背景:腰椎后路椎体间融合治疗腰椎退变性疾病,能够恢复椎间隙高度、维持腰椎生理前凸、提供腰椎的即刻稳定性及取得较高的椎间骨性融合率.目的:验证运用MAST QUADRANT 可扩张管通道微创系统行单侧椎弓根钉置入并椎体间融合治疗腰椎退变性疾病的适应证及有效性.方法:在3.0 cm的微创切口内放置MAST QUADRANT可扩张管,应用单侧椎弓根钉内固定加椎体间融合治疗腰椎退变性疾病患者32例.结果与结论:患者置入内固过程中未发生硬膜囊撕裂、神经根和大血管等副损伤.随访3个月以上.置入3个月后JOA评分明显高于置入前(P < 0.01),目测类比评分显著低于置入前(P < 0.01).X射线片显示椎间隙骨密度均逐渐增加,未发现椎间融合器移位、假关节、内固定松脱或折断等并发症,亦无炎症、过敏等不良反应.%BACKGROUND: Posterior lumbar interbody fusion for lumbar degenerative disease can restore disc height, maintain the lumbar lordosis, provide immediate stability for the lumbar spine and achieve a higher rate of interbody bonefusion. OBJECTIVE: To explore the indications, surgical techniques and early curative effects in treatment of lumbar degenerative diseases with posterior lumbar interbody fusion cage and pediclescrew fixation under MAST QUADRANT expansive pipe. METHODS: Thirty-two cases suffering from lumbar degenerative diseases were treated by posterior lumbar interbody fusion cage and unilateral pedicle screw fixation with MAST QUADRANT expansive pipe which was placed in 3.0 cm minimally invaswe incision.RESULTS AND CONCLUSION: Therewere no epidural capsuletear, injury of nerve root and great vessel after reatment. Postoperative follow up continued over 3 months. Compared with preoperation. JO As core difference had statistical significance at 3 months after operation (P < 0.01). VAS score difference also had statistical significance at 3 months after operation (P< 001

  12. A biomechanical study on cervical laminoplasty retaining the posterior ligaments complex and fixation with titanium miniplate on sheep cervical spine%单开门椎管扩大成形术后保留颈后韧带复合体加微型钛板固定的生物力学

    Institute of Scientific and Technical Information of China (English)

    张成程; 林月秋; 陈建明; 周吉祥

    2011-01-01

    Objective:To investigate the biomechanical characteristics of cervical laminoplasty retaining the posterior ligaments complex and fixation with titanium miniplate. Method:10 specimens of fresh sheep cervical spine were randomly divided into two groups (5 specimens in each group).Group A were subjected to opendoor laminoplasty retaining the posterior ligaments complex,while group B underwent the group A's approach plus miniplate fixation. Flexion-extension,lateral bending and axial rotation movements were applied on each group pre and postexperiment. All data were analyzed statistically. Result:In group A,there was no difference noted in flexion-extension between pre and postexperiment (P>0.05),but as for lateral bending and axial rotation,there was significant difference noted (P<0.05 respectively)In group B,there was no difference noted in flexion-extension and lateral bending between pre and postexperiment (P>0.05),but as for axial rotation,there was significant difference noted (P<0.05).Conclusion:Cervical laminoplasty retaining the posterior ligaments complex and fixation with titanium miniplate is superior than conventional laminectomy in flexion-extension and axial rotation.%目的:探讨保留颈后韧带复合体单开门椎管扩大成形术联合微型钛板固定的生物力学特性.方法:制备新鲜羊颈椎标本10具.分成两组,每组5具.A组.保留颈后方韧带复合体单开门椎管扩大成形术组;B组,保留颈后韧带复合体联合微型钛板同定单开门椎管扩大成形术组.两组先分别测完整标本状况下弯曲、左右侧屈及轴性旋转的生物力学数据.A组、B组制成手术模型标本后再分别测上述生物力学数据,与完整标本对比.结果:A组术后在抵抗前屈载荷时与完整标本时无明显差异(p>0.05),但在抵抗左右侧屈(P0.05),在对抗轴向旋转载荷时稳定性较完整标本下降(P<0.05),但较A组差异小(P<0.05).结论:保留颈后方韧带复合体结合

  13. Diagnosis of the downward displacement of the posterior leaflet of tricuspid valve from apical right heart two chamber view by echocardiography%心尖右心两腔观诊断小儿三尖瓣后瓣下移的方法探讨

    Institute of Scientific and Technical Information of China (English)

    蒋国平; 叶菁菁; 何瑾; 彭学慧; 赵镭; 何或; 杨秀珍

    2009-01-01

    Objective To evaluate the value of echocardiography method for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve with apical right heart two chamber view (AP-RH-2CV). Methods Rotating the probe clockwise from apical four chamber view(AP-4CV) to AP-RH-2CV at the septial and posterior leaflet of tricuspid valve, the shape, moving and position of the posterior leaflet of the tricuspid valve were observed by displaying the degree of downward displacement of the septial and posterior leaflet of tricuspid valve. The location of the orifice of tricuspid regurgitation was examined by color Doppler flow imaging(CDFI). Results In 15 patients with Ebstein's anomaly from the AP-RH-2CV, the downward displacement of posterior leaflet of tricuspid valve was clearly observed at the AP-RH-2CV. These results of echocardiography were confirmed by surgery except one ease missing out mild downward displacement of the anterior leaflet of tricuspid valve. Moreover, all 15 patients showed the obvious downward displacement of the location of the orifice of tricuspid regurgitation from AP-RH-2CV by CDFI. Conclusions The AP-RH-2CV is an ideal view in diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by echocardiography. The downward displacement of the location of the orifice of tricuspid regurgitation is a critical character for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by CDFI.%目的 探讨超声心尖右心两腔观诊断小儿三尖瓣后瓣下移的方法.方法 超声在心尖四腔观以隔瓣为中心,探头顺时针方向旋转至心尖右心两腔观,在旋转中动态显示三尖瓣隔瓣和后瓣的下移程度,观察三尖瓣后瓣的形态、活动和位置.彩色多普勒超声显示三尖瓣反流口位置.结果 15例三尖瓣后瓣和隔瓣下移患儿,超声在心尖右心两腔观均可清晰显示三尖瓣后瓣下移的特征.除1例超声诊断三尖瓣隔瓣和

  14. 后路单侧椎弓根钉固定联合椎间融合术治疗退行性腰椎失稳%POSTERIOR UNILATERAL PEDICLE SCREW FIXATION PLUS LUMBAR INTERBODY FUSION FOR TREATMENT OF DEGENERATIVE LUMBAR INSTABILITY

    Institute of Scientific and Technical Information of China (English)

    魏富鑫; 刘少喻; 崔尚斌; 王乐; 梁春祥; 龙厚清; 黄阳亮

    2013-01-01

    Objective To evaluate the effectiveness of posterior unilateral pedicle screw fixation plus lumbar interbody fusion in treatment of degenerative lumbar instability.Methods Between February 2008 and December 2011,33 patients with degenerative lumbar instability were treated with posterior unilateral pedicle screw fixation plus lumbar interbody fusion,including 14 cases of lumbar disc protrusion with instability,15 cases of lumbar spinal stenosis with instability,3 recurrent cases of lumbar disc protrusion at 1 year after discectomy,and 1 case of extreme lateral lumbar disc protrusion.There were 20 males and 13 females with an average age of 47.2 years (range,39-75 years).The average disease duration was 12.8 months (range,6-25 months).Single-segment-fixation was performed in 28 cases (L4,5 in 21 cases,L5,S1 in 6 cases,and L5,6 in 1 case),and double-segment-fixation was performed in 5 cases (L3.4 and L4,5).The clinical results were evaluated by using Oswestry disability index (ODI) and modified Japanese Orthopaedic Association (JOA) score for low back pain.Results Infection occurred in 1 case,and was cured after dressing change; primary healing was obtained in the other patients.Thirty-one patients were followed up 32.3 months on average (range,15-53 months).Cage displacement occurred in 1 case who received bilateral pedicle screw fixation plus lumbar interbody fusion; no screw breaking,Cage displacement,or pseudoarthrosis was observed in the others.X-ray films showed bone fusion in the other patients except 1 case of bone fusion failure.ODI and JOA score at last follow-up were significantly improved when compared with the ones before operation and at 2 weeks after operation (P <0.05); the improvement rates were 74.0% ± 10.1% and 83.6% ± 9.4%,respectively.Conclusion Posterior unilateral pedicle screw fixation plus lumbar interbody fusion is an effective and reliable method for patients with degenerative lumbar instability because it has the advantages of

  15. 髋臼横断骨折后柱长/短钢板内固定的有限元建模及分析%FEM Modeling and Analysis of Transverse Fractured Acetabulum with Fixations of Posterior Column Long Plate and Short Plate

    Institute of Scientific and Technical Information of China (English)

    吴淑琴; 潘宏侠; 裴葆青

    2011-01-01

    目的 建立有效的髋臼横断骨折有限元模型,完成两种内固定方式的比较.方法 利用Mimics 10.0中建立髋臼骨骨折的三维模型,在逆向工程Geomagic中进行相应处理后,在ANSYS Workbench中生成短/长钢板固定模型,并进行加载分析.结果 相同加载方式下,短钢板模型的最大位移、模型整体及髋臼窝处的最大应力和最大应变,均大于长钢板模型.另外,短钢板模型更容易错位失效.结论 本文有限元模型能有效地反映骨盆应力分布,分析结果表明后壁钢板固定时,将钢板长度延伸至坐骨结节处能提供更大的稳定性.%Objective To establish a valid finite element model of the transverse fractured acetabulum and finish the analysis of inner fixation ways. Methods The three-dimensional image of the pelvis was reconstructed with the software Mimics 10. 0 and was modified with the software Geomagic. Then the 3D model of fractured pelvis was imported into ansys workbench and was established after some operations. After that the integrated 3D finite element models of transverse fractured acetabulums were established, which were fixed with posterior column long and short plates respectively. Finally the vertical load pressure was exerted on the upper terminal plate of the pelvis with some constrainer, and the distribution of stress was analyzed. Results With same loads , the maximum total deformation , von-mises stress and von-mises strain of short plate were bigger than them of long plate. In addition, the model with short plate was easier to lapse. Conclusion It was indicated that the proposed model was stable and valid to contribute the stress of pelvis. For the fixation of transverse fractured acetabulum with a posterior plate, extending the plate to hucklebone tuber was considered more stable.

  16. Latarjet Fixation

    Science.gov (United States)

    Alvi, Hasham M.; Monroe, Emily J.; Muriuki, Muturi; Verma, Rajat N.; Marra, Guido; Saltzman, Matthew D.

    2016-01-01

    Background: Attritional bone loss in patients with recurrent anterior instability has successfully been treated with a bone block procedure such as the Latarjet. It has not been previously demonstrated whether cortical or cancellous screws are superior when used for this procedure. Purpose: To assess the strength of stainless steel cortical screws versus stainless steel cannulated cancellous screws in the Latarjet procedure. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen matched-pair shoulder specimens were randomized into 2 separate fixation groups: (1) 3.5-mm stainless steel cortical screws and (2) 4.0-mm stainless steel partially threaded cannulated cancellous screws. Shoulder specimens were dissected free of all soft tissue and a 25% glenoid defect was created. The coracoid process was osteomized, placed at the site of the glenoid defect, and fixed in place with 2 parallel screws. Results: All 10 specimens failed by screw cutout. Nine of 10 specimens failed by progressive displacement with an increased number of cycles. One specimen in the 4.0-mm screw group failed by catastrophic failure on initiation of the testing protocol. The 3.5-mm screws had a mean of 274 cycles (SD, ±171 cycles; range, 10-443 cycles) to failure. The 4.0-mm screws had a mean of 135 cycles (SD, ±141 cycles; range, 0-284 cycles) to failure. There was no statistically significant difference between the 2 types of screws for cycles required to cause failure (P = .144). Conclusion: There was no statistically significant difference in energy or cycles to failure when comparing the stainless steel cortical screws versus partially threaded cannulated cancellous screws. Clinical Relevance: Latarjet may be performed using cortical or cancellous screws without a clear advantage of either option. PMID:27158630

  17. Clinical Application of Single-side Pedicle Screw Fixation for Lumbar Posterior Fusion under Quad-rant System%可扩张通道单侧椎弓根内固定在腰椎融合术中的临床应用

    Institute of Scientific and Technical Information of China (English)

    张帅; 徐皓; 尹承慧; 黄小金

    2016-01-01

    目的:探讨经肌间隙可扩张通道单侧椎弓根内固定在单节段腰椎融合术中的临床应用价值。方法2012年8月至2014年6月,随机选取我院具有完整临床资料和随访信息的经肌间隙可扩张通道单侧椎弓根螺钉固定的患者45例。观察末次随访 Oswestry 功能障碍指数评分(oswestry disability index,ODI)和腰腿痛视觉模拟评分(visual an-alogue scale,VAS),术后1年 X 线片/ CT 观察测量椎间隙高度及观察椎间融合情况。结果术后末次随访 ODI、VAS评分及椎间隙高度较术前差异均有统计学意义(P <0.05),末次随访植骨融合率为100%。结论可扩张通道单侧椎弓根内固定在腰椎融合术中具有创伤小的优点,且疗效肯定,为腰椎退行性疾病的患者提供了一种简单、有效的治疗方法。%Objective To assess the clinical value of minimally invasive single-side pedicle screw fixation for lumbar pos-terior fusion. Methods A consecutive series of 45 patients who had undergone lumbar spinal fusion of 1 segment to treat de-generative lumbar disease was analyzed,which underwent TLIF with unilateral pedicle screw fixation under Quadrant system. More than 1 year all the patients were followed up with VAS scores and Oswestry disability questionnaire. All the patients ac-cepted X-line/ CT evaluation to compare the intervertebral height/ fusion rates at the operative level pre-operation with post-op-eration. Results The ODI score,VAS score and intervertebral height were significantly improved when compared with preop-erative one. The fusion rate were 100% . Conclusion Single-side pedicle screw fixation assisted by under Quadrant system caused less iatrogenic injury and had positive efforts post-operation. It can provide a simple and reliable choice in degenerative lumbar disease.

  18. Implant fixation of tibial avulsion fracture of the posterior cruciate ligament:knee joint range of motion and functional evaluation%植入物固定后交叉韧带胫骨止点撕脱骨折:膝关节活动度及功能评价

    Institute of Scientific and Technical Information of China (English)

    王良勇; 李建刚; 张春; 张俊; 杜红军; 崔操; 田大为

    2015-01-01

    BACKGROUND:From the biological structure, the posterior cruciate ligament is surrounded by the synovial folds of posterior capsule, arising from the inner side of the medial femoral condyle to the posterior part of tibial intercondyloid spine. The main traditional treatment method for posterior cruciate ligament tibial avulsion fracture is open operation, but it is difficult in anatomic reduction, cannot ful y restore knee joint stability and has a great negative impact on the normal function of posterior cruciate ligament. OBJECTIVE:To investigate the effects of arthroscopic implant internal fixation in the treatment of tibial avulsion fracture of the posterior cruciate ligament. METHODS:120 patients with tibial avulsion fracture of the posterior cruciate ligament were randomly assigned into treatment group and control group, with 60 cases in each group. The control group was given the traditional open surgery, and the treatment group was given the arthroscopic surgery. After 3 months, International Knee Documentation Committee (IKDC) scores and Lysholm scores were detected in the two groups;the knee joint range of motion was determined before and 3 months after treatment. RESULTS AND CONCLUSION:Wounds were healed at stage I in al patients with no serious complications. There was no difference in the knee joint range of motion between the two groups before treatment, but the range of motion was increased significantly in both two groups at 3 months after treatment (P<0.05), meanwhile which was higher in the treatment group than the control group (P<0.05). At 3 months after treatment, the excel ent knee function rate was significantly higher in the treatment group (97%) than the control group (88%) according to the Lysholm scores;the IKDC scores were significantly higher in the treatment than the control group in terms of claudication, support, pain, swel ing, and squat (P<0.05). These results indicate that the arthroscopic implant fixation of tibial avulsion

  19. 后路经伤椎植骨内固定治疗胸腰椎骨折的疗效分析%Effect of Posterior Vertebral Bone Graft Internal Fixation for the Treatment of Thoracic and Lumbar Fracture Analysis

    Institute of Scientific and Technical Information of China (English)

    曾德清; 熊福生; 万仲贤; 喻刚; 廖华; 吴威甫

    2015-01-01

    Objective To observe the ef icacy,indication and clinical outcome of fixation via injured vertebra for the treatment of thoracolumbar fracture.Methods From March 2012 to March 2014,30 patients with thinacolumbar fracture underwent surgical procedure of reduction and pediele screw at the fracture level,X-rays and CT scans were performed after operation,Cobb angle of the injured vertebral segment,the percentage of vertebral compression,and sagit al diameter stenosis rate of the injured spinal canal were observed for radiographic evaluation.Neurological function was evaluated by the Frankel scale.Results Al patients were fol1owed-up from 12 to 36 months.There was no pseudoarticulation,solid bone fusion was achieved in al cases.Cobb angle of the injured vertebral segment was cor ected from preoperative (25.6±9.7)degree to postoperative (9.1±4.1)degree and (10.2±4.7)degree at last fol ow-up.The percentage of vertebral compression was cor ected from preoperative (48.3±10.1)%to postoperative(6.5±3.2)%and(7.5±3.7)%at last fol ow-up.Spinal canal sagit al diameter stenosis rate was cor ected from preoperative(36.9±11.2)%to postoperative(6.3±4.7)%and(6.4±4.5)%one year after operation.The spinal cord function was improved 1 to 2 degree in al patients except 1 patients of grade A.Conclusion Indirect reduction and fixation with pedicle screw to treat thoracolumbar vertebral fracture have several advantages:less trauma,less stif ness,less complications with more stable vertebral column,which can rectify or prevent kyphosis ef ectively.%目的探讨经伤椎椎弓根螺钉内固定治疗胸腰椎骨折的可行性、适应症及临床疗效。方法自2012年3月~2014年3月采用后路经伤椎植骨内固定治疗胸腰椎骨折30例,分别于术后3~5d、12个月、末次随访时复查X线片及CT,对伤椎Cobb角、椎体压缩百分比、椎管占位、内固定物状况进行随访;通过Frankel标准对脊髓神经功能进行评定。

  20. 18例先天性脊柱侧凸患儿行后路半椎体切除加椎弓根系统内固定手术的护理%Perioperative nursing of 18 children undergoing posterior hemivertebrae excision and pedicle screw fixation for the congenital scoliosis

    Institute of Scientific and Technical Information of China (English)

    李燕晖; 鲁秀平; 郑艳红; 李卫平; 郭书姣; 陈晓颖

    2011-01-01

    This paper summarizes the perioperative nursing of 18 congenital scoliosis children treated by posterior hemiver-tebrae excision and pedicle screw fixation. Preoperative care focused on psychological nursing,traction nursing and pulmonary function training. After operation,the key points in nursing were vital signs monitoring,observation of patients' status,posture and skin care,prevention and control of postoperative complications,and functional exercises. All the patients were cured and discharged. The outcome within follow-up was satisfactory.%总结了18例后路半椎体切除加椎弓根系统内固定治疗先天性脊柱侧凸患儿的围手术期护理,术前重点做好心理护理、牵引护理、肺功能训练等,术后注意做好生命体征监测、病情观察、体位及皮肤护理、并发症护理、功能锻炼等。18例手术患儿均痊愈出院,随访效果良好。

  1. 腰椎短节段椎弓根螺钉固定术后近端邻近节段前凸原因分析%Pathogenesis analysis of proximal junctional lordosis after short-level posterior pedicle screw fixation in lumbar spine

    Institute of Scientific and Technical Information of China (English)

    刘海鹰; 王波; 王会民; 缪克难; 金朝晖

    2008-01-01

    Objective To analyze the possible reasons for proximal junctional lordosis(PJL)after short-segment posterior pedicle screw fixation in lumbar spine and discuss its proper management.Methods From December 2001 to August 2005,345 patients were treated by short-segment pedicle screw fixation and these patients were reviewed.Clinical outcome was evaluated according to Oswestry Disability Index(ODI).Proximal junctional lordosis was assessed evaluated on radiographs,by measuring lumbar lordosis angle,segmental angle at proximal level and lumbar-sacral angle.Risk factors of proximal junctional lordosis were analyzed.Resuits All patients were followed-up for 2 to 6 years(average 3.8 years).ODI after lumbar surgery was 9.7-46.2(average 19.6±10.7).PJL was noted in 78 patients(22.6%),37(10.7%)of whom were symptomatic and 21(6.1%)received revision surgery.PJL was more commonly occurred in patients over 60 years old,with reduced lumbar lordosis or veaical sacrum.The number of fusion-segment was not correlated to the occurrence of PJL.Conclusions Short-segment posterior pediele screw fixation can not improve lumbar sagittal alignment.Age over of 60 years,reduced lumbar lordosis and vertical sacrum are possible risk factors of PJL sacrum.%目的 分析腰椎后路椎弓根螺钉固定术后近端邻近节段前凸的可能原因,探讨合理的应对措施.方法 回顾分析2001年12月至2005年8月345例进行腰椎后路椎弓根螺钉患者,根据Oswestry功能障碍指数评价患者的临床效果,影像学检查观察近端邻近节段前凸情况,测量邻近节段椎间角、腰前凸角、腰骶角,并分析年龄、融合节段范围、腰骶力线对近端邻近节段前凸形成的影响.结果 全部患者随访2~6年(平均3.8年),术后Oswestry功能障碍指数为9.7~46.2(平均19.6±10.7).78例(22.6%)术后出现近端邻近节段前凸,37例(10.7%)出现临床症状,21例(6.1%)接受再次手术.年龄大于60岁、术后腰前凸减小、垂直骶骨的

  2. Arthroscopic double strand wire fixation anteriorly and posteriorly to anterior cruciate ligament for tibial intercondylar eminence fracture%关节镜下改良双股钢丝前后挤夹固定胫骨嵴撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    姜军; 陈坚

    2014-01-01

    Objective To explore the clinical outcomes of arthroscopic double strand wire fixation anteriorly and posteriorly to anterior cruciate ligament (ACL) for tibial intercondylar eminence fracture.Methods From January 2009 to February 2012,12 patients with tibial intercondylar eminence fracture were selected.There were 4 males and 8 females with an average age of 19.5 ± 10 (10-50) years.Time from injury to operation was 4 days to 2 years.All cases belonged to Meyers-Mekeever type Ⅱ and type Ⅲ.Arthroscopic double strand wire compressive fixation was performed anteriorly and posteriorly to ACL.Other measures included postoperative rehabilitation and supports with brace in knee extension when weight-bearing for 4-6 weeks.Results The average follow-up period was 15.6 (6-30) months.Final clinical results showed good range of motion and good knee stability.On postoperative radiology,there were good reduction of intercondylar eminence fracture and excellent healing.There was no occurrence of wire rupture.Postoperative IKDC and Lysholm scores were excellent (n =10) and good (n =2).There was no such complication as fragmentation of intercondylar eminence fracture bone,neurovascular injury or infection.Conclusion Arthroscopic double strand compressive fixation for tibial intercondylar eminence fracture may be easily performed without injury to ACL substance.The reduction is both stable and reliable.And the clinical outcome is excellent.%目的 探讨关节镜下采用双股钢丝前交叉韧带前后挤夹固定治疗胫骨嵴撕脱骨折的手术技术和临床效果.方法 2009年1月至2012年2月北京大学人民医院关节病诊疗中心收治膝关节胫骨嵴骨折12例,男4例,女8例,平均年龄10~50(19.5 ±10.0)岁,受伤时间4d~2年,均为Meyers-Mekeever分型Ⅱ型和Ⅲ型骨折.采用关节镜下改良双股钢丝前后挤夹固定治疗.术后功能锻炼,负重时伸直位支具固定4~6周.结果 所有病例均获得随访,平均时间15.6(6

  3. 后前入路治疗下颈椎骨折脱位伴双侧关节突绞锁%Decompression via posterior-anterior approach and anterior fixation in treatment of fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation

    Institute of Scientific and Technical Information of China (English)

    李鹏; 雪原; 王沛; 马信龙; 赵华健; 赵晓涛; 卢旭亚

    2011-01-01

    Objective To evaluate the surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation. Methods This study retrospectively reviewed 37 cases of lower cervical spine fracture with bilateral joints dislocation. There were 21 males and 16 females with an average age of 42 years (19-58). Distraction-flexion stage 3(DFS 3) were found in 24 cases and DFS 4 in 13 cases. All the cases were diagnosed by X-ray, CT and MRI and confirmed during the surgery. Decompression via posterior-anterior approach and anterior fixation had been adapted as the surgical strategy. The NASCIS and IMSOP standard were applied to definite the level of cervical spinal cord injury. The ASIA grading was used for evaluation the spinal cord function and the recovery rate. The X-ray and CT were used to observe reduction and bone fusion. Results The mean operative time was (4.5:±0.5) h, and the mean amount of blood loss was 360 ml (200-500 ml). All the incision healed. The two segments fixation was used in 23 cases, 3 segments fixation in 13 cases, and 4 segments fixation in 1 case. The mean follow-up period was 32 months (16-45 months).Postoperative X-ray and CT showed that bone fusion was achieved in all patients within 4-8 months, without graft displacement, or failure of implants. Spinal cord function did not aggravate, and sensory recovery ranged from 7 to 20 levels (averaged, 12.7). The ASIA grade were improved with an average of one grade. Conclusion To treat fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation, the posterlor-anterior approach and anterior fixation/fusion was benefit to preservation the cervical spinal cord function and reconstruction biomechanical stability of the cervical spine.%目的 探讨后前路减压、前路固定治疗下颈椎骨折脱位伴双侧关节突绞锁的可行性及临床效果.方法 2000

  4. Posterior Tibial Tendon Dysfunction

    Science.gov (United States)

    .org Posterior Tibial Tendon Dysfunction Page ( 1 ) Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the ...

  5. Advances and disputes of posterior malleolus fracture

    Institute of Scientific and Technical Information of China (English)

    FU Su; ZOU Zhen-yu; MEI Gang; JIN Dan

    2013-01-01

    Objective The objective of this article is to summarize the development of evaluation and treatment of posterior malleolus fracture (PMF).Data sources Data used in this review were mainly from English literature of PubMed data base.Study selection Articles were included in this review if they were related to the PMF or trimalleolar fracture.Results No consensus was found regarding what sizes of posterior malleolus fragments would lead to ankle instability thus affecting prognosis and should be fixed.Ⅹ-ray measurement is unreliable,while CT scan is widely recommended and it can recognize the occult posterior malleolus fractures associated with tibia shaft fractures,which are always undetected previously.Direct posterior malleolus fixation is suitable to stabilize syndesmotic injury.The basic and clinical researches support direct reduction and buttress plate fixation of posterior malleolus fracture through the posterolateral approach.Operative indications and timing of weight bearing are still in discussion.Conclusions Knowing whether ankle instability occurs and the proper methods to diagnose,evaluate,and operate can help manage the fracture.Further biomechanical research on ankle stability and clinical study to compare various treatment methods are required.

  6. 人工晶体睫状沟缝合固定术临床观察%Clinical observation of intraocular lens ciliary sulcus suture fixation

    Institute of Scientific and Technical Information of China (English)

    沙英虹; 史要武

    2015-01-01

    Objective To investigate clinical application of intraocular lens ciliary sulcus suture fixation.Methods Posterior chamber intraocular lens ciliary sulcus suture fixation was applied for 15 patients with traumatic lens subluxation, posterior capsule injury, posterior capsule injury after senile cataract ultrasonic emulsification, and non-lens after vitrectomy. Their clinical effects were observed.Results Follow-up for 6 months showed postoperative visual acuity in 15 cases were all better than best corrected visual acuity before operation.Conclusion Implement of intraocular lens ciliary sulcus suture fixation is a safe and effective method for non-lens capsule, lens posterior capsular rupture, or wide acantholysis of lens suspensory ligament.%目的 探讨人工晶状体睫状沟缝合固定术的临床应用.方法 对15例外伤性晶体半脱位,后囊破损,老年性白内障超声乳化后囊破损,玻璃体切割术后无晶体眼患者施行后房型人工晶体(IOL)缝线固定术,观察临床效果.结果 随诊6个月,15例患者术后视力均高于术前最佳矫正视力.结论 对无晶体囊膜及晶体后囊膜破裂或晶体悬韧带大范围松解施行人工晶状体睫状沟固定术是一种安全有效的方法.

  7. 经伤椎椎弓根植骨结合后路钉棒内固定治疗胸腰椎骨折的临床观察%Clinical Observation of Pedicle Graft by Damaged Vertebral Combined with Posterior Pedicle Screw Fixation in Treating Thoracolumbar Fractures

    Institute of Scientific and Technical Information of China (English)

    黄河; 李保华; 陈旭东; 舒春

    2014-01-01

    目的:探讨经伤椎椎弓根行椎体植骨在胸腰椎骨折中的治疗效果。方法治疗组胸腰椎爆裂性骨折76例,经后路行胸腰椎骨折复位内固定,并通过伤椎椎弓根行椎体植骨;对照组72例,为早期及同期(2008年以前)未通过椎弓根行椎体植骨的胸腰椎爆裂性骨折。两组均在术前、术后行DR及CT断层扫描检查,观察椎体高度的恢复、Cobb角的丢失情况及内固定有无松动断裂、弯曲等情况,进行比较、分析。结果治疗组的所有病例均得到随访,对照组54例获得随访,治疗组与对照组在远期丢失率,后凸畸形Cobb角度丢失率方面差异均有统计学意义。结论经伤椎椎弓根行伤椎椎体植骨、钉棒系统内固定治疗胸腰椎爆裂性骨折,术后可有效恢复伤椎椎体高度,重建前、中柱的稳定性,减少后期椎体高度的丢失,防止后凸畸形的加重及内固定的松动、断裂。%Objective To investigate Pedicle graft by damaged Vertebral the treatment of thoracolumbar fractures. Meth-ods Treatment group 76 cases, the posterior thoracic spine fracture fixation, and through the vertebral pedicle vertebral body bone;Control group, 72 cases of early and earlier(before 2008)did not undergo pedicle bone graft thoracolumbar burst fractures. Both groups were in the preoperative, postoperative DR and CT tomography examination, observation vertebral height restoration, Cobb angle of the circumstances and the loss of fracture fixation without loosening, bending, etc. , are compared and analyzed. Re-sults All the cases were followed up in treatment group,The treatment group and the control group with loss rate in the long term, kyphosis Cobb angle loss rate were significantly different. Conclusion The way of bone grafting through the vertebral pedicle and screw rod system internal fixation for the treatment of thoracolumbar burst fractures may effectively restore vertebralheight and re

  8. Atlantoaxial Pedicle Screw via Posterior Fixation and Fusion for the Treatment of Jefferson Fracture%寰枢椎椎弓根螺钉经后路固定融合治疗 Jefferson 骨折伴齿状突骨折

    Institute of Scientific and Technical Information of China (English)

    洪波; 向铁城; 黄象望; 刘向阳; 盛斌; 邓化龙; 熊伟

    2014-01-01

    [Objective] To explore clinical outcome of atlantoaxial pedicle screw via posterior fixation and infusion for the treatment of Jefferson fracture associated with odontoid fracture .[Methods] A total of 12 pa-tients with Jefferson fracture and odontoid fracture from March 2009 to May 2012 underwent atlantoaxial pedi-cle screw via posterior fixation and infusion .All patients were 8 males and 4 females with a mean age of 40 .3 years old(ranged 25 to 62 years old) .According to Anderson classification ,there were 9 patients with type II odontoid fracture and 3 patients with type III odontoid fracture .Preoperative JOA score of neurological func-tion were from 5~13(means 9 .6 ± 0 .2) .Before the operation ,the imaging examinations such as X-ray ,spiral 3-dimension CT and MRI and skull traction were performed .JOA scores were compared between before and one year after operation .The improvement rate was calculated .[Results]Atlantoaxial fracture dislocation a-chieved basic reduction .No vertebral artery injury ,spinal and nerve root injury occurred during the operation . No deterioration of spinal cord injury was observed after operation .All patients were followed up for 6~18 months(mean 13 months) .Clinical symptoms were improved significantly .Reexamination of X-ray and spiral CT 6 months after operation showed that all fractures were bone union .The screw position was good .No loosening ,defluxion and breaking occurred .JOA scores of neurological function one year after operation were 14~17(mean 16 .1 ± 0 .2) .The average improvement rate was 85 .8% .[Conclusion]Atlantoaxial pedicle screw via posterior fixation and infusion for the treatment of Jefferson fracture associated with odontoid fracture has significant efficacy .It is advantages such as stable fixation and high bone union rate .%[目的]探讨寰枢椎椎弓根螺钉经后路固定融合治疗 Jefferson 骨折伴齿状突骨折的临床疗效。[方法]自2009年3月至2012年5月对12例Jefferson骨折

  9. Biomechanical Study of Acetabular Tridimensional Memoryalloy Fixation System

    Science.gov (United States)

    Liu, Xin-Wei; Xu, Shuo-Gui; Zhang, Yun-Tong; Zhang, Chun-Cai

    2011-07-01

    We developed the acetabular tridimensional memoryalloy fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, NiTi shape memory alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis. Seven formalin-preserved cadaveric pelves were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelves were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; and (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40° to 90° about the acetabulur rim. Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1485 N) as compared to the intact condition (748 N, P = 0.009). Following reduction and internal fixation, the load distributed to the superior acetabulum (1545 N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (964 N) was familiar with fixation with reconstruction plate and was not different from intact state ( P = 0.45). These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit.

  10. The transpedicular corpectomy through simple posterior approach combined with internal fixation and prosthetic vertebral replacement for thoracic and lumbar spine metastatic tumor%单纯后路经椎弓根椎体次全切除内固定联合人工椎体置换治疗胸腰椎转移瘤

    Institute of Scientific and Technical Information of China (English)

    燕太强; 郭卫; 杨荣利; 董森; 李晓

    2011-01-01

    Objective To evaluate the clinical outcome of the transpedicular corpectomy through simple posterior approach combined with intemal fixation and prosthetic vertebral replacement for thoracic and lumbar spine metastatic tumor.Methods From January 2007 to March 2010, 21 patients with thoracic and lumbar spine metastatic tumors (9 males, 12 females; 16 in thoracic spine, 5 in lumbar spine) underwent the transpedicular corpectomy through simple posterior approach combined with internal fixation and prosthetic vertebral replacement.The mean age was 58 years (range, 39-77 years).The average pre-operative VAS score was 7.4 (range, 5-10).According to the pre-operative Frankel grades for spinal cord, 3 cases obtained grade C, 6 grade D and 12 grade E.Pre-operative ECOG grades showed 1 case with grade 2, 18 with grade 3 and 2 with grade 4.Results The mean operative time was 3.5 hours (range, 2-5 hours), with no intra-operative death.The mean intra-operative blood loss was 2150 ml (range, 800-5000ml).1 patient died of multiple organ failure two weeks postoperatively.A11 patients with pain reported lower VAS scores postoperatively (with average being 3.1; range, 1-4.5).Of the Frankel grades, 1 patient with grade C reported no change after surgery, while 1 patient with grade C was improved to grade D and 6 patients with grade D to grade E.3 cases (14.3%)were re-operated half year to 1 year after surgery due to recurrence.In the last follow-up, 20 patients had already been followed up for an average of 13 months (range, 3-24months).Among them, 13 cases died of the primary disease with an average survival of 10 months.The remaining surviving patients reported ECOG grades from grade 1 to grade 3.Conclusions The transpedicular corpectomy through simple posterior approach combined with internal fixation and prosthetic vertebral replacement for thoracic and lumbar spine metastatic tumor can provide plentiful decompression and achieve favorable surgical results.It can effectively

  11. Clinical observation on the manual small incision cataract surgery combined with rigid posterior chamber intraocular lens implantation performed by medical team in Africa%援非洲医疗队手法小切口白内障手术效果观察

    Institute of Scientific and Technical Information of China (English)

    郎莉莉; 陈建梅; 崔红平

    2016-01-01

    Objective To investigate the clinical effects of manual small incision cataract surgery combined with rigid posterior chamber intraocular lens implantation in 376 Moroccan cataract cases performed by medical team in Africa.Methods From March 2013 to February 2015 in Morocco,432 eyes of 376 Moroccan patients had undertaken manual small incision cataract surgery combined with rigid posterior chamber lens implantation.The postoperative visual acuity,intraoperative and postoperative complications were analyzed.Results The visual acuities at ≤0.04 were obtained in 9 eyes (2.08%),0.05 ~ 0.25 in 65 eyes(15.05%),0.3 ~0.5 in 236 eyes(54.63%),and≥0.6 in 122 eyes(28.24%) at 1 week postoperatively.The intraoperative complications were stated as follows.The posterior capsular rupture and vitreous prolapse occurred in 28 eyes (6.48%) with nucleus fallen into vitreous cavity in 1 eye,among which 22 eyes were applied posterior chamber lens implantation at stage Ⅰ,the intraocular lens had not been implanted in 6 eyes.Nine eyes (2.08%) complicated with iris prolapse and 12 eyes (2.78%) with progressive miosis.Two eyes(0.46%) complicated with iridodialysis which was sutured intraoperatively.The postoperative complications included the following items.At 1 week postoperatively,corneal edema occurred in 78 eyes(18.06%).The anterior chamber inflammatory responses occurred in 52 eyes(12.04%).The irregular pupil was noticed in 35 eyes (8.10%).The vitreous hemorrhage occurred in 1 eyes(0.23%)which was related to diabetic retinopathy.Other complications were not observed,such as endophthalmitis,secondary glaucoma,intraocular lens dislocation or bullous keratopathy.Conclusion Manual small incision cataract surgery combined with rigid posterior chamber lens implantation is an optimal cataract surgical method in some poverty-striken districts of Africa with the advantages of safety,effectiveness,satisfied results and low cost.And Chinese medical team also

  12. AN EXPERIMENTAL STUDY OF THE INTERLEUKIN 1 LEVELS IN AQUEOUS HUMOR AFTER TRANSSCLERAL FIXATION OF INTRAOCULAR LENSES

    Institute of Scientific and Technical Information of China (English)

    周朝晖; 何守志

    1998-01-01

    Purpose. To study the interleukin 1 (IL-1) levels in aqueous humor after transscleroal fixation of intraocular lenses (IOLs) implantation in rabbits and disciss the effect of IL-1 on postoperative anterior ocular inflammation, Methods. Twenty-seven pigmented rabbits were divided into three groups: G1, transscleral fixation of posterior chamber (PC) IOLs implantation; G2, Lens of rabbits were removed without IOLs implantation; GS, the control group, without surgical intervention. On the Ist, 3rd, 7th and 14th postoperative days, aqueous humor samples were obtained. Methyl thiazolyl tetrazolium(MTT) colormetry was used to detected for the presence of IL-1. The data were analyzed hy using analysis of variance of SAS soft ware. Results. It was found that IL-1 level in aqueous humor was increased after transscleral fixation of IOLs implantatlon, IL-1 level reached its maximum on the 14th postoperative days in the IOL implanted group. IL-1 levels on 1st, 3rd, 7th and 14th days postoperatively was significantly higher (P<0. 05) in IOLs implanted group than that of only extracapsular lenses extraction but no IOLs implantation group and that of the none sttrgical intervention group. Conclusions. IL-1 levels increased had a close relationship with a specific response to IOL implantation. The increase of IL-1 may be suggested as the principal mediators of immunological and inflammlatory responses, so that may play critical role in anterior ocular inflammative response after IOL implantation.

  13. Chamber transport

    Energy Technology Data Exchange (ETDEWEB)

    OLSON,CRAIG L.

    2000-05-17

    Heavy ion beam transport through the containment chamber plays a crucial role in all heavy ion fusion (HIF) scenarios. Here, several parameters are used to characterize the operating space for HIF beams; transport modes are assessed in relation to evolving target/accelerator requirements; results of recent relevant experiments and simulations of HIF transport are summarized; and relevant instabilities are reviewed. All transport options still exist, including (1) vacuum ballistic transport, (2) neutralized ballistic transport, and (3) channel-like transport. Presently, the European HIF program favors vacuum ballistic transport, while the US HIF program favors neutralized ballistic transport with channel-like transport as an alternate approach. Further transport research is needed to clearly guide selection of the most attractive, integrated HIF system.

  14. Posterior ankle impingement.

    Science.gov (United States)

    Giannini, Sandro; Buda, Roberto; Mosca, Massimiliano; Parma, Alessandro; Di Caprio, Francesco

    2013-03-01

    Posterior ankle impingement is a common cause of chronic ankle pain and results from compression of bony or soft tissue structures during ankle plantar flexion. Bony impingement is most commonly related to an os trigonum or prominent trigonal process. Posteromedial soft tissue impingement generally arises from an inversion injury, with compression of the posterior tibiotalar ligament between the medial malleolus and talus. Posterolateral soft tissue impingement is caused by an accessory ligament, the posterior intermalleolar ligament, which spans the posterior ankle between the posterior tibiofibular and posterior talofibular ligaments. Finally, anomalous muscles have also been described as a cause of posterior impingement.

  15. The use of rigid internal fixation in the surgical management of cervical spondylosis.

    Science.gov (United States)

    Kwon, Brian K; Vaccaro, Alexander R; Grauer, Jonathan N; Beiner, John M

    2007-01-01

    In the surgical management of cervical spondylosis, the application of rigid internal fixation can enhance the immediate stability of the cervical spine. The sophistication of such internal fixation systems and the indications for their use are continuously evolving. A sound understanding of regional anatomy, biomechanics, and kinematics within the cervical spine is essential for the safe and effective application of internal fixation. Numerous options currently exist for anterior cervical plating systems; some lock the screws to the plate rigidly (constrained), whereas others allow for some rotational or translational motion between the screw and plate (semiconstrained). The role of anterior fixation in single and multilevel fusions is still the subject of some controversy. Long anterior cervical reconstructions may require additional posterior fixation to reliably promote fusion. Rigid fixation in the posterior cervical spine can be achieved with lateral mass screws or pedicle screws. Although lateral mass screws provide excellent fixation within the subaxial cervical spine, the regional anatomy of C2 and C7 often make it difficult to place such screws, and pedicle screws at these levels are advocated. Pedicle screws achieve fixation into both the anterior and posterior column and are arguably the most stable form of rigid internal fixation within the cervical spine. Familiarity with these internal fixation techniques can be an extremely valuable tool for the spine surgeon managing these degenerative disorders of the cervical spine.

  16. Modified posterior vertebral column resection for Kümmell disease

    Science.gov (United States)

    Liu, Feng-Yu; Huo, Li-Shuang; Liu, Sen; Wang, Hui; Zhang, Li-Jun; Yang, Da-Long; Ding, Wen-Yuan

    2017-01-01

    Abstract Rationale: Kümmell's disease is defined as delayed traumatic vertebral collapse disease in which patients develop a kyphosis after asymptomatic minor spinal trauma. Both anterior approach and posterior approach have been reported, however, there is no standard treatment for Kümmell's disease. Patient concerns: We described a successful modified posterior vertebral column resection in a patient with Kümmell's disease. A 65-year-old woman reported persistent back pain for almost three months. Diagnoses: Kümmell's disease was diagnosed based on computer tomography (CT) and magnetic resonance imaging (MRI). Interventions: Modified posterior vertebral column resection combined with short-segment fixation was designed to treat this disease. Outcomes: The procedure was successful without any complications. Patient reported that symptoms were obviously improved in one week after operation. Lessons: Modified posterior vertebral column resection combined with short-segment fixation is an effective treatment option for Kümmell's disease. PMID:28151882

  17. APPLICATION OF ACETABULAR TRIDIMENSIONAL MEMORY ALLOY-FIXATION SYSTEM IN TREATMENT OF OLD ACETABULAR POSTERIOR WALL FRACTURE WITH BONE DEFECT%髋臼镍钛记忆合金三维内固定系统治疗陈旧性髋臼后壁骨折合并骨缺损

    Institute of Scientific and Technical Information of China (English)

    曹烈虎; 鲍广全; 张春才; 刘欣伟; 牛云飞; 许硕贵; 苏佳灿

    2011-01-01

    Objective To investigate the effectiveness of acetabular tridimensional memory alloy-fixation system (ATMFS) combined with autologous iliac bone in the treatment of old acetabular posterior wall fracture with bone defect. Methods Between January 2002 and February 2009, 17 patients with old acetabular posterior wall fracture and bone defect were treated, including 11 males and 6 females with an average age of 41.7 years (range, 20-60 years). The time from fracture to admission was 14-180 days (mean, 63 days). The displacement of the acetabular articular surface was more than or equal to 3 mm. According to the America Association of Orthopedic Surgeon (AAOS) acetabular fracture and defect classification standard, there were 4 cases of type I, 6 cases of type II, 5 cases of type III, and 2 cases of type IV. After the residual fracture fragments of the acetabular posterior wall and soft tissue hyperplasia were removed, the femoral head was reducted, and posterior wall defect was repaired with autologous iliac bone graft; ATMFS was used to fix acetabular posterior wall and artificial capsular ligament to reconstruct the hip so as to prevent re-dislocation of the femoral head. Results According to Matta imaging assessment standard, the results were excellent in 8 cases, good in 6 cases, fair in 2 cases, and poor in 1 case with an excellent and good rate of 82.3%. All incisions healed by first intention, and no sciatic nerve injury occurred. All patients were followed up 1-8 years (mean, 3.9 years). The mean time of fracture union was 3.6 months (range, 2-6 months). Avascular necrosis of femoral head occurred in 1 case, heterotopic ossification around the acetabulum in 1 case. According to Merle d'Aubign6-Postel scoring system evaluation, the clinical results were excellent in 9 cases, good in 6 cases, fair in 1 case, and poor in 1 case with an excellent and good rate of 88.2%. Conclusion ATMFS combined with autologous iliac bone graft and artificial ligament

  18. Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel

    Science.gov (United States)

    Kawaji, Takahiro; Sato, Tomoki; Tanihara, Hidenobu

    2016-01-01

    Purpose To report the results of sutureless scleral fixation of a posterior chamber intraocular lens (IOL) by using our developed simple technique. Methods We retrospectively reviewed the medical records of 48 eyes of 47 patients who underwent sutureless intrascleral IOL fixation by using our modified technique. A 25-gauge microvitreoretinal knife was used to perform sclerotomies and create limbus-parallel scleral tunnels with lamellar dissection in which the haptics were fixed. Results The IOLs were fixed and centered well. The mean follow-up period was 26.7 months. Postoperative complications included smooth vitreous hemorrhage in four eyes (8.3%), cystoid macular edema in two eyes (4.2%), and iris capture of the IOL in two eyes (4.2%). No other complications, such as breakage of the IOL, spontaneous IOL dislocation, or retinal detachment, were detected during the follow-up period. Conclusion The lamellar dissection of the limbus-parallel scleral tunnel can simplify the forceps-assisted introduction of the haptics into the scleral tunnel, and this technique seemed to be safe. PMID:26869757

  19. Combined anterior C2,3 reduction and fusion with posterior compressive C2 pedicle screw fixation for the treatment of unstable Hangman's fractures:16 eases review%第2、3颈椎前路融合联合第2颈椎椎弓根固定治疗不稳定Hangman骨折

    Institute of Scientific and Technical Information of China (English)

    谢宁; 倪斌; 陈德玉; 叶晓健; 肖建如; 袁文

    2008-01-01

    Objective To determine the outcome of combined anterior C2,3 reduction and fusion with Dosterior compressive C2 pedicle screw fixation for the management of unstable Hangman's fractures.Methods Sixteen cases of unstable Hangman's fractures were retrospectively reviewed through X-ray,MRI and three dimensional CT scans. Pre- and postoperative radiographs were measured for translation and angulation of C2,3 Skull traction under extension poison was conducted in all the patients right after their admission.Then anterior C2,3 discectomy followed by interbody fusion,either with iliac autograft or with box cage,and locking plate fixation were performed in each case.Because unsatisfied reduction,mainly residual large fracture gap or kyphosis,was found by the C-arm fluoroscopy during operations,posterior compressive C,pediele screw fixation was performed in one stage.According to the Levine-Edwards classification,there were 12 cases of type Ⅱ,2 of type Ⅱ a and 2 of type Ⅲ in this group.Results Follow-up ranged 6-38 months,averaged 26 months.Facture union and bone graft fusion were completed in an average of 4 months after operation.Complaints of neck pain and numbness of limbs disappeared in all patients after surgery,but range of neck motion decreased compared with normal people. Translation of C2 decreased from(4.2±1.4)mm preoperatively to(2.3±1.1)mm postoperatively,while angulation of C2,3 decreased from 8.6°±2.1° Dreoperativelv to 2.6°±1.0°postoperatively. Both have statistical significance(P<0.05). No implant failure or infection was observed.Conclusions The classification of Hangman's fracture should be modified in combination with MRI and CT scans to determine the stability of the fracture. Combined anterior C2,3 reduction and fusion with posterior compressive C2 pedicle screw fixation is the treatment of choice for patients with unstable Hangman's fractures.%目的 探讨前路C2,3复位融合联合C2椎弓根钉加压固定方法治疗

  20. 后路经伤椎固定联合伤椎及后外侧植骨治疗胸腰椎爆裂性骨折脊髓神经功能恢复研究%Study on posterior vertebral fixation combined with vertebral-posterolateral bone grafting in treatment of tho-racolumbar burst fractures

    Institute of Scientific and Technical Information of China (English)

    朱鑫; 徐海斌

    2015-01-01

    Objective To assess the clinical efficacy and safety for thoracolumbar fracture by the method of vertebral pedi‐cle screw fixation with transpedicular bone graft ,and consider its indications.Methods A total of 60 cases of patients with tho‐racolumbar unilateral or bilateral pedicle intact burst fracture ,were divided into the experimental group (posterior vertebral fix‐ation combined with vertebral bone posterolateral bone grafting) and control group (trauma with pedicle screw fixation and pos‐terolateral bone) with 30 cases in each group. We observed vertebral restoration degree (R) values (vertebral body height‘near the mean height of the anterior vertebral × 100% ) ,vertebral Cobb angle ,the fixed rate of complications ,spinal sequence re‐set ,neurological function recovery (Frankel score) in pre‐operation and at 1 week ,3 months ,12 months after opera‐tion.Results 60 cases were followed up for 12‐20 months (experimental group 16.4 ± 2.3 months;the control group of 16.1 ± 2.7 months). Vertebral fixation complications ,spinal sequence reset and neurological function recovery (Frankel score) were without statistical significance in pre‐operation and at 1 week ,3 months ,12 months after operation between the two groups (P>0.05). 12 months after operation ,two groups of Cobb angle and R value were statistically significant (P0.05). Conclusion Posterior vertebral fixation combined with vertebral‐posterolateral bone grafting in treatment of thoracolumbar burst fractures ,can effectively recover the support of the anterior column ,reduce the loss of the vertebral and kyphosis. The surgical methods in treatment of burst thora‐columbar fractures is a safe and effective method.%目的:探讨伤椎内植骨联合伤椎固定术治疗胸腰椎爆裂性骨折的安全性和临床疗效。方法将60例一侧或双侧椎弓根完好的胸腰椎爆裂性骨折患者,分为实验组(后路经伤椎固定联合伤椎植骨后外侧植骨)和

  1. 后路S-P截骨矫形椎弓根内固定治疗老年胸腰段重度椎体压缩骨折合并后凸畸形%Posterior Smith-Peterson osteotomy and transpedicle internal fixation for the treatment of se-nile thoracolumbar severe vertebral compression fracture with kyphosis

    Institute of Scientific and Technical Information of China (English)

    付青松; 王安全; 周宇; 李超; 崔红林; 吴昊

    2015-01-01

    Objective To evaluate operative method and effect of posterior Smith-Peterson osteotomy and transpedicle internal fixation for the treatment of elderly thoracolumbar severe vertebral compression fracture with kyphosis. Meth-ods 24 patients with elderly thoracolumbar severe vertebral compression fracture and kyphosis underwent operations by posterior Smith-Peterson osteotomy and transpedicle internal fixation. Results The duration of surgery was 1. 8~2.8(2.4±0.4)h;andtheintraoperativebloodlosswas240~460(320±85)ml.TheSmith-Petersonosteotomywere 1~3(1. 8 ± 0. 4). All cases were followed up for 18~42(26 ± 12. 4)months. The sagittal kyphosis Cobb angle was de-creased from 22°~48° (35. 6° ± 13. 4°) preoperatively to 5. 2°~10. 4°(8. 4° ± 2. 6°)at the last follow-up and correc-tion rate was 70. 4% ~78. 6% (76. 6% ±2. 2%) (P<0. 01). The JOA score of low lumbar pain was increased from 4~9 (6. 4 ± 2. 1)preoperatively to 20~24 (21. 6 ± 2. 8) at the last follow-up and correction rate was 73. 6% ± 4. 2%(P<0. 01). The ODI score was decreased from 32~44(37. 4 ± 5. 5)preoperatively to 8~14(11. 6 ± 2. 8) at the last follow-up and correction rate was 66. 9% ± 2. 4%(P<0. 01). Conclusions It is small operative trauma, high safe to treat elderly thoracolumbar severe vertebral compression fracture with kyphosis by posterior Smith-Peterson osteotomy and transpedicle internal fixation. The mild to moderate kyphosis can be got good corrective effect.%目的:探讨后路S-P截骨矫形椎弓根螺钉内固定治疗老年性胸腰段重度椎体压缩骨折合并后凸畸形的手术方法及疗效。方法对24例老年胸腰段重度椎体压缩骨折合并后凸畸形患者采取后路S-P截骨矫形椎弓根螺钉内固定手术治疗。结果手术时间1.8~2.8(2.4±0.4)h;术中出血量240~460(320±85)ml。 S-P截骨1~3(1.8±0.4)处。24例均获随访,时间18~42(26±12.4)个月。矢状面后凸Cobb角:术前22°~48°(35.6°±13.4

  2. 一期后路短节段固定并病灶旷置术治疗老年腰骶椎结核%One-stage posterior short-segment fixation combined with lesion-putting aside therapy for lumbar and sacral tuberculosis in old patients

    Institute of Scientific and Technical Information of China (English)

    钱明; 孙正望; 钟南哲; 孔金海; 肖辉; 李佳林; 张浩; 王静; 高欣; 王君成

    2016-01-01

    Objective To evaluate the therapeutic effect of one-stage posterior short-segment fixation combined with lesion exclusion therapy(lesion-putting aside therapy) for lumbar and sacral tuberculosis in old patients. Methods From January 2007 to December 2013,48 old patients with lumbar and sacral spinal tuberculosis were treated with one-stage posterior short-segment fixation combined with lesion exclusion therapy(filling the fenestrated intervertebral space with streptomycin powder). The operative time,blood loss,the bony fusion time and surgical complications were recorded. To evaluate the improvement of back pain and recovery of neurological deficits,visual analogue scale(VAS) score,Oswestry disability index(ODI) and American Spinal Injury Association(ASIA) classification were used. Results The follow-up time ranged 28-86 months,mean 63 months. The operative time was(139.5±51.8)min;the blood loss was(220.8±71.5)mL. The bony fusion was achieved 4.5±1.7 months after the operation in all the patients. Except for 3 patients of ASIA D grade,the neurological function of other patients all recovered to normal(E grade). No injury of the major vessel,neurological deficit and deep wound infection were observed. Second-stage decompressive laminectomy and lesion debridement were performed to relive the recurrent pain in 1 patient. Cutaneous neuralgia was seen in 1 patient,and relieved by non-steroidal analgesics drug. Conclusion One-stage posterior short-segment fixation combined with lesion exclusion therapy is suitable for lumbar and sacral tuberculosis in patients with neurological symptoms and refractory pain but without sequestrum and abscess. It can obtain the effect of relieving pain,nerve root decompression,maintaining stability and fusion simultaneously. However, the indication for this surgical procedure should be discussed before the operation.%目的:评价一期后路短节段固定并病灶旷置术治疗老年腰骶椎结核的疗效。方法2007年1

  3. Clinical efficacy of posterior decompression and fusion and internal fixation for treatment of degenerative lumbar spi-nal stenosis with lumbar segmental instability%后路减压融合内固定术治疗退变性腰椎椎管狭窄合并节段性腰椎不稳的临床疗效

    Institute of Scientific and Technical Information of China (English)

    李新福; 刘勇

    2014-01-01

    目的:观察后路腰椎椎管减压、椎弓根螺钉内固定并椎体间植骨融合术,治疗退变性腰椎椎管狭窄合并节段性腰椎不稳定患者的临床疗效。方法2006年1月~2011年12月收治的82例退变性腰椎椎管狭窄合并节段性腰椎不稳的患者,行后路减压融合内固定术治疗。采用Oswestry功能障碍指数(Oswestry disability index, ODI),疼痛视觉模拟量表(visual analogue scale, VAS)和日本骨科学会(Japanese Orthopaedic Association,JOA)评分评估临床疗效。同时行影像学检查,测量椎间隙高度,用Bridwell方法评价腰椎融合情况。结果平均随访48个月,术后腰痛VAS评分、腿痛VAS评分、JOA评分、ODI、椎间隙高度均较术前明显改善,差异有统计学意义(P<0.01)。末次随访时,根据Bridwell腰椎融合评价标准,Ⅰ级和Ⅱ级为80例(97.5%)。末次随访时,X线片、MRI检查发现4例螺钉松动断裂但已骨性融合(4%),2例植骨未融合,椎间隙高度降低(2%)。疗效评定优24例,良46例,可8例,差5例,优良率为85.4%。结论减压融合固定治疗退变性腰椎椎管狭窄症合并节段性腰椎不稳远期疗效肯定,但应把恢复该节段的稳定作为重点。%Objective To observe the Clinical efficacy of posterior decompression and fusion and internal fixation for treat -ment of degenerative lumbar spinal stenosis with lumbar segmental instability .Methods From 2006 January to 2011 Decem-ber, 82 cases of degenerative lumbar spinal stenosis with lumbar segmental instability were treated with posterior decompres -sion, fusion and internal fixation.Oswestry disability index (ODI), visual analogue scale (VAS) and Japanese Orthopaedic Association(JOA ) scores were used to evaluate the clinical efficacy .Intervertebral height were observed on roentgenographs , and Bridwell method were used to evaluate lumbar fusion .Results The average

  4. Posterior vertebral column resections combined with titanium screw rod fixation for the treatment of severe spinal deformity%后路椎体环截及钛合金钉棒内固定治疗重度脊柱畸形

    Institute of Scientific and Technical Information of China (English)

    卡哈尔•艾肯木; 楚戈; 黄佳; 高琪乐; 吴加文; 林旻中

    2013-01-01

    BACKGROUND:Vertebral column resection is the frequently mentioned spinal orthopaedic concept. Due to the high requirement of the operation skil , difficulty and more complications, the previous studies have reported from different aspects, and many researchers have focused on the analysis of complications, that may be related with the procedure and manner. OBJECTIVE:To analyze the efficacy and complications of posterior vertebral column resection combined with titanium screw rod fixation for the treatment of severe spinal deformity. METHODS:We retrospectively analyzed 48 patients with severe spinal deformity who treated with posterior vertebral column resection and titanium screw rod fixation, with an average removal of 1.6 vertebral. The patients were fol owed-up for 15-64 months. The Cobb angle (coronal plane and sagittal plane) of the patients before treatment, after treatment and in the final fol ow-up was analyzed, and the relative complications of the surgery were analyzed. RESULTS AND CONCLUSION:The patients with spinal deformity were divided into five categories, included kyphoscoliosis (n=11), severe scoliosis (n=20), congenital spinal deformity (n=4), spherical kyphosis (n=3), and angular kyphosis (n=10). The average coronal plane deformity angle of the patients was corrected from 84° preoperation to 35° postoperation, with the total correction rate of 54%. The average sagittal plane deformity angle was corrected from 90° preoperation to 42° postoperation, and the sagittal plane Cobb angle was decreased for 48°. The mean operation time was 545 minutes (204-1 355 minutes), the intraoperative blood loss was 1 610 mL (50-8 244 mL), and the average blood loss was 65%. After treatment, 31 cases had complications, including 13 cases of intraoperative neurological dysfunction (observed through electrophysiological monitoring and wake), permanent neurological dysfunction did not occur after timely treatment. The posterior vertebral column resection and

  5. Endoscopic transcervical anterior release and posterior fixation in the treatment of irreducible vertical atlantoaxial dislocation%颈前路内窥镜下松解复位后路内固定治疗难复性寰枢关节垂直脱位

    Institute of Scientific and Technical Information of China (English)

    马泓; 吕国华; 王冰; 李磊; 旷磊

    2014-01-01

    目的:探讨颈前路内窥镜下松解复位后路内固定治疗难复性寰枢关节垂直脱位的效果。方法:5例难复性寰枢关节垂直脱位患者接受一期前路经颈内镜松解复位后路内固定治疗,其中类风湿关节炎2例,原发性颅底凹陷症3例。所有患者均有神经功能受损的症状和体征,术前行颅骨牵引后摄片证实复位失败,采用颈前路内窥镜下松解复位后路内固定术治疗,观察临床症状改善情况,评价术前术后影像学资料及神经功能情况,随访术后并发症及植骨融合情况。结果:平均随访时间为25.8个月(12~40个月),所有患者均取得显著的脊髓功能改善,无并发症发生。前路术中内窥镜视野下可见寰齿关节韧带挛缩及疤痕组织增生,经松解后所有患者均取得寰枢关节解剖复位,患者术前齿状突最高点高于McRae 线5.02~7.02mm,平均5.79±0.75mm,术后为-9.89~1.53mm,平均-3.18±4.19mm(P<0.05);术前颈髓延髓角105°~139°,平均127.2°±11.58°,术后恢复至141°~164°,平均152.8°±9.60°(P<0.05);术前VAS评分4~7分,平均5.4±1.1分,术后改善至1~2分,平均1.6±0.5分(P<0.05);术前JOA评分7~12分,平均9.2±2.3分,术后提高至13~17分,平均15.2±1.6分(P<0.05),改善率为80.5%;术前ASIA分级B级1例、C级3例、D级1例,术后较术前提高1~2级;所有患者均获骨性融合且无并发症发生。结论:颈前路内窥镜下松解复位后路内固定是一种安全有效的治疗难复性寰枢关节垂直脱位的治疗手段。%Objectives: To describe the effect of endoscopic transcervical anterior release and posterior fixa-tion in treating patients with irreducible vertical atlantoaxial dislocation. Methods: Five consecutive patients with vertical atlantoaxial dislocation and upper cervical spinal cord compression underwent endoscopic tran-scervical anterior

  6. Clinical effect of posterior pedicle screw fixation combined with total laminectomy decompression on cervical spinal fracture and dislocation%后路椎弓根内固定联合全椎板减压治疗颈椎骨折脱位的临床效果

    Institute of Scientific and Technical Information of China (English)

    吕乔; 刘卫华; 杨会武; 程微; 杨子斌

    2016-01-01

    目的 探讨后路椎弓根内固定联合全椎板减压治疗颈椎骨折脱位的临床效果.方法 选择2010年1月至2014年7月云南省大理白族自治州人民医院收治的颈椎骨折脱位患者87例,术前美国脊髓损伤学会(ASIA)神经病损分级:A级18例,B级34例,C级21例,D级10例,E级4例.所有患者均采用单纯后路椎弓根内固定联合全椎板减压治疗,记录手术时间、术中出血量、术后引流量、并发症发生情况、置钉情况和随访情况,采用ASIA分级评定术后脊髓神经功能恢复情况.结果 87例患者均顺利完成手术,置钉成功率92.5%(285/308),手术时间40 ~ 96 min,平均(63±15)min;术中出血量100~400 ml,平均(260 ±44) ml;术后引流量230 ~3000ml,平均(320 ±46) ml.术后发生脑脊液漏6例,切口表层感染2例,肺不张3例,下肢静脉血栓形成3例,肺栓塞1例,顽固性低钠低氯血症2例,酸中毒、高钾血症1例,经对症治疗后均好转或痊愈术后13例(ASIA分级A级6例、B级7例)死亡,19例(ASIA分级B级12例、C级5例、D级2例)失访,余55例患者中完全解剖复位38例(69.1%),基本复位17例(30.9%),末次随访时无再脱位及断钉、断棒情况;末次随访时ASIA分级:A级12例,均无脊髓神经功能恢复;B级15例,1例恢复至C-级,6例恢复至B+级,8例无恢复;C级16例,8例恢复至D级,5例恢复至E-级,3例无恢复;D级8例,7例恢复至E级,1例无恢复.结论 后路椎弓根内固定联合全椎板减压治疗颈椎骨折脱位安全、有效.%Objective To evaluate the clinical effect of posterior pedicle screw fixation combined with total laminectomy decompression on cervical spinal fracture and dislocation.Methods Totally 87 patients with cervical spinal fracture and dislocation from January 2010 to July 2014 in Dali Bai Autonomous Prefecture People's Hospital were enrolled;preoperative American Spinal Injury Association(ASIS) grades were as follows:18 cases of grade A,34 cases of grade B

  7. Double bundle posterior cruciate ligament reconstruction: surgical technique and results.

    Science.gov (United States)

    Fanelli, Gregory C; Beck, John D; Edson, Craig J

    2010-12-01

    The keys to successful posterior cruciate ligament reconstruction are to identify and treat all pathology, use strong graft material, accurately place tunnels in anatomic insertion sites, minimize graft bending, use a mechanical graft tensioning device, use primary and back-up graft fixation, and use the appropriate postoperative rehabilitation program. Adherence to these technical principles results in successful single and double-bundle arthroscopic transtibial tunnel posterior cruciate ligament reconstruction based upon stress radiography, arthrometer, knee ligament rating scales, and patient satisfaction measurements.

  8. Long-term functional results after short-segment pedicle fixation of thoracolumbar fractures

    DEFF Research Database (Denmark)

    Mølmer, Michael; Gehrchen, Poul Martin; Dahl, Benny

    2013-01-01

    A retrospective study to assess the health-related quality of life in patients undergoing posterior fixation of thoracolumbar fractures, and to compare the outcome with norm scores and HRQL in patients undergoing surgical treatment for degenerative conditions of the spine.......A retrospective study to assess the health-related quality of life in patients undergoing posterior fixation of thoracolumbar fractures, and to compare the outcome with norm scores and HRQL in patients undergoing surgical treatment for degenerative conditions of the spine....

  9. Biomechanical comparison on two kinds of internal fixations on stress distribution of posterior pelvic ring%应用2种内固定方法对骨盆后环应力传导的生物力学比较

    Institute of Scientific and Technical Information of China (English)

    吴涛; 崔蕴威; 张奇; 陈伟; 李升; 张英泽

    2015-01-01

    distributed symmetrically.The specimens were placed in the biomecanical machine at a standing neutral posture.Vertical load up to 520 N was applied and the strain value of intact pelvic ring was recorded.The Tile C pelvic fractures were made.The symphysis pubis was fixed with plate,and the fracture of posterior pelvic ring was fixed with two kinds of internal fixators.The strain changes were recorded respectively.Results The symmetrical sites of the intact pelvic ring had similar strain changes(P >0.05).And the strain concentration sites ran along the sacrofemoral arch.Compared with the strain value of the intact pelvis,the strain changes of these sites(except site 5,6,10,11)in the pelvic fractures fixed with two kinds of internal fixation were not statistically significant(P > 0.05).Each strain value in the posterior pelvic ring fixed with MIAP combined with one IS screw was close to that in intact pelvis under 500 N vertical load.Conclusion In the intact pelvic ring,the conduction of vertical load runs along the sacrofemoral arch.The posterior pelvic ring fixed with MIAP combined with one IS screw can achieve better restoration of mechanical conduction than that fixed with two IS screws.

  10. Reduction of the posterior column in displaced acetabulum fractures through the anterior intrapelvic approach.

    Science.gov (United States)

    Kistler, Brian J; Sagi, H Claude

    2015-02-01

    The anterior intrapelvic approach can be used for the reduction and fixation of displaced fractures of the acetabulum. Reduction techniques and options for placement of fixation deviate to some degree from those used with the traditional ilioinguinal approach secondary to the surgeon's perspective and available vectors. Here, we present several techniques for the application of reduction clamps, reduction techniques, and fixation options for the posterior column in displaced fractures of the acetabulum treated through the anterior intrapelvic approach.

  11. 一期后路保留部分关节突开窗病灶清除短节段椎弓根螺钉内固定治疗腰骶椎结核%ONE-STAGE POSTERIOR RETAINING PART FACET JOINT IN LAMINECTOMY AND DEBRIDEMENT COMBINED WITH SHORT SEGMENTAL PEDICLE SCREW FIXATION FOR LUMBOSACRAL SPINAL TUBERCULOSIS

    Institute of Scientific and Technical Information of China (English)

    陈林; 覃建朴; 敖俊; 廖文波; 蔡玉强

    2016-01-01

    effectiveness of one-stage posterior retaining part facet joint in laminectomy,bone graft and debridement combined with short segmental pedicle screw fixation for lumbosacral spinal tuberculosis.Methods Between January 2010 and December 2014,32 cases of lumbosacral spinal tuberculosis (L4-S1) were treated by one-stage posterior retaining part facet joint in laminectomy,bone graft and debridement combined with short segmental pedicle screw fixation.There were 20 males and 12 females,aged 17-62 years (mean,43 years).The disease duration was 12-48 months (mean,18 months).The involved segments included L5,S1 level in 19 cases and L4.5 level in 13 cases.The effectiveness was evaluated by Oswestry disability index (ODI) and imaging parameters (lumbarsacral angle correction and Bridwel1 classification and CT fusion criteria) after operation.Results The operation was successfully completed in all patients;the average operation time was 180 minutes,and the average intraoperative blood loss was 400 mL.All cases were followed up 12 to 67 months (mean,15.6 months).At last follow-up,common toxic symptom of tuberculosis disappeared,and no internal fixation failure occurred.Neurological function was recovered to normal in 7 patients with neurological symptoms,and American Spinal Injury Association (ASIA) scale was improved to grade E from grade C (2 cases) and grade D (5 cases) before operation.At 1 year and last follow-up,the ODI scores were significantly improved when compared with preoperative score (P<0.05),but no significant difference was found between at 1 year and last follow-up (P>0.05).The lumbarsacral angle was significantly increased at 7 days,1 year and last follow-up when compared with preoperative one (P<0.05),but there was no significant difference between different time points after operation (P>0.05).The bone graft fusion time was 9-24 months (mean,12 months).At 1 year after operation and last follow-up,X-ray Bridwill bone fusion rates were 87.50% (28/32) and 93

  12. 微创后路经皮椎弓根螺钉内固定修复单纯前中柱损伤的急性胸腰椎骨折:回顾性、自身前后对照临床试验方案%Posterior percutaneous pedicle screw fixation for acute thoracolumbar vertebral fractures with simple anterior spinal column injury:study protocol for a retrospective, self-controlled trial

    Institute of Scientific and Technical Information of China (English)

    梁磊; 刘文德; 吴一凡; 孙小航; 丁俊杰

    2016-01-01

    pedicle screw fixation is commonly used for thoracolumbar fracture. However, associated disadvantages include severe trauma, extensive bleeding, long rehabilitation time, and long postoperative duration of intractable lumbar stiffness and low back pain. Percutaneous pedicle screw external fixation can reduce injury caused by screw insertion into the paraspinal muscles;particularly in acute thoracolumbar vertebral compression fracture with simple anterior spinal column injury. We hypothesized that minimal y invasive posterior percutaneous pedicle screw fixation for acute thoracolumbar vertebral fractures with simple anterior spinal column injury would exhibit good curative effects. OBJECTIVE:To retrospectively analyze the curative effects of minimal y invasive posterior percutaneous pedicle screw fixation on acute thoracolumbar vertebral fractures with simple anterior spinal column injury. METHODS:This retrospective, single-center, self-control ed trial was performed in PLA 153 Central Hospital, Zhengzhou, Henan Province, China. Thirty-two patients with acute thoracolumbar vertebral fracture with simple anterior spinal column injury (22 males and 10 females, average age 34.7 years, range 25-47 years) were included. Al patients underwent minimal y invasive posterior percutaneous pedicle screw internal fixation and were fol owed up for 3 months. The primary outcome measure was the Cobb angle of the injured vertebral body before, immediately after, and 3 months after internal fixation, which was used to investigate the change in the thoracolumbar spine curvature. The secondary outcome measures included:the anterior height of the injured vertebral body and radiographic findings before and immediately after internal fixation and at the last fol ow-up (to evaluate the recovery of thoracolumbar vertebral fracture), operation time, intraoperative blood loss, duration of hospitalization, and incidence of adverse events 3 months after internal fixation. The study protocol had been

  13. Photographic fixative poisoning

    Science.gov (United States)

    Photographic developer poisoning; Hydroquinone poisoning; Quinone poisoning; Sulfite poisoning ... Quinones Sodium thiosulfate Sodium sulfite/bisulfite Boric acid Photographic fixative can also break down (decompose) to form ...

  14. Traumatic atlantoaxial subluxation, posterior transfacet fixation: a case report

    Directory of Open Access Journals (Sweden)

    Mario Cahueque Lemus

    2015-03-01

    Full Text Available Cervical spine injuries are often described as catastrophic events in neurological terms, with very low survival rate. Lesions to C3-C7 segment are the most common (about 80% followed by segment C1-C2 (20%. The cervical spine injuries are of great importance, both by severity as the neurological implications. It is important to consider that among cervical traumas that do not present neurological damage at the time of the accident, 10% have deficits later, so all cervical trauma should be considered as potential spinal cord traumas, until the evolution of the case shows that definitively there is no spinal cord or nerve root damage. Cases have been reported with both atlantooccipital and atlantoaxial dislocations without neurological deficit, so these lesions went unnoticed in the emergency services. Some of the events to be considered at the time of the accident are suboccipital pain on axial skull pressure and spontaneous stiffness of the patient's neck. Dysphagia, pain on palpation of the anterior neck and a visible increase of prepharyngeal mass can also be observed, which is why it is important to keep the suspicion of craniocervical trauma in all patients who have these symptoms and carry out the relevant tests. This paper presents a case of post-traumatic atlantoaxial dislocation, which showed no neurological deficit at the time of the accident, but was later presented, as well as the surgical procedure carried out.

  15. Posterior Debridement with Trans-Pedicular Screw Fixation For ...

    African Journals Online (AJOL)

    ... osteomyelitis includes antibiotics with or without surgical intervention. Debridement is warranted for the treatment of idiopathic spondylo-discitis in ... Objective: Was to evaluate the surgical outcome of idiopathic lumbar spondylodiscitis treated ... relieved of pain and fully active with improvement neurological deficits, while ...

  16. Treatment of Multi - segmental Cervical Spondylotic Myelopathy Treated Posterior Unilateral Open-door Laminoplasty Combined with Centerpiece Ttitanium Plate Internal Fixation%后路单开门 Centerpiece 内固定治疗多节段脊髓型颈椎病

    Institute of Scientific and Technical Information of China (English)

    胡勇; 董伟鑫; 赵红勇; 袁振山; 孙肖阳; 马维虎; 徐荣明

    2014-01-01

    Objective To explore the clinical effect and safty of posterior unilateral open-door laminoplasty combined with Centerpiece titanium plate internal fixation for multi-segmental cervical spondylotic myelopathy. Methods From May 2010 to May 2012,32 patients with multi-segmental cervical spondylotic myelopathy were treated by posterior unilateral open door laminoplasty combined with Centerpiece titanium plate internal fixation. There were 20 males and 12 females,with a mean age of(60. 4 ± 7. 6)years(ranged 49 to 77 years). The neurofunction was evaluated by Japan Orthopaedic Association(JOA) score. The cervical curvature angle(α)was demonstrated by the cross angle between posterior vertebral body margins of C2 and C7 on cervical radiographs. Calculated cervical range of motion according to the difference of the angle of α between hyperex-tension and hyperflexion cervical radiographs. Calculated shoulder and pain VAS scores assess the range of axial symptoms. Re-sults The operative time and intraoperative blood loss were respectively 140 min(100 ~ 160 min)and 460 mL(250 ~ 800) mL. All patients were followed up from 12 to 38 months with an median of 22 months. The JOA scores was(9. 26 ± 3. 16)be-fore surgery and(12. 95 ± 2. 35)at 1 week after surgery,which showed significant differences(P ﹤ 0. 05). The improve rate of Japanese Orthopaedic Association(JOA)scores was(56. 4 ± 9. 3)% . The JOA scores was(13. 30 ± 2. 46)3 months after surgery and(13. 16 ± 1. 39)1 year after surgery,there were no significant differences when compared with the JOA scores at 1 week after surgery(P ﹥ 0. 05). The cervical curvature angle were(18. 1 ± 3. 8)° before surgery an(16. 7 ± 5. 4)° 3 months after surgery. There were no significient differences(P ﹥ 0. 05). The cervical range of motion was(35. 46 ± 11. 54)° before surgery and(30. 65 ± 8. 95)° 3 months after surgery. There were no significient differences(P ﹥ 0. 05). The VAS scores were ((3. 8 ± 1. 8)before surgery

  17. Doriot Climatic Chambers

    Data.gov (United States)

    Federal Laboratory Consortium — The Doriot Climatic Chambers are two, 60-feet long, 11-feet high, 15-feet wide chambers that are owned and operated by NSRDEC. The Doriot Climatic Chambers are among...

  18. 外伤性晶状体全脱位人工晶状体缝线固定术%Suture fixation of intraocular lens for traumatic complete luxation of lens

    Institute of Scientific and Technical Information of China (English)

    陈海英; 李健; 黄正如

    2015-01-01

    目的 评价玻璃体切除联合人工晶状体巩膜缝线固定植入术对外伤性晶状体全脱位的疗效.方法 回顾性分析外伤性晶状体全脱位56例(56跟)经玻璃体晶状体切除联合人工晶状体缝线固定植入术后的眼压、视力、并发症等情况.结果 术后6个月术眼眼压低于术前,视力显著提高(P=0.00),无严重并发症.结论 玻璃体晶状体切除联合注射式人工晶状体巩膜缝线植入术能有效治疗外伤性晶状体脱位.%Objective To evaluate the efficacy of vitrectomy and lensectomy followed with primary implantation of scleral-fixated posterior chamber intraocular lens for the treatment of traumatic complete luxation of lens.Methods The intraocular pressure,visual acuity,and complications of 56 eyes of 56 cases with traumatic lens dislocation who underwent vitrectomy,lensectomy,and primary implantation of scleral-fixated posterior chamber intraocular lens were analysed retrospectively.Results The condition of intraocular pressure after the surgery was better than that before the surgery and the visual acuity improved significantly compared with that of pre-operation (P =0.00).There was no serious complication 6 months after the operation.Conclusion Vitrectomy and lensectomy followed with primary implantation of scleralfixated posterior chamber intraocular lens for the treatment of traumatic lens dislocation is effective.

  19. 高度近视有晶状体眼后房型人工矫正晶状体植入术后视觉质量的临床评价%Clinical evaluation of visual quality following implantation of posterior chamber phakic intraocular corrective lens for high myopia

    Institute of Scientific and Technical Information of China (English)

    王松田; 郑广瑛; 李志刚; 王洁; 赵丽君; 王瑞娜

    2011-01-01

    Background Implantation of phakic posterior chamber intraocular corrective lens(ICL)is a new choice for correction of high myopia.Different from laser assisted in situ keratomileusis,implantation of phakic posterior chamber ICL will allow the good imaging quality because it remaines the matched relationship between cornea and lens.But its visual quality after operation is concerned by patient and ophthalmologists.ObjectiveThis study was to observe the effectiveness of implantation of posterior chamber phakic ICL on visual quality in patients with high myopia.Methods Eighty-four high myopia eyes of 42 patients accepted implantation of posterior chamber phakic ICL and follow-up of 6-month duration.The visual acuity,refractive status,wavefront,contrast sensitivity and accommodation were examined and compared before and after surgery.This clinical study complied with Declaration of Helsinki.The written informed consent was obtained from each patient before operation.Results A prospective observational trial design was used.The uncorrected visual acuity and best corrected visual acuity after operation were better than preoperative ones in all of the patients.The eye numbers of > 0.3 were increased after operation in comparison with before operation with a stable result among 1 day,1 month and 6 months after surgery (x2 =10.70,P>0.05).Spherical equivalent refraction was(-15.38 ± 1.03)D before surgery and(+0.55 ±0.06)at 1 day,(-1.22±0.09)D at 1 month and(-0.68 ± 0.06)D after 6 months,showing a significant difference among them(F=16 559.90,P<0.05).Total aberrations and higher-order aberrations were 11.00±0.25 and 0.43 ±0.05 before surgery,the wavefront aberrations were 2.21 ± 0.56 and 0.47±0.04 at 6 months after surgery with significant difference(t =1.65,P =0.10).Each spatial frequency contrast sensitivity and glare sensitivity on photopic and seotopie conditions in postoperation were higher compared with the preoperative(P<0.05).The accommodation in 1

  20. Directed Energy Anechoic Chamber

    Data.gov (United States)

    Federal Laboratory Consortium — The Directed Energy Anechoic Chamber comprises a power anechoic chamber and one transverse electromagnetic cell for characterizing radiofrequency (RF) responses of...

  1. Percutaneous reduction and fixation of intraarticular calcaneal fractures

    NARCIS (Netherlands)

    T. Schepers (Tim); L.M.M. Vogels (Lucas); I.B. Schipper (Inger); P. Patka (Peter)

    2008-01-01

    textabstractObjective: Percutaneous reduction by distraction and subsequent percutaneous screw fixation to restore calcaneal and posterior talocalcaneal facet anatomy. The aim of this technique is to improve functional outcome and to diminish the rate of secondary posttraumatic arthrosis compared to

  2. 后路固定椎间碎骨植骨与髂骨块植骨融合术治疗退行性腰椎不稳的临床研究%Clinical study of posterior internal fixation and iliac crest or granular bone grafting lumbar interbody fusion for the treatment of the degenerative lumbar instability

    Institute of Scientific and Technical Information of China (English)

    林斌; 林秋燕; 邵泽豹

    2012-01-01

    [Objective] To compare the clinical outcome of posterior pedicle screw fixation and iliac crest or granular bone grafting lumbar interbody fusion for the treatment of degenerative lumbar instability. [ Methods] There were 75 patients with degenerative lumbar disease. They were 41 males and 34 females, aged from 27 to 68 years with an average of 55. 6 years. Clinical manifestation; there were 72 cases with lower back pain and 47 cases with intermittent claudication. All of 75 cases had leg pain, including 37 cases of unilateral kg pain, 23 cases of bilateral leg pain and 15 cases of alternative leg pair.. Fifty - seven cases were positive with straight leg raising test, 66 cases had sensory disturbance, 58 cases had movement disorders, and 45 cases had abnormal achilles tendon reflex and knee jerk reflex, and 45 cases had injuries of cauda equina. There were 32 cases with degeneration of L4、5 , 26 cases with degeneration of L5S1 , 6 cases with degeneration of L3、4, and 11 cases with degeneration more than 2 segments. They were divided into two groups randomly: iliac bone group and granular bone group. The iliac bone group were treated with decompression, internal fixation for degenerative lumbar instability with pedicle screw and interbody fusion with iliac crest grafting. The granular bone group were treated with decompression, internal fixation and with granular bone grafting fusion. All of the cases had X -ray in routine and oblique view, CT and MRI preoperatively. The Japanese Orthopedic Association (JOA) score, Oswestry Disability Index (ODI) were evaluated before and 3, 6, 12 months after surgery. And fusion situation was evaluated by reviewing the roentgenographic film. [ Results] ( I ) Significant difference of JOA score and 0D1 were founded in each group before and after surgery. But it was no significant different between two groups. (2) The loss of intervertebral height was significant different between two group before and after surgery. The loss of

  3. Disckectomy, Partial Adjacent Centrum Resection, Bone Graft with Titanium Mesh and Titanium Plate Fixation for the Treatment of Single Segment Cervical Disc Degeneration with Adjacent Vertebral Posterior Osteophyte%椎间盘及部分椎体切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘突出伴椎体后缘骨赘

    Institute of Scientific and Technical Information of China (English)

    孙继飞; 何强; 刘振利; 陈庆胜

    2012-01-01

    目的 评价颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘退变突出伴相邻椎体后缘骨赘的疗效. 方法 应用颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘退变突出伴相邻椎体后缘骨赘22例.取颈椎前路手术切口,术中仅切除突出的椎间盘及相邻椎体的1/3~ 1/2,使脊髓得到彻底的减压.再用填满碎骨的钛网植于骨缺损处加用钛板螺丝钉内固定,固定范围仅限于相邻椎体.术前和术后通过神经功能JOA评分、颈部轴性症状、颈椎动态侧位片和颈椎MRI比较临床疗效. 结果 均获随访,平均15(6 ~24)个月,术后JOA评分优良率86.4%,颈部轴性症状减轻,脊髓功能明显得到恢复.颈椎活动度良好.X线检查见钛网植骨及钛板内固定良好,未见不稳现象.MRI示颈髓压迫解除. 结论 颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘突出伴相邻椎体骨赘效果显著,可最大限度地保留颈椎节段的活动度.%Objective To evaluate the clinical effects of disckectomy, partial adjacent centrum resection , bone graft with titanium mesh and titanium plate fixation for the treatment of single segment cervical disc degeneration with adjacent vertebral posterior osteophyte. Methods There were 22 cases received this kind of surgical procedure. By anterior cervical incision, the herniated disc and only 1/3 to 1/2 of the adjacent vertebral body were removed for the decompression of the spinal cord. Then the titanium mesh filled with the small bones was implanted in the bone defect followed by titanium screw fixation. The fixation was limited to the adjacent vertebral bodies. Preoperative and postoperative neurological functions of the JOA score, the cervical axial symptoms, the cervical dynamic radiographs and cervical spine MRI were used to compare the clinical

  4. Escleritis posterior bilateral Bilateral posterior scleritis

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    A. Zurutuza

    2011-08-01

    Full Text Available La escleritis posterior es un proceso inflamatorio de la parte posterior de la esclera. Su prevalencia es muy baja y el diagnóstico puede resultar complicado por la ausencia de signos oculares externos. Es más frecuente en mujeres. Cuando aparece en pacientes jóvenes no suele tener otras patologías asociadas, pero en mayores de 55 años hasta un tercio de los casos tienen relación con alguna enfermedad sistémica, sobre todo la artritis reumatoide. El diagnóstico de esta patología puede requerir un abordaje multidisciplinar y la colaboración de oftalmólogos con neurólogos, internistas o reumatólogos. En este artículo se describe un caso de escleritis posterior bilateral idiopática.Posterior scleritis is an inflammatory process of the posterior part of the sclera. Its prevalence is very low and its diagnosis can be complicated due to the absence of external ocular signs. It is more frequent in women. In young patients it does not usually have other associated pathologies, but in those over 55 years nearly one-third of the cases have a relation with some systemic disease, above all rheumatoid arthritis. The diagnosis of this pathology can require a multidisciplinary approach and the collaboration of ophthalmologists with neurologists, internists or rheumatologists. This article describes a case of idiopathic bilateral posterior scleritis.

  5. 膝后内侧小切口带线锚钉固定加早期康复锻炼治疗后交叉韧带胫骨止点骨折%Postmedial Approach for Repairing Fracture of Tibial Insertion of Posterior Cruciate Ligament by Small Incision Fixation with the Suture Anchor and Early Rehabilitation Exercises

    Institute of Scientific and Technical Information of China (English)

    湛梅圣; 邹季

    2015-01-01

    目的:观察膝后内侧小切口带线锚钉固定加早期康复锻炼治疗后交叉韧带胫骨止点骨折的临床效果。方法采取回顾性分析对两种治疗方法治疗后交叉韧带胫骨止点骨折48例患者的近期疗效进行比较。结果所有病例均获随访,术后 X 线片显示骨折均解剖复位,均达骨折愈合。术后6个月,治疗组临床疗效均明显高于对照组(P <0.05)。结论膝后内侧小切口带线锚钉固定加早期康复锻炼治疗后交叉韧带胫骨止点骨折,操作简便,创伤小,疗效满意。%Abstracts:Objective To study the clinical application of postmedial approach to the knee with small incision fixation with the suture anchor and early rehabilitation exercise for repairing fracture of tibial insertion of posterior cruciate ligament .Methods 48 patients with two therapeutic methods were retrospectively analyzed in 2011 January to 2014 January,then the short -term efficacy was compared.Results All the cases were followed up, X -ray examination of which showed anatomical reduction occurred in all the fractures ,and healed completely. After 6 months,the clinical efficacy of treatment group were significantly higher than the control group , the difference was statistically signifi-cant (P <0.05).Conclusion The operative method has superiority of little trauma , simple operation and satisfactory functional recovery of the affected extremities.

  6. A comparative study of two types of implantable lenses for correcting high myopia: A posterior chamber phakic refractive lens and a collamer lens%两种有晶状体眼后房型人工晶状体矫正高度近视的远期疗效

    Institute of Scientific and Technical Information of China (English)

    陆勤义; 廖荣丰; 夏卫东; 喻珺琦; 夏春丽; 费孝庆

    2014-01-01

    Objective To compare the clinical efficacy of two types of implantable lenses:a posterior chamber phakic refractive lens (PC-PRL) and a phakic posterior chamber implantable collamer lens (PPC-ICL) in two groups of patients with high myopia.Methods This was a retrospective study.Ninety-eight myopic eyes of 51 high myopia patients were enrolled.Eighteen patients (33 eyes) were implanted with PC-PRLs (PRL group),and the other 33 patients (65 eyes) were implanted with PPC-ICLs (ICL group).Visual acuity,mainfest refraction,intraocular pressure,endothelial cell density,the distance between the posterior surface of the cornea to the lens,and contrast sensitivity (CS) were measured at least 2 years after the surgery.The occurrence of complications was also observed in the patients.An independent samples t test and Wilcoxon rank sum test were used for statistical analysis.Results A comparison of uncorrected visual acuity after surgery between the PRL and ICL groups did not show a significant difference (Z=-1.871,P>0.05).Intraocular pressure was 12.03±2.61 mmHg in the PRL group and 13.35±3.37 mmHg in the ICL group (t=-1.197,P>0.05),while endothelial cell density was 2 185±516 cells/mm2 in the PRL group and 2 341±405 cells/mm2 in the ICL group (t=-1.168,P>0.05).There was no significant difference in a comparison of the distance between the posterior surface of the cornea to the lens,nor was there a significant difference between the arc height of 0.37±0.15 mm in the PRL group and 0.41±0.17 mm in the ICL group (t=-1.120,P>0.05).In addition,there was no significant difference in CS at all spatial frequencies.In terms of complications,in the PRL group,the lens deviated in 1 patient (1 eye) and cataract developed in 1 patient (1 eye); in the ICL group,a cataract developed in 1 patient (2 eyes) and posterior surface artificial crystals came in contact with the anterior surface of the lens which added to the opacity of the anterior capsule in 1 patient (2 eyes

  7. Delayed Hyphema after Posterior Chamber Intraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    A56-year-old man with senile cataract in the left eye underwent extracapsularcataract extraction(ECCE)and posteriorchamber intraocular lens(IOL)implanta-tion on December 19,1988.A 13D J-loopplannar lens was inserted in the ciliary sul-cus.The operation was successful with mildpostoperative response.His corrected visionwas 20/20. He had a follow-up examination onMarch 20,1989.No complication was notedand his vision retained 20/20.In theevening of the same day,the patient sud-denly felt discomfortable and...

  8. 人工晶状体睫状沟缝线固定术的临床观察%Clinical observation of ciliary sulcus fixation of intraocular lens

    Institute of Scientific and Technical Information of China (English)

    郑丁瑞

    2012-01-01

    Objective To explore the clinical efficacy of ciliary sulcus fixation of intraocular lens (IOL).Methods 15 cases ( 15 eyes) underwent sulcus fixation of posterior chamber IOL.The visual acuities,intraoperative and postoperative complications were observed.Results Postoperative corrected visual acuities:6 eyesat ≥0.5,8 eyesat0.2 ~0.4,1 eye at0.1.Conclusion Sulcus fixation of IOLis a reliable technique to treat complicated surgeries.%目的 探讨人工晶状体睫状沟缝线固定术的临床效果.方法 后房型人工晶状体(IOL)睫状沟缝线固定术15例(15眼),观察临床效果及术中、术后,近期、远期并发症.结果 术后矫正视力≥0.5者6眼,0.2 ~0.4者8眼,0.1者1眼.结论 人工晶状体睫状沟缝线固定术为特殊情况下的人工晶状体植入提供了一个可靠的固定方法.

  9. 后路一期半椎体切除节段性内固定融合治疗先天性脊柱侧凸%The Treatment of Hemivertebra Resection via the Posterior Approach along with Segments Internal Fixation for Congenital Kyphoscoliosis

    Institute of Scientific and Technical Information of China (English)

    孔维云; 张国华; 王宇飞; 杨克敏; 高薇; 李光全

    2013-01-01

    Objective To study the surgical strategies and techniques for the correction of congenital kyphoscoliosis with hemivertebra and evaluate the surgical results. Methods From June 2010 to June 2011,there were 6 congenital kyphoscoliostic patients with fully segmented hemivertebra were undergone hemivertebra resection through posterior approach, which included 4 males and 2 females with an average age of 15.7 years. The average Cobb angle of scoliosis was 73.4° (range, 52°~87°), the average Cobb angle of segmental kyphosis was 67.4° (range, 43°~89°) . The highest level of hemivertebrae was T9 and the lowest was L2. The surgical strategies were designed as followed:For the 2 cases without structural compensative curve, the posterior hemiverte-brae resection and short segmental internal fixation were performed. For the 4 cases with structural compensative curve, whose Risser signs were classified into 2-5, the hemivertebrae resection and long segmental internal fixa-tion were performed, and the compensative curve was included in the instrumentation level. Results The opera-tion time was 2.5~4.0 h (average,3.5 hours), the blood loss was 700-2 000 mL (mean,1 367 mL) . Numb-ness happened in one lower extremity postoperatively in 1 patient, and the symptom released in 1 month. The aver-age postoperative Cobb angle in coronal plane was 21.4° (11°~28°) with a correction rate of 67.9%. The aver-age postoperative Cobb angle in sagittal plane was 17.8° (12°~35°) with a correction rate of 75.2%. The fol-low-up period was from 26 months to 36 months (average, 26 months),no pseudoarthrosis,and obvious correc-tion loss either in coronal or sagittal plane was noted. Conclusion Hemivertebra resection and individualized oper-ation way has a good capability of correcting congenital kyphoscoliosis caused by hemivertebra.%目的探讨合并有半椎体畸形的脊柱侧后凸患者的手术矫正策略和方法,并对手术矫正效果进行评估.方法2010年6月至2011

  10. Effect of posterior chamber phakic intraocular lens implantation for high myopia on the stereopsis%有晶状体眼后房型人工晶状体植入术对高度近视患者立体视觉的影响

    Institute of Scientific and Technical Information of China (English)

    申笛; 姬菁文; 梁厚成; 马挺; 龙潭

    2016-01-01

    AIM:To observe the effect of posterior chamber phakic intraocuIar Iens impIantation for high myopia on the stereopsis. To evaIuate the impIantation of impIantabIe contact Iens from the highest form of visuaI angIe. METHODS:Fourty-six patients ( 92 eyes ) with high myopia were incIuded from January to December 2014. The average age of patients was 26. 13 ± 3. 37 ( 19 ~ 32 ) years, and 20 maIes ( 43%) and 26 femaIes ( 57%) were observed. AnaIysis the stereopsis of these patients before and after the impIantation of posterior chamber phakic intraocuIar Iens. RESULTS:The mean sphericaI equivaIent of aII the eyes was 10. 02±2. 71D before and -0. 02±0. 25D after surgeries. There was significant difference on the sphericaI equivaIent (t=14. 062, P=0. 000). There were 6 patients with the bIind of near stereopsis, the near stereopsis of the rest patients were 637. 50 ± 462. 08arcsec before the surgeries and there were none with the bIind of near stereopsis after surgeries. The near stereopsis of aII the patients were 126. 09 ± 165. 78arcsec after surgeries. There were 12 patients with the bIind of far stereopsis, the far stereopsis of the rest patients were 400. 59 ± 257. 00arcsec before the surgeries. After surgeries there were 2 patients with the bIind of far stereopsis, the far stereopsis of the rest patients were 152. 73 ± 111. 65arcsec. There were both significant differences on the near stereopsis ( Z=-5. 725,P=0. 000 ) and the far stereopsis ( Z=-4. 976, P=0. 000 ) before and after surgeries. CONCLUSION:Posterior chamber phakic intraocuIar Iens impIantation not onIy correct the ametropic of the high myopia, but aIso improve the visuaI acuity and the stereopsis.%目的::观察有晶状体眼人工晶状体植入术对高度近视患者立体视觉的影响,从视觉最高形式的角度评价有晶状体眼后房型人工晶状体( implantable contact lens, ICL )植入术的手术疗效。方法:分析2014-01/12于我院行有晶状体眼人工晶状体

  11. 有晶状体眼后房型人工晶状体植入矫正高度近视及散光疗效观察%Preliminary observation of the effect of Posterior chamber phakic intraocular lens for high myopia with or without astigmatism

    Institute of Scientific and Technical Information of China (English)

    唐晓蕾; 王晓莉; 赵媛; 曾涛; 夏敏; 邱丹

    2015-01-01

    目的 探讨有晶状体眼后房型人工晶状体植入矫正高度近视及散光的临床应用价值.方法 纳入2010年3月至2013年1月间14例(25只眼)高度近视及散光患者,其中男6例,女8例,年龄18~42岁,平均26.7岁.所有患者接受有晶状体眼后房型人工晶状体植人治疗,术后随访3个月,检查裸眼视力、最佳矫正视力、屈光度、散光度,并在裂隙灯下检查拱高和轴向移位等.结果 所有患者术后裸眼视力较术前提高,术后3个月均达到或超过术前最佳矫正视力.术前等效球镜为-7.00~-22.0D,平均-(12.52±2.50)D,术后等效球镜为-0.25~-0.75 D,平均-(0.54±0.11)D,术后屈光度较术前明显降低,差异有统计学意义(P<0.05).散光由术前-(1.83±1.12)D下降至术后-(0.55±0.21)D,差异有统计学意义(P<0.05).手术前后眼压、角膜内皮细胞密度差异无统计学意义(P>0.05).术后无拱高偏大者,1只眼拱高偏低.术后93.75% (15/16)的TICL患者轴向偏转<10°.结论 有晶状体眼后房型人工晶状体植入术矫正高度近视及散光可以获得良好的裸眼视力,为高度近视患者提供一种新的选择,但其长期稳定性及远期并发症需要进一步观察.%Objective To investigate the efficacy and safety of the implantation of posterior chamber phakic intraocular lens (ICL) for high myopia with or without astigmatism.Methods From March 2010 to January 2013,14 high myopia patients (25 eyes) with or without astigmatism including 6 males and 8 females were admitted to our department.The average age of these patients was 26.7 years old,ranging from 18 to 42.All of them were treated by implantation of posterior chamber phakic ICL.Vision and diopter,as well as the results of slit lamp examination were used to evaluate the efficacy during the follow up.Results All patients were implanted ICL successfully and adhered to follow-up.The uncorrected visual acuity of every eye after surgery had improved,same or

  12. A Short History of Posterior Dynamic Stabilization

    Directory of Open Access Journals (Sweden)

    Cengiz Gomleksiz

    2012-01-01

    Full Text Available Interspinous spacers were developed to treat local deformities such as degenerative spondylolisthesis. To treat patients with chronic instability, posterior pedicle fixation and rod-based dynamic stabilization systems were developed as alternatives to fusion surgeries. Dynamic stabilization is the future of spinal surgery, and in the near future, we will be able to see the development of new devices and surgical techniques to stabilize the spine. It is important to follow the development of these technologies and to gain experience using them. In this paper, we review the literature and discuss the dynamic systems, both past and present, used in the market to treat lumbar degeneration.

  13. Triple procedure in posterior segment intraocular foreign body

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    Azad Rajvardhan

    1998-01-01

    Full Text Available Three patients with intraocular foreign bodies and traumatic cataracts underwent single stage pars plana lensectomy with anterior capsule preservation, vitrectomy, removal of the foreign body, and intraocular lens implantation. The preserved anterior capsule permitted support for the placement of an intraocular lens in the posterior chamber in the ciliary sulcus. The procedure enabled early visual rehabilitation. This procedure seems useful in the management of posterior segment intraocular foreign body associated with cataract.

  14. ISR Intersection Vacuum Chamber

    CERN Multimedia

    1975-01-01

    This special vacuum chamber presenting a lateral opening at the beam crossing point is one of the many chambers specifically designed for a particular experiment. Here it is shown during assembly at the ISR mechanical worshop.

  15. Quantitative observation on changes of anterior segment by ultrasound biomicroscopy after posterior chamber phakic intraocular lens implantation%UBM量化观察有晶状体眼后房型人工晶状体植入术前后眼前节形态的变化

    Institute of Scientific and Technical Information of China (English)

    王瑞娜; 郑广瑛; 王松田; 王洁; 赵建国; 郭红亮; 赵丽君

    2011-01-01

    ObjectiveThe objective is to study the safety and effectiveness of implantation of posterior chamber phakic intraocular contact lens (ICL) by observing the changes in anterior segment using ultrasound biomicroscopy (UBM). Methods It was a perspective study. The study sampled 30 high myopia patients (30 eyes) who were treated with posterior chamber phakic ICL implant. Central anterior chamber depth (ACD), trabecular-iris angle (TIA), angle opening distance (AOD500), trabecular-ciliary processes distance (TCPD) and iris-ciliary processes distance (ICPD) were measured using UBM preoperatively,3 months and 1 year postoperatively. The distance from ICL to the central surface of lens and peripheral lens and intra-ocular pressure were measured postoperatively and examined using slit-lamp biomicroscope. Oneway ANOVA was used to analyze the distance between peripheral surface of ICL and the lens. One-way repeated measures ANOVA and Bonferroni were conducted. Results Preoperatively, 3 months and 1 year postoperatively, ACD were(3. 16 ± 0. 08 ) mm, ( 2. 76 ± 0. 13 ) mm, (2. 74 ± 0. 14) mm; AOD500 were (0.45 + 0.04) mm, (0.41 ± 0.04) mm, (0.41 ±0.03) mm; TIA were (35.00 ±3. 24)°, (32.47 ±3.56) °, (32. 40 ± 3. 23 ) °, respectively. There were significant difference in TIA, ACD and AOD ( P <0. 05) between preoperative and postoperative data. There was no significant difference between the two postoperative periods tested. TCPD and ICPD showed no significant difference between various time points ( F =0. 49, F =0. 57 ; P > 0. 05 ). Conclusions The decrease in ACD depth and correction in TIA and AOD were the noticeable changes observed in morphological structure of the ocular anterior segment after the ICL treatment. The incidence of complication did not increase as the result of the minor changes in morph structure during the course of the study. However, the long-term effects would require further long-term observation.%目的 应用超声生物显微镜(UBM)对

  16. The evaluation of curative effect for lumbar spondylolisthesis by posterior lumbar intervertebral compression bone graft fusion and pedicle screw internal fixation%椎间打压植骨融合椎弓根钉内固定术治疗腰椎滑脱症疗效评价

    Institute of Scientific and Technical Information of China (English)

    黄久勤; 王传文

    2009-01-01

    Objective To investigate the curative effect for lumbar spondylolisthesis by posterior lumbar intervertebral compression bone graft fusion and pedicle screw internal fixation.Method All 39 cases with lumbar spondylolisthesis accepted treatment during January 2003 to October 2007.There were cataplasia spondylolisthesis in 14 cases and isthmic spondylolisthesis in 25 cases.Twenty-two cases had spondylolisthesis in L4 and 17 cases had spondylolisthesis in L5.According to Meyerding grading,11 patients were classified as degree Ⅰ lesion.27 patients as degree Ⅱ lesion and 1 patient as degree Ⅲ lesion.By the help of X-ray machine,pedicle screw Was embedded in the vertebral spondylolisthesis and it Was lower vertebra.Laminectomy decompress was administered in vertebral spondylolisthesis and hold-down bars was placed to open intervertebral space.Then restored the vertebral spondylolisthesis and fixed it temporary.Next,intervertebral compression bone graft fusion was finished and was adjusted.Results Follow-up period was 5 months to 4 years.Clinical outcomes were measured with Prolo evaluation scale,35 cases were cured,4 cases were good effect.Conclusions This operation has been found to be asafe,rapid and effective method for lumbar spondylolisthesis and it produces a high fusion rate and lower expense.%目的 评价椎间打压植骨融合椎弓根钉内固定术治疗腰椎滑脱症的临床疗效.方法 2003年1月至2007年10月收治的腰椎滑脱症患者39例,其中退变性滑脱14例,峡部裂性滑脱25例.L4椎体滑脱22例,L5k椎体滑脱17例.按Meyerding滑脱程度分级标准:Ⅰ度滑脱11例,Ⅱ度滑脱27例,Ⅲ度滑脱1例.C型臂X线机透视定位下在滑脱椎体及其下位椎体间植入椎弓根螺钉,行滑脱椎体全椎板减压术,安放固定棒并撑开椎间隙,进行滑脱椎体复位及临时固定,处理椎间隙,行椎间打压植骨融合术,调整钉棒进行椎间适度加压,以植骨块稳定为度.结果 本组患者

  17. Biomechanical comparison of different stabilization constructs for unstable posterior wall fractures of acetabulum. A cadaveric study.

    Directory of Open Access Journals (Sweden)

    Yuntong Zhang

    Full Text Available PURPOSE: Operative treatment of unstable posterior wall fractures of acetabulum has been widely recommended. This laboratory study was undertaken to evaluate static fixation strength of three common fixation constructs: interfragmentary screws alone, in combination with conventional reconstruction plate, or locking reconstruction plate. METHODS: Six formalin-preserved cadaveric pelvises were used for this investigation. A posterior wall fracture was created along an arc of 40-90 degree about the acetabular rim. Three groups of different fixation constructs (two interfragmentary screws alone; two interfragmentary screws and a conventional reconstruction plate; two interfragmentary screws and a locking reconstruction were compared. Pelvises were axial loaded with six cycles of 1500 N. Dislocation of superior and inferior fracture site was analysed with a multidirectional ultrasonic measuring system. RESULTS: No statistically significant difference was found at each of the superior and inferior fracture sites between the three types of fixation. In each group, the vector dislocation at superior fracture site was significantly larger than inferior one. CONCLUSIONS: All those three described fixation constructs can provide sufficient stability for posterior acetabular fractures and allow early mobilization under experimental conditions. Higher posterior acetabular fracture line, transecting the weight-bearing surface, may indicate a substantial increase in instability, and need more stable pattern of fixation.

  18. Results of application of external fixation with different types of fixators

    Directory of Open Access Journals (Sweden)

    Grubor Predrag

    2012-01-01

    Full Text Available Introduction. Extra-focal or external fixation is the method of fracture fixation through the healthy part of the bone using pins or wires. Objective. The aim was to determine which external splints (Ortofix, Mitković, Charnley and Ilizarov had the best biomechanical properties in primary stabilization of spiral, transverse and commutative bone fractures. Methods. To determine the investigation methodology of biomechanical characteristics of the external fixator we used mathematical and computer simulator (software, juvidur physical model and clinical examination. Results. Values of advancing fragments in millimetres obtained by the study of mathematical and computer simulator (software: Charnley - 0.080 mm, Mitković M 20 - 0.785 mm, Ilizarov - 2.245 mm and Ortofix - 1.400 mm. In testing the juvidur model the following values were obtained: the external fixator Mitković M20 - 1.380 mm, Ortofix - 1.470 mm, Ilizarov - 2.410 mm, and Charnley - 2.510 mm. Clinical research of biomechanical characteristics of the effect of vertical force yielded the following results: Mitković M20 - 0.89 mm, Ortofix - 0.14 mm, Charnley - 0.80 mm and Ilizarov - 1.23 mm. Conclusion. When determining the total number of the stability test splints under the effect of vertical force (compression and force effect in antero-posterior, later-lateral plane of cross, spiral and comminuted long bone fractures, the best unified biomechanical stability was shown by the following external fixators: firstly, Mitković M20 (0.93mm, secondly, Charnley fixator (1.14 mm, thirdly, Ortofix (1.22 mm, and fourthly, Ilizarov (1.60 mm.

  19. Laser peripheral iridotomy changes anterior chamber architecture.

    Science.gov (United States)

    Theinert, Christian; Wiedemann, Peter; Unterlauft, Jan D

    2017-01-19

    The pressure gradient between anterior and posterior chamber in acute angle closure (AAC) and primary angle closure suspects is balanced by a sufficient laser peripheral iridotomy (LPI). The anterior chamber changes induced by LPI in patients with unilateral AAC were examined and compared to healthy eyes to define threshold values, which may help to discriminate between healthy and diseased eyes. Using Scheimpflug photography, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), and central corneal thickness (CCT) were measured before and after LPI in both eyes of unilateral AAC cases. These measurements were compared to a group of healthy control eyes to determine threshold values for ACD, ACV, and ACA. The ACD, ACV, and ACA increased significantly in the 25 AAC eyes after LPI. The ACD, ACV, ACA, and CCT values in the AAC eyes obtained before LPI were compared to a control group of 59 healthy eyes with wide open chamber angles. The cutoff values revealed by receiver operating characteristic analysis were 2.1 mm for ACD, 90.5 mm2 for ACV, and 27.25° for ACA. Our results confirm the significant changes of the anterior segments architecture induced by LPI in AAC eyes. The found threshold values for ACD, ACV, and ACA may help in daily clinical routine to discriminate between healthy eyes and those in need for a prophylactic LPI.

  20. Treatment of posterior Wall fractures of acetabulum

    Institute of Scientific and Technical Information of China (English)

    QI Xin; LIU Jian-guo; GONG Yu-bao; YANG Chen; LI Shu-qiang; FENG Wei

    2009-01-01

    Objective: To explore the treatment methods and outcome of posterior Wall fractures of the acetabulum.Methods: The data of 31 patients(25 males and 6females,aged 19-59 years,mean:40.5 years)with posterior wall fractures of the acetabulum hospitalized in our department from 2002 to 2006 were analyzed retrospectively in this study.The types of fractures,number of fragments,combined dislocations,and sciatic nerve function were documented before admission.All the fractures were treated with open reduction and internal fixation.Based on the fracture type and site,either screws alone or reconstructive plates were used.The Patients were immobilized for an average of 12 weeks before partial weight bearing was permitted.After follow-up for 12-70months(43.6months on average),modifled Merle d‘Aubigne score was adopted to evaluate the outcomes of the operations.Results: The percentages of the excellent,good,fair and poor results were 48.4%,41.9%,6.5%,and 3.3%,respectively.with a good to excellent rate of 90.2%.Idio-pathic sciatic nerve injury occurred in only one case.Conclusions: The sciatic nerve should be routinely exposed and protected during the surgery.The type of fixation should be based on the fracture type and site.Prolonged immobilization may be helpful in improving the final outcomes.

  1. Posterior Fossa Syndrome

    Directory of Open Access Journals (Sweden)

    Serhan Kupeli

    2014-08-01

    Full Text Available Posterior fossa syndrome is defined as the temporary and complete loss of speech after posterior fossa surgery which is not related to cerebellar hemorrhage, infection of the cerebellum, degenerative or neoplastic diseases of the cerebellum. In this review, we aimed to outline the incidence of posterior fossa syndrome, to define the risk factors for posterior fossa syndrome, to describe accompanying neurobehavioural and psychologic problems and to speculate about the etiologic mechanisms. The diagnosis of medulloblastoma and midline location of the tumor are important risk factors for the development of posterior fossa syndrome. These findings support the hypothesis that temporary ischemia and edema due to retracted and largely manipulated dentate nuclei and superior cerebellar pedincles may be the cause of mutism. Informing the family and the patient about the posterior fossa syndromemust be a component of the preoperative interview and patients who developed posterior fossa syndrome should be followed for accompanying neurobehavioural and psychologic problems even after mutism improved. [Archives Medical Review Journal 2014; 23(4.000: 636-657

  2. Current management of posterior wall fractures of the acetabulum.

    Science.gov (United States)

    Moed, Berton R; Kregor, Philip J; Reilly, Mark C; Stover, Michael D; Vrahas, Mark S

    2015-01-01

    The general goals for treating an acetabular fracture are to restore congruity and stability of the hip joint. These goals are no different from those for the subset of fractures of the posterior wall. Nevertheless, posterior wall fractures present unique problems compared with other types of acetabular fractures. Successful treatment of these fractures depends on a multitude of factors. The physician must understand their distinctive radiologic features, in conjunction with patient factors, to determine the appropriate treatment. By knowing the important points of posterior surgical approaches to the hip, particularly the posterior wall, specific techniques can be used for fracture reduction and fixation in these often challenging fractures. In addition, it is important to develop a complete grasp of potential complications and their treatment. The evaluation and treatment protocols initially developed by Letournel and Judet continue to be important; however, the surgeon also should be aware of new information published and presented in the past decade.

  3. 有晶状体眼后房型人工晶状体植入和准分子激光原位角膜磨削术矫正超高度近视的临床评价%Evaluations of Extreme Myopia Correction with Phakic Posterior Chamber Intraocular Lens and Laser in Situ Keratomileusis

    Institute of Scientific and Technical Information of China (English)

    沈晔; 李毓敏; 王竞

    2004-01-01

    目的:比较和评价有晶状体眼后房型人工晶状体(Phakic Posterior Chamber Intraocular Lens,PPCIOL)植入和准分子激光原位角膜磨削术(Laserin situ Keratomileusis,Lasik)矫正高度近视的有效性、安全性和稳定性.方法:高度近视患者43例,随机分为PPCIOL组和Lasik组,分别行可植入接触镜(Implantable Contact Lens,ICL)植入术和Laisk,随访并比较两组有效性和安全性指数,两年屈光度回退≤2 D的生存率,低对比度视力和眩光视力的改变.结果:PPCIOL组术前平均等效球面屈光度(-16.77±3.37)D(-11.75~-25.75 D);Lasik组术前平均等效球镜度(-13.8±2.71)D(-9.37~-23.75 D).术后1个月两组有效性无统计学差异,PPCIOL组安全性指数高于Lasik组(P<0.001),2 a时屈光度回退率分别为0、32.56%(P<0.001),术后3个月低对比视力和眩光视力PPCIOL组较术前提高比Lasik组明显(P<0.001).PPCIOL组有1例2眼术后6个月时有晶状体前囊混浊,两组未见其他并发症.结论:有晶状体眼后房型人工晶状体植入矫正超高度近视有效,安全性和稳定性较Lasik更好,并能获得良好的视觉质量.

  4. Posterior Corneal Surface Stability after Femtosecond Laser-Assisted Keratomileusis

    Directory of Open Access Journals (Sweden)

    Carlo Cagini

    2015-01-01

    Full Text Available The purpose of this study was to evaluate posterior corneal surface variation after femtosecond laser-assisted keratomileusis in patients with myopia and myopic astigmatism. Patients were evaluated by corneal tomography preoperatively and at 1, 6, and 12 months. We analyzed changes in the posterior corneal curvature, posterior corneal elevation, and anterior chamber depth. Moreover, we explored correlation between corneal ablation depth, residual corneal thickness, percentage of ablated corneal tissue, and preoperative corneal thickness. During follow-up, the posterior corneal surface did not have a significant forward corneal shift: no significant linear relationships emerged between the anterior displacement of the posterior corneal surface and corneal ablation depth, residual corneal thickness, or percentage of ablated corneal tissue.

  5. Unusual combination of posterior femoral head dislocation with anterior and posterior wall fractures in the ipsilateral acetabulum.

    Science.gov (United States)

    Chen, Wei; Su, Yanling; Zhang, Yingze; Zhang, Qi; Zheng, Zhanle; Pan, Jinshe

    2010-06-09

    Although hip dislocation combined with acetabular fracture is not an uncommon injury, anterior acetabular wall fractures rarely occur in patients who have posterior fracture-dislocations of the hip. This article presents a unique case of anterior and posterior wall fractures of the ipsilateral acetabulum in a patient who sustained traumatic posterior hip dislocation that resulted from a high-speed motor vehicle accident. The initial imaging evaluation, which did not include the obturator oblique view, revealed no concomitant anterior acetabular wall fracture. Repeated manipulative reductions were unsuccessful in reducing the displaced hip joint. Pelvic computed tomography (CT) scans revealed the initially missed anterior acetabular wall fracture fragments incarcerated in the left hip joint in addition to the hip dislocation and the posterior acetabular wall fracture. The incarcerated bone fragments lay between the anterior wall and the femoral head, and between the posterior wall and the femoral head, which appeared to derive from both anterior and posterior acetabular walls, respectively. Open reduction and internal fixation was performed to manage the posterior dislocation and associated acetabular fractures. Intraoperatively, the major anterior wall fragment was used to reconstruct the defected posterior wall. This case highlights the necessity of suspicion and pre- and postoperative monitoring of the obturator oblique view and CT scans to detect the potentially existing anterior acetabular wall fracture. Early surgical intervention is important to guarantee satisfactory outcomes of such complex fracture-dislocation injuries.

  6. Influence of internal fixation systems on radiation therapy for spinal tumor.

    Science.gov (United States)

    Li, Jingfeng; Yan, Lei; Wang, Jianping; Cai, Lin; Hu, Dongcai

    2015-07-08

    In this study, the influence of internal fixation systems on radiation therapy for spinal tumor was investigated in order to derive a theoretical basis for adjustment of radiation dose for patients with spinal tumor and internal fixation. Based on a common method of internal fixation after resection of spinal tumor, different models of spinal internal fixation were constructed using the lumbar vertebra of fresh domestic pigs and titanium alloy as the internal fixation system. Variations in radiation dose in the vertebral body and partial spinal cord in different types of internal fixation were studied under the same radiation condition (6 MV and 600 mGy) in different fixation models and compared with those irradiated based on the treatment planning system (TPS). Our results showed that spinal internal fixation materials have great impact on the radiation dose absorbed by spinal tumors. Under the same radiation condition, the influence of anterior internal fixation material or combined anterior and posterior approach on radiation dose at the anterior border of the vertebral body was the greatest. Regardless of the kinds of internal fixation method employed, radiation dose at the anterior border of the vertebral body was significantly different from that at other positions. Notably, the influence of posterior internal fixation material on the anterior wall of the vertebral canal was the greatest. X-ray attenuation and scattering should be taken into consideration for most patients with bone metastasis that receive fixation of metal implants. Further evaluation should then be conducted with modified TPS in order to minimize the potentially harmful effects of inappropriate radiation dose.

  7. Cervical posterior implant fixation for multi-segment cervical spondylotic myelopathy:improves symptoms but diminishes cervical range of motion%颈椎后路植入物固定修复多节段脊髓型颈椎病:可改善症状但降低了颈椎活动度

    Institute of Scientific and Technical Information of China (English)

    赵勇; 褚言琛; 李学森; 马金龙; 邹云雯

    2015-01-01

    BACKGROUND:Cervical Open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation are both procedures that treat cervical spondylotic myelopathy by expanding the space available for the spinal cord. Effectiveness and safety of two operative methods remain unclear. OBJECTIVE:To investigate the biocompatibility of implant and host between open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation to treat multi-segment cervical spondylotic myelopathy. METHODS: Data of 117 patients with multi-segment cervical spondylotic myelopathy (≥ 3 segments) were retrospectively analyzed. Sixty-five cases underwent open-door laminoplasty with unilateral mass screw fixation (laminoplasty group). Fifty-two cases underwent laminectomy with bilateral mass screw fixation (laminectomy group). Clinical outcomes were evaluated by the Japanese Orthopaedic Association scoring system and by recovery rate. Cervical curvature index and cervical range of motion were assessed by X-ray films in both groups. RESULTS AND CONCLUSION:The average folow-up time was 28 months (range 12-59 months) in both groups. No C5 nerve root palsy occurred in the two groups. Japanese Orthopaedic Association scores were greater during final folow-up than pre-fixation in both groups (P 0.05). Cervical range of motion was lower during final folow-up than pre-fixation in both groups (P 0.05)。两组末次随访颈椎活动度均低于固定前(P <0.01)。结果说明,颈后路单开门椎管成形单侧侧块内固定与全椎板切除双侧侧块内固定在改善神经功能、缓解疼痛、减少并发症上有相似的疗效,但一定程度上降低了颈椎活动度。

  8. Migration of polyethylene fixation screw after total knee arthroplasty.

    Science.gov (United States)

    Cho, Woo-Shin; Youm, Yoon-Seok

    2009-08-01

    Duracon (Howmedica, Rutherford, NJ) posterior stabilized total knee system has a snap fit locking mechanism of a tibial polyethylene, including an additional locking screw for further fixation of polyethylene. We report 13 cases of locking screw migration from tibial component after Duracon posterior stabilized primary total knee arthroplasty. Among 13 knees, screw migration in 10 asymptomatic cases was incidentally detected during regular follow-up, and they were just observed in the outpatient clinic. Only 3 knees had moderate pain, swelling, and instability, and revision was done on 2 of 3 knees.

  9. Biomechanical in vitro validation of intramedullary cortical button fixation for distal biceps tendon repair: a new technique.

    Science.gov (United States)

    Siebenlist, Sebastian; Lenich, Andreas; Buchholz, Arne; Martetschläger, Frank; Eichhorn, Stefan; Heinrich, Petra; Fingerle, Alexander; Doebele, Stefan; Sandmann, Gunther H; Millett, Peter J; Stöckle, Ulrich; Elser, Florian

    2011-08-01

    Extramedullary cortical button-based fixation for distal biceps tendon ruptures exhibits maximum load to failure in vitro but cannot restore the anatomic footprint and has the potential risk for injury to the posterior interosseous nerve. Double intramedullary cortical button fixation repair provides superior fixation strength to the bone when compared with single extramedullary cortical button-based repair. Controlled laboratory study. The technique of intramedullary cortical button fixation with 1 or 2 buttons was compared with single extramedullary cortical button-based repair using 12 paired human cadaveric elbows. All specimens underwent computed tomography analysis to determine intramedullary dimensions of the radial tuberosity as well as the thickness of the anterior and posterior cortices before biomechanical testing. Maximum load to failure and failure modes were recorded. For baseline measurements, the native tendon was tested for maximum load to failure. The intramedullary area of the radial tuberosity provides sufficient space for single or double intramedullary cortical button implantation. The mean thickness of the anterior cortex was 1.13 ± 0.15 mm, and for the posterior cortex it was 1.97 ± 0.48 mm (P button fixation with a mean load to failure of 455 ± 103 N, versus 275 ± 44 N for single intramedullary cortical button fixation (P button-based technique (P = .003). There were no statistically significant differences between single intramedullary and single extramedullary button fixation repair (P = .081). The mean load to failure for the native tendon was 379 ± 87 N. Double intramedullary cortical button fixation provides the highest load to failure in the specimens tested. Double intramedullary cortical button fixation provides reliable fixation strength to the bone for distal biceps tendon repair and potentially minimizes the risk of posterior interosseous nerve injury. Further, based on a 2-point-fixation, this method may offer a wider, more

  10. Odontoid screw fixation for fresh and remote fractures

    Directory of Open Access Journals (Sweden)

    Rao Ganesh

    2005-01-01

    Full Text Available Fractures of the odontoid process are common, accounting for 10% to 20% of all cervical spine fractures. Odontoid process fractures are classified into three types depending on the location of the fracture line. Various treatment options are available for each of these fracture types and include application of a cervical orthosis, direct anterior screw fixation, and posterior cervical fusion. If a patient requires surgical treatment of an odontoid process fracture, the timing of treatment may affect fusion rates, particularly if direct anterior odontoid screw fixation is selected as the treatment method. For example, type II odontoid fractures treated within the first 6 months of injury with direct anterior odontoid screw fixation have an 88% fusion rate, whereas fractures treated after 18 months have only a 25% fusion rate. In this review, we discuss the etiology, biomechanics, diagnosis, and treatment (including factors affecting fusion such as timing and fracture orientation options available for odontoid process fractures.

  11. Streamer chamber: pion decay

    CERN Multimedia

    1992-01-01

    The real particles produced in the decay of a positive pion can be seen in this image from a streamer chamber. Streamer chambers consist of a gas chamber through which a strong pulsed electric field is passed, creating sparks as a charged particle passes through it. A magnetic field is added to cause the decay products to follow curved paths so that their charge and momentum can be measured.

  12. Prototype multiwire proportional chamber

    CERN Multimedia

    1975-01-01

    Chambers of this type were initially developed within the Alpha project (finally not approved). They were designed such to minimize the radiation length with a view to a mass spectrometer of high resolution meant to replace the Omega detector. The chambers were clearly forerunners for the (drift) chambers later built for R606 with the novel technique of crimping the wires. See also photo 7510039X.

  13. Electromagnetic reverberation chambers

    CERN Document Server

    Besnier, Philippe

    2013-01-01

    Dedicated to a complete presentation on all aspects of reverberation chambers, this book provides the physical principles behind these test systems in a very progressive manner. The detailed panorama of parameters governing the operation of electromagnetic reverberation chambers details various applications such as radiated immunity, emissivity, and shielding efficiency experiments.In addition, the reader is provided with the elements of electromagnetic theory and statistics required to take full advantage of the basic operational rules of reverberation chambers, including calibration proc

  14. Refrigeration Test Chamber

    Data.gov (United States)

    Federal Laboratory Consortium — The enclosed and environmentally controlled chamber is able to test four units (single-phase) simultaneously at conditions ranging from tundra to desert temperatures...

  15. DORIOT CLIMATIC CHAMBERS

    Data.gov (United States)

    Federal Laboratory Consortium — The Doriot Climatic Chambers reproduce environmental conditions occurring anywhere around the world. They provide an invaluable service by significantly reducing the...

  16. Anterior transarticular screw fixation as a conventional operation for rigid stabilization

    Directory of Open Access Journals (Sweden)

    Manabu Sasaki

    2014-01-01

    Full Text Available Background: Anterior transarticular screw (ATS fixation is a useful surgical option for atlantoaxial (AA stabilization. This report presents a revised ATS method for AA fusion. Methods: A 79-year-old male presented with AA instability attributed both to an old odontoid fracture and severe degeneration of the lateral atlantoaxial joints (LAAJs. ATS fixation was performed through the conventional anterior cervical approach. The longest screw trajectories were planned preoperatively using multiplanar reconstruction computed tomography (CT scans, with entry points of the screws situated at the midpoint on the inferior border of the axial body. The surgical exposure was limited to opening at the entry points alone. Our retractor of choice was the Cusco speculum; it sufficiently secured space for utilizing the required instruments for screw placement while offering sufficient protection of soft tissues. Cannulated full-threaded bicortical screws stabilized the LAAJs. Screw insertion required a significant amount of coronal angulation up to the superior articular process of the atlas under open-mouth and lateral fluoroscopy image guidance. After ATS fixation, bone grafting was performed between the posterior laminae of the axis and the atlas through a conventional posterior approach. Results: Bony fusion between the atlas and the axis was confirmed radiographically. Arthrodesis of the LAAJs occurred despite no bone grafting. Conclusions: Rigid fixation of the LAAJs was obtained by our ATS technique, indicating that it is an alternative method for AA fixation when posterior rigid internal fixation is not applicable.

  17. Anterior transarticular screw fixation as a conventional operation for rigid stabilization.

    Science.gov (United States)

    Sasaki, Manabu; Matsumoto, Katsumi; Tsuruzono, Koichiro; Yoshimura, Kazuhiro; Shibano, Katsuhiko; Yonenobu, Kazuo

    2014-01-01

    Anterior transarticular screw (ATS) fixation is a useful surgical option for atlantoaxial (AA) stabilization. This report presents a revised ATS method for AA fusion. A 79-year-old male presented with AA instability attributed both to an old odontoid fracture and severe degeneration of the lateral atlantoaxial joints (LAAJs). ATS fixation was performed through the conventional anterior cervical approach. The longest screw trajectories were planned preoperatively using multiplanar reconstruction computed tomography (CT) scans, with entry points of the screws situated at the midpoint on the inferior border of the axial body. The surgical exposure was limited to opening at the entry points alone. Our retractor of choice was the Cusco speculum; it sufficiently secured space for utilizing the required instruments for screw placement while offering sufficient protection of soft tissues. Cannulated full-threaded bicortical screws stabilized the LAAJs. Screw insertion required a significant amount of coronal angulation up to the superior articular process of the atlas under open-mouth and lateral fluoroscopy image guidance. After ATS fixation, bone grafting was performed between the posterior laminae of the axis and the atlas through a conventional posterior approach. Bony fusion between the atlas and the axis was confirmed radiographically. Arthrodesis of the LAAJs occurred despite no bone grafting. Rigid fixation of the LAAJs was obtained by our ATS technique, indicating that it is an alternative method for AA fixation when posterior rigid internal fixation is not applicable.

  18. Basilar invagination secondary to hypoplasia of the clivus - Is there indication for craniocervical fixation?

    Directory of Open Access Journals (Sweden)

    Andrei Fernandes Joaquim

    2014-03-01

    Full Text Available The posterior fossa decompression is a form of treatment suggested for patients with basilar invagination (BI secondary to hypoplasia symptomatic of the clivus and atlantoaxial alignment preserved. Based on the fact that the worsening of cranial-cervical kyphosis (decrease of clivus-canal angle to less than 150o can result in anterior brainstem compression, we propose that some patients may benefit from the cranio-cervical fixation. We present a case report of a patient with BI secondary to clivus hypoplasia who underwent cranio-cervical fixation in extension, with a reduction in clivus-canal angle and improvement of symptoms without posterior fossa decompression.

  19. Iris Claw versus Scleral Fixation Intraocular Lens Implantation during Pars Plana Vitrectomy

    Directory of Open Access Journals (Sweden)

    Fereydoun Farrahi

    2012-01-01

    Full Text Available Purpose: To compare the outcomes of iris claw anterior chamber intraocular lens (ICACIOL with that of scleral fixation posterior chamber intraocular lens (SF-PCIOL implantation during pars plana vitrectomy (PPV as initial surgery to correct aphakia. Methods: Twelve patients with complicated cataract surgery or trauma who had suffered nucleus, whole crystalline lens or intraocular lens (IOL drop into the vitreous cavity, and undergone PPV with IC-ACIOL implantation over a period of one year were evaluated for the purpose of this study. Uncorrected visual acuity (UCVA, best corrected visual acuity (BCVA, central corneal thickness (CCT, spherical equivalent (SE refractive error, astigmatism and complications were recorded. The results were compared to outcomes of another group of 13 patients who had previously undergone PPV with SF-PCIOL implantation. Results: Mean improvement of UCVA was greater in IC-ACIOL eyes as compared to the SF-PCIOL group (-1.17±0.28 versus -0.89±0.21 logMAR, P=0.01, corresponding values for postoperative BCVA were 0.24±0.17 and 0.44±0.22 logMAR (P=0.041, respectively. Average postoperative SE was comparable in the IC-ACIOL and SFPCIOL groups at 0.6±1.03 and 0.56±1.23 diopters, respectively (P=0.290. However, 10 (83.3% IC-ACIOL eyes versus 6 (46.1% SF-PCIOL eyes had SE within 1 diopter of emmetropia (P=0.048. Mean postoperative increase in CCT was comaparble between the study groups (P=0.126. Conclusion: In the absence of sufficient capsular support, the use of an IC-ACIOL for correction of aphakia during PPV can be a good alternative and seems to entail better visual outcomes as compared to SF-PCIOL.

  20. Spondylolisthesis and Posterior Instability

    Energy Technology Data Exchange (ETDEWEB)

    Niggemann, P.; Beyer, H.K.; Frey, H.; Grosskurth, D. (Privatpraxis fuer Upright MRT, Koeln (Germany)); Simons, P.; Kuchta, J. (Media Park Klinik, Koeln (Germany))

    2009-04-15

    We present the case of a patient with a spondylolisthesis of L5 on S1 due to spondylolysis at the level L5/S1. The vertebral slip was fixed and no anterior instability was found. Using functional magnetic resonance imaging (MRI) in an upright MRI scanner, posterior instability at the level of the spondylolytic defect of L5 was demonstrated. A structure, probably the hypertrophic ligament flava, arising from the spondylolytic defect was displaced toward the L5 nerve root, and a bilateral contact of the displaced structure with the L5 nerve root was shown in extension of the spine. To our knowledge, this is the first case described of posterior instability in patients with spondylolisthesis. The clinical implications of posterior instability are unknown; however, it is thought that this disorder is common and that it can only be diagnosed using upright MRI.

  1. 后房型有晶状体眼人工晶状体矫治高度近视眼的3年随访报告%Three-year follow-up of posterior chamber phakic intraocular lens implantation for high myopia

    Institute of Scientific and Technical Information of China (English)

    俞阿勇; 王勤美; 朱双倩; 郑林燕; 薛安全; 苏炎峰

    2010-01-01

    Objective To investigate long-term efficacy and safety ofa posterior chamber phakic intraocular lens (PCPIOL) implantation for high myopia. Methods A consecutive group of 66 eyes in 41 patients with -15.12± 3.93 diopters (D) of myopia was implanted with the ICL PCPIOL (STAAR), and was examined preoperatively and 1, 2, 3 years postoperatively. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, intraocular pressure, and complications were evaluated. Results The implantation was successful in all of 66 eyes. Compared with preoperative data, UCVA, BCVA, and spherical equivalent (SE) were improved significantly. At 3-year postoperatively, UCVA in 86% eyes was 0.5 or better, in 43% was 0.8 or better; No loss of BCVA was found, 11% gained 1 line, and 68% gained 2 lines or more; SE in 96%, 57% eyes was within ± 1.00 D, ± 0.50D of attempted, respectively. At 1-, 2-, 3-year follow-up, the corneal endothelial loss was 9.26%, 12.84%, 18.54%, respectively. No severe complications occurred expect 1macular hemorrhage due to CNV. Conclusions At 3-year follow-up, the implantation of the PCPIOL proved to be safe and effective for the correction of myopia in phakic eyes.%目的 观察后房型有晶状体眼人工晶状体(PCPIOL)矫治高度近视眼的长期安全性和有效性.方法 高度近视眼患者41例(66只眼),等效球镜度数(SE)(-15.12±3.93)D,植入PCPIOL.术后随访3年,观察手术前后的视力、屈光状态、眼压、角膜、前房、瞳孔、PCPIOL和晶状体、眼底情况,并进行比较.结果 与术前比较,术后3、6个月、1、2、3年的裸眼视力(UCVA)、最佳矫正视力(BCVA)和SE显著改善.术后3年时,UCVA≥0.5有86%,≥0.8有43%;BCVA未见下降,11%比术前提高1行,68%比术前提高≥2行;96%眼的实际屈光度数稳定在预期的±1.00D,57%稳定在预期的±0.50D.术后1、2、3年的角膜内皮细胞累积丢失率分别为9.26%、12.84%、18.54%.除了1只眼黄斑出血

  2. New two-point scleral-fixation technique for foldable intraocular lenses with four hollow haptics.

    Science.gov (United States)

    Liu, He-Ting; Jiang, Zheng-Xuan; Tao, Li-Ming

    2016-01-01

    The study was to report a new two-point scleral-fixation technique for foldable intraocular lenses with four haptics. Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points. The postoperative best-corrected visual acuities (BCVAs) of all patients were significantly better than their preoperative BCVA. The results demonstrate that two-point, scleral fixations of foldable, intraocular lenses might be practicable and effective.

  3. Double calcaneal osteotomy with percutaneous Steinmann pin fixation as part of treatment for flexible flatfoot deformity: a review of consecutive cases highlighting our experience with pin fixation.

    Science.gov (United States)

    Boffeli, Troy J; Abben, Kyle W

    2015-01-01

    Surgical correction of flexible flatfoot deformity and posterior tibial tendon dysfunction has been extensively reported in published studies. When appropriate, calcaneal osteotomies for flatfoot correction have been a favorite of foot and ankle surgeons because of the corrective power achieved without the need to fuse any rearfoot joints. The medial displacement calcaneal osteotomy and Evans calcaneal osteotomy, together termed the double calcaneal osteotomy, have been reported several times by various investigators with a wide variety of fixation options. We undertook an institutional review board-approved retrospective review of 9 consecutive patients (11 feet), who had undergone double calcaneal osteotomy with 2 percutaneous Steinmann pin fixation for the correction of flexible flatfoot deformity, with or without posterior tibial tendon dysfunction. All patients had radiographic evidence of bone healing of the posterior calcaneal osteotomy and incorporation of the Evans osteotomy bone graft at 6 weeks and demonstrated clinical healing at 6 weeks. All patients had 2 percutaneous Steinmann pins placed through both osteotomies, and these were removed an average of 6 weeks postoperatively. No patient developed pin site complications. The only complication noted was sural neuritis, which was likely incision related. No patients had delayed union or nonunion, and we did not identify any graft shifting postoperatively. The present retrospective series highlights our experience with 2 percutaneous Steinmann pin fixation, demonstrating equal or better results than many previous published fixation methods for double calcaneal osteotomy. It is cost-effective and minimizes the potential risk of iatrogenic Achilles pathologic features associated with screw fixation.

  4. Posterior tracheal diverticulosis.

    Science.gov (United States)

    Madan, Karan; Das, Chandan J; Guleria, Randeep

    2014-10-01

    Multiple tracheal diverticulosis is a rare clinical entity. Tracheal diverticula are usually recognized radiologically as solitary right paratracheal air collections on thoracic computed tomography examination. They are usually asymptomatic but can occasionally present with persistent symptoms. We herein report the case of a 50-year-old male patient who underwent extensive evaluation for persistent cough. Multiple posterior right paratracheal air collections were recognized on thoracic multidetector computed tomography examination, which was confirmed as multiple-acquired posterior upper tracheal diverticula on flexible bronchoscopy. The patient improved with conservative medical management.

  5. CARBON DIOXIDE FIXATION.

    Energy Technology Data Exchange (ETDEWEB)

    FUJITA,E.

    2000-01-12

    Solar carbon dioxide fixation offers the possibility of a renewable source of chemicals and fuels in the future. Its realization rests on future advances in the efficiency of solar energy collection and development of suitable catalysts for CO{sub 2} conversion. Recent achievements in the efficiency of solar energy conversion and in catalysis suggest that this approach holds a great deal of promise for contributing to future needs for fuels and chemicals.

  6. Improving Carbon Fixation Pathways

    OpenAIRE

    Ducat, Daniel C.; Silver, Pamela A

    2012-01-01

    A recent resurgence in basic and applied research on photosynthesis has been driven in part by recognition that fulfilling future food and energy requirements will necessitate improvements in crop carbon-fixation efficiencies. Photosynthesis in traditional terrestrial crops is being reexamined in light of molecular strategies employed by photosynthetic microbes to enhance the activity of the Calvin cycle. Synthetic biology is well-situated to provide original approaches for compartmentalizing...

  7. DELPHI time projection chamber

    CERN Multimedia

    1989-01-01

    The time projection chamber is inserted inside the central detector of the DELPHI experiment. Gas is ionised in the chamber as a charged particle passes through, producing an electric signal from which the path of the particle can be found. DELPHI, which ran from 1989 to 2000 on the LEP accelerator, was primarily concerned with particle identification.

  8. Fluidized bed combustion chamber

    Energy Technology Data Exchange (ETDEWEB)

    Kullendorff, A.; Wikner, J.

    1985-03-25

    The chamber is confined in a pressure vessel. The lower part of the chamber has tilted parallel gutters up to the height of the fluidized bed. The slope of the gutter walls is 5 degrees-15 degrees and the top area of the gutters is 1.3 to 3 times larger than their bottom.

  9. Target chambers for gammashpere

    Energy Technology Data Exchange (ETDEWEB)

    Carpenter, M.P.; Falout, J.W.; Nardi, B.G. [and others

    1995-08-01

    One of our responsibilities for Gammasphere, was designing and constructing two target chambers and associated beamlines to be used with the spectrometer. The first chamber was used with the early implementation phase of Gammasphere, and consisted of two spun-Al hemispheres welded together giving a wall thickness of 0.063 inches and a diameter of 12 inches.

  10. Climatic chamber ergometer

    CSIR Research Space (South Africa)

    Atkins, AR

    1968-01-01

    Full Text Available The design and calibration of an ergometer for exercising subjects during calorimetric studies in the climate chamber, are described. The ergometer is built into the climatic chamber and forms an integral part of the whole instrumentation system foe...

  11. BEBC bubble chamber

    CERN Multimedia

    1972-01-01

    Looking up into the interior of BEBC bubble chamber from the expansion cylinder. At the top of the chamber two fish-eye lenses are installed and three other fish-eye ports are blanked off. In the centre is a heat exchanger.

  12. The Mobile Chamber

    Science.gov (United States)

    Scharfstein, Gregory; Cox, Russell

    2012-01-01

    A document discusses a simulation chamber that represents a shift from the thermal-vacuum chamber stereotype. This innovation, currently in development, combines the capabilities of space simulation chambers, the user-friendliness of modern-day electronics, and the modularity of plug-and-play computing. The Mobile Chamber is a customized test chamber that can be deployed with great ease, and is capable of bringing payloads at temperatures down to 20 K, in high vacuum, and with the desired metrology instruments integrated to the systems control. Flexure plans to lease Mobile Chambers, making them affordable for smaller budgets and available to a larger customer base. A key feature of this design will be an Apple iPad-like user interface that allows someone with minimal training to control the environment inside the chamber, and to simulate the required extreme environments. The feedback of thermal, pressure, and other measurements is delivered in a 3D CAD model of the chamber's payload and support hardware. This GUI will provide the user with a better understanding of the payload than any existing thermal-vacuum system.

  13. CHAMBER OF COMMERCE INFORMATION

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Experience Japan The Japanese Chamber of Commerce and Industry will further promote its Japan-experience program and seek cooperation with various Chinese institutions.Between early May and June 2007,the chamber organized a Chinese college student delegation to Japan with the support from its members in China.

  14. 椎弓根螺钉内固定材料置入并植骨融合后路矫正治疗重度僵硬性青少年特发性脊柱侧凸20例%Posterior correction using pedicle screw fixation combined with bone grafting and fusion for treatment of severe and rigid adolescent idiopathic scoliosis in 20 cases

    Institute of Scientific and Technical Information of China (English)

    臧危平; 刘祖德; 李展春; 冯宇; 张磊

    2008-01-01

    主弯平均Cobb角从术前的82°(75o~ 92o)矫正到31°(22°~37°),平均矫正率为62%.③双肩高度差及住院时间:术后脊柱侧位片均显示患者胸腰椎基本恢复正常后凸及前凸,平均双肩高度差为7.5 mm(0~11 mm),患者住院日为8~11 d, 平均9 d.④随访结果:所有患者均获术后4年随访,所有侧凸主弯矫正角度未发生丢失,固定节段全部融合,无断钉、断棒发生.结论:单纯后路椎弓根螺钉内固定材料置入并植骨融合术能有效治疗主弯在75o~92o,柔韧性≥ 20%的重度僵硬性青少年特发性脊柱侧凸.%BACKGROUND: Traditional anterior release followed by posterior correction and fusion is frequently used to treat severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve > 65° and flexibility < 34.5%; however, there are a great majority of complications. Whether isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may provide better effects on severe and rigid adolescent idiopathic scoliosis needs to be further studied.OBJECTIVE: To evaluate isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion for the treatment of severe and rigid adolescent idiopathic scoliosis. DESIGN: Case analysis.SETTING: Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiao Tong University.PARTICIPANTS: Twenty patients with severe and rigid adolescent idiopathic scoliosis, including 8 males and 12 females, were selected from Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiaotong University from June 1999 to August 2005. They were 12-18 years old, and the mean age was 14.6 years. All patients were finally diagnosed as X-ray of whole spine. According to King-Moe criteria, patients were classified into type Ⅰ(n =4), type Ⅱ(n =6), type Ⅲ (n =5), type Ⅳ(n =3) and type Ⅴ(n =2). Before surgery, mean Cobb angle of the major curve was 82

  15. Analysis of the safety of phakic posterior chamber contact lens implantation for extreme high myopia%有晶状体眼后房型人工晶状体植入术矫正超高度近视的安全性

    Institute of Scientific and Technical Information of China (English)

    罗栋强; 王华; 陶思思; 何书喜; 陈蛟

    2014-01-01

    目的 评估有晶状体眼后房型人工晶状体(PPC-ICL)植入术矫正超高度近视的安全性.方法 回顾性系列病例研究.对接受普通型PPC-ICL或散光型PPC-TICL植入矫正手术的超高度近视患者32例(64眼),术前球镜度-10.0~-19.0 D,柱镜度0.0~-3.0 D,等效球镜度为(-15.16±3.15)D,术后随访2年,观察指标包括UCVA、BCVA、屈光度、眼压、角膜内皮细胞计数、中央前房深度(ACD)、前房角(ACA)宽度、PPC-ICL拱高及晶状体透明度.手术前后数据比较采用配对t检验.结果 术后2年所有患者UCVA较术前明显提高,等效球镜度小于±1.0 D者达75%(48眼).术前患者眼压平均为(15.0±3.6)mmHg,术后2年平均为(16.0±3.3)mmHg,术前术后相比差异无统计学意义(t=0.474,P>0.05),术前患者ACD平均为(3.14±0.19)mm,术后2年平均为(2.70±0.26) mm,两者相比差异有统计学意义(t=6.327,P<0.05).术前ACA宽度平均45.00°±7.19°,术后平均32.80°±6.75°,术后ACA宽度较术前降低,平均减少13.20°±6.17°,术前术后相比差异有统计学意义(t=6.686,P<0.05).术前患者角膜内皮细胞计数平均为(2 844±266)个/mm2,术后2年平均为(2 729±255)个/mm2,术前术后比较差异无统计学意义(t=0.606,P>0.05).术后位于理想拱高(250~750 μm)者58眼,占总眼数91%.术后2眼发生晶状体前囊下混浊,无继发性青光眼和视网膜脱离发生.结论 PPC-ICL植入术矫正超高度近视具有良好的安全性.%Objective To analyze the safety of phakic posterior chamber implantable contact lens (PPC-ICL) implantation for extreme high myopia.Methods This study was a retrospective analysis.Spheric PPC-ICL or toric PPC-ICL implantation was performed in 64 eyes of 32 patients with extreme high myopia.The spherical refraction of these patients was-10.0 to-19.0 D and cylinder refraction was 0 to-3.00 D.Uncorrected visual acuity (UCVA),best-corrected visual acuity (BCVA),slit-lamp examination,intraocular pressure

  16. Cervical pedicle screw fixation at C6 and C7 A cadaveric study

    Directory of Open Access Journals (Sweden)

    Ye Li

    2015-01-01

    Conclusion: The intersection of the horizontal line through the midpoint of the transverse process root and vertical line through the intersection of the posterolateral and posterior planes of the isthmus can be used as an entry point for C6 and C7 pedicle screw fixation. The screws should be inserted at 60 or 90° with the posterolateral isthmus in the horizontal plane and at 75° with the posterior isthmus in the sagittal plane. The LSC should not exceed 30 mm.

  17. Congenital absence of the posterior elements of C2 vertebra: A case report

    Directory of Open Access Journals (Sweden)

    Trivedi P

    2003-04-01

    Full Text Available A rare case of the complete absence of the posterior elements of C2 is reported. The patient presented with neck pain without any neurological deficits and radiology revealed a mobile, partially reducible dislocation of the C2 over C3 vertebra. A posterior fusion utilizing a contour rod, sublaminar wire fixation, and onlay bone grafts between the occiput and the C3 vertebra was performed for spinal stability.

  18. Posterior Urethral Valves

    Directory of Open Access Journals (Sweden)

    Steve J. Hodges

    2009-01-01

    Full Text Available The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality for this disorder has improved due to early diagnosis and intensive neonatal care, thanks in part to the widespread use of prenatal ultrasound evaluations. In fact, the most common reason for the diagnosis of posterior urethral valves presently is the evaluation of infants for prenatal hydronephrosis. Since these children are often diagnosed early, the urethral obstruction can be alleviated rapidly through catheter insertion and eventual surgery, and their metabolic derangements can be normalized without delay, avoiding preventable infant mortality. Of the children that survive, however, early diagnosis has not had much effect on their long-term prognosis, as 30% still develop renal insufficiency before adolescence. A better understanding of the exact cause of the congenital obstruction of the male posterior urethra, prevention of postnatal bladder and renal injury, and the development of safe methods to treat urethral obstruction prenatally (and thereby avoiding the bladder and renal damage due to obstructive uropathy are the goals for the care of children with posterior urethral valves[1].

  19. Stability of extraoral vertical ramus osteotomy: plate fixation versus maxillomandibular/skeletal suspension wire fixation.

    Science.gov (United States)

    Mobarak, K A; Krogstad, O; Espeland, L; Lyberg, T

    2000-01-01

    The objective of this cephalometric study was to evaluate skeletal stability and time course of postoperative changes in 2 groups of mandibular prognathism patients following extraoral oblique vertical ramus osteotomy (VRO). One group (n = 22) received maxillomandibular fixation and skeletal suspension wires (MMF group) for a period of 8 weeks. In the other group (n = 22), the segments were rigidly fixed with plates and the patients were allowed to function immediately after surgery. Lateral cephalograms were taken on 5 occasions: immediately presurgical, immediately postsurgical, 8 weeks postsurgical, 6 months postsurgical, and 1 year postsurgical. During the first 8 weeks after surgery, the MMF group demonstrated posterior movement of the mandible, with an increase in mandibular plane angle, shortening of the rami, and dental compensations. Upon release of MMF and skeletal suspension wiring, a small anterior relapse tendency was observed, but the net setback 1 year after surgery was still greater than the actual surgical setback. In the plate fixation group, postoperative changes were mainly in the form of a small anterior relapse tendency in the range of 10% of the surgical setback. The results indicate that the use of plate fixation with VRO, while eliminating the inconvenience for the patient of several weeks of MMF and preventing the early side effects observed in the MMF group, also resulted in a more predictable surgical procedure, with excellent stability 1 year after surgery.

  20. Arthroscopic Repair of a Posterior Bony Bankart Lesion.

    Science.gov (United States)

    Poehling-Monaghan, Kirsten L; Krych, Aaron J; Dahm, Diane L

    2015-12-01

    Posterior bony defects of the glenoid rim, particularly those associated with instability, are often a frustrating challenge for arthroscopists because of the defects' inaccessibility from standard portals. This challenge is enhanced when the lesion is chronic and fibrous malunion of the fragment makes mobilization difficult. We present our technique for arthroscopic repair of the relatively uncommon chronic posterior bony Bankart lesion. By use of lateral positioning and a standard anterior viewing portal and posterior working portal, as well as a strategically placed posterolateral accessory portal, the lesion is first freed from its malreduced position and ultimately repaired using suture anchor fixation of the bony fragment along with its associated labrum directly to the remaining glenoid rim. This technique, facilitated by precise portal placement, results in satisfactory fragment reduction, appropriate capsular tension, and restoration of anatomy.

  1. Acute bony bankart lesion and surgical fixation.

    Science.gov (United States)

    Rosenthal, Michael D; Provencher, Matthew T

    2009-10-01

    The patient was a 25-year-old man who sustained a traumatic left anterior shoulder dislocation. After self-reducing the first time, as well as in subsequent repeated dislocations over the following 2-day period, the patient reported his injury to the medical staff, who sent him to the physical therapist for evaluation. Anterior-posterior, scapular outlet, and axillary radiographic views demonstrated a bony glenoid lesion consistent with a bony Bankart lesion, which was best seen on the scapular outlet view. A 3-dimensional computed tomography scan was performed to assess the size and displacement of the bony Bankart lesion. Six days following injury, the patient underwent operative fixation of the bony Bankart lesion. Following surgery, the patient completed 5 months of physical therapy and subsequently returned to high-demand upper body activities. At 3 years following surgery, the patient reported full functional ability without shoulder instability or pain.

  2. Current concepts review: the posterior cruciate ligament.

    Science.gov (United States)

    Fanelli, Gregory C; Beck, John D; Edson, Craig J

    2010-06-01

    Injuries to the posterior cruciate ligament (PCL) and methods of treatment of the injured PCL have historically been surrounded by controversy in the orthopedic community. The infrequent occurrence of PCL injuries and PCL-based, multiple ligament knee injuries has led to limitations in clinical studies and a subsequent lag in basic science and clinical research compared with that for other ligamentous injuries. In recent years, new studies have elucidated the biomechanical function and complex anatomy of the PCL leading to an increased interest in research, understanding, and treatment of these complex injuries. In addition to improved understanding of knee ligament structure and biomechanics, technical advancements in allograft tissue, surgical instrumentation, and graft tensioning and fixation methods and improved surgical techniques and postoperative rehabilitation methods have enhanced the results in PCL reconstruction and PCL-based, multiple ligament knee surgical outcomes.

  3. Posterior cruciate ligament: focus on conflicting issues.

    Science.gov (United States)

    Lee, Yong Seuk; Jung, Young Bok

    2013-12-01

    There is little consensus on how to optimally reconstruct the posterior cruciate ligament (PCL) and the natural history of injured PCL is also unclear. The graft material (autograft vs. allograft), the type of tibial fixation (tibial inlay vs. transtibial tunnel), the femoral tunnel position within the femoral footprint (isometric, central, or eccentric), and the number of bundles in the reconstruction (1 bundle vs. 2 bundles) are among the many decisions that a surgeon must make in a PCL reconstruction. In addition, there is a paucity of information on rehabilitation after reconstruction of the PCL and posterolateral structures. This article focused on the conflicting issues regarding the PCL, and the scientific rationales behind some critical points are discussed.

  4. Ipsilateral Traumatic Posterior Hip Dislocation, Posterior Wall and Transverse Acetabular Fracture with Trochanteric Fracture in an adult: Report of First Case

    Directory of Open Access Journals (Sweden)

    Skand Sinha

    2013-10-01

    Full Text Available Introduction: Posterior dislocation of the hip joint with associated acetabular and intertrochanteric fracture is a complex injury. Early recognition, prompt and stable reduction is needed of successful outcome. Case Report: 45 year old male patient presented with posterior dislocation of the hip with transverse fracture with posterior wall fracture of acetabulam and intertrochanteric fracture on the ipsilateral side. The complex fracture geometry was confirmed by CT scan. The patient was successfully managed by open reduction and internal fixation of intertrochanteric fracture was achieved with dynamic hip screw (DHS plate fixation followed by fixation of acetabular fracture with reconstruction plate. Conclusion: Hip dislocation combined with acetabular fracture is an uncommon injury; this article presents a unique case of posterior wall and transverse fractures of ipsilateral acetabulum with intertrochanteric fracture in a patient who sustained traumatic posterior hip dislocation. Early surgical intervention is important for satisfactory outcomes of such complex fracture-dislocation injuries. Keywords: Hip dislocation; acetabular fractures; intertrochanteric fracture; operative treatment.

  5. PS wire chamber

    CERN Multimedia

    1970-01-01

    A wire chamber used at CERN's Proton Synchrotron accelerator in the 1970s. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  6. OPAL Jet Chamber Prototype

    CERN Multimedia

    OPAL was one of the four experiments installed at the LEP particle accelerator from 1989 - 2000. OPAL's central tracking system consists of (in order of increasing radius) a silicon microvertex detector, a vertex detector, a jet chamber, and z-chambers. All the tracking detectors work by observing the ionization of atoms by charged particles passing by: when the atoms are ionized, electrons are knocked out of their atomic orbitals, and are then able to move freely in the detector. These ionization electrons are detected in the dirfferent parts of the tracking system. This piece is a prototype of the jet chambers

  7. ALICE Time Projection Chamber

    CERN Multimedia

    Lippmann, C

    2013-01-01

    The Time Projection Chamber (TPC) is the main device in the ALICE 'central barrel' for the tracking and identification (PID) of charged particles. It has to cope with unprecedented densities of charges particles.

  8. Vacuum chamber 'bicone'

    CERN Multimedia

    1977-01-01

    This chamber is now in the National Museum of History and Technology, Smithsonian Institution, Washington, DC, USA, where it was exposed in an exhibit on the History of High Energy Accelerators (1977).

  9. High rate drift chambers

    Energy Technology Data Exchange (ETDEWEB)

    Christian, D.C. (Fermilab, Batavia, IL 60510 (United States)); Berisso, M.C. (Fermilab, Batavia, IL 60510 (United States)); Gutierrez, G. (Fermilab, Batavia, IL 60510 (United States)); Holmes, S.D. (Fermilab, Batavia, IL 60510 (United States)); Wehmann, A. (Fermilab, Batavia, IL 60510 (United States)); Avilez, C. (Instituto de Fisica, Universidad de Guanajuato, Leon, Guanajuato (Mexico)); Felix, J. (Instituto de Fisica, Universidad de Guanajuato, Leon, Guanajuato (Mexico)); Moreno, G. (Instituto de Fisica, Universidad de Guanajuato, Leon, Guanajuato (Mexico)); Romero, M. (Instituto de Fisica, Universidad de Guanajuato, Leon, Guanajuato (Mexico)); Sosa, M. (Instituto de Fisica, Universidad de Guanajuato, Leon, Guanajuato (Mexico)); Forbush, M. (Department of Physics, Texas A and M University, College Station, TX 77843 (United States)); Huson, F.R. (Department of Physics, Texas A and M University, College Station, TX 77843 (United States)); Wightman, J.A. (Department of Physi

    1994-06-01

    Fermilab experiment 690, a study of target dissociation reactions pp[yields]pX using an 800 GeV/c proton beam and a liquid hydrogen target, collected data in late 1991. The incident beam and 600-800 GeV/c scattered protons were measured using a system of six 6 in.x4 in. and two 15 in.x8 in. pressurized drift chambers spaced over 260 m. These chambers provided precise measurements at rates above 10 MHz (2 MHz per cm of sense wire). The measurement resolution of the smaller chambers was 90 [mu]m, and the resolution of the larger chambers was 125 [mu]m. Construction details and performance results, including radiation damage, are presented. ((orig.))

  10. Toxic Test Chambers

    Data.gov (United States)

    Federal Laboratory Consortium — Description/History: Hazardous material test facility Both facilities have 16,000 cubic foot chambers, equipped with 5000 CFM CBR filter systems with an air change...

  11. Bubble chamber: antiproton annihilation

    CERN Multimedia

    1971-01-01

    These images show real particle tracks from the annihilation of an antiproton in the 80 cm Saclay liquid hydrogen bubble chamber. A negative kaon and a neutral kaon are produced in this process, as well as a positive pion. The invention of bubble chambers in 1952 revolutionized the field of particle physics, allowing real tracks left by particles to be seen and photographed by expanding liquid that had been heated to boiling point.

  12. Biomechanical evaluation of three fixation modalities for preperitoneal inguinal hernia repair: a 24-hour postoperative study in pigs

    Directory of Open Access Journals (Sweden)

    Guérin G

    2014-12-01

    Full Text Available Gaëtan Guérin, Xavier Bourges, Frédéric Turquier Covidien-Surgical Solutions, Research and Development, Trévoux, France Purpose: Tacks and sutures ensure a strong fixation of meshes, but they can be associated with pain and discomfort. Less invasive methods are now available. Three fixation modalities were compared: the ProGrip™ laparoscopic self-fixating mesh; the fibrin glue Tisseel™ with Bard™ Soft Mesh; and the SorbaFix™ absorbable fixation system with Bard™ Soft Mesh. Materials and methods: Meshes (6 cm ×6 cm were implanted in the preperitoneal space of swine. Samples were explanted 24 hours after surgery. Centered defects were created, and samples (either ten or eleven per fixation type were loaded in a pressure chamber. For each sample, the pressure, the mesh displacement through the defect, and the measurements of the contact area were recorded. Results: At all pressures tested, the ProGrip™ laparoscopic self-fixating mesh both exhibited a significantly lower displacement through the defect and retained a significantly higher percentage of its initial contact area than either the Bard™ Soft Mesh with Tisseel™ system or the Bard™ Soft Mesh with SorbaFix™ absorbable fixation system. Dislocations occurred with the Bard™ Soft Mesh with Tisseel™ system and with the Bard™ Soft Mesh with SorbaFix™ absorbable fixation system at physiological pressure (<225 mmHg. No dislocation was recorded for the ProGrip™ laparoscopic self-fixating mesh. Conclusion: At 24 hours after implantation, the mechanical fixation of the ProGrip™ laparoscopic self-fixating mesh was found to be significantly better than the fixation of the Tisseel™ system or the SorbaFix™ absorbable fixation system. Keywords: hernia, mesh, fixation, ProGrip™ laparoscopic self-fixating mesh

  13. Posterior capsule opacification and neovascularization treated with intravitreal bevacizumab and Nd:YAG capsulotomy

    Science.gov (United States)

    Sánchez-Castro, Grimelda Yuriana; Hitos-Fájer, Alejandra; Mendoza-Schuster, Erick; Velez-Montoya, Raul; Velasco-Barona, Cecilio Francisco

    2008-01-01

    We reported a 75-year-old diabetic man, who developed opacification and neovascularization of the posterior capsule after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The patient was treated with two injections of 2.5 mg of intravitreal bevacizumab. The treatment produced an important regression of the posterior capsular new vessels, allowing us to perform a successful Nd:YAG capsulotomy, clearing the visual axis and improving the visualization of the posterior pole. Even though, best corrected visual acuity was 20/200 due to diabetic macular edema. PMID:19668770

  14. [Posterior cortical atrophy].

    Science.gov (United States)

    Solyga, Volker Moræus; Western, Elin; Solheim, Hanne; Hassel, Bjørnar; Kerty, Emilia

    2015-06-02

    Posterior cortical atrophy is a neurodegenerative condition with atrophy of posterior parts of the cerebral cortex, including the visual cortex and parts of the parietal and temporal cortices. It presents early, in the 50s or 60s, with nonspecific visual disturbances that are often misinterpreted as ophthalmological, which can delay the diagnosis. The purpose of this article is to present current knowledge about symptoms, diagnostics and treatment of this condition. The review is based on a selection of relevant articles in PubMed and on the authors' own experience with the patient group. Posterior cortical atrophy causes gradually increasing impairment in reading, distance judgement, and the ability to perceive complex images. Examination of higher visual functions, neuropsychological testing, and neuroimaging contribute to diagnosis. In the early stages, patients do not have problems with memory or insight, but cognitive impairment and dementia can develop. It is unclear whether the condition is a variant of Alzheimer's disease, or whether it is a separate disease entity. There is no established treatment, but practical measures such as the aid of social care workers, telephones with large keypads, computers with voice recognition software and audiobooks can be useful. Currently available treatment has very limited effect on the disease itself. Nevertheless it is important to identify and diagnose the condition in its early stages in order to be able to offer patients practical assistance in their daily lives.

  15. External fixators in haemophilia.

    Science.gov (United States)

    Lee, V; Srivastava, A; PalaniKumar, C; Daniel, A J; Mathews, V; Babu, N; Chandy, M; Sundararaj, G D

    2004-01-01

    External fixators (EF) are not commonly used for patients with haemophilia. We describe the use of EF (Ilizarov, AO- uni- and bi-planar fixators and Charnley clamp) in nine patients (mean age: 19.2 years; range: 9-37) with haemophilia for the following indications - arthrodesis of infected joints, treatment of open fractures and osteoclasis. EF required an average of nine skin punctures [range: 4-17 were maintained for a period of 15 weeks (range: 8-29.5), without regular factor replacement, till bone healing was adequate and were removed with a single dose of factor infusion]. The mean preoperative factor level achieved was 85% (range: 64-102%). Much lower levels were subsequently maintained till wound healing. The average total factor consumption was 430 IU kg(-1) (range: 240-870), administered over a period of 17 days (range: 9-44). There were no major complications related to EF except in a patient who developed inhibitors. In conclusion, EF can be used safely in haemophilic patients who do not have inhibitors and does not require prolonged factor replacement.

  16. Minimal-invasive posterior approach in the treatment of the posterior wall fractures of the acetabulum.

    Science.gov (United States)

    Spagnolo, Rosario; Bonalumi, Matteo; Pace, Fabrizio; Capitani, Dario

    2009-05-01

    We examined patients affected by a posterior wall fracture of the acetabulum treated with a minimally invasive posterior approach (from 12 to 18 cm). During 2004-2006 19 patients were treated by this approach. 4 patients had a combined surgery by the ileo-inguinal approach. Fracture fixation was performed using reconstruction plates and screws. All the patients were studied with typical X-rays projection for pelvis and iliac oblique view and obturator oblique view (Judet view) and CT scan with 3D reconstruction. After 3 months a CT scan was performed on about 30% of our patients, which demonstrated the perfect healing of the fractures. The most important advantages we observed using this approach were a lesser split of the gluteus maximus and no risk of damage for the superior gluteal nerve. In the early post-operative rehabilitation we examined the trophism of the gluteus maximus, which was found to be better than in patients treated with the typical Kocher-Langenbeck approach. The only absolute contraindication for this technique is in obese patients. The post-operative complications include one case of heterotypic ossification of the gluteus minimus and one case of peroneal-nerve palsy with the spontaneous and complete recovery within 6 months. According to our experience this kind of approach could be used for posterior wall fracture of the pelvis and it can be extended to transverse fractures. In the post-operative period the greatest advantage is the lesser muscle damage and therefore a most effective rehabilitation.

  17. Flexible fixation and fracture healing

    DEFF Research Database (Denmark)

    Schmal, Hagen; Strohm, Peter C; Jaeger, Martin

    2011-01-01

    to the bone surface than external fixator bars. External fixators have the advantage of being less expensive, highly flexible, and technically less demanding. They remain an integral part of orthopaedic surgery for emergent stabilization, for pediatric fractures, for definitive osteosynthesis in certain...

  18. Eighth international congress on nitrogen fixation

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    This volume contains the proceedings of the Eighth International Congress on Nitrogen Fixation held May 20--26, 1990 in Knoxville, Tennessee. The volume contains abstracts of individual presentations. Sessions were entitled Recent Advances in the Chemistry of Nitrogen Fixation, Plant-microbe Interactions, Limiting Factors of Nitrogen Fixation, Nitrogen Fixation and the Environment, Bacterial Systems, Nitrogen Fixation in Agriculture and Industry, Plant Function, and Nitrogen Fixation and Evolution.

  19. Clamping stiffness and its influence on load distribution between paired internal spinal fixation devices.

    Science.gov (United States)

    Rohlmann, A; Calisse, J; Bergmann, G; Radvan, J; Mayer, H M

    1996-06-01

    The load distribution between two internal spinal fixation devices depends, besides other factors, on their stiffness. The stiffness ranges were determined experimentally for the clamps of the AO internal fixator with lateral nut and with posterior nut as well as for the clamps of the SOCON fixator. The stiffness of eight devices each differed by a factor of 3.1 for the clamp with lateral nut, by a factor of 1.5 for the clamp with posterior nut, and by a factor of 1.4 for the clamp of the SOCON fixator. For the AO clamp with lateral nut, the influence of the nut-tightening torque on the stiffness was determined. Using instrumented internal spinal fixation devices mounted to plastic vertebrae and simulating a corpectomy, the load distribution between the implants was measured for different tightening torques. It could be shown that, for the AO internal fixator whose clamps have a lateral nut, a nut-tightening torque > 5 Nm has only a negligible influence on load-sharing between the implants. Tooth damage occurs when the teeth of the clamp body and clamping jaw of the clamp with lateral nut do not gear together exactly, which leads to changes in the clamping stiffness and load-sharing between the two implants.

  20. Mixing processes in the vitreous chamber induced by eye rotations

    Science.gov (United States)

    Stocchino, Alessandro; Repetto, Rodolfo; Siggers, Jennifer H.

    2010-01-01

    In this paper, we study a model of flow in the vitreous humour in the posterior chamber of the human eye, induced by saccadic eye rotations. We concentrate on the effect of the shape of the chamber upon the mixing properties of the induced flows. We make particle image velocimetry measurements of the fluid velocity in a transparent plastic (Perspex) model of the posterior chamber during sinusoidal torsional oscillations about a vertical axis. We use a Newtonian fluid to model the vitreous humour, which is most realistic when either the vitreous humour is liquefied or has been replaced by purely viscous tamponade fluids. The model of the posterior chamber is a sphere with an indentation, representing the effect of the lens. In spite of the purely periodic forcing, a steady streaming flow is generated, which plays a fundamental role in the mixing processes in the domain. The streaming flow differs markedly from that in a perfect sphere, and its topological characteristics change substantially as the frequency of oscillation varies. We discuss the flow characteristics in detail and show that, for physiological parameter values, the Péclet number (based on a suitable measure of the steady streaming velocity) is large, suggesting that advection strongly dominates over diffusion for mass transport phenomena. We also compute particle trajectories based on the streaming velocity and use these to investigate the stirring properties of the flow.

  1. Mixing processes in the vitreous chamber induced by eye rotations

    Energy Technology Data Exchange (ETDEWEB)

    Stocchino, Alessandro [Department of Civil, Environmental and Architectural Engineering, University of Genoa (Italy); Repetto, Rodolfo [Department of Engineering of Structures, Water and Soil, University of L' Aquila (Italy); Siggers, Jennifer H [Department of Bioengineering, Imperial College London, London SW7 2AZ (United Kingdom)], E-mail: jorma@diam.unige.it

    2010-01-21

    In this paper, we study a model of flow in the vitreous humour in the posterior chamber of the human eye, induced by saccadic eye rotations. We concentrate on the effect of the shape of the chamber upon the mixing properties of the induced flows. We make particle image velocimetry measurements of the fluid velocity in a transparent plastic (Perspex) model of the posterior chamber during sinusoidal torsional oscillations about a vertical axis. We use a Newtonian fluid to model the vitreous humour, which is most realistic when either the vitreous humour is liquefied or has been replaced by purely viscous tamponade fluids. The model of the posterior chamber is a sphere with an indentation, representing the effect of the lens. In spite of the purely periodic forcing, a steady streaming flow is generated, which plays a fundamental role in the mixing processes in the domain. The streaming flow differs markedly from that in a perfect sphere, and its topological characteristics change substantially as the frequency of oscillation varies. We discuss the flow characteristics in detail and show that, for physiological parameter values, the Peclet number (based on a suitable measure of the steady streaming velocity) is large, suggesting that advection strongly dominates over diffusion for mass transport phenomena. We also compute particle trajectories based on the streaming velocity and use these to investigate the stirring properties of the flow.

  2. Use of pars plana vitrectomy with phacoemulsification in vitreous cavity to treat complete posterior dislocation of lens

    Directory of Open Access Journals (Sweden)

    Mutoh T

    2011-07-01

    Full Text Available Tetsuya Mutoh, Yukihiro Matsumoto, Makoto ChikudaDepartment of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, JapanBackground: The purpose of this study was to evaluate pars plana vitrectomy (PPV with phacoemulsification in the vitreous cavity for treatment of complete posterior dislocation of the lens without any damage to the lens capsule.Methods: We evaluated factors such as cause of dislocation, scleral fixation of an intraocular lens (IOL, preoperative and postoperative visual acuity, corneal endothelial cell density, and intraoperative and postoperative complications.Results: Displacement in the eleven eyes studied was mostly caused by ocular trauma and was idiopathic (four eyes each. Scleral fixation of the IOL was performed in seven of the eyes during first-time PPV. Visual acuity was improved in two eyes, unchanged in eight eyes, and worse in one eye. Mean corneal endothelial cell density was 2485 cells/mm2 preoperatively and 2301 cells/mm2 postoperatively. No significant differences were seen before and after the surgeries (P = 0.15, paired t-test. Intraoperative complications included retinal detachment and suprachoroidal hemorrhage in one eye each. The most common postoperative complication was transient ocular hypertension, which occurred in three eyes. IOL dislocation and vitreous incarceration of the anterior chamber in one eye required a second operation, while retinal detachment in one eye required a third operation.Conclusion: When treating a completely dislocated lens, prevention of retinal detachment which subsequently can affect the visual prognosis is the most important factor to be addressed after PPV with intravitreal phacoemulsification.Keywords: lens dislocation, pars plana vitrectomy, phacoemulsification in the vitreous cavity, retinal detachment

  3. Improved Rhenium Thrust Chambers

    Science.gov (United States)

    O'Dell, John Scott

    2015-01-01

    Radiation-cooled bipropellant thrust chambers are being considered for ascent/ descent engines and reaction control systems on various NASA missions and spacecraft, such as the Mars Sample Return and Orion Multi-Purpose Crew Vehicle (MPCV). Currently, iridium (Ir)-lined rhenium (Re) combustion chambers are the state of the art for in-space engines. NASA's Advanced Materials Bipropellant Rocket (AMBR) engine, a 150-lbf Ir-Re chamber produced by Plasma Processes and Aerojet Rocketdyne, recently set a hydrazine specific impulse record of 333.5 seconds. To withstand the high loads during terrestrial launch, Re chambers with improved mechanical properties are needed. Recent electrochemical forming (EL-Form"TM") results have shown considerable promise for improving Re's mechanical properties by producing a multilayered deposit composed of a tailored microstructure (i.e., Engineered Re). The Engineered Re processing techniques were optimized, and detailed characterization and mechanical properties tests were performed. The most promising techniques were selected and used to produce an Engineered Re AMBR-sized combustion chamber for testing at Aerojet Rocketdyne.

  4. Posterior coronal plating for tibial fractures: technique and advantages

    Directory of Open Access Journals (Sweden)

    Montu Jain

    2014-04-01

    Full Text Available Objective:Tibial shaft fractures are straightforward to treat but when associated with soft tissue injury particularly at the nail entry/plate insertion site or there is significant comminution proximally or a large butterfly fragment/a second split component in the posterior coronal plane, it is a challenge to the treating surgeon. The aim of the present report is to describe the technique of posterior coronal plating in such a scenario and its advantages. Methods:Between July 2008 and June 2011, 12 patients were pro spectively treated by this approach using 4.5 mm broad dynamic compression plates. Results:The time of bony consolidation and full weight bearing averaged 21.7 weeks (range, 16-26 weeks. Patients were followed up for at least 24 months (range, 24-48 months. At 1 year postoper atively, no loss in reduction or alignment was observed. Mean Hospital for Lower Extremity Measurement Functional Score was 72.8 (range, 64-78. All patients were satisfied with their treatment outcomes. Conclusion:Direct posterior approach and fixation using prone position helps to visualise the fracture fragments and provide rigid fixation. The approach is simple and extensile easily, apart from advantages of less soft tissue and hardware problems compared to standard medial or lateral plating. Key words: Tibial fractures; Bone plates; Orthopedic procedures

  5. Reversible posterior leukoencephalopathy syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ja; Yu, Won Jong; Ahn, Kook Jin; Jung, So Lyung; Lee, Yeon Soo; Kim, Ji Chang; Kang, Si Won [The Catholic Univ. of Korea, Taejon (Korea, Republic of); Song, Chang Joon [Chungnam National Univ. School of Medicine, Cheonju (Korea, Republic of); Song, Soon-Young; Koo, Ja Hong [Kwandong Univ. College of Medicine, Myungji Hospital, Seoul (Korea, Republic of); Kim, Man Deuk [College of Medicine Pochon CHA Univ., Seoul (Korea, Republic of)

    2001-10-01

    To review reversible posterior leukoencephalopathy syndrome. We reviewed 22 patients (M:F=3:19; age, 17-46 years) with the characteristic clinical and imaging features of reversible posterior leukoencephalopathy syndrome. All underwent brain MRI, and in three cases both CT and MRI were performed. In one, MRA was obtained, and in eleven, follow-up MR images were obtained. We evaluated the causes of this syndrome, its clinical manifestations, and MR findings including the locations of lesions, the presence or absence of contrast enhancement, and the changes seen at follow-up MRI. Of the 22 patients, 13 had eclampsia (six during pregnancy and seven during puerperium). Four were receiving immunosuppressive therapy (three, cyclosporine ; one, FK 506). Four suffered renal failure and one had complicated migraine. The clinical manifestations included headache (n=12), visual disturbance (n=13), seizure (n=15), focal neurologic sign (n=3), and altered mental status (n=2). Fifteen patients had hypertension and the others normotension. MRI revealed that lesions were bilateral (n=20) or unilateral (n=2). In all patients the lesion was found in the cortical and subcortical areas of the parieto-occipital lobes ; other locations were the basal ganglia (n=9), posterior temporal lobe (n=8), frontal lobe (n=5), cerebellum (n=5), pons (n=2), and thalamus (n=1). All lesions were of high signal intensity on T2-weighted images, and of iso to low intensity on T1-weighted images. One was combined with acute hematoma in the left basal ganglia. In eight of 11 patients who underwent postcontrast T1-weighted MRI, there was no definite enhancement ; in one, enhancement was mild, and in tow, patchy. CT studies showed low attenuation, and MRA revealed mild vasospasm. The symptoms of all patients improved. Follow-up MRI in nine of 11 patients depicted complete resolution of the lesions ; in two, small infarctions remained but the extent of the lesions had decreased. Reversible posterior

  6. DELPHI Barrel Muon Chamber Module

    CERN Multimedia

    1989-01-01

    The module was used as part of the muon identification system on the barrel of the DELPHI detector at LEP, and was in active use from 1989 to 2000. The module consists of 7 individual muons chambers arranged in 2 layers. Chambers in the upper layer are staggered by half a chamber width with respect to the lower layer. Each individual chamber is a drift chamber consisting of an anode wire, 47 microns in diameter, and a wrapped copper delay line. Each chamber provided 3 signal for each muon passing through the chamber, from which a 3D space-point could be reconstructed.

  7. Biomechanical comparison of posterior cruciate ligament reconstruction techniques using cyclic loading tests.

    Science.gov (United States)

    Hiraga, Yasuharu; Ishibashi, Yasuyuki; Tsuda, Eiichi; Toh, Harehiko Tsukada Satoshi

    2006-01-01

    Posterior tibial translation (PTT) of the posterior cruciate ligament (PCL) reconstructed-knee under cyclic loading of 1,000 cycles with a 100-N load was compared between four different procedures, including two reconstructions with patellar tendon graft (transtunnel and inlay techniques) and two reconstructions with hamstring tendon graft (Endobutton and EndoPearl techniques) in twelve fresh-frozen human knees. The EndoPearl technique is a direct tendon fixation using biodegradable interference screws and an anchoring device, while the Endobutton technique is an indirect tendon fixation using a titanium button and surgical tape. The change of PTT after cyclic loading in the Endobutton technique was significantly greater than in the other reconstruction technique. No graft rupture at the killer turn or complete pullout from the bone tunnel was found. The advantage of the inlay technique compared to the transtunnel technique with respect to the posterior stability could not be shown in the current study. Posterior laxity of PCL reconstructed-knees with hamstring tendon graft using the Endobutton technique increased more easily than that with patellar tendon graft. For PCL reconstruction using the hamstring tendon graft, anatomical fixation may be preferable to prevent excessive posterior laxity in the early phase of the rehabilitation protocol.

  8. Case of late-onset corneal decompensation after iris-fixated phakic intraocular lens implantation.

    NARCIS (Netherlands)

    Eijden, R. van; Vries, N.E. de; Cruysberg, L.P.J.; Webers, C.A.; Berenschot, T.; Nuijts, R.M.

    2009-01-01

    A 48-year-old myopic patient with bilateral anterior chamber depth of 3.1 mm and endothelial cell density (ECD) of 2525 cells/mm(2) and 2638 cells/mm(2) preoperatively had bilateral implantation of an Artisan iris-fixated phakic intraocular lens (pIOL). Five years postoperatively, unilateral corneal

  9. The KLOE drift chamber

    Energy Technology Data Exchange (ETDEWEB)

    Adinolfi, M.; Aloisio, A.; Ambrosino, F.; Andryakov, A.; Antonelli, A.; Antonelli, M.; Anulli, F.; Bacci, C.; Bankamp, A.; Barbiellini, G.; Bellini, F.; Bencivenni, G.; Bertolucci, S.; Bini, C.; Bloise, C.; Bocci, V.; Bossi, F.; Branchini, P.; Bulychjov, S.A.; Cabibbo, G.; Calcaterra, A.; Caloi, R.; Campana, P.; Capon, G.; Carboni, G.; Cardini, A.; Casarsa, M.; Cataldi, G.; Ceradini, F.; Cervelli, F.; Cevenini, F.; Chiefari, G.; Ciambrone, P.; Conetti, S.; Conticelli, S.; Lucia, E. De; Robertis, G. De; Sangro, R. De; Simone, P. De; Zorzi, G. De; Dell' Agnello, S.; Denig, A.; Domenico, A. Di; Donato, C. Di; Falco, S. Di; Doria, A.; Drago, E.; Elia, V.; Erriquez, O.; Farilla, A.; Felici, G.; Ferrari, A.; Ferrer, M.L.; Finocchiaro, G.; Forti, C.; Franceschi, A.; Franzini, P.; Gao, M.L.; Gatti, C.; Gauzzi, P.; Giovannella, S.; Golovatyuk, V.; Gorini, E.; Grancagnolo, F.; Grandegger, W.; Graziani, E.; Guarnaccia, P.; Hagel, U.V.; Han, H.G.; Han, S.W.; Huang, X.; Incagli, M.; Ingrosso, L.; Jang, Y.Y.; Kim, W.; Kluge, W.; Kulikov, V.; Lacava, F.; Lanfranchi, G.; Lee-Franzini, J.; Lomtadze, F.; Luisi, C.; Mao, C.S.; Martemianov, M.; Matsyuk, M.; Mei, W.; Merola, L.; Messi, R.; Miscetti, S.; Moalem, A.; Moccia, S.; Moulson, M.; Mueller, S.; Murtas, F.; Napolitano, M.; Nedosekin, A.; Panareo, M.; Pacciani, L.; Pages, P.; Palutan, M.; Paoluzi, L.; Pasqualucci, E.; Passalacqua, L.; Passaseo, M.; Passeri, A.; Patera, V.; Petrolo, E.; Petrucci, G.; Picca, D.; Pirozzi, G.; Pistillo, C.; Pollack, M.; Pontecorvo, L.; Primavera, M.; Ruggieri, F.; Santangelo, P.; Santovetti, E.; Saracino, G.; Schamberger, R.D.; Schwick, C.; Sciascia, B.; Sciubba, A.; Scuri, F.; Sfiligoi, I.; Shan, J.; Silano, P.; Spadaro, T.; Spagnolo, S.; Spiriti, E.; Stanescu, C.; Tong, G.L.; Tortora, L.; Valente, E.; Valente, P. E-mail: paolo.valente@lnf.infn.it; Valeriani, B.; Venanzoni, G.; Veneziano, S.; Wu, Y.; Xie, Y.G.; Zhao, P.P.; Zhou, Y

    2001-04-01

    The tracking detector of the KLOE experiment is 4 m diameter, 3.3 m length drift chamber, designed to contain a large fraction of the decays of low-energy K{sub L} produced at the Frascati DAPHINE phi-factory. The chamber is made by a thin carbon fiber structure and operated with a helium-based gas mixture in order to minimise conversion of low-energy photons and multiple scattering inside the sensitive volume. The tracking information is provided by 58 layers of stereo wires defing 12,582 cells, 2x2 cm{sup 2} in size in the 12 innermost layers and 3x3 cm{sup 2} in the outer ones. Details of the chamber design, calibration procedure and tracking performances are presented.

  10. The KLOE drift chamber

    CERN Document Server

    Adinolfi, M; Ambrosino, F; Andryakov, A; Antonelli, A; Antonelli, M; Anulli, F; Bacci, C; Bankamp, A; Barbiellini, G; Bellini, F; Bencivenni, G; Bertolucci, Sergio; Bini, C; Bloise, C; Bocci, V; Bossi, F; Branchini, P; Bulychjov, S A; Cabibbo, G; Calcaterra, A; Caloi, R; Campana, P; Capon, G; Carboni, G; Cardini, A; Casarsa, M; Cataldi, G; Ceradini, F; Cervelli, F; Cevenini, F; Chiefari, G; Ciambrone, P; Conetti, S; Conticelli, S; Lucia, E D; Robertis, G D; Sangro, R D; Simone, P D; Zorzi, G D; Dell'Agnello, S; Denig, A; Domenico, A D; Donato, C D; Falco, S D; Doria, A; Drago, E; Elia, V; Erriquez, O; Farilla, A; Felici, G; Ferrari, A; Ferrer, M L; Finocchiaro, G; Forti, C; Franceschi, A; Franzini, P; Gao, M L; Gatti, C; Gauzzi, P; Giovannella, S; Golovatyuk, V; Gorini, E; Grancagnolo, F; Grandegger, W; Graziani, E; Guarnaccia, P; Von Hagel, U; Han, H G; Han, S W; Huang, X; Incagli, M; Ingrosso, L; Jang, Y Y; Kim, W; Kluge, W; Kulikov, V; Lacava, F; Lanfranchi, G; Lee-Franzini, J; Lomtadze, F; Luisi, C; Mao Chen Sheng; Martemyanov, M; Matsyuk, M; Mei, W; Merola, L; Messi, R; Miscetti, S; Moalem, A; Moccia, S; Moulson, M; Müller, S; Murtas, F; Napolitano, M; Nedosekin, A; Panareo, M; Pacciani, L; Pagès, P; Palutan, M; Paoluzi, L; Pasqualucci, E; Passalacqua, L; Passaseo, M; Passeri, A; Patera, V; Petrolo, E; Petrucci, Guido; Picca, D; Pirozzi, G; Pistillo, C; Pollack, M; Pontecorvo, L; Primavera, M; Ruggieri, F; Santangelo, P; Santovetti, E; Saracino, G; Schamberger, R D; Schwick, C; Sciascia, B; Sciubba, A; Scuri, F; Sfiligoi, I; Shan, J; Silano, P; Spadaro, T; Spagnolo, S; Spiriti, E; Stanescu, C; Tong, G L; Tortora, L; Valente, E; Valente, P; Valeriani, B; Venanzoni, G; Veneziano, Stefano; Wu, Y; Xie, Y G; Zhao, P P; Zhou, Y

    2001-01-01

    The tracking detector of the KLOE experiment is 4 m diameter, 3.3 m length drift chamber, designed to contain a large fraction of the decays of low-energy K sub L produced at the Frascati DAPHINE phi-factory. The chamber is made by a thin carbon fiber structure and operated with a helium-based gas mixture in order to minimise conversion of low-energy photons and multiple scattering inside the sensitive volume. The tracking information is provided by 58 layers of stereo wires defing 12,582 cells, 2x2 cm sup 2 in size in the 12 innermost layers and 3x3 cm sup 2 in the outer ones. Details of the chamber design, calibration procedure and tracking performances are presented.

  11. MRI assessment of the posterior acetabular wall fracture in traumatic dislocation of the hip in children

    Energy Technology Data Exchange (ETDEWEB)

    Rubel, Ivan F.; Kloen, Peter; Helfet, David L. [Department of Orthopaedic Surgery, Weill Medical College of Cornell University, New York, NY (United States); Potter, Hollis G. [MRI Department, Diagnostic Radiology, Hospital for Special Surgery, New York (United States)

    2002-06-01

    Traumatic hip dislocations associated with posterior wall fractures of the acetabulum in the pediatric population are in general a consequence of high-energy trauma. After expeditious reduction, instability mandates for further diagnosis and intervention. Plain radiographs or computerized tomography (CT) scans can misjudge the involvement of the posterior wall of the acetabulum due to the partially calcified nature of the pediatric bone. We present two cases of pediatric traumatic hip dislocation associated with posterior wall fractures of the acetabulum. In both cases, obvious postreduction instability was noted without conclusive findings of etiology on plain X-rays or CT scans. Magnetic resonance imaging (MRI) disclosed an extensive posterior wall traumatic involvement in both cases and helped to decide in favor of open reduction of the hip and internal fixation of the posterior wall fragment. (orig.)

  12. micro strip gas chamber

    CERN Multimedia

    1998-01-01

    About 16 000 Micro Strip Gas Chambers like this one will be used in the CMS tracking detector. They will measure the tracks of charged particles to a hundredth of a millimetre precision in the region near the collision point where the density of particles is very high. Each chamber is filled with a gas mixture of argon and dimethyl ether. Charged particles passing through ionise the gas, knocking out electrons which are collected on the aluminium strips visible under the microscope. Such detectors are being used in radiography. They give higher resolution imaging and reduce the required dose of radiation.

  13. Charpak hemispherical wire chamber

    CERN Multimedia

    1970-01-01

    pieces. Mesures are of the largest one. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  14. 有晶状体眼后房型人工晶状体植入矫正高度近视的中远期疗效评价%Mid-long term follow-up results in correction of extreme mvopia by posterior chamber phakic intraocular lens

    Institute of Scientific and Technical Information of China (English)

    周天安; 沈晔; 汪阳; 夏建华

    2012-01-01

    Objective To evaluate the mid-long term stability and safety of posterior chamber phakic intraocular lens (ICL) implantation for the correction of extreme myopia. Methods This retrospective study included 993 eyes of 498 patients received ICL implantation from June 1996 to December 2008.Multivariate analysis and variance analysis were used to evaluate the stability of the results and to identify risk factors of the complications. Results Successful implantation was achieved in all patients.Spherical equivalent(SE) was (16.23 ±4.12,mean ±SD) D before the operation and ( -0.92 ± 1.22) D at the last examination. Intraocular pressure was (13.58 ± 2.93) mm Hg( 1 mm Hg =0.133 kPa)preoperatively which was ( 13.90 ± 3.01 ) mm Hg at the last examination. There was no statistical significance in follow-up( t =0.44 ~1.30,P > 0.05 ).Endothelial cell density was (2858.21 ± 395.13 )/mm2 before the operation and (2567.19 ± 423.45 ) /mm2 at last examination.Pupillary block glaucoma occurred in 2 eyes (0.2% ) at two hours and 1 eye (0.1% ) at one month after the operation.Three eyes developed anterior cataracts between 6 months to 1 year after ICL implantation and another 2 eyes subcapsular opacification at semi-peripheral regions occurred 4 years after the operation,and was not related with age,SE and vaults (F=2.42,1.98,0.81,P>0.05). Macular puckers were found in 5 eyes (0.5%) 1 year postoperatively,including 2 eyes developed choroidal neovascularization and received PDT,best corrected visual acuity lost more than 2 lines.Retinal detachment occurred in 2 eyes at 1.5 years after the operation.Acute iritis happened in 1 eye (0.1% ) and chronic iritis in 1 eye (0.1% ) which combined with slight pupil distortion and elevation of intraocular pressure.Iris stroma atrophy and pupil distortion were found in 2 eyes (0.2% ).Conclusion Correction of high myopia by ICL implantation is a safe procedure and the results are stable.%目的 总结有晶状体眼后房

  15. Postoperative Increase in Occiput–C2 Angle Negatively Impacts Subaxial Lordosis after Occipito–Upper Cervical Posterior Fusion Surgery

    OpenAIRE

    Inada, Taigo; Furuya, Takeo; Kamiya, Koshiro; Ota, Mitsutoshi; MAKI, Satoshi; Suzuki, Takane; Takahashi, Kazuhisa; Yamazaki, Masashi; Aramomi, Masaaki; Mannoji, Chikato; Koda, Masao

    2016-01-01

    Study Design Retrospective case series. Purpose To elucidate the impact of postoperative occiput–C2 (O–C2) angle change on subaxial cervical alignment. Overview of Literature In the case of occipito–upper cervical fixation surgery, it is recommended that the O–C2 angle should be set larger than the preoperative value postoperatively. Methods The present study included 17 patients who underwent occipito–upper cervical spine (above C4) posterior fixation surgery for atlantoaxial subluxation of ...

  16. The Clinical Effect of the Length of the Rod under Direct Vision Combined with Posterior Reduction and Internal Fixation with Pulling Nerve Injury with Severe Traumatic Lumbar Fracture and Dislocation%后路直视下长短棒结合提拉复位内固定治疗伴神经损伤的重度创伤性腰椎骨折脱位的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    孙中政; 孙海燕; 楚超; 孙树发; 丁超; 王英胜; 郝其全

    2015-01-01

    目的:观察直视下长短棒结合提拉复位内固定治疗伴神经损伤的重度创伤性腰椎骨折脱位在临床上的应用价值。方法回顾分析2010年~2013年解放军第89医院收治的35例伴神经损伤的重度腰椎骨折脱位采用后路直视下长短棒结合提拉复位内固定术,术后采用Suk标准判断植骨融合情况。结果平均手术时间约170min,出血量约600ml,术后随访脊柱植骨融合且稳定,术中未发现神经根及硬膜囊等医源性损伤。术后行脊柱正侧位X线检查,椎体脱位及旋转、成角移位均完全纠正,椎体前缘高度由术前的45%恢复到术后的95%.Cobb角从术前的32.5°±2.9°恢复至术后平均4.5°±2.2°。脊髓神经功能恢复按照Frankel截瘫分级,其中25例分别提高1~3级,10例A级无明显变化,术后3个月下地或坐轮椅,无迟发性脊髓损伤,未见断钉。结论重度骨折脱位伴神经损伤采用后路直视下长短棒结合提拉复位内固定术,可有效去除对神经的骨性压迫并重建脊柱的稳定性,融合率较高,安全有效。%[ ABSTRACT] Objective To observe the clinical application value of direct vision combined with the length of the rod pulling fixa -tion on lumbar fracture and dislocation with severe traumatic nerve injury .Methods Retrospective analysis of 35 cases of severe lumbar frac-ture and dislocation complicated with nerve injury in PLA 89th hospitals during 2010~2013 treated by pulling open reduction and internal fixation with posterior length under rod was made ,the treatment effect was evaluated by Suk standards .Results The average operation time ws about 170 minutes,blood loss was about 600ml,intraoperative nerve root and dural sac such as iatrogenic injury was not found and postop -erative follow-up showed stable spinal bone graft fusion .Postoperative lateral X -ray examination of the spine ,vertebrae dislocation and rota

  17. Heavy liquid bubble chamber

    CERN Multimedia

    1965-01-01

    The CERN Heavy liquid bubble chamber being installed in the north experimental hall at the PS. On the left, the 1180 litre body; in the centre the magnet, which can produce a field of 26 800 gauss; on the right the expansion mechanism.

  18. OPAL Muon Chamber

    CERN Multimedia

    OPAL was one of the 4 experiments installed at the LEP particle accelerator from 1989 to 2000. This is a slice of the outermost layer of OPAL : the muon chambers. This outside layer detects particles which are not stopped by the previous layers. These are mostly muons.

  19. LEP Vacuum Chamber

    CERN Multimedia

    1983-01-01

    This is a cut-out of a LEP vacuum chamber for dipole magnets showing the beam channel and the pumping channel with the getter (NEG) strip and its insulating supports. A water pipe connected to the cooling channel can also be seen at the back.The lead radiation shield lining is also shown. See also 8305563X.

  20. Scanning bubble chamber pictures

    CERN Multimedia

    1974-01-01

    These were taken at the 2 m hydrogen bubble chamber. The photo shows an early Shiva system where the pre-measurements needed to qualify the event were done manually (cf photo 7408136X). The scanning tables were located in bld. 12. Gilberte Saulmier sits on foreground, Inge Arents at centre.

  1. Liquid Wall Chambers

    Energy Technology Data Exchange (ETDEWEB)

    Meier, W R

    2011-02-24

    The key feature of liquid wall chambers is the use of a renewable liquid layer to protect chamber structures from target emissions. Two primary options have been proposed and studied: wetted wall chambers and thick liquid wall (TLW) chambers. With wetted wall designs, a thin layer of liquid shields the structural first wall from short ranged target emissions (x-rays, ions and debris) but not neutrons. Various schemes have been proposed to establish and renew the liquid layer between shots including flow-guiding porous fabrics (e.g., Osiris, HIBALL), porous rigid structures (Prometheus) and thin film flows (KOYO). The thin liquid layer can be the tritium breeding material (e.g., flibe, PbLi, or Li) or another liquid metal such as Pb. TLWs use liquid jets injected by stationary or oscillating nozzles to form a neutronically thick layer (typically with an effective thickness of {approx}50 cm) of liquid between the target and first structural wall. In addition to absorbing short ranged emissions, the thick liquid layer degrades the neutron flux and energy reaching the first wall, typically by {approx}10 x x, so that steel walls can survive for the life of the plant ({approx}30-60 yrs). The thick liquid serves as the primary coolant and tritium breeding material (most recent designs use flibe, but the earliest concepts used Li). In essence, the TLW places the fusion blanket inside the first wall instead of behind the first wall.

  2. LEP vacuum chamber, prototype

    CERN Multimedia

    CERN PhotoLab

    1983-01-01

    Final prototype for the LEP vacuum chamber, see 8305170 for more details. Here we see the strips of the NEG pump, providing "distributed pumping". The strips are made from a Zr-Ti-Fe alloy. By passing an electrical current, they were heated to 700 deg C.

  3. Secondary emission gas chamber

    CERN Document Server

    In'shakov, V; Skvortsov, V

    2014-01-01

    For a hadron calorimeter active element there is considered a gaseous secondary emis-sion detector (150 micron gap, 50 kV/cm). Such one-stage parallel plate chamber must be a radiation hard, fast and simple. A model of such detector has been produced, tested and some characteristics are presented.

  4. [Posterior reversible encephalopathy syndrome].

    Science.gov (United States)

    Petrović, Branko; Kostić, Vladimir; Sternić, Nadezda; Kolar, Jovo; Tasić, Nebojsa

    2003-01-01

    Reversible Posterior Leukoencephalopathy Syndrome was introduced into clinical practice in 1996 in order to describe unique syndrome, clinically expressed during hypertensive and uremic encephalopathy, eclampsia and during immunosuppressive therapy [1]. First clinical investigations showed that leucoencephalopathy is major characteristic of the syndrome, but further investigations showed no significant destruction in white cerebral tissue [2, 3, 4]. In majority of cases changes are localise in posterior irrigation area of the brain and in the most severe cases anterior region is also involved. Taking into consideration all above mentioned facts, the suggested term was Posterior Reversible Encephalopathy Syndrome (PRES) for the syndrome clinically expressed by neurological manifestations derived from cortical and subcortical changes localised in posterior regions of cerebral hemispheres, cerebral trunk and cerebellum [5]. Patient, aged 53 years, was re-hospitalized in Cardiovascular Institute "Dediwe" two months after successful aorto-coronary bypass performed in June 2001 due to the chest bone infection. During the treatment of the infection (according to the antibiogram) in September 2001, patient in evening hours developed headache and blurred vision. The recorded blood pressure was 210/120 mmHg so antihypertensive treatment was applied (Nifedipin and Furosemid). After this therapy there was no improvement and intensive headache with fatigue and loss of vision developed. Neurological examination revealed cortical blindness and left hemiparesis. Manitol (20%, 60 ccm every 3 hours) and i.v. Nytroglicerin (high blood pressure). Brain CT revealed oedema of parieto-occipital regions of both hemispheres, more emphasized on the right. (Figure 1a, b, c). There was no sign of focal ischemia even in deeper sections (Figure 1d, e, f). Following three days enormous high blood pressure values were registered. On the fourth day the significant clinical improvement occurred

  5. Progressive posterior cortical dysfunction

    Directory of Open Access Journals (Sweden)

    Fábio Henrique de Gobbi Porto

    Full Text Available Abstract Progressive posterior cortical dysfunction (PPCD is an insidious syndrome characterized by prominent disorders of higher visual processing. It affects both dorsal (occipito-parietal and ventral (occipito-temporal pathways, disturbing visuospatial processing and visual recognition, respectively. We report a case of a 67-year-old woman presenting with progressive impairment of visual functions. Neurologic examination showed agraphia, alexia, hemispatial neglect (left side visual extinction, complete Balint's syndrome and visual agnosia. Magnetic resonance imaging showed circumscribed atrophy involving the bilateral parieto-occipital regions, slightly more predominant to the right . Our aim was to describe a case of this syndrome, to present a video showing the main abnormalities, and to discuss this unusual presentation of dementia. We believe this article can contribute by improving the recognition of PPCD.

  6. Arthroscopic double-bundle posterior cruciate ligament reconstruction surgical technique.

    Science.gov (United States)

    Fanelli, Gregory C; Beck, John D; Edson, Craig J

    2010-06-01

    The keys to successful posterior cruciate ligament (PCL) reconstruction are to identify and treat all pathology, use strong graft material, accurately place tunnels in anatomic insertion sites, minimize graft bending, use a mechanical graft tensioning device, use primary and back-up graft fixation, and use the appropriate postoperative rehabilitation program. Adherence to these technical principles results in successful single-bundle and double-bundle arthroscopic transtibial tunnel PCL reconstruction based on stress radiography, arthrometer, knee ligament rating scales, and patient satisfaction measurements.

  7. Molecular Biology of Nitrogen Fixation

    Science.gov (United States)

    Shanmugam, K. T.; Valentine, Raymond C.

    1975-01-01

    Reports that as a result of our increasing knowledge of the molecular biology of nitrogen fixation it might eventually be possible to increase the biological production of nitrogenous fertilizer from atmospheric nitrogen. (GS)

  8. The Simplified Posterior Interosseous Flap.

    Science.gov (United States)

    Cavadas, Pedro C; Thione, Alessandro; Rubí, Carlos

    2016-09-01

    Several technical modifications have been described to avoid complications and simplify dissection. The authors describe some technical tips that make posterior interosseous flap dissection safer and more straightforward.

  9. 侧路与后路单椎间融合器联合单侧钉棒置入治疗腰椎退行性疾病%Lateral and posterior single cage combined with unilateral pedicle screw fixation for lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    严冬雪; 黄永吉; 马广斌; 罗军; 胡军祖; 肖荣驰

    2014-01-01

    背景:腰椎不稳、腰椎间盘突出症、椎间盘源性腰腿疼等腰椎退行性疾病常需实施椎间融合,但采用哪一种植入物进行植入好?还存在争议。  目的:比较L4、5侧路单椎间融合器椎间融合与传统开放后路单椎间融合器联合单侧钉棒内固定的椎间融合治疗腰椎退行性疾病的疗效。  方法:回顾性分析符合标准的L4、5单节段退变患者的临床资料,其中30例行侧路单椎间融合器内固定治疗(试验组),45例行后路单椎间融合器联合单侧钉棒内固定的椎间融合(对照组),比较两组疗效。  结果与结论:两组患者均获随访,随访时间10-37个月,平均13个月。两组切口均Ⅰ期愈合,试验组1例出现内固定后椎间融合器移位但无相应症状发生。两组患者治疗后有效率、住院天数、引流量比较差异无显著性意义(P>0.05),植入治疗时间及植入治疗中出血量试验组优于对照组(P0.05)。两种方式治疗部分腰椎退变性疾病效果相当,但侧路单椎间融合器内固定创伤小、治疗后恢复快。%BACKGROUND:Most of lumbar degenerative diseases, such as lumbar instability, lumbar disc herniation and discogenic lumbago, need lumbar spinal fusion for the spine stability, but the choice of internal fixation approaches is controversial. OBJECTIVE:To compare the effectiveness between lateral lumbar interbody fusion with single cage and single cage combined with unilateral pedicle screw fixation for the 4th and 5th single-level lumbar degenerative disease. METHODS:The clinical data of patients with single-level lumbar degenerative diseases (L4 and L5) undergoing lateral lumbar interbody fusion with single cage in 30 cases (experimental group) and single cage combined with unilateral pedicle screw fixation in 45 cases (control group) were analyzed retrospectively, and the curative effects were compared between the two groups. RESULTS AND

  10. External transpedicular spine fixation in severe spondylodiscitis – salvage procedure

    Directory of Open Access Journals (Sweden)

    Spalteholz, Matthias

    2013-11-01

    Full Text Available Specific and non-specific infections of the spine are rare. Due to their potential for severe instabilities, deformities and the impairment of neurological structures, the treatment is often prolonged and needs an interdisciplinary management. The clinical presentation is uncharacteristic, therefore diagnosis is often delayed. There are no prospective randomized studies for therapy recommendation. The surgical concept includes eradication of the infection and the reliable stabilization of involved segments. This concept is successful in most cases of endogenous vertebral osteomyelitis. The therapy of the exogenous spine infections after macro and micro surgery is more difficult, due to the critical wound situation and the involvement of the posterior parts of the spine. In these cases, infection-associated instability of the anterior part is complicated by critical posterior wound conditions.We present three cases of severe exogenous vertebral infections, where temporary external transpedicular spine fixation was used for salvage procedure, till soft tissue conditions have permitted a definitive internal stabilization.

  11. [Comparison of vacuum bag fixation and Orfit rack with thermoplastic membrane fixation for image-guided cervical cancer radiotherapy].

    Science.gov (United States)

    Li, Y B; Wang, Y L; Zhuo, Y H

    2017-06-23

    suitable for the cone-beam CT image-guided radiotherapy of cervical cancer patients. However, the displacement in the left and right directions of the vacuum bag fixation is smaller than the Orfit rack with thermoplastic membrane fixation. During the period of treatment, the mean value of the difference of displacement in the anterior and posterior directions of the Orfit rack with thermoplastic membrane fixation is mild, which can be used individually by the patients with a flexible body and good tolerance.

  12. Novel modified Ussing chamber for the study of absorption and secretion in human endoscopic biopsies

    DEFF Research Database (Denmark)

    Larsen, R; Mertz-Nielsen, A; Hansen, M B;

    2001-01-01

    The aim of this study was to design and evaluate a modified Ussing chamber, that makes use of constant air suction (modified Ussing air suction chamber, MUAS) for fixation of biopsy specimens. Standard size forceps biopsies were taken from the descending part of duodenum from patients undergoing......). Experimental biopsy specimens showed intact surface epithelium by histologic examination and did not differ from controls apart from minor indications of edge damage. No difference in basal electrical parameters and D-glucose fluxes were found between Helicobacter pylori positive and negative patients. Our...... data suggests that the MUAS chamber represents a promising alternative approach to measure transport processes in intestinal endoscopic biopsies....

  13. Anechoic Radio Frequency Test Chamber

    Data.gov (United States)

    Federal Laboratory Consortium — This chamber is used for characterization test of such systems as communications gear, tanks, radar, missiles, and helicopters. The dimensions of the chamber are 114...

  14. Arthroscopic Repair of Posterior Bony Bankart Lesion and Subscapularis Remplissage.

    Science.gov (United States)

    Luedke, Colten; Tolan, Stefan J; Tokish, John M

    2017-06-01

    Posterior shoulder instability with glenoid bone loss has only a fraction of the prevalence of anterior instability. Unlike the latter, there is a paucity of literature regarding the treatment of posterior bony Bankart lesions and even less with concomitant reverse Hill-Sachs lesions. This combination of pathology leads to a difficult situation regarding treatment options. We present our technique for arthroscopic repair of a posterior bony Bankart lesion and reverse Hill-Sachs lesion. The importance of proper portal placement cannot be overstated. By use of the lateral position and strategically placed portals, the posterior bony Bankart lesion and attached labral complex were appropriately mobilized. We reduced the glenoid bone, with the attached capsulolabral complex, to the glenoid rim and performed fixation using a knotless suture anchor. We then placed 2 double-loaded suture anchors into the reverse Hill-Sachs lesion. The sutures were passed creating horizontal mattress configurations that were tied at the end of the procedure, effectively externalizing the humeral head defect. Our technique results in satisfactory fragment reduction, as well as appropriate capsular tension, and effectively prevents the reverse Hill-Sachs lesion from engaging.

  15. 腰椎压缩性骨折后路椎弓根固定3种固定节段方式有限元分析%Finite element analysis for 3 kinds of posterior pedicle fixation to treat lumbar vertebral compression fractures

    Institute of Scientific and Technical Information of China (English)

    李鹏飞; 彭昊

    2014-01-01

    loadings are (0.000 1 mm)A group 87.00 ± 3.06,B group 41.00 ± 5.33,C group 13.80 ±8.20,the results of B [(0.89 ±0.08) mPa] and C [(0.80 ±0.11) mPa] group are lesser than it in A [(1.12 ±0.13) mPa] group (P <0.05),and C group is C lesser than it in B group (P <0.05).Conclusion It is indicated that it can be optimized to reduce the failure of internal fixation with pedicle screws in injured level and long segment fixation,pedicle screws in injured level and long segment fixation can decrease the deflection of injure vertebra so they are benefit for frcture rescover.

  16. Vitrectomy and translocation of the anterior chamber intraocular lens to the sulcus: a closed microsurgical technique for the UGH syndrome.

    Science.gov (United States)

    Gualtieri, William; Rossini, Paolo; Forlini, Cesare

    2008-01-01

    This interventional case report presents an anterior chamber intraocular lens (AC-IOL) translocation technique to manage a case of uveitis-glaucoma-hyphema (UGH) syndrome associated with posterior dislocation of nuclear fragments and vitreitis as a consequence of capsule rupture during cataract surgery. Pars plana vitrectomy followed by an AC-IOL translocation from the anterior chamber to the sulcus without additional surgical corneal incision was performed. At 12 months' follow-up, the original AC-IOL was in stable position in the posterior chamber, with binocular refractive balance and no further astigmatism and resolution of the UGH syndrome.

  17. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  18. Vacuum Chambers for LEP sections

    CERN Multimedia

    1983-01-01

    The picture shows sections of the LEP vacuum chambers to be installed in the dipole magnets (left) and in the quadrupoles (right). The dipole chamber has three channels: the beam chamber, the pumping duct where the NEG (non-evaporabe getter) is installed and the water channel for cooling (on top in the picture). The pumping duct is connected to the beam chamber through holes in the separating wall. The thick lead lining to shield radiation can also be seen. These chambers were manufactured as extruded aluminium alloy profiles.

  19. Multi-anode ionization chamber

    Energy Technology Data Exchange (ETDEWEB)

    Bolotnikov, Aleksey E. (South Setauket, NY); Smith, Graham (Port Jefferson, NY); Mahler, George J. (Rocky Point, NY); Vanier, Peter E. (Setauket, NY)

    2010-12-28

    The present invention includes a high-energy detector having a cathode chamber, a support member, and anode segments. The cathode chamber extends along a longitudinal axis. The support member is fixed within the cathode chamber and extends from the first end of the cathode chamber to the second end of the cathode chamber. The anode segments are supported by the support member and are spaced along the longitudinal surface of the support member. The anode segments are configured to generate at least a first electrical signal in response to electrons impinging thereon.

  20. Pedicle screw fixation against burst fracture of thoracolumbar vertebrae

    Institute of Scientific and Technical Information of China (English)

    L(U) Fu-xin; HUANG Yong; ZHANG Qiang; SHI Feng-lei; ZHAO Dong-sheng; HU Qiao

    2007-01-01

    Objective: To analyze the application of vertebral pedicle screw fixation in the treatment of burst fracture of thoracolumbar vertebrae.Methods: A total of 48 cases (31 males and 17 females, aged from 18-72 years, mean: 41.3 years) with thoracolumbar vertebrae burst fracture were treated by pedicle screw system since January 2004. According to the AO classification of thoracolumbar vertebrae fracture,there are 36 cases of Type A, 9 of Type B and 3 of Type C.Results: All patients were followed up for 6-25 months (average 12 months ), no secondary nerve root injury, spinal cord injury, loosening or breakage of pedicle screw were observed. The nerve function of 29 patients with cauda equina nerve injury was restored to different degrees. The vertebral body height returned to normal level and posterior process angle was rectified after operation.Conclusions: The vertebral pedicle screw internal fixation was technologically applicable, which can efficiently reposition and stablize the bursting fractured vertabrae,indirectly decompress canalis spinalis, maintain spine stablity, scatter stress of screw system, reduce the risk of loosening or breakage of screw and loss of vertebral height,and prevent the formation of posterior convex after operation.

  1. Extensor mechanism-sparing paratricipital posterior approach to the distal humerus.

    Science.gov (United States)

    Schildhauer, Thomas A; Nork, Sean E; Mills, William J; Henley, M Bradford

    2003-05-01

    Adequate exposure of the articular surface of the distal humerus and elbow joint is required for operative stabilization of bicolumnar distal humerus fractures. The transolecranon approach, which provides complete posterior visualization and access to the distal humerus, is commonly used. Nevertheless, an olecranon osteotomy and other extensor mechanism-disrupting approaches have risks and possible complications. Alternative exposures have been described primarily for total elbow arthroplasty, but these involve extensive and potentially devascularizing dissections. In extra-articular (OTA type A) and simple articular distal humeral fractures with simple or multifragmentary metaphyseal involvement (OTA type C1 and C2), extensile approaches may not be necessary. For these fracture patterns, an alternative exposure is the extensor mechanism-sparing paratricipital posterior approach to the distal humerus through a midline posterior incision. This approach avoids an osteotomy and mobilizes the triceps and anconeus muscle off the posterior humerus and the intermuscular septae and provides adequate exposure for open reduction and internal fixation.

  2. Periprosthetic fractures of the acetabulum during cup insertion: posterior column stability is crucial.

    Science.gov (United States)

    Laflamme, G-Yves; Belzile, Etienne L; Fernandes, Julio C; Vendittoli, Pascal A; Hébert-Davies, Jonah

    2015-02-01

    Periprosthetic hip fractures around acetabular components are rare with little information available to guide surgical management of these complex injuries. A retrospective review of intraoperative isolated acetabular periprosthetic fractures from three tertiary surgical units was done. A total of 32 patients were identified with 9 initially missed. Acetabular components were stable (type 1) in 11 patients with no failures; unstable (type 2) in 12 patients and treated with supplemental fixation. Non-union and displacement were correlated with absent posterior column plating. Missed fractures (type 3) had the highest reoperation rate. Anterior patterns all healed, whereas fractures with posterior column instability had a 67% failure rate. Periprosthetic acetabular fracture can heal successfully with posterior column stability. Plating is mandatory for large posterior wall fragments to achieve osteointegration. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. The APS ceramic chambers

    Energy Technology Data Exchange (ETDEWEB)

    Milton, S.; Warner, D.

    1994-07-01

    Ceramics chambers are used in the Advanced Photon Source (APS) machines at the locations of the pulsed kicker and bumper magnets. The ceramic will be coated internally with a resistive paste. The resistance is chosen to allow the low frequency pulsed magnet field to penetrate but not the high frequency components of the circulating beam. Another design goal was to keep the power density experienced by the resistive coating to a minimum. These ceramics, their associated hardware, the coating process, and our recent experiences with them are described.

  4. Classification of posterior vitreous detachment

    Directory of Open Access Journals (Sweden)

    Kakehashi A

    2013-12-01

    Full Text Available Akihiro Kakehashi,1 Mikiko Takezawa,1 Jun Akiba21Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, Saitama, 2Kanjodori Eye Clinic, Asahikawa, JapanAbstract: Diagnosing a posterior vitreous detachment (PVD is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography (OCT. By biomicroscopy, the vitreous condition is determined based on the presence or absence of a PVD. The PVD then is classified as either a complete posterior vitreous detachment (C-PVD or a partial posterior vitreous detachment (P-PVD. A C-PVD is further divided into a C-PVD with collapse and a C-PVD without collapse, while a P-PVD is divided into a P-PVD with shrinkage of the posterior hyaloid membrane (P-PVD with shrinkage and a P-PVD without shrinkage of the posterior hyaloid membrane (P-PVD without shrinkage. A P-PVD without shrinkage has a subtype characterized by vitreous gel attachment through the premacular hole in a posterior hyaloid membrane to the macula (P-PVD without shrinkage [M]. By OCT, a shallow PVD is classified as the absence of a shallow PVD or as a shallow PVD. A shallow PVD is then subclassified as a shallow PVD without shrinkage of the posterior vitreous cortex, a shallow PVD with shrinkage of the posterior vitreous cortex, and a peripheral shallow PVD. A shallow PVD without shrinkage of the posterior vitreous cortex has two subtypes: an age-related shallow PVD and a perifoveal PVD associated with a macular hole.Keywords: classification, optical coherence tomography, PVD, slit-lamp biomicroscopy

  5. Classification of posterior vitreous detachment.

    Science.gov (United States)

    Kakehashi, Akihiro; Takezawa, Mikiko; Akiba, Jun

    2014-01-01

    Diagnosing a posterior vitreous detachment (PVD) is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography (OCT). By biomicroscopy, the vitreous condition is determined based on the presence or absence of a PVD. The PVD then is classified as either a complete posterior vitreous detachment (C-PVD) or a partial posterior vitreous detachment (P-PVD). A C-PVD is further divided into a C-PVD with collapse and a C-PVD without collapse, while a P-PVD is divided into a P-PVD with shrinkage of the posterior hyaloid membrane (P-PVD with shrinkage) and a P-PVD without shrinkage of the posterior hyaloid membrane (P-PVD without shrinkage). A P-PVD without shrinkage has a subtype characterized by vitreous gel attachment through the premacular hole in a posterior hyaloid membrane to the macula (P-PVD without shrinkage [M]). By OCT, a shallow PVD is classified as the absence of a shallow PVD or as a shallow PVD. A shallow PVD is then subclassified as a shallow PVD without shrinkage of the posterior vitreous cortex, a shallow PVD with shrinkage of the posterior vitreous cortex, and a peripheral shallow PVD. A shallow PVD without shrinkage of the posterior vitreous cortex has two subtypes: an age-related shallow PVD and a perifoveal PVD associated with a macular hole.

  6. Council Chamber exhibition

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    To complete the revamp of CERN’s Council Chamber, a new exhibition is being installed just in time for the June Council meetings.   Panels will showcase highlights of CERN’s history, using some of the content prepared for the exhibitions marking 50 years of the PS, which were displayed in the main building last November. The previous photo exhibition in the Council Chamber stopped at the 1970s. To avoid the new panels becoming quickly out of date, photos are grouped together around specific infrastructures, rather than following a classic time-line. “We have put the focus on the accelerators – the world-class facilities that CERN has been offering researchers over the years, from the well-known large colliders to the lesser-known smaller facilities,” says Emma Sanders, who worked on the content. The new exhibition will be featured in a future issue of the Bulletin with photos and an interview with Fabienne Marcastel, designer of the exhibit...

  7. 寰枢椎脱位术中复位技术及内固定的研究进展%Intraoperative reduction and internal fixation for atlanto-axial dislocation

    Institute of Scientific and Technical Information of China (English)

    武乐成; 倪斌

    2016-01-01

    寰枢椎复合体是颈椎中最重要的功能单位.寰枢关节失稳或脱位,是脊柱外科的急重症之一.临床上多通过后路寰枢椎融合术重建寰椎复合体的稳定性.寰枢椎后路融合技术的发展经历了钢丝或钛缆捆扎固定、椎板夹固定、经寰枢关节螺钉固定、以及后来的钉板固定和钉棒固定等过程.对于术前牵引未能复位者,需进行术中复位.本文主要就以上术中复位技术和内固定方法进行综述.%Atlanto-axial complex is the most important functional unit of the cervical spine.Atlanto-axial instability or dislocation,one of the most serious pathologies in spinal surgery,is often managed by posterior atlantoaxial fixation and fusion.Several posterior fixation techniques have been used to stabilize the atlanto-axial complex,including wire/cable-bone fixation,Halifax clamps,transarticular screw fixation,screw-plate fixation and screw-rod fixation.For atlanto-axial dislocation that cannot be reduced with skull traction before operation,intraoperative reduction is often needed.Current intraoperative reduction techniques can be classified into transoropharyngeal surgical release followed by posterior reduction and fixation,transoropharyngeal reduction and fixation,and posterior reduction and fixation using screw-rod system according to approaches.Furthermore,posterior reduction can be performed using elevating-pull,leverages,and cantilever techniques.This study reviews the intraoperative reduction and fixation techniques mentioned above.

  8. Biomechanical analysis of fracture fixation with external fixator in vivo

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To investigate the different ways of measuring the main axial strain during treatment with an external fixator and to find the suitable compression loaded by the external fixator at an early stage.Methods: Eighteen healthy big-ear rabbits were randomly divided into two groups according to different measuring methods: Group A and Group B. In Group A,a strain gauge was affixed to the external tibial cortex with 502 glue, and in Group B, a bone cement-coated strain gauge was installed on the internal tibial cortex. Groups A and B were divided into two subgroups A1, A2 and B1,B2, respectively, according to the pressure of half of and the same as the body weight. A Z-shaped left mid-shaft tibial osteotomy was performed and fixed by an external fixator. Results: The scaler curves of Group A changed dramatically during the early stage. The trendlines of the internal and external cortex went consistently after reaching the stable stage while the latter strain value was higher than the former. The time for Group B reaching the stable stage was short, but its absolute strain value was less than that of Group A. Before they were pressed to the stable stage, the declined speed of Subgroup A1 was more slowly than that of Subgroup A2 while the results of Subgroups B1 and B2 were same. Group A had an ascending trend after it declined while Group B didn't have. After they reached the stable stage, both Subgroups A1 and A2 had a declining trend while Subgroup A2 was more quickly than Subgroup Al, Subgroup B1 was kept at a definite level while Subgroup B2 fluctuated.Conclusions: The axial strain under external fixator can be measured by bone cement coated-strain gauge in vivo. The data may suggest that half of the body weight load was suitable for external fixator.

  9. Delayed surgical treatment for a traumatic bilateral cervical facet joint dislocation using a posterior-anterior approach: a case report

    Directory of Open Access Journals (Sweden)

    Shimada Takashi

    2013-01-01

    Full Text Available Abstract Introduction There have been few reports of patients with bilateral cervical facet dislocations that remain untreated for eight weeks or more. We report the case of a 76-year-old man with an old bilateral cervical facet joint dislocation fracture that was treated by posterior-anterior reduction and fixation. Case presentation A 76-year-old Asian man was involved in a road traffic accident. He presented with neck pain and arm pain on his right side, but motor weakness and paralysis were not observed. He was treated conservatively; however, instability and spondylolisthesis at the C5 to C6 joint increased eight weeks after the injury. We performed a posterior-anterior reduction and fixation. After surgery, bony union was achieved, and his neck pain and arm pain disappeared. Conclusion We recommend reduction and fixation surgery if a patient has an old bilateral facet joint dislocation fracture in the cervical spine.

  10. Posterior scleral tuberculoma: case report

    Directory of Open Access Journals (Sweden)

    Antonio Augusto Velasco e Cruz

    2011-02-01

    Full Text Available Posterior scleral tuberculoma formation is an extremely rare condition. The few reports on scleral involvement in tuberculosis refer to cases of anterior scleritis. In the present manuscript we describe a patient who had rheumatoid arthritis and developed a large posterior scleral tuberculoma. The lesion provoked retinal detachment and visual loss and was diagnosed only after enucleation due to a misdiagnosis of choroidal melanoma.

  11. [Treatment of recurrent posterior epistaxis].

    Science.gov (United States)

    Bro, Søren Pauli; Bille, Jesper; Petersen, Kristian Bruun

    2017-08-21

    30% of the patients presenting with epistaxis at emergency wards and otorhinolaryngeal specialist departments have posterior bleeding. Traditional treatment with packing often leads to initial treatment failure, and many patients experience recurrent bleeding within the following month. Recurrent posterior epistaxis should be treated with local electrocautery or endoscopic ligation of the sphenopalatine artery to reduce patient discomfort, hospital stay, risk of treatment failure and recurrence.

  12. First metatarsophalangeal joint arthrodesis: current fixation options.

    Science.gov (United States)

    Moon, Jared L; McGlamry, Michael C

    2011-04-01

    This article reviews the current literature on first metatarsophalangeal joint arthrodesis rates using various forms of fixation, as well as reviewing biomechanical studies comparing the strengths of the different fixation options that are available.

  13. The application of atlantoaxial screw and rod fixation in revision operations for postoperative re-dislocation in children.

    Science.gov (United States)

    Ma, XiangYang; Yin, QingShui; Xia, Hong; Wu, ZengHui; Yang, JinCheng; Liu, JingFa; Xu, JunJie; Qiu, Feng

    2015-03-01

    We evaluate the feasibility, safety, and efficacy of atlantoaxial screw and rod fixation for revision operations in the treatment of re-dislocation after atlantoaxial operations in children. Eight consecutive children with atlantoaxial instability required a revision operation due to atlantoaxial re-dislocation caused by the failure of the initial posterior wire fixation. The children were 5-11 years of age with an average age of 8.5 years. The posterior atlantoaxial screw and rod fixation and fusion operation was then performed. Autograft bones harvested from rib (in 3 patients), local bone (2 patients), and the iliac crest bone (3 patients) were used. There were no complications such as vertebral artery or spinal cord injury during the operations or loosening or fracture of the fixations after the operations. Stability and reduction of the atlantoaxial segments were achieved in all patients postoperatively. Follow-up time was 24-55 months, with an average of 35 months. All patients achieved solid osseous fusion demonstrated on plain radiographs or CT scanning. Atlantoaxial screw and rod fixation is feasible in children and may be considered for use during the initial operation in the treatment of atlantoaxial dislocation in children to minimize the need for a revision operation. If a revision operation is required, atlantoaxial screw-rod fixation is a safe and effective method. Because the anatomical structure is complicated in revision operation patients, CAD-RP technology could guide the the procedures of exposure and screw placement.

  14. Sacral Fracture Nonunion Treated by Bone Grafting through a Posterior Approach

    Directory of Open Access Journals (Sweden)

    Sang Yang Lee

    2013-01-01

    Full Text Available Nonunion of a sacral fracture is a rare but serious clinical condition which can cause severe chronic pain, discomfort while sitting, and significant restriction of the level of activities. Fracture nonunions reportedly occur most often after nonoperative initial treatment or inappropriate operative treatment. We report a case of fracture nonunion of the sacrum and pubic rami that resulted from non-operative initial treatment, which was treated successfully using bone grafting through a posterior approach and CT-guided percutaneous iliosacral screw fixation combined with anterior external fixation. Although autologous bone grafting has been the gold standard for the treatment of pelvic fracture nonunions, little has been written describing the approach. We utilized a posterior approach for bone grafting, which could allow direct visualization of the nonunion site and preclude nerve root injury. By this procedure, we were able to obtain the healing of fracture nonunion, leading to pain relief and functional recovery.

  15. Complications of rigid internal fixation.

    Science.gov (United States)

    Campbell, Chris A; Lin, Kant Y

    2009-03-01

    Over the past 20 years, there have been many advances in the development of bone fixation systems used in the practice of craniomaxillofacial surgery. As surgical practices have evolved, the complications of each technologic advance have changed accordingly. Interfragmentary instability of interosseous wiring has been replaced by the risk of exposure, infection, and palpability of plate and screw fixation systems. The improved rigidity of plate fixation requires anatomic alignment of fracture fragments. Failure to obtain proper alignment has led to the phenomenon known as "open internal fixation" of fracture fragments without proper reduction. The size of the plates has decreased to minimize palpability and exposure. However limitations in their application have been encountered due to the physiologic forces of the muscles of mastication and bone healing. In the pediatric population, the long-standing presence of plates in the cranial vault resulted in reports of transcranial migration and growth restriction. These findings led to the development of resorbable plating systems, which are associated with self-limited plate palpability and soft tissue inflammatory reactions. Any rigid system including these produces growth restriction in varying amounts. In this discussion, we review the reported complication rates of miniplating and microplating systems as well as absorptive plating systems in elective and traumatic craniofacial surgery.

  16. Understanding Nitrogen Fixation

    Energy Technology Data Exchange (ETDEWEB)

    Paul J. Chirik

    2012-05-25

    synthesis of ammonia, NH{sub 3}, from its elements, H{sub 2} and N{sub 2}, via the venerable Haber-Bosch process is one of the most significant technological achievements of the past century. Our research program seeks to discover new transition metal reagents and catalysts to disrupt the strong N {triple_bond} N bond in N{sub 2} and create new, fundamental chemical linkages for the construction of molecules with application as fuels, fertilizers and fine chemicals. With DOE support, our group has discovered a mild method for ammonia synthesis in solution as well as new methods for the construction of nitrogen-carbon bonds directly from N{sub 2}. Ideally these achievements will evolve into more efficient nitrogen fixation schemes that circumvent the high energy demands of industrial ammonia synthesis. Industrially, atmospheric nitrogen enters the synthetic cycle by the well-established Haber-Bosch process whereby N{sub 2} is hydrogenated to ammonia at high temperature and pressure. The commercialization of this reaction represents one of the greatest technological achievements of the 20th century as Haber-Bosch ammonia is responsible for supporting approximately 50% of the world's population and serves as the source of half of the nitrogen in the human body. The extreme reaction conditions required for an economical process have significant energy consequences, consuming 1% of the world's energy supply mostly in the form of pollution-intensive coal. Moreover, industrial H{sub 2} synthesis via the water gas shift reaction and the steam reforming of methane is fossil fuel intensive and produces CO{sub 2} as a byproduct. New synthetic methods that promote this thermodynamically favored transformation ({Delta}G{sup o} = -4.1 kcal/mol) under milder conditions or completely obviate it are therefore desirable. Most nitrogen-containing organic molecules are derived from ammonia (and hence rely on the Haber-Bosch and H{sub 2} synthesis processes) and direct synthesis from

  17. Options for acetabular fixation surfaces.

    Science.gov (United States)

    Klika, Alison K; Murray, Trevor G; Darwiche, Hussein; Barsoum, Wael K

    2007-01-01

    Aseptic loosening is the most common cause for revision total hip arthroplasty (THA). Due to poor long-term results with cemented acetabular components, cementless implants that rely on biologic fixation became popular in the United States for both primary and revision procedures in the early 1980s. Cementless acetabular components used in THA have been reported to have superior radiographic performance compared with cemented fixation, although the optimal method of acetabular fixation remains controversial. Cementless acetabular components require initial implant stability to allow for bone ingrowth and remodeling into the acetabular shell, providing long-term durability of the prosthesis. Many improved implant materials are available to facilitate bone growth and remodeling, including the 3 most common surface treatments; fibermesh, sintered beads, and plasma spray coatings. Recently added to these are porous metal surfaces, which have increased porosity and optimal pore sizes when compared with titanium fibermesh. The most studied of these materials is the titanium fibermesh fixation surface, which has demonstrated a mechanical failure rate of 1% at 10 to 15 years. This technology utilizes the diffusion bonding process to attach fiber metal pads to a titanium substrate using heat and pressure. The sintered bead fixation surface offers a porous coating of various sizes of spherical beads, achieved by the sintering process, and has been shown to provide long-term fixation. While there are less long-term published data regarding the titanium plasma spray surface, its early results have provided evidence of its durability, even in the face of significant osteolysis. The most recently added alternative fixation surface is porous tantalum metal, which offers potentially greater bone ingrowth and bone graft incorporation due to its high porosity (80%) and low modulus of elasticity (3 MPa). Porous tantalum implants have shown early favorable clinical results and have

  18. Mush Column Magma Chambers

    Science.gov (United States)

    Marsh, B. D.

    2002-12-01

    Magma chambers are a necessary concept in understanding the chemical and physical evolution of magma. The concept may well be similar to a transfer function in circuit or time series analysis. It does what needs to be done to transform source magma into eruptible magma. In gravity and geodetic interpretations the causative body is (usually of necessity) geometrically simple and of limited vertical extent; it is clearly difficult to `see' through the uppermost manifestation of the concentrated magma. The presence of plutons in the upper crust has reinforced the view that magma chambers are large pots of magma, but as in the physical representation of a transfer function, actual magma chambers are clearly distinct from virtual magma chambers. Two key features to understanding magmatic systems are that they are vertically integrated over large distances (e.g., 30-100 km), and that all local magmatic processes are controlled by solidification fronts. Heat transfer considerations show that any viable volcanic system must be supported by a vertically extensive plumbing system. Field and geophysical studies point to a common theme of an interconnected stack of sill-like structures extending to great depth. This is a magmatic Mush Column. The large-scale (10s of km) structure resembles the vertical structure inferred at large volcanic centers like Hawaii (e.g., Ryan et al.), and the fine scale (10s to 100s of m) structure is exemplified by ophiolites and deeply eroded sill complexes like the Ferrar dolerites of the McMurdo Dry Valleys, Antarctica. The local length scales of the sill reservoirs and interconnecting conduits produce a rich spectrum of crystallization environments with distinct solidification time scales. Extensive horizontal and vertical mushy walls provide conditions conducive to specific processes of differentiation from solidification front instability to sidewall porous flow and wall rock slumping. The size, strength, and time series of eruptive behavior

  19. The ALICE time projection chamber

    CERN Multimedia

    Maximilien Brice

    2005-01-01

    This time projection chamber is part of the ALICE detector on the new LHC accelerator at CERN. Particles produced in collisions at the core of the detector will follow paths outward through the various sub-detector layers. If these particles carry a charge, they will ionise the gas contained within this chamber producing an electric signal as the ions drift in the chamber's electric field.

  20. Basilar invagination secondary to hypoplasia of the clivus - Is there indication for craniocervical fixation?

    OpenAIRE

    2014-01-01

    The posterior fossa decompression is a form of treatment suggested for patients with basilar invagination (BI) secondary to hypoplasia symptomatic of the clivus and atlantoaxial alignment preserved. Based on the fact that the worsening of cranial-cervical kyphosis (decrease of clivus-canal angle to less than 150o) can result in anterior brainstem compression, we propose that some patients may benefit from the cranio-cervical fixation. We present a case report of a patient with BI secondary to...

  1. Neuromuscular scoliosis and pelvic fixation in 2015: Where do we stand?

    OpenAIRE

    Anari, Jason B; Spiegel, David A.; Baldwin, Keith D

    2015-01-01

    Neuromuscular scoliosis is a challenging problem to treat in a heterogeneous patient population. When the decision is made for surgery the surgeon must select a technique employed to correct the curve and achieve the goals of surgery, namely a straight spine over a level pelvis. Pre-operatively the surgeon must ask if pelvic fixation is worth the extra complications and infection risk it introduces to an already compromised host. Since the advent of posterior spinal fusion the technology used...

  2. Management of posteriorly dislocated endocapsular tension ring and intraocular lens complex.

    Science.gov (United States)

    Deka, Satyen; Deka, Amarendra; Bhattacharjee, Harsha

    2006-05-01

    We report a case of late posteriorly dislocated endocapsular tension ring (ECR) and intraocular lens (IOL) complex into the vitreous cavity that behaved as a single 13 mm disc. A 3-port pars plana vitrectomy was performed, and perfluorocarbon liquid was used to retrieve the ECR-IOL complex to the retropupillary area. A 3-point scleral fixation was performed to reposition the inseparable ECR-IOL complex.

  3. Percutaneous Screw Fixation of Crescent Fracture-Dislocation of the Sacroiliac Joint.

    Science.gov (United States)

    Shui, Xiaolong; Ying, Xiaozhou; Mao, Chuanwan; Feng, Yongzeng; Chen, Linwei; Kong, Jianzhong; Guo, Xiaoshan; Wang, Gang

    2015-11-01

    Crescent fracture-dislocation of the sacroiliac joint (CFDSIJ) is a type of lateral compression pelvic injury associated with instability. Open reduction and internal fixation is a traditional treatment of CFDSIJ. However, a minimally invasive method has never been reported. The purpose of this study was to assess the outcome of closed reduction and percutaneous fixation for different types of CFDSIJ and present their clinical outcome. The authors reviewed 117 patients diagnosed with CFDSIJ between July 2003 and July 2013. Closed reduction and percutaneous fixation was performed in 73 patients. Treatment selection was based on Day's fracture classification. For type I fractures, fixation perpendicular to the fracture line were performed. For type II fractures, crossed fixation was performed. For type III fractures, fixation was performed with iliosacral screws. Forty-four patients were treated by open reduction and plate fixation. Demographics, fracture pattern distribution, blood loss, incision lengths, revision surgeries, radiological results, and functional scores were compared. All 117 patients were followed for more than 6 months (mean, 14 months [range, 6-24 months]). Blood loss, extensive exposure, duration of posterior ring surgery, duration of hospital stay, and infection rates were lower in the closed group (P<.01). Patients in the closed group achieved better functional performance (P<.01). There were no significant differences in reduction quality (P=.32), revision surgery rates (P=.27), and iatrogenic neurologic injuries (P=.2) between the 2 groups. The authors' results indicate that closed reduction and percutaneous fixation is a safe and effective surgical method for CFDSIJ. Copyright 2015, SLACK Incorporated.

  4. A Comparison of Clinical Outcomes of Dislocated Intraocular Lens Fixation between In Situ Refixation and Conventional Exchange Technique Combined with Vitrectomy

    Science.gov (United States)

    Eum, Sun Jung; Kim, Myung Jun; Kim, Hong Kyun

    2016-01-01

    Purpose. To evaluate surgical efficacy of in situ refixation technique for dislocated posterior chamber intraocular lens (PCIOL). Methods. This was a single-center retrospective case series. 34 patients (34 eyes) who underwent sclera fixation for dislocated IOLs combined with vitrectomy were studied. Of 34 eyes, 17 eyes underwent IOL exchange and the other 17 eyes underwent in situ refixation. Results. Mean follow-up period was 6 months. Mean logMAR best corrected visual acuity (BCVA) was not significantly different between the groups 6 months after surgery (0.10 ± 0.03 in the IOL exchange group and 0.10 ± 0.05 in the refixation group; p = 0.065). Surgically induced astigmatism (SIA) was significantly lower in the refixation group (0.79 ± 0.41) than in the IOL exchange group (1.29 ± 0.46) (p = 0.004) at 3 months, which persisted to 6 months (1.13 ± 0.18 in the IOL exchange group and 0.74 ± 0.11 in the refixation group; p = 0.006). Postoperative complications occurred in 3 eyes in the IOL exchange group (17.6%) and 2 eyes in the refixation group (11.8%). However, all of the patients were well managed without additional surgery. Conclusion. The in situ refixation technique should be preferentially considered if surgery is indicated since it seemed to produce a sustained less SIA