Objective To introduce and evaluate the efficacy of microsurgical decompression and titanium cage implants fusion with anterior plating in cervical spondylitic radiculopathy. Methods From September 2000 to September 2002, 54consecutive patients were treated with anterior microsurgical decompression followed by intervertebral fusion using a titanium cage packed with autogenous cancellous bone graft and an anterior cervical plating.There were 31 males and 23 females, with an average age of 45.2 years (38-65 years). The disease course was 5-19 months. The locations were C3,4 in 3 cases, C4,5 in 25, C5,6 in 21 and C6,7in 5 cases. The bony endplates were preserved to prevent cage subsidence. Thirty-nine cases suffered from monosegmental fusion and 15 cases did bisegmental fusion. The Cobb angle was 0.80±0.31° before operation. Results All wounds healed by first intention and no complications of vertebral artery injury, vertebralnerve injury and leakage of cerebrospinal fluid occurred. Dysphagia occurred within2 weeks in 2 cases, hoarseness occurred and recovered without treatment in 1 case, and pain in upper limbs aggravated and was relieved after 1 month of conservative treatment in 1 case. Fiftyfour patients were followed 12-36 months(16.4 months on average). The X-ray films showed no breakage of screws and robs and olisthy of implants. Fusion was achieved in 53 patients and the fusion rate was 98.2%. The Cobb angles were 5.50±0.22° after operation and 5.20±0.17° at final followup, showing significant differences when compared with before operation(Plt;0.01). According to Odom’s criteria, the resultswere excellent in 24 cases, good in 22 cases and fair in 8 cases, the excellentand good rate was 85.2%.Conclusion Anterior cervical microsurgical decompression is a safely and effectively treatment option in patients with cervical spondylitic radiculopathy caused by protrusion of intervertebral disc(1-2 discs) and by degenerative osteophyte. Titanium cage interbody fusion with concomitant use of anterior plating provides immediate biomechanical stability, successfully restores and maintains posterior interbody height and cervic、al lordosis to ensure satisfactory longtime outcomes.
Objective To investigate the clinical outcome of open reduction and internal fixation of calcaneal interarticular fractures. Methods From August 1998, 38 calcanneal interarticular fractures in 35 cases, including 8 of type Ⅱ, 14of type Ⅲ and 16 of type Ⅳ according to Sander’s classification, were treatedby open reduction to restore the posterior articular facet, subtalar facet, Bohler angle and Gissane’s angle, following internal fixation by plastic titanicalloy plate. Thirtythree calcanneal interarticular fractures were followed up for6 to 22 months, 12.3 months on average; and the healing time and joint functionwere evaluated according to Maryland Foot Score System. Results The average healing time of fracture was 7.1 weeks, ranging from 5 to 12 weeks; and the joint function was excellent in 18 calcanneus, good in 13 calcanneus, and the satisfactory rate was 93.9%. Conclusion Open reduction and internal fixation with plastic titanium plate is a good choice for calcaneal interarticular fractures.