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Application of a modified surgical position in anterior approach for total cervical artificial disc replacement

World Journal of Clinical Cases 2020年第1期8卷 38-45页

作者： Wen-Xiu Hou Hao-Xuan Zhang Xia Wang Hai-Ling Yang Xiao-Rong Luan Third Ward of Orthopedics Department Qilu HospitalShandong UniversityJinan 250012Shandong ProvinceChina Department of Spine Surgery Shandong Provincial Qianfoshan HospitalThe First Affiliated Hospital of Shandong First Medical UniversityJinan 250014Shandong ProvinceChina Department of Nursing Qilu HospitalShandong UniversityJinan 250012Shandong ProvinceChina

BACKGROUND Total cervical artificial disc replacement(TDR)has been considered a safe and effective alternative surgical treatment for cervical spondylosis and degenerative disc disease that have failed to improve with conservative *** the surgical patient is a critical part of the *** patient positioning is crucial not only for the safety of the patient but also for optimizing surgical exposure,ensuring adequate and safe anesthesia,and allowing the surgeon to operate comfortably during lengthy *** surgical posture is the traditional position used in anterior cervical approach;in general,patients are in a supine position with a pad under their shoulders and a ring-shaped pillow under their *** To investigate the clinical outcomes of the use of a modified surgical position versus the traditional surgical position in anterior approach for *** In the modified position group,the patients had a soft pillow under their neck,and their jaw and both shoulders were fixed with wide *** analyzed data included intraoperative blood loss,position setting time,total operation time,and perioperative blood pressure and heart *** Blood pressure and heart rate were not significantly different before and after body positioning in both groups(P>0.05).Compared with the traditional position group,the modified position group showed a statistically significantly longer position setting time(Panterior appro

关键词： anterior approach Surgical position Total cervical artificial disc replacement Cervical spondylosis

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Thoracolumbar fracture management:anterior approach.

Thoracolumbar fracture management:anterior approach.

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第八届全国脊柱脊髓损伤学术会议

作者： Dadi Jin,M.D. Department of orthopaedics & spine surgery,Nanfang hospital,Southern medical university,Guangzhou,510515.

＜正＞Objectives Our retrospective study was carried out to demonstrate the value of, indications for,and results of use of the anterior approach with decompression and instrumental stabilisation in paediatric patient... 详细信息

关键词： Thoracolumbar fracture anterior approach fracture classification

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Systematic Review of Surgical Treatment for stage III kummell's disease:anterior approach vs Posterior Osteotomy

Systematic Review of Surgical Treatment for stage III kummel...

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2016年浙江省骨科学学术年会

作者： Chen Zhenzhong Lou Chao He Dengwei 丽水市中心医院

Object:Most kummell’s disease have a good healing outcome with PVP or ***,The optimal treatment of stage Ⅲ kummell’s disease has been *** are several surgical options including anterior,posterior,and combined approaches,which are associated with varying degrees of *** aim of this study was to assess the surgery of anterior approach and posterior osteotomy for the treatment of stage Ⅲ kummell’s disease and to compare the two ***:A systematic review of literature on spinal surgery was conducted by searching MEDLINE,EMBASE and Google Scholar with a combination of keywords including "surgery" □ "kummell’s disease", "delayed posttraumatic vertebral osteonecrosis", "vertebral pseudarthrosis", "intravertebral vacuum cleft", "delayed vertebral collapse" and "compression fracture nonunion".Independent reviewers selected the articles for analysis after screening the titles,abstracts,and full texts,then extracted data and graded the quality of each paper according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)***:A total of 1,876 abstracts were identified using various keywords.2 cohort studies and 6 case series were eligible for inclusion,involving a total of 204 cases of stage Ⅲ kummell’s *** were 74 cases in3 studies regarding the clinical evaluation of anterior approach and 130 cases in 7 studies regarding the clinical evaluation of posterior ***:anterior approach and posterior osteotomy all achieve the improvement of pain,neurological dysfunction and imaging outcomes,and anterior methods seem to have higher complications rates.

关键词： stage Ⅲ kummell’s disease spinal surgery anterior approach posterior osteotomy postoperative outcomes systematic review

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anterior vs conventional approach right hepatic resection for large hepatocellular carcinoma:A systematic review and meta-analysis

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World Journal of Gastroenterology 2017年第44期23卷 7917-7929页

作者： Jian-Xin Tang Jin-Jun Li Rui-Hui Weng Zi-Ming Liang Nan Jiang Department of Hepatic Surgery The Third Affiliated Hospital of Sun Yat-sen University Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University

AIM To compare the clinical outcomes of right hepatectomy for large hepatocellular carcinoma via the anterior and conventional *** We comprehensively performed an electronic search of Pub Med, EMBASE, and the Cochrane Library for randomized controlled trials(RCTs) or controlled clinical trials(CCTs) published between January 2000 and May 2017 concerning the anterior approach(AA) and the conventional approach(CA) to right hepatectomy. Studies that met the inclusion criteria were included, and their outcome analyses were further assessed using a fixed or random effects *** This analysis included 2297 patients enrolled in 16 studies(3 RCTs and 13 CTTs). Intraoperative blood loss [weighted mean difference =-255.21; 95% confidence interval(95%CI):-371.3 to-139.12; P < 0.0001], intraoperative blood transfusion [odds ratio(OR) = 0.42; 95%CI: 0.29-0.61; P < 0.0001], mortality(OR = 0.59; 95%CI: 0.38-0.92; P = 0.02), morbidity(OR = 0.77; 95%CI: 0.62-0.95; P = 0.01), and recurrencerate(OR = 0.62; 95%CI: 0.47-0.83; P = 0.001) were significantly reduced in the AA group. Patients in the AA group had better overall survival(hazard ratio [HR] = 0.71; 95%CI: 0.50-1.00; P = 0.05) and disease-free survival(HR = 0.67; 95%CI: 0.58-0.79; P < 0.0001) than those in the CA *** The AA is safe and effective for right hepatectomy for large hepatocellular carcinoma and could accelerate postoperative recovery and achieve better survival outcomes than the CA.

关键词： anterior approach Conventional approach Right hepatectomy Hepatocellular carcinoma Postoperative complication Survival

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anterior vs conventional approach hepatectomy for large liver cancer:A meta-analysis

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World Journal of Gastroenterology 2014年第45期20卷 17235-17243页

作者： Lei Li Hai-Qing Wang Qing Wang Jian Yang Jia-Yin Yang Department of Liver Surgery Liver Transplantation Center West China Hospital of Sichuan University

AIM: To evaluate the clinical outcomes and safety of anterior-and conventional-approach hepatectomy for patients with large liver tumors. METHODS: PubMed, EMBASE, Google Scholar and the Cochrane Library databases were searched for randomized controlled trials (RCTs) and controlled clinical trials comparing anterior-approach hepatectomy (AAH) and conventional-approach hepatectomy (CAH). Two observers independently extracted the data using a spreadsheet and assessed the studies for inclusion. Studies that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed using either fixed effects or random effects models. RESULTS: Two RCTs and six controlled clinical trials involving 807 patients met the predefined inclusion criteria. A total of 363 patients underwent AAH and 444 underwent CAH. Meta-analysis indicated that the AAH group had fewer requirements for transfusion (OR = 0.37, 95%CI: 0.21-0.63), less recurrence (OR = 0.57, 95%CI: 0.37-0.87), and lower mortality (OR = 0.29, 95%CI: 0.13-0.63). There were no significant differences between AAH and CAH with regard to perioperative complications (OR = 0.94, 95%CI: 0.58-1.51), intraoperative tumor rupture (OR = 0.98, 95%CI: 0.40-2.40), or length of hospital stay (weighted mean difference = -0.17, 95%CI: -2.36-2.02). CONCLUSION: AAH has advantages of decreased transfusion, mortality and recurrence compared to CAH. It is a safe and effective method for large cancers requiring right hepatectomy. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

关键词： anterior approach Conventional approach Hepatectomy Liver tumor Meta-analysis

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Incidence and predictors of radial nerve palsy with the anterolateral brachialis splitting approach to the humeral shaft

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Chinese Journal of Traumatology 2016年第4期19卷 217-220页

作者： Mohamad Gouse Sandeep Albert Dan Barnabas Inja Manasseh Nithyananth Department of Orthopaedics Unit 1 Christian Medical College Vellore 632004 Tamil Nadu India

Purpose： Fractures of the humeral shaft are common and account for 3%-5%; of all orthopedic injuries. This study aims to estimate the incidence of radial nerve palsy and its outcome when the anterior approach is employed and to analyze the predictive factors. Methods： The study was performed in the department of orthopaedics unit of a tertiary care trauma referral center. Patients who underwent surgery for acute fractures and nonunions of humerus shaft through an anterior approach from January 2007 to December 2012 were included. We retrospectively analyzed medical records, including radiographs and discharge summaries, demographic data, surgical procedures prior to our index surgery, AO fracture type and level of fracture or nonunion, experience of the operating surgeon, time of the day when surgery was performed, and radial nerve palsy with its recovery condition. The level of humerus shaft fracture or nonunion was divided into upper third, middle third and lower third. Irrespective of prior surgeries done elsewhere, the first surgery done in our institute through an anterior approach was considered as the index surgery and subsequent surgical exposures were considered as secondary procedures. Results： Of 85 patients included, 19 had preoperative radial nerve palsy. Eleven （16%） patients developed radial nerve palsy after our index procedure. Surgeons who have two or less than two years of surgical experience were 9.2 times more likely to induce radial nerve palsy （p = 0.002）. Patients who had surgery between 8 p.m. and 8 a.m. were about 8 times more likely to have palsy （p = 0.004）. The rest risk factor is AO type A fractures, whose incidence of radial nerve palsy was 1.3 times as compared with type B fractures （p=0.338）. For all the 11 patients, one was lost to follow-up and the others recovered within 6 months. Conclusion： Contrary to our expectations, secondary procedures and prior multiple surgeries with failed implants and poor soft tissue were not predictiv

关键词： Radial neuropathy Humeral fractures anterior approach

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Protection of the liver during partial hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2004年第4期3卷 490-494页

作者： Sheung Tat Fan Centre for the Study of Liver Disease and Department of Surgery The University of Hong Kong Pokfnlam Hong Kong China

BACKGROUND: Liver failure is the most common cause of mortality for patients undergoing partial hepatectomy. Given adequate liver function and remnant liver volume and absence of co-morbid illness, the cause of liver failure is frequently related to technical errors, which induces mas- sive bleeding and ischemic damage to the liver remnant. DATA RESOURCES: From author' s practice at Queen Mary Hospital, the University of Hong Kong. RESULTS: To avoid technical errors leading to liver ische- mia and failure, adequate exposure, control of bleeding during liver transection, and planning of transection plane are important. Ultrasonic dissector is the best instrument in liver transection. Its careful use can reduce blood loss and help recognize the hepatic vein, the exposure of which serves as an important landmark for a correct transection plane. Even without Pringle maneuver, minimum bleeding during transection could be achieved. CONCLUSION: Protection of the liver remnant is impor- tant to patient survival after partial hepatectomy. It is achieved by meticulous surgical techniques that reduce bleeding to a minimum.

关键词： anterior approach middle hepatic vein ultrasonic dissector

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Radiological and anatomical study on the feasibility of exposing the cervicothoracic junction through window osteotomy in manubrium sterni

Radiological and anatomical study on the feasibility of expo...

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浙江省医学会骨科学分会30年庆典暨2011年浙江省骨科学学术年会

作者： Department of Spine Surgery,The Second Affiliated Hospital of Wenzhou Medical College,China Yi—xing Huang Yong—long Chi Sheng Wang

Purpose To assess the feasibility of exposing the cervicothoracic junction(CTJ)through window osteotomy in manubrium sterni. Methods For this study,120 cervical mid-sagittal MR images and 46 thin-section chest CT scan... 详细信息

关键词： cervicothoracic junction anterior approach manubrium sterni window osteotomy

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Application of anterior-only surgical treatment in single-level AO type B2 thoracolumbar fracture accompany with burst fracture in the vertebral body

Application of anterior-only surgical treatment in single-le...

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2014年浙江省骨科学学术年会

作者： JIANG Song-yi FAN Shun-wu Chen yi-lei Wang qiang You jia-xing Department of Orthopaedics SIR RUN RUN SHAW HospitalMedical College of Zhejiang University

Objective To explore effect of anterior-only surgical treatment in the treatment of AO type B2 thoracolumbar *** From June 2010 to October 2012,19 patients with AO type B2 thoracolumbar fracture were treated through an anterior approach using an expandable artificial vertebral body with *** were thirteen males and 6 females,aged from 22 to 51 years(average,37.1 ± 11.8 years).Injury located at T in 4case,T in 9 cases and L in 6 *** to Frankel grading system,here were 2 case of grade A,8 cases of grade B,6 cases of grade C,3 cases of grade *** operative duration,blood loss were *** local kyphosis angle was measured preoperatively and during the *** recovery was evaluated by Frankel grading *** All patients were successfully followed up for an average time of(30.2 ± 5.1) months(range,248months).The operative time ranged from 115 05 minutes(average,141.4 ± 27.2minutes).The blood lose ranged from 400310(average,771.1 ± 275.5ml).All the cases achieved bony fusion of the anterior column and posterior element 12 months *** local kyphosis angle improve from preoperative34.3 °±11.4 °(range,19.5°4.5°) to 3.6°±3.9°(range,-2.5°.6°) the day after the surgery,and3.0°±3.3°(range,-2.3°.9°) at the final *** Frankel scale improved 1 grade in 8 cases,2 grades in 6 cases,3 grades in 2 cases and no change in 3 *** anterior-only surgical treatment which sparing the posterior surgery showed good result in the treatment of single-level AO type B2 thoracolumbar fracture accompany with burst fracture in the vertebral body.

关键词： anterior approach thoracolumbar fracture flexion-distraction burst fracture

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