Zhonghua yi xue za zhi
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Zhonghua yi xue za zhi · Feb 2020
[Effect of supraorbital foramen variation on radiofrequency treatment of primary trigeminal neuralgia V1].
Objective: To compare the effect of different supraorbital foramen variations on the clinical efficacy of radiofrequency treatment of primary trigeminal neuralgia V1. Methods: The clinical data of 62 patients with primary trigeminal neuralgia (V1 branch) from February 2011 to August 2017 in the first hospital of Jiaxing were analyzed retrospectively. According to the shape of supraorbital foramen, the patients were divided into foramen group (n=28) and incisional group (n=34). ⋯ The patient had no other serious complications in the near and long term except for the swelling of puncture point. Conclusion: The short and long-term effective rates of supraperitoneal foramen in anatomical variants for the radiofrequency treatment of primary trigeminal neuralgia V1 are higher. The supraorbital foramen have higher long-term effective rates, there are no other serious adverse reactions excepting numbness, and the patients have a higher acceptability.
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Zhonghua yi xue za zhi · Feb 2020
[Effects of ultrasonic bone curettes combined with high-speed drills in posterior laminectomy and decompression procedure for severe thoracic spinal stenosis].
Objective: To evaluate the safety and efficacy of the combined use of ultrasonic bone curette with the high-speed drill in posterior laminectomy and decompression procedure for severe thoracic spinal stenosis, and propose the optimal cutting position for ultrasonic bone curette during the laminectomy. Methods: By observing and measuring the parameters of thoracic pedicle, lamina, inner wall of the vertebral canal and their relation with the surrounding structures on cadavers, we provided a morphological marker for laminectomy by an ultrasonic bone curette. Data of 19 patients with severe thoracic spinal stenosis treated by posterior laminectomy and decompression were collected from June 2017 to June 2018 in Shanghai Changzheng Hospital. ⋯ There was one case of dura injury and one case of thoracic nerve root injury during the operation in group B. Conclusions: It is safer and more reliable for the combined use of ultrasonic bone curette with the high-speed drill in posterior laminectomy and decompression procedure for the severe thoracic spinal stenosis. The interface between the cortical bone and the medial edge of cancellous bone of the pedicle could be identified as the cutting mark for ultrasonic bone curette in this procedure.
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Zhonghua yi xue za zhi · Feb 2020
[Technical notes and clinical efficacy analysis of full-endoscopic thoracic discectomy via transforaminal approach].
Objective: To study the technical notes and clinical efficacy of full-endoscopic thoracic intervertebral discectomy via transforaminal approach. Methods: We included 16 patients with thoracic disc herniation treated by full-endoscopic thoracic discectomy via transforaminal approach between January 2017 and September 2018 in ours department of orthopedics. The average age is 53.7 years. ⋯ Back pain and radicular pain were all relieved obviously in all patients, and spinal cord function was obviously restored. Transient intercostal neuralgia occurred in 2 cases after operation, and no other surgical complications occurred. Conclusions: Full-endoscopic or fluoroscopic foraminoplasty and full-endoscopic thoracic discectomyvia transforaminal approach under local anesthesia is a safe and effective treatment for soft and hard thoracic disc herniation located on the ventral side of the spinal cord.