Publications by authors named "Xizheng Song"

2 Publications

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Clinical effect evaluation of percutaneous vertebroplasty combined with the spinal external fixator for the treatment of osteoporotic compressive fractures with posterior vertebral defect.

Eur Spine J 2014 Dec 29;23(12):2711-7. Epub 2014 Aug 29.

Spinal Department, First Affiliated Hospital of University of South China, 69 Chuanshan Road, Hengyang, 421001, Hunan, China.

Purpose: The purpose of this study is to report a new technique and assess clinical outcome of compressive fractures with posterior vertebral defect treated by percutaneous vertebroplasty combined with the spinal external fixator.

Method: 80 patients (32 males and 48 females), ranging from 62 to 88 years old with the mean age of 71.5 years, underwent surgery for the compressive fractures with posterior vertebral defect by percutaneous vertebroplasty combined with the spinal external fixator. All patients were diagnosed to have fresh compressive fractures with osteoporosis and posterior vertebral defect shown on roentgenograms, computed tomography scans or magnetic resonance imaging preoperatively. They underwent spinal external fixation firstly to be fixed and restored, then to be carried out percutaneous vertebroplasty. The mean follow-up was 24 months (16-42 months). Spinal canal encroachment, spinal cobb angle and vertebral body height loss were measured to assess clinical outcome before and after surgery, at the final follow-up. The Visual Analogue Scale and Oswestry Disability Index were used for pain and functional assessment. In all cases, preoperative and postoperative radiographs and magnetic resonance imaging were obtained.

Results: The average time of surgery was 88 min (75-115 min). The mean blood loss was 10 ml (6-12 ml) during surgery. The anterior height loss of vertebral body decreased significantly from 79.3 ± 11% before surgery to 8.0 ± 5.2% after surgery, and 7.6 ± 6.0% at the final follow-up. The spinal canal encroachment significantly reduced from 19.9 ± 2.6 % preoperatively to 4.0 ± 0.7% postoperatively, 4.1 ± 0.7% at the final follow-up. The Cobb angle was corrected from 25.8 ± 7.9° primarily to 8.2 ± 4.1° postoperatively, 7.8 ± 3.1° at the final follow-up. There were significant differences (p < 0.05) among them before and after the surgery. Postoperative VAS and Oswestry scores were both significantly different from the preoperative and follow-up (p < 0.05).

Conclusion: The preliminary results are encouraging, showing that the spinal external fixator combined with percutaneous vertebroplasty was a safe and effective method to treat the osteoporotic compressive fractures with posterior vertebral defect.
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http://dx.doi.org/10.1007/s00586-014-3346-3DOI Listing
December 2014

External spinal skeletal fixation combination with percutaneous injury vertebra bone grafting in the treatment of thoracolumbar fractures.

Spine (Phila Pa 1976) 2011 Apr;36(9):E606-11

Spinal Department, First Affiliated Hospital of University of South China, Hengyang city, Hunan, China.

Study Design: A technical report of thoracolumbar fractures managed by percutaneous external pedicular fixation and intracorporeal bone grafting.

Objective: To develop a new technique by combining simplified percutaneous external pedicular fixator with intracorporeal bone grafting to treat thoracolumbar fractures and assess its technical safety and clinical efficacy.

Summary Of Background Data: For surgical treatment of thoracolumbar fractures, the classical techniques are beneficial in decompression, restoration, fixation, and graft fusion, but they are also hugely invasive procedures. The earlier external spinal fixation procedures are good at indirect restoration, decompression, and elastic fixation of spinal fracture. However, they are limited by remains of a large external frame and inability of vertebral reconstruct. Therefore, the minimally invasive techniques combining simplified percutaneous external pedicular fixation and intracorporeal bone grafting might be a useful alternative.

Methods: There were 50 consecutive patients who had thoracolumbar fractures with or without associated incomplete neurologic deficit. They underwent percutaneous external pedicle fixation and intracorporeal bone grafting surgery within 7 days of admission, had their implants removed after 3 months, and were prospectively followed for at least 12 months. American Spine Injury Association grading, spinal canal encroachment, spinal Cobb angle, and vertebral body height were calculated before and after surgery to assess clinical outcome.

Results: A minimum of 12-month follow-up was achieved in 50 patients. The average operative time was 90 minutes (range, 50-160 minutes). The mean bone graft volume was 4.8 cm (range, 3.2-10.6 cm). The intraoperative mean blood loss was 100 mL (range, 50-180 mL). Forty-two patients all had at least one American Spine Injury Association grade neurologic improvement on final follow-up observation; there were no surgery-related complications. The mean anterior height of vertebral body was 53.2% (range 25%-78%) before surgery, 93.6% (range 78%-104%) after surgery, and 94% (range 79%-103%) at final follow-up. The preoperative Cobb angle of the primary curve averaged 30.7° (range 8°-67°), and corrected to 4.5° (range 0°-12.0°) immediately after surgery, There were statistically significant (P < 0.01) among them before and after operation. There was no instrumentation failure or measurable loss of sagittal curve and vertebral height correction in any cases.

Conclusion: The new technique by combination of percutaneous external transpedicular fixation and transpedicular bone grafting is a feasible, safe, useful, efficient, and minimally invasive method to treat thoracolumbar fractures. It is a reasonable alternative method to other minimally invasive techniques of surgical management of the thoracolumbar fractures.
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http://dx.doi.org/10.1097/BRS.0b013e3181f92dacDOI Listing
April 2011