Objective To explore the cl inical appl ication of rib autograft for reconstructing il iac crest by anterior approach of thoracic and lumbar vertebrae, and to observe the short-term and long-term effects. Methods From September 2004 to September 2007, 54 cases of thoracic and lumbar injuries were treated by the surgery of anterior approach of thoracic and lumbar vertebrae.There were 39 males and 15 females with an average age of 42 years old (range, 27-59 years old), including 4 cases of tuberculosis of spine and 50 cases of thoracic and lumbar vertebrae bursting fracture. All cases underwent the surgery of anterior approach of thoracic or lumbar and il iac crest was used as autograft. Fifty-four patients wererandomized into the reconstruction group (RG, n=25) and the non-reconstruction group (NRG, n=29). The patients of RGgroup were treated with rib autograft for reconstructing il iac crest. There were no statistically significant differences in general data between two groups (P gt; 0.05). The visual analogue scores (VAS) was used to estimate pain degree of treated hip after 2 weeks, and 3, 12 months. The extenion satisfaction grade of il iac crest and the comfort degree of action while bundl ing waist belt were estimated after 12 months. It was observed whether or not anterior superior il iac spine avulsion fracture occurred on the premise of non-accidental trauma within 1 year. The occurrence of fracture and the union status of reconstructed il iac crest were observed by X-ray after 1 year. Results All wounds achieved primary heal ing. No compl ication was found at early stage. All patients were followed up 1 year. There was no significant difference in the VAS of the treated hip under conditions of cl inostatism rest between two groups after 2 weeks and 3 months (P gt; 0.05). But there was significant difference in the VAS under conditions of action after 2 weeks and 3 months, under conditions of cl inostatism rest after 12 months (P lt; 0.05), and the VAS of RG was lower than that of NRG. The exterior satisfaction grade of il iac crest and comfort degree of action while bundl ing waist belt in RG were higher than those in NRG after 1 year, showing significant differences (P lt; 0.05). No anterior superior il iac spine avulsion fracture occurred after 1 year. And in RG group no fracture of reconstructed il iac crest occurred after 1 year. The X-ray film showed that the two ends of rib reconstructed by il iac crest were blur, and that the rib healed well with il iac bone. Conclusion Rib autograft for reconstruction of il iac crest by anterior approach of thoracic and lumbar vertebrae was economic and convenient. It could improve local appearance, reduce the local pain, and improve patients’ l ife quality.
目的 觀察比較鹽酸氨基葡萄糖單獨使用及與硫酸軟骨素聯合使用治療腰椎小關節骨關節炎（LFOA） 的臨床療效。 方法 2009年1月－2011年1月，將80例LFOA患者隨機分成兩組，A組口服鹽酸氨基葡萄糖，B組口服鹽酸氨基葡萄糖和硫酸軟骨素兩種藥物，6周為1個療程，間斷治療4個療程。分別比較用藥前與用藥后3、6周及5、8、11個月時的日本骨科協會（JOA）評分、晨僵和壓痛程度變化。 結果 治療后，兩組的JOA評分在各觀察時點均增加，與治療前比較差異有統計學意義（P＜0.05）。組間行JOA評分治療改善率的比較，在各觀察時點差異均有統計學意義（P＜0.05），B組JOA評分改善率優于A組。治療3周后，兩組晨僵和壓痛評分均降低，與本組治療前比較差異有統計學意義（P＜0.05）；組間比較，差異亦有統計學意義（P＜0.05），B組晨僵和壓痛程度均低于A組。第6周，第5、8、11個月，兩組組間比較晨僵和壓痛程度差異均無統計學意義（P＞0.05），但各療程結束后兩組晨僵和壓痛程度均呈持續降低趨勢。 結論 單獨應用鹽酸氨基葡萄糖及鹽酸氨基葡萄糖與硫酸軟骨素的聯合應用治療LFOA療效確切，聯合用藥優于單獨應用鹽酸氨基葡萄糖。