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Open reduction of unstable fractures and fracture-dislocations of the thoracic and lumbar spine with Harrington instrumentation is a convenient and ideal method. It can restore the anatomical structure of the spine and facilitate the recovery of spinal cord and cauda equina. The fixation is firm enough to make nursing and the morbidity rate is much reduced. Since Nov. 1978 we have performed such kind of operation on 28 cases of thoraco-lumbar fracture-dislocations with paraplegia. All cases were caused by acute... Open reduction of unstable fractures and fracture-dislocations of the thoracic and lumbar spine with Harrington instrumentation is a convenient and ideal method. It can restore the anatomical structure of the spine and facilitate the recovery of spinal cord and cauda equina. The fixation is firm enough to make nursing and the morbidity rate is much reduced. Since Nov. 1978 we have performed such kind of operation on 28 cases of thoraco-lumbar fracture-dislocations with paraplegia. All cases were caused by acute injury but one by syphilitic spondylitis. 24 cases had incomplete paraplegia and 4 complete ones. The former 24 cases regained more or less some neural function while the latter 4 cases remained unchanged except in one case there was a slight improvement in sensation and motion. One case was complicated with loosening of the steel rod one year after operation. The operative procedure and the treatment for different type of fractures and some suggestions to minimize complications were discussed. 使用体内撑开器,对胸腰椎不稳定骨折伴截瘫进行复位和内固定,是简便而理想的方法。本院自1978年11月以来,对28例胸腰椎不稳定骨折伴截瘫,使用内撑开器进行治疗,除1例为梅毒性脊椎炎外,其余都是损伤性骨折伴截瘫。24例为不完全截瘫,4例为完全性截瘫。不完全截瘫术后恢复良好,而4例完全截瘫仅1例感觉和运动稍有恢复,其余均未见好转。手术对不同类型骨折的使用方法及减少并发症等问题,进行了讨论。 The clinical pictures of ankylosing spondylitis ( AS)were analyzed in 157 patients. It was found that AS occurs more frequently between 15 to 30 years of age, being more prevalent in men than in women. The incidence ratio of male to female was 14.7:1. Approximately 23.6% of patients had a positive family history with the disease. The initial joint involvement was usually located in the hip ( 33.1%) , lumbar spine ( 24.2% ) and sacroiliac joints ( 21 .7% ) , and the spine and sacroiliac joints are predominatly... The clinical pictures of ankylosing spondylitis ( AS)were analyzed in 157 patients. It was found that AS occurs more frequently between 15 to 30 years of age, being more prevalent in men than in women. The incidence ratio of male to female was 14.7:1. Approximately 23.6% of patients had a positive family history with the disease. The initial joint involvement was usually located in the hip ( 33.1%) , lumbar spine ( 24.2% ) and sacroiliac joints ( 21 .7% ) , and the spine and sacroiliac joints are predominatly affected. The definite diagnosis of AS requires X-Ray evidence of unilateral or bilateral sacroiliitis, presence of pain at the dorsolumbar junction or in the lumbar spine with stiffness, progressive limitation of motion of the spine, limitation of chest expansion to less than 2.5cm and HLA-B2v positive and rheumatoid factor ( RF ) negative. 本文对157例强直性脊柱炎患者进行了临床分析。认为AS多初发于15—24岁之间的男性青年,男女发病比例为14.7:1。有23.6%的病人有家族史。初发关节多在髋关节(33.1%)、腰椎(24.2%)及骶髂关节(21.7%);受累关节以骶髂关节及脊柱为主。对AS的诊断必须有经X线摄片证实的单侧或双侧骶髂关节炎,并有腰背部疼痛和僵硬,脊柱活动进行性障碍,胸扩度少于2.5cm及HLA—B_(27)阳性,RF阴性. Guanjieling was used in the treatment of 357 cases of chronic joint deseases including rheumotoid arthritis 177 cases,ankylosing spondylitis 34 cases, Sjogren syndrome 11 cases, Hypertrophic arthritis 36 cases,chronic muscular rheumatism 20 cases, chronic rheumatism 20 cases, perlarthritis 12 cases and micellaneous 47 cases. 273 cases aged above 31 years old (76.2% ) . All of the cases were treated with Guanjieling (Composed of Tripterygium wolfordii Hook,Radix Achyranthis Bideu-tatac, Gentian macrophylla... Guanjieling was used in the treatment of 357 cases of chronic joint deseases including rheumotoid arthritis 177 cases,ankylosing spondylitis 34 cases, Sjogren syndrome 11 cases, Hypertrophic arthritis 36 cases,chronic muscular rheumatism 20 cases, chronic rheumatism 20 cases, perlarthritis 12 cases and micellaneous 47 cases. 273 cases aged above 31 years old (76.2% ) . All of the cases were treated with Guanjieling (Composed of Tripterygium wolfordii Hook,Radix Achyranthis Bideu-tatac, Gentian macrophylla pall, Rhizoma Polygonati, Rhizoma Dioscoreae, Cornu Cervi Degelatinatum ) . 用“关节灵”治疗了357例慢性关节病患者,其中类风湿性关节炎177例,强直性脊柱炎34例,干燥综合征11例,增生性关节炎36例,慢性肌风湿20例,慢性风湿性关节炎20例,关节周围炎12例.其它47例;年龄31岁以上共272例(76.2%)。关节灵由雷公藤、细辛、牛膝、秦艽、黄精、山药,鹿角霜等药组成。357例平均服药3.7个月,治愈或缓解48例(13.4%),显效152例(42.6%),好转151例(42.3%),无效6例(1.7%)。
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