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Lian-shun Jia

Publications and source records attributed to Lian-shun Jia.

8 recordsLinked to original sources
PubMed2006

[In vivo experimental study of hat type cervical intervertebral fusion cage].

OBJECTIVE: To compare the characteristics of interbody fusion achieved using hat type cervical intervertebral fusion cage (HCIFC) with those of an autologous tricortical iliac crest graft, Harms cage and Carbon cage in a goat cervical spine model. METHODS: Thirty-two goats underwent C(3, 4) discectomy and fusion in which the following were used: Group 1, autologous tricortical iliac crest bone graft (8 goats); Group 2, Harms cage filled with autologous iliac crest graft (8 goats); Group 3, Carbon cage filled with autologous iliac bone (8 goats); Group 4, HCIFC filled with autologous iliac graft (8 goats). Radiography was performed pre- and postoperatively and after 1, 2, 4, 8, and 12 weeks. At the same time points, disc space height, intervertebral angle, and lordosis angle were measured. After 12 weeks, the goats were killed and fusion sites were harvested. Biomechanical testing was performed in flexion, extension, axial rotation, and lateral bending to determine the stiffness and range of motion. All cervical fusion specimens underwent histomorphological analysis. RESULTS: One week after operation, the DSH, IVA and LA of HCIFC and Carbon cage were statistically greater than those of autologous iliac bone graft and Harms cage. Significantly higher values for disc space height, intervertebral angle and lordosis angle were shown in cage-treated goats than in those that received bone graft over a 12-week period. The stiffness of Harms cage in axial rotation and later bending were statistically greater than that of other groups. Radiographic and histomorphologic evaluation showed better fusion results in cage groups than in autologous bone group. CONCLUSIONS: HCIFC can provide a good intervertebral distractability and enough biomechanical stability for cervical fusion.

Animals↗
PubMed2006

[Diagnosis and treatment for the injury of cervical disc and longitudinal ligament].

OBJECTIVES: To study the diagnosis and treatment for the injury of cervical disc and longitudinal ligament. METHODS: From 2001 to 2005, the clinical data of sixty-three patients with cervical disc and longitudinal ligament injury were studied. Early treatment was done based on spinal cord injuries and spinal stabilities by X rays and MRI. Early operation was done in fifty-four cases and early non-operation in nine cases. RESULTS: The follow-up time was six to forty-one months in all patients. The neurological recovery was found in two of eight complete SCI post-operation, thirty-one in thirty-nine incomplete SCI. Cervical collar or plaster orthotic were used in nine cases with four to six weeks. Evidence of instability was noted in four patients, who were operated with anterior decompression fusion. Neck chronic pain was found in two patients, anterior decompression and fusion was done in one with cervical spinal cord compression. CONCLUSIONS: MRI examination is the most value measure for the diagnosis of cervical disc and longitudinal ligament injury. Early anterior decompression and fusion was an important approach for cervical disc and longitudinal ligament injury.

Adolescent↗
PubMed2006

[The biomechanical study of craniovertebral junction fixation with posterior transarticular screw].

OBJECTIVE: To evaluate the stability of biomechanics of occipitoatlantoaxial reconstruction with transarticular screw fixation. METHODS: Twelve fresh human cadaveric occipitocervical spine specimens were mounted in a custom-designed, spine-testing machine that applied pure moments while recording the three-dimensional angular movement at occiput (Oc)-C(1) and C(1 - 2) segments. The specimens were tested under seven different conditions: the intact (intact group), the occipitoatlantoaxial instability (Destabilized group), fixation with Ti-cable plus bone graft group (cable + graf group), fixation with the transarticular fixation (CTS group), fixation with SUMMIT occitocervical spinal fixation system (SUMMIT group), fixation with transarticular screw plus bone graft (CTS + graf group), and fixation with SMMIT system and plus graft group (SUMMIT + graf group). The data obtained were statistically analyzed. RESULTS: The CTS group reduced motion to well within the normal rang. In the Oc-C(1) segment, The CTS group and SUMMIT group allowed a very small rang of motion (ROM) and neutral zone (NZ) during lateral bending and axial rotation. The ROM and NZ during flexion and extension of the SUMMIT group, were significantly smaller than those of cable + graf group and CTS group (6.64 degrees +/- 0.59 degrees, 2.49 degrees +/- 0.26 degrees, 0.50 degrees +/- 0.03 degrees, 0.21 degrees +/- 0.01 degrees, 0.27 degrees +/- 0.07 degrees, 0.13 degrees +/- 0.01 degrees vs 10.01 degrees +/- 1.26 degrees, 3.80 degrees +/- 0.79 degrees, 7.93 degrees +/- 1.34 degrees, 3.18 degrees +/- 0.95 degrees, 9.54 degrees +/- 0.87 degrees, 5.93 degrees +/- 0.74 degrees, P < 0.05). In the C(1 - 2) segment, ROM and NZ in all directions of CTS group were smaller in rotation than SUMMIT group (1.64 degrees +/- 0.39 degrees, 0.61 degrees +/- 0.15 degrees, 0.14 degrees +/- 0.05 degrees, 0.02 degrees +/- 0.01 degrees, 0.32 degrees +/- 0.04 degrees, 0.08 degrees +/- 0.01 degrees, vs 0.21 degrees +/- 0.04 degrees, 0.07 degrees +/- 0.03 degrees, 0.21 degrees +/- 0.12 degrees, 0.10 degrees +/- 0.02 degrees, 2.92 degrees +/- 0.28 degrees, 1.27 degrees +/- 0.11 degrees, all P < 0.05). There was no significant difference in ROM and NZ in all directions between CTS + graf group and SUMMIT + Graf group (P > 0.05). CONCLUSION: In vivo biomechanics studies show that posterior occipitocervical transarticular fixation has unique features in reconstructing dynamic stability of the occipitoatlantoaxis, especially in controlling stability of rotation and lateral flexion, thus ensuring successful fusion of the implanted bone and allowing for clinical use of the technique.

Adult↗
PubMed2005

[The study of total spondylectomy in the treatment of cervical spinal tumors].

OBJECTIVE: To study the surgical indications, approaches and the clinical results of the total spondylectomy and instrumentation reconstruction in the treatment of cervical spinal tumor. METHODS: From October 1998 to October 2003, 39 patients with lower cervical bone tumors, including 34 cases with primary tumor and 5 cases with metastatic tumor, were admitted and operated on with total spondylectomy. The patients underwent anteroposterior total spondylectomy including anterior cervical plating, titanium mesh reconstruction and posterior instrumentation based on the location of tumor lesions in the lower cervical spine. One vertebral level total spondylectomy was performed in 29 cases, two level in 7 cases and three level in 3 cases. RESULTS: The postoperative follow-up ranged from 6 months to 4 years. A majority of patients achieved good results postoperatively. Nineteen cases had complete relief of neurological status. One patient died of multiple metastases and systemic failure 24 months later. One case with malignant neurilemmoma developed local recurrence one year postoperatively. CONCLUSION: Anteroposterior total spondylectomy and reconstruction can reduce local recurrence, improve neurological function and increase operation therapeutic effect. Meanwhile, the technique of cervical total spondylectomy carries relatively greater risks and should be more attention to the operation indication.

Adolescent↗
PubMed2005

[Surgical treatment and its related factors of cervical spondylotic myelopathy].

OBJECTIVE: To observe the results and its related factors of surgical treatment of cervical spondylotic myelopathy (CSM). METHODS: Totally 365 CSM patients were reviewed. All patients were treated with anterior cervical decompression and fusion with autogenous iliac bone or titanium mesh cages with local bone graft. Anterior locking plates were used for fixation. Five patients received revision surgery 3 to 6 months after the initial operation. RESULTS: Clinical function was excellent in 175 patients (47.94%), good in 129 patients (35.34%), fair in 44 patients (12.05%), and poor in 17 patients (4.66%). CONCLUSION: Anterior cervical decompresion of CSM has good clinical efficacy. The timing of operation, disease severity, and surgical technique are the important factors affecting the outcome of treatment.

Adult↗
PubMed2004

[Key points about atlanto-axial internal-fixation and fusion using Gallie's technique].

OBJECTIVE: To study the clinical problems about posterior atlanto-axial internal-fixation and fusion for atlanto-axial instability or dislocation. METHODS: Surgical treatments of 138 cases with atlanto-axial instability or dislocation were reviewed. There were 62 cases of odentoid malformation, 54 cases of odentoid fracture or rupture of transverse ligament, 22 cases of subluxation and rotation. All cases were treated using Gallie's technique. Six cases were also fixed with transarticular screws, and protected with Philadelphia collar. Other patients were fixed with plaster paris brackets. The followed-up period was 1 to 12 years with an average of 3 year and 5 months. RESULTS: According to Sumi's criteria, excellent 70 cases (50.7%), good 40 cases (29.0%), fair 15 cases (10.9%), poor 13 cases (9.4%). 9 cases with bone graft postponed fusion were cured by enhance external-fixation. 2 cases with nonunion were treated with revision surgery. Complication of cord injury happened in 1 case. CONCLUSION: Gallie's fusion technique is an effective method to manage the atlanto-axial instability or dislocation. Skull distraction before operation and reliable external-fixation post operative are important assistant measures. Key points for successful operation are careful wiring or cable traversing, decortication of posterior arc of C1, and maintaining the physiological height between C1 and C2 posterior arc. Indications and objectives should be conformed before revision surgery for failure cases.

Adolescent↗
PubMed2003

[Investigation of resection and reconstruction procedure of high-sacrum tumors].

OBJECTIVE: To investigate the way of resection of high-sacrum tumors and the way and duration of the spinal-pelvic TSRH or ISOLA internal fixation. METHOD: From October 1998 through April 2002, 35 patients with sacral tumor were enrolled in our hospital, including 4 cases in L(5)-S(1), 2 in L(5)-S(2), 4 in S(1), 8 in S(1 - 2), 6 in S(1 - 3), 6 in S(1 - 4), 5 in S(1 - 5). 35 patients were followed by lumbo-pelvic TSRH or ISOLA internal fixation and corresponding chemotherapy and radiotherapy. RESULTS: In the follow-up period of 6 - 42 months, the short-term results were satisfactory with the lumbosacral pain reduced and the neurological function improved in different degrees, however dysuria occurred in 1 case and skin necrobiosis at coccygeal incision occurred in 1 case; two cases experienced cerebrospinal fluid leakage and 1 case experienced postoperative infection and delayed healing, 1 case with chordoma and 2 cases with malignant fibrous histiocytoma recurred 1 year after postoperation, one of these 2 cases with malignant fibrous histiocytoma suffered from lung metastasis and died of system failure 19 months after postoperation. No fractured rod occurred. CONCLUSION: Surgical procedure and postoperative comprehensive treatment have important effects on the prognosis. High-sacral tumor resection and reconstruction are effective means of achieving stabilization, providing significant pain relief and preserving ambulatory capacity.

Adolescent↗