Zhongguo gu shang = China journal of orthopaedics and traumatology
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There has been rapid progress in endoscopy-and imaging technology-based minimally invasive surgery for the treatment of lumbar disc herniation (LDH). It is advategeous over conventional surgery in that it not only reduces surgical trauma but relieves sufferings of patients. ⋯ How to expand the indications and solve the practical problem of lumbar reconstruction remains to be the direction of future breakthrough. This article is a summary of the progress and current situation of minimally invasive percutaneous and endoscopic techniques for the treatment of LDH.
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Spinal cord injury is a difficult medical problem and current therapeutic methods could not obtain satisfactory results. Recent 20 years, stem cell technology developed rapidly, embryonic stem cells and adult stem cells were used for treating neurological disease and nerve injury of animal models and the clinical results were confirmed. ⋯ Recently, induced pluripotent stem cells were developed as a new method for the treatment of spinal cord injuries by the autologous transplantation. Starting from this work, the purpose of this review is to assess the differentiate ability of induced pluripotent stem cells into neurocyte and review the latest developments in this area.
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One of the complications of total hip arthroplasty is intraoperative periprosthetic fracture. Periprosthetic fracture is divided into acetabular fracture and femoral fracture. Risk factors for intraoperative periprosthetic fracture include use of minimally invasive techniques, press-fit cementless stems, revision operations and osteoporosis. It has been recognized that treatment of intraoperative periprosthetic fractures should be based on the classification of the Vancouver system for intraoperative fractures.
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Percutaneous vertebroplasty (PVP) is widely used as an effective treatment for compression fracture, additional adjacent vertebral body fractures are frequently reported after operation, but the relationship between the vertebroplasty and adjacent vertebral body fracture remains unknown. The possible causes of refracture after operation include mechanical force factor, bone cement and clinical factors. Except for the changes of stress and stiffness of the adjacent vertebral bodies, the extravasation of cement and osteoporosis itself of the vertebral bodies should be concerned about. To aim at above-mentioned reasons, simultaneously, preventive strategies, such as prophylactic cement injection into adjacent non-fractured vertebrae, additional PVP and injectable copolymer hydrogel are approached in this review.
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Meta Analysis
[Systematic review of clinical randomized controlled trials on manipulative treatment of lumbar disc herniation].
To evaluate the efficacy and safety of the manipulative treatment on lumbar disc herniation and analyze the current status of clinical studies. ⋯ This study shows that manipulative treatment on lumbar disc herniation is safe, effective, and both cure rate and the effective rate is better than other therapies. But the number of documents is limited and the quality is not very high, and the conclusion is still uncertain, high-quality evidence is needed to be further validated.