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To summarize the clinical application result of the selective nerve root blocks in limited operation of the lumbar spine.From January 2008 to October 2012,68 patients with lumbar spinal canal stenosis with multiple levels were underwent the selective nerve root blocks in limited operation of the lumbar spine,including 47 males and 21 females with an average age of 56 years old ranging from 45 to 80. After never roots blocks,64 cases were positive for limited operation of the lumbar spine; the other 4 cases were negative and abort the operation.The nerve roots block operation smoothly and no complications related to the nerve roots block occurred. There was no neurologic injury complication in this study. Follow-up period ranged from 16 to 45 months postoperatively (means, 32 months). The recovery effect was calculated with Macnab scores, the result was excellent in 44 cases, good in 18 cases, poor in 1.Operative treatment for lumbar spinal canal stenosis with multiple levels is focused on the areas causing symptomate neural compression rather than prophylactic decompression at areas of nonsymptomatic disease. Application of selective nerve root blocks can accurately judge the responsible vertebral body and pain source and improve the curative effect of limited operation of the lumbar spine

To summarize the clinical application results of the micro-decompression procedure for the treatment of lumbar spinal stenosis with multilevel.From January 2004 to December 2008, 40 patients with lumbar spinal stenosis with multilevel were treated by micro-decompression procedure. There were 28 males and 12 females, ranging in ages from 55 to 80 years,with an average of 58 years. The course of this disease ranged from 18 months to 12 years,averaged 32 months. Forty patients with lumbar spinal stenosis with multilevel were diagnosed by CT or MRI examination. There were 20 cases with two levels stenosis (L4,5 and L5S1), 15 cases with three levels stenosis (L3,4, L4,5 and L5S1), and 5 cases with four levels stenosis (L2,3, L3,4, L4,5 and L5S1). The therapeutic effects were evaluated according MacNab standard in aspect of pain, bladder function, range of lumbar spine motion and muscle strength of lower limb.All of the incisions healed without infections and complications. The mean operation time of each side was 70 minutes (ranged from 50 to 90 minutes), and mean blood loss was 150 ml (ranged from 90 to 200 ml). All the patients were followed up from 22 to 52 months with an average of 26 months. According to MacNab standard, 28 cases got an excellent result, 10 good and 2 poor.Operative treatment for lumbar spinal stenosis with multilevel should focus on the symptom sites causing by neural compression and preventive decompression operations are not necessary for nonsymptomatic sites. The micro-decompression procedure can be easily tolerated by older patients;it can decrease the damage to the posterior stabilizing structures of the lumbar spine. It is easily to access to spinal canal and decompress the nerve roots.

To analyze the cause of the postoperative shortening in distal radius fractures and to find treatment strategies to enhance the reduction effect of distal radius fracture and long-term efficacy.From June 2005 to January 2009, 46 patients with distal radius fractures were treated by surgical operation including 17 males and 29 females,ranging from 27 to 90 years old with an average age of 48 years. All fractures were reduced satisfactory with smooth articular surface. The postoperative radial shortening was analyzed.All patients were followed-up for 6 to 24 months with an average of 14 months. Among them, 12 patients had radial shortening. The causes of postoperative radial shortening includes: (1) patients older than 60 years; (2) severe osteoporosis; (3) preoperative displacement and comminuted fractures; (4) inappropriate fixation methods; (5) inadequate bone graft; (6) premature load.The key points to enhance the treatment outcomes include precise judgement of the fracture type and bone quality, sufficient bone graft, firmly fixed after anatomical reduction and an appropriate plan for early loadless functional exercise. Traumatic arthritis may be avoided or delayed if the above-mentioned six causes can be taken into consideration or preventive measures can be taken.

To explore operative effect of lumbar intervertebral disc herniation accompanying with lumbar instability.Form June 2000 to June 2006, 46 patients of lumbar intervertebral disc herniation accompanying with lumbar instability were treated with decompression through posterior approach, diskectomy, spinal fusion and vertebral pedicle internal fixation. Including 33 males and 13 females,the age was from 37 to 68 years with an average of 48 years. The course of disease was from 4 months to 20 years with an average of 3.5 years. There were simple segment in 21 cases, double segments in 22 cases, three segments in 3 cases.All patients were followed up for 12-45 months with an average of 25 months. All cases got solid fusion and clinical symptom improved obviously. According to clinical standard to evaluation, 32 cases obtained excellent result, 8 good, 6 fair. The rate of excellent and good was 86.9%.Diskectomy, spinal fusion and internal fixation can obtain satisfactory clinical effect for lumbar intervertebral disc herniation accompanying with lumbar instability.