Objective To compare the early effectiveness and safety of mini open endoscopy assisted anterior cervical discectomy and fusion (MOEA-ACDF) versus traditional ACDF in the treatment of cervical spondylotic myelopathy (CSM). MethodsA retrospective analysis was conducted on the clinical data of 60 patients with CSM admitted between January 2022 and January 2023 who met the selection criteria, including 30 cases each undergoing MOEA-ACDF and traditional ACDF. Except for age and height of the adjacent vertebral body (HAVB), no significant difference was observed between groups (P>0.05) in the gender, body mass index, disease duration, surgical segment, preoperative visual analogue scale (VAS) scores for neck/upper limb pain, neck disability index (NDI), Japanese Orthopaedic Association (JOA) score, and C2-7 Cobb angle. The operation time, postoperative drainage volume, and occurence of complications, as well as VAS scores for neck/upper limb pain, NDI, JOA score and its improvement rate, C2-7 Cobb angle, HAVB, and bone graft fusion status (Bridwell classification) at the surgical segment were recorded and compared between groups. Results Both groups completed the operations successfully. The MOEA-ACDF group exhibited significantly longer operation time compared to the ACDF group (P<0.05), and no significant difference was found in the postoperative drainage volume between groups (P>0.05). Postoperatively, only 1 case in the MOEA-ACDF group developed subcutaneous ecchymosis in the neck, while the incidence of complications showed no significant difference between groups (P>0.05). All patients were followed up 12-28 months (mean, 17.6 months). Over time, both groups demonstrated gradual improvement in NDI, VAS scores for neck/upper limb pain, and JOA scores (P<0.05). At 1, 3, and 6 months, as well as at last follow-up, no significant difference was observed in all indicators between groups (P>0.05). At last follow-up, the improvement rates of JOA scores in the two groups reached 90% (27/30), with no significant difference in the grading of improvement between groups (P>0.05). Imaging re-examination revealed increased C2-7 Cobb angle and HAVB in both groups postoperatively (P<0.05), but no significant changes over time (P>0.05). At 1 month after operation and last follow-up, no significant difference was observed in C2-7 Cobb angle between groups (P>0.05). Regarding the HAVB, ACDF group demostrated superior outcomes compared to MOEA-ACDF groups (P<0.05). Both groups achieved bone graft fusion, and no significant difference between groups was observed in Bridwell classification at 6 months or last follow-up. During follow-up, no failure of internal fixation, sinking or displacement of cage, degeneration of adjacent segment was found. ConclusionMOEA-ACDF has good early effectiveness in the treatment of CSM, and can effectively improve the height and physiological curvature of cervical spine, which is equivalent to the traditional ACDF.
Objective To explore the influence of two emergency reception and triages workflows between Wenchuan and Lushan earthquakes on the victim’s length of stay in emergency department of the West China Hospital of Sichuan University. Methods A total of 65 victims admitted in the West China Hospital within 12 hours after Lushan earthquake were retrospectively analyzed, and their diagnosis and treatment information and the length of stay in emergency department were collected and compared with those of the victims in Wenchuan earthquake. Then we analyzed the influence of two emergency reception and triage workflows on the length of stay of the batches of earthquake victims. Results For the Lushan earthquake victims, the median length of stay in the emergency reception and triage workflow was 0.51 hour, while that was 2.13 hours for the Wenchuan earthquake victims, with a significant difference (Plt;0.05). Conclusion The emergency reception and triage workflow for Lushan earthquake victims is a summarized experience and improvement based on that for Wenchuan earthquake, which can be used as references for treating batches of victims in the emergency department after a disaster.
Objective To explore the allocation of necessary living goods for the emergency medical rescue teams at Lushan earthquake sites. Methods The living goods requirements of 59 emergency medical rescue members at Lushan earthquake sites were investigated using a questionnaire and then analyzed, in order to provide references for the allocation of necessary living goods for emergency medical rescue teams in future. Results The top five necessary living goods for emergency medical rescue members at earthquake sites were food, drinking water, toilet, communication product, and bedclothe. The needs of bath of the members who stayed longer than 3 days were more than the members who stayed shorter than 3 days, with a significant difference (Plt;0.05). The number of living goods that female members need were more than that male members need (Plt;0.05). Conclusion For improving the work efficiency and quality of life, emergency medical rescue teams need to be equipped with not only the medical supplies, but also necessary living goods based on the length of stay and the ratio between male and female.
