Sheng Lu

Kunming Medical College, Yün-nan, Yunnan, China

Are you Sheng Lu?

Claim your profile

Publications (26)20.14 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the treatment of carpal collapse using a four-corner arthrodesis concentrator of nickel-titanium memory alloy. From August 2006 to August 2010, 18 patients with carpal collapse had scaphoid excision and four-corner (capitate, lunate, triquetrum, and hamate) arthrodesis using a nickel-titanium memory alloy four-corner arthrodesis concentrator. The mean follow-up time was 30 months (range, 12-48). Various wrist parameters, including grip strength, wrist motion, and degree of pain were recorded and compared before and after surgery. The average fusion time was 2.3 months (range, 2-4). Neither nonunion nor wound infection was found in any of the patients. At one year follow-up, the grip strength had reached 80% of that of the healthy side, whereas the range of motion was greater than 50% of the contralateral side. After the surgery, the mean pain scores were improved. Four-corner arthrodesis using a nickel-titanium memory alloy four-corner arthrodesis concentrator effectively treated carpal collapse and preserved most wrist function. Therapeutic IV.
    The Journal of hand surgery 11/2012; 37(11):2246-51. · 1.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: With the rapid increase in the use of thoracic pedicle screws in scoliosis, accurate and safe placement of screw within the pedicle is a crucial step during the scoliosis surgery. To make thoracic pedicle screw placement safer various techniques are used, Patient-specific drill template with pre-planned trajectory has been thought as a promising solution, it is critical to assess the efficacy, safety profile with this technique. In this paper, we develop and validate the accuracy and safety of thoracic transpedicular screw placement with patient-specific drill template technique in scoliosis. Patients with scoliosis requiring instrumentation were recruited. Volumetric CT scan was performed on each desired thoracic vertebra and a 3-D reconstruction model was generated from the CT scan data. The optimal screw size and orientation were determined and a drill template was designed with a surface that is the inverse of the posterior vertebral surface. The drill template and its corresponding vertebra were manufactured using rapid prototyping technique and tested for violations. The navigational template was sterilized and used intraoperatively to assist with the placement of thoracic screws. After surgery, the positions of the pedicle screws were evaluated using CT scan and graded for validation. This method showed its ability to customize the placement and the size of each pedicle screw based on the unique morphology of the thoracic vertebra. In all the cases, it was relatively very easy to manually place the drill template on the lamina of the vertebral body during the surgery. This method significantly reduces the operation time and radiation exposure for the members of the surgical team, making it a practical, simple and safe method. The potential use of such a navigational template to insert thoracic pedicle screws in scoliosis is promising. The use of surgical navigation system successfully reduced the perforation rate and insertion angle errors, demonstrating the clear advantage in safe and accurate pedicle screw placement of scoliosis surgery.
    Medical & Biological Engineering 03/2012; 50(7):751-8. · 1.76 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The considerable variation in anatomical abnormalities of hip joints associated with different types of developmental dysplasia of hip (DDH) makes reconstruction in total hip arthroplasty (THA) difficult. It is desirable to create patient-specific designs for THA procedures. In the cases of adult single DDH, an accuracy-improved method has been developed for acetabular cup prosthesis implantation of hip arthroplasty. From October 2007 to November 2008, 22 patients with single DDH (according to the Crowe standard, all dysplasia hips were classified as type I) were scanned with spiral CT pre-operatively. These patients scheduled for THA were randomly assigned to undergo either conventional THA (control group, n = 11) or navigation template implantation (NT group, n = 11). In the NT group, three-dimensional (3D) CT pelvis image data were transferred to a computer workstation and 3D models of the hip were reconstructed using the Mimics software. The 3D models were then processed by the Imageware software. In brief, a template that best fitted the location and shape of the acetabular cup was 'reversely' built from the 3D model, the rotation centre of the pathological hip determined by mirroring that of the healthy site, and a guiding hole in the template was then designed. The navigational templates were manufactured using a rapid prototyping machine. These navigation templates guide acetabular component placement. Based on the predetermined abduction angle 45° and anteversion angle 18°, after 1 year follow-up, the NT group showed significantly smaller differences (1.6° ± 0.4°, 1.9° ± 1.1°) from the predetermined angles than those in the control group (5.8° ± 2.9°, 3.9° ± 2.5°) (P < 0.05). The template designs facilitated accurate placement of acetabular components in dysplasia of acetabulum. The hip's center of rotation in DDH could be established using computer-aided design, which provides a useful method for the accurate location of prosthesis with a low cost-performance ratio without excessive technical workload on the surgical team.
    International Journal of Medical Robotics and Computer Assisted Surgery 12/2011; 7(4):469-74. · 1.49 Impact Factor
  • Source
    Advanced Applications of Rapid Prototyping Technology in Modern Engineering, 09/2011; , ISBN: 978-953-307-698-0
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study was to develop a novel, patient-specific, navigational template for thoracic pedicle screw placement. Twenty thoracic cadaver specimens were randomly divided into two groups of 10: the navigational template group and the free-hand group. A volumetric CT scan was performed on each thoracic vertebra, and a three-dimensional reconstruction model was generated. A drill template was designed with a surface that was the inverse of the posterior vertebral surface. Each drill template and its corresponding vertebra were manufactured using a rapid prototyping technique and tested for violation. Two hundred and forty screws were implanted into the thoracic spines and the positions of the screws were evaluated. Two hundred and forty thoracic screws were inserted using either the navigational template method or the free-hand method. The accuracy rate and incidence of risk for setting thoracic pedicle screws differed statistically between the two methods (P < 0.05): The navigational template method had a higher accuracy rate and a lower incidence of risk than the free-hand method. Moreover, the free-hand method had a significant learning curve, whereas a learning curve for the navigational template method was not obvious. We have developed a novel, patient-specific, navigational template for thoracic pedicle screw placement with good applicability and high accuracy.
    Archives of Orthopaedic and Trauma Surgery 08/2011; 132(1):65-72. · 1.36 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To develop and validate the efficacy and accuracy of a novel drill template for cervical pedicle instrumentation. A CT scan of the cervical vertebrae was performed, and a 3D model of the vertebrae was reconstructed using MIMICS 10.01 software. The 3D vertebral model was then exported in STL format, and opened in a workstation running UGS Imageware 12.0 software to determine the optimal pedicle screw size and orientation. A virtual navigational template was established according to the laminar anatomic trait, and physical navigational templates were manufactured using rapid prototyping. The navigational templates were used intraoperatively to assist in the placement of cervical pedicle screws. In all, 84 pedicle screws were placed, and the accuracy of screw placement was confirmed with postoperative X-rays and CT scans. Eighty-two screws were rated as Grade 0, 2 as Grade 1, and no screws as Grade 2 or 3. Hence, safer screw positioning was accomplished with the drill template technique. This study demonstrates a patient-specific template technique that is easy to use, can simplify the surgical act, and generates highly accurate cervical pedicle screw placement. The advantages of this technology over traditional techniques are that it enables planning of the screw trajectory to be completed prior to surgery, and that the screw can be sized to fit the patient's anatomy.
    Computer Aided Surgery 01/2011; 16(5):240-8. · 0.78 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Current techniques for total knee arthroplasty have certain drawbacks, including violation of the intramedullary canals and limited accuracy. The aim of this research was to develop and validate the accuracy of a new computer-assisted preoperative planning concept for the creation of patient-specific navigational templates to replace conventional instruments. Volumetric computerized tomography (CT) scanning was performed on 30 cadaveric knees, and a three-dimensional reconstruction model of each knee was generated from the scan data. Using a reverse-engineering technique, optimal lower-limb alignment and rotational alignment were determined. A navigational template was also designed with a surface that matched the distal femur and proximal tibia. This template, with its corresponding femur and tibia, was manufactured using a rapid-prototyping technique and tested for violations. The navigational template was then used intraoperatively to assist with an arthroplasty in each of the 30 cadaveric knees. Following surgery, the positions of the prostheses were evaluated with X-rays and CT scans. The method showed a high degree of accuracy and reproducibility. In all cases, placing the template manually on the lamina of the femur and tibia was relatively easy. Twenty-eight prostheses were considered to be positioned entirely accurately, whereas two prostheses were considered to have a 1-2° malpositioning. This study thus introduces a novel navigational template for total knee arthroplasty. Preliminary cadaveric trials have demonstrated that this design can improve the accuracy of osteotomy in the surgical procedure.
    Computer Aided Surgery 01/2011; 16(6):288-97. · 0.78 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Treatment of cubitus varus deformity from a malunited fracture is a challenge. Anatomically accurate correction is the key to obtaining good functional outcomes after corrective osteotomy. The aim of this study was to attempt to increase the accuracy of treatment by use of 3-dimensional (3D) computer-aided design. We describe a novel method for ensuring an accurate osteotomy method in the treatment of cubitus varus deformity in teenagers by means of 3D reconstruction and reverse engineering. Between January 2006 and May 2008, 12 male and 6 female patients with cubitus varus deformities underwent scanning with spiral computed tomography (CT) preoperatively. The mean age was 15.7 years, ranging from 13 to 19 years. Three-dimensional CT image data of the affected and contralateral normal bones of cubitus were transferred to a computer workstation. Three-dimensional models of cubitus were reconstructed by use of MIMICS software. The 3D models were then processed by Imageware software. An osteotomy template that best fitted the angle and range of osteotomy was "reversely" built from the 3D model. These templates were manufactured by a rapid prototyping machine. The osteotomy templates guide the osteotomy of cubitus. An accurate angle of osteotomy was confirmed by postoperative radiography. After 12 to 24 months' follow-up, the mean postoperative carrying angle in 18 patients with cubitus varus deformity was 7.3° (range, 5° to 11°), with a mean correction of 21.9° (range, 12° to 41°). The patient-specific template technique is easy to use, can simplify the surgical act, and generates highly accurate osteotomy in cubitus varus deformity in teenagers.
    Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 01/2011; 20(1):51-6. · 1.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Exposure of the anterior or lateral lumbar via the retroperitoneal approach easily causes injuries to the lumbar plexus. Lumbar plexus injuries which occur during anterior or transpsoas lumbar spine exposure and placement of instruments have been reported. This study aims is to provide more anatomical data and surgical landmarks in operations concerning the lumbar plexus in order to prevent lumbar plexus injuries and to increase the possibility of safety in anterior approach lumbar surgery. To study the applied anatomy related to the lumbar plexus of fifteen formaldehyde-preserved cadavers, Five sets of Virtual Human (VH) data set were prepared and used in the study. Three-dimensional (3D) computerized reconstructions of the lumbar plexus and their adjacent structures were conducted from the VH female data set. The order of lumbar nerves is regular. From the anterior view, lumbar plexus nerves are arranged from medial at L5 to lateral at L2. From the lateral view, lumbar nerves are arranged from ventral at L2 to dorsal at L5. The angle of each nerve root exiting outward to the corresponding intervertebral foramen increases from L1 to L5. The lumbar plexus nerves are observed to be in close contact with transverse processes (TP). All parts of the lumbar plexus were located by sectional anatomy in the dorsal third of the psoas muscle. Thus, access to the psoas major muscle at the ventral 2/3 region can safely prevent nerve injuries. 3D reconstruction of the lumbar plexus based on VCH data can clearly show the relationships between the lumbar plexus and the blood vessels, vertebral body, kidney, and psoas muscle. The psoas muscle can be considered as a surgical landmark since incision at the ventral 2/3 of the region can prevent lumbar plexus injuries for procedures requiring exposure of the lateral anterior of the lumbar. The transverse process can be considered as a landmark and reference in surgical operations by its relative position to the lumbar plexus. 3D reconstructions of the lumbar plexus based on VCH data provide a virtual morphological basis for anterior lumbar surgery.
    BMC Musculoskeletal Disorders 01/2011; 12:76. · 1.88 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the treatment outcomes of a four-corner arthrodesis concentrator of Ni-Ti memory alloy for carpal collapse. From August 2006 to November 2009, 13 patients with carpal collapse underwent scaphoid excision and four-corner (capitate, lunate, triquetrum and hamate) arthrodesis using a four-corner arthrodesis concentrator of Ni-Ti memory alloy. The mean follow-up time was 26.5 months (range, 7-38 months). Various wrist parameters, including the grip strength, range of wrist movements and degree of pain (visual analogue scales) were recorded and compared before and after surgery. The average fusion time was 2.3 months (range, 2-4 months). Neither non-union nor wound infection was found in any of the patients. By the sixth month postoperatively, the grip strength had reached an average of 32.49 ± 6.21 kg with a range of 22.3-39.7 kg, this being 80.8% of that found on the healthy side. The range of motion reached over 53.0% of that of the healthy side. Preoperatively and at 6 months postoperatively, the mean pain scores were (4.46 ± 1.27) and 1.31 ± 0.95, respectively, when resting (P < 0.05), and 7.00 ± 1.41 and 2.62 ± 1.26, respectively, when weight-bearing (P < 0.05). The mean value of the Krimmer wrist score was 79.2 (range, 64-84). The rate of excellent and fine results was 84.6% (11/13), being excellent in three cases, good in eight and fair in two. Four-corner arthrodesis using a four-corner arthrodesis concentrator of Ni-Ti memory alloy is an effective method for treating carpal collapse and preserving most wrist function.
    Orthopaedic Surgery 11/2010; 2(4):266-71.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Total hip resurfacing arthroplasty is increasingly being used. One of its goals is to closely mimic the normal anatomy and normal biomechanics of the hip joint. Prosthesis location has a large impact on implant survival and patient function; but in conventional hip resurfacing arthroplasty, precise positioning sometimes cannot be achieved. We describe a novel method for ensuring accurate prosthesis implantation in hip resurfacing arthroplasty by means of 3-dimensional reconstruction and reverse engineering.
    The Journal of arthroplasty 10/2010; 26(7):1083-7. · 1.79 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: STUDY DESIGN.: Prospective trial. OBJECTIVE.: To develop and validate a novel, patient-specific navigational template for cervical pedicle placement. SUMMARY OF BACKGROUND DATA.: Owing to the narrow bony anatomy and the proximity to the vertebral artery and the spinal cord, cervical instrumentation procedures demand the need for a precise technique for screw placement. PATIENT.: Specific drill template with preplanned trajectory has been thought as a promising solution for cervical pedicle screw placement. METHODS.: Patients with cervical spinal pathology (n = 25) requiring instrumentation were recruited. Volumetric CT scan was performed on each desired cervical vertebra and a 3-dimensional reconstruction model was generated from the scan data. Using reverse engineering technique, the optimal screw size and orientation were determined and a drill template was designed with a surface that is the inverse of the posterior vertebral surface. The drill template and its corresponding vertebra were manufactured using rapid prototyping technique and tested for violations. The navigational template was sterilized and used intraoperatively to assist with the placement of cervical screws. In total, 88 screws were inserted into levels C2-C7 with 2 to 6 screw in each patient. After surgery, the positions of the pedicle screws were evaluated using CT scan and graded for validation. RESULTS.: This method showed its ability to customize the placement and the size of each screw based on the unique morphology of the cervical vertebra. In all the cases, it was relatively very easy to manually place the drill template on the lamina of the vertebral body during the surgery. The required time between fixation of the template to the lamina and insertion of the pedicle screws was about 80 seconds. Of the 88 screws, 71 screws had no deviation and 14 screws had deviation <2 mm, 1 screw had a deviation between 2 to 4 mm and there were no misplacements. Fluoroscopy was used only once for every patient after the insertion of all the pedicle screws. CONCLUSION.: The authors have developed a novel patient-specific navigational template for cervical pedicle screw placement with good applicability and high accuracy. This method significantly reduces the operation time and radiation exposure for the members of the surgical team. The potential use of such a navigational template to insert cervical pedicle screws is promising. This technique has been clinically validated to provide an accurate trajectory for pedicle screw placement in the cervical spine.
    Spine 12/2009; 34(26):E959-66. · 2.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To provide a new method in the fixation of sacral fracture by means of three-dimensional reconstruction and reverse engineering technique. Pelvis image data were obtained from three-dimensional CT scan in patients with sacral fracture. The data were transferred into a computer workstation. The three-dimensional models of pelvis were reconstructed using Amira 3.1 software and saved in STL format. Then the three-dimensional fracture models were imported into Imageware 9.0 software. Different situations of reduction (total reduction, half reduction and non-reduction) were simulated using Imageware 9.0 software. The best direction and location of extract iliosacral lag screws were defined using reverse engineering according to these three situations and navigation templates were designed according to the anatomic features of the postero-iliac part and the channel. The exact navigational template was made by rapid prototyping. Drill guides were sterilized and used intraoperatively to assist in surgical navigation and the placement of iliosacral lag screws. Accurate screw placement was confirmed with postoperative X-ray and CT scanning. The navigation template was found to be highly accurate. The navigation template may be a useful method in minimal-invasive fixation of sacroiliac joint fracture.
    Chinese Journal of Traumatology (English Edition) 09/2009; 12(4):214-7.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the feasibility and clinical significance of the computed tomography angiography (CTA) for the latissimus dorsi muscle (LDM) flap transplantation. From September 2007 to August 2008, 3 cases of soft tissue defects in limbs were treated with LDM flap transplantation. Three patients included 2 males and 1 female who were 23- to 42-years-old. All of soft tissue defects were caused by trauma. The locations were the forearm in 2 cases and the leg in 1 case. The area of defect was 17 cm x 8 cm-20 cm x 10 cm. All cases received CTA to observe the distribution and anastomosis of thoracodorsal artery. Subsequently, three-dimensional computer reconstruction were carried out to display the stereoscopic structure of the LDM flap and to design the LDM flap before operation. The anatomy characteristic of LDM flap can be displayed accurately by the three-dimensional reconstruction model. The distribution of thoracodorsal artery in 3 cases of flaps was in concordance with preoperative design completely. All the flaps were excised successfully, the area of the flap was 19 cm x 10 cm-22 cm x 12 cm. All the transferred flaps survived completely. All cases were followed up from 4 months to 12 months. The color and texture of the flaps were good. The three-dimensional reconstructive images can provide visible, stereoscopic and dynamic anatomy for clinical application of LDM flap. The digitized three-dimensional reconstructive models of LDM flap structures can be applied in clinical training and pre-operative design.
    Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 08/2009; 23(7):818-21.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To develop a novel method of spinal pedical stereotaxy by reverse engineering and rapid prototyping techniques, and to validate its accuracy by experimental and clinical studies. A 3D reconstruction model for the desired lumbar vertebra was generated by using the Mimics 10.11 software, and the optimal screw size and orientation were determined using the reverse engineering software. Afterwards, a drill template was created by reverse engineering principle, whose surface was the antitemplate of the vertebral surface. The drill template and its corresponding vertebra were manufactured using the rapid prototyping technique. The accuracy of the drill template was confirmed by drilling screw trajectory into the vertebral biomodel preoperatively. This method also showed its ability to customize the placement and size of each screw based on the unique morphology of the lumbar vertebra.The drill template fits the postural surface of the vertebra very well in the cadaver experiment. Postoperative CT scans for controlling the pedicle bore showed that the personalized template had a high precision in cadaver experiment and clinical application. No misplacement occurred by using the personalized template. During surgery, no additional computer assistance was needed. The authors have developed a novel drill template for lumbar pedicle screw placement with good applicability and high accuracy. The potential use of drill templates to place lumbar pedicle screws is promising. Our methodology appears to provide an accurate technique and trajectory for pedicle screw placement in the lumbar spine.
    Chinese Journal of Traumatology (English Edition) 07/2009; 12(3):177-80.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The present method of C2 laminar screw placement relies on anatomical landmarks for screw placement. Placement of C2 laminar screws using drill template has not been described in the literature. The authors reported on their experience with placement of C2 laminar screws using a novel computer-assisted drill guide template in nine patients undergoing posterior occipito-cervical fusion. CT scan of C2 vertebrae was performed. 3D model of C2 vertebrae was reconstructed by software MIMICS 10.01. The 3D vertebral model was then exported in STL format, and opened in a workstation running software UG imageware12.0 for determining the optimal laminar screw size and orientation. A virtual navigational template was established according to the laminar anatomic trait. The physical vertebrae and navigational template were manufactured using rapid prototyping. The navigational template was sterilized and used intraoperative to assist the placement of laminar screw. Overall, 19 C2 laminar screws were placed and the accuracy of screw placement was confirmed with postoperative X-ray and CT scanning. There were not complications of related screws insertion. Average follow-up was 9 months (range 4-13 months), 77.8% of the patients exhibited improvement in their myelopathic symptoms; in 22.2% the symptoms were unchanged. Postoperative computed tomographic (CT) scanning was available for allowing the evaluation of placement of thirteen C2 laminar screws, all of which were in good position with no spinal canal violation. This study shows a patient-specific template technique that is easy to use, can simplify the surgical act and generates highly accurate C2 laminar screw placement. Advantages of this technology over traditional techniques include planning of the screw trajectory is done completely in the presurgical period as well as the ability to size the screw to the patient's anatomy.
    European Spine Journal 07/2009; 18(9):1379-85. · 2.47 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To observe the primary clinical result of digital template as navigation to the upper cervical pedicle instrumentation. CT scan of upper cervical vertebrae was performed. 3-D model of upper cervical vertebrae was reconstructed by software Amira 3.1 and was preserved in STL format. Then 3-D model was run in software UG Imageware 12.0, the best pedicle channel was extracted according to the reverse engineering principle. A virtual navigational template was established according to he lamina anatomic trait, and the best pedicle channel. The virtual vertebrae and navigational template were manufactured using rapid prototyping. The navigational template was sterilized and used intra operative to assist with the placement of pedicle screw. The Accuracy of screw placement was confirmed with postoperative X-ray and CT scanning. The digital navigational template had been established and used in the 3 cases, the good trajectory of cervical pedicle had been showed by the CT scan of post operation. There were not complications of related pedicle screw insertion. A novel method of upper cervical pedicle location using Reverse Engineering and rapid prototyping has been developed; the navigational template is found to be highly accuracy and has great expectation.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 04/2009; 47(5):359-62.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The great accuracy of computer-assisted operative systems for pedicle screw insertion makes them highly desirable for spinal surgeries. However, computer-assisted pedicle screw placement is expensive, and the learning curve for these techniques is significant. We have developed a novel method of spinal pedicle stereotaxy by reverse engineering (RE) and rapid prototyping (RP) and have validated the method's accuracy by cadaveric and clinical study. A volumetric CT scan was performed on each desired lumbar vertebra and a three-dimensional (3D) reconstruction model was generated with MIMICS 10.1, while the optimal screw size and orientation were determined using UG Imageware 12.1. A drill template was created using UG Imageware 12.1, with a surface that is the inverse of the vertebral surface. The drill template and its corresponding vertebra were manufactured using RP. The method was tested on six cadavers without any fluoroscopic control at surgery. Eventually, the technology was applied in six clinical cases. The accuracy of the drill template was confirmed by preoperatively drilling the screw trajectory into the vertebra biomodel. In the cadaveric experiment, 36 pedicle screws were inserted and no pedicle perforation was observed by postoperative CT scan. In the six clinical patients, the best fit for positioning the template was easily found manually during the operation. The required time between fixation of the template to the lamina and insertion of the pedicle screw into each segment (one or two vertebrae) was 1-2 min. In total, 22 screws were inserted into T12-L5, with two to four screws/patient. No misplacement occurred using the individual templates. Fluoroscopy was used only once after all the pedicle screws had been inserted. The method significantly reduces operation time and radiation exposure for the members of the surgical team. The authors have developed a novel computer-assisted drill template for lumbar pedicle screw placement. This method has shown its ability to customize the placement and size of each screw, based on the unique morphology of the lumbar vertebra. The potential use of drill templates to place lumbar pedicle screws is promising.
    International Journal of Medical Robotics and Computer Assisted Surgery 03/2009; 5(2):184-91. · 1.49 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Male genital dysfunction was recognized as a complication following anterior approach lumbar surgery. Disruption of efferent sympathetic pathways such as the abdominal aortic plexus (AAP) and superior hypogastric plexus (SHP) which lied pre-abdominal aorta and iliac artery had been thought as the main reason. Though there were some clinical reports of retrograde ejaculation, the applied anatomic study of the autonomic nerve anterior to the lumbar was little. The purpose was to find out a lumbar surgery approach which was ejaculation preservation through the detailed study of the anatomy and histology observation of the autonomic nerve anterior to the lumbar vertebrae. The lumbar region of ten male cadavers was dissected and analyzed. We investigated the relationship between the peritoneum and abdominal aorta, iliac artery and sacral promontory fascia, as well as the trend and distribution of the autonomic nerve and SHP anterior to the L5-S1. We also observed the distribution of autonomic nerve at retroperitoneum through hematoxylin and eosin (HE)-stained tissues pre-aorta, para-aorta, and pre-vertebrae sacrales. Superior hypogastric plexus, which deviated to left, located in a triangle formed by the common iliac arteries and its bilateral branches, its truck sited anterior to the lumbarsacral space in seven cases (70%), and anterior to sacrum in three cases (30%); at the aortic bifurcation, SHP strided over left iliac artery from left-hand side, then located in front of sacrum in four cases (40%), and sifted to the left at the lumbar sacral promontory in six cases (60%); from both anatomic and histological view, the autonomic nerve plexus lying in an fascia layer of retroperitoneum. At the anterior approach lumbar surgery of trans-peritoneum, we should choose the right-hand side incision; the SHP should be pushed aside carefully from right to left along intervertebral disc. The accurate surgical plane was at the deeper layer of autonomical nerve fascia; we also could lift the complete autonomical nerve layer which lies behind the aorta and lumbar sacral promontory, so that the autonomic nerve could be preserved.
    Anatomia Clinica 03/2009; 31(6):425-30. · 0.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the surgical methods and clinical results of reconstructing soft tissue defects in dorsum of forefoot with distally based saphenous neurocutaneous flap of lower rotating point. From January 2005 to August 2007, 6 cases of soft tissue defects in dorsum of forefoot, including 4 males and 2 females aged 28-53 years, were treated with the distally based saphenous neurocutaneous flaps of lower rotating point. The soft tissue defect was in left foot in 2 cases and in right foot in 4 cases. Five cases of soft tissue defects were caused by crush, and 1 case was caused by traffic accident. Tendons and bones were exposed in all cases. The defects after debridement were 7.0 cm x 5.0 cm to 9.0 cm x 5.5 cm in size. Emergency operation was performed in 2 cases and selective operation in 4 cases. Rotating point of the flaps was from 1 to 3 cm above medial malleolus. The size of the flaps ranged from 8.0 cm x 6.0 cm to 13.0 cm x 6.5 cm. Neuroanastomosis was performed in 2 cases of the flaps. Skin defects in donor site were repaired with thickness skin graft. Four cases of the transferred flaps survived completely and the other 2 cases began to swell and emerge water blister from the distant end of the flap after operation, which resulted in distal superficial necrosis of flaps, healing was achieved after change dressings and skin grafted. Skin graft in donor site survived completely in all cases. All cases were followed up from 6 to 18 months. The color and texture and thickness of the flaps were similar to recipient site. Pain sensation and warmth sensation of the 2 flaps whose cutaneous nerve were anastomosed recovered completely, two point discrimination were 8 mm and 9 mm respectively. Sensation and warmth sensation of the 4 flaps whose cutaneous nerve were not anastomosed recovered partly. All patients returned to their normal walking and running activities and no ulceration occurred. No donor site morbidity was encountered. Blood supply of the distally based saphenous neurocutaneous flap of lower rotating point is sufficient, the flap is especially useful for repair of soft tissue defects in dorsum of forefoot.
    Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 12/2008; 22(11):1285-7.

Publication Stats

103 Citations
20.14 Total Impact Points

Institutions

  • 2008–2012
    • Kunming Medical College
      Yün-nan, Yunnan, China
  • 2011
    • Government of the People's Republic of China
      Peping, Beijing, China
  • 2010–2011
    • Inner Mongolia Medical University
      Suiyüan, Inner Mongolia, China
  • 2009–2011
    • Chengdu Military General Hospital
      Hua-yang, Sichuan, China