Jian-Xiang Zhang

Anhui Medical University, Luchow, Anhui Sheng, China

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Publications (3)2.07 Total impact

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    ABSTRACT: The axis body fractures are relatively uncommon and have a variety of presentations. Surgical management to them has been only reported as case reports or included as a minor part of clinical management. The objective of this study is to summarize the indications for surgery and report the clinical outcome of surgical treatment based on different fracture patterns. A retrospective analysis of 28 consecutive patients presenting with the axis body fractures was undertaken. The indications for surgical treatment were defined as: (1) fractures associated with instability of adjacent joints; (2) irreducible displaced superior articular facet fracture; (3) fractures resulting in spinal cord compression. The fractures were classified as sagittal, coronal, transverse and lateral mass fracture. One of the following surgical procedures was applied according to the fracture pattern: posterior C1-C2 pedicle screws fixation and fusion (I); posterior C1-C3 screws fixation and fusion (II); posterior osteosynthesis with C2 transpedicular half-thread lag screws (III). 13 patients were successfully managed operatively. Two transverse and two unilateral lateral mass fractures were treated with surgical procedure I, five sagittal fractures with II, four coronal fractures with III. Complications of malposition of screws and neurologic deficit did not occur during operation. Satisfactory reduction and bony union were demonstrated on postoperative radiographics. Conservative treatment is still advocated as primary management for most axis body fractures. But for patients with obvious adjacent joints instability or irreducible displaced superior articular facet fracture, surgical intervention based on the different fracture pattern is necessary.
    No preview · Article · Jan 2014 · European Spine Journal
  • Chun Han · Qing-Guo Yang · Jian-Xiang Zhang · Xing-Yi Hua · Yin-Shun Zhang · Xu-Yu Liao
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    ABSTRACT: To explore the feasibility of C1-2 pedicle screw fixation and fusion technique in treating atlantoaxial instability. From January 2006 to January 2009,18 patients with atlantoaxial instability were treated with C1-2 pedicle screws and plates fixation under general anesthesia. There were 11 males and 7 females, the age for 17-62 years with the mean of 37.7 years. The course of disease was from 3 days to 30 months with an average of 10.6 months. The patients had different degrees neck pain and disturbance of sensation or (and) dyskinesia, had atlantoaxial instability from images before operation. The JOA scoring before operation were from 8 to 15 with an average of 11.4. Bone fusion of patients was observed with X-rays, CT and MR image at the same time after operation and the JOA scoring was compared with preoperative. A total of 72 screws were successfully placed in 18 cases, among them, 15 cases were followed up from 6 to 24 months with an average of 11.5 months. Fifteen cases obtained bone fusion with time for 3-6 months without the complications of internal fixation failure or redislocation of atlas. The spinal compression had differently improved, postoperative JOA scoring was from 12 to 17 scores with an average of 14.5 scores. Pedicle screw fixation and fusion in atlas has advantages of firm fixation and high fusion rate, it is a better choices for atlantoaxial instability. It is not suitable for variations of sulcus of vertebral artery of atlas and posterior arch of atlas.
    No preview · Article · Jul 2010 · Zhongguo gu shang = China journal of orthopaedics and traumatology
  • Gao He · Jian-xiang Zhang · Cai-liang Shen · Qing-guo Yang · Shu Jiang
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    ABSTRACT: To explore the clinical features, treatment and prognosis of the C5 palsy after surgery of cervical spondylosis. Two hundred and twenty-three cases treated from March 1994 to October 2003 were retrospectively reviewed. Seven of the 223 cases developed the complication of C5 palsy, manifesting the paresis of the deltoid muscle as well as the sensory deficits and (or) intractable pain in shoulder. The incidence was 3.1%. In this study, 2 cases occurred in the anterior subcorpectomy, 5 cases developed in the laminoplasty with 1 case on the opened side, 3 cases on the hinged side and 1 case on both sides. All the 7 cases with the C5 palsy recovered within 2 weeks to 6 months. The C5 palsy can develop either anterior decompression or posterior open-door laminoplasty of cervical spondylosis. Generally speaking, patients with postoperative C5 palsy can be cured by conservative measures. And prognosis is good.
    No preview · Article · Jul 2005 · Zhonghua wai ke za zhi [Chinese journal of surgery]