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Objective To study the effect ofmethylprednisolone (MP) on the expression of heatshock protein 70 (HSP70) following the injury of spinal cord (SC1) in rats. Methods 125 SD rots wererandomly divided into 5 groups: the simple operation group (n=30), the MP control group (n=30), theinjury group (n=30), the MP treatment group (n=30) and the normal control group (n=5). Specimen of thespinal cord were collected at 2, 6, 12, 24, 48, 72 h after SCI, respectively. Their pathomorphology wasobserved and HSP70 expression was detected by immunohistochemistry. Results After treatment ofMP, the secondary injury was lightened, according to the HE staining of the specimen.lmmunohistochemistry revealed that there were no HSP70 expression in the normal control group and theMP control group, that there was a little HSP70 in the simple operation group, and that there was a lot ofHSP70 in the injury group 2 h after injury, and the expression peaked at 24 h and maintained to 72 h afterinjury. The expression was significantly increased and the peak of expression was in advance in the MPtreatment group as compared with injury group, and it was also found in neuropil of white substance ofspinal cord. Conclusion High-dose NIP can obviously increase the expression of HSP70 in injuredspinal cord, and has the peak time of expression in advance, and enlarge the scope of expression. It maybe one of the mechanism to protect the spinal cord that MP guide myeloid tissue to overexpress HSP70after spinal cord injury.

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<p><b>OBJECTIVE</b>To study the pathology characteristics and management of Hangman's fracture combined with intervertebral disc injury.</p><p><b>METHODS</b>Twenty-one patients suffered from this special injury were converged in this study. All patients underwent anterior C(2 - 3) discectomy and fusion, 18 cases were fixed by anterior cervical plate. The type of fractures, radiology characteristics, and clinical outcomes were investigated.</p><p><b>RESULTS</b>No graft displacement or absorption, infection and neurologic deterioration occurred. All fresh dislocation of axis and C(2 - 3) angulation were corrected. Fusion of C(2 - 3) intervertebral space and pedicle fracture were acquired in all of the patients. After a mean follow-up of 31 months, ranging from 8 to 48 months, nearly all of the complains disappeared after operation.</p><p><b>CONCLUSIONS</b>Hangman's fracture is not restricted at pedicle of the axis. Fracture combined with intervertebral disc injury is a special type of Hangman's fracture. Anterior discectomy and fusion of C(2 - 3) intervertebral disc is an effective operation method in accord with the pathophysiology of this special injury.</p>

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Objective To study the prevention and treatment of complications occurring in anterior cervical spinal surgery.Methods3163cases with cervical spondylotic meylopathy,spinal injury,spinal tu-mor and spinal tuberculosis treated by anterior cervical surgery,were included in this study.Trephination,corpectomy,disectomy and debridement were used for decompression,iliac bone autograft,BAK cage,cubic shaped cages and titanium mesh cages were used for bone grafting,while anterior cervical spine locking plates were performed in some of the cases.1848cases were followed-up from6months to8years with an aver-age of 2years and3months.646cases suffered from operative complications,372cases were immediate due to anterior cervical surgery,and the incidence of morbidity was11.76%.Results26cases of transient laryn-geal nerve or superior laryngeal nerve injury recovered in4to12weeks without special treatment.Most of 16cases with cervical hemotoma were caused by bleeding of smaller blood vessels and obstruction of drainage.13cases of spinal cord or nerve root irritation or injury were treated with medicine for dehydration,12of them had good result.11cases of CSF leakage were cured with cervical spinal immobilization and moderate local compression.8cases of local infection were cured with antibiotics or combined with debride-ment and suturing.2cases of esophagus perforation were repaired and healed.8cases of grafted bone dis-placement were re-operated on the day or second day of occurring.17cases of pseudoarthritis had revision surgery.6of 35cases of adjacent segments degeneration with new symptoms of spinal cord compression were treated with anterior cervical decompression again,and had good results.Most of 342cases of iliac donor side com plications were local pain or lateral femoral cutaneous nerve injury,infection occurred in some cases.Compli cations related to instruments included10cases of BAK subsidence,1case of plate breakage,1case of screws and plate back-out and7cases of titanium mesh cage subsidence.216cases of cervical axial pain were cured3to6months later with medicine.There was1case of sudden death in this group.Conclusion Many kinds of operative complications could occur in anterior cervical surgery.A standardized procedure in diagnosis and surgery methods are the key points to decrease and prevent operative related complications.