Prevalence, distribution characteristic and risk factors of lumbar vertebral axial rotation in patients with lumbar disc herniation: a retrospective study.

This retrospective study aimed to investigate the impact of lumbar disc herniation (LDH) on vertebral axial rotation (VAR) in the lumbar spine, focusing on both close and distant neighboring vertebrae. A total of 516 patients with LDH and an equal number of healthy individuals were included in the study, matched for age and gender. The degree of axial rotation for each lumbar spine vertebra was assessed using the Nash-Moe index. The results revealed that the prevalence of VAR in the lumbar spine was significantly higher in the LDH group compared to the Control group (65.7% vs 46.7%, P < 0.001). Among the LDH group, the L2 vertebra had the highest frequency of VAR (49.5%), followed by L1 (45.1%), and then L3 to L5 (33.6%, 8.9%, 3.1%, respectively). A similar pattern was observed in the Control group (L2, 39.8%; L1, 34.6%; L3, 23.2%; L4, 3.1%; L5, 0.8%). Furthermore, the study found that disc herniation was associated with a higher incidence of VAR not only in close neighboring vertebrae but also in distant neighboring vertebrae. This indicates that the biomechanical influence of LDH extends beyond just the immediate adjacent vertebrae. To identify potential risk factors for VAR in LDH patients, multivariate analysis was performed. The results revealed that age was an independent risk factor for VAR (OR 1.022, 95% CI [1.011, 1.034], P < 0.001). However, the duration of symptoms and presence of back pain were not found to be significant risk factors for VAR.

The change of Roussouly classification after posterior lumbar fusion surgery.

Background: Roussouly classification is an important morphologic classification which can help to determine high local stress zones of the spine. Different lumbar morphologies of Roussouly type suggest different biomechanics leading to degenerative evolution. This study aimed both to describe the change of the Roussouly classification of the human spine after posterior lumbar fusion surgery and to explore the influencing factors of postoperative Roussouly type. Methods: The study is a retrospective case-control study on preoperative and postoperative Roussouly types. A total of 167 patients with lumbar degenerative disease who had undergone short-level transforaminal lumbar interbody fusion surgery between January 2014 and December 2017 in the Department of Orthopedic Surgery, First Affiliated Hospital, Air Force Medical University, were recruited. Preoperative and postoperative general data including gender, age, follow-up time, Oswestry disability index (ODI) score, visual analogue scale (VAS) score, diagnosis, and surgical segment were recorded. Clinical parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), and sagittal vertical axis (SVA) were measured using Surgimap software, and the Roussouly classification was assessed. Results: This study included 86 male patients and 81 female patients with a mean age of 52.0±12.4 [14-88] years. The mean follow-up time for these patients was 11.5±6.9 months. The value of sagittal alignment parameters changed after the posterior lumbar fusion surgery, except for the PI value (P=0.591). Roussouly classification changed after surgery. The preoperative Roussouly values of preoperative PI, SS, and LL were significantly different in patients of 4 postoperative Roussouly types. Conclusions: The Roussouly classification changes after posterior lumbar fusion surgery. This change is independent of gender, age, follow-up time, and the number of surgical segments. The preoperative Roussouly type and PI value are essential in predicting one's postoperative Roussouly type.

Facet joint degeneration-An initial procedure of the cervical spine degeneration.

Objective: This study aims to emphasize the initiating role of facet joint (FJ) degeneration in the process of cervical spine degeneration induced by tangential load, and we further validate it in a novel cervical spine degeneration animal model. Methods: The characteristics of cervical degeneration in patients of different ages were summarized through case collection. In the rat models, Hematoxylin-Eosin, Safranin O staining, and micro-computed tomography were used to show the histopathological changes and bone fiber structure of FJ and the height of intervertebral disc (IVD) space. The ingrowth of nociceptive sensory nerve fibers was observed by immunofluorescence staining. Results: FJ degeneration without IVDs degeneration was more common in people with cervical spondylosis in young patients. The obvious degeneration phenotypes of the FJs preceded the IVDs at the same cervical segment in our animal model. The SP+ and CGRP+ sensory nerve fibers were observed in the articular subchondral bone of degenerated FJs and porous endplates of degenerated IVDs. Conclusion: The FJ degeneration may act as the major contributor to cervical spine degeneration in young people. The dysfunction of functional unit of spine, not a certain part of IVD tissue, results in the occurrence of cervical degeneration and neck pain.

Associations between facet tropism and vertebral rotation in patients with degenerative lumbar disease.

BACKGROUND: Vertebral rotation and facet tropism are very common in various lumbar degenerative diseases. Facet tropism means the presence of asymmetric angles on both sides of the facet joints. Studies have shown that facet tropism contributes to lumbar degenerative disease, and also inevitably leads to the asymmetry of movement and the imbalance of force, which may be possible to rotate the vertebral body. The aim of this study was to explore the correlation between lumbar vertebral rotation and facet tropism in patients with lumbar degenerative diseases. METHODS: A total of 198 patients with lumbar degenerative diseases from 2018 to 2019 were enrolled. Five hundred and seventy vertebral rotation angles and 1140 facet angles were measured. The vertebral bodies are divided into non-rotation group (Group A) and rotation group (Group B) with the vertebral rotation angle of 3° as the boundary. The information including gender, age, BMI (body mass index), bone mineral density, history of smoking, drinking, hypertension, diabetes, diagnosis, segment distribution, and degree of facet degeneration were also counted. Using inter-class correlation coefficients (ICC) to test the reliability of measurement results. Univariate and multivariate logistic regression analysis were used to analyze the relationship between vertebral rotation and facet tropism. RESULTS: The consistency of the ICC within the groups of the observers is above 0.8, with good agreement. The results of univariate analysis showed that facet tropism was significantly different between group A and group B (OR (odds ratio) = 3.30, 95% CI = 2.03-5.35, P < 0.0001). Other significant factors were included as adjustment variables into the multivariate regression model. Three models were analyzed separately (Model 1: non-adjusted. Model 2: adjust for age; facet degeneration; Model 3: adjust for age; disease distribution; segment distribution; facet degeneration). The results showed that after adjusting the confounders, the correlation between facet tropism and vertebral rotation did not change (Model 1: OR = 3.30, 95% CI = 2.03-5.35, P < 0.0001; Model 2: adjusted OR = 2.87, 95% CI = 1.66-4.97, P = 0.0002, Model 3: adjusted OR = 2.84, 95% CI = 1.56-5.17, P = 0.0006). CONCLUSION: Current research demonstrates that there is an association between vertebral rotation and facet tropism, suggesting that vertebral rotation may also have a certain degree of correlation with lumbar degenerative diseases.

Endoplasmic Reticulum Stress: An Emerging Therapeutic Target for Intervertebral Disc Degeneration.

Low back pain (LBP) is a global health issue. Intervertebral disc degeneration (IDD) is a major cause of LBP. Although the explicit mechanisms underpinning IDD are unclear, endoplasmic reticulum (ER) stress caused by aberrant unfolded or misfolded proteins may be involved. The accumulation of unfolded/misfolded proteins may result in reduced protein synthesis and promote aberrant protein degradation to recover ER function, a response termed the unfolded protein response. A growing body of literature has demonstrated the potential relationships between ER stress and the pathogenesis of IDD, indicating some promising therapeutic targets. In this review, we summarize the current knowledge regarding the impact of ER stress on the process of IDD, as well as some potential therapeutic strategies for alleviating disc degeneration by targeting different pathways to inhibit ER stress. This review will facilitate understanding the pathogenesis and progress of IDD and highlights potential therapeutic targets for treating this condition.

Application of an innovative ridge-ladder-shaped polycrystalline diamond compact cutter to reduce vibration and improve drilling speed.

Polycrystalline diamond compact bits have been widely used in the Oil and Gas drilling industry, despite the fact that they may introduce undesired vibration into the drilling process, for example, stick-slip and bit bounce, which accelerate the failure rate and lead to higher drilling costs. First, we develop an innovative ridge-ladder-shaped polycrystalline diamond compact cutter, which has ridge-shaped cutting faces and multiple cutting edges with stepped distribution, in the hope of reducing vibration and improving drilling speed. Then, the scrape tests of ridge-ladder-shaped and general polycrystalline diamond compact cutters are carried out in a laboratory, indicating that the cutting, lateral, and longitudinal forces on ridge-ladder-shaped polycrystalline diamond compact cutters are smaller and with minor fluctuations. Due to different rock-breaking mechanisms, ridge-ladder-shaped polycrystalline diamond compact cutters have higher cutting efficiency compared to general polycrystalline diamond compact cutters, which is also verified experimentally. Finally, the drilling characteristics of a new polycrystalline diamond compact bit fitted with some ridge-ladder-shaped polycrystalline diamond compact cutters are compared to those of a general polycrystalline diamond compact bit by means of finite element simulation. The results show that introducing ridge-ladder-shaped polycrystalline diamond compact cutters can not only reduce the stick-slip vibration, bit bounce, and backward rotation of drill bits effectively, but also improve their rate of penetration.

Hydraulic structure design and downhole flow field optimization of geophysical drill bits in a limestone stratum.

The hydraulic structure of conventional geophysical drill bit is designed for the general stratum. When conventional geophysical drill bit pierces into a limestone stratum, the shape of cuttings is large because of the high brittleness of limestone. The cuttings are ground repeatedly; this phenomenon can reduce drilling efficiency and increase drilling costs. According to the characteristics of limestone cuttings, the numerical simulation method is used to research downhole flow field characteristics of conventional geophysical drill bit. First, the influence of key hydraulic structure parameters on cuttings removal performance is found. Then, the hydraulic structure is optimized. The flow field characteristics of the hydraulic structure of the geophysical drill bit before and after optimization in the flow path is analyzed, at the bottom of the bit and the annulus area of the shaft lining. The optimized downhole crossflow area increased from 50% to 98%. No vortex was observed at the exit of the flow path and cuttings groove. The downhole pressure gradient increased from 0.12 Mpa to 0.15 Mpa. The cutting removal space in the annulus area of the shaft lining is fully utilized. Field tests show that the cutting removal and drilling performance of optimized geophysical drill bit has improved and the drilling speed increases by 20.6%.