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Objective:To compare the efficacy of fusion and non-fusion hybrid operation with Dynesys system with the traditional fusion operation with rigid instrumentation in the patients with multi-segment lumbar degenerative disease.Methods:A total of 30 patients with multi-segment lumbar degenerative disease who were subjected to operation from January 2017 to October 2019 in Shenzhen People's Hospital were included in the study. There were 13 males and 17 females, age: 60.8±13.2 years, range: 25 to 83 years. 28 patients with two segments, 1 with three segments, and 1 with four segments. The patients were divided into two groups, i.e the hybrid operation group (13 cases, 9 males and 4 females, average age: 56.6 years, range: 25 to 83 years) versus the traditional fusion group (17 cases, 4 males and 13 females, average age: 63.9 years, range: 46 to 80 years). The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), range of motion (ROM), adjacent segment degeneration (ASD) and complications.Results:There were no statistically significant differences in operation data, such as operation time, intraoperative blood loss, postoperative drainage volume and length of hospitalization, between the two groups. There were no significant differences for ROM in the surgical segments between the two groups before operation (hybrid group and traditional group were 9.6°±4.9° vs. 8.9°±6.1°, t=0.341, P=0.736, respectively). However, after 12 months follow-up, the ROM disappeared in the traditional group and was partially preserved in the hybrid group, with statistically significant differences (hybrid group and traditional group were 5.4°±2.7° vs. 0°, t=9.104, P=0.001, respectively). There was a statistical difference in intervertebral disc height between the two groups at 12 months post-operation, though no statistical difference was found before operation (8.8±1.9 mm vs. 10.5±1.7 mm, t=2.927, P=0.006). There was no statistically significant difference in the intervertebral disc height of the upper adjacent vertebrae between the two groups before and after operation. There were statistically significant differences in ODI scores before operation (63.4%±11.0% vs. 71.3%±9.2%, t=2.146, P=0.041), and 12 months post-operation (17.2%±2.1% vs. 15.5%±2.3%, t=2.091, P=0.046), while no statistical difference was found in VAS scores. Conclusion:The fusion and non-fusion hybrid operation with Dynesys system has comparable clinical efficacy with the traditional fusion operation with rigid instrumentation in the treatment of multisegment lumbar degenerative disease. Meanwhile, the hybrid surgery can preserve the motion of surgical segments and provide a dynamic stability of the vertebral body. The hybrid surgery can be used as a new surgical method for multi-segment lumbar degenerative disease.
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Epstein-Barr virus (EBV), a definite tumorigenic virus, is closely related to the development of nasopharyngeal cancer, gastric cancer, lymphoma and other tumors. EBV encodes a total of 44 mature microRNAs, which can regulate the expression of virus and host genes. EBV-encoded microRNAs and their regulated target molecules participate in the biological functions of tumor apoptosis, proliferation, invasion, and metastasis during tumorigenesis and development, and play an important role in the development of tumor.
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Humans , Carcinogenesis/genetics , Epstein-Barr Virus Infections/genetics , Gene Expression Regulation, Neoplastic , Herpesvirus 4, Human/genetics , MicroRNAs/genetics , Nasopharyngeal Neoplasms/geneticsABSTRACT
Objective To analyze the clinical value of transforaminal endoscopic minimally invasive surgery for the treatment of recurrent lumbar disc herniation.Methods Strictly included in the criteria,47 patients diagnosed with recurrent lumbar disc herniation who was treated unsuccessfully with conservative treatment were selected from our department from May 2011 to December 2015.There were 31 males and 16 females,with an average age of 43.45 ±3.37 years old (29-62 years old).There were L3,4 section in 4 cases,L4,5 section in 32 cases,and L5S1 section in 11 cases.The interval between the first operation and the reoperation was between 10 and 185 months,with an average of 49 months.In the first operation,there were 11 cases of posterior intervertebral disc endoscopy (MED) surgery,and 36 cases of decompression of vertebral disc nucleus pulposus surgery.Take a prone position under local anesthesia percutaneous puncture intervertebral foramen in the endoscopic minimally invasive surgery,intraoperative decompression of vertebral canal and nerve root canal,removal of intervertebral disc nucleus pulposus tissue,explore and release nerve root.The Oswestry disability index (ODI),visual analogue scale (VAS) and improved Macnab standard were used to assess the efficacy of the operation.Operation segments intervertebral height change,lumbar power X-ray slice of intervertebral Angle was measured according to preoperative and last follow-up of lumbar lateral X-ray observation,and lumbar spine motion (the range of motion,ROM) was calculated.Results All cases were successfully performed,no open surgery,and all cases were followed up.The average surgical blood volume was 10.3± 2.7 ml,the operation time was 63.5±11.6 min,no nerve root injury,dural injury,cerebrospinal fluid leakage,muscle strength decline,secondary obstruction,lumbar instability or other serious complications occurred.The follow-up time was from 18 to 52 months,with an average of 35.5±5.1 months.The preoperative ODI 51.35± 15.29 decreased to 3.31 ±2.17 at the last postoperative follow-up,the preoperative VAS score 8.11 ± 1.05 decreased to (1.03± 0.81) at the last postoperative follow-up,and the difference was statistically significant (P ＜ 0.05).As to the last follow-up evaluation of curative effect,according to the modified MacNab method,the fine rate was 87.2％;At the time of the last follow-up,surgery intervertebral disc height of front and rear section before and after surgery had no significant differences (P ＞ 0.05),the motion of operation segmental lumbar (the range of motion,ROM) had no significant difference (P ＞ 0.05).Conclusion Under the premise of strict control of surgical indications,the clinical efficacy of minimally invasive surgery for the treatment of recurrent lumbar disc herniation is reliable.The transforaminal approach does not affect the stability of the spine.The operation has the advantages of small trauma,fewer complications,and is safe and effective.
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BACKGROUND:Major abdominal vascular injury is a seldom serious complication during lumbar discectomy. Once occurring, it wil cause critical condition, and incorrect rescue and operation wil lead to patient’s death or functional disorder of the limbs. ＜br> OBJECTIVE:To explore the cause, diagnosis, prevention and treatment action for major abdominal vascular injury caused by lumbar discectomy. ＜br> METHODS:One case of common iliac artery injury caused by lumbar discectomy was reviewed in the aspects of diagnosis, prevention and treatment action. ＜br> RESULTS AND CONCLUSION:The case suffered from common iliac artery injury caused by lumbar discectomy of right L 4-5 vertebrae, and achieved successful rescue by timely diagnosis, surgical intervention and artificial blood vessel transplantation. Injury of the vessels is relevant with many factors, including surgical operation, anatomy, pathology, etc. Unexplained intervertebral hemorrhage accompanied with sudden drop of blood pressure during surgery hints the possible occurrence of major vascular injury. Accurate diagnosis and instant surgical intervention is the key to rescue the patient’s life.
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BACKGROUND:At present, vertebroplasty and spinal canal decompression are common methods for treatment of metastatic spinal tumors. Iodine-125 (125 I) radioactive seed implantation has been shown to control the tumor. However, there were few clinical studies on combined therapy using above-mentioned methods. OBJECTIVE:To compare the differences of 125I radioactive seed implantation combined with vertebroplasty and titanium al oy nail-rod fixation and vertebroplasty combined with titanium al oy nail-rod fixation for treating thoracolumbar metastases on pain control, general performance and improvement of the spinal cord function, and to evaluate clinical value of 125 I radioactive seed implantation combined with therapeutic plans. METHODS:Thoracolumbar metastases patients undergoing titanium al oy nail-rod fixation were selected in the Department of Spinal Surgery, Shenzhen Municipal People’s Hospital in China from October 2009 to March 2013. They were assigned to experimental and control groups according to with or without 125 I radioactive seed implantation. Improvement in neurological function was observed before and 2 weeks, 1, 6, and 12 months after titanium al oy nail-rod fixation in both groups. RESULTS AND CONCLUSION:Al patients were fol owed up for 7 to 29 months, averagely 15.8 months. There was no loosening of titanium al oy nail-rod fixation and the position of bone cement was good. No seed migration or radioactive spinal cord injury was observed. No relapse or diffusion in the surgical site was observed during fol ow up. Visual Analogue Scale and Karnofsky Performance Status scores were higher in the experimental group than in the control group (P0.05). Results indicated that 125 I radioactive seed implantation combined with vertebroplasty and titanium al oy nail-rod fixation for treatment of metastatic spinal tumors showed obvious outcomes in relieving cancer pain.
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ObjectiveTo study the effect and mechanism of NGF gene modified SCs on DRG (dorsal root ganglion) neurons repair after compressed injury.MethodsSCs were obtained by one enzyme digestion method.SCs were transfected with NGF gene by adenovirus.Thirty-two female SD rats with compression injury of dorsal root ganglia on right lumbar nerve roots.were divided randomly into following groups:Normal saline(NS) group,Pure SCs group,Ad-NGF group,and SCs+NGF group.Nerve root tissues were harvested 2 weeks after treatment.Western blot were used to detect the proNGF volume in nerve root tissue lysis; Double-labeling fluorescent Immunohistochemistry(IHC) was used to count the number of β-Tubulin Ⅲ positive cells and activating transcription factor 3 positive cells.The ratio of injured neurons to survived neurons was calculated.ResultsWestern bolt showed the proNGF volume in nerve root tissue lysis of SCs+NGF group increased dramatically.Double-labeling fluorescent IHC showed SCs+NGF group vs any group,the density of survived DRG neurons(β-Tubulin Ⅲ positive cells) increased significantly,meanwhile the percentage of injured neurons (ATF3 positive cells) in survived neurons decreased dramatically.Conclusion NGF gene Modified SCs could promote the survival of DRG neurons after compression injury and decrease the ratio of injured neurons.We conclude that this study provides a new treatment strategy for the patients who suffer from chronic compression injury on nerve roots and DRG neurons.
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BACKGROUND: Gallium is a non-essential trace element in the human body. In vivo experiments have confirmed that gallium can directly inhibit bone osteelysis, prevent bone calcium release, increase bone calcium content, serves as a new drug treatment of metabolic bone disease, its anti-bone transformation mechanism remains unclear. OBJECTIVE: To observe the effects of gallium nitrate on collagen and bone calcium protein in osteeporotic rat model. METHODS: Ninety female SD rats were divided into control group (n = 20) and osteoporosis group (n = 70) at random. Control group rats were sutured to close abdominal cavity after bilateral ovarian was exposed. Osteoporosis group rats received the bilateral ovariectomy to produce osteoporotic rat models, which then were assigned into 4 groups by random digits table: osteoporotic control group (n = 16) by intraperitoneal injection of saline, 3 times per week; Low-dose gallium salt group (n = 16) by intrapedtoneal injection of I mg/kg of galfium nitrate, 3 times per week; High-dose gallium salt group (n = 15) by intraperitoneal injection of 2 mg/kg ofgallium nitrate, 3 times per week; Estrogen group (n = 15) by intraperitoneal injection of estradiol, 3 times per week. After 12 weeks of the treatment, the bone collagen, osteocalcin protein and hydroxyproline levels in bone specimens were detected. RESULTS AND CONCLUSION: Compared with control group, the content of collagen in osteoporosis control group was reduced (P < 0.05), the contents of aminohexose and hydroxyproline increased (P < 0.05), no significant differences were observed in the content of sulfate-base for both groups. Following gallium and estradiol treatment, the collagen contents enhanced (P < 0.05), while the contents of aminohexose and hydroxyproline reduced (P < 0.05). High-dose gallium salt group had a remarkable curative effect compared with low-dose gallium salt group (P < 0.05), and was similar to estradiol group (P > 0.05). it is indicated that gallium nitrate can improve bone metabolism status with osteoporosis through increasing the content of collagen and decreasing the content of hydroxyproline, 2 mg/kg gallium nitrate are similar to estrogen treatment.
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Objective To study the function, effect and mechanism of prevention of pressure sore formation with stimulation of the dorsal ramus of spinal nerve root by transcutaneous pulse using plateshape surface electrode. Methods According to the odd number and even number of admission date, 81 patients were divided into the control group (41 cases) and the observation group (40 cases). The control group received standard pressure sore prevention nursing according to Basic Nursing, the observation group received stimulation of the dorsal ramus of spinal nerve root by transcutaneous pulse using plate-shape surface electrode based upon routine nursing. Results 1 case caught grade Ⅰ pressure sere,1 case with grade Ⅱ pressure sere, and the incidence rate was 4.88% in the observation group, while in the control group, 5 cases caught grade Ⅰ pressure sore,4 cases with grade Ⅱ pressure sore, and the incidence rate was 22.50%. Conclusions Combination of routine prevention method with stimulation of the dorsal ramus of spinal nerve root by transcutancous pulse to prevent pressure sore formation can reduce the incidence rate of pressure sore in high risk population. This technique is easy, painless, noninvasive, and is a novel method for early prevention of pressure sore.
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Stent implantation is now the favorable therapy of coronary heart disease, but the restenosis occurring in association with the currently used stents device has become the main obstacle limiting the further development of stent. To change the expanding behavior of endovascular stents by way of design optimization is considered one of the effective approaches for reducing the damage to the intima of blood vessel and thereby decreasing the in-stent restenosis. So in this paper, the finite element method was used to systematically simulate and analyze the influences of different width of ring supporter and the non-symmetrical design of stent on its transitorily expanding behavior. The results show that among the structure parameters, the width of ring supporter of stent influences its expanded pressure remarkably. When designing the endovascular stent, we make its ring supporter unsymmetrical, i. e., we make the width of ring supporter of stent change degressively from its central part to end part. By this means, the dogboning, which normally happens in the expanding process of the balloon/stent system, can be effectively controlled and the acute vascular injuries can be reduced.
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Humans , Computer-Aided Design , Coronary Stenosis , Finite Element Analysis , Prosthesis Design , StentsABSTRACT
To improve the biocompatibility of metallic implants, bioactive nano-multilayer films consisting of polyethylenimine (PEI) and hyaluronan (HA) were prepared on biomedical 316L stainless steel surface via electrostatic self-assembly. Small angle X-ray diffraction curve revealed that multilayer films arranged regularly layer-by-layer. Atomic force micrcscopy (AFM) was applied to determine the surface topograph and roughness. The results showed that the coated surface became smoother with the increase of number of layers. Platelet adhesion experiment indicated that the nano-multilayer films significantly reduced the platelet adhesion on the surfaces and exhibited obviously improved haemocompatibility.
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Angioplasty, Balloon, Coronary , Coated Materials, Biocompatible , Chemistry , Hyaluronic Acid , Chemistry , Materials Testing , Metal Nanoparticles , Chemistry , Microscopy, Atomic Force , Platelet Adhesiveness , Polyethyleneimine , Chemistry , Stainless Steel , Chemistry , Stents , X-Ray DiffractionABSTRACT
Stent implantation can cause thrombus, vessel injury and blood flow disturbance which are considered as the main causes of instent restenosis. In order to investigate the influence of stent implantation on vessel wall and blood flow, we used finite element method (FEM) and computational fluid dynamics (CFD) in this work. The results showed that the implantation of the stent could cause vessel injury and flow stagnation. The instant recoil of the implanted stent is much more than that of the stent itself (12.3% versus 3.1%). In conclusion, FEM and CFD can help illustrate and quantify some biomechanical characteristics for the optimization of stent design.
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Humans , Blood Flow Velocity , Physiology , Computer Simulation , Finite Element Analysis , Models, Cardiovascular , Prosthesis Design , Prosthesis Implantation , Methods , StentsABSTRACT
In this study we examined the in vitro characteristics of MSCs adhesion to polypeptides modified surface of polymer PLGA-[ASP-PEG]. We study the adhesion of marrow stromal cells in biomaterials at diferrent times using a micropipette aspiration technique. Comparison the adhesion of PLGA-[ASP-PEG] combinating GRGDSPC polypeptides versus PLGA-[ASP-PEG]. The adhesive conditions of MSCs on the materials were observed by scanning electron microscope. Four hours after MSCs inoculating in biomerials, the cell adhesion force of PLGA-[ASP-PEG] is 172.78 +/- 15. 23N and the force of PLGA-[ASP-PEG] combinating GRGDSPC polypeptides is 209.47 +/- 92.59N. There are no difference between two biomaterials. After 12 hours,the adhesion force of PLGA-[ASP-PEG] combinating GRGDSPC polypeptides is 576.23 +/- 165.74N, and the cell force of PLGA-[ASP-PEG] is 261.84 +/- 100.09 N. There are very significant difference between the two biomaterials. However, after 24 hours,the adhesion forces of the two biomaterials have no difference. The density of MSCs on PLGA-[ASP-PEG]-GRGDSPC surface was much higher than that of PLGA-[ASP-PEG]. Combination polypeptides in the surface of biomaterials can enhance the adhesion of MSCs.
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Animals , Female , Male , Rats , Animals, Newborn , Aspartic Acid , Chemistry , Biocompatible Materials , Chemistry , Bone Marrow Cells , Cell Biology , Cell Adhesion , Cells, Cultured , Lactic Acid , Chemistry , Mesenchymal Stem Cells , Cell Biology , Peptides , Chemistry , Polyglycolic Acid , Chemistry , Rats, Sprague-Dawley , Tissue EngineeringABSTRACT
Wall shear stress plays an important role in the development of in-stent restenosis. It has been demonstrated that low wall shear stress. is associated with neointimal hyperplasia. We used computational fluid dynamics (CFD) to investigate the steady and pulsatile flows in the vicinity of model stents and focused on the changes of wall shear stress caused by the implanted stents. The results showed that wall shear stress depended greatly on the size and structure of the stents, which would have implications for the optimization of intravascular
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Humans , Angioplasty, Balloon, Coronary , Biomechanical Phenomena , Computer Simulation , Computer-Aided Design , Coronary Restenosis , Hemodynamics , Physiology , Prosthesis Design , Shear Strength , StentsABSTRACT
Coronary stent is an important device used in Percutaneous Transluminal Coronary Angioplasty (PTCA) which is usually implanted to support the stenosed artery. Its expansion behavior depending on inflating of balloon and characters of recoil happening while the balloon is retrieved is the most important aspects which should be concerned in operation. In this paper, the finite element method was applied to systematically analyze the influence of strut width and thickness and the scale of dilatation of stent on its performance in expansion. The results show that increasing the strut width or thickness can improve the critical internal pressure needed for stent to expand fast. And the change of stent length while expanded is only associated with its structure and final dilatation state. If stent geometry is the same, it is the stent material that may be the main aspect to affect the recoil of stent. Experiment result is well consistent with simulation which indicates that the finite element method can substitute for the stent prototype testing to some extent.
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Humans , Angioplasty, Balloon , Angioplasty, Balloon, Coronary , Finite Element Analysis , Models, Theoretical , Prosthesis Design , Stents , Stress, MechanicalABSTRACT
Since coronary stent is an important device used in percutaneous support the stenosed artery, its ability to expant the diseased artery wall shall be one of the most significant prerequisites for optimal stent performance. In this paper, the finite element model of coronary stent to resist compressing was set up based on the stent prototype testing. Using the numerical simulation, it was systematically analyzed that the influence of the size of the dilatation of stent and stent strut width and thickness on the stent mechanical properties of the resistance to compressive force applied by two opposite planes. The results show that this resistibility is weakened with the increasing of the final expanded diameter of stent, but increasing the stent strut width or thickness can improve it, and it is equivalent to this improvement to increase the dimension of strut cross section of the stent in the two directions. Experiment result is well consistent with simulation which indicates that the finite element method can substitute for the stent prototype testing to some extent.
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Angioplasty, Balloon, Coronary , Compressive Strength , Computer Simulation , Finite Element Analysis , Models, Cardiovascular , Prosthesis Design , Stents , Tensile StrengthABSTRACT
BACKGROUND: Many clinical cases have proved that the satisfactory reposition, fusion and internal fixation in the internal fixation for inferior lumbar spondylolisthesis are not consistent with the postoperative symptoms and physical signs, and functional restoration.OBJECTIVE: To investigate the application of somatosensory evoked potential(SEP) in the monitoring during internal fixation for inferior lumbar spondylolisthesis, and the effects of SEP monitoring on the improvement of postoperative symptoms and the spinal functions as well.DESIGN: A randomized controlled trial.SETTING: Inpatient department of spinal surgery, an affiliated hospital of a university. PARTICIPANTS: Fifty-two patients with inferior lumbar spomlylolisthesis including 23 male and 29 female cases aged between 18 and 68 years old were admitted by the Department of Spinal Surgery, Second Affiliated Hospital(Shenzhen People's Hospital) of Jinan University, from June 2000 to December 2003. All cases were randomly divided into control group(n = 20) and monitor group ( n = 32).METHODS: SEP induced by segmental stimulation in cutaneous nerve was used in the control group for preoperative and intraoperative monitoring, and postoperative follow up. The intraoperative potential changes in patients with excellent and good improvement in postoperative functions had been retrospectively investigated to confirm the effective indices for intraoperative monitoring, which thereby provided references for intraoperative monitoring in patients of monitor group.MAIN OUTCOME MEASURES: ① Evaluation of postoperative spinal function; ② SEP latency and amplitude.RESULTS: SEP values after postoperative anesthesia were set as basis.The manifestations of intraoperative potential alterations: ① If the latency reduced 10% -15% or the amplitude increases more than 40% after fixation, it suggested favorable prognosis; ② The potential indices were stable during monitoring, or the reduction of latency was less than 10%,or the increase of amplitude was less than 30%, the fixation could be continued, and partial functions of nerve root and symptoms could be improved after surgery; ③ During the surgery, if potential indices had transient lluctuation, which could be recovered to basic potential within 15 to 20 minutes, fixation should be stopped during the fluctuation. Still partial functions of nerve root and symptoms could be improved after surgery; ④If the intraoperative latency prolonged more than 5%, or amplitude reduced more than 10%, or part of the components disappeared, or the wave shape dispersed, it might suggest postoperative aggravation of pain and dyskinesia. So intraoperative adjustment was necessary. The coincident rate of the improvement of the indices of intraoperative monitoring and the improvement of postoperative spinal function reached 93.75%.CONCLUSION: SEP induced by segrmental stimulation in cutaneous nerve is an objective and effective method in the monitoring and instruction of decompression, reposition, fixation of internal fixation for inferior lumbar spondylolisthesis, which has important merits in the improvement of the function of nerve root and the restoration of spinal function.
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BACKGROUND: The assessment of chronic nerve root injury is mainly depend on indirect evidences of imaging results.OBJECTIVE: This study is designed to find out the relationship between the degrees of the pathological changes of nerve roots and motor evoked potential (MEP) changes due to chronic compression.DESIGN: A self-controlled trial with animals as subjects.SETTING: Spine Surgery Department of the Second Clinical Hospital of Jinan University.MATERIALS: The trial was completed in the Spinal Surgery Department of the Second Clinical Hospital of Jinan University from October 2001 to May 2003. The subjects were 30 healthy cats of either gender weighing 3 to 5 kg.INTERVENTIONS: The compression model was established by wedging a Ⅴ-shape bone flap into the right intervertebral foramens between C7, C8 and T1 vertebrae. The left foramens served as controls. The cats underwent CT examination on the 2nd, 4th, 8th and 12th postoperative week to show the foramen changes. Six randomly selected cats underwent magnetic stimulation MEP each time on the 2nd, 4th, 8th, 12th and 24th week. The injuries to the compressed nerve roots were assessed according to Mackinnon Standard and they were compared with the MEP wave.MAIN OUTCOME MEASURES: Whether the superficial magnetic stimulated MEP monitoring result was in correspondence with the pathological changes of the chronically compressed nerve roots.RESULTS: The MEP did not show any abnormal changes for Grade Ⅰ injury prolonged to 9.6- 10. 2 ms. There was almost no evoke potential at all stimulation points for grade Ⅴ nerve root injury.CONCLUSION: That the injured nerve root presents dysesthesia and normal MEP results suggests grade Ⅰ injury. Prolonged latency including prolonged F wave suggests grade Ⅱ injury. And additional amplitude decrease together with widened and unclassifiable waves implies the injury be grade Ⅲ. The prominent features of grade Ⅳ nerve injury is much more decreased amplitudes and more prolonged latency. For grade Ⅴ injury there is always disappearance of whole MEP or some potential components. The superficial magnetic stimulated MEP monitoring results are in correspondence with the pathological changes of the nerve roots due to chronic compression, which means MEP monitoring results could serve as the quantitative indication to pathological changes of nerve injury.
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BACKGROUND: As a novel procedure in minimally invasive spine surgery (MISS), percutaneous laser disc decompression(PLDD) has been applied widely in the recent development in clinical practices.OBJECTIVE: This study was designed to evaluate the influences of PLDD on the stability in cervical spinal constructs.DESIGN: A before-after comparison trail based on patients.SETTING: The experiment was performed at the spine surgery department of a hospital affiliated to a university.PARTICIPANTS: Twenty-eight patients who were diagnosed as lateral cervical disc herniation at the Spine Surgery Department of Shenzhen People' s Hospital, Second Hospital Affiliated to Jinan University were involved from October 2001 to April 2003. Of all of the patients, 17 were male and 11 were female. They have 29 cervical disc protrusions altogether.INTERVENTIONS: Monitored by X-ray, a 400 μm fixed optical fiber was introduced into the injured intervertebral disc via a 9-gauge flexible trocar through an anterior cervical approach. An Nd-YAG laser system,with a 1 060 nm wavelength and an output power of 15W, was employed to ablate or decompress the inner disc tissue. The disc tissue was exposedto 500- 950 J laser powers.MAIN OUTCOME MMEASURES: Before and 6 months after the PLDD, the deviation of adjacent vertebra displacements was observed and changings of the wedge angles of the intervertebral discs were calculated respectively.RESULTS: The deviation of adjacent vertebra displacements showed no significant difference between before and after operation, when the patients were examined with a more flexed-position or a more extended-position(t=0.811 7-0.827 2, P＞ 0.05), and no significant changes in the wedge angles of the intervertebral discs could be observed either(t=0.768 7-0.827 1,P ＞ 0.05).CONCLUSION: Applying percutaneous laser disc decompression to lateral cervical disc herniation has many advantages, such as simplicity of operation, minimal invasion and having no impact on the stability in cervical spinal constructs.
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BACKGROUND:There is lack of an objective and standardized animal model for assessing the therapeutic effect of physical and medication treatment on bone defoct, the effectiveness of operation, as well as the role of bone substitute in the repairing of bone defects.DESIGN:Verified study on the experimental model of bone nonunion in rabbitsSETTING: Department of Orthopaedics in Shenzhen people' s Hospital MATERIALS:Twenty common grade pure New Zealand rabbits of either gender were selected with body mass of (2.5±0.5)kg,aged 6 to 8 months.METHODS :This experiment was carried out at the experimental animal center of Shenzhen people's Hospital between May and August 1999. 1.5cm bone segment (including periosteum)was cut off in the middle of forearm radius in 20 common grade pure NewZealand rabbits,the broken ends were covered with bone wax, 10 weeks later, the bone nonunion status was assessed by macropathological observation, pathohistological and X-ray examination.MAIN OUTCOME MEASURES:Observations on rabbit forearm radius defects by macropathological observation, pathohistological and X-ray examination.RESULTS :Twenty rabbits(40 side radius)were enrolled in this study and weeks later, bone defect region was found filled with fibrous cicatricial tissue without osseous connection ,bone wax was not absorbed, capitulum was ossified with medullary cavity blocked,a small amount of callus formed at both broken ends of fractural bone ,length of bone defect ranged from 0.8 to blocked under optical microscope,chondrocyte and osteocyte could be observed arranging disorderly and covered with fibrous membrane,defect reosseous connection could be detected at defect region at week 10,broken end was ossified and medullary cavity was blocked ,there was small amount of callus appeared at both broken ends displaying irregular shape.CONCLUSION:Bone nonunion experimental animal was successfully established on rabbits in this study, with pathological changes meeting the need of bone nonunion and displaying typical properties,which can be used as reliable and feasible experimental animal model.
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Objective To characterize the x-ray image of vertebral artery type of cervical spondylosis and explore its significance in rehabilitation treatment. Methods The X-ray films of 42 cases of vertebral artery type of cervical spondylosis were measured and analyzed. The treatment approaches including restriction of cervical movement,traction,epidural block and surgery were planned and implemented accordingly. Results The X-ray image revealed the following changes in the patients: the straightened physiologic curvature of the cervical spine,cervical vertebral unsteadiness,zygapophyzeal joint hyperplasia. Various treatment approaches are effective to patients with various manifestations. Conclusion Employing treatment approaches on the basis of X-ray images is of great signi-ficance for the effective treatment of patients with cervical spondylosis of vertebral artery type.