摘要
OBJECTIVE@#To observe the clinical efficacy of the simple expansion of the spinal canal decompression, decompression plus hydroxyapatite/polyamide artificial lamina reconstruction, and decompression plus titanium mesh reconstruction in the treatment of spinal canal stenosi.@*METHODS@#A total of 39 patients with lumbar spinal stenosis (with or without disc herniation, spondylolisthesis less than I degree), who received therapy of surgery from January, 2011 to January, 2012, were retrospectively analyzed. All patients were divided into 3 groups: a laminectomy surgery alone group (group A, n=15), a decompression plus hydroxyapatite/polyamide artificial lamina reconstruction group (group B, n=14), and a laminectomy decompression plus reconstruction with titanium mesh group (group C, n=10). Intraoperative situation, the postoperative excellent rate and JOA score were analyzed.@*RESULTS@#The duration and blood loss in surgery in group A was much less than that in the group B and C (P0.05). Twelve months after the surgery, the group B and C showed advantage over the group A (P0.05); the group B and C showed advantage over the group A in 12 months after the operation (P<0.05). No serious complications were related to the surgery in the 3 groups. Imaging changes were not significant difference.@*CONCLUSION@#The decompression plus hydroxyapatite/polyamide artificial lamina reconstruction and the decompression plus titanium mesh reconstruction show advantages in long-term effect over the simple vertebral canal decompression.
Subject(s)
Humans , Decompression, Surgical , Intervertebral Disc Displacement , General Surgery , Laminectomy , Laminoplasty , Plastic Surgery Procedures , Retrospective Studies , Spinal Canal , General Surgery , Spinal Fusion , Spinal Stenosis , General Surgery , Titanium , Treatment Outcome摘要
BACKGROUND: Schwann cell can excrete many neurotrophic factors,protect neuron, and be nutritious to neuron. It also can promote the recover of injury of nerve.OBJECTIVE: To observe the expression of Schwann cell derived neurotrophic factor(SDNF) in developing lumber spinal cord of normal adult and different embryo rats as well as immature rats, and the effect on spinal cord in various developing period.DESIGN: Randomized and Controlled animal study.MATERIALS: The experiment was completed in the Animal Laboratory of Nanhua University in September 2003. Totally 30 Wister rats, in each gender,weighing 150-300 g, were selected from Animal Laboratory of Nanhua University.INTERVENTIONS: ① Selection and section: The normal lumbar spinal cord and dorsal root ganglia of normal adults rats with body mass in 180-220 g and 4-6 mature stages were fixed. Frozen sections were selected from 8 pregnant female rats including various embryol rats and immature rats. ② Immunohistochemical staining: Regarding protein antibody of SDNF as the first antibody,avidin-biotin peroxidase method was used to stain, the ash value was observed and the demi-quantitative value was worked out by scanning staining depth in order to analyze the expression of SDNF in lumbar spinal cord.MAIN OUTCOME MEASURES: ① Immunohistochemical staining of normal lumbar spinal cord; ② Immunohistochemical staining of developing lumbar spinal cord.RESULTS: Eight female rats were pregnant, and all samples were selected from the fetal rats and the immature rats. ① There appeared well-distributed SDNF, staining the whole white matter and Ⅲ, Ⅳ, Ⅴ stratum of the poster horn of gray matter of adult rats, and the dorsal root ganglia is much more intensively stained than lumber spinal cord. ② There was a inclination of early increase and late declination of SDNF immunoreactivity and the staining reaches a maximum at 21-day embryo, and then decreased at 7-day embryo and 12-day embryo after birth.CONCLUSION: There is lower expression of SDNF in lumber spinal cord of adult rats. But the expression of SDNF decreases gradually in the developing lumber spinal cord of rats. This means that SDNF may promote the development of spinal cord of embryo rats.
摘要
Objective To investig ate the expression of Schwann cell derived fa ctor (SDNF) in normal or under the condi tion of different injuries on the sciati c nerves of rats. Methods Sevent y-five S D rats were divided into three groups ac cording to different injuri es including transection, transection fo llowed by epineurial suture, and crush. Ten normal rats were treated as control. T he immunohistochemistry of both sciatic nerve and spinal cord were performed at 5,7,14,30,60 days after operation respec tively. Result (1)lower levels o f SDNF were detected in normal sciatic nerve, t he whole white matter and the laminae Ⅲ~ Ⅴ of dorsal horn of spinal cord. (2)In g roup transection, the SDNF levels reache d a maxium at 14 days after operation in proxi mal segment, at 7 days in distal segment , and at 5 days in spinal cord. There ap peared a highest expression in related t issue of both group crushing and group s uturing at 60 days after operation. (3)SD N F staining of dorsal horn ipsilateral to the nerve lesion was stronger than that of contralateral. There was a transient expression in spinal motor neurons ipsi lateral to nerve lesion at 5 days in gro up crushing and group transection and at 30 days in group suturing. Conclusi on (1)There is a weaker expression i n norma l sciatic nerve and spinal cord. (2)The expression of SDNF varies with the diffe rent nerve lesions. (3)Significant quant ities of SDNF are released from Schwann cells after nerve lesion, and SDNF is then available to the axon of the lesioned neurons which may promote neuro n repair.