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BACKGROUND: Thyroid eye disease (TED) is an inflammatory process involving lymphocyte-mediated immune response and orbital tissue damage. The anti-insulin-like growth factor-1 receptor (IGF-1R) antibodies produced by B lymphocytes are involved in the activation of orbital fibroblasts and the inflammatory process of orbital tissue damage in TED. The purpose of this study was to explore the role of IGF-1R in the mechanistic connection between orbital fibroblasts and B lymphocytes in TED. METHODS: Orbital fibroblasts sampled from orbital connective tissues and peripheral B lymphocytes isolated from peripheral blood, which were obtained from 15 patients with TED and 15 control patients, were co-cultured at a ratio of 1:20. The level of IGF-1R expression in orbital fibroblasts was evaluated by flow cytometry and confocal microscopy. Transient B lymphocyte depletion was induced with anti-CD20 monoclonal antibody rituximab, while the IGF-1R pathway was blocked by the IGF-1R binding protein. The expression levels of interleukin-6 (IL-6) and regulated upon activation, normal T cell expressed and secreted (RANTES) in the co-culture model were quantified via ELISA. RESULTS: IGF-1R expression was significantly elevated in TED orbital fibroblasts compared to that of controls. A 24-h co-culture of orbital fibroblasts with peripheral B lymphocytes induced elevated expression levels of IL-6 and RANTES in each group (TED patients and controls), with the highest levels occurring in TED patients (T + T group). Rituximab and IGF-1R binding protein significantly inhibited increased levels of IL-6 and RANTES in the co-culture model of TED patients. CONCLUSIONS: IGF-1R may mediate interaction between orbital fibroblasts and peripheral B lymphocytes; thus, blocking IGF-1R may reduce the local inflammatory response in TED. Rituximab-mediated B lymphocyte depletion played a role in inhibiting inflammatory responses in this in vitro co-culture model, providing a theoretical basis for the clinical application of anti-CD20 monoclonal antibodies in TED.
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Linfocitos B , Fibroblastos , Oftalmopatía de Graves , Receptor IGF Tipo 1 , Femenino , Humanos , Masculino , Linfocitos B/inmunología , Linfocitos B/metabolismo , Comunicación Celular , Células Cultivadas , Quimiocina CCL5/metabolismo , Técnicas de Cocultivo , Fibroblastos/metabolismo , Oftalmopatía de Graves/metabolismo , Oftalmopatía de Graves/inmunología , Interleucina-6/metabolismo , Depleción Linfocítica , Órbita/metabolismo , Órbita/inmunología , Receptor IGF Tipo 1/metabolismo , Rituximab/farmacología , Rituximab/uso terapéuticoRESUMEN
All-normal-dispersion (ANDi) dissipative soliton mode-locking is realized based on nonlinear multimode interference (NMI), which is implemented by offset-splicing three pieces of graded-index multimode fibers (GIMFs) and acts as a saturable absorber. The higher-order modes can be excited by offset-splicing GIMFs (OS-GIMFs), which eliminates adding the step multimode fiber (SIMF) into the resonant cavity and the precise length requirement of the SIMF. In the experiment, the stable dissipative soliton mode-locking at 1030 nm can be obtained with the pulse width of 7.3 ps and the repetition rate of 20.52 MHz, and the bandwidth is 6.98 nm. The maximum output is 3.2 mW with the pump power of 257 mW. The OS-GIMFs can significantly improve the saturated absorption and can easily realize dissipative soliton mode-locking in ANDi regions, which makes it attractive in ultrafast photonics.
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Manipulating the Li plating behavior remains a challenging task toward Li-based high-energy batteries. Generally, the Li plating process is kinetically controlled by ion transport, concentration gradient, local electric field, etc. A myriad of strategies have been developed for homogenizing the kinetics; however, such kinetics-controlled Li plating nature is barely changed. Herein, a ferroelectric substrate comprised of homogeneously distributed BaTiO3 was deployed and the Li plating behavior was transferred from a kinetic-controlled to a thermodynamic-preferred mode via ferroelectric effect. Such Li deposits with uniform hexagonal and cubic shapes are highly in accord with the thermodynamic principle where the body-centered cubic Li is apt to expose more (110) facets as possible to maximally minimize its surface energy. The mechanism was later confirmed due to the spontaneous polarization of BTO particles trigged by an applied electric field. The instantly generated reverse polarized field and charged ends not only neutralized the electric field but also leveled the ion distribution at the interface.
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The important role of p-n junction in modulation of the optoelectronic properties of semiconductors is widely cognized. In this work, for the first time the synthesis of p-GaSe/n-MoS2 heterostructures via van der Waals expitaxial growth is reported, although a considerable lattice mismatching of ≈18% exists. According to the simulation, a significant type II p-n junction barrier located at the interface is expected to be formed, which can modulate optoelectronic properties of MoS2 effectively. It is intriguing to reveal that the presence of GaSe can result in obvious Raman and photoluminescence (PL) shift of MoS2 compared to that of pristine one, more interestingly, for PL peak shift, the effect of GaSe-induced tensile strain on MoS2 has overcome the p-doping effect of GaSe, evidencing the strong interlayer coupling between GaSe and MoS2 . As a result, the photoresponse rate of heterostructures is improved by almost three orders of magnitude compared with that of pristine MoS2 .
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Molibdeno/química , Semiconductores , Espectrometría RamanRESUMEN
Long microchannels with thin walls, small width, and nanoholes or irregular shaped microgaps, which are similar to capillaries or cancerous vessels, are urgently needed to simulate the physiological activities in human body. However, the fabrication of such channels remains challenging. Here, microchannels with designable holes are manufactured by combining laser printing with line-contact capillary-force assembly. Two microwalls are first printed by femtosecond laser direct-writing, and subsequently driven to collapse into a channel by the capillary force that arises in the evaporation of developer. The channel can remain stable in solvent due to the enhanced Van der Waals' force caused by the line-contact of microwalls. Microchannels with controllable nanoholes and almost arbitrary patterns can be fabricated without any bonding or multistep processes. As-prepared microchannels, with wall thicknesses less than 1 µm, widths less than 3 µm, lengths more than 1 mm, are comparable with human capillaries. In addition, the prepared channels also exhibit the ability to steer the flow of liquid without any external pump.
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BACKGROUND: To determine the correlation between clinical activity scores (CAS) of thyroid-associated ophthalmology (TAO) patients and their locally produced and/or systemically circulating insulin-like growth factor-1 (IGF-1), and to assess the possible pathogenic role of IGF-1 in TAO. METHODS: Eighteen patients with TAO, and 16 age- and gender-matched controls were included in the present study. Among them, orbital tissue surgically collected from five TAO patients and five healthy controls was used for orbital fibroblasts (OFs) culture and in vitro study. Total and free IGF-1 in serum levels were determined by an ELISA kit for all the participants in this study. The IGF-1 concentration in culture media of OFs was determined using a noncompetitive time-resolved radioimmunoassay kit. The effect of octreotide (OCT), a somatostatin analog, on proliferation of OFs was assessed using the MTT assay. IGF-1 mRNA levels were measured by real-time polymerase chain reaction (PCR). RESULTS: Cultured OFs from both TAO patients and normal donors secreted IGF-1, and the secretion continued over a 72 hour period in vitro. IGF-1 secretion by OFs was elevated in the TAO group. Both the elevated secretion of IGF-1 and proliferation of OFs from TAO patients could be inhibited by OCT. Result of quantitative PCR showed that IGF-1 mRNA expression by OFs in TAO patients was up-regulated more than 2-fold compared with normal controls (P < 0.05), and this up-regulation was prevented by OCT treatment. Total and free serum IGF-1 levels in TAO patients were similar to those of normal controls. However, the IGF-1 level in cultured medium of OFs from TAO patients, but not serum levels of IGF-1, was positively correlated with CAS (r = 0.97, P = 0.017). CONCLUSIONS: Local production of IGF-1 by cultured OFs may be positively correlated with CAS, whereas systemically circulating IGF-1 may remain unchanged in TAO patients. Thus, locally produced IGF-1 may develop a role in the pathogenesis of TAO in an autocrine or paracrine fashion. The inhibitory effect of OCT on proliferating and IGF-1 mRNA levels of cultured OFs from TAO patients may be used as the mechanistic explanation for somatostatin analog as a valuable option in the treatment of TAO.
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Oftalmopatía de Graves/sangre , Factor I del Crecimiento Similar a la Insulina/metabolismo , Órbita/metabolismo , Adulto , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Ensayo de Inmunoadsorción Enzimática , Femenino , Fibroblastos/metabolismo , Fluoroinmunoensayo , Oftalmopatía de Graves/etiología , Humanos , Factor I del Crecimiento Similar a la Insulina/genética , Masculino , Persona de Mediana Edad , Octreótido/farmacología , ARN Mensajero/metabolismo , Reacción en Cadena en Tiempo Real de la PolimerasaRESUMEN
OBJECTIVE: To investigate the clinical significance of the Octopus 101 kinetic and Static combined automatic perimetry in Anterior Ischemic Optic Neuropathy (AION). To assess the merit and demerit of Octopus 101 kinetic and static combined automatic perimetry performed in AION cases. METHODS: 45 AION patients were detected with Octopus 101 with kinetic and static 30 degrees, 60 degrees scope static program from June 2006 to September 2008. The mean defect (MD), loss variance (LV), areas of isopter, and reaction time were analyzed. The correlation between MD, areas of isopter and reaction time were analyzed. RESULTS: In AION, there are kinds of visual field defect related to the optic lesions in static perimetry examine. Kinetic programme display the isopter deletion. Isopter areas using I-2e and III-4e stimulus are significantly different (P < 0.05). Smaller stimulus can find more periphery changes in AION. CONCLUSIONS: The Octopus 101 perimeter can provide static and kinetic program in the same sitting. In clinical practice it is necessary to perform both static and kinetic examination in patients with AION because the visual field defects are diverse, and the data provided by static and kinetic program are complementary.
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Neuropatía Óptica Isquémica/diagnóstico , Pruebas del Campo Visual/instrumentación , Adulto , Femenino , Humanos , Masculino , Pruebas del Campo Visual/métodos , Campos VisualesRESUMEN
Although the anisotropy and strategies for the modulation of the anisotropy in ReS2 have been widely reported, a comprehensive study on the inherent electronic anisotropy of ReS2 is still absent to date; therefore, the mechanism of anisotropy evolution is ambiguous as well. In this study, we have conducted a systematic investigation on the evolution of electronic anisotropy in bilayer ReS2, under the modulation of charge doping levels and temperature. It is found that the adjustability of electronic anisotropy is largely attributed to the angle-dependent scattering from defects or vacancies at a low doping level. At a high doping level, in contrast, the inherent electronic anisotropy can be recovered by filling the traps to attenuate the influence of scattering. This work renders insights into the exploration of electronic anisotropy in 2D materials.
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OBJECTIVE: To assess the applicability and reliability of Dynamic Contour Tonometry (DCT) in the measurement of intraocular pressure (IOP) and ocular pulse amplitude (OPA) in patients with primary open-angle glaucoma (POAG), ocular hypertension (OHT), normal tension glaucoma (NTG) and normal controls. METHODS: 120 subjects were included in the present study as follows: 30 patients in each group, total four groups, i. e. , POAG, OHT, NTG and normal control. IOP measured by DCT was compared to that by Goldmann applanation tonometry (GAT). OPA, central cornea thickness (CCT), central cornea curve (CCV), heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP), other associated parameters, were also determined for the subjects of each group. RESULTS: The IOP of all groups measured by DCT was (21.68 +/- 2.02), (23.37 +/- 2.65), (18.43 +/- 3.08), (17.04 +/- 2.07) mm Hg (1 mm Hg = 0.133 kPa); and the IOP measured by GAT was (21.18 +/- 2.95), (23.28 +/- 5.95), (16.39 +/- 3.60), (14.66 +/- 2.27) mm Hg, there was no significant differences between the IOP measured by these two methods (t = 1.338, 1.445, 1.682, 1.803; P = 0.197, 0.151, 0.136, 0.081). Significant differences of OPA levels in different groups were observed (F = 21.311, P = 0.000). OPA reading was affected by HR, SBP, DBP, IOP and CCT, while there was no correlation with patients' age. CONCLUSIONS: Regarding to the IOP measurement, DCT was in concord with GAT readings. The differences in OPA among POAG, OHT and the normal groups and the lowest OPA reading in NTG patients indicate different intraocular hemodynamic status among these groups. OPA measurement may be useful to early detection and progression follow-up of glaucoma patients.
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Glaucoma de Ángulo Abierto/fisiopatología , Presión Intraocular , Tonometría Ocular/instrumentación , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Glaucoma/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Hipertensión Ocular/fisiopatología , Tonometría Ocular/métodosRESUMEN
h-BN is a widely used ultrathin insulator that can be synthesized in a controllable manner by chemical vapor deposition, similar to the growth of graphene. However, it is challenging to grow large-size single crystalline h-BN because of the ambiguous understanding of its growth mechanism. In this study, we propose a novel in situ formed nanoparticle-assisted growth strategy for large-size single crystalline h-BN growth on conventional polycrystalline copper. We found that the areal nucleation density of h-BN can be suppressed from â¼105 nuclei per mm2 to â¼102 nuclei per mm2 by the in situ formed nanoparticles that were introduced by pre-oxidation. Thus, single crystalline h-BN with lateral length of up to â¼102 µm was readily synthesized. Furthermore, for first time we discovered that the areal nucleation density of h-BN initially decreases and then increases under extreme annealing conditions, indicating that there is a competition-induced limit for suppressing the nucleation of h-BN on copper. This mechanism is universal for h-BN and graphene synthesis, which probably paves the way for large-size graphene/h-BN heterostructures synthesis in the future.
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OBJECTIVE: To investigate the clinical significance of the Octopus 101 GKP kinetic and static automated perimetry in the diagnosis of the primary open angle glaucoma (POAG). METHODS: Thirty POAG patients (POAG group) and 34 normal individuals (control group) were detected with Octopus 101 GKP static and kinetic perimetry with GKP and TOP program from October 2006 to March 2007. The visual acuity, intraocular pressure (IOP), cupping/disc (C/D) ratio, mean defect (MD), loss variance (LV), areas of isopter, and testing time were analyzed. RESULTS: The mean visual acuity, mean IOP and mean C/D ratio were significantly different between POAG group and control group (P = 0.000), and so was the testing time (P = 0.001). The mean test time was (307.78 +/- 134.50) s in the POAG group and was (228.12 +/- 75.33) s in the normal group. No linear correlation was found between the IOP and the areas of isopter or MD between these two group. The visual parameters (I 2e and III 4e) as to the areas of isopter of POAG were significantly different (P = 0.000), and so were the MD, LV and areas of isopter (P = 0.000). Static perimetry had a sensitivity of 80% and a specificity of 45%, and kinetic perimetry had a sensitivity of 86% and a specificity of 63%. The combined method of static and kinetic approaches had a sensitivity of 90%. CONCLUSIONS: The Octopus 101 GKP static and kinetic perimetry can perform an automated test that combines the advantages of both kinetic and static perimetry, resulting in a decreased subjectivity and individual difference by adjusting the response time and improved accuracy of test results. By changing stimulus size, background illumination, and stimulus angular velocity, the combination of the kinetic and static test may provide a higher sensitivity in the diagnosis of the early stage of POAG, particularly in patients with early peripheral visual field defect.
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Glaucoma de Ángulo Abierto/diagnóstico , Pruebas del Campo Visual/métodos , HumanosRESUMEN
Chemical vapor deposition growth of 1T' ReS2x Se2(1-x) alloy monolayers is reported for the first time. The composition and the corresponding bandgap of the alloy can be continuously tuned from ReSe2 (1.32 eV) to ReS2 (1.62 eV) by precisely controlling the growth conditions. Atomic-resolution scanning transmission electron microscopy reveals an interesting local atomic distribution in ReS2x Se2(1-x) alloy, where S and Se atoms are selectively occupied at different X sites in each Re-X6 octahedral unit cell with perfect matching between their atomic radius and space size of each X site. This structure is much attractive as it can induce the generation of highly desired localized electronic states in the 2D surface. The carrier type, threshold voltage, and carrier mobility of the alloy-based field effect transistors can be systematically modulated by tuning the alloy composition. Especially, for the first time the fully tunable conductivity of ReS2x Se2(1-x) alloys from n-type to bipolar and p-type is realized. Owing to the 1T' structure of ReS2x Se2(1-x) alloys, they exhibit strong anisotropic optical, electrical, and photoelectric properties. The controllable growth of monolayer ReS2x Se2(1-x) alloy with tunable bandgaps and electrical properties as well as superior anisotropic feature provides the feasibility for designing multifunctional 2D optoelectronic devices.
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OBJECTIVE: To compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation. METHODS: From January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T12 in 2 cases, L1 in 5 cases, L2 in 7 cases, L3 in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T12 in 2 cases, L1, in 7 cases, L2 in 9 cases, L3 in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups. RESULTS: All patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence. CONCLUSION: For patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.
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Vértebras Lumbares/lesiones , Tornillos Pediculares , Fracturas de la Columna Vertebral/cirugía , Fusión Vertebral/métodos , Vértebras Torácicas/lesiones , Adulto , Descompresión Quirúrgica/métodos , Femenino , Humanos , Vértebras Lumbares/cirugía , Masculino , Persona de Mediana Edad , Procedimientos de Cirugía Plástica , Estudios Retrospectivos , Vértebras Torácicas/cirugíaRESUMEN
OBJECTIVE: To explore the clinical effect of transforaminal lumbar interbody fusion (with single cage) combined with unilateral pedicle screw fixation in treating lumbar instability. METHODS: The clinical data of 50 patients with lumbar instability were retrospectively analyzed. They underwent treatment and obtained following up more than 8 months from 2009 to 2012. All patients complicated with refractory or recurrent lower back pain, and unilateral primarily or unilateral lower limb radiation pain, X-ray and CT films showed lumbar instability. The patients were respectively treated with transforaminal lumbar interbody fusion (with single cage) combined with unilateral or bilateral pedicle screw fixation. According to different fixation methods, they divided into unilateral fixation group and bilateral fixation group. There were 20 patients with 22 intervertebral spaces in unilateral fixation group, 8 males and 12 females, aged from 26 to 66 years old, 2 cases with isthmic spondylolisthesis of degree I, 8 cases with degenerative spondylolisthesis, 10 cases with lumbar disc herniation; fusion location with L3,4 was in 1 case, L4,5 was in 12 cases, L5S1 was in 9 cases. There were 30 patients with 30 intervertebral spaces in bilateral fixation group, 14 males and 16 females, aged from 41 to 62 years old, 4 cases with isthmic spondylolisthesis of degree I,14 cases with degenerative spondylolisthesis, 12 cases with lumbar disc herniation; fusion location with L3,4 was in 3 cases, L4,5 was in 15 case, L5S1 was in 12 cases. Operation time, intraoperative blood loss, postoperative drainage, complications were analyzed and intervertebral height, lordosis angle changes, fusion rate and clinical effect were compared between two groups. RESULTS: All incisions obtained primary healing,lower limb radiation pain and low back pain disappeared basically, no infection, endorachis injury was found. Foot drop occurred in one case of bilateral fixation group and no iatrogenic neurological symptom was found in unilateral fixation group. All patients were followed up from 8 to 18 months with an average of (10.8?4.3)months. Ac- cording to JOA score improvement rate (RIS) to assess clinical effect, all patients got excellent and good results, there was no statistically significant difference between two groups. Two methods can both effectively increase the pathological intervertebral height. Unilateral fixation group was better than bilateral fixation group in aspect of operation time, intraoperative blood loss and postoperative drainage. CONCLUSION: With strict indication and good skills, transforaminal lumbar interbody fusion (with single cage) combined with unilateral pedicle screw fixation in treating lumbar instability has advantages of smaller traumatic, less blood loss, faster recovery for the patient and can reduce the economic cost.
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Vértebras Lumbares/cirugía , Tornillos Pediculares , Fusión Vertebral/métodos , Adulto , Anciano , Terapia Combinada , Femenino , Humanos , Desplazamiento del Disco Intervertebral/fisiopatología , Desplazamiento del Disco Intervertebral/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Espondilolistesis/fisiopatología , Espondilolistesis/cirugíaRESUMEN
OBJECTIVE: To compare the clinical effect of thoracolumbar fractures between single-segment pedicle screw fixation approach for the gap of paravertebral muscles and double-segment pedicle screw fixation approach for the stripping of paravertebral muscles. METHODS: From September 2008 to January 2010, 65 patients with incomplete compressed thoracolumbar fractures or burst thoracolumbar fractures with unilateral endplate injury were randomly divided into two groups. Thirty patients were treated with single-segment pedicle screw fixation through the gap of paravertebral muscles (treatment group). Thirty-five patients were treated with double-segment pedicle screw fixation through the stripping of the paravertebral muscles (control group). All the internal fixations were taken out during 10-12 months after operation. Operative time, perioperative blood loss volume and postoperative drainage volume were compared between two groups. At final follow-up, the change of neurological ASIA grade were recorded; and postoperative 5 days and final follow-up, compared Denis classification of lumbar and back pain between two groups; and analyzed the sagittal index and compressibility of anterior border of vertebral body by X -ray lateral projection. RESULTS: All patients were follow-up from 14 to 22 months with an average of 18.3 months. No postoperative infection, secondary spinal cord injury was found. One case of control group occurred internal fixation breakage at the 11th month after operation and other internal fixation no loosening. There was no significant difference in operative time, the recovery of neurological function between the two groups (P > 0.05). Perioperative blood loss volume and postoperative drainage volume of treatment group was less than that of control group (P < 0.01). And in Denis classification of lumbar and back pain, the treatment group recovered more quickly, and the residual pain of lumbar and back was less than that of control group (P < 0.01). Postoperative posterior salient and compression of anterior border of vertebral body improved in two groups (P < 0.01), there was no significant difference in degree of improvement between two groups (P > 0.05); but both loss existed at final follow-up (P < 0.01), there was no significant difference in loss of posterior salient between two groups (P > 0.05). In the treatment group, the loss of rectify of anterior border of vertebral body existed, but it was less than that of the control group. CONCLUSION: In the premise of strict controlling surgery indications, the treatment of thoracolumbar fractures with single-segment pedicle screw fixation through the gap of paraspinal muscles, can effectively recover the height of vertebral body and rectify posterior salient, and reduce the fixed segment. Compared with the traditional operative method of double-segment pedicle screw fixation through the stripping of paraspinal muscle, it can obviously reduce the operation wound and the bleeding, lessen the pain of lumbar and back. And the recent clinical effect is satisfied.
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Tornillos Óseos , Fijación Interna de Fracturas/métodos , Vértebras Lumbares/lesiones , Fracturas de la Columna Vertebral/cirugía , Vértebras Torácicas/lesiones , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To evaluate the value of transforaminal approach single interbody fusion cage combining with fixation with pedicle screws in treating lumbar instability. METHODS: From 2006 to 2009, 36 patients (39 interspaces) with lumbar instability were retrospectively analyzed, included 14 males and 22 females; aged from 45 to 68 years with an average of 54 years; course of disease was from 6 months to 12 years with an average of 4 years. Of them, instability in lumbar disc herniation had 8 cases, lumbar spinal stenosis 5 cases, postoperative instability in lumbar disc herniation 3 cases, lumbar spondylolysis 20 cases; unstable segment in L3,4 had 2 cases, L4,5 18 cases, L5S1 13 cases, and double segment 3 cases (both L4,5 and L5S1). All patients underwent decompression, reduction, interbody fusion with single cage from transforaminal approach with pedicle screws and posterolateral fusion. The clinical effects were evaluated according to imaging results and JOA scoring system. RESULTS: All the patients were followed up from 8 to 32 months with an average of 18 months. The results of 38 intervertebral fusion, suspicious fusion of a vertebral space, fusion rate was 97.4% (38/39). Segmental lordosis angle after operation was increased (4.09 +/- 0.13) degrees than before operation (P < 0.01), and final follow-up was reduced (3.83 +/- 0.17) degrees than after operation (P > 0.05). JOA scoring before operation and final follow-up were respectively 8.14 +/- 1.09 and 13.54 +/- 1.19, there was statistically significant between the two periods (P < 0.01); the JOA score improvement rate (RIS): 28 cases got excellent result, 6 good and 2 fair, the rate of excellent and good was 94.4%. CONCLUSION: The path through the transforaminal approach single-fusion cage, implantation of pedicle screw fixation fusion surgery can simplify operations, reduce complications, and can obtain satisfactory clinical efficacy, which is an effective method for the treatment of lumbar instability.