Effectiveness and safety of interspinous spacer versus decompressive surgery for lumbar spinal stenosis: A meta-analysis of randomized controlled trials.

STUDY DESIGN: A meta-analysis of randomized controlled trials. OBJECTIVE: Our meta-analysis was conducted to investigate whether interspinous spacer (IS) results in better performance for patients with lumbar spinal stenosis (LSS) when compared with decompressive surgery (DS). BACKGROUND DATA: DS and IS are common surgeries for the treatment of LSS. However, controversy remains as to whether the IS is superior to DS. METHODS: We comprehensively searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials for prospective randomized controlled trials that compared IS versus DS for LSS. The retrieved results were last updated on July 30, 2023. RESULTS: Eight studies involving 852 individuals were included in the meta-analysis. The pooled data indicated that IS was superior to DS considering shorter operation time (P = .003), lower dural violation rate (P = .002), better Zurich Claudication Questionnaire Physical function score (P = .03), and smaller foraminal height decrease (P = .004), but inferior to DS considering the higher rate of reoperation (P < .0001). There was no significant difference between the 2 groups regarding hospital stay (P = .26), blood loss (P = .23), spinous process fracture (P = .09), disc height decrease (P = .87), VAS leg pain score (P = .43), VAS back pain score (P = .26), Oswestry Disability Index score (P = .08), and Zurich Claudication Questionnaire symptom severity (P = .50). CONCLUSIONS: In summary, we considered that IS had similar effects with DS in hospital stay, blood loss, spinous process fracture, disc height decrease, VAS score, Oswestry Disability Index score, and Zurich Claudication Questionnaire Symptom severity, and was better in some indices such as operation time, dural violation, Zurich Claudication Questionnaire Physical function, and foraminal height decrease than DS. However, due to the higher rate of reoperation in the IS group, we considered that both IS and DS were acceptable strategies for treating LSS. As a novel technique, further well-designed studies with longer-term follow-up are needed to evaluate the effectiveness and safety of IS.

Deletion of C9orf53 promotes the growth of head and neck squamous cell carcinoma and is associated with poor prognosis of patients with head and neck squamous cell carcinoma.

Head and neck squamous cell carcinoma (HNSCC) is the fifth most common carcinoma worldwide, and accounts for ~600,000 new cases every year. The information on the molecular carcinogenesis of HNSCC is very limited. In the present study, the role of C9orf53 in HNSCC was investigated. The levels of C9orf53 were assayed by reverse transcription-quantitative polymerase chain reaction. The levels of C9orf53 in cells were overexpressed by overexpression plasmid and inhibited by small-interfering RNA. Cell proliferation was assayed by MTT, and cell apoptosis was assessed by FACS analysis. It was demonstrated that C9orf53 deletion was associated with a decreased survival of patients. The level of C9orf53 in HNSCC tissues was lower compared with the matched normal tissues adjacent to tumors. A lower expression of C9orf53 promoted cell proliferation, and the overexpression of C9orf53 induced cell apoptosis. In conclusion, a low level of C9orf53 in HNSCC promoted the growth of HNSCC cells, which might be associated with the low survival rate of patients with HNSCC.

A novel videographic method for quantitatively tracking vibrissal motor recovery following facial nerve injuries in rats.

BACKGROUND: Previous studies of vibrissal movements employ either optoelectronic recording techniques in the head fixed rodent, or videographic recordings in freely moving animals. However, both approaches have shortcomings for quantitatively tracking the process of vibrissal motor recovery. NEW METHOD: A critical feature of our videographic method is to measure tagged vibrissae movements while leaving all others intact in body restrained rats without head fixation. Thirty two adult rats underwent facial nerve manipulation and testing. All animals underwent baseline preoperative whisking testing. In the experimental groups, the right facial nerve was either crushed, or transected and sutured. In the control groups, the left facial nerve underwent either sham surgery, or transection denervation. Whisking function was measured for the ensuing 2 to 12 weeks. Data were analyzed for whisking recovery. RESULTS: Baseline preoperative whisking testing showed that majority of free whisking on the both sides is synchronous and symmetric, which allows us to compare vibrissal motor data between intact and manipulated side after facial nerve injury. As expected, the recovery of whisking function following crush is better and earlier than that with transection and suture. COMPARISON WITH EXISTING METHOD(S): To our knowledge, this novel videographic method is a significant simplification over currently employed optoelectronic recording techniques and videographic methods. CONCLUSIONS: Our novel videographic method may be a powerful tool to investigate motor recovery from facial nerve manipulation in the rat model.

[Influence of TiN, TiCN coating on corrosion resistance of dental pure titanium].

PURPOSE: To investigate the effects of TiN and TiCN coating on corrosion resistance of pure titanium in the simulated oral environment. METHODS: The dental pure titanium commonly used in making removable denture was casted with 15 specimens, 10mm × l0mm × 1mm in size. The specimens were randomly divided into group A, group B and group C. In the group B and group C, the specimens were coated with a thickness of 2.5µm TiN and TiCN coating on surface by multi-arc physical vapor deposition, respectively. After microscopic energy spectrum analysis, microstructure and phase diffraction were examined by FESEM. Hardness and Young modulus of the various coating were determined by nanoindentation. The polarization curves of all specimens in artificial saliva were measured by PARSTAT' 2273 electrochemical station. The data were analyzed with SPSS 17.0 software package for t test, one-way ANOVA and nonparametric test. RESULTS: Both the microhardness and elastic modulus in the group B and group C were significantly superior to those in the group A (P<0.001). Meanwhile, both the microhardness and elastic modulus in the group C were significantly higher than those in the group B (P<0.01). Corrosion potential (Ecorr) was group A > group B > group C (P<0.05). However, corrosion current density (Icorr) was significantly lower in the group A than in the group B, and in the group A than in the group C (P<0.01), while not significantly different between the B and group C (P>0.05).Breakdown potential (Ebreak) was group A

[The application of biopsy and kyphoplasty in the diagnosis and treatment of osteoporotic thoracolumbar vertebral compression fracture nonunion].

OBJECTIVES: To investigate the clinical efficacy and safety of biopsy and Kyphoplasty in the diagnosis and treatment of osteoporotic thoracolumbar vertebral fracture nonunion, and to explore the clinical characteristics of the disease. METHODS: From July 2005 to May 2010, the clinical data of 8 patients with nonunion of osteoporotic thoracolumbar vertebral fractures were studied. There were 3 males and 5 females, with the mean age of 73.5 years (range, 65 - 86 years). The fracture vertebrae were 3 cases in T(12), 4 in L(1), and 1 in L(2). All cases received radiography, CT and MRI examination. All patients were treated by using Kyphoplasty. Five patients were performed bone biopsy successfully, 3 patients were failed. The curative effect was evaluated by visual analogue scale (VAS), anterior vertebral height restoration at preoperative, postoperative and followed-up time. RESULTS: All patients tolerated the procedure well with immediate relief of back pain after Kyphoplasty. No severe complications were found in all patients. Three cases had the pathologic appearance of sequestrum, 2 cases were sparse cancellous bone, 3 cases were abortive to biopsy. All the patients were followed up of 22.6 months (range, 3 - 37 months), the VAS was 9.5 before operation, 2.1 at the third day postoperatively, there were significant difference between the two phase (P < 0.05), and 2.3 at last follow-up, there were no difference between postoperation and follow-up phase (P > 0.05). And the height of compressed body recovered markedly. The vertebral height had a recovery rate of 67.2% postoperatively, 64.1% and at last follow-up, there were no difference between the two phase (P > 0.05). CONCLUSIONS: Kyphoplasty is an effective and safe method in the treatment of osteoporotic throacolumbar vertebral fracture nonunion. Bone biopsy can play a further role of differential diagnosis.

[Keyhole partial laminectomy and tapping technique combined blind transpedicular screw placement in cervical spine].

OBJECTIVE: To investigate the clinical efficacy and safety of keyhole partial laminectomy and tapping technique combined blindly transpedicular screw placement in cervical spine. METHODS: Keyhole partial laminectomy and tapping technique combined blindly transpedicular screw placement, was introduced. It was performed in 40 patients. The fusion and screw position were observed in postoperative X-ray and CT, and the breach of pedicle were evaluated. Neurological improvement was followed up. RESULTS: Thirty-one cases were followed up, the mean follow-up period was 35 months. 28 cases screw fixation firmly and fusion completely, 3 cases fusion partly and no screw loosening. only 6.74% had a critical breach. Neurological function were improved in 29 cases of spinal cord injuries, only critical complication in one case. CONCLUSIONS: Keyhole partial laminectomy and tapping technique. combined blind placement is one of most usefull, feasible and safe procedures in transpedicular screw placement of the cervical spine.