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BACKGROUND: Percutaneous endoscopic interlaminar discectomy (PEID), which poses advantages for certain types of herniated disc, is gaining wider acceptance in clinical practice. We retrospectively analyzed the efficacy of the PEID technique in treatment of calcified lumbar disc herniation. STUDY DESIGN: A retrospective case-control study. SETTING: University hospital in China. OBJECTIVE: To evaluate the efficacy of the PEID technique in treatment of calcified lumbar disc herniation, and a comparison between calcified and noncalcified disc herniation was drawn to analyze the causes of herniated disc calcification. METHODS: Data from patients who underwent full-endoscopic lumbar discectomy in our department between March 2011 and May 2013 were collected. Thirty cases with calcified lumbar disc herniation were included in the study group, and 30 age-, gender-, and body mass index (BMI)-matched cases with noncalcified lumbar disc herniation served as controls. Perioperative data, preoperative and postoperative Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) values, MacNab scores, and postoperative low-extremity dysesthesia among patients in the 2 groups were collected. RESULTS: The values of computed tomography (CT) in the calcified group were significantly higher than those in the noncalcified group (P < 0.01). The preoperative disease courses in the 2 groups were similar. However, there was a statistically significant difference in the duration of traditional Chinese medicines (TCM) administration (P < 0.01). VAS and ODI scores improved significantly after surgery, but there were no significant differences between the 2 groups (P > 0.05). Three months after surgery, the rate of low-extremity dysesthesia in the calcified group was significantly higher than that in the control group (P = 0.03) but became similar at 6 months. By applying MacNab criteria the proportions of good and excellent were greater than 90% in both groups, and there was no difference between groups (P > 0.05). LIMITATIONS: The sample size was small in this retrospective study. CONCLUSION: The PEID technique is an effective method in the treatment of calcified lumber disc herniation, although the rate of postoperative dysesthesia is higher in this group during the early postoperative period. Long-term TCM administration may be related to the calcification of herniated lumbar discs.
Assuntos
Calcinose/cirurgia , Discotomia Percutânea/métodos , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Neuroendoscopia/métodos , Adulto , Idoso , Calcinose/diagnóstico por imagem , Calcinose/epidemiologia , Estudos de Casos e Controles , China/epidemiologia , Progressão da Doença , Feminino , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/epidemiologia , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND:Until now, there is yet no complete recovery from spinal cord injury in terms of structure and functional recoveries. Neurotrophic factors have limited effects on nerve regeneration. Currently, stem cel transplantation may be an effective way to repair spinal cord injury. OBJECTIVE:To separate, cultivate and purify mouse spinal cord-derived neural stem cels using serum-free suspension method folowed by morphological observation, immunofluorescence technology and multi-lineage differentiation experiments. METHODS:By using the suspension culture method, mouse spinal cord-derived neural stem cels at embryonic day 13.5 were cultured and purified. Cel morphology changes were observed under inverted microscope. Cel proliferation ability was detected using cel counting kit-8. Nestin and Sox2 expression was detected by immunofluorescence technology. Multilineage differentiation of spinal cord-derived neural stem cels at passage 4 was detected by natural differentiation method in order to prove the differentiation ability. RESULTS AND CONCLUSION: Serum-free medium suspension culture method was successfuly applied to separate spinal cord-derived neural stem cels. Cultured cels had good proliferative ability and highly expressed Nestin and Sox2 that was in accordance with the results of DAPI nucleus staining, suggesting the high purity of cels. After induction, the cels could express both Tuj1 and GFAP, indicating the cels had good differentiation potential. This experiment has successfuly established the isolation, culture, identification system of spinal cord-derived neural stem cels, providing experimental basis for subsequent studies of neural stem cels.
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Objective To determine the postprandial acid distributions in patients with gastroesophageal reflux disease (GERD), and their potential relationship with esophageal acid exposure. Methods Esophageal and gastric pH were recorded in a 1 h fasting segment and a 4 h postprandial segments using a triple-channel pH catheter with three antimony electrodes, which were positioned 5 cm proximal to the upper margin of LES(LES-5 cm), 5 cm and 10 cm distal to the upper margin of LES(LES+5 cm and LES+10 cm), respectively. Esophageal acid exposure and gastric integrated acidity (IA) were calculated for each ambulatory pH study. Ten healthy subjects (HS) and 10 patients with GERD were enrolled. Results (1) Total postprandial IA had a trend to be lower at LES+5 cm than at LES+10 cm in HS, but there was no significant difference between the two positions in patients with GERD. (2)Two hours after meal, there was no significant difference of gastric IAs and baseline in HS. Whereas gastric IAs in patients with GERD returned back to a higher level than baseline: LES+5 cm: 5.4 (1.8-6.8) mmol/L?h vs 1.8(0.3-3.1) mmol/L?h (P