Morphometric measurement of lower lumbar intervertebral foramina based on digital three-dimensional simulation.

AIM: This study aimed to investigate the morphology of the lower lumbar intervertebral foramina through use of a digital three-dimensional (3D) simulation model to guide the endoscope through the intervertebral foramina. MATERIAL AND METHODS: Individuals without disease affecting the lumbar vertebrae underwent computed tomography (CT) scanning in the supine position. The CT images obtained were imported to medical software to reconstruct a 3D model of the lumbar vertebrae. The stereoscopic longitudinal and transverse diameters of the lumbar intervertebral foramina were measured directly on the established simulation model. Comparisons in terms of sex and age were performed using t-test or analysis of variance. RESULTS: In total, 100 individuals were included in the study. Average longitudinal and transverse diameters of the lower lumbar intervertebral foramen decreased moving inferiorly. The longitudinal and transverse diameters of the lower lumbar intervertebral foramina were similar between sexes and between age groups. However, longitudinal diameter decreased with age (P 0.05). CONCLUSION: The reconstructed lumbar vertebrae simulation model presented in this study has high fidelity to the structure of the human lumbar spine. This approach provides individualized, accurate, standardized, and detailed guidance for endoscopic surgery through the lumbar intervertebral foramen.

[Studies on the interaction between malanin and metal ions by fluorescence spectra methods].

A novel protein with anti-tumor activities named malanin was isolated and purified from an endemic plant in Yunnan and Guangxi provinces. Effects of copper ion, silver ion and calcium ion on malanin and apo-malanin fluorescence spectra were studied. The results showed that copper ion leads to obvious statistic quenching of malanin and apo-malanin fluorescence. The dissociation constant of them from malanin and apo-malanin were about 2.37 X 10(-4) and 2.66 X 10(-4) mol · L(-1), respectively. The silver ion did not have quenching action on malanin fluorescence, but it had statistic quenching effect on apo-malanin fluorescence, and its dissociation constant was 2.37 X 10(-4) mol · L(-1). Calcium ion did not have quenching action on malanin and apo-malanin fluorescence. It plays an important role in keeping malanin natural conformation.

[Metrx quadrant system in the surgery of lumbar spondylolisthesis: preliminary clinical application].

OBJECTIVE: To evaluate the clinical efficacy and minimal invasiveness of quadrant posterior distraction system in the posterior lumbar spondylolisthesis (LS) surgery. METHODS: Sixty-one LS patients were randomly divided into two groups: quadrant posterior minimally invasive surgery system as invasive group (n = 30) and traditional open surgery as open group (n = 31). The clinical outcome of pain relief was assessed by the scoring systems of visual analogue scale (VAS) and Oswestry disability index (ODI) for low back pain. Radiographic assessment: preoperative and 1-day, 3-month and last follow-up (12 months) radiographs were analyzed including the index of relative posterior disc height. RESULTS: The scores of VAS and ODI of invasive group were less than open group at Months 3 and 12 post-operation (P < 0.01). Relative posterior disc height of intra-operation and Month 3 was not significantly different (P > 0.05). And there was only statistical significance difference within 12 months (P < 0.05). At Month 12 post-operation, the fluctuating rate was slight. CONCLUSION: The minimally invasive operation with Quadrant is less traumatic to the patients than traditional open operation in the protection of spinal stability, postoperative rehabilitation and radiographs. This new minimally invasive spine technique should be popularized.

[Studies on the chemical constituents of the stems of Piper betle].

OBJECTIVE: To study the chemical constituents from the stems of Piper betle. METHODS: Various chromatographic techniques were used to isolate and purify the constituents. The structures of these compounds were elucidated on the basis of spectral analysis. RESULTS: Nine compounds were isolated from the petroleum ester and ethyl acetate soluble fractions of the 70% acetone extract and their structures were identified as 6beta-hydroxystigmast-4-en-3-one (1), beta-sitosterol (2), stigmasterol (3), oleanolic acid (4), 23-hydroxyursan-12-en-28-oic acid (5), beta-sitosterol-3-O-beta-D-glucoside-6'-O-palmitate (6), beta-daucosterol (7), (2S) -4'-hydroxy- 2,3-dihydroflavonone-7-O-beta-D-glucoside (8) and alpha-ethyl glucoside (9). CONCLUSION: Among these compounds, 1, 3 -9 are isolated from this plant for the first time.

[Experimental study of reservation flaval ligament on prevention of peridural adhesion after operation on lumbar disc].

OBJECTIVE: Through an experiment in rabbits, to evaluate the role of reservation flaval ligament using different methods to prevent the epidural adhesion by observing the morphological changes and provide experiment evidences for clinic. METHODS: 45 adult rabbits were divided into three groups: Group A (treated with no reservation of flaval ligament), Group B (treated with reserving half flaval ligament), and Group C (treated with reserving the complete flaval ligament). Every group has 15 rabbits. At the 2nd, 4th and 8th weeks, the samples were obtained for gross observation, histological examinations, and the images were analysed by computer. The data were processed using SPSS11.5. RESULT: Gross Observation and Histological Examinations, at the 2nd, 4th and 8th postoperative week, there was significant difference between the group A, B and C (gross observation: F2w=4.660, F4w=8.591, F8w=31.858, P<0.05; histological examinations: F2w=5.190, F4w=9.561, F8w=34.658, P<0.05). Images analysis: the difference was very significant in the groups at 2nd, 4th and 8th weeks (F2w=30.783, F4w=47.350, F8w=25.544, P<0.01). With time passing, the ratio became larger and larger in the same group. CONCLUSIONS: Reserving the complete flaval ligament can significantly prevent the peridural adhesion from the back as a barrier, and can reduce the adhesion formed.

[Prevention of dura adherence in spinal canal after microendoscopic discectomy by different methods: a clinical study of 165 cases].

OBJECTIVE: To evaluate the effects of different methods in prevention of post-operational scar formation and dura adherence in the spinal canal after microendoscopic discectomy (MED). METHODS: 165 patients undergoing MED were randomly divided into 3 equal groups: Group A, with the yellow ligament dissected and with the space between vertebral laminae sprinkled with sodium hyaluronate before the closing of the incision; Group B, with the yellow ligament reserved; and Group C, with the yellow ligament reserved and with the space between vertebral laminae sprinkled with sodium hyaluronate before the closing of the incision. All the patients were followed up 2, 4, and 8 weeks, and 1 and 2 years after the operation. Japanese Orthopedic Association (JOA) scoring system was used to evaluate the outcomes. RESULTS: The JOA scores 2 weeks after MED were not significantly different among the 3 groups; and from then on the JOA scores of Groups B and C were all higher than those of group A (A and B: t(4w) = 0.602, t(8w) = 0.701, t(1y) = 0.623, t(2y) = 0.654; A and C: t(4w) = 0.833, t(8w) = 0.759, t(1y) = 0.714, t(2y) = 0.771, all P < 0.05), however, there were not significantly differences at all time points between Groups B and C (B and C: t(2w) = 0.041, t(4w) = 0.135, t(8w) = 0.980, t(1y) = 0.530, t(2y) = 0.103, all P > 0.05). CT showed that a great amount of scar was seen, surrounding the dura mater sac and nerve roots in Group A, and there was a great amount of scar outside the yellow ligament and no remarkable compression of dura mater sac and nerve roots in Groups B and C. CONCLUSION: Reservation of yellow ligament effectively prevents scar adhesion inside the vertebral canal after MED. Sprinkling of sodium hyaluronate is also effective, however, its effect only lasts a short time.