Posterior full-endoscopic cervical discectomy in cervical radiculopathy: A prospective cohort study.

OBJECTIVES: This study was conducted to assess the clinical outcomes of using the posterior full-endoscopic cervical discectomy (PECD) in comparison with the conventional anterior cervical decompression and fusion (ACDF) in treating patients with cervical radiculopathy. PATIENTS AND METHODS: From May 2015 to January 2018, patients with single cervical radiculopathy were enrolled in this study. The operative time, blood loss, hospital stay, and perioperative complications were recorded. The Visual Analog Scale (VAS) for neck and arm pain, the Neck Disability Index (NDI), and the modified MacNab criteria were used to quantify the postoperative outcomes. RESULTS: A total of 84 patients were initially enrolled in this study, while three patients were lost during the follow-up. The remaining 81 patients were divided into two groups. Thirty-eight patients underwent conventional ACDF, and the rest 43 patients were treated by PECD procedure. The patients in the ACDF group were slightly older than those in the PECD group (51.4 ± 8.2 VS 46.6 ± 8.8 years old, p = 0.012*). The blood loss and hospital stay were significantly less in patients treated with PECD compared with those undergoing ACDF (p < 0.05*). There were no significant differences in the VAS scores, the NDI, and the modified MacNab criteria between the two groups. The patients in the ACDF group obtained a better Cobb angle and had less operative time compared with those in the PECD group (p < 0.05*). Only mild complications were observed in both groups, with no significant difference (p = 0.28). CONCLUSION: PECD could significantly relieve pain and disability with no severe complication, and the majority of patients were satisfied with this technique. Thus, it is safe and effective to use this procedure in managing patients with cervical radiculopathy as an alternative procedure to ACDF.

Efficacy of Using Platelet-Rich Plasma in Spinal Fusion Surgery-A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Compliant Meta-Analysis.

BACKGROUND: Platelet-rich plasma (PRP) has been frequently used to enhance bone regeneration. A meta-analysis was conducted to systematically assess the fusion rate and pain relief of applying PRP during spinal fusion surgery. METHODS: Studies investigating spinal fusion surgery combined with PRP were retrieved from Medline and the Web of Science in accordance with the inclusion and exclusion criteria. A quality evaluation was conducted using the Cochrane collaboration tool for randomized controlled trials and the Newcastle-Ottawa scale quality assessment for cohort trials. Statistical analysis was performed using RevMan, version 5.3. RESULTS: A total of 12 studies, including 3 randomized controlled trials and 9 cohort studies, with 661 patients, were included in the present meta-analysis. The mean age was 52.3 ± 8.0 years. Overall, the pooled results demonstrated that the differences in the fusion rates between the PRP and non-PRP treatment groups were not statistically significant. The risk ratio was 1.01 (95% confidence interval, 0.95-1.06; P = 0.83). Also, no significant difference in pain relief measured using the visual analog scale was found between the 2 groups. The mean difference was -0.08 (95% confidence interval, -0.26 to 0.11; P = 0.42). CONCLUSIONS: Adding PRP did not increase the fusion rates from spinal fusion surgery. In addition, no significant difference was found in pain relief between the PRP and non-PRP treatment groups.

Clinical application of endoscopic surgery in extra sheath in minimally invasive neurosurgery / 中华神经医学杂志

Objective To explore the experience and methods of neuro-endoscopy in minimally invasive treating intracranial diseases.Methods The surgery effect and complications of minimally invasive treatment under neuro-endoscopy on 52 patients with intracranial diseases,admitted to our hospital from October 2010 to March 2013,were retrospectively summarized; in these 52 patients,20 had pituitary adenoma,20 had hypertensive intracerebral hemorrhage,1 had intracranial hematoma followed arteriovenous malformation,2 had intracranial hematomas after brain injury,2 had cholesteatoma,2 had optic canal decompression,2 had cerebrospinal fluid rhinorrhea,1 had multi-separated subacute subdural hematoma and the last 2 had arachnoid cyst.Results Except for 1 patient having cholesteatoma appeared bleeding of the petrosalvein intraoperatively,which resulted in cerebellum hemorrhage following postoperative venous hemorrhagic infarction and unfavourable prognosis,the rest of the patients recovered well; in 20 patients having hypophysoma,15 (75％) achieved total resection of the pituitary adenoma,and no postoperative cerebrospinal fluid rhinorrhea occurred; in 23 cases of intracranial hematomas,22 were cleared satisfactorily,and the left one occurred rehemorrhage in one side but craniotomy hematoma removal was successfully performed again.The eyesight of 2 patients with optic canal decompression was improved obviously.The repair effects of 2 patients with cerebrospinal fluid leakage were very good without intracranial infection or recurrence.The 2 patients with arachnoid cyst recovered satisfactorily without other complications.One patient with multi-separated subacute subdural hematoma recovered with hematoma clear postoperative satisfactorily; and one patient with cholesteatoma postoperative recovered satisfactorily with tumor resection.Conclusion Neuro-endoscopy has many advantages such as exposed wide range,good deep lighting,minimally invasive and high efficiency in endoscopic transnasal transsphenoidal skull base surgery and intracranial hematomas removal.

Bone marrow-derived mesenchymal stem cells inducing the proliferation and differentiation of ventral mesencephalic precursors / 中华神经医学杂志

Objective To explore the potential neurotrophic effect of bone marrow-derived mesenchymal stem cells (BMSCs) on the proliferation and differentiation of ventral mesencephalic precursors (VMPs).Methods VMPs from E 11 inbred rat embryos and BMSCs from adult rats were cultured in 2 separate groups.Moreover,a co-cultured group was also established.Afterwards,the 3 different differentiation mediums obtained from these 3 defined groups were used to influence the differentiation procedures of normal VMPs that had amplification in vitro for 7 d.The growth of cells was observed;immunocytochemical staining was performed on these cells at the late differentiation phase.Relative yields of TH+ cells were calculated and compared.Results Seven d after the inducing differentiation,the total cell numbers multiplied about 44.13±4.75,60.63±5.25 and 64.00±7.63 folds in the VMP control group,the BMSCs group and the VMP+BMSCs co-cultured group,respectively,as compared with those before the differentiation.Correspondingly, the ratios of TH+ cells in the total cell population were (18.76±5.20)%, (23.49±4.10)% and (28.08±5.42)% in the VMP control group,the BMSCs group and the VMP+BMSCs co-cultured group,respectively; significant differences betwwen each 2 groups were found (P<0.05).Conclusion BMSCs can secret nutritional factors to promote the proliferation and committed differentiation of VMPs into dopaminergic neurons.