[Current advances in research of semaphorin 3A:a potential target for the treatment of nospecific low back pain].

Nonspecific low back pain is closely associated with afferent nerve ingrowth into degenerated IVDs and increasing the inflammatory response. Members of the class 3 semaphorins signal their response through two prominent receptors; the NRP (Neuropilin-1) and the Plexin A. Sema3A (Semaphorin3A) is primarily known for their role in modulating neuronal survival as well as neurite outgrowth and guidance via regulation of Sema3A-NRP-1-plexinA signal pathway. Also, sema3A is shown to be conductive to innervate the inner painful degenerated IVDs (Intervertebral discs). Furthermore, sema3A is thought to act as a barrier to endothelial cells survival and migration on vascular endothelial growth factor (VEGF) and inhibition of KLF5-induced (Krüppel-like factor 5) inflammatory mediators within degenerated IVDs. Therefore, Sema3A produce a new perspective of dual-action therapeutic agent for attenuating the regulator of innervation and angiogenesis into degenerated IVDs and inhibition of KLF5-induced inflammation.

A case-control study on the treatment of protrusion of lumbar intervertebral disc through PELD and MED.

We compared the clinical effects between the percutaneous endoscopic lumbar discectomy (PELD) and microendoscopic discectomy (MED) treatments for protrusion of lumbar intervertebral disc. We conducted a retrospective analysis on 60 patients who were diagnosed with single-segment protrusion of lumbar intervertebral disc during the period from January 2009 to June 2016. Patients were divided into two groups, the PELD and MED groups, which contained 30 cases each. We evaluated the operation results according to oswestry dysfunction index (ODI), visual analogue scale (VAS) and the improved MacNab standard. The average follow-up visit period after the operation was 18 months and the operation time of the two groups was not statistically different. The cadaverine quantity of bleeding in the PELD group is less than that in the MED group. Moreover, the average length of incision and the length of stay were shortened for the PELD group compared to the MED group. The ODI and VAS after operation for the two groups improved significantly compared to that before operation (P<0.05). The qualified rates of the PELD and MED groups were 93.0 and 90.0%, respectively, as of the improved MacNab method. The complication occurrence rates for the two groups during perioperative period were not different. Therefore, the short-term efficacy of the two minimally invasive operation methods (PELD and MED) on the treatment of protrusion of lumbar intervertebral disc is satisfactory. In cases where operation indications are chosen strictly, PELD can be regarded as a method of safety and efficiency due to the advantages of minimal incision, less bleeding, minimal trauma and faster postoperative recovery.

[Application of Jintian'ge capsule in treatment of vertebral compression fracture in senile osteoporosis patients].

To study the clinical application of Jintian'ge capsule in treatment of vertebral compression fracture in senile osteoporosis patients. In the study, 69 senile osteoporotic vertebral compression fracture patients hospitalized in our hospital between January 2012 and June 2014 were selected and randomly divided into the control group and the treatment group. Patients in the control group were treated by percutaneous kyphoplasty (PKP), while those in the treatment group were given Jintian'ge capsule in addition to PKP. Efforts were made to visit the patients before the surgery and in three month after that, observe and compared the vertebral height, Cobb's angle, bone density, visual analogue scale (VAS) and Oswestry disability index between patients in the two groups. According to the findings, compared with before the treatment, patients in the two groups showed significant improvements in the vertebral height, Cobb's angle, bone density, VAS and Oswestry disability index three months after the surgery (P < 0.05); During the visit three months after the treatment, compared with the control group, the treatment group showed notable increases in all parameters (P < 0.05), particularly in the vertebral height, VAS and Oswestry disability index (P < 0.05). Based on the above findings, Jintian'ge capsule is applicable in adjuvant therapy after the osteoporotic vertebral compression facture PKP surgery.

[Analysis of correlative factors of non-surgical vertebral fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures].

OBJECTIVE: To investigate the correlative factors of non-surgical vertebral fractures after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures(OVCFs). METHODS: From August 2009 to September 2011, 126 patients who underwent single-level PVP for OVCFs were included in this study. They were followed up with an average time of 13.6 months,divided into the refracture group and non-refracture group according to the onset of non-surgical vertebral fractures or not. In refracture group,there were 14 males and 18 females with an average age of (67.63+/-7.28) years(ranged, 54 to 82); and in non-refracture group,there were 40 males and 54 females with an average age of (66.26+/-6.79) years (ranged, 55 to 76). The refracture group wps divided again into adjacent vertebral fracture (AVF) group (7 males and 13 females) and remote vertebral fracture(RVF) group (4 males and 8 females). The age, sex, bone mineral density(BMD), injecting bone cement volume, the recovery rate of vertebral body height,kyphosis corrected degree were recorded and the correlative factors of non-surgical vertebral fractures were analyzed. RESULTS: There was no statistically significant differences in age, sex, BMD, injecting bone cement volume and kyphosis corrected degree between refracture group and non-refracture group (P>0.05), and there was statistically significant difference in the recovery rate of vertebral body height (P<0.05). There was no statistically significant difference in BMD, kyphosis corrected degree between adjacent vertebral fracture group and non-refracture group (P>0.05); and there was statistically significant difference in injecting bone cement volume,recovery rate of vertebral body height(P<0.05). There was no statistically significant difference in BMD,injecting bone cement volume,recovery rate of vertebral body height, kyphosis corrected degree between remote vertebral fracture group and non-refracture group (P>0.05). CONCLUSION: Recovery of vertebral body height may prefigure increasing risk of refracture in non-surgical vertebral body for the patient with OVCFs after PVP, and the adjacent vertebral fracture maybe concerned with injecting bone cement volume and recovery rate of vertebral body height.

[Anterior cervical decompression and fusion by microscope for the treatment of cervical spondylotic myelopathy].

OBJECTIVE: To explore clinical effects of anterior cervical decompression and fusion by microscope in treating cervical spondylotic myelopathy. METHODS: From February 2005 to March 2010,21 patients with cervical spondylotic myelopathy, 13 males and 8 females with an average age of 51.5 years (ranged, 32 to 71), were treated with anterior cervical decompression using high-speed bur,then bone grafting and fusion with auto iliac bone and internal fixation by microscope. According to JOA score of cervical spondylosis to evaluate clinical effects before and after operation. RESULTS: All patients were followed up from 18 to 24 months with an average of 20 months. JOA score improved significantly from preoperative 9.26 +/- 1.72 to postoperative 13.64 +/- 1.38 (t = 2.452, P = 0.000). According to JOA score, 12 cases were excellent, 7 good and 2 fair. CONCLUSION: Anterior cervical decompression and fusion by microscope is a refined, safe and effective surgical procedure for cervical spondylotic myelopathy.

[Case-control studies between two methods of minimally invasive surgery and traditional open operation for thoracolumbar fractures].

OBJECTIVE: To investigate the surgical therapeutic result of thoracolumbar fracture treated by two minimally invasive surgery or by traditional open operation. METHODS: From June 2004 to April 2010, 76 patients (45 males and 31 females, with an average age of 36.4 years, ranging from 21 to 58 years) with thoracolumbar fracture were divided into three groups. In group A, 24 patients were treated with minimally invasive internal fixation by endoscope. In group B, 20 patients were treated by Sextant percutaneous pedicle screws fiaxation. In group C, 32 patients were performed with traditional open fixation surgery. The perioperative index and radiographic factor were compared among the three groups. RESULTS: All patients were followed-up for 1 year in average. The internal fixation devices were taken out averaged 1 year after operation,there were no complications related to the internal fixaton systems. The perioperative index of groups A and B including the incision size, surgical blood loss, surgical draining loss, hospital stay time and post-operation VAS score were significant smaller than group C (P < 0.05). The Cobb's angle, sagittal index, and anterior height of the fracture vertebral body were all significantly different between pre-operation and post-operation in each group (P < 0.05). CONCLUSION: These two methods of minimally invasive surgical treatments are effective and safe for patients with thoracolumbar fracture,because of less damage to muscles, less blood loss and quicker recovery, compared to the traditional open operation.

[Improvement technique of double endobutton plate for the treatment of type III acromioclavicular joint dislocation].

OBJECTIVE: To evaluate the clinical outcomes of improvement technique of double Endobutton plate for the treatment of Tossy III acromioclavicular joint dislocation. METHODS: From June 2008 to June 2009, 18 patients with Tossy III acromioclavicular joint dislocation were treated with improvement technique of double Endobutton plate. There were 11 males and 7 females, with an average age of 35 years old ranging from 28 to 55 years. The time from injury to operation was 2 to 5 days (means 3.5 days). All patients were followed and the clinical outcomes were recorded. RESULTS: These 18 patients were followed up from 4 to 8 months (averaged 6 months). All acromioclavicular joint dislocation were reduced. According to the scales of Karlsson, the post-operation function 1 of shoulder-joint in 16 patients were A grade and 2 patients were B grade. CONCLUSION: The improvement technique of double Endobutton plate is an effective ideal treatment methods for Tossy III acromioclavicular joint dislocation due to its less invasion and convenience and good biocompatibility.

[Minimally invasive trochanteric antegrade nail fixation for the treatment of intertrochanteric fractures of femur in elder].

OBJECTIVE: To evaluate the clinical effect of minimally invasive Trochanteric Antegrade Nail (TAN) for the treatment of intertrochanteric fractures of femur in elder. METHODS: From January 2005 to June 2008, 80 patients with intertrochanteric fractures of femur were treated with minimally invasive fixation of Trochanteric Antegrade Nail. There were 16 males and 64 females with an average age of 75 years ranging from 65 to 93 years. According to Evans classification, there were 8 cases of type I, 32 of type II, 30 of type III, 6 of type IV and 4 of type V. After the operation of minimally invasive Trochanteric Antegrade Nail fixation,patients begun to do the continuous passive motion (CPM) and active motion of the injured hip joint and knee joint. RESULTS: All patients were followed from 5 to 18 months with an average of 10 months. All factures were healing in time from 10 to 14 weeks with none screw breakage. Proximal screw exiting out about 0.5 cm occurred in 3 patients without obvert symptom. Three patients appeared lower limb deep venous thrombosis and were cured with medicine. According to the scales of Sanders, pain score was 9.08 +/- 1.19, ambulation score 8.85l +/- 1.09, function score 9.10 +/- 1.27, muscle strength score 9.13 +/- 1.18, daily life score 8.91 +/- l.07, X-ray evaluation score 9.34 +/- 1.09, so as the results were excellent in 56 cases, good in 20, poor in 4. CONCLUSION: With the advantage of mini-invasion, operative convenience and stable fixation, minimally invasive TAN fixation is an effective method for intertrochanteric fractures in elder.

[Analysis of curative effect of discectomy for lumbar intervertebral disc herniation].

OBJECTIVE: To evaluate the short and long term results of discectomy for lumbar intervertebral disc herniation. METHODS: From 2000 to 2007, 400 patients (male 220 and female 180, the age was from 16 to 73 years old with an average of 42.3 years) with lumbar intervertebral disc herniation underwent discectomy by posterior mini-incision less than 5 cm and vertebrae plate was ectomized in 2 cm x 2 cm winder,and nerve root was compressied. The short and long term clinical result were analyzed with SPSS 10.0 software. RESULTS: Three hundred and eighty patients were followed up in the short term (less than 2 years after operation), 308 cases obtained excellent result, 48 good, fair 24, the excellent and good rate was 93.7%. Three hundred and forty-eight patients were followed up in the long term (more than 3 years after operation), 244 cases obtained excellent result, 48 good, fair 56,the excellent and good rate was 83.9%. There was significant difference in follow-up between the short and long term (P < 0.05). CONCLUSION: The clinical effect of discectomy for lumbar intervertebral disc herniation decreased with time lapse.