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1.
Bratisl Lek Listy ; 121(2): 137-142, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32115967

RESUMO

AIM: The aim of this work was to investigate the effects of Impedance Therapy (IT) in the treatment of degenerative disc disease (DDD) by confirming the presence of the "disc grow-up" (DGU) phenomenon. METHOD: The set consisted of 55 patients with DDD with the average age of 51.3 years divided into two groups - the experimental group and the control group. The experimental group consisted of 29 patients with the average age of 56.7 years. The control group consisted of 26 patients with the average age of 45.8 years. RESULTS: In the experimental group of patients with DDD, who received IT, the DGU phenomenon with a success rate of 76 % was observed, with the average increase in the volume of the intervertebral disc of 31 % (p < 0.000). In the control group of patients receiving the standard electrotherapy, the DGU phenomenon was not proven - the DDD progressed normally with the mean volume reduction of 15 %       (p < 0.000). CONCLUSIONS: Degenerative disc disease, as a disease of modern civilization, is treatable. It can be concluded that the theory that degenerative disc changes are irreversible was disproven by the impact of impedance therapy (Tab. 5, Ref. 14).


Assuntos
Impedância Elétrica , Degeneração do Disco Intervertebral , Disco Intervertebral , Humanos , Degeneração do Disco Intervertebral/terapia , Vértebras Lombares , Pessoa de Meia-Idade
2.
Zhongguo Gu Shang ; 33(2): 136-9, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32133812

RESUMO

OBJECTIVE: To study the correlation and clinical value of the arc height of upper and lower endplates, the height of intervertebral space and osteophyte of posterior edge of intervertebral space in patients with cervical spondylosis. METHODS: A total of 108 patients with cervical spondylosis who underwent cervical spondylosis surgery from September 2017 to September 2018 were included in the study. Including 48 males with an average age of 52 years (30 to 72) and 60 females with an average age of 54 years (37 to 79). Among them, C2,3 of 6 cases, C3,4 of 15 cases, C4,5 of 32 cases, C5,6 of 42 cases, C6,7 of 13 cases. X-ray films of cervical spine were taken before and after operation. The images were accessed by PACS (Picture Archiving and Communication Systems) system. The lower and upper endplate arc heights (L1, L2), intervertebral space height (L3), and posterior osteophyte width (L4) were measured. Spearman was used to analyze the correlation between them. RESULTS: L1 was negatively correlated with L4 (r=-0.34, P<0.05), L3 was negatively correlated with L4 (r=-0.36, P<0.05). L1 was positively correlated with L3 (r=0.38, P<0.05), L2 was positively correlated with L3 (r=0.48, P<0.05). There was no significant difference between L 1 and L2 (P>0.05), L2 and L4 (P>0.05). CONCLUSION: The arc height of the lower endplate is negatively correlated with the width of osteophyte in the posterior margin of the intervertebral space. The cervical degeneration degree can be determined by measuring the arc height of the lower endplate, which has guiding significance for the early prevention and treatment of cervical spondylosis.


Assuntos
Disco Intervertebral , Osteófito , Espondilose , Adulto , Idoso , Vértebras Cervicais , Feminino , Humanos , Articulações , Masculino , Pessoa de Meia-Idade , Pescoço , Espondilose/cirurgia
3.
Zhonghua Yi Xue Za Zhi ; 100(1): 26-31, 2020 Jan 07.
Artigo em Chinês | MEDLINE | ID: mdl-31914554

RESUMO

Objective: To investigate the impact of heterotopic ossification (HO) after cervical disc replacement (CDR) on clinical outcome and radiological outcome of adjacent segment. Methods: The data of patients underwent single-level Prestige-LP CDR between January 2008 and March 2014 in West China Hospital with a minimum 36 months of follow-up were retrospectively analyzed in this study. The incidence of HO, whether it affected clinical outcome, and its impact on adjacent segment intervertebral disc height (IDH), range of motion (ROM) and adjacent segment degeneration were observed. The data were compared with independent sample t test between the two groups. Results: Ninety-two patients were included in this study, including 48 males and 44 females, the mean age was (44±8) years, and the mean follow-up was (62±23) months. At the final follow-up, 34 patients developed HO after CDR, but the incidence of Grade 4 HO was 7.6%. In both of the HO and non-HO groups, clinical outcomes at the final follow-up were all significantly improved when compared to those before the operation. And there was no significant differences in any clinical indexes between the HO and non-HO groups. The adjacent segment IDH before operation and at the final follow-up in the HO group and non-HO group were similar(t=0.596, 0.825 and t=0.877, 0.644, all P>0.05). The preoperative adjacent segment ROM of HO group was similar with that in non-HO group(t=0.056, 0.709, both P>0.05), but the adjacent segment ROM in HO group was higher than that in the non-HO group at the final follow-up (upper adjacent segment: 10.0°±2.0° vs 9.0°±1.3°; lower adjacent segment: 10.2°±1.9° vs 8.8°±1.3°, t=2.824, 4.022, both P<0.05). The incidence of adjacent segment degeneration of HO group was higher than that of non-HO group at the final follow-up(41.2% vs 19.0%, χ(2)=5.343, P<0.05). Conclusions: HO is a common phenomenon in the long-term follow-up after the CDR operation with Prestige LP prosthesis, but HO does not affect the improvement of clinical outcome. HO after CDR might be one of important risk factors accelerating adjacent segment degeneration.


Assuntos
Disco Intervertebral , Ossificação Heterotópica , Adulto , Vértebras Cervicais , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
4.
Life Sci ; 243: 117244, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31891721

RESUMO

AIMS: Endplate chondrocyte apoptosis is an important contributor to the pathogenesis of cartilaginous endplate (CEP) degeneration that leads to the initiation and development of intervertebral disc degeneration (IDD). In this study, we hypothesized that Parkin-mediated mitophagy and nuclear factor E2-related factor 2 (Nrf2)-mediated antioxidant system played an important role in endplate chondrocyte survival under pathological conditions. MATERIALS AND METHODS: Human endplate chondrocytes were stimulated with H2O2 to mimic pathological conditions. Western blotting, immunofluorescence staining, and flow cytometry were applied to detect the indicators related to mitochondrial dynamics, mitophagy, Nrf2 signaling, and apoptosis. The puncture-induced rat models were established to evaluate the changes in vivo. KEY FINDINGS: Our results showed that H2O2 induced oxidative stress, mitochondrial dysfunction, and apoptosis in endplate chondrocytes. These H2O2-induced detrimental effects were inhibited by pretreatment with the mitochondria-targeted antioxidant Mito-TEMPO. In addition, mitochondrial dynamics, Parkin-mediated elimination of dysfunctional mitochondria, and Nrf2-mediated antioxidant system were promoted by H2O2. Knockdown of Parkin or Nrf2 increased H2O2-induced detrimental effects. Moreover, upregulation of Parkin and Nrf2 by polydatin protected endplate chondrocytes against H2O2-induced mitochondrial dysfunction, oxidative stress, and apoptosis. Finally, puncture-induced rat models showed that polydatin exerted a protective effect on CEP and disc degeneration. SIGNIFICANCE: Targeting Parkin and Nrf2 to improve mitochondrial homeostasis, redox balance and endplate chondrocyte survival may represent a potential therapeutic strategy for preventing IDD.


Assuntos
Apoptose/fisiologia , Condrócitos/patologia , Disco Intervertebral/patologia , Fator 2 Relacionado a NF-E2/fisiologia , Estresse Oxidativo/fisiologia , Ubiquitina-Proteína Ligases/fisiologia , Idoso , Animais , Células Cultivadas , Condrócitos/efeitos dos fármacos , Condrócitos/metabolismo , Feminino , Técnicas de Silenciamento de Genes , Humanos , Peróxido de Hidrogênio/farmacologia , Disco Intervertebral/efeitos dos fármacos , Disco Intervertebral/metabolismo , Masculino , Pessoa de Meia-Idade , Fator 2 Relacionado a NF-E2/genética , Fator 2 Relacionado a NF-E2/metabolismo , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Ubiquitina-Proteína Ligases/genética , Ubiquitina-Proteína Ligases/metabolismo
5.
World Neurosurg ; 133: 343-357.e1, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31550538

RESUMO

BACKGROUND: The center of rotation (COR), instantaneous center of rotation (ICR), instantaneous axis of rotation, instantaneous helical axis, finite helical axis, and helical axis of motion are important kinematic parameters for evaluating the quality of intervertebral motion of the cervical spine (QIMC). These parameters embody different concepts and are calculated using various methods. In this review, the distinctions and connections between these kinematic parameters are analyzed according to the concepts, research, and measurement techniques to provide a theoretic basis for future research and new research directions. METHODS: The PubMed/MEDLINE databases were searched for studies published in English related to the concepts, research, and calculation of these parameters. The included studies were classified according to the different research or calculation methods, and the proportion of each study type was calculated and analyzed. RESULTS: Forty articles were selected. The methods for analyzing the QIMC include in vivo and in vitro studies and finite element analysis. The primary methods for calculating these parameters include the method of perpendicular bisectors and the finite helical axis method. CONCLUSIONS: COR was the simplest but not the most accurate parameter to evaluate the QIMC. Conversely, instantaneous helical axis/helical axis of motion were the most accurate, but relatively complex parameters to evaluate the QIMC. ICR showed dynamic changes during flexion-extension motion, but not the three-dimensional kinematic motion of the cervical spine. These parameters were equivalent only in certain situations but cannot be substituted for each other in the clinic. A dynamic radiographic in vivo study was the most convenient and frequently used research method to calculate COR, but failed to describe the dynamic movement. The method of perpendicular bisectors was widely used to calculate the COR or ICR. Therefore, a combination of new research and calculation methods to simply and effectively evaluate the QIMC requires further investigation.


Assuntos
Vértebras Cervicais/fisiologia , Disco Intervertebral/fisiologia , Amplitude de Movimento Articular/fisiologia , Fenômenos Biomecânicos/fisiologia , Humanos , Rotação
6.
World Neurosurg ; 133: 163-166, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31606498

RESUMO

BACKGROUND: Cervical disk arthroplasty is now a widely accepted alternative to anterior cervical interbody fusion, which is known to reduce normal cervical motion and increase the incidence of adjacent segment disease. Although multiple studies report the use of cervical disk arthroplasty to treat multilevel cervical disease, this is the first report in the literature detailing the placement of multiple, noncontiguous artificial disks. CASE DESCRIPTION: We describe a 41-year-old male who presented with myelopathy and left upper extremity radiculopathy resulting from 2 cervical disk herniations separated by a normal intervening level. He underwent an anterior cervical diskectomy and placement of an artificial disk prosthesis at cervical (C) 4-5 and C6-7 while leaving C5-6 intact. CONCLUSIONS: This approach serves to preserve cervical motion, spinal stability, and lordosis across all 3 levels, thus demonstrating that it is a viable alternative to a multilevel anterior cervical interbody fusion.


Assuntos
Vértebras Cervicais/cirurgia , Discotomia/métodos , Deslocamento do Disco Intervertebral/cirurgia , Disco Intervertebral/cirurgia , Radiculopatia/cirurgia , Doenças da Medula Espinal/cirurgia , Substituição Total de Disco/métodos , Adulto , Humanos , Deslocamento do Disco Intervertebral/complicações , Masculino , Radiculopatia/etiologia , Doenças da Medula Espinal/etiologia , Resultado do Tratamento
7.
World Neurosurg ; 133: e165-e172, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31476465

RESUMO

BACKGROUND: Cartilaginous endplate (CEP), a thin layer of hyaline cartilage located between the vertebral endplate and nucleus pulposus, transports the nutrient into the disc. The objective of this study was to evaluate the influence of T140 (polyphemusin II-derived peptide) on the CEP cell growth, apoptosis, and the matrix formation via the stromal cell-derived factor-1 (SDF-1)/cysteine X cysteine (CXC) receptor-4 (CXCR4) signaling pathway. METHODS: Sprague-Dawley rats were euthanized by cervical dislocation and dissected for the isolation and the appraisal of CEP cells that were extracted from the endplate in rat intervertebral discs and were then added with different concentrations of reagents (SDF-1 and T140). The effect of T140 on CEP cell proliferation and apoptosis were analyzed. The messenger RNA (mRNA) and protein expressions of CXCR4, prominin-1, proteoglycans, type II collagen, B-cell lymphoma-2 (Bcl-2), and Bcl-2 associated X protein were analyzed by reverse transcription quantitative polymerase chain reaction and Western blot analysis. RESULTS: T140 promoted the proliferation of CEP cells and inhibited the apoptosis of CEP cells. Additionally, T140 suppressed the mRNA and protein expression of CXCR4, prominin-1, and Bcl-2 associated X protein, and increased the mRNA and protein expression of proteoglycans, type II collagen, and Bcl-2. CONCLUSIONS: T140 promotes the proliferation and matrix formation and inhibits the apoptosis of CEP cells by blocking the SDF-1/CXCR4 signaling pathway in vitro, which provides a certain therapeutic effect on the degeneration of intervertebral discs.


Assuntos
Apoptose/efeitos dos fármacos , Quimiocina CXCL12/fisiologia , Condrócitos/efeitos dos fármacos , Matriz Extracelular/efeitos dos fármacos , Cartilagem Hialina/citologia , Disco Intervertebral/citologia , Oligopeptídeos/farmacologia , Receptores CXCR4/fisiologia , Transdução de Sinais/efeitos dos fármacos , Animais , Divisão Celular/efeitos dos fármacos , Proteínas da Matriz Extracelular/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Disco Intervertebral/efeitos dos fármacos , Masculino , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Ratos , Ratos Sprague-Dawley
8.
World Neurosurg ; 133: e205-e210, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31493606

RESUMO

BACKGROUND: Good short- and mid-term clinical efficacy of percutaneous cervical nucleoplasty (PCN) for cervical degenerative diseases (CDD) with neck pain has been reported. However, few studies have assessed its long-term influence in patients with both neck pain and cervical vertigo. This study aimed to evaluate the curative efficacy of PCN for CDD with neck pain and cervical vertigo with minimum of 6 years of follow-up. METHODS: Inpatients who underwent PCN for CDD with neck pain and cervical vertigo between April 2010 and March 2013 were enrolled. Clinical outcomes were assessed using the Cervical Vertigo Evaluation Scale (CVES); greater CVES scores reflected less impairment. Additional open surgeries were recorded. RESULTS: Among 40 patients, 100% completed the 1-year short-term and 3-year mid-term follow-up (FU); 85% completed the 6-year long-term FU. Clinical effective rates were 67.5%, 67.5%, and 52.94% at short-, mid-, and long-term FU, respectively. CVES scores were greater than the preoperative CVES scores at all FU timepoints (P < 0.01). However, the CVES score was lower at the final FU than at the 3-year FU (P < 0.05). The neck pain score significantly decreased over time and was lower than the cervical vertigo score at the final FU (P > 0.05). Reoperation rates were 1/40 (2.50%) and 3/34 (8.82%) at mid- and long-term FU, respectively. CONCLUSIONS: PCN in patients with CDD neck pain and cervical vertigo showed satisfactory clinical efficacy at short- and mid-term FU, and it was fair at long-term FU. Thus, PCN could be a complementary operation for CDD.


Assuntos
Discotomia Percutânea/métodos , Degeneração do Disco Intervertebral/cirurgia , Disco Intervertebral/cirurgia , Cervicalgia/cirurgia , Vertigem/cirurgia , Adulto , Idoso , Vértebras Cervicais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Reoperação , Vertigem/etiologia
9.
World Neurosurg ; 133: e84-e88, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31470152

RESUMO

BACKGROUND: Spinopelvic sagittal parameters have a significant influence on adjacent segment degeneration (ASD) after fusion surgery. The association between ASD and sagittal balance is not well understood. The purpose of this study was to investigate the biomechanical influence of various sacral slope (SS) degrees on adjacent segments after transforaminal lumbar interbody fusion (TLIF) at the L4-L5 level. METHODS: We conducted a finite element model of the L1-S1 based on computed tomography scan images. The L1-S1 model with L4-L5 TLIF was modified with various SS degrees (33°, 38°, 43°, and 48°) to investigate the biomechanical influence of SS on adjacent segments. The range of motion (ROM) and intradiscal pressure (IDP) of the adjacent segments (L3-L4 and L5-S1) were compared among models using various SS angles. RESULTS: When the SS angle increased, the ROM and IDP in L5-S1 decreased gradually after TLIF at the L4-L5 level in all motion patterns. Nevertheless, the ROM and IDP in L3-L4 were not significantly different among various SS angles. CONCLUSIONS: Decreased SS after lumbar fusion surgery may pose a higher risk of ASD. Therefore, restoring appropriate SS should be considered during decision-making prior to fusion surgery to reduce the risk of degenerative changes.


Assuntos
Vértebras Lombares/cirurgia , Sacro/diagnóstico por imagem , Fusão Vertebral/métodos , Antropometria , Fenômenos Biomecânicos , Análise de Elementos Finitos , Humanos , Disco Intervertebral/fisiopatologia , Vértebras Lombares/diagnóstico por imagem , Pressão , Amplitude de Movimento Articular , Sacro/patologia , Tomografia Computadorizada por Raios X
10.
Cell Prolif ; 53(2): e12746, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31867863

RESUMO

Human high-temperature requirement protein 1 (HTRA1) is a member of serine proteases and consists of four well-defined domains-an IGFBP domain, a Kazal domain, a protease domain and a PDZ domain. HTRA1 is a secretory protein and also present intracellularly and associated with microtubules. HTRA1 regulates a broad range of physiological processes via its proteolytic activity. This review examines the role of HTRA1 in bone biology, osteoarthritis, intervertebral disc (IVD) degeneration and tumorigenesis. HTRA1 mediates diverse pathological processes via a variety of signalling pathways, such as TGF-ß and NF-κB. The expression of HTRA1 is increased in arthritis and IVD degeneration, suggesting that HTRA1 protein is attributed to cartilage degeneration and disease progression. Emerging evidence also suggests that HTRA1 has a role in tumorigenesis. Further understanding the mechanisms by which HTRA1 displays as an extrinsic and intrinsic regulator in a cell type-specific manner will be important for the development of HTRA1 as a therapeutic target.


Assuntos
Serina Peptidase 1 de Requerimento de Alta Temperatura A/metabolismo , Degeneração do Disco Intervertebral/metabolismo , Degeneração do Disco Intervertebral/patologia , Neoplasias/metabolismo , Neoplasias/patologia , Sequência de Aminoácidos , Animais , Humanos , Disco Intervertebral/metabolismo , Alinhamento de Sequência , Transdução de Sinais/fisiologia , Temperatura Ambiente
11.
Georgian Med News ; (295): 13-16, 2019 Oct.
Artigo em Russo | MEDLINE | ID: mdl-31804191

RESUMO

The aim of the study is to evaluate the effectiveness of transforaminal endoscopic microdiscectomy in patients with herniated intervertebral discs at the L3 - S1 level of the lumbar spine. A retrospective analysis of the treatment of 468 patients with hernias of intervertebral discs of the lumbar spine was conducted, of them: 262 patients were treated in the Rivne Regional Clinical Hospital; 206 patients in the spinal surgery department of the State Institution "Institute of Traumatology and Orthopedics of the National Academy Medical Sciences of Ukraine". The study was conducted in the period from April 2016 to January 2019. In the preoperative period, all patients underwent an MRI or CT scan - examination of the lumbar spine, functional radiographs, and general clinical examinations were performed. According to the results of studies in the postoperative period, a significant improvement in the quality of life of the operated patients was revealed in accordance with the Oswestry Disability Index (the average for the group was 35,9%, which corresponds to a good result). There was a positive dynamics of pain in VAS (in the preoperative period - 8,8 ± 0,7 points; 6 months after the operation - 1,2 ± 0,5 points, with a predominance of lumbodynia and with an almost complete absence of radicular syndrome). In 28 (6,0%) patients, a hernia recurred within 6 months, however, in the remaining 440 (94,1%) patients, positive results of neurological symptoms were observed in dynamics. The obtained results confirm the high efficiency of ETD and the low risk of postoperative complications.


Assuntos
Deslocamento do Disco Intervertebral , Disco Intervertebral , Humanos , Deslocamento do Disco Intervertebral/terapia , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento , Ucrânia
12.
Zhonghua Yi Xue Za Zhi ; 99(46): 3622-3626, 2019 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-31826583

RESUMO

Objective: To investigate the impact of implant height on the morphology of cervical facet joints in artificial cervical disc replacement (ACDR). Methods: A finite element model of the cervical spine from C(2) to C(7) was constructed. The surgical processes of ACDR were simulated by insertion of 5 mm, 6 mm or 7 mm Prestige-LP artificial cervical discs. The morphological changes of cervical facet joints were recorded in terms of facet overlap distance, facet overlap area and facet angle. Results: The normal height Prestige-LP cervical disc could restore the natural status of the cervical spine. Compared with the intact condition, the model with ≥2 mm height implant would reduce the overall range of motion (ROM) by 19.2% in flexion, 19.4% in extension, 18.4% in lateral bending and 19.0% in axial rotation. Besides, the ROM at the surgical level reduced by 15.8% in flexion, 15.4% in extension and lateral bending and 19.0% in rotation. The upper and lower adjacent levels (C(4/5) and C(5/6)) showed more obvious changes in ROM, which reduced by 26.8% and 26.5% in flexion, 26.6% in extension, 26.5% and 26.4% in lateral bending, and 26.4% and 26.3% in rotation, respectively. The reduction of facet overlap distance, facet angle and facet overlap area with the ≥2 mm height artifact was 9.6%, 30.7%, and 17.9% respectively at the upper adjacent level, and 22.3%, 35.3% and 28.2% respectively at the surgical level, compared with the intact model.The morphology of facet joints at the lower adjacent level were slightly changed. Conclusion: The implant height selection in ACDR should be in accordance with the physiological intervertebral disc height. Artifact with ≥2 mm in height would obviously change the morphology of facet joints, thus should not be used in clinical practice.


Assuntos
Disco Intervertebral , Substituição Total de Disco , Articulação Zigapofisária , Fenômenos Biomecânicos , Vértebras Cervicais , Análise de Elementos Finitos , Amplitude de Movimento Articular
13.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(12): 1491-1497, 2019 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-31823546

RESUMO

Objective: To measure anatomical parameters related to cervical uncovertebral joint and provide data support for the design of uncovertebral joint fusion cage. Methods: According to the inclusion and exclusion criteria, raw DICOM data of cervical CT scan in 60 patients (30 males and 30 females, aged 39-60 years) were obtained, then the three-dimensional cervical spine model was reconstructed for anatomical measurement by using the Mimics19.0 software. The height of the uncinate process, the length of the uncinate process, the width of the uncinate process, and the length of the uncovertebral joint in the intervertebral foramen region were measured bilaterally from C3 to C7. The anterior and posterior distances between the uncinate processes were measured from C3 to C7. The height of the uncovertebral joint space, the central height of the intervertebral disc space, and the depth of the intervertebral disc space were also measured from C2, 3 to C6, 7. The mean, standard deviation, maximum, and minimum were calculated by using the SPSS22.0 statistical software for the design of uncovertebral joint fusion cage. Results: The height of the uncinate process, the length of the uncinate process, the width of the uncinate process, and the length of the uncovertebral joint in the intervertebral foramen region of C3-C7 and the height of the uncovertebral joint space of C2, 3-C6, 7 showed no significant difference between two sides (P>0.05). The height of the uncovertebral joint space also had no significant difference between females and males (P>0.05). The anterior distances between the uncinate processes of C3-C7 were significantly larger than the posterior distances between the uncinate processes (P<0.05), the uncovertebral joint presented a posterior cohesive shape. The central height of the intervertebral disc space in male group was slightly higher than that in female group, and the differences were significant (P<0.05) at C2, 3 and C5, 6; the depth of the intervertebral disc space in male group was significantly higher than that in female group (P<0.05). The central height of the intervertebral disc space was (4.94±0.49) mm (range, 3.81-5.90 mm), the depth of the intervertebral disc space was (15.78±1.23) mm (range, 12.94-18.85 mm), the anterior and posterior distances between the uncinate processes were (17.19±2.39) mm (range, 13.39-24.63 mm) and (10.84±2.12) mm (range, 7.19-16.64 mm), respectively. According to the results of the anatomical research, the height of the uncovertebral joint fusion cage was designed as 5, 6, 7, and 8 mm; the depth of the uncovertebral joint fusion cage was designed as 12, 13, 14, 15, and 16 mm; the width of the uncovertebral joint fusion cage was designed as 14-18 mm; and the two wings are designed as arc-shape with 2 and 3 mm in width. Conclusion: There are certain differences in the anatomical parameters of the uncovertebral joint between different segments. The uncovertebral joint fusion cage that designed based on the results of anatomical research is suitable for most patients.


Assuntos
Disco Intervertebral , Fusão Vertebral , Articulação Zigapofisária , Adulto , Animais , Vértebras Cervicais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço , Tomografia Computadorizada por Raios X
14.
BMC Evol Biol ; 19(1): 226, 2019 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842740

RESUMO

BACKGROUND: Recently we proposed an evolutionary explanation for a spinal pathology that afflicts many people, intervertebral disc herniation (Plomp et al. [2015] BMC Evolutionary Biology 15, 68). Using 2D data, we found that the bodies and pedicles of lower vertebrae of pathological humans were more similar in shape to those of chimpanzees than were those of healthy humans. Based on this, we hypothesized that some individuals are more prone to intervertebral disc herniation because their vertebrae exhibit ancestral traits and therefore are less well adapted for the stresses associated with bipedalism. Here, we report a study in which we tested this "Ancestral Shape Hypothesis" with 3D data from the last two thoracic and first lumbar vertebrae of pathological Homo sapiens, healthy H. sapiens, Pan troglodytes, and several extinct hominins. RESULTS: We found that the pathological and healthy H. sapiens vertebrae differed significantly in shape, and that the pathological H. sapiens vertebrae were closer in shape to the P. troglodytes vertebrae than were the healthy H. sapiens vertebrae. Additionally, we found that the pathological human vertebrae were generally more similar in shape to the vertebrae of the extinct hominins than were the healthy H. sapiens vertebrae. These results are consistent with the predictions of the Ancestral Shape Hypothesis. Several vertebral traits were associated with disc herniation, including a vertebral body that is both more circular and more ventrally wedged, relatively short pedicles and laminae, relatively long, more cranio-laterally projecting transverse processes, and relatively long, cranially-oriented spinous processes. We found that there are biomechanical and comparative anatomical reasons for suspecting that all of these traits are capable of predisposing individuals to intervertebral disc herniation. CONCLUSIONS: The results of the present study add weight to the hypothesis that intervertebral disc herniation in H. sapiens is connected with vertebral shape. Specifically, they suggest that individuals whose vertebrae are towards the ancestral end of the range of shape variation within H. sapiens have a greater propensity to develop the condition than other individuals. More generally, the study shows that evolutionary thinking has the potential to shed new light on human skeletal pathologies.


Assuntos
Fósseis , Hominidae/anatomia & histologia , Deslocamento do Disco Intervertebral/patologia , Vértebras Lombares/patologia , Pan troglodytes/anatomia & histologia , Vértebras Torácicas/patologia , Animais , Evolução Biológica , Humanos , Disco Intervertebral/patologia , Vértebras Lombares/anatomia & histologia , Vértebras Torácicas/anatomia & histologia
15.
Medicine (Baltimore) ; 98(52): e18465, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876730

RESUMO

This study aimed to investigate the correlation of long noncoding RNA zinc finger antisense 1 (lncRNA ZFAS1) expression with disease risk, disease severity and inflammatory cytokines levels in lumbar disc degeneration (LDD) patients.83 LDD patients underwent surgery and 28 traumatized, non-LDD patients underwent lumbar disc surgery (controls) were consecutively enrolled in this case-control study. Lumbar disc tissue was obtained during surgery and herniated nucleus pulposus (HNP) was isolated to detect lncRNA ZFAS1 expression and inflammatory cytokines mRNA levels by RT-qPCR, and determine protein levels of inflammatory cytokines by western blot.HNP lncRNA ZFAS1 expression in LDD patients was up-regulated compared with controls (P < .001), and receiver operating characteristic (ROC) curve showed lncRNA ZFAS1 expression disclosed a good predictive value for LDD risk with area under curve (AUC) 0.753 (95% CI 0.646-0.859). And after adjustment by age, gender and body mass index (BMI), lncRNA ZFAS1 (P = .017) remained to be an independent predictive factor for higher LDD risk. In addition, lncRNA ZFAS1 expression was positively associated with Modified Pfirrmann Grade (P = .015). As to inflammatory cytokines, lncRNA ZFAS1 expression was observed to be positively correlated with TNF-α (P = .002), IL-1ß (P = .007) and IL-6 (P = .015) mRNAs expressions while reversely associated with IL-10 mRNA level (P = .014); and lncRNA ZFAS1 expression was also positively correlated with protein levels of TNF-α (P = .038) and IL-6 (P = .027) while reversely associated with IL-10 protein expression (P = .039).lncRNA ZFAS1 expression associates with increased risk, elevated disease severity and higher inflammatory cytokines levels in LDD patients.


Assuntos
Citocinas/metabolismo , Degeneração do Disco Intervertebral/metabolismo , Deslocamento do Disco Intervertebral/metabolismo , Disco Intervertebral/metabolismo , Vértebras Lombares , RNA Antissenso/metabolismo , RNA Longo não Codificante/metabolismo , Adulto , Biomarcadores/análise , Western Blotting , Estudos de Casos e Controles , Citocinas/análise , Feminino , Humanos , Interleucina-10/análise , Interleucina-10/metabolismo , Interleucina-1beta/análise , Interleucina-1beta/metabolismo , Interleucina-6/análise , Interleucina-6/metabolismo , Disco Intervertebral/química , Masculino , Pessoa de Meia-Idade , RNA Longo não Codificante/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Risco , Índice de Gravidade de Doença , Fator de Necrose Tumoral alfa/análise , Fator de Necrose Tumoral alfa/metabolismo
16.
Spine (Phila Pa 1976) ; 44(22): E1290-E1297, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31689248

RESUMO

STUDY DESIGN: This is an in vitro study of bovine disc cells exposed to pulsed electromagnetic fields. OBJECTIVE: The purpose of the present study was to investigate whether pulsed electromagnetic fields (PEMF) effects on the expression of interleukin-6 (IL-6) expression is mediated by two known inflammation regulators, nuclear factor-κB (NF-κß) and phosphorylated mitogen-activated protein kinase p38 (p38-MAPK) signaling pathways SUMMARY OF BACKGROUND DATA.: Inflammatory cytokines play a dominant role in the pathogenesis of disc degeneration. Increasing evidence showed that PEMF, a noninvasive biophysical stimulation, can have physiologically beneficial effects on inflammation and tissue repair. Our previous research shows that PEMF treatment can reduce IL-6 expression by intervertebral disc cells. However, the underlying mechanisms of PEMF action are yet to be uncovered. METHODS: Intervertebral disc nuclear pulposus cells were challenged with interleukin-1α (IL-1α) (for mimicking inflammatory microenvironment) and treated with PEMF simultaneously up to 4 hours. Cells were then collected for NF-κß and phosphorylated p38-MAPK protein detection with Western blot. Additionally, the RelA (p65) subunit of NF-κß was examined with immunostaining for assessment of NF-κß activation. RESULTS: As expected, Western blot results showed that both NF-κß and phosphorylated p38 expression were significantly increased by IL-1α treatment. This induction was significantly inhibited to control condition levels by PEMF treatment. Immunostaining demonstrated similar trends, that PEMF treatment reduced the NF-κß activation induced by IL-1α exposure. CONCLUSION: Our data indicate that the previously-reported inhibitory effect of PEMF treatment on disc inflammation is mediated by NF-κß and phosphorylated p38-MAPK signaling pathways. These results further establish PEMFs anti-inflammatory activity, and may inform potential future clinical uses for management of inflammation associated with disc degeneration. LEVEL OF EVIDENCE: N/A.


Assuntos
Campos Eletromagnéticos , Interleucina-6/metabolismo , Disco Intervertebral , NF-kappa B/metabolismo , Transdução de Sinais/efeitos da radiação , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Animais , Bovinos , Disco Intervertebral/citologia , Disco Intervertebral/metabolismo , Disco Intervertebral/efeitos da radiação
17.
Spine (Phila Pa 1976) ; 44(23): 1613-1622, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31730570

RESUMO

STUDY DESIGN: Experimental study with human mesenchymal stem cells (MSCs) and intervertebral disc (IVD) tissue samples. OBJECTIVE: This study aimed to characterize the effect of MSC homing on the Tie2-positive IVD progenitor cell population, IVD cell survival, and proliferation. SUMMARY OF BACKGROUND DATA: Homing of human MSCs has been described as potential alternative to MSC injection, aiming to enhance the regenerative capacity of the IVD. IVD cells expressing Tie2 (also known as CD202b or Angiopoietin-1 receptor TEK tyrosine kinase) represent a progenitor cell population with discogenic differentiation potential. However, the fraction of Tie2-positive progenitor cells decreases with aging and degree of IVD degeneration, resulting in a potential loss of the IVD's regenerative capacity. METHODS: Human MSCs, isolated from vertebral bone marrow aspirates, were labeled and seeded onto the endplate of bovine IVDs and human IVD tissue. Following MSC migration for 5 days, IVD cells were isolated by tissue digestion. The fractions of Tie2-positive, dead, apoptotic, and proliferative IVD cells were evaluated by flow cytometry and compared to untreated IVDs. For human IVDs, 3 groups were investigated: nondegenerated (organ donors), IVDs of patients suffering from spinal trauma, and degenerative IVD tissue samples. RESULTS: MSC homing enhanced the fraction of Tie2-positive IVD cells in bovine and human IVD samples. Furthermore, a proliferative response and lower fraction of dead cells were observed after MSC homing in both bovine and human IVD tissues. CONCLUSION: Our findings indicate that MSC homing enhances the survival and regenerative capability of IVD cells, which may be mediated by intercellular communication. MSC homing could represent a potential treatment strategy to prevent the onset of the degenerative cascade in IVDs at risk such as IVDs adjacent to a fused segment or IVDs after herniation. LEVEL OF EVIDENCE: N/A.


Assuntos
Proliferação de Células/fisiologia , Disco Intervertebral/metabolismo , Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/metabolismo , Receptor TIE-2/biossíntese , Animais , Bovinos , Morte Celular/fisiologia , Diferenciação Celular/fisiologia , Células Cultivadas , Feminino , Humanos , Disco Intervertebral/patologia , Degeneração do Disco Intervertebral/metabolismo , Degeneração do Disco Intervertebral/terapia , Técnicas de Cultura de Órgãos
18.
Medicine (Baltimore) ; 98(41): e17579, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593145

RESUMO

RATIONALE: Minimally invasive surgeries for thoracic disc herniation (TDH) evolved rapidly in recent years, and multiple approaches have been put forward. Thoracic discectomy via percutaneous spine endoscopy (PSE) is inadequately documented because of the low prevalence of TDH and the high difficulty of thoracic spine endoscopy techniques. Herein, we present a TDH case who underwent percutaneous endoscopic thoracic discectomy. PATIENT CONCERNS: A 28-year-old male suffered backpain and partial paralysis in lower extremities. DIAGNOSES: Magnet resonance imaging demonstrated T11-12 TDH, with cranially migrated disc fragment. INTERVENTIONS: The patient underwent percutaneous endoscopic thoracic discectomy via posterolateral approach with the assistance of endoscopic reamer in the procedure of foramino-laminaplasty. OUTCOMES: The patient's muscle force improved immediately, and the backpain relieved after 5 days post-surgery. In the 6-month follow-up, he had normal muscle force without paresthesia in lower limbs. LESSONS: The innovative design of endoscopic reamer provides effective plasty and access establishment with lower risk and difficulty, which ensures the vision and the operating space of the procedure of decompression. With this technique, the indications of thoracic PSE were broadened to both ventral and dorsal thoracic stenosis.


Assuntos
Discotomia Percutânea/métodos , Endoscopia/métodos , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Torácicas/cirurgia , Adulto , Dor nas Costas/diagnóstico , Dor nas Costas/etiologia , Humanos , Disco Intervertebral/cirurgia , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/patologia , Imagem por Ressonância Magnética , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Paraplegia/diagnóstico , Paraplegia/etiologia , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/patologia , Resultado do Tratamento
19.
Medicine (Baltimore) ; 98(40): e17336, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577728

RESUMO

Lumbar 3-joint complex degeneration is a multifactorial, pathological process. Previous studies included insufficient quantitative analyses to prove the relationship between disc degeneration and facet joint osteoarthritis (OA). We assessed the correlation between intervertebral disc and lumbar facet joint degeneration using computed tomography (CT) and magnetic resonance imaging (MRI) parameters.A total of 152 participants who underwent conventional MRI and CT in the clinostat position were included in this study. The presence of lumbar disc degeneration was identified using the Pfirrmann grading system, and the presence of lumbar facet joint degeneration was identified using the Weishaupt grading system. Facet tropism was defined as a divergence more than 7° between the facet joint angles of both sides at the same segment. The intervertebral disc heights were also measured.Most facet joint OA probably appeared at the segment with intervertebral disc degeneration of more than grade III. Facet joint OA was significantly exacerbated with the progression of disc degeneration grade. The intervertebral height significantly decreased with the progression of facet joint degeneration grades, except for grades 0 and 1.Our current study found that each individual joint degeneration influences the other 2 in the lumbar 3-joint complex. Facet tropism was significantly associated with lumbar disc degeneration. Narrowing of the intervertebral disc height probably aggravates the facet joint degeneration further at the same level.


Assuntos
Degeneração do Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Articulação Zigapofisária/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Disco Intervertebral/patologia , Degeneração do Disco Intervertebral/complicações , Degeneração do Disco Intervertebral/patologia , Vértebras Lombares/patologia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Osteoartrite/complicações , Osteoartrite/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem , Articulação Zigapofisária/patologia
20.
Cell Prolif ; 52(6): e12704, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31621141

RESUMO

Intervertebral disc degeneration (IDD) is a common cause of low back pain, which inflicts more global disability than any other condition. Although IDD was deemed to be a natural process that comes with ageing, a growing body of evidence suggested that both genetic and environmental factors could modify the development of IDD. In this connection, aberrant function of nucleus pulposus cells has been implicated in IDD pathogenesis. Circular RNAs are a novel class of endogenous non-coding RNAs that play crucial regulatory roles in diverse cellular processes. Recently, deregulation of circRNAs in nucleus pulposus cells was found to functionally participate in IDD development. In this review, we summarize the current knowledge regarding the deregulation of circRNAs in IDD in relation to their actions on nucleus pulposus cell functions, including cell proliferation, apoptosis and extracellular matrix synthesis/degradation. The potential clinical utilities of circRNAs as therapeutic targets for the management of IDD are also discussed.


Assuntos
Degeneração do Disco Intervertebral/sangue , Disco Intervertebral/patologia , MicroRNAs/sangue , Núcleo Pulposo/metabolismo , Proliferação de Células/genética , Humanos , Transdução de Sinais/genética
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