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1.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(3): 366-374, 2021 Mar 15.
Artigo em Chinês | MEDLINE | ID: mdl-33719247

RESUMO

Objective: To investigate the effect of zinc finger protein A20 on lumbar intervertebral disc degeneration in rabbits. Methods: Twenty-six 3-month-old New Zealand rabbits, 2.0-2.5 kg in weight, were used to establish the model of intervertebral disc degeneration at L 3, 4, L 4, 5, and L 5, 6 by transabdominal needle puncture. At 4 weeks after operation, the 24 rabbits were randomly divided into 4 groups after successful modeling, which checked by MRI. The target intervertebral discs of each group were injected with zinc finger protein A20 overexpressed adenovirus (Ov-A20 group), empty carrier adenovirus (NC group), phosphate buffer saline (control group), and shRNA-A20 adenovirus (Sh-A20 group). The biological responses of animals in each group were comprehensive scored before 1 day of injection and after 1, 2, 3, and 6 days of injection. At 2, 4, and 8 weeks after injection, the animals in each group were observed by MRI to obtain the exact T2 relaxation time (T2 signal value). After MRI examination, the animals were killed to take the degenerative intervertebral disc tissue; and the tissue was detected by Alcian blue staining to observed the intervertebral disc degeneration. The expressions of zinc finger protein A20, collagen Ⅱ, and aggrecan were detected by immunohistochemistry staining. The expressions of zinc finger protein A20, nuclear factor κB binding protein [P65, phosphate P65 (P-P65), collagen Ⅱ, aggrecan], inflammatory factors [tumor necrosis factor α (TNF-α), interleukin 1ß (IL-1ß)], autophagy-related protein [LC3 (LC3Ⅱ/LC3Ⅰ) and P62] were detected by Western blot. Results: The comprehensive score of biological response in each group after injection was significantly lower than that before injection ( P<0.05). At 6 days after injection, the comprehensive score of biological response in the Sh-A20 group was significantly lower than that in other groups ( P<0.05), and there was no significant difference among other groups ( P>0.05). The detection of MRI showed that the T2 signal value in the Ov-A20 group was the highest at 2, 4, and 8 weeks after injection ( P<0.05), and the T2 signal value in the Sh-A20 group was the lowest at 2 and 4 weeks after injection ( P<0.05). There was no significant difference between other groups ( P>0.05). Alcian blue staining showed that the expression of aggrecan was the highest in Ov-A20 group and the lowest in Sh-A20 group at 4 weeks ( P<0.05); the expression of aggrecan in Ov-A20 group was the highest at 8 weeks ( P<0.05), and there was no significant difference between other groups ( P>0.05). Immunohistochemical staining showed that the expressions of zinc finger protein A20, collagen Ⅱ, and aggrecan were the highest in Ov-A20 group and lowest in Sh-A20 group ( P<0.05). Western blot showed that the expressions of zinc finger protein A20, collagen Ⅱ, aggrecan, and LC3 (LC3Ⅱ/LC3Ⅰ) proteins were the highest in the Ov-A20 group and the lowest in Sh-A20 group ( P<0.05), while the expressions of P-P65, TNF-α, IL-1ß, and P62 proteins were the lowest in Ov-A20 group and the highest in Sh-A20 group ( P<0.05). There was no significant difference in the expression of p65 protein between groups ( P>0.05). Conclusion: Zinc finger protein A20 can effectively regulate the process of lumbar intervertebral disc degeneration in rabbits by inhibiting inflammation.


Assuntos
Degeneração do Disco Intervertebral , Disco Intervertebral , Agrecanas , Animais , Modelos Animais de Doenças , Coelhos , Proteína 3 Induzida por Fator de Necrose Tumoral alfa/genética
2.
Zhonghua Yi Xue Za Zhi ; 101(9): 611-614, 2021 Mar 09.
Artigo em Chinês | MEDLINE | ID: mdl-33685040

RESUMO

Heterotopic ossification(HO) and progressive bone formation(PBF) are main factors affecting the motion ability of target segments after cervical artificial disc replacement(CADR).The severity of pre-operative degeneration of target segment is the most important factor in the occurrence and progression of HO and PBF. The occurrence and progression of HO and PBF can be reduced basically through the improvement of degeneration evaluation system for intervertebral disc (including height, range of motion and osteophyte formation), uncovertebral joint and facet joint and standardization of surgical indication. The application of new anatomical prosthesis and improved surgical technique are also important factors to reduce the occurrence and development of HO and PBF.


Assuntos
Degeneração do Disco Intervertebral , Disco Intervertebral , Ossificação Heterotópica , Substituição Total de Disco , Vértebras Cervicais/cirurgia , Seguimentos , Humanos , Degeneração do Disco Intervertebral/cirurgia , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
3.
Zhongguo Gu Shang ; 34(1): 40-4, 2021 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-33666018

RESUMO

OBJECTIVE: To investigate the biomechanical affect of percutaneous transforaminal endoscopic discectomy(PTED) on adjacent segments with different degrees of degeneration and related risk of adjacent segment diseases (ASD) caused by this operation. METHODS: A healthy male adult volunteer was selected, and the lumbosacral vertebra image data was obtained by CT scan, and the external contour of the bone structure was reconstructed. On this basis, the external contour of the bone structure was fitted by using the smooth curve in 3D-CAD software, and the complete three-dimensional finite element modelof the non degenerate L3-S1 segment and the degenerative models of the L3-L4 and L5-S1 segment were drawn forward. In L4, L5 segment simulating PTED surgery through the removal of right part of articular process and nucleus pulposus and anulus fibrosus. After PTED was simulated in the L4-L5 segment and the risk of ASD has been evaluated by six changes of biomechanical indicators in flexion, extension, left and right lateral bending, left and right axial rotation conditions. RESULTS: In the finite element model without adjacent segmental disc degeneration, the annulus fibrosus von Mises stress and intradiscal pressure of the PTED model showed only a slight increase under most stress conditions, and a slight decrease in a few conditions, and there was no significant change trend before and after surgery. In the original degenerated adjacent segment disc model, the biomechanical indicators related to disc degeneration in the pre- and post-PTED model showed significant deterioration, leading to an increased risk of potential adjacent spondylopathy. CONCLUSION: PTED surgery will not lead to the significant deterioration of postoperative biomechanical environment of non-degeneration adjacent intervertebral discs, and the original degeneration of adjacent intervertebral discs is a important risk factor for ASD.


Assuntos
Discotomia Percutânea , Degeneração do Disco Intervertebral , Disco Intervertebral , Adulto , Fenômenos Biomecânicos , Análise de Elementos Finitos , Humanos , Disco Intervertebral/cirurgia , Degeneração do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Masculino , Amplitude de Movimento Articular
4.
Radiologe ; 61(3): 275-282, 2021 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-33570680

RESUMO

CLINICAL/METHODOLOGICAL PROBLEM: Spondylodiscitis is an inflammation of the intervertebral disc, which in adults is generally associated with spondylitis of the adjacent vertebrae. It often presents clinically with nonspecific symptoms such as back or neck pain. It may be caused by various pathogens, especially bacteria. One or more vertebral segments can be affected. The infection can spread to surrounding compartments and can lead to epidural abscesses. Radiology, in particular magnetic resonance imaging (MRI), plays an important role in the diagnostic work-up and in the follow-up to monitor response to therapy. Treatment consists of conservative (antibiotics) and invasive approaches, including surgery. Interventional puncture and drainage is a promising alternative to surgery, especially in early stages of abscess formation. STANDARD RADIOLOGICAL METHODS: Magnetic resonance imaging (MRI), computed tomography (CT), nuclear medical procedures, conventional x­ray. PERFORMANCE: MRI has the highest value. CT and nuclear medical procedures can be used as a supplement to MRI and in patients with contraindications for MRI. PRACTICAL RECOMMENDATIONS: With adequate diagnosis and therapy, spondylodiscitis has a good prognosis. In addition to targeted or calculated drug therapy, invasive treatment is the main focus, especially for epidural abscesses. Interventional radiological drainage can represent a less invasive alternative to surgical treatment.


Assuntos
Discite , Abscesso Epidural , Discite/diagnóstico por imagem , Discite/terapia , Abscesso Epidural/diagnóstico por imagem , Abscesso Epidural/terapia , Humanos , Disco Intervertebral , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X
5.
Medicine (Baltimore) ; 100(6): e24583, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578557

RESUMO

ABSTRACT: Lumbar disc prostheses have been used increasingly in recent years. The successful design of lumbar disc prostheses depends on accurate morphometric parameters. However, the morphologic dimensions of lumbar endplate area have not been investigated in Chinese population.A total of 1800 lumbar endplates were retrospectively accessed in 150 Chinese adults. Eighteen parameters of each lumbar segment were measured by three-dimensional computed tomography reconstructions from T12/L1 to L5/S1. These obtained parameters were compared between genders, bilateral sides, vertebral segments, and different populations.Endplate length and width increased in general, and there was a significant decrease for length/width ratio from T12 to S1 (P = .03). The average concavity depth of the lower lumbar endplate (2.09 ±â€Š0.93 mm) was usually larger than that of the upper lumbar endplate (1.61 ±â€Š0.74 mm) (P = .02). The percentage of the most concave point of the upper and lower lumbar endplate was 50.01 ±â€Š10.76% and 56.41 ±â€Š9.93%, respectively. Anterior, medium, or posterior intervertebral endplate height was severally 10.01 ±â€Š1.98 mm, 10.46 ±â€Š2.03 mm, and 6.41 ±â€Š1.74 mm, and increased among vertebral segments (P = .01).The intervertebral endplate angle significantly increased from T12-L1 to L5-S1 (P = .01). Parameters displayed significant difference between genders. The morphometric parameters of different populations also showed differences.In conclusion, there is a morphologic discrepancy in dimensions of lumbar endplate regarding genders, vertebral segments, and different populations. It is essential to design the lumbar disc prosthesis suited for Chinese patients specially, for which the morphometric parameters in our study can be utilized.


Assuntos
Disco Intervertebral , Vértebras Lombares/diagnóstico por imagem , Próteses e Implantes , Desenho de Prótese , Adulto , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
6.
Spine (Phila Pa 1976) ; 46(4): E243-E249, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33475276

RESUMO

STUDY DESIGN: An in vitro experimental study testing a Gelatin-poly (γ-glutamic acid) hydrogel for disc repair. OBJECTIVE: To evaluate the cytocompatibility and degradability of the above mentioned hydrogel for intervertebral disc annular fibrosis (AF) repair. SUMMARY OF BACKGROUND DATA: No repair strategies for correcting annular defects in lumbar discectomy have been clinically well recognized. Exogenous supplementation of regenerative materials to fill defects is a minimally invasive way to restore compromised mechanical properties. The injected materials, most commonly gelatin-based materials with cross-linking agents, serve as sealants and as a scaffold for incorporating biomaterials for augmentation. However, cytotoxicity of hydrogel crosslinking agents is of concern in developing viable materials. METHODS: This in vitro experimental study evaluated a newly developed gelatin-based hydrogel for intervertebral disc AF repair. Mechanical strength was augmented by γ-PGA, and 1-(3-dimethylaminopropyl)-3-ethyl-carbodiimide hydrochloride (EDC) was used for material crosslinking. Isolated bovine tail intervertebral discs (IVDs) were used to test the hydrogel, and hydrogel surface monolayer AF cell culture was used to investigate efficacy in hydrogel constructs of different EDC concentrations. Cell metabolic activity was evaluated with Alamar blue assay, cell viability assay with live/dead stain, and sulfated glycosaminoglycan (GAG) and double strain DNA were quantified to evaluate proliferation of implanted cells and synthesis of extracellular matrix (ECM) proteins. RESULTS: EDC concentrations from 10 to 40 mM resulted in significant decreases in AF cell proliferation without obvious influence on cell viability. Higher EDC concentrations resulted in decreased percentage of Alamar blue reduction and GAG and DNA concentration, but did not affect GAG/DNA and live-dead ratios. Degradation tests revealed that higher EDC concentrations decreased the hydrogel degradation rate. CONCLUSION: The developed gelatin-poly (γ-PGA) hydrogel with 20 mM EDC concentration provides an effective gap-filling biomaterial with good cytocompatibility, suggesting substantial promise for use as a sealant for small AF defects.Level of Evidence: N/A.


Assuntos
Adesivos/uso terapêutico , Gelatina/farmacologia , Ácido Glutâmico/farmacologia , Degeneração do Disco Intervertebral/tratamento farmacológico , Disco Intervertebral/efeitos dos fármacos , Animais , Anel Fibroso/cirurgia , Materiais Biocompatíveis , Bovinos , Células Cultivadas , Discotomia , Ácido Glutâmico/metabolismo , Glicosaminoglicanos , Hidrogéis , Disco Intervertebral/cirurgia , Degeneração do Disco Intervertebral/cirurgia , Ácido Poliglutâmico/análogos & derivados
7.
Int J Mol Sci ; 22(2)2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33445782

RESUMO

Intervertebral disc (IVD) degeneration is a major risk factor of low back pain. It is defined by a progressive loss of the IVD structure and functionality, leading to severe impairments with restricted treatment options due to the highly demanding mechanical exposure of the IVD. Degenerative changes in the IVD usually increase with age but at an accelerated rate in some individuals. To understand the initiation and progression of this disease, it is crucial to identify key top-down and bottom-up regulations' processes, across the cell, tissue, and organ levels, in health and disease. Owing to unremitting investigation of experimental research, the comprehension of detailed cell signaling pathways and their effect on matrix turnover significantly rose. Likewise, in silico research substantially contributed to a holistic understanding of spatiotemporal effects and complex, multifactorial interactions within the IVD. Together with important achievements in the research of biomaterials, manifold promising approaches for regenerative treatment options were presented over the last years. This review provides an integrative analysis of the current knowledge about (1) the multiscale function and regulation of the IVD in health and disease, (2) the possible regenerative strategies, and (3) the in silico models that shall eventually support the development of advanced therapies.


Assuntos
Degeneração do Disco Intervertebral/fisiopatologia , Disco Intervertebral/fisiopatologia , Animais , Simulação por Computador , Matriz Extracelular/fisiologia , Humanos , Transdução de Sinais/fisiologia , Engenharia Tecidual/métodos
8.
Methods Mol Biol ; 2221: 41-52, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32979197

RESUMO

Cells isolated from the intervertebral disc are often used for in vitro experimentation. Correctly separating the intervertebral disc tissue in annulus fibrosus and nucleus pulposus is particularly challenging when working with surplus material from surgery or specimens from donors with an advanced age. Moreover, lineage controls are only sparsely reported to verify tissue of origin. Here we describe an approach to intervertebral disc cell isolation from human and bovine origin.


Assuntos
Anel Fibroso/citologia , Separação Celular/métodos , Disco Intervertebral/citologia , Núcleo Pulposo/citologia , Animais , Bovinos , Humanos , Engenharia Tecidual
9.
Life Sci ; 267: 118929, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33359244

RESUMO

OBJECTIVE: To investigate if the modification of human adipose-derived mesenchymal stem cells (hADSCs) by the antioxidants superoxide dismutase 2 (Sod2) and catalase (Cat) can attenuate the pathological conditions of intervertebral disc degeneration (IVD). METHODS: In vitro, MTT assay and qRT-PCR was used to detect cell proliferation and gene expressions in hADSCs transduced with Ad-null (an adenovirus vector containing no transgene expression cassette), Ad-Sod2 (recombinant adenovirus Sod2) and Ad-Cat. IVD mouse models were generated by needle puncture and treated with hADSCs with/without Ad-null/Ad-Sod2/Ad-Cat. X-ray evaluation, magnetic resonance imaging (MRI) analysis, histological analysis, immunohistochemistry, Western blots, ELISAs and qRT-PCR were performed. RESULTS: hADSCs transduced with Ad-Sod2 and Ad-Cat showed enhanced cell proliferation with the upregulation of SOX9, ACAN, and COL2. In vivo, IVD mice injected with hADSCs showed increased disc height index, MRI index and mean T2 intensities, as well as the attenuated histologic grading of the annulus fibrosus (AF) and NP accompanied by the upregulation of GAG and COL2, which were further improved in the Ad-Sod2 hADSC + IVD and Ad-Cat hADSC + IVD groups. Furthermore, the increased expression of IL-1ß, IL-6 and TNF-α was reduced in IVD mice injected with hADSCs. Compared with the hADSC + IVD group, the Ad-Sod2 hADSC/Ad-Cat hADSC + IVD groups had lower expression of pro-inflammatory factors. CONCLUSION: Modification of hADSCs by the antioxidants Sod2 and Cat improved the pathological condition of intervertebral disc tissues with increased GAG and COL2 expression, as well as reduced inflammation, thereby demonstrating a therapeutic effect in IVD.


Assuntos
Catalase/metabolismo , Degeneração do Disco Intervertebral/terapia , Superóxido Dismutase/metabolismo , Animais , Catalase/fisiologia , Proliferação de Células/fisiologia , Modelos Animais de Doenças , Humanos , Disco Intervertebral/metabolismo , Disco Intervertebral/patologia , Degeneração do Disco Intervertebral/enzimologia , Degeneração do Disco Intervertebral/patologia , Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/enzimologia , Células-Tronco Mesenquimais/patologia , Camundongos , Distribuição Aleatória , Superóxido Dismutase/fisiologia , Fator de Necrose Tumoral alfa/metabolismo
10.
Elife ; 92020 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-33382035

RESUMO

The spatiotemporal proteome of the intervertebral disc (IVD) underpins its integrity and function. We present DIPPER, a deep and comprehensive IVD proteomic resource comprising 94 genome-wide profiles from 17 individuals. To begin with, protein modules defining key directional trends spanning the lateral and anteroposterior axes were derived from high-resolution spatial proteomes of intact young cadaveric lumbar IVDs. They revealed novel region-specific profiles of regulatory activities and displayed potential paths of deconstruction in the level- and location-matched aged cadaveric discs. Machine learning methods predicted a 'hydration matrisome' that connects extracellular matrix with MRI intensity. Importantly, the static proteome used as point-references can be integrated with dynamic proteome (SILAC/degradome) and transcriptome data from multiple clinical samples, enhancing robustness and clinical relevance. The data, findings, and methodology, available on a web interface (http://www.sbms.hku.hk/dclab/DIPPER/), will be valuable references in the field of IVD biology and proteomic analytics.


Assuntos
Envelhecimento/metabolismo , Matriz Extracelular/metabolismo , Disco Intervertebral/metabolismo , Proteoma/metabolismo , Idoso , Humanos , Imagem por Ressonância Magnética/métodos , Proteômica/métodos
11.
J Clin Neurosci ; 82(Pt A): 134-140, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33317722

RESUMO

INTRODUCTION: At L5-S1, anterior access can be performed with a supine anterior lumbar interbody fusion (ALIF) or lateral position oblique lumbar interbody fusion (LOLIF). We compared clinical and radiographic features of both approaches. METHODS: A retrospective study of L5-S1 ALIF and LOLIF patients (2013-2018) by 3 spine surgeons and a vascular surgeon at our hospital was performed. Inclusion criteria were patients undergoing L5-S1 anterior surgery only without other anterior or lateral fusion levels, and data collected were patient demographics, cage parameters, perioperative variables, and radiographic parameters. 58 patients were included (33 ALIF and 25 LOLIF). RESULTS: The average surgical time was 211.94 min for ALIF and 154.86 min for LOLIF (p < 0.001). The average blood loss was 214 ml for ALIF and 74 ml for LOLIF (p < 0.001). The average number of days to solid food was 2.55 for ALIF and 0.8 for LOLIF (p < 0.001). The average anterior L5-S1 disc height increase was 8.52 mm for ALIF and 5.02 mm LOLIF (p = 0.018), and the average posterior L5-S1 disc height increase was 3.34 mm for ALIF and 1.30 mm for LOLIF (p = 0.034). The average L5-S1 segmental lordosis increase was 6.82 degrees for ALIF and 7.63 degrees for LOLIF (p = 0.638). CONCLUSION: The LOLIF is a feasible option for L5-S1 anterior access compared to ALIF. However, supine ALIF afforded larger cages to be placed, resulting in greater postoperative disc height. There did not appear to be a significant difference in postoperative L5-S1 segmental lordosis between the two approaches.


Assuntos
Vértebras Lombares/cirurgia , Região Lombossacral/cirurgia , Fusão Vertebral/métodos , Adulto , Feminino , Humanos , Disco Intervertebral , Lordose , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(12): 1624-1629, 2020 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-33319547

RESUMO

Objective: To summarize the research progress in creep characteristics of lumbar intervertebral disc. Methods: The relevant literature at home and abroad was systematically searched. Then, the concept and structural basis of lumbar disc creep, the description of creep characteristics, and the latest progress of its influencing factors were summarized and analyzed. Results: The intervertebral disc is viscoelastic. After loading, the deformation increases with time. However, the degree of increase is not linear with time. That is creep, which plays an important role in buffering the load generated by human activities and absorbing energy in order to maintain stable movement of the spine. Both experimental and simulation studies can well describe the creep behavior of intervertebral disc. Various models including standard linear solid model and corresponding constitutive equations can quantify and compare the creep characteristics, which can be obviously changed by the degeneration of intervertebral disc and the mode of loading stress. Conclusion: Creep is an important mechanical properties of intervertebral discs, and an in-depth understanding of the creep characteristics of lumbar intervertebral discs is of great guiding significance for the intervention and treatment of low back pain.


Assuntos
Degeneração do Disco Intervertebral , Disco Intervertebral , Fenômenos Biomecânicos , Humanos , Vértebras Lombares , Região Lombossacral , Estresse Mecânico , Suporte de Carga
13.
Zhonghua Yi Xue Za Zhi ; 100(45): 3578-3583, 2020 Dec 08.
Artigo em Chinês | MEDLINE | ID: mdl-33333680

RESUMO

Objective: To investigate the correlation between the severity of uncovertebral joints degeneration and heterotopic ossification (HO) after single-level artificial cervical disc replacement (ACDR). Methods: From January 2005 to January 2016, 70 patients who had undergone single-level ACDR in Peking University Third Hospital and had at least 5 years follow-up were included in this study. There were 35 males and 35 females with an average age of (42±8) years (range, 25-62 years). Cervical spine A-P X-rays were taken to assess the degeneration of uncovertebral joints and lateral X-rays were taken to assess the degeneration of intervertebral space. Cervical spine lateral and the flexion-extension X-rays at 5 years follow up were taken to assess HO. Degeneration of uncovertebral joints were evaluated by the classification system set-up in Peking University Third Hospital. Kellgren&Lawrence grading system was used to evaluate the degeneration of intervertebral space. HO was evaluated by the McAfee grading standards. The data were collected before surgery and at 5-years follow-up, then the correlation between degeneration of uncovertebral joints, degeneration of intervertebral space and HO was analyzed with Spearman non-parametric test. Results: The average follow-up time of 70 patients was (62.7±4.8) years (range, 52-74 months). There was a significant positive correlation between preoperative uncovertebral joints degeneration and HO after ACDR (r=0.585, P<0.01). There was a significant positive correlation between preoperative intervertebral space degeneration and HO (r=0.557, P<0.01). There was a significant positive correlation between preoperative intervertebral space degeneration and preoperative uncovertebral joints degeneration (r=0.727, P<0.01). Conclusion: There is a significant positive correlation between preoperative uncovertebral joints degeneration and HO after ACDR.


Assuntos
Degeneração do Disco Intervertebral , Disco Intervertebral , Ossificação Heterotópica , Substituição Total de Disco , Articulação Zigapofisária , Adulto , Vértebras Cervicais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço , Resultado do Tratamento
14.
Zhonghua Yi Xue Za Zhi ; 100(45): 3584-3589, 2020 Dec 08.
Artigo em Chinês | MEDLINE | ID: mdl-33333681

RESUMO

Objective: To analyze the incidence of heterotopic ossification after artificial cervical disc replacement with Discover disc, and to explore the effect of heterotopic ossification on postoperative radiological and clinical efficacy. Methods: From January 2010 to January 2015, 45 patients with cervical spondylosis underwent single-level artificial cervical disc replacement in Shanghai Changzheng Hospital, including 29 cases of cervical spondylotic myelopathy, 11 cases of cervical spondylotic radiculopathy and 5 cases of mixed cervical spondylosis. At the last follow-up, Mehren grading method was used for classification of heterotopic ossification, among which, grade 0-Ⅱ was defined as low grade ossification group, and 26 patients (16 male, 10 female) were enrolled in this group; grade Ⅲ-Ⅳ was defined as high grade ossification group, and 19 patients (12 males, 7 females) were included in this group. C(2-7) Cobb angle, cervical total range of motion and range of motion at index level were used to evaluate the radiological outcomes of the two groups. Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) score and visual analogue scale (VAS) were used to evaluate the clinical outcomes of the two groups. The adjacent segment intervertebral disc height and range of motion were used to evaluate the effects of heterotopic ossification on adjacent segment. Results: All patients were followed up regularly for (98±18) months. There were no statistical differences between the two groups regarding to demographic data (all P>0.05). There was no significant differences in C(2-7) Cobb angle and total range of motion between the two groups at the last follow-up (all P>0.05), but range of motion at index level in the group with low grades was significantly higher than that in the group with high grades (7.8°±6.2° vs 2.6°±1.2°, t=3.60, P<0.05). There was no significant differences in JOA score, recovery rate and NDI score between the two groups (all P>0.05). There was no significant differences in the adjacent segment intervertebral disc height before operation and at the last follow-up (both P>0.05). There was no significant differences in range of motion at adjacent segment before operation (P>0.05), while range of motion at adjacent segment in the group with low grades was significantly lower than that in the group with high grades (9.5°±1.1° vs 10.6°±1.8° and 9.4°±1.4° vs 10.5°±1.7°, repectively, t=2.54, 2.31, both P<0.05). Conclusions: Heterotopic ossification does not affect the clinical outcomes, cervical curvature and cervical total range of motion after artificial cervical disc replacement with Discover disc. However, the higher grade of heterotopic ossification, the lower range of motion at index level and the higher range of motion at adjacent segment.


Assuntos
Degeneração do Disco Intervertebral , Disco Intervertebral , Ossificação Heterotópica , Substituição Total de Disco , Vértebras Cervicais/cirurgia , China , Feminino , Seguimentos , Humanos , Degeneração do Disco Intervertebral/cirurgia , Masculino , Ossificação Heterotópica/etiologia , Amplitude de Movimento Articular , Estudos Retrospectivos , Substituição Total de Disco/efeitos adversos , Resultado do Tratamento
15.
Zhonghua Yi Xue Za Zhi ; 100(45): 3590-3595, 2020 Dec 08.
Artigo em Chinês | MEDLINE | ID: mdl-33333682

RESUMO

Objective: To investigate the clinical outcomes and radiographic results of artificial cervical disc replacement (ACDR) for cervical adjacent segment disease (ASD). Methods: The clinical data of 28 patients with single-segment cervical ASD treated with ACDR in Xi 'an Honghui Hospital from December 2013 to July 2016 were retrospectively analyzed. There were 19 males and 9 females with a mean age of (46±7) years (36-63 years). Preoperative, postoperative 1 month and postoperative 24 months of clinical and radiographic outcomes were recorded and compared. The clinical outcome mainly includes Japanese orthopedic association (JOA), Neck Disability Index (NDI%), Odom score and complications. Imaging assessment mainly included range of motion (ROM) of cervical spine, surgical segment ROM, Cobb angle of surgical segment, degree of adjacent disc degeneration, heterotopic ossification, and prosthesis related image parameters. Results: In terms of clinical outcome, the average JOA score was 12.7±1.5 before surgery, 14.0±1.0 one month after surgery, 15.8±0.9 24 months after surgery, and the improvement rate of JOA was 75%±19%. The mean NDI% was 27.0%±2.8% before surgery, 20.5%±1.6% one month after surgery, and 15.3%±2.8% 24 months after surgery; the difference before and after treatment was statistically significant (F=159.101, P<0.01). Twenty patients were classified with excellent Odom score and 8 patients with good Odom score at the final follow-up. The total ROM of cervical spine, operation segment ROM, operation segment Cobb angle were all improved significantly after the operation (F=4.633, 6.063, 26.952, all P<0.05). There was a statistical difference in Miyazaki classification between adjacent discs above ACDR and below the fusion segment 24 months after surgery (µ(c)=2.12, P=0.034). The incidence of heterotopic ossification was 14.3%. The results of displacement degree of prosthesis were as follow: coronal plane (0.30±0.11) mm, sagittal plane (0.28±0.10) mm; subsidence of the prosthesis: (0.27±0.09) mm. No prosthesis loosening was observed. Conclusions: The clinical outcome of revision of cervical ASD by ACDR is satisfactory. The risk of intervertebral disc degeneration in adjacent segments is significantly lower than that of ACDF due to the presence of certain motor function postoperatively.


Assuntos
Degeneração do Disco Intervertebral , Disco Intervertebral , Fusão Vertebral , Substituição Total de Disco , Adulto , Vértebras Cervicais/cirurgia , Feminino , Seguimentos , Humanos , Degeneração do Disco Intervertebral/cirurgia , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
16.
Arch. med. deporte ; 37(199): 318-325, sept.-oct. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-199346

RESUMO

INTRODUCTION: This study evaluated the effect of the vibratory platform on the lumbar spine morphology of Wistar rats sub-mitted to hormonal deprivation by oophorectomy. MATERIAL AND METHOD: Twenty rats were divided into four groups: Pseudo-oophorectomy (GP), Pseudo-oophorectomy Treated (GPT ), Oophorectomy (GO), Oophorectomy Treated (GOT ). After 60 days of postoperative, the treated groups started exercises on a vibratory platform in the frequency parameters of 60 Hz, alternating vibration with amplitude of 2 mm, acceleration of 57.6 m/s² and time of 10 minutes, three times in the during the four week period. Following the euthanasia of the animals, the lumbar spine was dissected and processed for analysis of the anterior and posterior longitudinal ligaments, intervertebral disc height (IVD), nucleus pulposus (NP) height, radiographic density of the lumbar vertebrae and IVD morphology. RESULTS: The results showed a decrease in the height of the NP associated to the GO and morphological alterations such as lamellar disorganization and presence of rifts in the fibrous ring, alterations of the structural limits and decrease of the NP cavity; while the other groups presented organized lamellae, peripheral and nuclear region well delimited and wide cavity of the nucleus. CONCLUSION: In this way, it can be concluded that the oophorectomy protocol promoted a decrease in the height of the NP of the IVD and that the exercise in the vibratory platform did not generate lesions in the analyzed tissues, as well as preserved the structural organization of the IVD and the height of the NP of oophorectomized rats


INTRODUCCIÓN: Este estudio evaluó el efecto de la plataforma vibratoria sobre la morfología de la columna lumbar de las ratas de Wistar sometidas a privación hormonal por ooforectomía. MATERIAL Y MÉTODO: Veinte ratas fueron divididas en cuatro grupos: Pseudo-ooforectomía (GP), Pseudo-ooforectomía tratada (GPT ), Ooforectomía (GO), Ooforectomía tratada (GOT ). Después de 60 días de postoperatorio, los grupos tratados iniciaron los ejercicios en una plataforma vibratoria en los parámetros de frecuencia de 60 Hz, alternando vibración con amplitud de 2 mm, aceleración de 57,6 m/s² y tiempo de 10 minutos, tres veces en el período de cuatro semanas. Tras la eutanasia de los animales, la columna lumbar fue diseccionada y procesada para el análisis de los ligamentos longitudinales anteriores y posteriores, la altura del disco intervertebral (DIV ), la altura del núcleo pulposo (NP), la densidad radiográfica de las vértebras lumbares y la morfología del DIV. RESULTADOS: Los resultados mostraron una disminución en la altura del PN asociado al GO y alteraciones morfológicas tales como desorganización laminar y presencia de fisuras en el anillo fibroso, alteraciones de los límites estructurales y disminución de la cavidad del PN; mientras que los otros grupos presentaron láminas organizadas, región periférica y nuclear bien delimitadas y amplia cavidad del núcleo. CONCLUSIÓN: De esta manera, se puede concluir que el protocolo de ooforectomía promovió una disminución en la altura del PN de la IVD y que el ejercicio en la plataforma vibratoria no generó lesiones en los tejidos analizados, además de preservar la organización estructural de la IVD y la altura de la NP de las ratas ooforectomizadas


Assuntos
Animais , Feminino , Ratos , Ovariectomia/efeitos adversos , Vértebras Lombares/patologia , Disco Intervertebral/patologia , Vibração/efeitos adversos , Ratos Wistar , Distribuição Aleatória , Vértebras Lombares/diagnóstico por imagem , Disco Intervertebral/diagnóstico por imagem , Fatores de Tempo , Radiografia , Ligamentos Longitudinais/diagnóstico por imagem , Ligamentos Longitudinais/patologia
17.
Zhongguo Gu Shang ; 33(9): 867-72, 2020 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-32959577

RESUMO

OBJECTIVE: To explore the biomechanical characteristics of "three-dimensional balanced manipulation" for the treatment of cervical spondylotic radiculopathy(CSR). METHODS: A CSR patient was treated with "three-dimensional balanced manipulation", and the mechanical changes during the manipulation were monitored by mechanical testing system. Using spiral CT to scan the neck of the patient to obtain DICOM data. The three-dimensional finite element model of cervical spondylotic radiculopathy was established by using Mimics software, Geographic Studio software. The "three-dimensional balance manipulation" was simulated and loaded, and the mechanical parameters of each part were replaced into the finite element model, and the finite element analysis was carried out by using ANSYS software to study the internal stress changes and displacement deformation of vertebral body and intervertebral disc under the action of "three-dimensional balance manipulation". RESULTS: The established C3-C7 finite element model of the CSR patient consisted of 5 vertebrae, 4 intervertebral discs and 3 ligaments, involving 153 471 nodes and 64 978 units. The stress of C3-C7 vertebral body was mainly located in anterior and root of C5 spinous processes, arch, vertebral arch and the combination of the two after full loading of manipulation, and the maximum stress was 17.781 MPa. The deformation sites were mainly concentrated in articular processes and anterior transverse processes of C3, superior articular processes and transverse processes of C4, articular processes of C5. The stress of C3-C7 intervertebral disc mainly distributed in the anterior part of C3, 4 intervertebral disc and the nucleus pulposus of C4, 5 and C5, 6. The displace mentextended to the middle and posterior part of C3, 4 nucleus pulposus, around the nucleus of C4, 5 and C5, 6 and anterior part of cervical intervertebral disc. CONCLUSION: The establishment of three-dimensional finite element model of C3-C7 cervical spondylotic radiculopathy can simulate the geometry and material properties of cervical spine, and also accurately reflects the biomechanical characteristics of cervical spine, verifys the internal mechanism of "three-dimensional balanced manipulation" on CSR, proves the safety and effectiveness of treatment, guides more standardized manipulation, and avoids medical accidents.


Assuntos
Disco Intervertebral , Radiculopatia , Espondilose , Fenômenos Biomecânicos , Vértebras Cervicais , Análise de Elementos Finitos , Humanos , Amplitude de Movimento Articular
18.
Orv Hetil ; 161(31): 1286-1292, 2020 08.
Artigo em Húngaro | MEDLINE | ID: mdl-32750014

RESUMO

INTRODUCTION: Low back pain is a major factor that influences both society and economy. In Hungary, 21% of the population suffers from low back pain or back pain, and six out of ten take medication for the disease. Therapy is complex and no single method has been proved effectively to treat this disease. There are four main factors associated with low back pain: the geometry of the spine, morphological degeneration, the pain of the patients associated with the degeneration and the degree of the impairment. AIM: To investigate the relationship between the distribution of lumbar lordosis and the degeneration of intervertebral discs by mathematical analysis and its software application. METHOD: Algorithmic analysis of 60 MRIs and their classification into degeneration classes using discriminant analysis. RESULTS: By the classification, three independent variables show significant results: the gender, the age, and the digression percentage (K), but not the gold standard Cobb-angle. The common correct predicted classification value of the classification functions is 83% and the correct predicted classification value is 92% in the most relevant serious degeneration class. CONCLUSION: According to our results, the average degeneration of lumbar spine can be determined indirectly by the gender, the age, and the K (lordosis distribution) values with the Spinalyze Software which is available online for free. Orv Hetil. 2020; 161(31): 1286-1292.


Assuntos
Degeneração do Disco Intervertebral/epidemiologia , Lordose/epidemiologia , Vértebras Lombares/diagnóstico por imagem , Análise Discriminante , Humanos , Hungria/epidemiologia , Disco Intervertebral , Vértebras Lombares/fisiopatologia , Imagem por Ressonância Magnética
20.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1206-1212, July-Aug. 2020. graf, ilus
Artigo em Português | LILACS, VETINDEX | ID: biblio-1131485

RESUMO

O objetivo deste trabalho foi verificar em quais projeções foi possível identificar compressão da medula espinhal em cães com doença do disco intervertebral (DDIV) cervical e propor um sequenciamento das projeções a ser realizado no exame mielográfico dessa região. Foram avaliadas quatro projeções mielográficas (lateral, ventrodorsal e oblíquas esquerda e direita) de 41 pacientes diagnosticados com DDIV cervical. Em 40 pacientes (97,5%), foi possível identificar compressão da medula espinhal na projeção lateral; em 22 (53,6%), nas oblíquas; e em 11 (26,8%), na ventrodorsal (P<0,05). Havia lateralização da compressão em 22 (53,6%) pacientes; 100% delas (n=22) foram detectadas pelas projeções oblíquas e 50% (n=11) pela ventrodorsal. Em 10 (24,4%) cães, foi observado mais que um local de compressão, tendo as projeções ventrodorsal e oblíquas auxiliado na definição do local de compressão em 50% e 70%, respectivamente. Pode-se concluir que todas as projeções mielográficas estudadas permitem identificar compressão na medula espinhal em cães com DDIV cervical, sendo a incidência lateral a que mais a revelou, seguida das oblíquas e da ventrodorsal, estabelecendo-se, assim, uma proposta de sequenciamento das projeções mielográficas a serem realizadas para essa região.(AU)


The aim of this study was to verify in which of the myelographic views it was possible to identify spinal cord compression in dogs with cervical intervertebral disc disease (IVDD), and to establish a sequence in which myelographic views should be obtained for this region. Four myelographic views (lateral, ventrodorsal, left oblique and right oblique) of 41 patients diagnosed with cervical IVDD were evaluated. In 40 patients (97.5%) it was possible to identify spinal cord compression by lateral view, 22 (53.6%) by the oblique view, and 11 (26.8%) by the ventrodorsal view (P< 0.05). There were lateralized compressions in 22 (53.6%) patients, detected by all oblique views (100%) and by 11 (50%) of the ventrodorsal views. In 10 (24.4%) dogs, more than one compression site was observed, where the ventrodorsal view helped to decide the site in 50% of the cases and oblique in 70%. It can be concluded that all the tested myelographic views allow the identification of spinal cord compressions in dogs with cervical IVDD, the lateral view being the most relevant, followed by the oblique and ventrodorsal view, therefore establishing a sequence of myelographic views should be obtained for this region.(AU)


Assuntos
Animais , Cães , Compressão da Medula Espinal/diagnóstico por imagem , Disco Intervertebral/patologia , Mielografia/veterinária
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