ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical results of anterior cervical discectomy and reconstruction with a self-locking cage and internal fixation with short segmental plate for multilevel cervical spondylotic myelopathy.</p><p><b>METHODS</b>From January 2012 to June 2015, a total of 106 patients received anterior cervical discectomy and reconstruction with a self-locking cage and internal fixation with short segmental plate were followed up. There were 71 males and 35 females, aged from 42 to 74 years old with an average of(55.4±5.1) years. Three segments were involved in 82 cases and four segments in 24 cases. Operation time, blood loss, postoperative drainage, and hospitalization time were recorded. Visual analogue scale(VAS) and Japanese Orthopaedic Association Score (JOA) were analyzed before and after operation(including 5 days, 3, 6, 12 months after operation and final follow-up), and the JOA improvement rate was analyzed. The cervical lordosis and ROM were measured before and after operation(including the follow-up point above) by X-rays. The postoperative complications were recorded and analyzed as well.</p><p><b>RESULTS</b>All the operations were successful. The average operative time was (126.2±25.1) min, and the amount of blood loss was (82.1±26.3) ml. All the patients were followed up from 12 to 48 months with an average of (30.4±10.5) months. The VAS score of neck pain and JOA score was significantly better from 6.11±1.54 and 9.22±2.42 preoperatively to 2.14±0.51 and 12.46±1.42 at 5 days post-operation, respectively(<0.05). The improvement rate of JOA was (56.7±21.6)%, there was no statistically significant difference of VAS, JOA scores and the improvement rate of JOA at each time after operation (>0.05). Postoperative cervical lordosis at 3 months was significantly improved from preoperative (11.5±6.8)° to (19.6±8.9)°(<0.05), and it can keep satisfactory stability until final follow-up(>0.05). Postoperative ROM at 3 months was significantly decreased from the preoperative (37.6±10.4)° to (18.2±5.9)°(<0.05), but there was no significant change in the process of follow-up (>0.05). All the complications such as dysphagia (19 cases), axial neck pain(6 cases), cerebral fluid leakage(3 cases), and hoarseness(2 cases), got better after conservative treatment. Three cases had intervertebral space non-fusion until final follow-up(without clinical symptom), but no loosening, breakage, or displacement of internal fixation were found.</p><p><b>CONCLUSIONS</b>Anterior cervical discectomy, reconstruction with a self-locking cage and internal fixation with short segmental plate which can reduce intraoperative injury, restore cervical lordosis, improve neurological function and lower postoperative complications, it is an alternative treatment for multilevel cervical spondylotic myelopathy.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To study the effects of Bushen Zhuangjin Decoction (BZD) containing serum on the apoptosis of chondrocytes induced by mechanics stimulus.</p><p><b>METHODS</b>The BZD containing serum was extracted. The chondrocyte nutritive media was divided into 3 groups, i.e., the common nutritive medium group, the blank rabbit serum medium group, and the BZD nutritive medium group. The apoptosis of chondrocytes was induced by continuing mechanics stimulus in 24 h. Then the chondrocytes were collected. The apoptosis rate of chondrocytes was determined by flow cytometry. The contents of interleukin 1beta (IL-1beta) and nitric oxide (NO) in the corresponding media were determined.</p><p><b>RESULTS</b>The apoptosis of chondrocytes in the BZD nutritive medium group (19.55 +/- 7.98)% was lower than that of the common nutritive medium group (39.32 +/- 13.45)% and the blank rabbit serum medium group (37.87 +/- 9.67)%, showing statistical difference (P < 0.05). The contents of IL-1beta and NO were also lower in the BZD nutritive medium group with statistical difference when compared with those of the other two groups (P < 0.05).</p><p><b>CONCLUSION</b>BZD containing serum could protect mechanics stimulus induced apoptosis of chondrocytes.</p>