ABSTRACT
BACKGROUND:Salvianolic acid B is an effective monomer component of Salvia miltiorrhiza, which has been shown in recent years to have neuroprotective role and to promote nerve recovery, but its mechanism is not clear. OBJECTIVE: To explore the protective mechanism of salvianolic acid B on Schwann cels in rats with spinal cord injury. METHODS: Schwann cels of Sprague-Dawley rats were cultured and divided into normal control group, model group, 10 μmol/L methylprednisolone group and salvianolic acid B group (0.1, 1, 10, 100 μmol/L). Models of Schwann cel injury induced by lipopolysaccharide were established in al the groups except the normal control group. After intervention, growth curve and proliferative activity of Schwann cels were detected, and protein and gene expressions of β-catenin and nuclear factor-κB were observed. RESULTS AND CONCLUSION: At 48, 72, 96 hours after intervention, the cel viability of the model group was significantly lower than that of the normal control group (P < 0.01). Compared with the model group, the cel viability of salvianolic acid B group (10 μmol/L) was significantly increased at 72 and 96 hours (P < 0.05); the expressions of nuclear factor-κB protein and mRNA in the methylprednisolone group and salvianolic acid B group were declined significantly (P < 0.01), but the expressions of β-catenin mRNA and protein in the salvianolic acid B group significantly increased (P < 0.05). These results suggest that salvianolic acid B improves the viability of Schwann cels which are stimulated with lipopolysaccharide, suppresses expression of nuclear factor-κB mRNA and protein, and promotes the expression of β-catenin mRNA and protein. Above may be one of the mechanisms which salvianolic acid B protects Schwann cels.
ABSTRACT
MAIN OUTCOME MEASURES: Free running EMG and stimulus triggered EMG, including time, frequency, amplitude, muscle group were observed and recorded simultaneously. Never root functional injury and restoration after surgery were detected.RESULTS: 378 pedicle screws in 74 patients were monitored intraoperatively, and only 3 pedicle screw malposition (2 of L_4, 1 of L_5) was detected and then replaced with the help of C-arm fluoroscopic examination. Myoelectricity appeared when the current intensity was less than 10 mA. The correct rate of implantation was 99.2%. Nerve root impingement was found in two cases during laminectomy for L_5 and S_1 decompression and never root solution, which alerted the surgical team of critical neural structures. Nerve symptoms of the lower limb were aggravated after surgery and restored following 2-4 weeks of conventional treatment. The error injury rate of nerve root was 2.7%. In all reported cases, no irreversible neurological deficit was observed 2-4 weeks after operation.CONCLUSION: Intraoperative EMG monitoring can find improperly placed screws and detect impending nerve root injury promptly. Combined EMG and 3-D imaging modality monitoring is a reliable and practicable method that can be used to protect neural structures during complex lumbosacral surgery.
ABSTRACT
[Objective] To evaluate the early effect of posterior dynamic lumbar stabilization in lumbar degenerative disease.[Methods]The clinical outcomes of 31 patients with lumbar degenerative disease treated by posterior decompression with Wallis posterior dynamic lumbar stabilization implant or combined with posterior lumbar fusion were retrospectively studied,and assessed with visual analogue scale(VAS)and spinal operative standard of Chinese Medical Association.The early effect and complications associated with Wallis posterior dynamic lumbar stabilization were recorded.[Results]The operative procedure of Wallis posterior dynamic lumbar stabilization implant was easy and less invasive.The VAS scores were 7.9?2.0,2.6?1.2 and 1.7?0.8 at one day preoperatively,two week postoperatively and final follow-up,respectively.The good to excellent result was 94.4% at the lastest follow-up.No compliction related with Wallis posterior dynamic lumbar stabilization was found.[Conclusion]It is easy and safe to use Wallis posterior dynamic lumbar stabilization in treatment of degenerative lumbar disease,and the early effect is good.The Wallis system provides an alternative for treatment of lumbar degenerative disease.