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BACKGROUND:Percutaneous vertebroplasty with bone cement plus hyperextension position reset for acute thoracolumbar vertebral osteoporotic compression fractures has been reported to achieve good clinical efficacy.OBJECTIVE:To evaluate the efficacy of unilateral percutaneous vertebroplasty with bone cement plus hyperextension position reset for Kümmell disease in the elderly.METHODS:Twenty-two old patients with Kümmell disease were included,involving 8 males and 14 females,aged 55-84 years old,and the injuried vertebrae included T11 (n=2),T12 (n=8),L1 (n=7),L2 (n=4),L3 (n=2),L4 (n=2),and L5 (n=1).All patients underwent the unilateral percutaneous vertebroplasty with bone cement plus hyperextension position reset.The visual analogue scale and the Oswestry Disability Index scores,vertebral body height as well as vertebral kyphosis angle were determined before and after treatment.RESULTS AND CONCLUSION:(1) All patients were successfully operated,pain relieved or disappeared within 24 hours postoperatively.No spinal cord injury,pulmonary embolism and other complications were found.One patient presented with cement leakage without obvious clinical symptoms;two patients had non-adjacent vertebral fractures during follow-up.(2) The visual analogue scale and Oswestry Disability Index scores at 1 day postoperatively were significantly lower than those at baseline (P ＜ 0.05).(3) The anterior,medial and posterior height of involved vertebral body,kyphotic angle of involved vertebral body at 1 day postoperatively were significantly higher than those at baseline (P ＜ 0.05).(4) These results manifest that unilateral percutaneous vertebropiasty with bone cement plus hyperextension position reset to treat Kümmell disease in the elderly can significantly relieve back pain,restore partial vertebral height,correct local kyphosis and improve functional recovery of the injured vertebrae.
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Aim To investigate the drug-containing serum of Rhizoma drynariae on osteogenesis differentiation of bone marrow mesenchymal stem, and discuss the possible mechanism.Methods BMSCs were cultured in media with different concentrations of medicine containing serum.BMSCs proliferation ability was detected in 3,5,7,9 days by CCK-8.ALP activity was detected after 7,10,14 days′ induction.After 3 weeks culturing, alizarin red staining was performed to observe the formation of calcium nodules.The expression of β-catenin,LRP5,RUNX-2 and Osteriex mRNA were detected using RT-PCR.The protein expression of β-catenin,LRP5 was detected using Elisa method.Results Rhizoma drynariae drug-containing serum could obviously promote the proliferation of BMSCs and calci-fied nodule formation.Besides, the ALP activity was improved in a certain period of time.The expression of β-catenin,LRP5,GSK-3β,RUNX-2 and Osteriex mRNA were significantly up-regulated,and the protein expression of β-catenin,LRP5 was up-regulated too.The expression of GSK-3β was down-trgulated.Conclusions Rhizoma drynariae drug-containing serum promotes mineralization and osteogenic differentiationof BMSCs, and the mechanism is closely related with activating WNT/beta-catenin signaling pathway, raising the beta-catenin, LRP5, RUNX-2, and Osteriex mRNA expression, beta-catenin, LRP5 protein expression,and down-regulation of GSK-3β mRNA expression.
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[Objective]To investigate the efficacy of tissue-engineerring artificial bone in treating rabbit bone defect.[Method]Rabbit bone marrow stromal cell were separated for cell culture,and subculture was done to increase the number of bone marrow stromal cell.A combined grafting material was made of bone marrow stromal cell and bioglass.The mixture,ilium and bioglass were used respectively to repair segment defects created in the radius of rabbits.The repair capability was assessed by figuration,radiography,histochemistry stains,scanning electron microscopy and biomechanical analysis at 12 weeks after operation.[Result]The amount of new bone formation with tissue-engineering artificial bone was more than that of other 3 groups.At 12 weeks the defect was bridged with the appearance of marrow cavities,but the bony healing was not found in the blank controls,which were repaired by fibrous tissue.After 12 weeks,the new bone formation in the group of the combined bone marrow stromal cells and bioglass showed the best performance.There was significant difference between groups.[Conclusion]Bone marrow stromal cell is a kind of good bony stem cell.The mechanism of osteogenesis may attribute to both intramembranous and endochondral ossification.The tissue engineering structuring bone marrow stromal cell is a promising method to repair bone defects.
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Objective To evaluate and analyze the results of one stage anteroposterior decompression and internal fixation for ossification of posterior longitudinal ligaments (OPLL). Methods One stage anteroposterior decompression and fixation was carried out from October 2001 to March 2004 in eight cases of OPLL including seven males and one female with age of 32-55 years (average 48.2 years). Results All cases were followed up for 6-30 months. According to criteria of Japan Orthopedic Association (JOA), the postoperative JOA score increased for 1-8 scores (mean 4.5 scores). The postoperative improvement rate of symptom was 50%. Conclusion One stage anteroposterior decompression and internal fixation is a good alternative method for treatment of OPLL, for it has advantages of complete decompression, reliable therapeutic effect and sound recovery.