Primary Aspergillus spondylodiscitis in a liver transplant recipient / 中华医学杂志(英文版)

Solid organ transplant recipients are at increased risk for Aspergillus infections. However, the cases of Aspergillus spondylodiscitis are rare and mostly resulted from the hematogenous spread of invasive pulmonary Aspergillosis. Here, we report a case of primary spondylodiscitis in a liver transplant recipient. Six months after transplantation, a chronic and progressive lumbar back pain was presented. The patient had no fever and the white blood cell count was normal. High plasma (1→3)-beta-d-glucan (BDG) level was detected at the time of back pain. The pathogen was Aspergillus flavus. Clinical and radiological healing was achieved through posterior only debridement and voriconazole therapy.

The effect of the thoracic cage on the vertebral axial rotation of adolescent idiopathic scoliosis: a biomechanical study / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of the rib cage on the vertebral axial rotation of adolescent idiopathic scoliosis under axial load condition.</p><p><b>METHODS</b>Three dimensional finite element model of adolescent idiopathic scoliosis included and excluded thoracic cage was built based on the data of computer tomography. The model was imported into the preprocessor of the ANSYS 8.0 software for assigning boundary and loading conditions. Then the axial loading condition was simulated after entering the solution modular. The magnitude and direction of each vertebral axial rotation of the scoliotic spine were read and analyzed in the postprocessor of the ANSYS software.</p><p><b>RESULTS</b>The rib cage had a significant influence on the axial rotation of the vertebra above the structural curve and had no influence on the axial rotation of the lumbar and sacral vertebra. The effect of the thoracic cage on the axial rotation of the apical vertebra was limited. Under different loading conditions, the apical vertebra of both models rotated in the same direction. The magnitude of the vertebral rotation of both models has no statistical significance.</p><p><b>CONCLUSIONS</b>Adolescent idiopathic scoliosis can lead to the anatomical changes of the vertebra and the thoracic cage. The corresponding changes of biomechanical features of the scoliotic spine and rib cage would occur. The deformed thoracic cage could not maintain the rotation stability as the normal one.</p>

Combined pedicle subtraction osteotomy and polysegmental closing wedge osteotomy for correction of the severe thoracolumbar kyphotic deformity in ankylosing spondylitis / 中华外科杂志

<p><b>OBJECTIVE</b>To study retrospectively the efficacy and complications of combined pedicle subtraction osteotomy (PSO) and polysegmental closing wedge osteotomy for correction of the severe rigid thoracolumbar kyphotic deformity in ankylosing spondylitis (AS).</p><p><b>METHODS</b>A total of 8 consecutive male patients with AS and severe thoracolumbar kyphotic deformity (mean age 32 years, range 28 - 46) were involved in this study from August 2004 to June 2007. The average preoperative Cobb angle of thoracic spine (T(1)-T(12)) was 96 degrees (range, 80 degrees - 112 degrees ), the mean preoperative angle of lumbar lordosis (L(1)-S(1)) was 10 degrees (5 degrees - 15 degrees ). The mean chin-brow angle was 47 degrees (range, 40 degrees - 58 degrees ). The average gaze angle was 43 degrees (range, 32 degrees - 50 degrees ). After preoperative assessment, single-level PSO was performed in L(3) vertebrae and two-level polysegmental closing wedge osteotomy was performed in thoracolumbar vertebrae (T(12)-L(1), L(1-2)). Radiographic and clinical results and complications were assessed.</p><p><b>RESULTS</b>The surgical time was (298.1 +/- 20.7) minutes and blood loss during the procedure was (1588.8 +/- 171.6) ml. The follow-up period was (11.5 +/- 7.7) months. The postoperative angle and the amount of correction of the thoracic and lumbar spine were 76.1 degrees +/- 9.6 degrees , 20.3 degrees +/- 1.1 degrees and 48.4 degrees +/- 4.7 degrees , 38.4 degrees +/- 4.7 degrees respectively. The postoperative chin-brow and gaze angle was 16.5 degrees +/- 4.6 degrees and 73.0 degrees +/- 5.2 degrees , respectively. The amount of correction for sagittal balance was (12.3 +/- 1.6) cm. No nerve, vascular injury, stress fracture and coronal decompensation occurred in the patients.</p><p><b>CONCLUSIONS</b>Combined PSO and polysegmental closing wedge osteotomy by posterior approach only is safe and effective for correction of the severe rigid thoracolumbar kyphotic deformity in AS. The visual field is significantly improved after surgery.</p>

Research advance in effectiveness of bracing for adolescent idiopathic scoliosis / 上海第二医科大学学报

The role of bracing for adolescent idiopathic scoliosis,which came into application in 1960's,has long been controversial.There are various brace instrument with different reported effectiveness.In this paper,we summarize the research findings and main views in the effectiveness of bracing for adolescent idiopathic scoliosis in the past ten years,and explore the possible causes leading to the different results.Besides,we are trying to point out the research trend,in hope of drawing a scientific conclusion on the effectiveness of bracing treatment in the near future.

Application and advance of finite element method in spinal biomechanics / 上海第二医科大学学报

As a novel research tool in the field of the spinal biomechanics, the finite element method (FEM) complements and verifies the traditional research methods, which has been attached increasingly greater importance. In this paper, we briefly introduce the achievement made in the field of spinal biomechanics by FEM in the past decade, summarize the physiological and pathological behaviors of various spinal anatomical parts described by FEM, and present the basic view of using FEM to optimize the surgery instrument design.

Relationship between rotatioanal deformity and operational correction rate in scoliosis / 上海第二医科大学学报

Objective To study the relationship between rotational deformity and operational correction rate in scoliosis. MethodsFrom January 2005 to December 2006,44 cases of adolescent idiopathic scoliosis with operational correction were reviewed.Before operation,all the patients were performed MRI scan of the whole spine and the rotation angle of superior and inferior endplate of nine vertebraes with the center of apical vertebrae were measured so that the mechanical torsion angle of vertebrae and disc were calculated,and the rotation compliance of the spine was obtained.In addition,preoperative plain,lateral and bending film of thoracic-lumbar vertebrae were taken to measure the Cobb angle,and the items above were compared with those of post-operation to calculate the scoliosis flexibility and correction rate.Correlation analysis was conducted between the rotation compliance,flexibility and operational correction rate in scoliosis.Results There were significant differences in the mean coronal and sagittal Cobb angle before and after the operation(P