ABSTRACT
BACKGROUND:For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate. OBJECTIVE:To evaluate the short-term efficacy of the treatment of young adult lumbar disc herniation through the technology of the posterior Waveflex non-fusion pedicle screw elastic fixed smal window nucleus pulposus extirpation associated with annulus repair. METHODS: Thirty-eight patients with lumbar disc herniation were involved in this study, among which, 18 cases in the elastic fixation group were subjected to a posterior lumbar smal window nucleuspulposus extraction along with annulus repair together bound with Waveflex elastic fixation; the rest 20 cases in the nucleus pulposus removal group underwent simple nucleus pulposus extirpation. After these operations, a series of folow-up study was conducted, including: folow-up analysis of clinical efficacy and complications, colection of low-back pain visual analogue scores, colection of Japanese Orthopaedic Association scores (JOA), regular assessment of Oswestry dysfunction index, and reevaluation of the lumbar lateral radiographs related indicators. RESULTS AND CONCLUSION:Folow-up visits to the patients were conducted 12-20 months later since the operations. Both groups showed a better performance than before treatment in the pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain (P < 0.05) during the last visit. The pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain in the dynamic fixation group were superior to those in the nucleus pulposus removal group (P <0.05). Stil in the last folow-up, operative segment disc height in the dynamic fixation group was greater than that before treatment, and the operative segment range of motion was smaler than that before treatment (P <0.05). These results suggest that compared to nucleus pulposus removal, Waveflex system associated with nucleus pulposus excision annulus repair has a more satisfactory effect in the early recovery of lumbar spine function and exerts a positive effect on the stability of the operated segments in the treatment of lumbar protrusion of the intervertebral disc in young adults.
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BACKGROUND:Spinal posterior surgery is the most common treatment method for thoracolumbar fracture. During exposure of conventional posterior surgery, a wide-range stripping and pul ing of paraspinal muscles easily induced failure syndrome of lumbar surgery. OBJECTIVE:To compare the reset conditions and stability of thoracolumbar fractures after treatment with pedicle screw paraspinal muscle approach and conventional posterior median approach fixation. METHODA total of 62 patients with thoracolumbar fractures without nerve injury were retrospectively analyzed. 22 patients were treated with paraspinal muscle approach and general spine system. 21 patients were treated with conventional median approach and general spine system. 19 patients were treated with conventional median approach and AF internal fixation system. The therapeutic effects of the three kinds of fixation methods were compared by comparing clinical indexes in patients of the three groups, including operation time, intraoperative blood loss, postoperative drainage, dead space volume, scores of the Visual Analogue Scale of back pain, wound complications, height of injured vertebrae and the Cobb angle. RESULTS AND CONCLUSION:Operation time, intraoperative blood loss, postoperative drainage and dead space volume were better in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group (P0.05). No significant difference in scores of the Visual Analogue Scale of back pain was visible among the three groups at 1 week after fixation (P>0.05). The scores of the Visual Analogue Scale of back pain were apparently lower in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group at 3 and 6 months after fixation. No incision infection was observed in patients of the three groups. These results suggested that compared with conventional posterior median approach, paraspinal muscle approach has some advantages, such as smal trauma, less bleeding, postoperative rapid recovery, and high degree of satisfaction. The effects of general spine system and AF internal fixation system in the repair of thoracolumbar fractures on internal fixation are similar, but general spine system has some advantages such as simple to be operated, save time, less bleeding, stable fixation and good reduction. General spine system combined with paraspinal muscle approach is a good method to repair thoracolumbar spine fracture.
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ObjectiveTo study the impact of EZH2 silence on the sensitivity of human hepatic multidrug-resistant cancer cells Bel/Fu to 5-Fu.MethodsBel/Fu cells were cultured in vitro; EZH2 siRNA was used to interfere EZH2 expression; RT-PCR and Western blot was used to detect the efficiency of interference.MTT assay was used to detect the cellular growth inhibitory rate; Annexin V-FITC/PI double staining was used to detect the apoptosis rate of cells ; Flow cytometry was to analyze cell cycle ; Western blot analysis was used to detect the expression of multidrug resistance-associated protein MDR1 after silencing EZH2.The experiment set up four groups:control group,5-Fu treatment group,EZH2 siRNA treatment group,5-Fu combined with EZH2 siRNA treatment group. ResultsThe expression of EZH2 was greatly decreased after 24 h in the combined group,the apoptotic inhibitory rate by MTT was 43.17％ ± 3.81％,higher than other three groups; the apoptotic rate in the combined group by Flow cytometry was 30.4％ ± 1.77％,markedly higher than other three groups.The cell cycle of the combined group detected by Flow cytometry was 69.16％ ±2.31％ of cells in the combined group at G1 phase,the percentage was higher than other three group,30.76％ ± 1.29％ at S,G2 and M phases,lower than other three groups,indicating the cell cycle was blocked at G1 phase.MDR1 protein level in the combined group was lower than other groups.ConclusionsSilencing EZH2 strengths the sensitivity of Bel/Fu cells to 5-Fu,probably by a mechanism decreasing the expression of MDR1.
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Objective To summarize the surgery effect of removal of tuberculum sellae meningiomas by anterior interhemispheric approach.Methods The data of 18 cases of removal of tuberculum sellae meningiomas by anterior interhemispheric approach were analyzed retrospectively.Results Simpson grade Ⅰ resection was achieved in 5 cases;grade Ⅱ in 10 cases and grade Ⅲ in 3 cases.15 patients were followed up for 6 months to 7 years,3.1 years on average.6 patients recovered normal ability in work and life,6 patients' symptom was improved after sugery,3 patients' postoperative visual acuity remained unchanged,2 patients got the result of medium disability and 1 patient died.Conclusion Large tuberculum sellae meningiomas that grows anteriorly and superiorly can be well exposed through anterior interhemispheric approach,the amount of page pull is reduced,so the satisfactory sugical effect can be achieved.
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Objective To evaluate guglidnai detachable ceil(GDC)embolization therapy in treatment of acnte stage ruptured aneurysms.Methods 86 patients were involved in our study,we treat aneurysms with different intravascular therapy techniques,anti-artery-spasm treatment and lumber centesis were performed after therapy.Resuits 72 patients received 100% embolization,10 patients received 95% embolization,4 patients received 90% embolization,no patient died due to therapy in follow-up,further function recover was found.Conclusion Acute stage intravascular therapy combined with comprehensive measures can effectively improve the outcome of patients with ruptured aneurysms.