Difference of spino-pelvic sagittal alignment between lumbar disc herniation and lumbar canal stenosis in adults / 中国骨伤

<p><b>OBJECTIVE</b>To study the difference of spino-pelvic sagittal alignment between lumbar disc herniation(LDH) and lumbar canal stenosis(LCS) in adults.</p><p><b>METHODS</b>The integrated imaging data of 88 patients with lumbar disc herniation (42 cases) or lumbar canal stenosis(46 cases) were searched from January 1, 2015 to September 10, 2016 in our hospital.Twenty-two cases were excluded because of age factor, 36 cases of LDH (LDH group) and 30 cases of LCS (LCS group) were internalized in the study. The spino-pelvic parameters were measured including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), thoracolumbar junction (TLJ), sagittal vertical axis (SVA), sagittal vertical axis location (SVA-Location), T₁-spinopelvic inclination (T₁-SPI), T9-spinopelvic inclination (T₉-SPI). Independent sampletest was used in order to analyze the above data.</p><p><b>RESULTS</b>Thoracic kyphosis (TK) in LDH group was smaller than that of LCS group (difference was about 6 degree), there was significant difference between two groups (=0.031). And there were no significant differences in other parameters between two groups (>0.05).</p><p><b>CONCLUSIONS</b>The patients with lumbar disc herniation, the kyphosis of the thoracic spine is smaller, the truncus prones to the straight. The lumbar kyphosis is greater in patients with lumbar spinal stenosis, and the sagittal curvature of the lumbar spine is more obvious.</p>

Research progress of the mechanism of repairing bone defect with PRP / 中国骨伤

Platelet-rich plasma (PRP) is a kind of plasma with high concentration of platelet,which includes a lot of growth factors. It was widely used in oral and maxillofacial surgery and orthopedics, for the repairing of bone, cartilage and soft tissues. The growth factors, especially PDGF and TGF-beta, plays an important role in different stages and aspects.

Clinical application and advancement of artificial intervertebral discs for lumbar degenerative disease / 中国骨伤

Degenerative disc disease is not only a common disease in the area of spinal surgery, but also one of the main reasons for the low back pain of the adults and disability. Conventionally it was considered be affirmative for the effect of the lumbar spinal fusion. But the way retained the physiological motor function. The lumbar motion segment fusion accelerated degeneration of adjacent segment disc and facet joint. Further study of lumbar functional anatomy and biomechanics made development of modern artificial disc device of different structures and materials possible. Besides the lumbar fusion, artificial lumbar disc replacement has become another choice in treating the lumbar degenerative diseases. The purpose is to release the pain which caused by the degenerative disc for a long period and to reconstruct the height of intervertebral disc in order to protect the nerve tissue. Retaining the spinal movement was in order to avoid degeneration of facet joints and adjacent segments, then, restore the spinal characteristic of kinematics and load at last. This review aims to explain the type of artificial lumbar intervertebral disc, the field of research and its clinical application advancement and prospects.

Changes in the expression of platelet-derived growth factor in astrocytes in diabetic rats with spinal cord injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Prospective mortality studies in the United States revealed that the mortality was elevated in diabetics compared to normal individuals following chronic spinal cord injury (SCI). Our study was conducted to investigate the levels of platelet-derived growth factor (PDGF) of astrocytes in SCI in streptozotocin (STZ)-induced diabetic rats.</p><p><b>METHODS</b>Thirty male Sprague-Dawley (SD) rats were randomly divided into 3 groups: SCI group, diabetic SCI group, and sham operation control group. We employed STZ-induced diabetic SD rats and a weight-drop contusion SCI model. The rats were sacrificed on day 7 after the induction of SCI. Immunohistochemistry and Western blotting analysis were used to detect the PDGF expression level. Basso, Beattie and Bresnahan locomotor rating scale (BBB) was also used to evaluate the neurological recovery level of the rats.</p><p><b>RESULTS</b>PDGF positive astrocyte numbers were significantly higher and PDGF staining was more intensive in astrocytes in the SCI group than in the diabetic SCI group (P < 0.05). The diabetic SCI group showed a slower recovery of motor function with a lower BBB score 7 days after acute spinal injury.</p><p><b>CONCLUSIONS</b>PDGF is an important factor for the recovery of neurological function after acute spinal injury and hyperglycemia in diabetic rats could depress the expression of PDGF in injured spinal cord. This may help to explain the slower recovery and higher mortality in diabetics after SCI.</p>

Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury.</p><p><b>STUDY DESIGN</b>We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax.</p><p><b>METHODS</b>Experiments were conducted in male Sprague-Dawley rats (n=78) weighing 300-400 g. The spinal cord was compressed posteriorly at T10 level using a custom-made screw for 6 h, 24 h or continuously, followed by decompression by removal of the screw. The rats were sacrificed on Day 1 or 3 or in Week 1 or 4 post-decompression. The spinal cord was removed en bloc and examined at lesion site, rostral site and caudal site (7.5 mm away from the lesion).</p><p><b>RESULTS</b>The numbers of TUNEL-positive cells were significantly lower at the site of decompression on Day 1, and also at the rostral and caudal sites between Day 3 and Week 4 post-decompression, compared with the persistently compressed group. The numbers of cells between Day 1 and Week 4 were immunoreactive to caspase-3 and B-cell lymphoma-2 (Bcl-2)-associated X-protein (Bax), but not to Bcl-2, correlated with those of TUNEL-positive cells.</p><p><b>CONCLUSION</b>Our results suggest that decompression reduces neural cell apoptosis following spinal cord injury.</p>

Effect of static magnetic field on deep wound healing of SD rats / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effect of static magnetic field on deep wound healing of SD rats and VEGF during the wound healing and different strength static magnetic field on deep wound healing of SD rats.</p><p><b>METHODS</b>Divided forty-eight SD rats into three groups: 0.16 T magnetic disk treatment (0.16 T group), 0.32 T magnetic disk treatment (0.32 T group), control group. General wounds healing situation was observated on the 3, 6, 9, 12 day. The area of every wound was calculated. The tissue of granulation was dyeing by immune tissue chemical decoration method, in which VEGF protein content with its range in tissue was measured.</p><p><b>RESULTS</b>The healing index of 0.16 T magnetic group wounds were larger than that of control group on 6th and 9th day, there were statistical difference. The healing index of 0.32 T magnetic group wounds were larger than that of control group on 3rd, 6th, 9th and 12th day, there were statistical difference. The healing index of 0.32 T group wounds contrasted to that of 0.16 T group wounds had no statistical significance. Observation of VEGF at the course of wound healing:the expressing of VEGF in magnetic group wounds on 3rd and 6th was stronger than in control group wounds, there were statistical difference. While there were no obvious difference between them on 9th and 12th day (P>0.05). But the contrast between that in 0.32 T group and in 0.16 T group had no statistical difference. The expressing strength of VEGF in magnetic group reached the peak amplitude on the 6th day, and that in control group reached peak amplitude on 9th day. And the peak amplitude of magnetic group was stronger than that of control group.</p><p><b>CONCLUSION</b>Static magnetic disc of 0.16T and 0.32 T can promote deep wound of SD rats heal. The mechanism of static magnetic field promoting wound heal may be relative to the expressing highly of VEGF during early and middle time.</p>

Diagnosis and treatment of odontoid fracture combined with lower cervical spinal injury / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the mechanism, clinical features and treatment of odontoid fracture combined with lower cervical spinal injury.</p><p><b>METHODS</b>From January 1999 to December 2004, 57 cases of type II or shallow type III odontoid fractures were studied retrospectively. Six cases were found combined with lower cervical injury, the mean age was 54 years, and 4 of the 6 cases were complicated with cervical spondylarthrosis or ankylosing spondylitis. For the lower cervical injury, fracture-dislocation was found in 2 cases, the disruption of disc and ligament was found in 4 cases among which 2 cases were suffered from incomplete spinal cord injury; Both were caused by lower cervical spinal injury. All of the 6 cases were performed with surgery in odontoid fracture and lower cervical spinal injury simultaneously; Lower cervical spinal injuries were stabilized firstly in 2 cases, which responsible for neurological involvement; For the other 4 cases without neurological involvement, stabilization was performed in odontoid fracture firstly in 2 cases, due to inability to achieve reduction of odontoid fracture preoperatively, however, for the another 2 cases with anatomic reduction of the odontoid fracture preoperatively, lower cervical injuries were stabilized firstly.</p><p><b>RESULTS</b>After an average follow-up of 10 months, all cases were obtained solid fusion both in odontoid fracture and lower cervical spinal injury, and without the complications associated with operation and prolonged bed rest. Two cases with neurological defect improved 1 scale in Frankel score.</p><p><b>CONCLUSIONS</b>The incidence of odontoid fracture combined with lower cervical spinal injury is about 10.5% of the odontoid fracture, and it is vulnerable in the elderly patient with cervical spondylarthrosis. MRI should be used routinely for accurate diagnosis. Surgical stabilization is the choice of treatment due to facilitating early rehabilitation and reducing the complications. The surgical schedule is planned according to the fact of neurological involvement and the extent of stability between the odontoid fracture and lower cervical spinal injury.</p>