ABSTRACT
OBJECTIVE@#To explore a method of modified incision to prevent the postoperative spinal lateral angulation via anterior approach for lumbar fracture.@*METHODS@#A total 40 patients with lumbar fracture from January 2016 to Jun 2017 were internalized in the study. Including 28 males and 12 females, aged from 27 to 68 years with an average of (39.5±14.9) years. Among them, 28 cases caused by high fall, 9 cases by heavy injury, 3 cases by traffic accidents; and 35 fractures were located at L₁,4 at L₂,1 at L₃. All the fractures were type A based on AO classification. According to Frankel classify of spinal cord injury, 5 cases were grade A, 1 case was B, 10 cases were C, 15 cases were D, 9 cases were E. The patients were divided randomly into modified incision groups and routine incision groups. All patients were treated with decompression, internal fixation and titanium mesh supported bone graft fusion via anterior approach. All the internal fixation materials were ANTERIOR (Medtronic Inc). Incision direction and incision plane were improved in modified incision groups. The coronal Cobb angle and the angle between the vertebral screw and the corresponding endplate were analyzed before and after operation.@*RESULTS@#Pre-and post-operative coronal Cobb angles were (1.20±3.26) °, ( 2.16±3.55)° in modified incision groups and(1.22±4.42)°, (3.91±3.78)° in routine incision groups respectively. And there was no statistical difference before operation, and there was statistical difference after operation between two groups(=0.017). There was no lateral angulation of more than 5 degrees in modified incision group, but there was lateral angulation of 5 to 10 degrees in routine incision group in 6 cases. The incidence of lateral angulation about 5 degrees after operation was significantly different between two groups (=0.010). There was significant difference in the angle between the proximal two vertebral screws and the corresponding endplate between two groups (0.05).@*CONCLUSIONS@#The improvement of incision direction and plane can effectively prevent the postoperative spinal lateral angulation via anterior approach for lumbar fracture.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bone Screws , Fracture Fixation, Internal , Lumbar Vertebrae , Spinal Fractures , General Surgery , Thoracic Vertebrae , Treatment OutcomeABSTRACT
<p><b>AIM</b>To investigate the effects of transforming growth factor-beta1 (TGF-beta1) and signal protein Smad3 on rat myocardial hypertrophy.</p><p><b>METHODS</b>The total protein was analysed by flow cytometer assay to judge the hypertrophy of myocardial cell incubated with different level of TGF-beta1 in cultured myocardial cells of neonatal rats. The models of rat cardiac hypertrophy were produced with constriction of the abdominal aorta. At the different time after the operation, the rats were killed, and the left ventricular mass indexes (LVMl) were investigated. The mRNA expressions of TGF-beta1 and Smad3 of cultured cells and hypertrophic left ventricles were assessed by RT-PCR, the protein expressions of Smad3 were assessed by Western blot.</p><p><b>RESULTS</b>In cultured neonatal myocardial cells, different level TGF-beta1 could significantly increase the total protein, and TGF-beta1 (3 ng/ml) could increase the expression of mRNA and protein of Smad3 and continued for 8 h of cultured cardiomyocytes. The LVMI and the expression of TGF-beta1 mRNA and Smad3 mRNA/protein of hypertrophic left ventricle were increased at the 3rd day after the operation and continued for 4 weeks. The peak expression of them was in 2 weeks after operation.</p><p><b>CONCLUSION</b>TGF-beta1 has the effects on rat myocardial hypertrophy, signal protein Smad3 is included in the pathologic progress of rat myocardial hypertrophy.</p>