ABSTRACT
BACKGROUND: Yaotu Granules have been proved to protect human nucleus pulposus cells and delay their degeneration. Notably, Yaotu Granules for lumbar disc herniation has achieved good clinical results.OBJECTIVE: To investigate the effect of the herbal compound formula Yaotu Granules on the Fas/FasL expression in a rabbit model of lumbar disc degeneration, and further elucidate the underling mechanism of preventing and treating lumbar disc degeneration.METHODS: Twenty New Zealand white rabbits were enrolled and the models of lumbar disc degeneration were established by minimally invasive puncture and rotation cutting, followed by randomized into normal saline, low-, middle-,and high-dose groups (n=5 per group). 10 mL of normal saline, 10, 20, and 40 mL of water decoction of Yaotu Granules were administered intragastrically into the normal saline, low-, middle-, and high-dose drug groups for 21 days, twice daily, respectively. Subsequently, the expression level of Fas/FasL in the rabbit nucleus pulposus cells in each group was detected.RESULTS AND CONCLUSION: The signal intensity of the rabbit lumbar disc on MRI was decreased, and ruptured annulus and posterior herniated disc were visible at 12 weeks after modeling. Masson staining showed that the nucleus pulposus cells arranged in disorder, and even ruptured. Additionally, safranin O staining found that the number of nucleus pulposus cells was decreased obviously. The order of the relative expression levels of Fas and FasL mRNA in the nucleus pulposus cells was as follows: normal saline group > low-dose drug group > middle-dose drug group > high-dose drug group (P < 0.05). These results suggest that Yaotu Granules delay the rabbit lumbar disc degeneration by downregulating the expression level of Fas/FasL.
ABSTRACT
BACKGROUND: The age of patients with lumbar disc herniation tends to younger, and choosing which surgical method for young patients is a difficult in clinic. . OBJECTIVE: To investigate the curative efficacy and imaging characteristics of the dynamic stabilization using Bioflex System for young patients with single-level lumbar disc herniation. METHODS: Eighty patients diagnosed for single level lumbar disc herniation in Shenzhen Hospital of Chinese Medicine from October 2013 to November 2015 were randomly divided into experimental and control groups (n=40 per group). The patients in the experimental group underwent dynamic stabilization using Bioflex System, and the controls received percutaneous transthoracic discectomy. The Visual Analogue Scale and Japanese Orthopedic Association scores and Oswestry Disability Index were used to evaluate the clinical efficacy. The ventral and dorsal intervertebral disc height, distance between spinous processes, and the maximum height between intervertebral foramens were measured through digital radiography, CT and MRI examinations at baseline, 3, 6, and 12 months of follow-up. The operation time, intraoperative blood loss and complications were compared between groups. RESULTS AND CONCLUSION: (1) At 12 months postoperatively, the restoration of the ventral and dorsal intervertebral disc height, distance between spinous processes, and the maximum height between intervertebral foramens in the experimental group were significantly superior to those in the control group (P < 0.05). (2) The Visual Analogue Scale and Japanese Orthopedic Association scores and Oswestry Disability Index scores were significantly improved in both groups (P < 0.05); all above scores did not differ significantly between two groups at 3 and 6 months postoperatively (P >0.05); and all above scores in the experimental group were significantly superior to those in the control group at 12 months postoperatively (P < 0.05). (3) The operation time and intraoperative blood loss in the experimental group were significantly lower than those in the control group (P < 0.05). (4) There were no significant differences in the incidence of complications between two groups (P > 0.05). (5) These results show that although percutaneous transthoracic discectomy has advantages on the operation time and intraoperative blood loss; the two surgical methods show no significant differences in the early curative efficacy and complications. Besides, in terms of long-term efficacy, Bioflex System can significantly alleviate pain, restore intervertebral height, and prevent degeneration of the intervertebral disc and adjacent vertebrae.