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1.
Neuroscience Bulletin ; (6): 1469-1480, 2021.
Article in English | WPRIM | ID: wpr-922634

ABSTRACT

Effective methods for visualizing neurovascular morphology are essential for understanding the normal spinal cord and the morphological alterations associated with diseases. However, ideal techniques for simultaneously imaging neurovascular structure in a broad region of a specimen are still lacking. In this study, we combined Golgi staining with angiography and synchrotron radiation micro-computed tomography (SRμCT) to visualize the 3D neurovascular network in the mouse spinal cord. Using our method, the 3D neurons, nerve fibers, and vasculature in a broad region could be visualized in the same image at cellular resolution without destructive sectioning. Besides, we found that the 3D morphology of neurons, nerve fiber tracts, and vasculature visualized by SRμCT were highly consistent with that visualized using the histological method. Moreover, the 3D neurovascular structure could be quantitatively evaluated by the combined methodology. The method shown here will be useful in fundamental neuroscience studies.


Subject(s)
Animals , Imaging, Three-Dimensional , Mice , Neural Networks, Computer , Spinal Cord/diagnostic imaging , Synchrotrons , X-Ray Microtomography
2.
Article in English | WPRIM | ID: wpr-922595

ABSTRACT

OBJECTIVES@#The measurement of diabetic foot ulcers is important for the success in diabetic foot ulcer management. At present, it lacks the accurate and convenient measurement tools in clinical. In recent years, artificial intelligence technology has demonstrated the potential application value in the field of image segmentation and recognition. This study aims to construct an intelligent measurement model of diabetic foot ulcers based on the deep learning method, and to conduct preliminary verification.@*METHODS@#The data of 1 042 diabetic foot ulcers clinical samples were collected. The ulcers and color areas were manually labeled, of which 782 were used as the training data set and 260 as the test data set. The Mask RCNN ulcer tissue color semantic segmentation and RetinaNet scale digital scale target detection were used to build a model. The training data set was input into the model and iterated. The test data set was used to verify the intelligent measurement model.@*RESULTS@#This study established an intelligent measurement model of diabetic foot ulcers based on deep learning. The mean average precision@.5 intersection over union (mAP@.5IOU) of the color region segmentation in the training set and the test set were 87.9% and 63.9%, respectively; the mAP@.5IOU of the ruler scale digital detection in the training set and the test set were 96.5% and 83.4%, respectively. Compared with the manual measurement result of the test sample, the average error of the intelligent measurement result was about 3 mm.@*CONCLUSIONS@#The intelligent measurement model has good accuracy and robustness in measuring the diabetic foot ulcers. Future research can further optimize the model with larger-scale data samples.


Subject(s)
Artificial Intelligence , Diabetes Mellitus , Diabetic Foot , Humans
3.
Article in Chinese | WPRIM | ID: wpr-863198

ABSTRACT

Hair loss is a common problem encountered by both male and female in social life. A variety of systemic diseases, skin diseases, trauma, etc. can lead to hair loss, but androgenetic alopecia is its main cause. Hair loss can cause a series of influences, such as affecting one's self-esteem and emotional health. Healthy and beautiful hair is very important for a person's external image, and the external image can affect a person's work and life to some extent. Hair transplantation surgery has gradually evolved, and its surgical effect is remarkable. However, hair transplantation technology is still not perfect and still faces many challenges, including the supply of hair, the survival rate of the hair, the length of the operation and the concealment of marks after the operation. In this paper, the current status of hair transplant surgery and some important challenges and possible solutions were discussed.

4.
Article in Chinese | WPRIM | ID: wpr-608996

ABSTRACT

Objective To explore the association between the genetic polymorphism of CYP3A4,CYP2D6 and response to methadone maintenance treatment(MMT)among heroin-dependent patients.Methods Patients undergoing MMT in 6 MMT clinics were randomly selected,information about general socia-demographic characteristics,drug abuse history,and MMT data of patients were collected,genotypes of peripheral blood CYP3A4 and CYP2D6 polymorphic loci were detected.Results A total of 820 patients were enrolled in the study,210 cases were with good response and 610 cases with poor response to MMT.Difference in age between different response groups was statistically significant(P0.05).Conclusion The association between CYP3A4 rs2242480,CYP2D6 rs16947 and response to MMT has not yet found in heroin-dependent patients.

5.
Article in Chinese | WPRIM | ID: wpr-814954

ABSTRACT

OBJECTIVE@#To explore the clinical value of early and one-stage posterior laminectomy decompression, fracture reconstruction and lateral mess screw fixation combined with anterior cervical corpectomy or discectomy for the treatment of fresh and severe lower cervical spine fracture and dislocation.
@*METHODS@#A total of 156 consecutive cases of severe fracture and dislocation of lower cervical spine were reviewed from January 2008 to January 2015. Skull traction was installed when the patients were enrolled in the hospital, so the operation was performed as early as possible. Firstly, the posterior procedure was applied to the patients prone on a frame. A standard posterior laminectomy, fixation and fusion were performed with lateral mass screws and rods. The cervical spine reconstruction was achieved by laminecomy, partially facetectomy, leverage and distraction. The technique of rotating rod was applied to recover the sequence of the cervical and keep or increase the zygopophysis and lordosis of the cervical on the sagittal plane. After the skull traction removed, a standard anterior approach to the cervical spine was initiated as the second stage of the procedure. Anterior cervical corpectomy or discectomy, spinal cord decompression, antograft and cervical spine auto-locking plate fixation were carried out. The stability, the fusion rate of the injured segments and spinal cord decompression were observed on the regular postoperative X-ray film and CT scan. The function of the spinal cord was evaluated by American Spinal Injury Association (ASIA) classification.
@*RESULTS@#A total of 137 cases were followed-up, 19 failed to follow-up and 8 of them were due to death. The follow-up time was from 9.0 months to 35.0 months (mean: 13.7 months). All patients got completely reduction of the cervical spine. The injured segments were stable. There was no patient of bone graft no-fusion. The cervical intervertebral height and lordosis were reconstructed and maintained and all grafts were fused at the end of follow-up period. There was no complication related to internal fixation breakage, loosening or displacement. There was also no neurovascular and esophagus complications during the operation. Twelve patients complained neck pain at the final follow-up. There were 12 cases of wound infection and 12 cases of neck inflammatory. They were healed after anti-inflammatory therapy. There were 13 cases of cerebrospinal fluid leakage, and they were healed after the symptomatic treatment. The neuro-function of most patients was improved, and ASIA classification was improved by 1 to 2 grade.
@*CONCLUSION@#Early and one-stage posterior-anterior decompression and reconstruction for the patients with fresh and severe lower cervical spine fracture and dislocation can achieve good reduction and cervical alignment of cervical spine. The injured segments can gain postoperative immediate stability. It also gives a completely decompression, which is benefit to the patients for nursing, functional exercise, and the functional recovery of the spinal cord.


Subject(s)
Bone Plates , Bone Screws , Bone Transplantation , Cervical Vertebrae , Decompression, Surgical , Diskectomy , Fracture Fixation, Internal , Humans , Joint Dislocations , Laminectomy , Reconstructive Surgical Procedures , Spinal Fractures , Tomography, X-Ray Computed , Traction
6.
Chinese Journal of Orthopaedics ; (12): 641-650, 2016.
Article in Chinese | WPRIM | ID: wpr-493607

ABSTRACT

Objective To compare the minimum 5?year follow?up outcomes of surgical management by posterior only ap?proaches, anterior only approaches and combined posterior and anterior approaches for thoracic tuberculosis in adults, and evalu?ate the mid term follow?up results of posterior only approaches. Methods All of 184 patients with monosegment thoracic tubercu?losis between January 2003 and November 2010 were studied retrospectively. Among these patients, 62 cases were treated with posterior debridement combine with interbody fusion (PO group), 65 cases were treated by posterior instrumentation, anterior de?bridement and bone graft in one or two?stage procedures (AP Group ), and 57 cases were treated by anterior only approach (AO Group). The operation time, blood loss, Visual Analogue Scale, complications, recovery of neurological function, kyphosis angle, correction rate and loss angle were respectively compared between each group. Results Comparison of postoperative curative ef?fects showed:mean operation time and blood loss:PO group (260.05±30.75 min,735.95±161.43 ml) was better than AP group (411.65 ± 55.61 min, 1178.65 ± 184.50 ml)and AO group (343.65 ± 24.74 min, 965.35 ± 122.59 ml);corrective angle and correction rate:PO group (6.78°±1.13°, 72.48%±12.97%) and AP group (6.97°±1.05°, 73.10%±11.42%) were better than AO group (13.98°± 1.73°, 44.95%±16.84%);bed time:PO group and AO group were shorter than AP group. Mid term follow?up outcomes showed:ky?phosis angle and loss angle:PO group (8.56°±1.09°, 1.89°±1.41°) and AP group (8.55°±1.65°, 1.63°±1.11°) were better than AO group (16.39°±1.59°, 2.80°±1.29°);bone fusion time, VAS and recovery of neurological function:there were no statistically differ?ence in all groups. Conclusion The mid term follow?up outcomes of posterior debridement combined with interbody fusion is sat?isfied in the management of monosegment thoracic tuberculosis. It is a safe and effective method.

7.
Article in Chinese | WPRIM | ID: wpr-491472

ABSTRACT

The paper introduced the general picture of Xiangya Hospital in the past five years in its development of ahigh-level research hospital of international influence.Aiming at this strategic goal, the hospital proceeds by means of discipline development,talent training,research platform building, international academic exchange,performance appraisal and incentive,budget guarantee and system development.All these efforts contribute to the building of a mutual-supportive,efficient and sustainable medical science innovation system tailored to large hospitals.

8.
Article in Chinese | WPRIM | ID: wpr-815178

ABSTRACT

OBJECTIVE@#To investigate the strategies of posterior short-segment fixation and plant iliac fusion surgery, and the clinical efficacy of them on the treatment of upper cervical vertebra trauma.@*METHODS@#Three hundred and thirty-four patients with upper cervical vertebra trauma admitted into our hospital from June, 2005 to April, 2010 were studied retrospectively. Thirty-six were treated by posterior short-segment fusion, which included 22 and 14 male and female patients, respectively. Among them, 23 or 6 patients were related to traffic or falling accident, 5 or 2 patients were related to crashing object or fight. The clinical efficacy was evaluated by head and neck pain VAS score, JOA scores of nerve function and the rate of graft bone fusion.@*RESULTS@#The postoperative VAS scores were lower than that of pre-operation, and the difference was significant (P<0.001). The postoperative JOA scores of nerve function was superior to preoperative scores (P<0.05). During follow-up, no internal fixation failure happened while bony fusion could be seen.@*CONCLUSION@#The method of posterior short-segment fixation and bone graft fusion in treating patients with cervical spine injury is highly efficacy, which possesses great clinical value.


Subject(s)
Bone Transplantation , Cervical Vertebrae , Wounds and Injuries , Female , Fracture Fixation, Internal , Humans , Male , Reconstructive Surgical Procedures , Retrospective Studies , Spinal Fusion , Treatment Outcome
9.
Article in Chinese | WPRIM | ID: wpr-484907

ABSTRACT

BACKGROUND:Propagation phase contrast tomography can greatly improve the spatial resolution of chondrocytes and microvessels depending on the high colimation and high coherence performance of hard X-ray. OBJECTIVE: To detect the alteration of angioarchitecture after spinal cord injury in rats using propagation phase contrast tomography. METHODS: Eight male Sprague-Dawley rats were divided into two groups: in experimental group, an acute spinal cord injury model was induced in rats by the modified Alen’s method; in sham control group, rats were subjected to laminectomy. At 1 day after operation, normal and injured spinal cord segments were taken and treated with formaldehyde-methyl salicylate sequentialy for 48 hours. The segments were scanned by propagation phase contrast tomography in BL13W1 beamline experimental station of Shanghai Synchrotron Radiation Facility, China. Harvested data were analyzed by VGStudio Max 2.1 software for three-dimensional reconstruction and microvasculature quantitative analysis. RESULTS AND CONCLUSION:The propagation phase contrast tomography successfuly simulated the morphology of angioarchitecture folowing spinal cord injury. After acute spinal cord contusion, the destruction of nerve tissues was accompanied by severe microvasculature damage. Intramedulary tissue damage and loss of blood supply was spread from the central zone to the ends. Three-dimensional microvascular quantitative data showed that after spinal cord contusion, the number of microvessels and vascular perfusion volume drasticaly reduced (P < 0.01). These findings indicate that the propagation phase contrast tomography without angiography has potential as a new ultra high-resolution visualization technique for three-dimensional microvessel imaging and quantitative analysis.

10.
Article in Chinese | WPRIM | ID: wpr-467095

ABSTRACT

Objective: To investigate the clinical efficacy of two different anterior cervical surgeries in treatment of multi-segmental cervical spondylosis. Methods: A total of 86 patients with multi-segmental cervical spondylosis were treated by anterior cervical surgery procedure. Among them, 62 and 24 cases were involved in three and four gap, respectively. Each patient underwent the surgery of long or segmented anterior cervical decompression and fixation. Preoperative and postoperative cervical curvature change, internal if xation stability, fusion rate and nerve function were evaluated. Results: All patients were successfully completed the operation, segmented surgery showed better cervical lordosis recovery, but there were no significant difference between long and segmented anterior cervical surgery in blood loss and recovery of neurological function (P>0.05). Conclusion: The segmented anterior cervical surgery has advantages in the treatment of multi-segmental cervical spondylosis.

11.
Article in Chinese | WPRIM | ID: wpr-814828

ABSTRACT

OBJECTIVE@#To analyse the effect of low intensity pulsed ultrasound stimulation (LIPUS) on accelerating the fibrocartilage layer repair of patella-patellar tendon junction.@*METHODS@#A total of 60 mature female New Zealand white rabbits undergoing standard partial patellectomy were divided into 2 groups randomly. The control group was given comfort treatment and the treatment group was given LIPUS treatment starting from day 3 to the end of week 6 postoperatively. The scheduled time points of animal euthanization would be at week 6, week 12 and week 18 postoperatively. The patella-patellar tendon (PPT) complex would be harvested and cut into sections after decalcification for H&E staining, Safranine o/fast green staining. The thickness and gray value of fibrocartilage layer were analyzed by SANO Microscope Partner image analyzer.@*RESULTS@#At week 6, week 12 and week 18 postoperatively, the fibrocartilage layer in the treatment group was significantly thicker than that in the control group (P<0.01), and the gray value of fibrocartilage layer was significantly smaller than that in the control group (P<0.01).@*CONCLUSION@#LIPUS helps to accelerate the fibrocartilage layer repair of patella-patellar tendon junction in rabbit models.


Subject(s)
Animals , Female , Fibrocartilage , Pathology , Patella , General Surgery , Patellar Ligament , Wounds and Injuries , Pathology , General Surgery , Rabbits , Tendon Injuries , Therapeutics , Ultrasonic Therapy , Methods , Wound Healing , Physiology
12.
Article in Chinese | WPRIM | ID: wpr-814736

ABSTRACT

OBJECTIVE@#To determine the effect of tetramethylpyrazine (TMP) on the expression of migration inhibitory factor (MIF) in acute spinal cord injury (ASCI) in rats.@*METHODS@#Allen's weight-drop method was used to establish a rat model of ASCI at T10. A total of 110 adult SD rats were divided into a sham operation group (group S, n=10), a control group (group C, n=50), and a TMP group (group T, n=50). Spinal cord functionality was measured by a modified Rivilin loxotic plate degree, BBB score, and combined behavioral score (CBS) at 1, 3, 5, 7, 14 and 21 d postoperatively. The injured spinal cord tissue samples were harvested at 1, 3, 6, 12 h and 1, 3, 5, 7, 14, 21 d postoperatively (n=5 at each time point) and used to prepare continuous histological sections, in which the expression of MIF was analyzed by immunohistochemistry.@*RESULTS@#The degree in group T measured by modified Rivlin loxotic plate test after the ASCI was significantly higher than that in group C at 7, 14, and 21 d (P<0.05). BBB score in group T was significantly higher than that in group C at 5, 7, 14, and 21 d after the ASCI (P<0.05). CBS score in group C was significantly higher than that in group T at 5, 7, 14, and 21 d after the ASCI (P<0.05). The significantly low number of MIF positive cells was shown in group T when compared with that in group C at 12 h and 1, 3, 5, 7 d after the ASCI (P<0.05). As time passed, there was negative correlation between modified Rivlin loxotic plate degree and MIF expression and also between BBB score and MIF, and there was positive correlation between CBB score and MIF expression.@*CONCLUSION@#TMP has protective effect after the ASCI, and may promote the repair of injured spinal cord tissues. TMP may decrease the MIF expression in cells after the ASCI.


Subject(s)
Animals , Immunohistochemistry , Intramolecular Oxidoreductases , Metabolism , Macrophage Migration-Inhibitory Factors , Metabolism , Pyrazines , Pharmacology , Rats , Rats, Sprague-Dawley , Spinal Cord Injuries , Metabolism
13.
Journal of Medical Biomechanics ; (6): E159-E165, 2012.
Article in Chinese | WPRIM | ID: wpr-803959

ABSTRACT

Objective To study three-dimensional feature of the thickness of subchondral cortical bone, the surface area and space width of the facet joints as well as its morphological characteristics and variation, and to compare the differences of these parameters in patients with low back pains and healthy people, based on three dimensional reconstruction images of the facet joints. Methods CT scanning from L1/2 to L5/S1 at supine position was performed on 90 subjects to obtain two-dimensional images of the facet joints and three-dimensional point-cloud data of the subchondral cortical bone, the surface area and space width of the facet joints after reconstruction. Distributions of these parameters between the superior and inferior facet joints and at different regions of the articular process were investigated, and differences of these parameters in lumbar segments, gender, age and symptoms were also compared. Results (1)At superior facet, the largest thickness was located at the cranial region, while at inferior facet, it was located at the caudal region. The thickness of subchondral cortical bone was significantly smaller at central region than at the other regions. A more obvious difference could be observed at the lower lumbar levels(L4/5, L5/S1). (2)The average surface area of the facet joints was (173.2±3.6) mm2, and it was increased with the lumbar level and age increasing, especially at the L4/5 level and at the age of more than 40. The surface area of superior facet joints was significantly larger than that of inferior facet joints for patients with low back pains (except at L5/S1 level), who had an obviously larger surface area of the facet joints than healthy people. (3)The average thickness of space width of the facet joints was (1.46±0.08) mm, and it was decreased with age decreasing, especially at the age of more than 40. The female had significantly larger space width than the male, while patients with low back pains had significantly smaller space width. At each facet joint, the space at cranial region was significantly larger than that at caudal region, and it was also significantly larger at central region than at surrounding region. These differences were more obvious at the lower three lumbar levels. Conclusions Computer-assistant image processing and reconstruction analysis techniques can accurately measure the relative parameters of lumbar facet joints with complicated structure in three dimensional space. The feature of the facet joints was correlated with shape of the facet joint surface,stress on the joint and degeneration of the joint, so it was a reflection of adaptive changes in human body structure due to the long-term loading on the facet joint.

14.
Article in Chinese | WPRIM | ID: wpr-428624

ABSTRACT

ObjectiveTo evaluate the clinical effects of surgery using scar flap in situ combined with radiotherapy in 24 hours in the restorative treatment of keloids on the auricula and the preventive effects of the therapy in the recurrence of the keloids.MethodsThe scar flap in situ was designed,its size was large enough for covering the wound of the keloid on the auricula.The keloids along the designed lines were excised using local anesthesia,the flap was clipped into the one with even thickness and suitable size which covered the wound tensionlessly to ensure that the scar flap in situ survived well,and then the wound was bandaged with pressure and drained when necessary.18-24 hours after the surgery the wound was perpendicularly irradiated by the 5 MeV high energy electron beam (beta particle) of the Siemens Primus linear accelerator.After the dressing change was performed and the drain was removed; the wound was exposed to the irradiation,3-4 Gy segmentation dose per time,and the wound was then bandaged with pressure.The radiation was performed every two days and four times altogether with a total irradiation dose of 12-16 Gy.Stitches were removed 8-10 days after the surgery.ResultsThere were no avascular necrosis in the 25 scar flaps in situ and the wounds were all primary healing with normal color and fine appearance.All the patients were satisfied with the surgery.There was no recurrence of the 23 patients during the 8 to 42 months' follow-up,but there was a tendency to recur in 2 patients after 4-6 months,and the recurrence was controlled after the beta methasone was locally injected for 2-4 times.ConclusionsIt is not necessary to harvest the flaps on the other sites applying the sear flap in situ in the restorative treatment of keloids on the auricula,and therefore it prevents the formation of the keloids on the donor sites.Furthermore,the surgery is simple and the appearance of the auricula is fine,and it presents satisfactory clinical effects to irradiate the wound in 24 hours after the surgery.

15.
Article in Chinese | WPRIM | ID: wpr-413849

ABSTRACT

Objective To assess polymerase chain reaction(PCR)combined with restriction fragment length polymorphism(RFLP)and gene sequencing technologies in the detection and typing of HPV DNA.Methods Tissue specimens were collected from skin diseases and venereal disease in perianal or genitals.PCR was performed with HPV DNA general primers(MY09/11)in tissue samples. Positive fragments of HPV DNA were purified and digested by restriction enzymes.The digested fragments were typed by po]yacrylamide gel electrophoresis(PAGE).The Resultswere verified by direct sequencing.Results In 50 clinical samples there were 35 HPV DNA positive,including 26 from patients with condyloma acuminatum,8 from patients with bowenoid papulosis,and 1 from patients with squamous cell carcinoma.In HPV DNA positive samples,19 were HPV6,3 were HPV11,8 were HPV16,4 were HPV6 and HPV 11,and I was HPV62.Sequencing Resultswere in accordance with the PCR-RFLP Results .Conclusion PCRRFLP method is effective in the detection and typing of HPV DNA.

16.
Article in Chinese | WPRIM | ID: wpr-403063

ABSTRACT

BACKGROUND: Experiments has demonstrated that low-intensity pulse ultrasound stimulations(LIPUS) can accelerate bone healing. However, Its affect mechanisms on maturation of regenerated bone remain unclear.OBJECTIVE: The hypothesis that LIPUS has positive effect on maturation of regenerate bone was put forward creatively, and wants to vedfy the hypothesis by compare the difference between LIPUS intervention and no intervention.METHODS: Thlrty-six adult, healthy, New Zealand White rabbits were randomly assigned to LIPUS treatment group and control.group, with 18 animals in each group.All animals were undergone mid-diaphyeaal tibia ostactomy and were immobilized in Orthofix M103 Mini lengtheners. After a eaven-day latency period, gradual distraction of 0.5 mm per twelve hours for 10 days to produce 10 mm distraction. A 4-weeks course of LIPUS treatment was applled over the distraction site for twenty minutes daily starting immediately after the completion of distraction. At weeks 4, 8, 12 after distraction, the bone healing was evaluated by X-ray film, and total mineralized areas were measured by Image J software. The newly formed bone In the lerigthening field was harvested and stained with haematoxylin-eosin, Masson's tdchroma end VG. Thearaas of newly formed bone were measured to calculate a percentage of the total callus area.RESULTS AND CONCLUSION: Thirty-six rabbits ware included in the final analysis, At week 4 after distraction, the maturation of newly formed bone in LIPUS treatment group appeared eadier than that in the control groups. The bona callus image presented in the marginal and center region of experimental defect, increased greatly and had higher density until filled of the lengthening fields. Many bone-like masses appeared in the newly formed tissues and the tissues surrounding the bone granules partially changed Into bone-like tissues, and the rate of callus production was increased (P < 0.05). There was no significant difference between two groups at weeks 8 and 12 after distraction. Histological results showed that that new bone formation of the LIPUS group was earlier than the control group at weeks 4, 8, and 12 after distraction. The percentage of new bona on total callus area of the LIPUS group was greater than that of the control group at weak 4, but there was no obvious difference at weeks 8 and 12 after distraction. LIPUS accelerates new bone formation, increases the size of the distraction callus, exhibits highly effective in achieving maturation of bone in the animal modal with distraction osteogenesis.

17.
Article in Chinese | WPRIM | ID: wpr-402431

ABSTRACT

BACKGROUND: With deepening of spinal biomechanics, artificial lumbar disc replacement is considered to be the optimal choice for treating degenerative lumbar disease. However, studies concerning biomechanics of artificial lumbar disc are insufficient. OBJECTIVE: To establish the three-dimensional (3-D) finite element model of artificial lumbar disc replacement and to explore the effects of artificial lumbar disc replacement on zygapophyseal joints using biomechanical analysis. METHODS: Based on normal 3-D finite element model of lumbar motion segment, L4-5 intervertebral disc, superior and inferior endplates were removed, and then, the model of SB-Charite Ⅲ disc prosthesis was added, which remained annular fibrosus and ligaments at L4-5 intervertebral space. Thus, 3-D finite element model of L4-5 segments artificial lumbar disc replacement was constructed. Biomechanical analysis of this model was processed under axial load, forward flexion, lateral bending or posterior extension moments. The stress data were contrasted with the normal 3-D finite element model of artificial disc replacement. RESULTS AND CONCLUSION: After artificial lumbar disc replacement, the data of biomechanical analysis indicated: ①There was no significant differences between the zygapophyseal joint and normal segment of stress under axial load (P > 0.01).②Compared with normal segment, the stress of anterior, posterior of upper and lower vertebral body and bilateral zygapophyseal joint had no obviously difference under forward flexion and posterior extension moments (P > 0.01). ③The stress differences between the both sides of upper and lower vertebral body and bilateral zygapophyseal joint were not significant under lateral bending moment (P > 0.01). Artificial lumbar disc replacement can keep the stress of motion segment at normal level, which can meet the needs of spinal functional reestablishment.

18.
Chinese Journal of Orthopaedics ; (12): 1077-1081, 2010.
Article in Chinese | WPRIM | ID: wpr-386218

ABSTRACT

Objective To evaluate the therapeutic effect of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation for the treatment of lower thoracic disc herniation.Methods From June 2000 to June 2010,36 cases of lower thoracic disc herniation were treated with method of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation,including 23 males and 13 females,with an average of 42 years old(range,22-61 years old).The courses of disease were from 21 days to 69 months,with an average of 22 months.The lesion locations were T10-11 for 12 cases,T11-12 for 15 cases and T12L1 for 9 cases.Each of the patients underwent X-ray and MR examination,31 of them underwent CT scanning.Twenty-five cases were central protrusion type,7 cases were para-central protrusion type,4 cases were lateral protrusionstype.The clinical results were evaluated by Otanni scored system.Results The operative time was 135-220 min,with average of 155 min.The blood loss was 350-800 ml,with average of 460 ml.All patients were successfully operated without neurological symptoms aggravation and accidents.Cerebrospinal fluid leakage occurred in 12 cases,which was treated by continuous suture or dura patch repair.Two cases with giant disc herniation suffered from muscle strength decrease of lower limbs after surgery,which gradually recovered after drug treatment of hormones,dehydration,high-pressure oxygen and nerve nutrients.Postoperative X-ray examinations showed that there were no internal fixation loosening.The followed-up period was 14 days to 48 months,mean 4 months.According to Otani scored system,there were excellent results in 12 cases,good results in 18 cases and poor results in 1 case.The clinical satisfaction rate was 83.3%.Conclusion Posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation is a safe and effective surgical procedure for the treatment of lower thoracic disc herniation.

19.
Article in Chinese | WPRIM | ID: wpr-814221

ABSTRACT

OBJECTIVE@#To examine the biomechanical effect of lumbar discectomy and disc replacement on compressive load in proximal adjacent segment, to understand the characteristics of the prosthesis and effects in spine after artificial disc replacement (ADR), and to evaluate long-term clinical effect in adjacent segments.@*METHODS@#Complete human cadaveric ligamentous lumbar spine specimens were used to make 3 models: an intact sample, a discectomy sample, and a sample of ADR after the discectomy. The compressive load in proximal segment above the injury segment was measured separately in various loading cases on the 3 models.@*RESULTS@#The changes of intervertebral loads in the adjacent segments made the compressive load increase in the proximal segment after the discectomy. The compressive load in the proximal segment was lower in the ADR group than that in the injury group. There was no significant difference between the ADR group and intact group.@*CONCLUSION@#Discectomy increases the compressive load in the proximal segment, while ADR reduces it, showing the same compressive load level with the intact model in the proximal segment. Changes of compressive loading in adjacent level segments after discectomy and ADR, may be the cause of abnormal stress distribution and movements of adjacent segments, and be of benefit for the disc replacement.


Subject(s)
Adult , Biomechanical Phenomena , Cadaver , Diskectomy , Methods , Humans , Intervertebral Disc , General Surgery , Lumbar Vertebrae , Physiology , General Surgery , Models, Biological , Prosthesis Implantation , Weight-Bearing , Physiology
20.
Article in Chinese | WPRIM | ID: wpr-405763

ABSTRACT

Objective To explore the effect of low intensity pulsed ultrasound stimulation (LI-PUS) on the maturation of regenerate bone in a rabbit limb lengthening model. Methods Sixty skeletal mature female New Zealand white rabbits were randomly divided into an LIPUS treatment group and a control group. All rabbits were underwent mid-diaphyseal tibial osteotomy and immobilized in an Orthofix M103 Mini lengther. Gradual distraction at 0. 5 mm every 12 h for 10 d was performed at day 7 postoperatively. A 4-week course of LIPUS treatment group was applied over the distraction site for 20 min daily starting immediately after the completion of the distraction only for the treatment group. Rabbits were euthanized and the mid-diaphyseal tibia was harvested for evaluation at 4, 8, and 12 wk after the completion of the bone lengthening protocol. Radiographic analysis was performed to study the formation of bone callus using the ImageJ software at 12 wk after the completion of the bone lengthening protocol. Bone mineral density (BMD) of regenerate bone was measured by Dual energy X-ray absorptiometry (DEXA) . Torsional testing to failure was performed on the tibia specimens at 8 and 12 wk after the completion of the bone lengthening protocol. Results Radio-graphic measurement showed higher relative gray scale of bone callus in the LIPUS group than that in the control group at 12 wk (P < 0. 05) . BMD in the LIPUS group was significantly higher than that in control group at 8 and 12 wk (P < 0. 05). Biomechanical testing showed that the ultimate torque, ultimate torsional stiffness, and energy absorption at failure of regenerated bone at 8 and 12 wk in the LIPUS treatment group were better than those in the control group (P < 0. 05) Conclusion LIPUS as a biophysical stimulation may accelerate the formation and maturation of regenerate bone in rabbit tibia lengthening model.

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