RESUMEN
ABSTRACT Objective: To compare effectiveness of Dynesys and hybrid system in treating patients with multi-segmental lumbar degenerative disease (LDD). Methods: Patients involved in this retrospective study were divided into Dynesys (n = 22) and Hybrid (n = 13) groups. Clinical outcomes were evaluated using Oswestry Disability Index (ODI), and Visual Analogue Scale (VAS). Radiologic evaluations included X-ray, MRI, and CT. Furthermore, different complications were analyzed. Results: At the last follow-up, ODI and VAS of each group were improved (p < 0.05), and the range of motion (ROM) of operating segments decreased. However, Dynesys group preserved a larger extent of ROM at the final follow-up (p < 0.05). ROM of the upper adjacent segment was increased in both groups (p < 0.05), while the disc heights were decreased at the final follow-up (p < 0.05). Besides, Dynesys group had a more obvious decrease in the disc height of dynamic segments (p < 0.05). No significant difference existed in complications between both groups (p > 0. 05). Conclusion: In our study, similar satisfactory results were obtained in both groups. Both surgical procedures can be employed as effective treatments for middle-aged and physically active patients with multi-segmental LDD. Level of Evidence III; Retrospective Comparative Study.
RESUMO Objetivo: Comparar a eficácia do Dynesys e do sistema híbrido no tratamento de pacientes com doença degenerativa lombar multissegmentar (DLD). Métodos: Os pacientes envolvidos neste estudo retrospectivo foram divididos em grupos Dynesys (n = 22) e Híbrido (n = 13). Os desfechos clínicos foram avaliados por meio do Oswestry Disability Index (ODI) e da Escala Visual Analógica (EVA). As avaliações radiológicas incluíram radiografia, ressonância nuclear magnética (RNM) e tomografia computadorizada. Ademais, diferentes complicações foram analisadas. Resultados: No acompanhamento final, o ODI e a EVA de todos os grupos melhoraram (p < 0,05), e houve diminuição da amplitude de movimento (ADM) dos segmentos operacionais. No entanto, o grupo Dynesys preservou uma maior extensão da ADM no acompanhamento final (p < 0,05). A ADM do segmento superior adjacente foi ampliada em ambos os grupos (p < 0,05), enquanto as alturas dos discos foram reduzidas no acompanhamento final (p < 0,05). No entanto, o grupo Dynesys apresentou uma redução mais evidente na altura do disco dos segmentos dinâmicos (p < 0,05). Não houve diferença significativa nas complicações entre esses dois grupos (p > 0,05). Conclusão: Neste estudo, resultados satisfatórios semelhantes foram obtidos em ambos os grupos. Ambos os procedimentos cirúrgicos podem ser empregados como tratamentos eficazes para pacientes de meia-idade e fisicamente ativos com LDD multissegmentar. Nível de Evidência III; Estudo Retrospectivo Comparativo.
RESUMEN
To investigate the preventive effect of epimedium-defivod phytoestrogen (PE) on osteoporosis induced by ovariectomy (OVX) in rats, 11-month-old female Wistar rats were randomly di- vided into Sham, OVX and PE groups. One week after OVX, daily oral administration of PE (0.4 g·kg-1·day·-1) started in PE group, and rats in Sham and OVX groups were given vehicle accordingly. The administrations lasted for 12 weeks. The biological markers including serum osteocalcin (OC) and urinary deoxypyridinoline (DPD) for bone turnover were evaluated at the end of the 12th week. On the 13th week, all the rats were sacrificed. The right proximal tibiae were removed, subjected to micro CT for determination of trabeonlar bone structure and then bone histomorphometry was per- formed to assess bone remodeling. The OVX rats were in a high bone turnover status as evidenced by increased bone formation markers and bone resorption markers. Treatment with PE could suppress the high bone turnover rate in OVX rats. Micro CT data revealed that PE treatment could ameliorate the deterioration of the micro-architecture of proximal tibiae induced by OVX, as demonstrated by greater bone volume, increased trabecular thickness and less trahecular separation in PE group in comparison with OVX group. The static and dynamic parameters of bone histomorphometry indi- cated that there were significant increases in bone formation variables and significant decreases in bone resorption variables between PE and OVX groups. The findings suggest that PE has a beneficial effect on trabecular bone in OVX rat model and this effect is possibly associated with stimulation of bone formation as well as inhibition of bone resorption.