Local X-irradiation promotes regeneration of spinal cord central nervous system in a rat model / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of local X-irradiation on spinal cord injury by using physiology, kinology, electrophysiology and histology method.</p><p><b>METHODS</b>46 female Sprague-Dawley rats were subjected to spinal cord injury by weight dropping on T(11-12). All animals were divided into 3 groups randomly. One of the animal groups was irradiated with 10 Gy at the lesion site; another was irradiated with 20 Gy, the other without irradiation is regarded as sham-group. The animals were euthanized at different time points at 4 and 12 weeks after irradiation. Spinal cord callus was assessed by using physiology, kinology, and electrophysiology and histology method.</p><p><b>RESULTS</b>In all the groups, the NF at 14 weeks were found higher than that of 6 weeks. Both 10 Gy irradiated and 20 Gy irradiated groups were higher than those of group at each time point (P < 0.05). The MBP decreased at 14 weeks in irradiated groups (P < 0.05), but increased at 14 weeks in sham-group (P < 0.05), the MBP of irradiated groups was lower than that sham-group at 14 weeks (P < 0.05). The GFAP and Nogo-A at 14 weeks were higher than that in 6 weeks in all the groups (P < 0.05), and there was no statistical significance with physiology, kinology, electrophysiology test in all groups.</p><p><b>CONCLUSION</b>A self-repair mechanism exists after SCI, which will last at least 14 weeks. Local irradiation promotes the regeneration of spinal cord system after injury to some extent.</p>

Diagnosis and operative treatment of far lateral lumbar disc herniation / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the characteristics and operative selection of far lateral lumbar disc herniation (FLLDH).</p><p><b>METHODS</b>Twenty-three cases of FLLDH, 14 were foraminal, and 9 were extraforaminal lumbar disc herniation. Of the 23 cases, low back pain was observed in 8 cases (31%), severe lower leg pain in 21 cases (91%) and Lasegue sign in 10 cases (43%). CT and MRI showed the protruded disc in and outside of the foramen clearly. Three surgical procedures were performed, including hemilaminotomy with medial facetectomy, facetectomy with pedicle screw fixation and fusion with posteolateral bone grafting, and the transmuscular approaches.</p><p><b>RESULTS</b>Twenty-two cases were followed up for an average of 3.6 years. According to the Macnab criteria, 15 patients achieved excellent results, good 4, fair 3 and poor 0. Excellent and good rate was 86%.</p><p><b>CONCLUSIONS</b>The symptoms and signs of FLLDH mainly result from injury of upper nerve segments with the dominant symptom of severe lower leg pain. CT and MRI appearance are not only sensitive but also specific for the diagnosis of FLLDH. In foraminal lumbar disc herniation, the hemilaminotomy with medial facetectomy is recommended. While in extraforaminal lumbar disc herniation, either facetectomy with pedicle screw fixation and fusion with posterolateral bone grafting or transmuscular approaches for removal of nucleus pulposus can be chosen. Microendoscopic discectomy is a new, safe and efficient method for the disease, however, a skillful microendoscopic technique should be mastered prior.</p>