Clinical application of a novel posterior lumbar fusion method and the short-term observation of its effect / 中华外科杂志

<p><b>OBJECTIVE</b>To increase local blood supply of bone graft, a novel posterior lumbar spine fusion method with orthotopic paraspinal muscle-pediculated bone flaps was constructed, and the fusion rate and clinical effect.were observed.</p><p><b>METHODS</b>From June 2007 to December 2010, 117 patients of lumbar spinal stenosis or lumbar destabilization treated with the novel posterior lumbar fusion method were studied, 49 males and 68 females, aged from 40 to 77 years, average 61.5 years. Clinical effect was evaluated by JOA and VAS score preoperatively and postoperatively, and the fusion result was evaluated by three-dimensional CT reconstruction postoperatively.</p><p><b>RESULTS</b>Seventeen cases lost of follow up, the rest were followed up from 7 to 38 months, average 19 months. There was significant difference between pre- and postoperative JOA and VAS score (P < 0.01), the preoperative JOA score was 10.3 ± 1.9, and 25.4 ± 4.2 at the latest follow-up, the improvement rate was 81.0% ; the preoperative VAS score was 8.5 ± 0.8, and 2.3 ± 0.4 at the latest follow-up. The three-dimensional CT reconstruction showed that 126 of the 133 segments formed solid fusion in 100 patients who completed the follow-up, the fusion rate was 94.7%.</p><p><b>CONCLUSION</b>The novel posterior lumbar fusion method make the bone graft position more precise, stable and increases the fusion rate, which can effectively reduce pseudarthrosis and have a promising clinical effect.</p>

The relationship between bone-loss of steroid-induced osteonecrosis and local expression of OPG/OCIF / 中华预防医学杂志

<p><b>OBJECTIVE</b>To probe the relationship between the osteoprotegerin/osteoclastogenesis inhibitory factor (OPG/OCIF) expression of bone and the relative bone-loss.</p><p><b>METHODS</b>Steroid-induced osteonecrosis-model was reproduced in thirty-one new Zealand hares, and 24 ones were alive 3 days after administration of endotoxin and methylprednisolone. The alive creatures were divided into control group and trial groups randomly. After the creatures being executed, bone-density measurement of the femurs, HE staining, Ca(+ +) staining and OPG/OCIF immunohistochemistry staining were performed, followed by image processing and statistical analysis.</p><p><b>RESULTS</b>In the early period of steroid-induced osteonecrosis, the local OPG/OCIF expression significantly decreased, with a large number of osteoclasts in the local medulla, followed by a progressively bone-loss.</p><p><b>CONCLUSION</b>Corticosteroid could inhibit OPG/OCIF expression in the bone, increase the activity and differentiation of osteoclast relatively, and worsen bone-loss in steroid-induced osteonecrosis.</p>