ABSTRACT
OBJECTIVE: To investigate the relationship between spine-pelvic sagittal parameters and clinical efficacy before and after oblique lumbar interbody fusion(OLIF). METHODS: A retrospective analysis of clinical data of 65 patients with lumbar degenerative diseases treated with OLIF were performed from July 2017 to July 2018. There were 26 males and 39 females aged from 33 to 79 years old with an average of (62.72±10.23) years old. Oswestry Disability Index (ODI) and visual analogue scale (VAS) before and at the latest follow up were evaluated. Disc height (DH) and spine- pelvic sagittal parameters of the surgical segment were measured before and at the latest follow- up, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and lumbar lordosis (LL). According to the difference of PI-LL, it was judged whether PI and LL match and the patients were grouped, PI-LL ranged from -9° to 9° was set as matching group, and PI-LL less than -9° or larger than 9° was set as mismatching group. The spine-pelvic sagittal parameters were analyzed before and at the latest follow-up of OLIF in patients with lumbar degenerative diseases, and the correlation between changes and clinical efficacy was compared. RESULTS: All patients were followed up from 8 to 20 months with an average of (14.20±3.68) months. Operation time was (91.54±25.97) min, intraoperative blood loss was (48.15±10.14) ml, and the hospitalization time ranged from 6 to 19 days with an average of (9.28± 2.50) days. Totally 84 surgical levels, 46 patients were single segment and 19 patients were double segments. VAS and ODI score were improved from (4.88±0.99) point, (67.60±13.73) % preoperatively to (2.85±1.30) points, (30.57±6.48) % at the latest follow-up. There were significant differences in VAS and ODI scores between before and at the latest follow-up. The sagittal parameters of LL, PT, SS, PI, PI -LL and the surgical level DH were (42.80 ±16.35)° , (23.22 ±10.91)° , (26.95 ± 13.30)°, (50.22±14.51)°, (7.53±16.13) °, (0.91±0.29) cm preoperatively and improved to the latest follow-up (49.95± 12.82) °, (17.94±9.24) °, (33.71±12.66) °, (51.65±10.26) °, (1.68±17.00) °, (1.20±0.40) cm;there were statistical differences in LL, PT, SS, PI-LL, DH before operation and at the latest follow up, while no difference in PI. LL of preoperative PI-LL in matched group was (48.76±11.09)° , and (38.00±18.37)° in PI-LL mismatch group, there was difference between two groups. There were no differences in VAS, ODI, PT, SS, PI and DH between two groups. At the latest follow-up, ODI between PI-LL matched group and PI-LL mismatched group were (29.40±5.93)% and (32.86±7.02)% respectively, and had difference in ODI between two groups;while there were no significant differences in VAS, LL, PT, SS, PI, and DH. Pearson correlation analysis showed preoperative PT-LL was positively correlated with VAS;PT was positively correlated with ODI at the latest follow-up. CONCLUSION: OLIF has a good surgical effect on lumbar degenerative diseases, and could change spine-pelvic sagittal parameters of patient to a certain extent, and further restoring the balance of the sagittal plane of lumbar spine.
Subject(s)
Spinal Fusion , Adult , Aged , Female , Humans , Lumbar Vertebrae , Lumbosacral Region , Male , Middle Aged , Pelvis , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: Osteoarthritis is a disorder of joints featuring inflammation and degeneration of articular cartilage. Recently, miRs have been found to be associated in the regulation of chondrocytes and their apoptosis. miR-18a-3p has been found to be associated in the pathogenesis of rheumatoid arthritis, however, its role in articular cartilage tissues remains unclear. METHODS: C57BL/6 strain of mice and human cartilage tissue were used for the study. Histological analysis was done on isolated cartilage samples followed by TUNEL assay and immunohistochemical analysis. The chondrocytes were isolated from mouse and human cartilage tissues, RNA was isolated and subjected for qRT-PCR analysis. The chondrocytes were transfected with miR-18a-3p agomir, antagomir and siHOXA-1. Luciferase assay was done in 293T cells. Flow cytometry analysis was done and western blot analysis for studying the expression of proteins. RESULTS: The expression of miR-18a-3p was upregulated in chondrocytes after exposing them to interlukin- 1ß (IL-1ß) in vitro. The transfection of miR-18a-3p antagomir halted the IL-1ß mediated apoptosis. The luciferase assay suggested that miR-18a-3p targets the 3'UTR region of HOXA1 gene thus blocking its expression. The treatment of HOXA1 siRNA demonstrated the rescuing effect of miR- 18a-3p antagomir on the apoptosis of chondrocytes. Treatment of miR-18a-3p antagomir attenuated the surface of cartilage in osteoarthritis mice and the agomir worsened it. TUNEL assay suggested decreased apoptosis and over-expression of HOAX1 in osteoarthritis mice post miR-18a-3p knockdown. CONCLUSION: The findings confirmed the involvement of miR-18a-3p/HOXA1 pathway as a potential mechanism in the regulation of Osteoarthritis.