Lumbar Vertebral Endplate Defects on Magnetic Resonance Imaging in Degenerative Spondylolisthesis: Novel Classification, Characteristics, and Correlative Factor Analysis.

BACKGROUND: Endplate defects are commonly seen in patients with lumbar degenerative disease. However, little is known about the presence of endplate defects in patients with degenerative spondylolisthesis (DS). In the present study, we have introduced a classification system for endplate defects in patients with DS using routine magnetic resonance imaging findings and explored the correlative factors. METHODS: Endplate defects were classified into 3 major categories (rim defects, focal defects, and erosive defects) and 5 subtypes (anterior type, posterior type, arc type at the anterior rim, notch type, and Schmorl's nodes). The incidence rates of the endplate defects were compared between the slippage and nonslippage levels. The correlations between the endplate defects and age, sex, disc degeneration, Modic changes (MCs), body mass index, slippage segment, and slippage degree were analyzed. RESULTS: Endplate defects were present in 47.43% of the endplates in DS. The most common endplate defects were rim defects. The occurrence of endplate defects, especially anterior defects, was more common at the slippage levels. Endplate defects were associated with age and closely related to MCs and the severity of disc degeneration. The slippage degree, slippage segment, body mass index, and sex differences were not associated with endplate defects in our study. The results obtained using this novel classification system were stable and consistent. CONCLUSIONS: The results from the present study have shown that the novel radiological classification system of endplate defects is reliable. Endplate defects were associated with slippage but not with the slippage degree or slippage segment differences in DS. The correlation between endplate defects and age and between MCs and disc degeneration were important features on the magnetic resonance imaging scans of patients with DS.

Clinical Rehabilitation Effect of Postoperative Lower-Limb Training on the Patients Undergoing OLIF Surgery: A Retrospective Study.

Background: In this study, it was aimed to investigate the clinical rehabilitation effect of lower-limb training on the patients that undergo oblique lumbar interbody fusion (OLIF) procedures. Methods: The eligible participants undergoing OLIF procedures between 01/2017 and 07/2019 were identified. All the patients underwent one-segment fusion operation (L3-4 or L4-5). Based on whether the participants received postoperative rehabilitation training, they were divided into two groups: intervention group and control group. Postoperatively, the participants in the intervention group were trained with lower-extremity rehabilitation exercise and maintained for three months. All participants got reexamined at the first postoperative week, the second postoperative week, the first postoperative month, and the third postoperative month (last follow-up). Comparisons were made in terms of the lower-extremity muscle force, visual analogue scale (VAS) score, lumbar JOA score, Oswestry disability index (ODI), the incidence of deep venous thrombosis (DVT), and patient satisfaction. Results: Seventy-seven participants in the intervention group (32 males and 45 females) and 82 in the control group (39 males and 43 females) were incorporated in this study. The median age of the participants was 57 years (39∼73) in the intervention group and 54 years (35∼71) in the control group. No statistical significance between the two groups was found (P > 0.05). ODI score was less in the intervention group as compared to the control group in the first week after surgery (P=0.029). VAS and JOA scores were better in the intervention group in the first two weeks after surgery (P < 0.05). DVT incidence in the intervention group was lower than the control group at final follow-up (P=0.037). Both group participants have achieved good grading in muscle force rehabilitation but no significant differences between the two groups. Additionally, satisfaction was higher in the intervention group than the control group. Conclusions: In summary, postoperative lower-extremity rehabilitation exercise can effectively accelerate patients' health recovery from the OLIF surgery and increase their satisfaction.

Psycho-Physiological Effects of a Peony-Viewing Program on Middle-Aged and Elderly Individuals at Different Phenological Stages.

To address the question of whether the behavior of humans to view different phenological peony flowers has various effects on their physical and mental parameters, we investigated psycho-physiological responses of 74 participants (61.3 ± 10.78 years old) to environments of pre- and post-viewing tree peonies at four stages, including the exhibition leaf stage (ELS), initial bloom stage (IBS), full bloom stage (FBS), and terminal bloom stage (TBS). Physiological factors were examined using systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), fingertip pulse (FP), blood oxygen saturation (SpO2), and psychological evaluation, which was carried out using the Profile of Mood States (POMS) and State⁻Trait Anxiety Inventory (STAI). The results indicated that the SBP, DBP, HR, and FP levels of participants were significantly reduced after viewing tree peonies, whereas no remarkable alterations in SpO2 were found. The POMS scores of anger⁻hostility (A⁻H), fatigue⁻inertia (F⁻I), tension⁻anxiety (T⁻A), confusion⁻bewilderment (C⁻B), and depression⁻dejection (D⁻D) were significantly lower, but of vigor⁻activity (V⁻A) was higher post-viewing than pre-viewing. Furthermore, participants exhibited markedly decreased anxiety levels according to the STAI. Notably, the changes in measurement indices were more pronounced at the FBS. Our studies demonstrated that a short peony-viewing program, especially at the FBS with completely opened and large tree peony flowers, would be a promising therapeutic method for improving physiological functions as well as an effective psychological relaxation strategy for middle-aged and elderly individuals.