Outcome of one-stage percutaneous endoscopic debridement and lavage combined with percutaneous pedicle screw fixation for lumbar pyogenic spondylodiscitis.

BACKGROUND: This study assessed the therapeutic effect of one-stage percutaneous endoscopic debridement and lavage (PEDL) combined with percutaneous pedicle screw fixation (PPSF) in the treatment of lumbar pyogenic spondylodiscitis. METHODS: From March 2017 to October 2019, 51 patients diagnosed with pyogenic spondylodiscitis underwent PPSF followed by PEDL in our department. Biopsy specimens were examined for microorganisms and evaluated histopathologically. Clinical outcomes were assessed by physical examination, routine serological testing, visual analogue scale (VAS), Oswestry Disability Index (ODI) and imaging studies. RESULTS: Of the enrolled patients, the operation time ranged from 90 min to 114 min every level with an average of 102 min, and the average drainage time ranged from 6 days to 10 days with an average of 7.4 days. All patients who complained of lower back pain symptoms were more relieved than before surgery. Causative pathogens were identified in 20 of 51 biopsy specimens; Staphylococcus aureus was the most prevalent. However, there were eight patients with postoperative complications. The mean follow-up was 25.0 ± 3.8 (range: 20-32) months. Inflammatory markers showed that infection was controlled. The VAS and ODI improved significantly. At the last follow-up, magnetic resonance imaging showed that the infected lesions had disappeared. CONCLUSION: PEDL supplementing PPSF may be useful for patients with single-level lumbar pyogenic spondylodiscitis, as it is minimally invasive, especially for patients who cannot undergo conventional open surgery due to poor health or advanced age.

LncRNA LINC00662 Exerts an Oncogenic Effect on Osteosarcoma by the miR-16-5p/ITPR1 Axis.

BACKGROUND: Osteosarcoma (OS) is one of the most malignant bone tumors and has a high metastatic rate. Increasing research has demonstrated the vital roles of long noncoding RNAs (lncRNAs) in human cancers, including OS. LncRNA LINC00662 has been revealed to act as an oncogene involved in multiple tumor progression. This study aimed to investigate the expression pattern, function, and regulatory mechanism of LINC00662 in OS. METHODS: Patients who underwent OS surgery were involved in this study. Experiments including RT-qPCR, MTT, western blot, FISH, RNA pull-down, luciferase reporter, colony formation, transwell invasion and migration, and sphere formation assay were performed to investigate the regulatory role of LINC00662 in OS. RESULTS: In the present study, our findings demonstrated the upregulation of LINC00662 expression in OS tissues and cells, and high expression of LINC00662 predicted a poor clinical prognosis of patients' iNOS. Through a series of in vivo assays, LINC00662 knockdown suppressed OS cell proliferation, invasion, migration, and stemness property maintenance. Further mechanistical investigations indicated that LINC00662 functioned as a competing endogenous RNA (ceRNA) for sponging microRNA-16-5p (miR-16-5p) to upregulate the expression of IP receptor type 1 (ITPR1) in OS cells. Restoration assays validated the involvement of ITPR1 in LINC00662-mediated regulation of cell functions in OS. CONCLUSION: LINC00662 exerts oncogenic functions in OS by targeting the miR-16-5p/ITPR1 axis.

Epidemiological features of traumatic spinal cord injury in Guangdong Province, China.

Study design: A retrospective hospital-based study.Objective: To describe the epidemiological profile of traumatic spinal cord injury (TSCI) in Guangdong Province.Setting: Two hospitals within Guangdong Province, China.Methods: Medical records of patients diagnosed with TSCI admitted to Foshan Hospital of Traditional Chinese Medicine and Zhujiang Hospital of South Medical University from 1 January 2011 to 31 December 2015 were retrospectively reviewed. Epidemiological characteristics, such as age, sex, occupation, etiology, neurological level of injury, American Spinal Injury Association Impairment Scale at admission, death and cause of death during the acute hospitalization and concomitant injuries.Results: During the study period, 482 cases were identified. Male-to-female ratio was 3.4:1, with a mean age of 41.5 ± 12.6 years old. The leading cause was falls (49.3%), followed by motor vehicle collisions (MVCs) (34.8%). The most common injury site was the cervical spinal cord, especially C4-C6, accounting for 39.8%.Conclusion: The number of TSCI patients in Guangdong Province is large and is exhibiting a rising trend. The leading causes were falls and MVCs. The low-falls (height < 1 m) group has expanded over this period. With China entering an ageing society, more appropriate preventative measures should be implemented for fall-related injuries among the elderly.

Double-level isthmic spondylolisthesis treated with posterior lumbar interbody fusion with cage.

Objective: Double-level isthmic spondylolisthesis in the lumbar spine is rare. The authors report on 21 cases of double-level isthmic spondylolisthesis treated by posterior lumbar interbody fusion (PLIF) with cage.Patients and methods: Between 2005 and 2015, twenty-one patients with double-level isthmic spondylolisthesis who underwent posterior lumbar interbody fusion (PLIF) with cage were reviewed retrospectively. The VAS (Visual Analogue Scale) and JOA (Japanese Orthopedic Association) score were used to evaluate preoperative and postoperative clinical outcomes.Results: The back pain and sciatica decreased from 6.53 and 4.24 points preoperatively to 1.80 and 1.18 points on the VAS at final follow-up, respectively. The average JOA score improved from 13.4 ± 3.2 preoperative to 25.4 ± 1.5 (range, 17-28) points postoperative. The average recovery rate was 76.9%. The good and excellent rate was 85.7% (18/21). The fusion rate was 95.2% (20/21). Changes in disc height, degree of listhesis, whole lumbar lordosis, and sacral inclination following surgery were also observed.Conclusions: Our results suggest that PLIF with cage appears to be an appropriate technique for the treatment of double-level isthmic spondylolisthesis.

Arachnoiditis ossificans associated with syringomyelia: a case report.

The association of arachnoiditis ossificans with syringomyelia is a rare pathological entity. We present an unusual case who presented with progressive myelopathy caused by arachnoidits ossificans and syringomyelia. The pathophysiology and treatment strategy of this rare entity are still controversial.

Double-level isthmic spondylolisthesis treated with posterior lumbar interbody fusion: A review of 32 cases.

OBJECTIVE: The incidence of double-level isthmic spondylolisthesis is rare. The aim of this study is to evaluate the short-term functional and radiological outcomes of surgical treatment for double-level isthmic spondylolisthesis. PATIENTS AND METHODS: Between 2004 and 2014, thirty-two patients with double-level isthmic spondylolisthesis who underwent posterior lumbar interbody fusion (PLIF) with autogenous bone chips were reviewed retrospectively. The clinical outcomes were measured by VAS (Visual analog scale) and JOA(Japanese Orthopedic Association) score. RESULTS: At an average follow-up of 2.8 years, the mean score on the VAS of back pain and sciatica decreased from 6.48 and 4.26 points preoperatively to 1.82 and 1.10 points at final follow-up, respectively. The average JOA score improved from 13.8±3.1 preoperative to 25.6±1.3 (range, 17-28) points postoperative. The average recovery rate was 77.6%. The good and excellent rate was 84.3% (27/32). The fusion rate was 87.5% (28/32). Changes in disc height, degree of listhesis, whole lumbar lordosis, and sacral inclination between the pre- and postoperative periods were significant. CONCLUSIONS: Our findings suggest that PLIF with autogenous bone chips for double-level isthmic spondylolisthesis could yield good functional short-term results. It seems to be a viable approach in the treatment of double-level isthmic spondylolisthesis.

Outcomes of autograft alone versus PEEK+ autograft interbody fusion in the treatment of adult lumbar isthmic spondylolisthesis.

OBJECTIVES: Bone resulting from a complete resection of the posterior arch can be cut into an autograft bone that contains the facet joint structure and morselised bone for interbody fusion. However, whether a strut autograft that contains this trimmed facet joint can produce the same clinical and radiographic outcomes as a cage for interbody fusion remains unclear. The aim of this study was to compare the outcomes of a local facet joint autograft alone to those of polyetheretherketone (PEEK)+autograft for posterior lumbar interbody fusion (PLIF) in the treatment of adult isthmic spondylolisthesis. PATIENTS AND METHODS: A retrospective analysis was performed on 84 patients with single lumbar isthmic spondylolisthesis who were treated with a local facet joint autograft alone (group A; n=44) or PEEK+autograft (group B; n=40) in PLIF with a minimum follow-up period of 24 months. Pain and disability were assessed using the visual analogue scale, Oswestry disability index and Kirkaldy-Willis criteria. In the radiological evaluation, disc height, slippage reduction, and fusion status were examined. Postoperative complications were also monitored. RESULTS: At the last follow-up examination, 84.1% (37/44) of the patients in group A and 82.5% (33/40) of the patients in group B had a good outcome, and there were no significant differences between the two groups. Boh Methods led to significant improvements in disc height, and while PEEK+autograft produced a smaller loss in disc height, the difference was insignificant. The improvements in slippage and the fusion and complication rates between the two groups were similar. CONCLUSION: There were no significant differences in the clinical outcomes or radiographic improvements of both fusion methods in the treatment of adult isthmic spondylolisthesis. An autograft excised from a complete posterior arch containing a facet joint for interbody fusion is effective and affordable for treating isthmic spondylolisthesis.