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Sample records for cervical disc degeneration

  1. MRI evaluation of spontaneous intervertebral disc degeneration in the alpaca cervical spine.

    Science.gov (United States)

    Stolworthy, Dean K; Bowden, Anton E; Roeder, Beverly L; Robinson, Todd F; Holland, Jacob G; Christensen, S Loyd; Beatty, Amanda M; Bridgewater, Laura C; Eggett, Dennis L; Wendel, John D; Stieger-Vanegas, Susanne M; Taylor, Meredith D

    2015-12-01

    Animal models have historically provided an appropriate benchmark for understanding human pathology, treatment, and healing, but few animals are known to naturally develop intervertebral disc degeneration. The study of degenerative disc disease and its treatment would greatly benefit from a more comprehensive, and comparable animal model. Alpacas have recently been presented as a potential large animal model of intervertebral disc degeneration due to similarities in spinal posture, disc size, biomechanical flexibility, and natural disc pathology. This research further investigated alpacas by determining the prevalence of intervertebral disc degeneration among an aging alpaca population. Twenty healthy female alpacas comprised two age subgroups (5 young: 2-6 years; and 15 older: 10+ years) and were rated according to the Pfirrmann-grade for degeneration of the cervical intervertebral discs. Incidence rates of degeneration showed strong correlations with age and spinal level: younger alpacas were nearly immune to developing disc degeneration, and in older animals, disc degeneration had an increased incidence rate and severity at lower cervical levels. Advanced disc degeneration was present in at least one of the cervical intervertebral discs of 47% of the older alpacas, and it was most common at the two lowest cervical intervertebral discs. The prevalence of intervertebral disc degeneration encourages further investigation and application of the lower cervical spine of alpacas and similar camelids as a large animal model of intervertebral disc degeneration. PMID:26135031

  2. Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation: comparison study with asymptomatic volunteers

    OpenAIRE

    Okada, Eijiro; Matsumoto, Morio; Fujiwara, Hirokazu; Toyama, Yoshiaki

    2010-01-01

    An association between progression of cervical disc degeneration and that of lumbar disc degeneration has been considered to exist. To date, however, this association has not yet been adequately studied. Age-related changes in the cervical intervertebral discs were evaluated by magnetic resonance imaging (MRI) in patients with lumbar disc herniation, and compared with the MRI findings of healthy volunteers without lower back pain. The purpose of this study was to clarify whether the prevalenc...

  3. Histological, magnetic resonance imaging, and discographic findings on cervical disc degeneration in cadaver spines. A comparative study

    International Nuclear Information System (INIS)

    A total of 210 cervical intervertebral discs were taken at autopsy from 36 cadavers, and underwent both magnetic resonance imaging (MRI) and discography to compare their diagnostic efficacies for investigating degenerative changes in the cervical spine. The age of the subjects had ranged from 43 to 92 years with an average of 68.1 years. Following the autopsy, MRI and discography were performed on the excised cervical spinal column, and the specimen was then prepared for histological examination. The findings were compared with those of the lumbar spine that had previously been reported by Yasuma et al. on 1238 lumbar discs from 197 cadavers ranging in age from 11 to 92 years. The results were as follows: Low intensity in the T2-weighted MRI was well correlated with histological degeneration in the cervical disc. The rate of appearance of the posterior protrusion of the cervical disc on the MRI was in accordance with the degree of histological disc degeneration, but it did not always correspond with histological posterior protrusion. There was a remarkably high incidence for false-positive posterior protrusion on the MRI, which should be kept in mind on reading the MRI. In the comparison of the MRI with the discography, a certain positive correlation was found as for disc degeneration, but not in complete accordance. There was a considerable difference in the patterns of degeneration and in posterior protrusion of the discs between the cervical spine and the lumbar spine. The posterior protrusion in the cervical disc was more likely related to horizontal fissure and hyalinization of the posterior annulus, while posterior protrusion in the lumbar disc was often related to reversed orientation of the bundles and myxomatous degeneration of the posterior annulus. This difference was attributed to the difference in the mechanical properties of the cervical and lumbar spines. (author)

  4. Degeneration of the cervical disc: histology compared with radiography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Decisions about the treatment of neck pain are largely made on the basis of information gained from plain X-rays and magnetic resonance imaging (MRI), which are used routinely as part of preliminary investigation. We performed a descriptive cadaveric study to compare histology with radiography and MRI. We correlated plain radiography, disc height [Farfan index (FI)] and MRI findings with histology to assess the ability of radiology to detect significant pathologic lesions. The study included 52 motion segments from nine subjects over the age of 50, who underwent routine hospital autopsy. Disc degeneration was assessed by histology, radiography, disc height (FI: anterior disc height plus posterior disc height divided by anterioposterior diameter) and MRI using established grading systems. Most of the discs were classified radiologically as grade 1 (19/52), grade 2 (13/52), grade 3 (9/52) or grade 4 (3/52). Eight of the discs were graded as normal. The distribution of MRI grades was grade 0 (9/36), grade 1 (9/36), grade 2 (7/36), grade 3 (8/36) and grade 4 (3/36). Half of the discs (26/52) showed advanced (grade 4) degeneration histologically. FI correlated with histological grade (P=0.013), MRI grade (P=0.02) and radiological grade (P<0.001) of degeneration. Radiological and histological grade of degeneration showed a weak correlation (r=0.3, P=0.033). MRI correlated with overall histological grade (r=0.41, P=0.015, n=34). Histological features (e.g., tears, rim lesions, prolapse of nucleus material) were poorly recognised by MRI, which had a sensitivity for disc material prolapse and annulus tears of less than 40%. Our study showed that discs from patients over 50 years are histologically severely degenerated; however, these changes may not be detected by conventional radiography and MRI. (orig.)

  5. Degeneration of the cervical disc: histology compared with radiography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Christe, A.; Vock, P. [University of Berne, Department of Radiology, Inselspital, Berne (Switzerland); Laeubli, R.; Berlemann, U. [University of Berne, Department of Orthopaedic Surgery, Inselspital, Berne (Switzerland); Guzman, R.; Schroth, G. [University of Berne, Department of Neuroradiology, Inselspital, Berne (Switzerland); Moore, R.J. [Institute of Medical and Veterinary Science, Adelaide (Australia); Loevblad, K.O. [University of Berne, Department of Neuroradiology, Inselspital, Berne (Switzerland); Geneva University Hospital, Neuroradiology SRRI, Geneva 14 (Switzerland)

    2005-10-01

    Decisions about the treatment of neck pain are largely made on the basis of information gained from plain X-rays and magnetic resonance imaging (MRI), which are used routinely as part of preliminary investigation. We performed a descriptive cadaveric study to compare histology with radiography and MRI. We correlated plain radiography, disc height [Farfan index (FI)] and MRI findings with histology to assess the ability of radiology to detect significant pathologic lesions. The study included 52 motion segments from nine subjects over the age of 50, who underwent routine hospital autopsy. Disc degeneration was assessed by histology, radiography, disc height (FI: anterior disc height plus posterior disc height divided by anterioposterior diameter) and MRI using established grading systems. Most of the discs were classified radiologically as grade 1 (19/52), grade 2 (13/52), grade 3 (9/52) or grade 4 (3/52). Eight of the discs were graded as normal. The distribution of MRI grades was grade 0 (9/36), grade 1 (9/36), grade 2 (7/36), grade 3 (8/36) and grade 4 (3/36). Half of the discs (26/52) showed advanced (grade 4) degeneration histologically. FI correlated with histological grade (P=0.013), MRI grade (P=0.02) and radiological grade (P<0.001) of degeneration. Radiological and histological grade of degeneration showed a weak correlation (r=0.3, P=0.033). MRI correlated with overall histological grade (r=0.41, P=0.015, n=34). Histological features (e.g., tears, rim lesions, prolapse of nucleus material) were poorly recognised by MRI, which had a sensitivity for disc material prolapse and annulus tears of less than 40%. Our study showed that discs from patients over 50 years are histologically severely degenerated; however, these changes may not be detected by conventional radiography and MRI. (orig.)

  6. Three-level cervical disc herniation

    Directory of Open Access Journals (Sweden)

    St. Iencean Andrei

    2015-09-01

    Full Text Available Multilevel cervical degenerative disc disease is well known in the cervical spine pathology, with radicular syndromes or cervical myelopathy. One or two level cervical herniated disc is common in adult and multilevel cervical degenerative disc herniation is common in the elderly, with spinal stenosis, and have the same cause: the gradual degeneration of the disc. We report the case of a patient with two level cervical disc herniation (C4 – C5 and C5 – C6 treated by anterior cervical microdiscectomy both levels and fusion at C5 – C6; after five years the patient returned with left C7 radiculopathy and MRI provided the image of a left C6 – C7 disc herniation, he underwent an anterior microsurgical discectomy with rapid relief of symptoms. Three-level cervical herniated disc are rare in adults, and the anterior microdiscectomy with or without fusion solve this pathology.

  7. Quantitative T2 magnetic resonance imaging compared to morphological grading of the early cervical intervertebral disc degeneration: an evaluation approach in asymptomatic young adults.

    Directory of Open Access Journals (Sweden)

    Chun Chen

    Full Text Available OBJECTIVE: The objective of this study was to evaluate the efficacy of quantitative T2 magnetic resonance imaging (MRI for quantifying early cervical intervertebral disc (IVD degeneration in asymptomatic young adults by correlating the T2 value with Pfirrmann grade, sex, and anatomic level. METHODS: Seventy asymptomatic young subjects (34 men and 36 women; mean age, 22.80±2.11 yr; range, 18-25 years underwent 3.0-T MRI to obtain morphological data (one T1-fast spin echo (FSE and three-plane T2-FSE, used to assign a Pfirrmann grade (I-V and for T2 mapping (multi-echo spin echo. T2 values in the nucleus pulposus (NP, n = 350 and anulus fibrosus (AF, n = 700 were obtained. Differences in T2 values between sexes and anatomic level were evaluated, and linear correlation analysis of T2 values versus degenerative grade was conducted. FINDINGS: Cervical IVDs of healthy young adults were commonly determined to be at Pfirrmann grades I and II. T2 values of NPs were significantly higher than those of AF at all anatomic levels (P0.05. T2 values decreased linearly with degenerative grade. Linear correlation analysis revealed a strong negative association between the Pfirrmann grade and the T2 values of the NP (P = 0.000 but not the T2 values of the AF (P = 0.854. However, non-degenerated discs (Pfirrmann grades I and II showed a wide range of T2 relaxation time. T2 values according to disc degeneration level classification were as follows: grade I (>62.03 ms, grade II (54.60-62.03 ms, grade III (<54.60 ms. CONCLUSIONS: T2 quantitation provides a more sensitive and robust approach for detecting and characterizing the early stage of cervical IVD degeneration and to create a reliable quantitative in healthy young adults.

  8. Disc degeneration: current surgical options

    Directory of Open Access Journals (Sweden)

    C Schizas

    2010-10-01

    Full Text Available Chronic low back pain attributed to lumbar disc degeneration poses a serious challenge to physicians. Surgery may be indicated in selected cases following failure of appropriate conservative treatment. For decades, the only surgical option has been spinal fusion, but its results have been inconsistent. Some prospective trials show superiority over usual conservative measures while others fail to demonstrate its advantages. In an effort to improve results of fusion and to decrease the incidence of adjacent segment degeneration, total disc replacement techniques have been introduced and studied extensively. Short-term results have shown superiority over some fusion techniques. Mid-term results however tend to show that this approach yields results equivalent to those of spinal fusion. Nucleus replacement has gained some popularity initially, but evidence on its efficacy is scarce. Dynamic stabilisation, a technique involving less rigid implants than in spinal fusion and performed without the need for bone grafting, represents another surgical option. Evidence again is lacking on its superiority over other surgical strategies and conservative measures. Insertion of interspinous devices posteriorly, aiming at redistributing loads and relieving pain, has been used as an adjunct to disc removal surgery for disc herniation. To date however, there is no clear evidence on their efficacy. Minimally invasive intradiscal thermocoagulation techniques have also been tried, but evidence of their effectiveness is questioned. Surgery using novel biological solutions may be the future of discogenic pain treatment. Collaboration between clinicians and basic scientists in this multidisciplinary field will undoubtedly shape the future of treating symptomatic disc degeneration.

  9. Cervical Disc Disease: Biomechanical Aspects

    OpenAIRE

    Kolstad, Frode

    2011-01-01

    Degenerative disc disease in the cervical spine may cause significant pain and disability. Patients present themselves with neck pain, radiculopathy, and/or myelopathy. When the symptoms do not improve with conservative treatment, surgical treatment is considered. The goal of surgical treatment is to decompress nervous structures and to restore the normal anatomical conditions of disc height, alignment, and stability.The present thesis concerns four studies involving the treatment of cervical...

  10. Endoscopic anterior decompression in cervical disc disease

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    Yad Ram Yadav

    2014-01-01

    Full Text Available Background: Although microscopic anterior cervical discectomy with or without fusion are common surgical procedures for treatment of cervical herniated discs, loss of disc height, pseudarthrosis, and adjacent disc degeneration are some of the problems associated with it. This study is aimed to evaluate results of endoscopic microforaminotomy in cervical disc diseases. Materials and Methods: A prospective study of 50 patients of mono segmental soft or hard disc causing myeloradiculopathy was undertaken. A visual analogue scale (VAS for neck and arm pain and functional outcomes using the Nurick grading system were assessed. There were 28, 12, 8, and 2 patients at C5-6, C6-7, C4-5, and C3-4 levels disc diseases, respectively. Patients with two or more level disc, instabilities, disc extending more than half vertebral body height, and previous operation at the same segment were excluded. Results: Age ranged from 21 to 67 years. Average postoperative reduction in disc height, operating time, and blood loss was 1.1 mm, 110 minutes, and 30 ml, respectively. Average pre-operative VAS score for arm pain and Nurick grading was 7.6 and 2.7, which improved to 1.9 and 0.82, respectively. All patients improved; 1, 2, 3 grade improvement was seen in 10, 27, and 10 patients, respectively. There was no significant complication or any mortality. Conclusion: Although longer follow up of large number of patients is required, endoscopic microforaminotomy is a safe and an effective alternative to microscopic anterior discectomy with or without fusion.

  11. Do We Need Biomarkers for Disc Degeneration?

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    Helen E. Gruber

    2006-01-01

    Full Text Available Disc degeneration plays a major role in this country's medical, social and economic structure. The life-time prevalence of low back pain, which has disc degeneration as its cause, is about 80% in the general population. It is a primary cause of disability and estimated costs related to low back disorders exceed $100 billion per year in the U.S. alone. Biomarkers are becoming increasingly important as indicators of the presence of disease, and in evaluating outcomes during clinical treatment. Cell-based biologic therapies which are currently being developed to treat disc degeneration are going to be most efficacious when applied to the early stages of disc disease. In this article we ask: 1 Whether there are existing biomarkers which could play a role in detecting early stages of disc degeneration, and 2 Highlight exciting potentials in future biomarker screening for disc degeneration.

  12. The NEtherlands Cervical Kinematics (NECK) Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; A double-blind randomised multicenter study

    NARCIS (Netherlands)

    M.P. Arts (Mark); R. Brand (René); B.W. Koes (Bart); W.C. Peul (Wilco); M.E. van den Akker (Elske)

    2010-01-01

    textabstractBackground. Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is

  13. Reoperations Following Cervical Disc Replacement

    OpenAIRE

    Skovrlj, Branko; Lee, Dong-Ho; Caridi, John Michael; Cho, Samuel Kang-Wook

    2015-01-01

    Cervical disc replacement (CDR) has emerged as an alternative surgical option to cervical arthrodesis. With increasing numbers of patients and longer follow-ups, complications related to the device and/or aging spine are growing, leaving us with a new challenge in the management and surgical revision of CDR. The purpose of this study is to review the current literature regarding reoperations following CDR and to discuss about the approaches and solutions for the current and future potential c...

  14. Genetic association studies in lumbar disc degeneration

    DEFF Research Database (Denmark)

    Eskola, Pasi J; Lemmelä, Susanna; Kjær, Per;

    2012-01-01

    Low back pain is associated with lumbar disc degeneration, which is mainly due to genetic predisposition. The objective of this study was to perform a systematic review to evaluate genetic association studies in lumbar disc degeneration as defined on magnetic resonance imaging (MRI) in humans....

  15. CT discography for cervical soft disc hernia

    International Nuclear Information System (INIS)

    In this study the effectiveness of computed tomographic discography (CTD) in diagnosing cervical soft disc hernia was evaluated. Twenty-five interververtebral discs of 15 cases with cervical soft disc hernia were examined with a discography and then a CT scan. Results of the CT scan were as follows: three discs were protruded, 12 discs were prolapsed, 6 discs were extruded, and 4 discs were sequestrated. The findings were helpful in determining the location of soft disc hernians between the median and posterolateral discs. They were also valuable in classifying types of hernians and surgical aproaches. (author)

  16. Magnetic resonance imaging of intervertebral disc degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Hiroshi; Noguchi, Masao (Kitakyushu City Yahata Hospital, Fukuoka (Japan)); Kira, Hideaki; Fujiki, Hiroshi; Shimokawa, Isao; Hinoue, Kaichi

    1993-02-01

    The aim of this study was to correlate the degree of lumbar intervertebral disc degeneration with findings of magnetic resonance imaging (MRI). Seventeen autopsied (from 7 patients) and 21 surgical (from 20 patients) intervertebral discs were used as specimens for histopathological examination. In addition, 21 intervertebral discs were examined on T2-weighted images. Histopathological findings from both autopsied and surgical specimens were well correlated with MRI findings. In particular, T2-weighted images reflected increased collagen fibers and rupture within the fibrous ring accurately. However, when severely degenerated intervertebral discs and hernia protruding the posterior longitudinal ligament existed, histological findings were not concordant well with T2-weighted images. Morphological appearances of autopsy specimens, divided into four on T2-weighted images, were well consistent with histological degeneration. This morphological classification, as shown on T2-weighted images, could also be used in the evaluation of intervertebral disc degeneration. (N.K.).

  17. Magnetic resonance imaging of intervertebral disc degeneration

    International Nuclear Information System (INIS)

    The aim of this study was to correlate the degree of lumbar intervertebral disc degeneration with findings of magnetic resonance imaging (MRI). Seventeen autopsied (from 7 patients) and 21 surgical (from 20 patients) intervertebral discs were used as specimens for histopathological examination. In addition, 21 intervertebral discs were examined on T2-weighted images. Histopathological findings from both autopsied and surgical specimens were well correlated with MRI findings. In particular, T2-weighted images reflected increased collagen fibers and rupture within the fibrous ring accurately. However, when severely degenerated intervertebral discs and hernia protruding the posterior longitudinal ligament existed, histological findings were not concordant well with T2-weighted images. Morphological appearances of autopsy specimens, divided into four on T2-weighted images, were well consistent with histological degeneration. This morphological classification, as shown on T2-weighted images, could also be used in the evaluation of intervertebral disc degeneration. (N.K.)

  18. Diagnosis of cervical disc disease

    International Nuclear Information System (INIS)

    High resolution CT easily localized lesions including soft tissues of the bone such as disc protrusion and thickening of the yellow ligament. In all cases, myelography demonstrated compression of the nerve roots of the spinal cord which corresponded to CT findings at the level where plain CT revealed a lesion. However, CT metrizamide myelography demonstrated the lesion more clearly than did conventional myelography. CT metrizamide myelography also outlined compression of the nerve roots satisfactorily and demonstrated compressed findings of the spinal cord in the dynamic study. Thus, high resolution CT was useful for screening of cervical disc disease, and CT metrizamide myelography, for identification of lesions of the nerve roots. (Chiba, N.)

  19. Cervical disc hernia operations through posterior laminoforaminotomy

    OpenAIRE

    Coskun Yolas; Nuriye Guzin Ozdemir; Hilmi Onder Okay; Ayhan Kanat; Mehmet Senol; Ibrahim Burak Atci; Hakan Yilmaz; Mustafa Kemal Coban; Mehmet Onur Yuksel; Umit Kahraman

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients ...

  20. Do We Need Biomarkers for Disc Degeneration?

    OpenAIRE

    Gruber, Helen E.; Edward N. Hanley, Jr.

    2007-01-01

    Disc degeneration plays a major role in this country's medical, social and economic structure. The life-time prevalence of low back pain, which has disc degeneration as its cause, is about 80% in the general population. It is a primary cause of disability and estimated costs related to low back disorders exceed $100 billion per year in the U.S. alone. Biomarkers are becoming increasingly important as indicators of the presence of disease, and in evaluating outcomes during clinical treatment. ...

  1. Artificial Cervical Disc Replacement Improves Mobility

    Science.gov (United States)

    Artificial Cervical Disc Replacement Improves Mobility February 18, 2009 From PinnacleHealth, Harrisburg, PA Welcome to this “OR ... this new technology with the use of an artificial disc has some significant benefits over the previous ...

  2. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... so much different than the fusion. The ProDisc C total disc replacement from Synthes Spine is an ... intervertebral disc in the cervical spine. The ProDisc C is indicated for patients suffering from intractable symptomatic ...

  3. Percutaneous laser disc decompression for cervical disc herniation

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical application of percutaneous laser disc decompression (PLDD) in the treatment of cervical disc herniation. Methods: The region between anterolateral cervical visceral sheath and carotid sheath was used as puncture access. Under C-arm fluoroscopic monitoring, the puncture needle was inserted to the cervical intervertebral space center, then, the photofiber was implanted in PLDD was performed in 32 patients of cervical disc herniation by using SLT30 semiconductor laser device with the laser output of 500-1 000 J. Results: The effective rate was 87.5%. No infection or serious complications occurred. Conclusion: Percutaneous laser disc decompression is a safe, effective and less invasive treatment for cervical disc herniation. (authors)

  4. Anterior cervical discectomy with fusion in patients with cervical disc degeneration: a prospective outcome study of 258 patients (181 fused with autologous bone graft and 77 fused with a PEEK cage

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    Roenning Paal

    2010-03-01

    Full Text Available Abstract Background Anterior cervical discectomy with fusion (ACDF is challenging with respect to both patient selection and choice of surgical procedure. The aim of this study was to evaluate the clinical outcome of ACDF, with respect to both patient selection and choice of surgical procedure: fusion with an autologous iliac crest graft (AICG versus fusion with an artificial cage made of polyetheretherketone (PEEK. Methods This was a non-randomized prospective single-center outcome study of 258 patients who underwent ACDF for cervical disc degeneration (CDD. Fusion was attained with either tricortical AICG or PEEK cages without additional anterior plating, with treatment selected at surgeon's discretion. Radicular pain, neck-pain, headache and patient satisfaction with the treatment were scored using the visual analogue scale (VAS. Results The median age was 47.5 (28.3-82.8 years, and 44% of patients were female. 59% had single-level ACDF, 40% had two level ACDF and 1% had three-level ACDF. Of the patients, 181 were fused with AICG and 77 with a PEEK-cage. After surgery, the patients showed a significant reduction in radicular pain (ΔVAS = 3.05, neck pain (ΔVAS = 2.30 and headache (ΔVAS = 0.55. Six months after surgery, 48% of patients had returned to work: however 24% were still receiving workers' compensation. Using univariate and multivariate analyses we found that high preoperative pain intensity was significantly associated with a decrease in pain intensity after surgery, for all three pain categories. There were no significant correlations between pain relief and the following patient characteristics: fusion method (AICG or PEEK-cage, sex, age, number of levels fused, disc level fused, previous neck surgery (except for neck pain, previous neck trauma, or preoperative symptom duration. Two hundred out of the 256 (78% patients evaluated the surgical result as successful. Only 27/256 (11% classified the surgical result as a failure

  5. 人颈椎间盘退变与细胞凋亡及基质金属蛋白酶11的表达%Matrix metalloproteinase 11 expression and cell apoptosis in human cervical disc degeneration

    Institute of Scientific and Technical Information of China (English)

    郭团茂; 刘淼; 张银刚; 张小卫; 武世勋

    2011-01-01

    背景:前期研究发现基质金属蛋白酶11基因在人退变颈、腰椎间盘组织中明显上调.目的:观察人退变颈椎间盘髓核组织中基质金属蛋白酶11的表达与细胞凋亡的关系.方法:纳入30个经MRI确认的退变颈椎间盘髓核组织和20个因颈椎创伤治疗获得的正常颈椎间盘髓核组织.结果与结论:苏木精-伊红染色显示退变的颈椎间盘髓核组织中髓核细胞较正常髓核组织明显减少(P < 0.01),而凋亡细胞较正常髓核组织明显增多(P < 0.01).免疫组化染色显示退变的颈椎间盘髓核组织中基质金属蛋白酶11的表达明显高于正常髓核组织(P < 0.01),且基质金属蛋白酶11表达与TUNEL染色检测到的细胞凋亡正相关(r=0.44,P < 0.05).说明高表达的基质金属蛋白酶11不仅可直接破坏细胞外基质尚可诱导髓核细胞凋亡,在椎间盘退变的过程中发挥重要作用.%BACKGROUND: Previous studies have shown that matrix metalloproteinase 11 gene is obviously upregulated in humandegenerated cervical and lumbar disc tissues.OBJECTIVE: To investigate the relationship between matrix metalloproteinase 11 expression in human cervical intervertebraldiscs and cell apoptosis.METHODS: Thirty discs from patients with cervical spondylosis diagnosed by MRI, and 20 discs of individuals with cervical spinaltrauma but without anamnesis evidence for disc degeneration or previous spine-ralated operations were included.RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that nucleus pulposus cells were signifcantly reduced(P < 0.01), but apoptotic cells were significantly increased (P < 0.01) in the degenerated nucleus pulposus tissue of cervicalintervertebral discs than in the normal nucleus pulposis tissue. Immunohistochemical staining showed that matrixmetalloproteinase 11 expression was significantly greater (P < 0.01) in the degenerated nucleus pulposus tissue of cervicalintervertebral discs than in the normal nucleus

  6. Cervical disc arthroplasty with ProDisc-C artificial disc: 5-year radiographic follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-bin; SUN Yu; ZHOU Fei-fei; LIU ZHONG-jun

    2013-01-01

    Background Cervical disc arthroplasty is an alternative surgery to standard cervical decompression and fusion for disc degeneration.Different types of cervical disc prosthesis are used in China.The aim of this study was to evaluate the radiographic outcomes of cervical arthroplasty using the ProDisc-C prosthesis.Methods Radiographic evaluation,including static and dynamic flexion-extension lateral images,was performed at baseline and at final follow-up.Results Twenty six patients who had single-level ProDisc-C arthroplasty were followed up for a mean period of 63 months (56-76 months).The range of motion at the operated level was 9.3°±3.7° at baseline and 7.3°±3.5° at final follow-up,with a significant difference (P <0.05).Seventeen of 26 levels (65.4%) developed heterotopic ossification:three were classified as grade Ⅱ,13 were classified as grade Ⅲ,and 1 as grade Ⅳ,according to McAfee's classification.Forty nine adjacent segments were evaluated by lateral Ⅹ-ray and 18 (36.7%) segments developed adjacent segment degenerations.Conclusions ProDisc-C arthroplasty had acceptable radiographic results at 5-year follow-up.The range of motion was preserved.However,more than 60% of the patients developed heterotopic ossification.

  7. Inflammation in intervertebral disc degeneration and regeneration

    OpenAIRE

    Molinos, Maria; Almeida, Catarina R.; Caldeira, Joana; Cunha, Carla; Gonçalves, Raquel M.; Barbosa, Mário A.

    2015-01-01

    Intervertebral disc (IVD) degeneration is one of the major causes of low back pain, a problem with a heavy economic burden, which has been increasing in prevalence as populations age. Deeper knowledge of the complex spatial and temporal orchestration of cellular interactions and extracellular matrix remodelling is critical to improve current IVD therapies, which have so far proved unsatisfactory. Inflammation has been correlated with degenerative disc disease but its role in discogenic pain a...

  8. Biomechanical analysis of the camelid cervical intervertebral disc

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    Dean K. Stolworthy

    2015-01-01

    Full Text Available Chronic low back pain (LBP is a prevalent global problem, which is often correlated with degenerative disc disease. The development and use of good, relevant animal models of the spine may improve treatment options for this condition. While no animal model is capable of reproducing the exact biology, anatomy, and biomechanics of the human spine, the quality of a particular animal model increases with the number of shared characteristics that are relevant to the human condition. The purpose of this study was to investigate the camelid (specifically, alpaca and llama cervical spine as a model of the human lumbar spine. Cervical spines were obtained from four alpacas and four llamas and individual segments were used for segmental flexibility/biomechanics and/or morphology/anatomy studies. Qualitative and quantitative data were compared for the alpaca and llama cervical spines, and human lumbar specimens in addition to other published large animal data. Results indicate that a camelid cervical intervertebral disc (IVD closely approximates the human lumbar disc with regard to size, spinal posture, and biomechanical flexibility. Specifically, compared with the human lumbar disc, the alpaca and llama cervical disc size are approximately 62%, 83%, and 75% with regard to area, depth, and width, respectively, and the disc flexibility is approximately 133%, 173%, and 254%, with regard to range of motion (ROM in axial-rotation, flexion-extension, and lateral-bending, respectively. These results, combined with the clinical report of disc degeneration in the llama lower cervical spine, suggest that the camelid cervical spine is potentially well suited for use as an animal model in biomechanical studies of the human lumbar spine.

  9. Fusion around cervical disc prosthesis: case report.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.

    2005-01-01

    OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a righ

  10. Stem cell horizons in intervertebral disc degeneration

    Directory of Open Access Journals (Sweden)

    Joseph Ciacci

    2009-01-01

    Full Text Available Joseph Ciacci1, Allen Ho1,2, Christopher P Ames3, Rahul Jandial41Division of Neurosurgery, University of California, San Diego, La Jolla, California, USA; 2Del E Webb Neurosciences, Aging and Stem Cell Research Center, The Burnham Institute for Medical Research, La Jolla, California, USA; 3Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; 4Division of Neurosurgery, Department of Surgery, City of Hope Cancer Center, Duarte, CA, USAAbstract: Intervertebral disc degeneration remains a pervasive and intractable disease arising from a combination of aging and stress on the back and spine. The growing field of regenerative medicine brings the promise of stem cells in the treatment of disc disease. Scientists and physicians hope to employ stem cells not only to stop, but also reverse degeneration. However, there are many important outstanding issues, including the hostile avascular, apoptotic physiological environment of the intervertebral disc, and the difficulty of obtaining mesenchymal stem cells, and directing them towards chondrocytic differentiation and integration within the nucleus pulposus of the disc. Given the recent advances in minimally invasive spine surgery, and developing body of work on stem cell manipulation and transplantation, stem cells are uniquely poised to bring about large-scale improvements in treatment and outcomes for degenerative disc disease. In this review we will first discuss the cellular and molecular factors influencing degeneration, and then examine the efficacy and difficulties of stem cell transplantation.Keywords: intervertebral disc degeneration, stem cells, disc disease, mesenchymal stem cells, stem cell transplantation

  11. Bryan total disc arthroplasty: a replacement disc for cervical disc disease

    OpenAIRE

    Wenger, Markus

    2010-01-01

    Markus Wenger1, Thomas-Marc Markwalder21Neurosurgery, Klinik Beau-Site and Salem-Spital, Berne, Switzerland; 2Attending Neurosurgeon FMH, Private Practice Spine Surgery, Berne-Muri, SwitzerlandAbstract: Total disc arthroplasty is a new option in the treatment of cervical degenerative disc disease. Several types of cervical disc prostheses currently challenge the gold-standard discectomy and fusion procedures. This review describes the Bryan Cervical Disc System and presents the Bryan prosthes...

  12. Comparison of adjacent segment degeneration five years after single level cervical fusion and cervical arthroplasty:a retrospective controlled study

    Institute of Scientific and Technical Information of China (English)

    SUN Yu; ZHAO Yan-bin; PAN Sheng-fa; ZHOU Fei-fei; CHEN Zhong-qiang; LIU Zhong-jun

    2012-01-01

    Background Cervical arthroplasty is indicated to preserve cervical motion and prevent accelerated adjacent segment degeneration.Whether accelerated adjacent segment degeneration is prevented in the long term is unclear.This trial compared adjacent segment degeneration in Bryan disc arthroplasty with that in anterior cervical decompression and fusion five years after the surgery.Methods We studied patients with single level degenerative cervical disc disease.The extent of adjacent segment degeneration was estimated from lateral X-rays.Results Twenty-six patients underwent single level Bryan disc arthroplasty and twenty-four patients underwent single level anterior cervical decompression and fusion.All patients were followed up for an average of sixty months.In the Bryan arthroplasty group,nine(17.6%)segments developed adjacent segment degeneration,which was significantly lower than that(60.4%)in the anterior cervical decompression and fusion group.Eleven segments in the Bryan arthroplasty group developed heterotopic ossification according to McAfee's classification and two segments had range of motion less than 2°.In the heterotopic ossification group,four(19.5%)segments developed adjacent segment degeneration,similar to the number in the non-heterotopic ossification group(16.7%).Adjacent segment degeneration rate was 50% in gradeⅣ?group but 11.8% in gradeⅡ?to Ⅲ.Conclusions Adjacent segment degeneration was accelerated after anterior cervical decompression and fusion.However,Bryan disc arthroplasty avoided accelerated adjacent segment degeneration by preserving motion.Patients with gradeⅣ?heterotopic ossification lost motion,and the rate of adjacent segment degeneration was higher than that in patients without heterotopic ossification.

  13. Cervical disc hernia operations through posterior laminoforaminotomy

    Directory of Open Access Journals (Sweden)

    Coskun Yolas

    2016-01-01

    Full Text Available Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years. Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%. On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

  14. Cervical disc hernia operations through posterior laminoforaminotomy

    Science.gov (United States)

    Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

  15. Mid-term clinical outcome of Bryan artificial cervical disc replacement for cervical spondylosis and its effect on degeneration of adjacent discs%Bryan人工颈椎椎间盘置换术治疗颈椎病的中期临床效果及对邻近椎间盘退变的影响

    Institute of Scientific and Technical Information of China (English)

    王贝宇; 曾建成; 孔清泉; 刘浩; 丁琛; 胡韬; 石锐; 李涛; 洪瑛; 宋跃明; 刘立岷

    2011-01-01

    Objective To observe the clinical outcome of Bryan artificial cervical disc replacement for cervical spondylo-sis, and to investigate its effect on degeneration of adjacent discs in mid-term study. Methods From November 2004 to December 2007, 34 patients (38 discs) receiving Bryan artificial cervical disc replacement were included in this study. Clinical results were evaluated by SF-36 score, neck disability index (NDI) score, neck/arm pain visual anatague scale (VAS) scores and Odom' s scale. The data were collected before surgery and at 1 week ,3,6, 12, 24, 36, 48 and 60 months after surgery. Adjacent degeneration was assessed by scoring system of cervical disk degeneration based on neutral lateral radiographs before operation and 12, 24, 36, 48 and 60 months after surgery. Incidence of postoperative complications and reoper-ations were also recorded. Results The neurological symptoms of each patient were significantly alleviated in short term after operation. The postoperative SF-36 physical component score and SF-36 mental component score, NDI score and neck/arm pain VAS scores were significantly improved compared with those of pre-operation. In 36 and 48 months after surgey, excellent and good outcomes were observed , though there were some cases with decreased outcomes; sound outcomes were achieved at the final follow-up in all cases. Mild degeneration of adjacent discs occurred after operation, but there was no severe degeneration at the final follow-up. There was no prosthesis subsidence or excursion, no heterotopic ossification or spontaneous fusion, and no reoperation. Conclusion Bryan artificial disc replacement has a sound clinical outcome in mid-term and can protect against acceleration of adjacent discs degeneration.%目的 观察Bryan人工颈椎椎间盘置换术治疗颈椎病的中期临床效果,研究该术对邻近椎间盘的影响.方法 2004年11月~2007年12月间,对34例颈椎间盘突出症患者共38个节段实施Bryan人工颈椎

  16. Activ C cervical disc replacement for myelopathy

    Directory of Open Access Journals (Sweden)

    L McGonagle

    2011-01-01

    Full Text Available Background: Cervical disc replacement is becoming an increasingly popular treatment option for cervical myelopathy. It retains motion at the affected segment, unlike anterior cervical discectomy and fusion. The aim of this study is to assess the outcomes of a series of patients who underwent Activ C disc replacement for cervical myelopathy. Materials and Methods: A series of patients at the above Trust with clinical and radiological evidence of cervical myelopathy who were suitable for cervical disc replacement from 2007 to 2009 were included. Implants were inserted by one of two consultant surgeons {IMS, MO′M}. Patients were assessed preoperatively and at six, 12 and 24 months, postoperatively, with a visual analogue score (VAS for neck and arm pain severity and frequency, the Neck Disability Index questionnaire (NDI and the Centre for Epidemiologic Studies Depression questionnaire (CES-D. Results: Ten patients underwent surgery between May 2007 and July 2009, 6 women, and 4 men. Average age was 54 years (40-64. Disc levels replaced were: four at C4-5; eight at C5-6; seven at C6-7. Three patients had one disc replaced, five patients had two discs replaced, and two patients had three discs replaced. The VAS for neck pain improved from 5.9 pre-operatively to 1.4-24 months postoperatively and the VAS arm pain improved from 5.4 to 2.6. The NDI improved from 51% preoperatively to 26.8% at 24 months postoperatively. The CES-D showed a slight increase from 19.5 preoperatively to 21.7 at 24 months, postoperatively. Conclusion: Cervical decompression and disc replacement improves pain and function in patients with cervical myelopathy. This benefit is maintained at 24 months post op, with no cases requiring revision.

  17. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available Artificial Cervical Disc Replacement Improves Mobility February 18, 2009 From PinnacleHealth, Harrisburg, PA Welcome to this “OR ... this new technology with the use of an artificial disc has some significant benefits over the previous ...

  18. Imbalanced protein expression patterns of anabolic, catabolic, anti-catabolic and inflammatory cytokines in degenerative cervical disc cells: new indications for gene therapeutic treatments of cervical disc diseases.

    Directory of Open Access Journals (Sweden)

    Demissew S Mern

    Full Text Available Degenerative disc disease (DDD of the cervical spine is common after middle age and can cause loss of disc height with painful nerve impingement, bone and joint inflammation. Despite the clinical importance of these problems, in current publications the pathology of cervical disc degeneration has been studied merely from a morphologic view point using magnetic resonance imaging (MRI, without addressing the issue of biological treatment approaches. So far a wide range of endogenously expressed bioactive factors in degenerative cervical disc cells has not yet been investigated, despite its importance for gene therapeutic approaches. Although degenerative lumbar disc cells have been targeted by different biological treatment approaches, the quantities of disc cells and the concentrations of gene therapeutic factors used in animal models differ extremely. These indicate lack of experimentally acquired data regarding disc cell proliferation and levels of target proteins. Therefore, we analysed proliferation and endogenous expression levels of anabolic, catabolic, ant-catabolic, inflammatory cytokines and matrix proteins of degenerative cervical disc cells in three-dimensional cultures. Preoperative MRI grading of cervical discs was used, then grade III and IV nucleus pulposus (NP tissues were isolated from 15 patients, operated due to cervical disc herniation. NP cells were cultured for four weeks with low-glucose in collagen I scaffold. Their proliferation rates were analysed using 3-(4, 5-dimethylthiazolyl-2-2,5-diphenyltetrazolium bromide. Their protein expression levels of 28 therapeutic targets were analysed using enzyme-linked immunosorbent assay. During progressive grades of degeneration NP cell proliferation rates were similar. Significantly decreased aggrecan and collagen II expressions (P<0.0001 were accompanied by accumulations of selective catabolic and inflammatory cytokines (disintegrin and metalloproteinase with thrombospondin motifs 4

  19. Magnetic resonance imaging of diseased cervical and lumbar intervertebral discs

    International Nuclear Information System (INIS)

    Magnetic resonance images (MRI) of diseased cervical and lumbar intervertebral discs involving both intrinsic and extrinsic cord lesions were examined using either a 0.15 T resistive or a 0.5 T superconductive magnetic imaging system. The vertebrae, intervertebral discs, and spinal cord were delineated on spin-echo (SE) images with a long repetition time (TR) and a short echo time (proton density-weighted image). Protrusion of degenerated intervertebral discs into the spinal canal was clearly demonstrated not only on sagittal but also on parasagittal and transverse views. The location of protruded discs and compression of the spinal cord, caudal sac, and nerve roots were well visualized three-dimensionally. Pathological features of intervertebral discs were well appreciated on T2-weighted images with long TR and SE pulse sequences. Degeneration of intervertebral discs resulted in decreased signal intensity in cases of lumbar disc involvement. For suspected myelomalacia, the intrinsic cord lesion resulting from traumatic disc protrusion appeared as focal low signal intensity on T1-weithed images and as somewhat high intensity on T2 weighted images. The inversion recovery sequence with median inversion time displayed an inferior image of low contrast and was judged uninformative in comparison to SE imags. The findings showed MRI to be an essential diagnostic technique for spinal cord disorders. It clearly pinpoints the anatomic structures of the spine and the features of disc degeneration. Both extrinsic and intrinsic cord abnormalities can be identified with MRI. The selection of proper pulse sequences is required for the differentiation of the object of interest. (Namekawa, K)

  20. Magnetic resonance imaging of diseased cervical and lumbar intervertebral discs

    Energy Technology Data Exchange (ETDEWEB)

    Kadoya, Satoru; Nakamura, Tsutomu; Takarada, Akira; Yamamoto, Itaru; Sato, Shuji.

    1989-02-01

    Magnetic resonance images (MRI) of diseased cervical and lumbar intervertebral discs involving both intrinsic and extrinsic cord lesions were examined using either a 0.15 T resistive or a 0.5 T superconductive magnetic imaging system. The vertebrae, intervertebral discs, and spinal cord were delineated on spin-echo (SE) images with a long repetition time (TR) and a short echo time (proton density-weighted image). Protrusion of degenerated intervertebral discs into the spinal canal was clearly demonstrated not only on sagittal but also on parasagittal and transverse views. The location of protruded discs and compression of the spinal cord, caudal sac, and nerve roots were well visualized three-dimensionally. Pathological features of intervertebral discs were well appreciated on T/sub 2/-weighted images with long TR and SE pulse sequences. Degeneration of intervertebral discs resulted in decreased signal intensity in cases of lumbar disc involvement. For suspected myelomalacia, the intrinsic cord lesion resulting from traumatic disc protrusion appeared as focal low signal intensity on T/sub 1/-weithed images and as somewhat high intensity on T/sub 2/ weighted images. The inversion recovery sequence with median inversion time displayed an inferior image of low contrast and was judged uninformative in comparison to SE imags. The findings showed MRI to be an essential diagnostic technique for spinal cord disorders. It clearly pinpoints the anatomic structures of the spine and the features of disc degeneration. Both extrinsic and intrinsic cord abnormalities can be identified with MRI. The selection of proper pulse sequences is required for the differentiation of the object of interest. (Namekawa, K).

  1. Artificial cervical disc replacement: range of motion of replacement segment and degeneration of adjacent segments%人工颈椎间盘置换:置换节段活动度及相邻节段退变分析

    Institute of Scientific and Technical Information of China (English)

    陈渲宇; 初冬; 伍骥; 郑超; 黄蓉蓉; 崔玉明; 尚咏; 范恒华; 虞攀峰; 赵旭红

    2015-01-01

    BACKGROUND:In recent years,artificial cervical disc replacement surgery as a new method for the treatment of cervical disease has gradualy been accepted and understood,but relevant complications have gradualy attracted attention.OBJECTIVE:To investigate the clinical outcomes of artificial cervical disc replacement in the treatment of cervical disease and the range of motion of the replacement segment.METHODS: A total of 25 patients with artificial cervical disc replacement in the treatment of cervical spondylosis,who were treated in the Department of Orthopedics,Air Force General Hospital of Chinese PLA from August 2006 to April 2012,were enroled in this study,including 15 males and 10 females,aged 31-76 years,averagely 51.04 years.There were 6 cases of double segments and 19 cases of single segment.They were folowed up for 24 to 93 months.Clinical results were assessed using the Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores.Imaging was used to observe range of motion,cervical curvature,heterotopic ossification,and degeneration of adjacent segments.RESULTS AND CONCLUSION:Neurological function in al patients was improved to different degrees.One case suffered from mild heterotopic ossification,but no clinical symptoms were found.No significant difference in range of motion of surgical segment,and range of motion of upper and lower adjacent segments was detected between pre-replacement and final folow-up results (P>0.05).No significant difference in range of motion of C2-C7 was found between pre-replacement and final folow-up results (P>0.05).Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores were significantly improved during final folow-up compared with pre-replacement (P<0.05).These results indicated that artificial cervical disc replacement in the treatment of cervical disease can achieve better clinical efficacy,can keep the range of motion of

  2. Bovine explant model of degeneration of the intervertebral disc

    OpenAIRE

    Sivan Sarit; Menage Janis; Roberts Sally; Urban Jill PG

    2008-01-01

    Abstract Background Many new treatments for degeneration of the intervertebral disc are being developed which can be delivered through a needle. These require testing in model systems before being used in human patients. Unfortunately, because of differences in anatomy, there are no ideal animal models of disc degeneration. Bovine explant model systems have many advantages but it is not possible to inject any significant volume into an intact disc. Therefore we have attempted to mimic disc de...

  3. Material Science in Cervical Total Disc Replacement

    OpenAIRE

    Pham, Martin H.; Mehta, Vivek A.; Alexander Tuchman; Hsieh, Patrick C.

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common ...

  4. MR imaging of cervical disc disease

    International Nuclear Information System (INIS)

    Since magnetic resonance imaging (MRI) technology has been greatly improved, MRI for cervical disc disease has become widely used in many facilities. Among non-invasive procedures, MRI is regarded as one of the most useful ones. Conventional myelography, CT myelography, and MRI were performed on 10 patients with cervical disc disease. The authors discussed the correlation between conventional myelography, CT myelography, and MRI as regards their ability to determine the localization and the laterality of disc protrusion and osteophyte. In our MRI study, we use both short-echo (SE) images and GRASS images. The parameters of our GRASS included 5 mm-thick sections. TR=200, TE=20, and flip angles of 10deg. This pulse sequence generates images with high signal cerebrospinal fluid (CSF), resulting in a high-contrast CSF-spinal cord, osteophyte, and disc protrusion. As yet, although it easily shows the localization and laterality of the disc and/or osteophyte, image quality of the GRASS is not yet sufficient to allow us to evaluate detailed deformity of the spinal cord and nerve root. The authors stress the usefulness of this GRASS image for the evaluation of suspected cervical disc disease. (author)

  5. The Research of Artificial Cervical Disc Replacement

    Institute of Scientific and Technical Information of China (English)

    Zhao Zhua; Qiang Shenb

    2008-01-01

    Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. It develops quickly during recent years. Currently there are several cervical arthroplasty devices. Each device varies in terms of materials, range of motion and constraint. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses as well as discussing issues regarding indications and technique. It is hoped that an improvement of cervical arthroplasty occurs in terms of materials and design as spinal surgeons enter a new dines of the management of cervical spine disease.

  6. Material Science in Cervical Total Disc Replacement.

    Science.gov (United States)

    Pham, Martin H; Mehta, Vivek A; Tuchman, Alexander; Hsieh, Patrick C

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281

  7. Material Science in Cervical Total Disc Replacement

    Directory of Open Access Journals (Sweden)

    Martin H. Pham

    2015-01-01

    Full Text Available Current cervical total disc replacement (TDR designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti, and cobalt-chrome (CoCr. These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation.

  8. Gene expression profile analysis of human intervertebral disc degeneration

    Science.gov (United States)

    Chen, Kai; Wu, Dajiang; Zhu, Xiaodong; Ni, Haijian; Wei, Xianzhao; Mao, Ningfang; Xie, Yang; Niu, Yunfei; Li, Ming

    2013-01-01

    In this study, we used microarray analysis to investigate the biogenesis and progression of intervertebral disc degeneration. The gene expression profiles of 37 disc tissue samples obtained from patients with herniated discs and degenerative disc disease collected by the National Cancer Institute Cooperative Tissue Network were analyzed. Differentially expressed genes between more and less degenerated discs were identified by significant analysis of microarray. A total of 555 genes were significantly overexpressed in more degenerated discs with a false discovery rate of < 3%. Functional annotation showed that these genes were significantly associated with membrane-bound vesicles, calcium ion binding and extracellular matrix. Protein-protein interaction analysis showed that these genes, including previously reported genes such as fibronectin, COL2A1 and β-catenin, may play key roles in disc degeneration. Unsupervised clustering indicated that the widely used morphology-based Thompson grading system was only marginally associated with the molecular classification of intervertebral disc degeneration. These findings indicate that detailed, systematic gene analysis may be a useful way of studying the biology of intervertebral disc degeneration. PMID:24130454

  9. Gene expression profile analysis of human intervertebral disc degeneration

    Directory of Open Access Journals (Sweden)

    Kai Chen

    2013-01-01

    Full Text Available In this study, we used microarray analysis to investigate the biogenesis and progression of intervertebral disc degeneration. The gene expression profiles of 37 disc tissue samples obtained from patients with herniated discs and degenerative disc disease collected by the National Cancer Institute Cooperative Tissue Network were analyzed. Differentially expressed genes between more and less degenerated discs were identified by significant analysis of microarray. A total of 555 genes were significantly overexpressed in more degenerated discs with a false discovery rate of < 3%. Functional annotation showed that these genes were significantly associated with membrane-bound vesicles, calcium ion binding and extracellular matrix. Protein-protein interaction analysis showed that these genes, including previously reported genes such as fibronectin, COL2A1 and f-catenin, may play key roles in disc degeneration. Unsupervised clustering indicated that the widely used morphology-based Thompson grading system was only marginally associated with the molecular classification of intervertebral disc degeneration. These findings indicate that detailed, systematic gene analysis may be a useful way of studying the biology of intervertebral disc degeneration.

  10. MRI findings of traumatic cervical disc herniation

    International Nuclear Information System (INIS)

    In general practice, disc hernia is increasingly being questioned about its relation with traffic injuries. In this study, we examined the image findings of cervical disc herniation for findings indicative of traumatic hernia. In 2008, we examined 35 cases of cervical disc herniation at our hospital by MRI. The patients were divided into two groups; patients with trauma history (19 cases) and those without (16 cases), and their images were compared. Disc herniation in the trauma group showed high intensity at T2, with some of the patients in this group also indicating continuous high intensity of the internal and herniated discs. Traumatic force was found to cause swelling under the laryngeal soft tissue. Cases with further flexion injury showed interspinous ligament hemorrhage. These findings strongly suggest the involvement of injury. But given that some younger patients in the non-trauma group also show high intensity at T2*, attention must be paid not to confuse swelling below the larynx with inflammation of the longus colli muscle. (author)

  11. Notochord Cells in Intervertebral Disc Development and Degeneration

    Directory of Open Access Journals (Sweden)

    Matthew R. McCann

    2016-01-01

    Full Text Available The intervertebral disc is a complex structure responsible for flexibility, multi-axial motion, and load transmission throughout the spine. Importantly, degeneration of the intervertebral disc is thought to be an initiating factor for back pain. Due to a lack of understanding of the pathways that govern disc degeneration, there are currently no disease-modifying treatments to delay or prevent degenerative disc disease. This review presents an overview of our current understanding of the developmental processes that regulate intervertebral disc formation, with particular emphasis on the role of the notochord and notochord-derived cells in disc homeostasis and how their loss can result in degeneration. We then describe the role of small animal models in understanding the development of the disc and their use to interrogate disc degeneration and associated pathologies. Finally, we highlight essential development pathways that are associated with disc degeneration and/or implicated in the reparative response of the tissue that might serve as targets for future therapeutic approaches.

  12. Lumbar Disc Degenerative Disease: Disc Degeneration Symptoms and Magnetic Resonance Image Findings

    OpenAIRE

    Saleem, Shafaq; Aslam, Hafiz Muhammad; Rehmani, Muhammad Asim Khan; Raees, Aisha; Alvi, Arsalan Ahmad; Ashraf, Junaid

    2013-01-01

    Study Design Cross sectional and observational. Purpose To evaluate the different aspects of lumbar disc degenerative disc disease and relate them with magnetic resonance image (MRI) findings and symptoms. Overview of Literature Lumbar disc degenerative disease has now been proven as the most common cause of low back pain throughout the world. It may present as disc herniation, lumbar spinal stenosis, facet joint arthropathy or any combination. Presenting symptoms of lumbar disc degeneration ...

  13. Bovine explant model of degeneration of the intervertebral disc

    Directory of Open Access Journals (Sweden)

    Sivan Sarit

    2008-02-01

    Full Text Available Abstract Background Many new treatments for degeneration of the intervertebral disc are being developed which can be delivered through a needle. These require testing in model systems before being used in human patients. Unfortunately, because of differences in anatomy, there are no ideal animal models of disc degeneration. Bovine explant model systems have many advantages but it is not possible to inject any significant volume into an intact disc. Therefore we have attempted to mimic disc degeneration in an explant bovine model via enzymatic digestion. Methods Bovine coccygeal discs were incubated with different concentrations of the proteolytic enzymes, trypsin and papain, and maintained in culture for up to 3 weeks. A radio-opaque solution was injected to visualise cavities generated. Degenerative features were monitored histologically and biochemically (water and glycosaminoglycan content, via dimethylmethylene blue. Results and Conclusion The central region of both papain and trypsin treated discs was macro- and microscopically fragmented, with severe loss of metachromasia. The integrity of the surrounding tissue was mostly in tact with cells in the outer annulus appearing viable. Biochemical analysis demonstrated greatly reduced glycosaminoglycan content in these compared to untreated discs. We have shown that bovine coccygeal discs, treated with proteolytic enzymes can provide a useful in vitro model system for developing and testing potential new treatments of disc degeneration, such as injectable implants or biological therapies.

  14. Features of intervertebral disc degeneration in rat's aging process

    Institute of Scientific and Technical Information of China (English)

    Yin-gang ZHANG; Zheng-ming SUN; Jiang-tao LIU; Shi-jie WANG; Feng-ling REN; Xiong GUO

    2009-01-01

    Objective: The age-related change is important part of degenerative disc disease. However, no appropriate animal model or objective evaluation index is available. This study aimed to investigate the features of intervertebral disc degeneration in aging process of rats. Methods: 22-month-old Sprague-Dawley (SD) rats were used as spontaneously occurring intervertebral disc degeneration models and 6-month-old rats as young controls. Expression of collagen types Ⅱ and Ⅹ was measured by immunohistochemistry. Degenerations of intervertebral discs were scored according to Miyamoto's method. Numbers and areas of afferent vascular buds were measured. The thicknesses of non-calcified and calcified layers were measured and statistically analyzed.Results: There were less collagen type Ⅱ expression and more collagen type Ⅹ expression in the calcified layer of the cartilage endplates and nucleus pulposus in the rats of the aged group than in the young control. There were fewer and smaller afferent vascular buds in the rats of the aged group than in the young control group. The ratio of the non-calcified to the calcified layers in the rats of the aged group significantly decreased, compared with that of the young control group (P<0.01). Conclusion: Rats can spontaneously establish intervertebral disc age-related degeneration. The expression of collagen types Ⅱ and Ⅹ, numbers and areas of afferent vascular buds, the ratio of the non-calcified to the calcified layers, and water and glycosaminoglycan contents in the nucleus pulposus are sensitive indexes of intervertebral disc degeneration.

  15. Effect of osteoporosis and intervertebral disc degeneration on endplate cartilage injury in rats

    Institute of Scientific and Technical Information of China (English)

    Lei Wang; Wei Cui; Jean Pierre Kalala; Tom Van Hoof; Bao-Ge Liu

    2014-01-01

    Objective:To investigate the effect of osteoporosis and intervertebral disc degeneration on the endplate cartilage injury in rats.Methods:A total of48 femaleSpragueDawley rats(3 months) were randomly divided intoGroupsA,B,C andD with12 rats in each group.Osteoporosis and intervertebral disc degeneration composite model, simple degeneration model and simple osteoporosis model were prepared inGroupsA,B andC respectively.After modeling, four rats of each group at12th,18th and24th week were sacrificed.Intervertebral height of cervical vertebra C6/C7 was measured.Micro-CT was used to image the endplate of cephalic and caudal cartilage atC6/C7 intervertebral disc.Abraded area rate ofC6 caudal andC7 cephalic cartilage endplate was calculated, and thenC6/C7 intervertebral disc was routinely embedded and sectioned, stained with safraninO to observe histological changes microscopically.Results:At12,18 and 24 weeks, intervertebral disc height ofC6/C7 were(0.58±0.09) mm,(0.53±0.04) mm and(0.04±0.06) mm inGroupA rats,(0.55±0.05) mm,(0.52±0.07) mm and(0.07±0.05) mm inGroupB rats.At24th week, intervertebral disc height ofGroupA rats was significantly lower than that ofGroupB rats (P0.05).At12 and18 weeks, the abraded rate ofC6 caudal andC7 cephalic cartilage endplate inGroupA rats were significantly higher than that inGroupsB,C andD rats(P0.05).Microscopic observation ofCT showed that ventral defects inC6 caudal orC7 cephalic cartilage endplate inGroupsA andB appeared after12 weeks of modeling;obvious cracks were found in front of theC6 andC7 vertebral body, and cartilage defect shown the trend of "repairing" at18 and24 weeks after modeling.Conclusions:Intervertebral disc degeneration and osteoporosis can cause damage to the cartilage endplate.Co-existence of these two factors can induce more serious damage to the endplate, which has possitive correlation with intervertebral disc degeneration.Osteoporosis plays a certain role in intervertebral disc degeneration process, and

  16. Genetic association studies in lumbar disc degeneration: a systematic review.

    Directory of Open Access Journals (Sweden)

    Pasi J Eskola

    Full Text Available OBJECTIVE: Low back pain is associated with lumbar disc degeneration, which is mainly due to genetic predisposition. The objective of this study was to perform a systematic review to evaluate genetic association studies in lumbar disc degeneration as defined on magnetic resonance imaging (MRI in humans. METHODS: A systematic literature search was conducted in MEDLINE, MEDLINE In-Process, SCOPUS, ISI Web of Science, The Genetic Association Database and The Human Genome Epidemiology Network for information published between 1990-2011 addressing genes and lumbar disc degeneration. Two investigators independently identified studies to determine inclusion, after which they performed data extraction and analysis. The level of cumulative genetic association evidence was analyzed according to The HuGENet Working Group guidelines. RESULTS: Fifty-two studies were included for review. Forty-eight studies reported at least one positive association between a genetic marker and lumbar disc degeneration. The phenotype definition of lumbar disc degeneration was highly variable between the studies and replications were inconsistent. Most of the associations presented with a weak level of evidence. The level of evidence was moderate for ASPN (D-repeat, COL11A1 (rs1676486, GDF5 (rs143383, SKT (rs16924573, THBS2 (rs9406328 and MMP9 (rs17576. CONCLUSIONS: Based on this first extensive systematic review on the topic, the credibility of reported genetic associations is mostly weak. Clear definition of lumbar disc degeneration phenotypes and large population-based cohorts are needed. An international consortium is needed to standardize genetic association studies in relation to disc degeneration.

  17. Acupuncture and Spontaneous Regression of a Radiculopathic Cervical Herniated Disc

    Directory of Open Access Journals (Sweden)

    Kim Sung-Ha

    2012-06-01

    Full Text Available The spontaneous regression of herniated cervical discs is not a well-established phenomenon. However, we encountered a case of a spontaneous regression of a severe radiculopathic herniated cervical disc that was treated with acupuncture, pharmacopuncture, and herb medicine. The symptoms were improved within 12 months of treatment. Magnetic resonance imaging (MRI conducted at that time revealed marked regression of the herniated disc. This case provides an additional example of spontaneous regression of a herniated cervical disc documented by MRI following non-surgical treatment.

  18. Total Disc Arthroplasty and Anterior Cervical Discectomy and Fusion in Cervical Spine: Competitive or Complimentary? Review of the Literature

    OpenAIRE

    Jawahar, Ajay; Nunley, Pierce

    2012-01-01

    Anterior cervical discectomy and arthrodesis has come to represent standard of care for patients with persistent radicular and/or myelopathic symptoms that have failed to improve with conservative treatments. One potential complication of the procedure is the accelerated degeneration of the vertebrae and the intervertebral discs adjacent to the level fused and the effects of fusion on those levels. The concern that fusion may be a contributing factor to accelerated adjacent segment degenerati...

  19. Cervical total disc replacement is superior to anterior cervical decompression and fusion: a meta-analysis of prospective randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Yujie Zhang

    Full Text Available Despite being considered the standard surgical procedure for symptomatic cervical disc disease, anterior cervical decompression and fusion invariably accelerates adjacent segment degeneration. Cervical total disc replacement is a motion-preserving procedure developed as a substitute to fusion. Whether cervical total disc replacement is superior to fusion remains unclear.We comprehensively searched PubMed, EMBASE, Medline, and the Cochrane Library in accordance with the inclusion criteria to identify possible studies. The retrieved results were last updated on December 12, 2014. We classified the studies as short-term and midterm follow-up.Nineteen randomized controlled trials involving 4516 cases were identified. Compared with anterior cervical decompression and fusion, cervical total disc replacement had better functional outcomes (neck disability index [NDI], NDI success, neurological success, neck pain scores reported on a numerical rating scale [NRS], visual analog scales scores and overall success, greater segmental motion at the index level, fewer adverse events and fewer secondary surgical procedures at the index and adjacent levels in short-term follow-up (P 0.05.Cervical total disc replacement presented favorable functional outcomes, fewer adverse events, and fewer secondary surgical procedures. The efficacy and safety of cervical total disc replacement are superior to those of fusion. Longer-term, multicenter studies are required for a better evaluation of the long-term efficacy and safety of the two procedures.

  20. Degenerated human intervertebral discs contain autoantibodies against extracellular matrix proteins

    Directory of Open Access Journals (Sweden)

    S Capossela

    2014-04-01

    Full Text Available Degeneration of intervertebral discs (IVDs is associated with back pain and elevated levels of inflammatory cells. It has been hypothesised that discogenic pain is a direct result of vascular and neural ingrowth along annulus fissures, which may expose the avascular nucleus pulposus (NP to the systemic circulation and induce an autoimmune reaction. In this study, we confirmed our previous observation of antibodies in human degenerated and post-traumatic IVDs cultured in vitro. We hypothesised that the presence of antibodies was due to an autoimmune reaction against specific proteins of the disc. Furthermore we identified antigens which possibly trigger an autoimmune response in degenerative disc diseases. We demonstrated that degenerated and post-traumatic IVDs contain IgG antibodies against typical extracellular proteins of the disc, particularly proteins of the NP. We identified IgGs against collagen type II and aggrecan, confirming an autoimmune reaction against the normally immune privileged NP. We also found specific IgGs against collagens types I and V, but not against collagen type III. In conclusion, this study confirmed the association between disc degeneration and autoimmunity, and may open the avenue for future studies on developing prognostic, diagnostic and therapy-monitoring markers for degenerative disc diseases.

  1. Frisbee - the first artificial cervical disc of 3RD generation

    Directory of Open Access Journals (Sweden)

    Karin Büttner-Janz

    2014-03-01

    Full Text Available OBJECTIVE: The current cervical disc arthroplasty is limited by postoperative facet joint arthritis, heterotopic ossification and segmental kyphosis. The total Frisbee disc, which has an upper convex/concave non-spherical surface and a lower flat sliding surface, is a new approach for improved outcomes. Prior to clinical application, safety and suitability tests are required. METHODS: The Frisbee is the first 3rd generation disc according to a new classification of total disc because it can precisely mimic the segmental ROM, including the soft limitation of axial rotation. The ISO 18192-1 test was carried out to determine the rate of wear debris. A FE model was used to assess the safety of prosthetic components. In the sagittal plane several variables to determine the most favorable lordotic angle were evaluated. RESULTS: Two angled prosthetic plates are safer than one sliding angled core to prevent the displacement. The lordosis of 7° of the Frisbee leads to kyphosis of no more than 2° without reduction of the ROM. The wear rate of the Frisbee is five times smaller compared to an FDA-approved disc with a spherical sliding surface. CONCLUSIONS: Based on the test results, the clinical application of Frisbee can now be studied. The postoperative kyphosis observed with other devices is not an issue with the Frisbee design. Physiological ROM is combined with the significant reduction of wear debris. For these reasons the Frisbee has the potential to provide a better balanced segmental loading reducing the degeneration of the joint surface and heterotopic ossification.

  2. Degenerated human intervertebral discs contain autoantibodies against extracellular matrix proteins

    OpenAIRE

    S Capossela; P Schläfli; Bertolo, A; T Janner; BM Stadler; T Pötzel; Baur, M; JV Stoyanov

    2014-01-01

    Degeneration of intervertebral discs (IVDs) is associated with back pain and elevated levels of inflammatory cells. It has been hypothesised that discogenic pain is a direct result of vascular and neural ingrowth along annulus fissures, which may expose the avascular nucleus pulposus (NP) to the systemic circulation and induce an autoimmune reaction. In this study, we confirmed our previous observation of antibodies in human degenerated and post-traumatic IVDs cultured in vitro. We hypothesis...

  3. New treatment strategies for canine intervertebral disc degeneration

    OpenAIRE

    Smolders, L.A.

    2013-01-01

    Degeneration of the intervertebral disc (IVD) is a common problem in dogs and humans. IVD degeneration can lead to herniation of the IVD with subsequent compression of neural structures and various clinical signs, including back pain. Current treatment of IVD disease is conservative or surgical. However, these therapies do not restore health or functionality to the IVD and may lead to spinal instability and recurrence of clinical signs. Therefore, the aim of this thesis was to investigate the...

  4. Frisbee - the first artificial cervical disc of 3RD generation

    OpenAIRE

    Karin Büttner-Janz; Bernhard Meyer; Rafael Donatus Sambale; Hans-Joachim Wilke; Nelli Rüdiger; Eiko Büttner

    2014-01-01

    OBJECTIVE: The current cervical disc arthroplasty is limited by postoperative facet joint arthritis, heterotopic ossification and segmental kyphosis. The total Frisbee disc, which has an upper convex/concave non-spherical surface and a lower flat sliding surface, is a new approach for improved outcomes. Prior to clinical application, safety and suitability tests are required. METHODS: The Frisbee is the first 3rd generation disc according to a new classification of total disc because it can...

  5. Calcified cervical intervertebral disc in children: radiological findings

    International Nuclear Information System (INIS)

    Nucleus pulposus calcification in children (CCIDC) is relatively rare but well known clinical syndrome, usually localized at the level of cervical spine. More than hundred and fifty cases have been reported in the literature with an increasing number of new reports in the last decade. The disease entity has been attributed to trauma, inflammation , or increased hydrostatic pressure with the disc, but the exact etiology still remains uncertain. The prognosis of disc calcification in children is good. As a rule pain resolves and there is a spontaneous resorption. Although the benign nature of the disease has been emphasized by many authors, herniation of the calcified nucleus pulposus through ruptured annulus fibrosus may occasionally occur. This rare but potentially serious complication with radiological signs of extradural space occupying lesion rises the question of eventual operative therapy. In several cases which have been reported in literature remission of symptoms occurred with conservative treatment. Radiological investigations are important for the diagnosis, evaluation of extent and follow-up of the disease. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) may be used. The first radiologic examination is standard radiography of the cervical spine. An addition of oblique views suggested before introduction of CT for better presentation of eventual protrusion (extrusion) of calcified discs material into the region of the intervertebral foramen (nerve root comprehension). Since frequently multilevel disc calcifications have been reported some authors suggest standard radiography of the whole spine. Radiography clearly demonstrates nucleus pulposus calcifications, which are round, oval flattened or fragmented. Radiographic appearances are to some extent reminiscent of discographic findings in normal or degenerated disc. Affected disc spaces may be slightly expanded indicating possibility of increased intradiscal pressure. Some of the

  6. Gender difference in genetic association between IL1A variant and early lumbar disc degeneration

    DEFF Research Database (Denmark)

    Eskola, Pasi J; Kjær, Per; Sorensen, Joan S;

    2012-01-01

    The purpose of the present study was to analyze the associations between specific genetic markers and early disc degeneration (DD) or early disc degeneration progression (DDP) defined by magnetic resonance imaging (MRI).......The purpose of the present study was to analyze the associations between specific genetic markers and early disc degeneration (DD) or early disc degeneration progression (DDP) defined by magnetic resonance imaging (MRI)....

  7. Concomitance of fibromyalgia syndrome and cervical disc herniation

    OpenAIRE

    GÜLER, MUSTAFA; Aydın, Teoman; Akgöl, Erdal; Taşpınar, Özgür

    2015-01-01

    [Purpose] Fibromyalgia syndrome (FMS) and cervical disc herniation (CDH) are a common diseases commonly encountered in physical therapy clinics. There are also patients who have both of these diseases. In this study we aim to investigated whether FMS is a risk factor for cervical disc herniation and the frequency of their coincident occurrence. [Subjects and Methods] Thirty-five patients having a primary FMS diagnosis according to the American Rheumatism Association criteria are taken into co...

  8. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... over, you know, fusion. People wonder, does it cause problems at the next level up, so if ... a concern. Will the fusion at this disc cause problems at the disc above or the disc ...

  9. Mid- to Long-Term Outcomes of Cervical Disc Arthroplasty versus Anterior Cervical Discectomy and Fusion for Treatment of Symptomatic Cervical Disc Disease: A Systematic Review and Meta-Analysis of Eight Prospective Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Yan Hu

    Full Text Available This study aimed to investigate the mid- to long-term outcomes of cervical disc arthroplasty (CDA versus anterior cervical discectomy and fusion (ACDF for the treatment of 1-level or 2-level symptomatic cervical disc disease.Medline, Embase, and the Cochrane Central Register of Controlled Trials databases were searched to identify relevant randomized controlled trials that reported mid- to long-term outcomes (at least 48 months of CDA versus ACDF. All data were analyzed by Review Manager 5.3 software. The relative risk (RR and 95% confidence intervals (CIs were calculated for dichotomous variables. The weighted mean difference (WMD and 95%CIs were calculated for continuous variables. A random effect model was used for heterogeneous data; otherwise, a fixed effect model was used.Eight prospective randomized controlled trials (RCTs were retrieved in this meta-analysis, including 1317 and 1051 patients in CDA and ACDF groups, respectively. Patients after an ACDF had a significantly lower rate of follow-up than that after CDA. Pooled analysis showed patients in CDA group achieved significantly higher rates of overall success, Neck Disability Index (NDI success, neurological success and significantly lower rates of implant/surgery-related serious adverse events and secondary procedure compared with that in ACDF group. The long-term functional outcomes (NDI, Visual Analog Scale (VAS neck and arm pain scores, the Short Form 36 Health Survey physical component score (SF-36 PCS, patient satisfaction and recommendation, and the incidence of superior adjacent segment degeneration also favored patients in CDA group with statistical difference. Regarding inferior adjacent segment degeneration, patients in CDA group had a lower rate without statistical significance.This meta-analysis showed that cervical disc arthroplasty was superior over anterior discectomy and fusion for the treatment of symptomatic cervical disc disease in terms of overall success, NDI

  10. The Mobi-C cervical disc for one-level and two-level cervical disc replacement: a review of the literature

    Directory of Open Access Journals (Sweden)

    Alvin MD

    2014-11-01

    Full Text Available Matthew D Alvin,1,2 Thomas E Mroz1,3,41Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 2Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA; 4Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH, USABackground: Cervical disc arthroplasty (CDA is a novel motion-preserving procedure that is an alternative to fusion. The Mobi-C disc prosthesis, one of many Food and Drug Administration (FDA-approved devices for CDA, is the only FDA-approved prosthesis for two-level CDA. Hence, it may allow for improved outcomes compared with multilevel fusion procedures.Purpose: To critically assess the available literature on CDA with the Mobi-C prosthesis, with a focus on two-level CDA.Methods: All clinical articles involving the Mobi-C disc prosthesis for CDA through September 1, 2014 were identified on Medline. Any paper that presented Mobi-C CDA clinical results was included. Study design, sample size, length of follow-up, use of statistical analysis, quality of life outcome scores, conflict of interest, and complications were recorded.Results: Fifteen studies were included that investigated Mobi-C CDA, only one of which was a level Ib randomized control trial. All studies included showed non-inferiority of one-level Mobi-C CDA to one-level anterior cervical discectomy and fusion (ACDF. Only one study analyzed outcomes of one-level versus two-level Mobi-C CDA, and only one study analyzed two-level Mobi-C CDA versus two-level ACDF. In comparison with other cervical disc prostheses, the Mobi-C prosthesis is associated with higher rates of heterotopic ossification (HO. Studies with conflicts of interest reported lower rates of HO. Adjacent segment degeneration or disease, along with other complications, were not assessed in most studies.Conclusion: One-level Mobi-C CDA is non-inferior, but not superior, to one-level ACDF for patients

  11. Biochemical imaging of cervical intervertebral discs with glycosaminoglycan chemical exchange saturation transfer magnetic resonance imaging: feasibility and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Schleich, Christoph; Mueller-Lutz, Anja; Zimmermann, Lisa; Boos, Johannes; Wittsack, Hans-Joerg; Antoch, Gerald; Miese, Falk [Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Dusseldorf (Germany); Schmitt, Benjamin [Siemens Ltd. Australia, Healthcare Sector, Macquarie Park, NSW (Australia)

    2016-01-15

    To evaluate glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging at 3T in the assessment of the GAG content of cervical IVDs in healthy volunteers. Forty-two cervical intervertebral discs of seven healthy volunteers (four females, three males; mean age: 21.4 ± 1.4 years; range: 19-24 years) were examined at a 3T MRI scanner in this prospective study. The MRI protocol comprised standard morphological, sagittal T2 weighted (T2w) images to assess the magnetic resonance imaging (MRI) based grading system for cervical intervertebral disc degeneration (IVD) and biochemical imaging with gagCEST to calculate a region-of-interest analysis of nucleus pulposus (NP) and annulus fibrosus (AF). GagCEST of cervical IVDs was technically successful at 3T with significant higher gagCEST values in NP compared to AF (1.17 % ± 1.03 % vs. 0.79 % ± 1.75 %; p = 0.005). We found topological differences of gagCEST values of the cervical spine with significant higher gagCEST effects in lower IVDs (r = 1; p = 0). We could demonstrate a significant, negative correlation between gagCEST values and cervical disc degeneration of NP (r = -0.360; p = 0.019). Non-degenerated IVDs had significantly higher gagCEST effects compared to degenerated IVDs in NP (1.76 % ± 0.92 % vs. 0.52 % ± 1.17 %; p < 0.001). Biochemical imaging of cervical IVDs is feasible at 3T. GagCEST analysis demonstrated a topological GAG distribution of the cervical spine. The depletion of GAG in the NP with increasing level of morphological degeneration can be assessed using gagCEST imaging. (orig.)

  12. Lumbar intervertebral disc degeneration and related factors in Korean firefighters

    OpenAIRE

    Jang, Tae-Won; Ahn, Yeon-Soon; Byun, Junsu; Lee, Jong-In; Kim, Kun-Hyung; KIM, YOUNGKI; Song, Han-Soo; Lee, Chul-Gab; Kwon, Young-Jun; Yoon, Jin-Ha; Jeong, Kyoungsook

    2016-01-01

    Objectives The job of firefighting can cause lumbar burden and low back pain. This study aimed to identify the association between age and lumbar intervertebral disc degeneration and whether the association differs between field and administrative (non-field) firefighters. Methods Subjects were selected using a stratified random sampling method. Firefighters were stratified by geographic area, gender, age and type of job. First, 25 fire stations were randomly sampled considering regional dist...

  13. Intervertebral disc (IVD): Structure, degeneration, repair and regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Whatley, Benjamin R.; Wen Xuejun, E-mail: xjwen@clemson.edu

    2012-02-01

    Low back pain affects a large portion of the population, resulting in high care costs for therapy and treatment. One primary cause of low back pain is the degeneration of the intervertebral disc (IVD) resulting in the compression of the spinal nerves and adjacent vertebrae. Exact causes of degeneration are unknown, but it is thought that natural aging, and both biological and genetic factors may play a significant role in the degenerative process. Conventional methods to alleviate low back pain include spinal fusion and artificial disc replacement. Traditional treatments through spinal fusion may eliminate pain yet do not restore disc function and lead to further degeneration of adjacent levels by altering disc biomechanics and natural kinematics. Recently, artificial IVD replacements have started to gain interest, with two IVD implants currently approved in the United States. Although these implants facilitate the preservation of motions and disc space height, they are unable to sustain compressive forces due to their lack of elasticity. In addition, the implants may produce wear debris that can cause osteolysis and other deleterious effects. As an alternative to these conventional approaches, tissue engineered IVD constructs offer the advantage of biointegration while preserving the essential attributes of natural motion and disc space restoration. There is a great need for the development of tissue engineered scaffolds that simulate the natural 3D morphology and microenvironment of the targeted tissue. Scaffolds should facilitate biological transport to satisfy nutrition and waste removal requirements within the IVD. The discrete tissue architectures of the nucleus pulposus (NP) and annulus fibrosus (AF) have posed great challenges to IVD tissue engineering. Current attempts have not been able to satisfy the biological functions and/or mechanical properties of native tissue. Therefore, these current scaffolds are far from satisfactory. This review highlights the

  14. Intervertebral disc (IVD): Structure, degeneration, repair and regeneration

    International Nuclear Information System (INIS)

    Low back pain affects a large portion of the population, resulting in high care costs for therapy and treatment. One primary cause of low back pain is the degeneration of the intervertebral disc (IVD) resulting in the compression of the spinal nerves and adjacent vertebrae. Exact causes of degeneration are unknown, but it is thought that natural aging, and both biological and genetic factors may play a significant role in the degenerative process. Conventional methods to alleviate low back pain include spinal fusion and artificial disc replacement. Traditional treatments through spinal fusion may eliminate pain yet do not restore disc function and lead to further degeneration of adjacent levels by altering disc biomechanics and natural kinematics. Recently, artificial IVD replacements have started to gain interest, with two IVD implants currently approved in the United States. Although these implants facilitate the preservation of motions and disc space height, they are unable to sustain compressive forces due to their lack of elasticity. In addition, the implants may produce wear debris that can cause osteolysis and other deleterious effects. As an alternative to these conventional approaches, tissue engineered IVD constructs offer the advantage of biointegration while preserving the essential attributes of natural motion and disc space restoration. There is a great need for the development of tissue engineered scaffolds that simulate the natural 3D morphology and microenvironment of the targeted tissue. Scaffolds should facilitate biological transport to satisfy nutrition and waste removal requirements within the IVD. The discrete tissue architectures of the nucleus pulposus (NP) and annulus fibrosus (AF) have posed great challenges to IVD tissue engineering. Current attempts have not been able to satisfy the biological functions and/or mechanical properties of native tissue. Therefore, these current scaffolds are far from satisfactory. This review highlights the

  15. Axial T2* mapping in intervertebral discs: a new technique for assessment of intervertebral disc degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Hoppe, Sven; Quirbach, Sebastian; Krause, Fabian G.; Benneker, Lorin M. [Inselspital, Berne University Hospital, Department of Orthopaedic Surgery, Berne (Switzerland); Mamisch, Tallal C. [Inselspital, Berne University Hospital, Department of Radiology, Berne (Switzerland); Werlen, Stefan [Clinic Sonnenhof, Department of Radiology, Berne (Switzerland)

    2012-09-15

    To demonstrate the potential benefits of biochemical axial T2* mapping of intervertebral discs (IVDs) regarding the detection and grading of early stages of degenerative disc disease using 1.5-Tesla magnetic resonance imaging (MRI) in a clinical setting. Ninety-three patients suffering from lumbar spine problems were examined using standard MRI protocols including an axial T2* mapping protocol. All discs were classified morphologically and grouped as ''healthy'' or ''abnormal''. Differences between groups were analysed regarding to the specific T2* pattern at different regions of interest (ROIs). Healthy intervertebral discs revealed a distinct cross-sectional T2* value profile: T2* values were significantly lower in the annulus fibrosus compared with the nucleus pulposus (P = 0.01). In abnormal IVDs, T2* values were significantly lower, especially towards the centre of the disc representing the expected decreased water content of the nucleus (P = 0.01). In herniated discs, ROIs within the nucleus pulposus and ROIs covering the annulus fibrosus showed decreased T2* values. Axial T2* mapping is effective to detect early stages of degenerative disc disease. There is a potential benefit of axial T2* mapping as a diagnostic tool, allowing the quantitative assessment of intervertebral disc degeneration. circle Axial T2* mapping effective in detecting early degenerative disc disease. (orig.)

  16. Axial T2* mapping in intervertebral discs: a new technique for assessment of intervertebral disc degeneration

    International Nuclear Information System (INIS)

    To demonstrate the potential benefits of biochemical axial T2* mapping of intervertebral discs (IVDs) regarding the detection and grading of early stages of degenerative disc disease using 1.5-Tesla magnetic resonance imaging (MRI) in a clinical setting. Ninety-three patients suffering from lumbar spine problems were examined using standard MRI protocols including an axial T2* mapping protocol. All discs were classified morphologically and grouped as ''healthy'' or ''abnormal''. Differences between groups were analysed regarding to the specific T2* pattern at different regions of interest (ROIs). Healthy intervertebral discs revealed a distinct cross-sectional T2* value profile: T2* values were significantly lower in the annulus fibrosus compared with the nucleus pulposus (P = 0.01). In abnormal IVDs, T2* values were significantly lower, especially towards the centre of the disc representing the expected decreased water content of the nucleus (P = 0.01). In herniated discs, ROIs within the nucleus pulposus and ROIs covering the annulus fibrosus showed decreased T2* values. Axial T2* mapping is effective to detect early stages of degenerative disc disease. There is a potential benefit of axial T2* mapping as a diagnostic tool, allowing the quantitative assessment of intervertebral disc degeneration. circle Axial T2* mapping effective in detecting early degenerative disc disease. (orig.)

  17. Clinical and radiologic comparison of dynamic cervical implant arthroplasty versus anterior cervical discectomy and fusion for the treatment of cervical degenerative disc disease.

    Science.gov (United States)

    Li, Zhonghai; Yu, Shunzhi; Zhao, Yantao; Hou, Shuxun; Fu, Qiang; Li, Fengning; Hou, Tiesheng; Zhong, Hongbin

    2014-06-01

    This study compared the clinical and radiological outcomes of dynamic cervical implant (DCI; Scient'x, Villers-Bretonneux, France) arthroplasty versus anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease. This prospective cohort study enrolled patients with single-level cervical degenerative disc disease who underwent DCI arthroplasty or ACDF between September 2009 and June 2011. Patients were followed up for more than 2years. Clinical evaluation included the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), Neck Disability Index (NDI), Japan Orthopedic Association (JOA) score, and visual analog scale (VAS) scores for neck and arm pain. Radiological assessments included segmental range of motion (ROM), overall ROM (C2-C7), disc height (DHI), and changes in adjacent disc spaces. The VAS, SF-36, JOA, and NDI scores improved significantly after surgery in both the DCI and ACDF groups. The VAS, JOA, and SF-36 scores were not significantly different between the DCI and ACDF groups at the final follow-up. The segmental ROM at the treated level and overall ROM increased significantly after surgery in the DCI group, but the ROM in the adjacent cephalad and caudal segments did not change significantly. The mean DHI at the treated level was significantly restored after surgery in both groups. Five patients (12.8%) in the DCI group showed new signs of adjacent segment degeneration. These results indicate that DCI is an effective, reliable, and safe procedure for the treatment of cervical degenerative disc disease. However, there is no definitive evidence that DCI arthroplasty has better intermediate-term results than ACDF. PMID:24411326

  18. Molecular mechanisms of cell death in intervertebral disc degeneration (Review).

    Science.gov (United States)

    Zhang, Fan; Zhao, Xueling; Shen, Hongxing; Zhang, Caiguo

    2016-06-01

    Intervertebral discs (IVDs) are complex structures that consist of three parts, namely, nucleus pulposus, annulus fibrosus and cartilage endplates. With aging, IVDs gradually degenerate as a consequence of many factors, such as microenvironment changes and cell death. Human clinical trial and animal model studies have documented that cell death, particularly apoptosis and autophagy, significantly contribute to IVD degeneration. The mechanisms underlying this phenomenon include the activation of apoptotic pathways and the regulation of autophagy in response to nutrient deprivation and multiple stresses. In this review, we briefly summarize recent progress in understanding the function and regulation of apoptosis and autophagy signaling pathways. In particular, we focus on studies that reveal the functional mechanisms of these pathways in IVD degeneration. PMID:27121482

  19. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... a total disc replacement arthroplasty on a young patient who has a herniated disc in her neck. ... way in, it’s, you know, I find that patients have very little pain after surgery. And just ...

  20. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... spine problems in up to date but this new technology with the use of an artificial disc ... of patients for many, many. Prior to this new technology, we would take out that disc and ...

  1. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... problems in up to date but this new technology with the use of an artificial disc has ... patients for many, many. Prior to this new technology, we would take out that disc and then ...

  2. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... to delineate the exact trajectory into the disc space. So now he’s found the disc space, what he wants to do is confirm it ... has stuck a marker into this actual disc space, and the next thing he is goes to ...

  3. Percutaneous treatment of cervical and lumbar herniated disc

    Energy Technology Data Exchange (ETDEWEB)

    Kelekis, A., E-mail: akelekis@med.uoa.gr; Filippiadis, D.K., E-mail: dfilippiadis@yahoo.gr

    2015-05-15

    Therapeutic armamentarium for symptomatic intervertebral disc herniation includes conservative therapy, epidural infiltrations (interlaminar or trans-foraminal), percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments for intervertebral disc herniation which can be performed as outpatient procedures. They can be classified in 4 main categories: mechanical, thermal, chemical decompression and biomaterials implantation. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. Indications include the presence of a symptomatic, small to medium sized contained intervertebral disc herniation non-responding to a 4–6 weeks course of conservative therapy. Contraindications include sequestration, infection, segmental instability (spondylolisthesis), uncorrected coagulopathy or a patient unwilling to provide informed consent. Decompression techniques are feasible and reproducible, efficient (75–94% success rate) and safe (>0.5% mean complications rate) therapies for the treatment of symptomatic intervertebral disc herniation. Percutaneous, imaging guided, intervertebral disc therapeutic techniques can be proposed either as an initial treatment or as an attractive alternative prior to surgery for the therapy of symptomatic herniation in both cervical and lumbar spine. This article will describe the mechanism of action for different therapeutic techniques applied to intervertebral discs of cervical and lumbar spine, summarize the data concerning safety and effectiveness of these treatments, and provide a rational approach for the therapy of symptomatic intervertebral disc herniation in cervical and lumbar spine.

  4. Insertion of PCB to treat traumatic cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    马远征; 隰建成; 陈兴; 关长勇; 全长彬

    2002-01-01

    Objective: To evaluate the clinical effect of PCB (a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate) in treating traumatic cervical intervertebral disc herniation. Methods: Anterior decompression and PCB internal fixation were used in 22 patients with traumatic cervical intervertebral disc herniation. They were followed up from 3 to 16 months and analyzed by symptom and image data. Among them, 16 patients underwent fixation at one level and 6 patients at two levels. Results: This technique did not cause intraoperative complications. After surgery no screw backout or device failure was found. Based on the JOA grade, 20 patients improved clinically and 2 gently because of serious cervical stenosis. The general excellent rate was 90.9%. Conclusions: PCB internal fixation is stable. Morbidity of donor and acceptor sites is less. No collars are needed after surgery.

  5. Insertion of PCBto treat traumatic cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    马远征; 陈兴; 等

    2002-01-01

    Objective:To evaluate the clinical effect of PCB(a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate)in treating taunatic cervical intervertebral disc herniation.Methods:Anterior decompression and PCB internal fixation were used in 22patients with traumatic cervical intervertebral disc herniation.They were followed up from3to16months and analyzed by symptom and imape data.Among them,16 patients underwent fixation at one level and 6patients at two levels.Results:This technique did not cause intraoperative complications.After surgery on screw backout or device failure was found.Based on the JOAgrade,20 patients improved clinically and 2gently because of serious cervical stenosis.The general excellent rate was90.9%.Conclusions:PCB internal fixation is stable.Morbidity of donor and acceptor sites is less.No collars are needed after surgery.

  6. Intradural tumor and concomitant disc herniation of cervical spine

    Directory of Open Access Journals (Sweden)

    Mihir R Bapat

    2011-01-01

    Full Text Available We report a rare patient of a simultaneous extradural and intradural compression of the cervical spinal cord due to co-existent intervertebral disc herniation and an intradural schwannoma at the same level. The intradural lesion was missed resulting in recurrence of myelopathy after a surprisingly complete functional recovery following anterior cervical discectomy. Retrospectively, it was noted that the initial cord swelling noticed was tumor being masked by the compression produced by the herniated disc. A contrast magnetic resonance imaging scan is important in differentiating intradural tumors of the spinal cord. A high index of suspicion is often successful in unmasking both the pathologies.

  7. Effect of intervertebral disc degeneration on disc cell viability: a numerical investigation.

    Science.gov (United States)

    Galbusera, Fabio; Mietsch, Antje; Schmidt, Hendrik; Wilke, Hans-Joachim; Neidlinger-Wilke, Cornelia

    2013-01-01

    Degeneration of the intervertebral disc may be initiated and supported by impairment of the nutrition processes of the disc cells. The effects of degenerative changes on cell nutrition are, however, only partially understood. In this work, a finite volume model was used to investigate the effect of endplate calcification, water loss, reduction of disc height and cyclic mechanical loading on the sustainability of the disc cell population. Oxygen, lactate and glucose diffusion, production and consumption were modelled with non-linear coupled partial differential equations. Oxygen and glucose consumption and lactate production were expressed as a function of local oxygen concentration, pH and cell density. The cell viability criteria were based on local glucose concentration and pH. Considering a disc with normal water content, cell death was initiated in the centre of the nucleus for oxygen, glucose, and lactate diffusivities in the cartilaginous endplate below 20% of the physiological values. The initial cell population could not be sustained even in the non-calcified endplates when a reduction of diffusion inside the disc due to water loss was modelled. Alterations in the disc shape such as height loss, which shortens the transport route between the nutrient sources and the cells, and cyclic mechanical loads, could enhance cell nutrition processes. PMID:21970697

  8. A Prospective Study of the Functional Outcome of Anterior Cervical Discectomy With Fusion in Single Level Degenerative Cervical Disc Prolapse

    Science.gov (United States)

    Kamani, Mayur M; Shetty, Vikram; Rai, H. Ravindranath; Hegde, Deepak

    2016-01-01

    Introduction Cervical spondylotic myelo-radiculopathy is a form of spinal cord dysfunction syndrome and usually accompanies age related degeneration of the spine. Aim To determine the functional outcome of anterior cervical discectomy with fusion and plating in single level degenerative cervical disc prolapse. Materials and Methods A total of 20 patients diagnosed with degenerative single level cervical disc prolapse who presented to the Department of Orthopaedic Surgery, Justice KS Hegde Charitable Hospital, Mangalore from the period of November 2012 to May 2014 were enrolled in the study. Complete clinical and radiological evaluation of the patients was done. A trial of conservative management was tried in all these patients for a period of two months. They were taken up for surgery only when conservative management had failed. Scoring of neck function before the surgery was done as per the Modified Japanese Orthopaedic Association (MJOA) score. All patients underwent anterior cervical discectomy and fusion (ACDF) with tricortical iliac crest bone grafting. Fixation was performed with titanium locking cervical plates. All patients were reviewed at 6 weeks and 6 months postoperatively. Assessment of neck function was done as per the MJOA scoring during all the reviews. Radiographic assessment was also done during all the reviews. The complications noted were documented. The statistical analysis was done using percentages; the arithmetic mean was calculated using SPSS software (version 16.0). Results Amongst the 20 patients included in the study, 1 patient died postoperatively due to oesophageal rupture. of the remaining 19 patients reviewed and followed up, all of them had improvement of symptoms and were reported to be in the ‘mild category’ as per the MJOA score. One patient developed dysphonia, in the immediate postoperative period due to recurrent laryngeal nerve palsy which recovered in a period of three months postoperative. Conclusion Single level

  9. A Review of Animal Models of Intervertebral Disc Degeneration: Pathophysiology, Regeneration, and Translation to the Clinic

    Science.gov (United States)

    Ghosh, Peter

    2016-01-01

    Lower back pain is the leading cause of disability worldwide. Discogenic pain secondary to intervertebral disc degeneration is a significant cause of low back pain. Disc degeneration is a complex multifactorial process. Animal models are essential to furthering understanding of the degenerative process and testing potential therapies. The adult human lumbar intervertebral disc is characterized by the loss of notochordal cells, relatively large size, essentially avascular nature, and exposure to biomechanical stresses influenced by bipedalism. Animal models are compared with regard to the above characteristics. Numerous methods of inducing disc degeneration are reported. Broadly these can be considered under the categories of spontaneous degeneration, mechanical and structural models. The purpose of such animal models is to further our understanding and, ultimately, improve treatment of disc degeneration. The role of animal models of disc degeneration in translational research leading to clinical trials of novel cellular therapies is explored. PMID:27314030

  10. A Review of Animal Models of Intervertebral Disc Degeneration: Pathophysiology, Regeneration, and Translation to the Clinic

    Directory of Open Access Journals (Sweden)

    Chris Daly

    2016-01-01

    Full Text Available Lower back pain is the leading cause of disability worldwide. Discogenic pain secondary to intervertebral disc degeneration is a significant cause of low back pain. Disc degeneration is a complex multifactorial process. Animal models are essential to furthering understanding of the degenerative process and testing potential therapies. The adult human lumbar intervertebral disc is characterized by the loss of notochordal cells, relatively large size, essentially avascular nature, and exposure to biomechanical stresses influenced by bipedalism. Animal models are compared with regard to the above characteristics. Numerous methods of inducing disc degeneration are reported. Broadly these can be considered under the categories of spontaneous degeneration, mechanical and structural models. The purpose of such animal models is to further our understanding and, ultimately, improve treatment of disc degeneration. The role of animal models of disc degeneration in translational research leading to clinical trials of novel cellular therapies is explored.

  11. A Review of Animal Models of Intervertebral Disc Degeneration: Pathophysiology, Regeneration, and Translation to the Clinic.

    Science.gov (United States)

    Daly, Chris; Ghosh, Peter; Jenkin, Graham; Oehme, David; Goldschlager, Tony

    2016-01-01

    Lower back pain is the leading cause of disability worldwide. Discogenic pain secondary to intervertebral disc degeneration is a significant cause of low back pain. Disc degeneration is a complex multifactorial process. Animal models are essential to furthering understanding of the degenerative process and testing potential therapies. The adult human lumbar intervertebral disc is characterized by the loss of notochordal cells, relatively large size, essentially avascular nature, and exposure to biomechanical stresses influenced by bipedalism. Animal models are compared with regard to the above characteristics. Numerous methods of inducing disc degeneration are reported. Broadly these can be considered under the categories of spontaneous degeneration, mechanical and structural models. The purpose of such animal models is to further our understanding and, ultimately, improve treatment of disc degeneration. The role of animal models of disc degeneration in translational research leading to clinical trials of novel cellular therapies is explored. PMID:27314030

  12. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... implant components work together with the surrounding spinal structures to provide stability and function. The ProDisc C implant is secured to the vertebral bodies above and below the disc space and held in place with two central keels. ...

  13. Application of cervical arthroplasty with Bryan cervical disc:long-term X-ray and magnetic resonance imaging follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-bin; SUN Yu; CHEN Zhong-qiang; LIU Zhong-jun

    2010-01-01

    Background Cervical disc arthroplasty is a new technique for treating degenerative cervical disease. Its goal is to avoid the degeneration of adjacent levels by preserving motion at the treated level. The aims of this study were to evaluate the radiologic outcomes of Bryan cervical disc replacement and the degenerative status of adjacent segments.Methods Twenty-two patients at a single center underwent discectomy and implantation of Bryan cervical disc. The mean follow-up period was 60 months (57-69 months). Twenty patients underwent single-level arthroplasty and two underwent arthroplasty at two levels. The levels of surgery included C3/4 (3 levels), C4/5 (2 levels), C5/6 (18 levels) and C6/7 (1 level). Radiographic evaluation included dynamic X-ray examination and magnetic resonance imaging (MRI) at baseline and at final follow-up.Results On X-ray examination, the range of motion (ROM) at the operated level was 7.2° (2.5°-13.0°) at baseline and 7.8° (1.0°-15.0°) at final follow-up (P >0.05). Heterotopic ossification around the prosthesis was observed in eight levels,and two levels showed loss of motion (ROM <2°). MRI showed worsening by a grade at the upper level in 2/22 patients,and worsening by a grade at the lower level in 3/22, according to Miyazaki's classification. No further impingement of the ligamentum flavum into the spinal canal was observed at adjacent levels, though the disc bulge was slightly increased at both the adjacent upper and lower levels at final follow-up.Conclusions Arthroplasty using Bryan cervical disc prosthesis resulted in favorable radiologic outcomes in this study.Disc degeneration at adjacent levels may be postponed by this technique.

  14. Intradiscal injection of simvastatin retards progression of intervertebral disc degeneration induced by stab injury

    OpenAIRE

    Zhang, Huina; Lin WANG; Park, Jun Beom; Park, Paul; Yang, Victor C.; Hollister, Scott J.; La Marca, Frank; Lin, Chia-Ying

    2009-01-01

    Introduction Earlier work indicates that the cholesterol-lowering drug, simvastatin, is anabolic to chondrogenic expression of rat intervertebral disc (IVD) cells, which suggests a potential role for simvastatin in IVD regeneration. In this study, we expand on our earlier work to test the effectiveness of simvastatin on disc degeneration utilizing a rat tail disc degeneration model. Methods 30 rats that underwent 21 G needle-puncture at rat tail discs were injected with simvastatin-loaded pol...

  15. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... been utilized to perform anterior cervical discectomies and fusions. The fusion procedure has been the most common way to ... significant benefits over the previous procedure of the fusion, and that is, able to maintain motion of ...

  16. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... put my handle back on, and meanwhile, the scrub nurse is preparing the actual disc itself because ... was doing that on the back table, the scrub nurse and the circulating nurse were putting together ...

  17. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... the location of the diseased disc, and the soft tissues are moved away from the front of the ... a zero-profile implant that does not contact soft tissue structures after it is implanted. The technical aspect ...

  18. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... wonder, does it cause problems at the next level up, so if I fuse this disc here, ... fusion, then the hope is that the next levels hopefully won’t feel the stress, and by ...

  19. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... to date but this new technology with the use of an artificial disc has some significant benefits ... facing straight up. The incision that Dr. Beutler uses is a little over an inch long, and ...

  20. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... the way to do this in the near future of the state of the art. What are ... the-art of treating disc herniations in the future. Thank you. Thank you for watching this “OR ...

  1. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... stress, and by not feeling the stress, they should maintain good discs, hopefully over the lifetime of ... right where it wants to be, and that should be a natural position for the bones of ...

  2. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... implant that is composed of two cobalt chrome alloy end plates and a polyethylene insert. The polyethylene ... the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to promote bony ...

  3. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... place with two central keels. All bone contacting surfaces of the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to promote bony on growth, providing long-term ...

  4. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... fascia, which is kind of connective tissue that helps hold things together. It’s the very last layer ... placing a marker external to the skin to help to delineate the exact trajectory into the disc ...

  5. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... it out, the patient’s chin is to the right and the chest wall is towards the left, and he’s dissecting up and down. So the ... other nerve, the one that goes down his left arm, and if both are freed up, we’ll put in a piece of disc where we took out our disc right through here. Can I have a nerve fork, ...

  6. Protective Effect of Ligustrazine on Lumbar Intervertebral Disc Degeneration of Rats Induced by Prolonged Upright Posture

    Directory of Open Access Journals (Sweden)

    Qian-Qian Liang

    2014-01-01

    Full Text Available Most chronic low back pain is the result of degeneration of the lumbar intervertebral disc. Ligustrazine, an alkaloid from Chuanxiong, reportedly is able to relieve pain, suppress inflammation, and treat osteoarthritis and it has the protective effect on cartilage and chondrocytes. Therefore, we asked whether ligustrazine could reduce intervertebral disc degeneration. To determine the effect of ligustrazine on disc degeneration, we applied a rat model. The intervertebral disc degeneration of the rats was induced by prolonged upright posture. We found that pretreatment with ligustrazine for 1 month recovered the structural distortion of the degenerative disc; inhibited the expression of type X collagen, matrix metalloproteinase (MMP-13, and MMP3; upregulated type II collagen; and decreased IL-1β, cyclooxygenase (COX-2, and inducible nitric oxide synthase (iNOS expression. In conclusion, ligustrazine is a promising agent for treating lumbar intervertebral disc degeneration disease.

  7. Expression and significance of VEGF and p53 in degenerate intervertebral disc tissue

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yu Lu; Xiao-Hong Ding; Li-Jun Zhong; Hong Xia; Xiao-Dong Chen; Hai Huang

    2013-01-01

    Objective: To investigate the mechanism of expression and significance of vascular endothelial growth factor (VEGF) and p53 in degenerate intervertebral disc tissue. Methods: Pathological sections collected from 156 patients with lumbar disc herniation after surgery were tested by immunohistochemistry method, for evaluation of the expression of VEGF and p53 in degenerate intervertebral disc tissue. Results: 98 cases (62.8%) with vascular infiltration phenomenon are found, and positive rates of VEGF and p53 in degenerate intervertebral disc tissue are 73.42%(116/156) and 58.97% (92/156); co-expression rate is 53.2%(83/156); the expression rates of VEFG and p53 are significantly higher in the tissue with blood vessel infiltration than in the tissue without infiltration; there is a close relationship of VEGF with p53. Conclusions: VEGF and p53 gene synergetic express in degenerate intervertebral disc tissue, working together in neovascularization and infiltration, and accelerating intervertebral disc tissue degeneration.

  8. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Directory of Open Access Journals (Sweden)

    A.C. Issy

    Full Text Available Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  9. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Energy Technology Data Exchange (ETDEWEB)

    Issy, A.C.; Castania, V.; Castania, M. [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Salmon, C.E.G. [Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Nogueira-Barbosa, M.H. [Divisão de Radiologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Bel, E. Del [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Defino, H.L.A. [Departamento de Biomecânica, Medicina e Reabilitação do Sistema Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2013-03-15

    Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  10. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    International Nuclear Information System (INIS)

    Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration

  11. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Directory of Open Access Journals (Sweden)

    A.C. Issy

    2013-03-01

    Full Text Available Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  12. Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Y.; Lee, S.H.; Shin, S.W. [Wooridul Spine Hospital, Department of Neurosurgery, Kangnam-gu (Korea); Chung, S.E.; Park, H.S. [Wooridul Spine Hospital, Department of Radiology, Kangnam-gu (Korea)

    2005-12-01

    A discogenic cervical headache is a subtype of cervicogenic headache (CEH) that arises from a degenerative cervical disc abnormality. The purpose of this study was to evaluate the clinical outcome of percutaneous endoscopic cervical discectomy (PECD) for patients with chronic cervical headache due to soft cervical disc herniation. Seventeen patients underwent PECD for intractable headache. The inclusion criteria were soft disc herniation without segmental instability, proven by both local anesthesia and provocative discography for headache unresponsive to conservative treatment. The mean follow-up period was 37.6 months. Fifteen of the 17 patients (88.2%) showed successful outcomes based on the Macnab criteria. Pain scores on a visual analog scale (VAS) improved from a preoperative mean of 8.35{+-}0.79 to 2.12{+-}1.17, postoperatively (P<0.01). The mean disc height decreased from 6.81{+-}1.08 to 5.98{+-}1.07 mm (P<0.01). There was no newly developed segmental instability or spontaneous fusion on follow-up radiography. In conclusion, PECD appears to be effective for chronic severe discogenic cervical headache under strict inclusion criteria. (orig.)

  13. Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation

    International Nuclear Information System (INIS)

    A discogenic cervical headache is a subtype of cervicogenic headache (CEH) that arises from a degenerative cervical disc abnormality. The purpose of this study was to evaluate the clinical outcome of percutaneous endoscopic cervical discectomy (PECD) for patients with chronic cervical headache due to soft cervical disc herniation. Seventeen patients underwent PECD for intractable headache. The inclusion criteria were soft disc herniation without segmental instability, proven by both local anesthesia and provocative discography for headache unresponsive to conservative treatment. The mean follow-up period was 37.6 months. Fifteen of the 17 patients (88.2%) showed successful outcomes based on the Macnab criteria. Pain scores on a visual analog scale (VAS) improved from a preoperative mean of 8.35±0.79 to 2.12±1.17, postoperatively (P<0.01). The mean disc height decreased from 6.81±1.08 to 5.98±1.07 mm (P<0.01). There was no newly developed segmental instability or spontaneous fusion on follow-up radiography. In conclusion, PECD appears to be effective for chronic severe discogenic cervical headache under strict inclusion criteria. (orig.)

  14. Association of abdominal obesity with lumbar disc degeneration--a magnetic resonance imaging study.

    Directory of Open Access Journals (Sweden)

    Jani Takatalo

    Full Text Available PURPOSE: To evaluate whether midsagittal (abdominal obesity in magnetic resonance imaging (MRI, waist circumference (WC and body fat percentage are associated with lumbar disc degeneration in early adulthood. METHODS: We obtained the lumbar MRI (1.5-T scanner of 325 females and 233 males at a mean age of 21 years. Lumbar disc degeneration was evaluated using Pfirrmann classification. We analysed the associations of MRI measures of obesity (abdominal diameter (AD, sagittal diameter (SAD, ventral subcutaneous thickness (VST, and dorsal subcutaneous thickness (DST, WC and body fat percentage with disc degeneration sum scores using ordinal logistic regression. RESULTS: A total of 155 (48% females and 147 (63% males had disc degeneration. AD and SAD were associated with a disc degeneration sum score of ≥3 compared to disc degeneration sum score of 0-2 (OR 1.67; 95% confidence interval (CI 1.20-2.33 and OR 1.40; 95% CI 1.12-1.75, respectively among males, but we found no association among females. WC was also associated with disc degeneration among males (OR 1.03 per one cm; 95% CI 1.00-1.05, but not among females. CONCLUSION: Measures of abdominal obesity in MRI and waist circumference were associated with disc degeneration among 21-year-old males.

  15. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... it gets inserted, it’s very rough. It’s titanium plasma sprayed, and this allows for the body to ... surfaces of the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to ...

  16. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... diseased disc and releasing pressure on the surrounding nerves and spinal cord. We’re going to do an image ... with that motion is going to push against nerves or the spinal cord. So it’s sometimes a little bit more ...

  17. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... is exactly where I’m putting my instruments right now, and those are small pieces of disc that I’m taking out. I’m obviously going real slow through this area, and the reason is ...

  18. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... ultrahigh molecular weight polyethylene, and it’s a medical-grade plastic that’s really been made to sustain active ... the disc level above and below as well. Good point. It does, and so I’m kind ...

  19. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... the next levels hopefully won’t feel the stress, and by not feeling the stress, they should maintain good discs, hopefully over the ... was an appropriate procedure that would work. These studies turned out well, and the FDA has approved ...

  20. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... the next levels hopefully won’t feel the stress, and by not feeling the stress, they should maintain good discs, hopefully over the ... FDA studies, in our study, in all the literature that I’ve read has been extremely positive ...

  1. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... see it gets inserted, it’s very rough. It’s titanium plasma sprayed, and this allows for the body ... the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to promote bony ...

  2. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... That’s the actual disc space right there. It’s beautiful. So I’m going to take a scalpel ... And that’s where I wan it. That looks beautiful, so I’m very pleased about that. I’ ...

  3. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... plate. Obviously that procedure has worked out very well, but there’s probably a lot of really significant ... fusing this area, putting in an artificial disc. Well it allows motion, you know, and there’s been ...

  4. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... younger patients, the patients in their 30s and 40s with disc herniations, than an older patient, let’s ... go to the recovery room, spend maybe an hour, hour and 15 minutes in recovery room and ...

  5. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... the next levels hopefully won’t feel the stress, and by not feeling the stress, they should maintain good discs, hopefully over the ... cord. So it’s sometimes a little bit more work. Well, there’s the space for where that nerve ...

  6. Investigation of intervertebral disc degeneration using multivariate FTIR spectroscopic imaging.

    Science.gov (United States)

    Mader, Kerstin T; Peeters, Mirte; Detiger, Suzanne E L; Helder, Marco N; Smit, Theo H; Le Maitre, Christine L; Sammon, Chris

    2016-06-23

    Traditionally tissue samples are analysed using protein or enzyme specific stains on serial sections to build up a picture of the distribution of components contained within them. In this study we investigated the potential of multivariate curve resolution-alternating least squares (MCR-ALS) to deconvolute 2nd derivative spectra of Fourier transform infrared (FTIR) microscopic images measured in transflectance mode of goat and human paraffin embedded intervertebral disc (IVD) tissue sections, to see if this methodology can provide analogous information to that provided by immunohistochemical stains and bioassays but from a single section. MCR-ALS analysis of non-degenerate and enzymatically in vivo degenerated goat IVDs reveals five matrix components displaying distribution maps matching histological stains for collagen, elastin and proteoglycan (PG), as well as immunohistochemical stains for collagen type I and II. Interestingly, two components exhibiting characteristic spectral and distribution profiles of proteoglycans were found, and relative component/tissue maps of these components (labelled PG1 and PG2) showed distinct distributions in non-degenerate versus mildly degenerate goat samples. MCR-ALS analysis of human IVD sections resulted in comparable spectral profiles to those observed in the goat samples, highlighting the inter species transferability of the presented methodology. Multivariate FTIR image analysis of a set of 43 goat IVD sections allowed the extraction of semi-quantitative information from component/tissue gradients taken across the IVD width of collagen type I, collagen type II, PG1 and PG2. Regional component/tissue parameters were calculated and significant correlations were found between histological grades of degeneration and PG parameters (PG1: p = 0.0003, PG2: p < 0.0001); glycosaminoglycan (GAG) content and PGs (PG1: p = 0.0055, PG2: p = 0.0001); and MRI T2* measurements and PGs (PG1: p = 0.0021, PG2: p < 0.0001). Additionally

  7. Return to Play After Cervical Disc Surgery.

    Science.gov (United States)

    Kang, Daniel G; Anderson, Justin C; Lehman, Ronald A

    2016-10-01

    Criteria for return to sports and athletic activities after cervical spine surgery are unclear. There is limited literature regarding the outcomes and optimal criteria. Determining return to play criteria remains a challenge and continues to depend on the experience and good judgment of the treating surgeon. There is strong consensus in the literature, despite lack of evidence-based data, that athletes after single-level anterior cervical discectomy and fusion (ACDF) may safely return to collision and high-velocity sports. The athlete should be counseled and managed on a case-by-case basis, taking into consideration the type of sport, player-specific variables, and type of surgery performed. PMID:27543397

  8. Influence of IL-20 on lumbar disc degeneration:An experimental study

    OpenAIRE

    Yang, Tianjing; Xu, Huaqing

    2015-01-01

    Objective: To determine the influence of IL-20 on the development of lumbar degeneration. Methods: The study design was prospective and carried out in Tianjin Fourth center Hospital, Tianjin, China between Jan 2012 and Jan 2014. Sixty-nine patients with degenerative disc disease treated surgically were included in experimental group, and fifteen patients with normal discs were included in control group. The evaluation of disc degeneration was performed using T2-weighted sagittal MRI according...

  9. A Review of Animal Models of Intervertebral Disc Degeneration: Pathophysiology, Regeneration, and Translation to the Clinic

    OpenAIRE

    Chris Daly; Peter Ghosh; Graham Jenkin; David Oehme; Tony Goldschlager

    2016-01-01

    Lower back pain is the leading cause of disability worldwide. Discogenic pain secondary to intervertebral disc degeneration is a significant cause of low back pain. Disc degeneration is a complex multifactorial process. Animal models are essential to furthering understanding of the degenerative process and testing potential therapies. The adult human lumbar intervertebral disc is characterized by the loss of notochordal cells, relatively large size, essentially avascular nature, and exposure ...

  10. Painful, degenerating intervertebral discs up-regulate neurite sprouting and CGRP through nociceptive factors

    OpenAIRE

    Krock, Emerson; Rosenzweig, Derek H.; Chabot-Doré, Anne-Julie; Jarzem, Peter; Weber, Michael H.; Ouellet, Jean A; Stone, Laura S.; Haglund, Lisbet

    2014-01-01

    Intervertebral disc degeneration (IVD) can result in chronic low back pain, a common cause of morbidity and disability. Inflammation has been associated with IVD degeneration, however the relationship between inflammatory factors and chronic low back pain remains unclear. Furthermore, increased levels of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) are both associated with inflammation and chronic low back pain, but whether degenerating discs release sufficient conce...

  11. Cervical disc herniation manifesting as a Brown-Sequard syndrome

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2012-01-01

    Full Text Available Brown-Sequard syndrome is commonly seen in the setting of spinal trauma or an extramedullary spinal neoplasm. The clinical picture reflects hemisection of the spinal cord. We report a rare case of Brown-Sequard syndrome caused by a large cervical herniated disc. A 63-year-old man presented with progressive right hemiparesis and disruption of pain and temperature sensation on the left side of the body. Magnetic resonance imaging showed large C3-C4 disc herniation compressing the spinal cord at that level, with severe canal stenosis from C4 through C7. Decompressive cervical laminoplasty was performed. After surgery, complete sensory function was restored and a marked improvement in motor power was obtained.

  12. A computational study of intervertebral disc degeneration in relation to changes in regional tissue composition and disc nutrition

    OpenAIRE

    Ruiz Wills, Carlos

    2015-01-01

    Up to 85% of the world population suffers from low back pain, a clinical condition often related to the intervertebral disc (IVD) degeneration (DD). Altered disc cell nutrition affects cell viability and can generate catabolic cascades that degrade the extracellular matrix (ECM). Also, a major degenerative biochemical change in the disc is the proteoglycan (PG) loss, which affects the osmotic pressure and hydration that is critical for cell nutrition. However, the relationship between biochem...

  13. Signal intensity loss of the intervertebral discs in the cervical spine of young patients on fluid sensitive sequences

    Energy Technology Data Exchange (ETDEWEB)

    Bruin, F. de; Horst, S. ter; Bloem, J.L.; Reijnierse, M. [Leiden University Medical Center, Department of Radiology, C2-S, Albinusdreef 2, PO box 9600, Leiden (Netherlands); Berg, R. van den; Hooge, M. de; Gaalen, F. van; Heijde, D. van der [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Fagerli, K.M. [Diakonhjemmet Hospital, Department of Rheumatology, Oslo (Norway); Landewe, R. [Amsterdam Medical Center, Department of Rheumatology, Amsterdam (Netherlands); Oosterhout, M. van [Groene Hartziekenhuis, Department of Rheumatology, Gouda (Netherlands)

    2016-03-15

    To evaluate the signal intensity (SI) of the intervertebral discs of the cervical spine on magnetic resonance (MR) fluid sensitive sequences, and correlate this to secondary signs of degeneration on MR and radiographs as well as to age. A total of 265 patients aged ≥16 with back pain (≥3-months, <2-year, onset <45-years) from the SPondyloArthritis Caught Early (SPACE) cohort were included. Sagittal 1.5 T MR images and lateral radiographs of the cervical spine were independently evaluated by two readers for: SI of the intervertebral discs using a grading system based of Pfirrmann (grade 1 normal/bright SI; 2 inhomogeneous/bright SI; 3 inhomogeneous/mildly decreased SI; 4 inhomogeneous/markedly decreased SI; 5 signal void), disc herniation and Modic changes (MRI) and disc space narrowing, osteophytes and sclerosis (radiograph). Readers were blinded for clinical information. Descriptive statistics were used for characteristics and prevalence of findings, and regression analysis was used for age and grades. Of 265 patients (36 % male, mean age 30), 221 (83 %) patients had 1 to 6 discs (median 4) with decreased SI. Of 1,590 discs, 737 (46 %) were grade 1; 711 (45 %) grade 2; 133 (8 %) grade 3; 8 (1 %) grade 4 and 1 (0 %) grade 5. Secondary signs of degeneration were rare and seen predominantly in C5-C7 and appear to be related to signal loss grade 3 and 4. Low signal intensity of intervertebral discs in absence of secondary degenerative signs in the cervical spine on fluid sensitive MR images might be pre-existing and part of the natural course. (orig.)

  14. Safe physiotherapy interventions in large cervical disc herniations.

    LENUS (Irish Health Repository)

    Keramat, Keramat Ullah

    2012-01-01

    A 34-year-old woman was seen in a physiotherapy department with signs and symptoms of cervical radiculopathy. Loss of cervical lordosis and a large paracentral to intraforaminal disc prolapse (8 mm) at C5-C6 level was reported on MRI. She was taking diclofenac sodium, tramadol HCl, diazepam and pregabalin for the preceding 2 months and no significant improvement, except temporary relief, was reported. She was referred to physiotherapy while awaiting a surgical opinion from a neurosurgeon. In physiotherapy she was treated with mobilisation of the upper thoracic spine from C7 to T6 level. A cervical extension exercise was performed with prior voluntary extension of the thoracic spine and elevated shoulders. She was advised to continue the same at home. General posture advice was given. Signs and symptoms resolved within the following four sessions of treatment over 3 weeks. Surgical intervention was subsequently deemed unnecessary.

  15. RESULTS OF SURGICAL TREATMENT IN CERVICAL HERNIATED DISC ANALYSIS OF 275 CASES

    OpenAIRE

    L. Eva

    2010-01-01

    Background: Problems of surgical treatment of cervical disc hernia are still far from being resolved. It shows variety of surgical procedures it. The operations for cervical level with radiculopatie were quite limited. Limits method were dictated by the absence of accurate diagnosis, microsurgical methods, extensions, sometimes unjustified, conservative treatment. Material and method Complex issue of cervical spine degenerative pathologies, particularly cervical disc hernia with radicular syn...

  16. Combined Anterior Approach with Transcorporeal Herniotomy for a Huge Migrated Cervical Disc Herniation

    OpenAIRE

    Choi, Kyung-Chul; Ahn, Yong; Lee, Choon Dae; Lee, Sang-Ho

    2011-01-01

    The report describes the herniation of a huge migrated cervical disc, which was treated by a combined anterior approach. A 50-year-old man presented with radiculopathy and myelopathy. Radiological images revealed the herniation of a huge disc which had migrated superiorly from the C6-7 disc to the C5-6 disc. We tried to combine an anterior cervical discectomy and fusion (ACDF) and transcorporeal herniotomy to avoid corpectomy. Postoperatively, successful clinical and radiological results were...

  17. Artificial cervical disc replacement: Principles, types and techniques

    Directory of Open Access Journals (Sweden)

    Sekhon L

    2005-01-01

    Full Text Available Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. Currently there are four cervical arthroplasty devices available on the market whose results in clinical use have been reported. Each device varies in terms of materials, range of motion, insertion technique and constraint. It is not known which device is ideal. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses available on the market as well as discussing issues regarding indications and technique. Pitfalls are discussed and early experiences reviewed. In time, it is hoped that a refinement of cervical arthroplasty occurs in terms of both materials and design as well as in terms of indications and clinical outcomes as spinal surgeons enter a new era of the management of cervical spine disease.

  18. Can discoblock replace discography for identifying painful degenerated discs?

    International Nuclear Information System (INIS)

    Objectives: The aim of the present study was to intra-individually compare provocative discography and discoblock (disc analgesia) of idiopathic degenerated discs (IDD) results to each other, to clinical parameters, and to MRI findings. By this the value of both diagnostic features should be critically reevaluated. Methods: 31 intervertebral IDD (Pfirrmann III°–IV°) of 26 patients were analyzed for surgery decision making by combined discoblock/discography procedure in an open MRI at 1 T. A correlation analysis was performed between the Dallas Discogram Scale, pain discrimination score (PDS: concordant/discordant/no pain), positive discoblock (Numerical Rating Scale [NRS] reduction by ≥3, 60 min after intervention), presence of Modic changes or high intensity zones (HIZ), patient sex and age, intervention level, injection pressure and discography endpoint analysis (pain/pressure/anatomic/volume). Results: Concordant pain could be evoked in 35% of the IDDs whereas discoblock was positive in 64%. Patients’ age, sex, Dallas I, Dallas II, and Pfirrmann scores, as well as the presence of HIZ did not correlate to PDS or discoblock results. Discoblock correlated positively to concordant pain. Further positive correlation was found between PDS and intervention level/pressure, between discoblock and Modic changes/discography endpoint as well as between HIZ and discography endpoint. Conclusions: We suggest discoblock to be an additional tool for surgery decision making in patients with IDD because it correlates to concordant pain evoked by provocative discography as well as to presence of Modic changes. Additionally, assessment of a release instead of provocation of pain can be of advantage

  19. Texture-based quantification of lumbar intervertebral disc degeneration from conventional T2-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Michopoulou, Sofia; Speller, Robert; Todd-Pokropek, Andrew (Dept. of Medical Physics and Bioengineering, University College London (United Kingdom)), e-mail: s.michopoulou@ucl.ac.uk; Costaridou, Lena (Dept. of Medical Physics, School of Medicine, Univ. of Patras (Greece)); Vlychou, Marianna (Dept. of Radiology, Univ. Hospital of Larissa, Univ. of Thessaly (Greece))

    2011-02-15

    Background: Disc degeneration quantification is important for monitoring the effects of new therapeutic methods, such as cell and growth factor therapy. Magnetic resonance (MR) image texture reflects biochemical and structural tissue properties and has been used for differentiating between normal and pathological status in a variety of medical applications. Purpose: To investigate the suitability of textural descriptors for the quantification of intervertebral disc degeneration using conventional T2-weighted magnetic resonance images of the lumbar spine. Material and Methods:: A 3 Tesla scanner was used, and conventional T2- weighted MR images were obtained, and a total of 255 lumbar discs were analyzed. An atlas-based method was used for segmenting the disc regions from the images. A set of first and second order statistics describing texture of each region were calculated. The validity and reliability of these descriptors for disc degeneration severity quantification was tested through their correlation with patient age and qualitative clinical grading of degeneration severity. Texture quantification results were compared to a widely accepted method for disc degeneration quantification based on the measurement of disc's mean signal intensity. Results: Out of the set of texture descriptors tested, two descriptors quantifying image intensity inhomogeneity, i.e. the grey level standard deviation and co-occurrence derived sum of squares displayed the strongest association to patient age and clinical grading of disc degeneration severity (P < 0.001). This is attributed to these inhomogeneity descriptors' capability to capture the progressive loss of nucleus-annulus distinction in the degenerative progress. Statistical analysis indicates that these descriptors can effectively separate between early stages of degeneration. Quantitative measurements are highly repeatable (intraclass correlation >0.98). Conclusion: Inhomogeneity descriptors could be a valuable

  20. In Vivo Mouse Intervertebral Disc Degeneration Model Based on a New Histological Classification

    Science.gov (United States)

    Ohnishi, Takashi; Sudo, Hideki; Iwasaki, Koji; Tsujimoto, Takeru; Ito, Yoichi M.; Iwasaki, Norimasa

    2016-01-01

    Although human intervertebral disc degeneration can lead to several spinal diseases, its pathogenesis remains unclear. This study aimed to create a new histological classification applicable to an in vivo mouse intervertebral disc degeneration model induced by needle puncture. One hundred six mice were operated and the L4/5 intervertebral disc was punctured with a 35- or 33-gauge needle. Micro-computed tomography scanning was performed, and the punctured region was confirmed. Evaluation was performed by using magnetic resonance imaging and histology by employing our classification scoring system. Our histological classification scores correlated well with the findings of magnetic resonance imaging and could detect degenerative progression, irrespective of the punctured region. However, the magnetic resonance imaging analysis revealed that there was no significant degenerative intervertebral disc change between the ventrally punctured and non-punctured control groups. To induce significant degeneration in the lumbar intervertebral discs, the central or dorsal region should be punctured instead of the ventral region. PMID:27482708

  1. Fractalkine receptor chemokine (CX3CR1 influences on cervical and lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    In-Soo Oh

    2015-01-01

    of CX3CL1 and CX3CR1 in the disc degeneration and to compare between cervical and lumbar HNP. Materials and Methods: The mRNA concentrations of CX3CL1/CX3CR1 chemokine were analyzed in the surgically obtained disc specimens from C-HNP (n = 13 and L-HNP (n = 13 by real-time polymerase chain reaction (PCR. The localization of CX3CL1/CX3CR1 chemokine in the disc of C-HNP and L-HNP patients was determined using immunohistochemical study. Blood samples from patients with C-HNP and L-HNP patients were stained for CX3CR1 with flow cytometric analysis. Results: The CX3CL1 positive cell ratio in the discs was observed in both groups by immunohistochemical study. CX3CR1 was strongly expressed on endothelial cells in C-spine disc, but sparely expressed in L-spine disc. There was greater CX3CR1 mRNA expression in C-HNP patients than in L-HNP patients as quantified by reversal transcription-PCR (P = 0.010. CX3CR1 positive cell frequencies and CX3CR1 expression levels were increased in CD4 (+ T-cells and natural killer (NK cells from patients with C-HNP (P = 0.210 and P = 0.040. Conclusions: This study identified that increases in CX3CL1 and CX3CR1-expressing cells are significantly related to pathomechanism of HNP for the first time. Especially, CD4 (+ T-cells and NK cells expressing CX3CR1 may play an important role in developing C-HNP.

  2. Association of abdominal obesity with lumbar disc degeneration--a magnetic resonance imaging study

    OpenAIRE

    Jani Takatalo; Jaro Karppinen; Simo Taimela; Jaakko Niinimäki; Jaana Laitinen; Roberto Blanco Sequeiros; Dino Samartzis; Raija Korpelainen; Simo Näyhä; Jouko Remes; Osmo Tervonen

    2013-01-01

    PURPOSE: To evaluate whether midsagittal (abdominal) obesity in magnetic resonance imaging (MRI), waist circumference (WC) and body fat percentage are associated with lumbar disc degeneration in early adulthood. METHODS: We obtained the lumbar MRI (1.5-T scanner) of 325 females and 233 males at a mean age of 21 years. Lumbar disc degeneration was evaluated using Pfirrmann classification. We analysed the associations of MRI measures of obesity (abdominal diameter (AD), sagittal diameter (SAD),...

  3. Paraplegia by Acute Cervical Disc Protrusion after Lumbar Spine Surgery.

    Directory of Open Access Journals (Sweden)

    Sheng-Huan Chen

    2005-04-01

    Full Text Available Non-traumatic paraplegia caused by herniation of the cervical intervertebral disc is anuncommon postoperative complication. A patient with claudication and radiculopathy wasscheduled for lumbar laminectomy due to spinal stenosis. Postoperatively, numbness belowT6 was found in his both legs of the patient. MRI showed a protruded intervertebral discbetween C6 and C7. Despite urgent disectomy, the patient's lower extremities remained paralyzedwithout significant improvement for 3 months. Loss of muscle support during generalanesthesia, excessive neck extension during endotracheal intubation and positioning, as wellas bucking and agitation are believed as triggering factors for the protrusion of the cervicaldisc. We suggest that a complete history taking and physical examination be accomplishedin patients scheduled for lumbar spine surgery in order to exclude coexisting cervical spinedisorders. In addition, skillful endotracheal intubation and careful neck positioning aremandatory for patients receiving surgery in the prone position.

  4. The value of MRI in the preoperative diagnosis of cervical disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Kuroki, Takefusa; Kumano, Kiyoshi; Hirabayashi, Shigeru; Takahashi, Ryuji; Inasaka, Riki (Kanto Rosai Hospital, Tokyo (Japan))

    1991-12-01

    To determine whether or not magnetic resonance (MR) imaging would become an alternative to conventional myelography in the preoperative diagnosis of cervical disc herniation, MR images of 13 patients were retrospectively reviewed. MR imaging revealed herniated one disc, 2 discs, and 3 discs in 4, 6, and 3 patients, respectively. When herniation confined to one disc was consistent with clinical manifestations, MR imaging alone was capable of determining the disc involved in herniation. MR imaging was, however, of limited value in determining the responsible disc for herniation when there were two or more herniated discs on MR images. (N.K.).

  5. Heterotopic ossification in cervical disc arthroplasty: Is it clinically relevant?

    OpenAIRE

    Barbagallo, Giuseppe M.; Corbino, Leonardo A.; Olindo, Giuseppe; Albanese, Vincenzo

    2010-01-01

    Study design:  Retrospective cohort study. Objective:  To analyze the presence and clinical relevance of heterotopic ossification (HO) at 3 years mean follow-up. Methods:  Thirty patients suffering from cervical radiculopathy and/or myelopathy treated with anterior disc replacement (ADR) were studied. HO was classified using the McAfee grading system. Range of motion was measured from flexion and extension x-rays. Short-form 36 and neck disability index (NDI) assessed functional outcome. Resu...

  6. Treatment of Protrusion of Cervical Intervertebral Disc by Tuina

    Institute of Scientific and Technical Information of China (English)

    YE Jian-guo

    2004-01-01

    Twenty-five cases of protrusion of cervical intervertebral disc were treated by the manipulations of rolling, pressing, pushing with one-finger, traction, obliquely pulling, grasping of five channels, sweeping, etc. The result showed that 10 cases were cured, 14 cases got marked effectiveness and 1 case was improved.%采用滚、按、一指禅、拔伸、斜扳、拿五经、扫散法等手法,治疗颈椎间盘突出症患者25例,结果治愈10例,显效14例,好转1例.

  7. The non-invasive investigation of lumbar disc degeneration in patients with chronic low back pain

    International Nuclear Information System (INIS)

    The painful degenerate disc is a recognised cause of low back pain. Magnetic Resonance Imaging (MRI) has now replaced discography in the non-invasive assessment of disk degeneration. However, the prohibitive capital expense of MRI and the small number of MR units in Australia produce limitations in clinical access. In contrast, Computed Tomography (CT) is readily available and is performed in most patients prior to MRI referral. This prospective study was undertaken to determine whether preliminary CT could offer any information about disc degeneration and so reduce the demand on a MRI scanner. 30 consecutive patients were studied all of whom had both CT and MRI examinations. Of a total 107 discs examined by both techniques, MRI was able to identify 37 degenerate discs. Conclusive evidence of degeneration (i.e. the presence of intervertebral gas) was only seen in 3 discs at CT (1 patient). Of the 29 posterior disc bulges found on CT, all were both bulging and degenerate on MRI. Indications for MRI based on the CT findings are recommended. Using these criteria, 13% (4 patients) of this study group could have avoided an expensive and unnecessary MR investigation. A useful algorithm for the investigation and assessment of patients with chronic low back pain is discussed. 8 refs., 5 figs., 1 tab

  8. Treatment of the degenerated intervertebral disc; closure, repair and regeneration of the annulus fibrosus

    NARCIS (Netherlands)

    Sharifi, Shahriar; Bulstra, Sjoerd K.; Grijpma, Dirk W.; Kuijer, Roel

    2015-01-01

    Degeneration of the intervertebral disc (IVD) and disc herniation are two causes of low back pain. The aetiology of these disorders is unknown, but tissue weakening, which primarily occurs due to inherited genetic factors, ageing, nutritional compromise and loading history, is the basic factor causi

  9. Hypertension is independently associated with lumbar disc degeneration: a large-scale population-based study

    OpenAIRE

    Samartzis, D; Bow, HYC; Karppinen, JI; Luk, KDK; Cheung, BMY; Cheung, KMC

    2014-01-01

    INTRODUCTION: Hypertension, as elevated systolic blood pressure (SBP) and / or diastolic blood pressure (DBP), is a factor related to cardiovascular disease; however, its role in development of disc degeneration remains speculative. Hence, this large-scale population-based study addressed the association of blood pressure with lumbar disc ...

  10. Magnetic resonance imaging for each type of herniated cervical intervertebral disc

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham Gyum [Ansan 1 College, Ansan (Korea, Republic of)

    2000-04-15

    The classification of herniated intervertebral cervical disc types are clinically important, as treatment methods would be slightly different according to the specific type of the herniated disc. 423 patients who suffered from herniated intervertebral cervical discs were tested with Magnetic Resonance Imaging (MRI), to distinguish the type of the herniated discs. The following are the results: The age of the patients tested ranged from 16 to 75 years old and the mean age of the patients was 41.4 years of age. There were twice as many male patients with a ratio of 288: 135 men to women. 101 patients suffered from single herniated discs while 322 patients suffered from multi-herniated discs. Of single herniated disc injuries. 52 patients had protruded discs (52%) while 25 patients had extruded discs (25%). 21 Patients (21%) had herniated intervertebral discs between C{sub 4} {approx} C{sub 5} and 51 patients (50%) and had the same injury between C{sub 5} and C{sub 6}. Of multi-herniated disc injuries. 140 patients had protruded discs (44%). while 45 patients had extruded discs (14%). 54 patients had both protruded and extruded discs (17%). 36 patients (11%). herniated discs C{sub 3} {approx} C{sub 6}: 69 patients (21%). herniated discs C{sub 3} {approx} C{sub 7}: 47 patients (15%) herniated discs C{sub 4} {approx} C{sub 6} and 67 patients (20%) herniated discs C{sub 5} {approx} C{sub 7}.

  11. Lumbar intervertebral disc puncture under C-arm fluoroscopy: a new rat model of lumbar intervertebral disc degeneration.

    Science.gov (United States)

    Li, Dapeng; Yang, Huilin; Huang, Yonghui; Wu, Yan; Sun, Taicun; Li, Xuefeng

    2014-01-01

    To establish a minimally invasive rat model of lumbar intervertebral disc degeneration (IDD) to better understand the pathophysiology of the human condition. The annulus fibrosus of lumbar level 4-5 (L4-5) and L5-6 discs were punctured by 27-gauge needles using the posterior approach under C-arm fluoroscopic guidance. Magnetic resonance imaging (MRI), histological examination by hematoxylin and eosin (H&E) staining, and reverse transcription polymerase chain reaction (RT-PCR) were performed at baseline and 2, 4, and 8 weeks after disc puncture surgery to determine the degree of degeneration. All sixty discs (thirty rats) were punctured successfully. Only two of thirty rats subjected to the procedure exhibited immediate neurological symptoms. The MRI results indicated a gradual increase in Pfirrmann grade from 4 to 8 weeks post-surgery (PCol2), and Sox9 mRNAs, which encode disc components, decreased gradually post-surgery. In contrast, mRNA expression of type I collagen (Col1), an indicator of fibrosis, increased (P<0.05). The procedure of annular puncture using a 27-gauge needle under C-arm fluoroscopic guidance had a high success rate. Histological, MRI, and RT-PCR results revealed that the rat model of disc degeneration is a progressive pathological process that is similar to human IDD. PMID:24770648

  12. Angiogenesis in the degeneration of the lumbar intervertebral disc

    OpenAIRE

    David, Gh; Ciurea, AV; Iencean, SM; Mohan, A.

    2010-01-01

    The goal of the study is to show the histological and biochemical changes that indicate the angiogenesis of the intervertebral disc in lumbar intervertebral disc hernia and the existence of epidemiological correlations between these changes and the risk factors of lumbar intervertebral disc hernia, as well as the patient's quality of life (QOL). We have studied 50 patients aged between 18 and 73 years old, who have undergone lumbar intervertebral disc hernia surgery, making fibroblast growth ...

  13. Acute monoplegia associated with non-traumatic intradural cervical disc herniation:

    Directory of Open Access Journals (Sweden)

    Ahmet Menkü

    2014-03-01

    Full Text Available Intradural disc herniation has been reported as a rare and particular type of intervertebral disc herniation. It occurs mostly in the lumbar spine, and rarely in the cervical or thoracic spine. Non-traumatic cervical intradural disc herniation is rare, with only 17 cases reported in English literature at the cervical region and can manifest itself by severe symptoms such as Brown-Sequard syndrome, transverse myelopathy and radiculopathy. We present a unique case of intradural cervical disc herniation only causing lower extremity monoplegia. To our knowledge, this is the first case described in the literature. The patient underwent microsurgical removal of the herniated disc via an anterior approach followed by interbody fixation using a cervical cage. J Clin Exp Invest 2014; 5 (1: 112-114

  14. MRI findings in posterior disc prolapse associated with cervical fracture dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Go; Shiba, Keiichiro; Ueta, Takayoshi; Shirasawa, Kenzo; Ohta, Hideki; Mori, Eiji; Rikimaru, Shunichi; Hida, Shinichi; Tokunaga, Masami (Spinal Injuries Center, Fukuoka (Japan))

    1994-03-01

    Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: (1) discontinuity of injured disc, (2) anterior indentation of spinal cord at the site of dislocated vertebral body, and (3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author).

  15. MRI findings in posterior disc prolapse associated with cervical fracture dislocation

    International Nuclear Information System (INIS)

    Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: 1) discontinuity of injured disc, 2) anterior indentation of spinal cord at the site of dislocated vertebral body, and 3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author)

  16. Clinical and radiologic comparison of dynamic cervical implant arthroplasty and cervical total disc replacement for single-level cervical degenerative disc disease.

    Science.gov (United States)

    Shichang, Liu; Yueming, Song; Limin, Liu; Lei, Wang; Zhongjie, Zhou; Chunguang, Zhou; Xi, Yang

    2016-05-01

    Anterior cervical discectomy and fusion, to date the most successful spine procedure for the surgical treatment of cervical radiculopathy, has limitations that have led to the development of non-fusion cervical procedures, such as cervical total disc replacement (TDR) and dynamic cervical implant (DCI) arthroplasty. We compared the clinical and radiological results of DCI and cervical TDR for the treatment of single-level cervical degenerative disc disease in Chinese patients. A retrospective review of 179 patients with cervical spondylotic myelopathy who underwent DCI or TDR between April 2010 and October 2012 was conducted, and 152 consecutive patients (67 patients single-level DCI and 85 single-level TDR) who completed at least 2years of follow-up were included. Clinical and radiological assessments were performed preoperatively and at 1week and 3, 6, 12, and 24months postoperatively. The most common operative level was C5/C6 (49.3%). The differences in blood loss, duration of surgery, and duration of hospitalization were not statistically significant. The Japanese Orthopaedic Association scale, Visual Analog Scale, Neck Disability Index, and Short Form-36 scores improved significantly after surgery in both the DCI and TDR groups (P<0.05), but the differences were not statistically significant at the final follow-up. The rate of occurrence of heterotopic ossification was 22.4% and 28.2% in the DCI and TDR groups, respectively. As an effective non-fusion technique, DCI is a more economical procedure. Further prospective, randomized studies with long-term follow-up periods are needed to determine the long-term effects. PMID:26928156

  17. Transplantation of gene-modified nucleus pulposus cells reverses rabbit intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    LIU Yong; LI Jian-min; HU You-gu

    2011-01-01

    Background Intervertebral disc degeneration is the main cause of low back pain. The purpose of this study was to explore potential methods for reversing the degeneration of lumbar intervertebral discs by transplantation of gene-modified nucleus pulposus cells into rabbit degenerative lumbar intervertebral discs after transfecting rabbit nucleus pulposus cells with adeno-associated virus 2 (AAV2)-mediated connective tissue growth factor (CTGF) and tissue inhibitor of metalloproteinases 1 (TIMP1) genes in vitro.Methods Computer tomography (CT)-guided percutaneous annulus fibrosus injury was performed to build degenerative lumbar intervertebral disc models in 60 New Zealand white rabbits. rAAV2-CTGF-IRES-TIMP1-transfected rabbit nucleus pulposus cells were transplanted into degenerative lumbar intervertebral discs (transplantation group),phosphate-buffered saline (PBS) was injected into degenerative lumbar intervertebral discs (degeneration control group)and normal lumbar intervertebral discs served as a blank control group. After 6, 10 and 14 weeks, the disc height index (DHI) and signal intensity in intervertebral discs were observed by X-ray and magnetic resonance imaging (MRI) analysis.The expression of CTGF and TIMP1 in nucleus pulposus tissue was determined by Western blotting analysis, the synthesis efficiency of proteoglycan was determined by a 35S-sulfate incorporation assay, and the mRNA expression of type Ⅱ collagen and proteoglycan was detected by RT-PCR.Results MRI confirmed that degenerative intervertebral discs appeared two weeks after percutaneous puncture.Transgenic nucleus pulposus cell transplantation could retard the rapid deterioration of the DHI. MRI indicated that degenerative intervertebral discs were relieved in the transplantation group compared with the degeneration control group. The expression of collagen Ⅱ mRNA and proteoglycan mRNA was significantly higher in the transplantation group and the blank control group compared with the

  18. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Tarush Rustagi

    2011-01-01

    Full Text Available Brown-Séquard's syndrome (BSS is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

  19. Posterior approach for cervical fracture–dislocations with traumatic disc herniation

    OpenAIRE

    NAKASHIMA, HIROAKI; Yukawa, Yasutsugu; Ito, Keigo; Machino, Masaaki; El Zahlawy, Hany; Kato, Fumihiko

    2010-01-01

    In the treatment algorithm for cervical spine fracture–dislocations, the recommended approach for treatment if there is a disc fragment in the canal is the anterior approach. The posterior approach is not common because of the disadvantage of potential neurological deterioration during reduction in traumatic cervical herniation patients. However, reports about the frequency of this deterioration and the behavior of disc fragments after reduction are scarce. Forty patients with traumatic disc ...

  20. The Management of a Patient with a Cervical Disc Herniation: A Case Report

    Directory of Open Access Journals (Sweden)

    Peter Pidcoe

    2008-01-01

    Full Text Available Purpose: To present the management of a patient with a cervical disc herniation and illustrate the efficacy of cervical traction as a main form of treatment for cervical disc herniation in conjunction with a home exercise program.Background: A 71-year-old white female diagnosed with cervical disc herniation at the levels of C5-6 and C6-7 presented to physical therapy with neck pain radiating into the left upper extremity down to the 5th digit of the left hand.Treatment: The patient reported to outpatient physical therapy for cervical disc herniation and radiculopathy. After initial evaluation she received intermittent cervical traction and was given a home exercise program consisting of cervical lateral flexion stretch, unilateral wall stretch for pectoralis muscles and to continue with her over the door cervical traction.Conclusion: Cervical traction and a good home exercise program have been shown to reduce cervical disc herniation and its subsequent symptoms.

  1. Functional probe for annulus fibrosus-targeted intervertebral disc degeneration imaging.

    Science.gov (United States)

    Kim, Hye-Yeong; Mcclincy, Michael; Vo, Nam V; Sowa, Gwendolyn A; Kang, James D; Bai, Mingfeng

    2013-10-01

    Intervertebral disc degeneration (IDD) is closely associated with low back pain. Typically nonsurgical treatment of IDD is the most effective when detected early. As such, establishing reliable imaging methods for the early diagnosis of disc degeneration is critical. The cellular and tissue localization of a facile functional fluorescent probe, HYK52, that labels disc annulus fibrosus is reported. HYK52 was synthesized with high yield and purity via a two-step chemical reaction. Rabbit disc cell studies and ex vivo tissue staining images indicated intracellular localization and intervertebral disc (IVD) tissue binding of HYK52 with negligible cytotoxicity. Moreover, HYK52 is purposefully designed with a functional terminal carboxyl group to allow for coupling with various signaling molecules for multimodal imaging applications. These results suggest that this IVD-targeted probe may have great potential in early diagnosis of IDD. PMID:23839314

  2. Kinematic Evaluation of Association between Disc Bulge Migration, Lumbar Segmental Mobility, and Disc Degeneration in the Lumbar Spine Using Positional Magnetic Resonance Imaging

    OpenAIRE

    Hu, Jonathan K.; Morishita, Yuichiro; Montgomery, Scott R.; Hymanson, Henry; Taghavi, Cyrus E.; Do, Duc; Wang, Jeff C.

    2011-01-01

    Degenerative disc disease and disc bulge in the lumbar spine are common sources of lower back pain. Little is known regarding disc bulge migration and lumbar segmental mobility as the lumbar spine moves from flexion to extension. In this study, 329 symptomatic (low back pain with or without neurological symptoms) patients with an average age of 43.5 years with varying degrees of disc degeneration were examined to characterize the kinematics of the lumbar intervertebral discs through flexion, ...

  3. RESULTS OF SURGICAL TREATMENT IN CERVICAL HERNIATED DISC ANALYSIS OF 275 CASES

    Directory of Open Access Journals (Sweden)

    L. Eva

    2010-02-01

    Full Text Available Background: Problems of surgical treatment of cervical disc hernia are still far from being resolved. It shows variety of surgical procedures it. The operations for cervical level with radiculopatie were quite limited. Limits method were dictated by the absence of accurate diagnosis, microsurgical methods, extensions, sometimes unjustified, conservative treatment. Material and method Complex issue of cervical spine degenerative pathologies, particularly cervical disc hernia with radicular syndrome was studied on a group of 275 patients. Results: From the 275 patients with herniated disc cervical admitted in the study, 182 (66.18% of cases had surgical intervention to a single level disc, 72 patients (26.18% of cases in two levels, 20 patients (7.27% cases at three levels and one case (0.36% at four levels.

  4. Analysis of Gene Expression Pattern of Lumbar Intervertebral Disc Degeneration in Human

    Institute of Scientific and Technical Information of China (English)

    HU Ming; MA Yuan-zheng; FENG Hui-cheng; CHEN Xing; CHAI Xiao-jun; PENG Wei; LI Hong-wei

    2006-01-01

    Objective To investigate the gene expression changes in normal and degeneration lumbar intervertebral disc in humans, providing information for clinical. Methods The PCR products of 4096 human genes were spotted onto a kind of chemical-material-coated-glass slides. The total RNAs were isolated from the tissues. Both the mRNAs from the degeneration and normal lumbar intervertebral disc in humans were reversely transcribed to the cDNAs, which used as the hybridization probes with the incorporations of fluorescent dUTP. The mixed probes were then hybridized to the cDNA microarray. After high-stringent washing, the cDNA microarray was scanned for the fluorescent signals and analyzed with computer image analysis. Results Among the 4096 targets,there were 706 genes whose expression levels differed between the degeneration and normal lumbar intervertebral disc in all cases,comprising 298 up-regulated and 358 down-regulated ones. Conclusion DNA microarray technology is an effective technique in screening for differently expressed genes between the degeneration and normal lumbar intervertebral disc. Cell apoptosis plays an important role in the process of lumbar intervertebral disc degeneration.

  5. Clinical and radiographic results of cervical artificial disc arthroplasty: over three years follow-up cohort study

    Institute of Scientific and Technical Information of China (English)

    TIAN Wei; HAN Xiao; LIU Bo; LI Qin; HU Lin; LI Zhi-yu; YUAN Qiang; HE Da; XING Yong-gang

    2010-01-01

    Background Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic effects of cervical disc arthroplasty in short term have been ascertained. The aim of this study is to research the data of mid-term results.Methods In this prospective cohort study, 50 patients who underwent cervical disc arthroplasty from December 2003 to January 2006 were enrolled. There were 39 patients who received 1-level disc arthroplasty, and 11 patients received 2-level disc arthroplasty, with an average age of 50.9 years (range from 29 to 73). The median follow-up was 41.85months (range from 36.00-55.63 months). Patients were followed prospectively with respect to their symptoms,neurologic signs, and radiographic results.Results The median value of Japanese Orthopaedic Association (JOA) score was 14.0 before surgery, and 16.5 at the most recent follow-up (P <0.01). The median value of the recovery rate of the JOA score was 92.2%. The preoperative range of motion (ROM) at the indexed level was (10.40±4.97)°, which has significantly correlated with the most recent follow-up ROM which was (8.56±4.76)° (P <0.05, r=0.33). The ROM at the operative level at the most recent follow-upwas greater than the value at the 3-month follow-up of (7.52±3.37)° (P <0.05). The preoperative functional spinal unit (FSU) angulation was (-0.96±6.52)°, which was not significantly correlated with that of the most recent follow-up value of (-2.65±7.95)° (P <0.01, r=0.53). The preoperative endplate angulation was (2.61±4.85)°, which had no significant correlation with that of the most recent follow-up value of (0.71±6.41)° (p >0.05).Conclusions The clinical and radiographic results of cervical disc arthroplasty are good in mid-term follow-up. The normal range of motion of the operated level and the biomechanics in the cervical spine are well

  6. Computed tomography in the diagnosis of cervical disc herniation with radiculopathy

    International Nuclear Information System (INIS)

    Computed tomography (CT) is an accurate method of diagnosing cervical disc herniation in patients with radiculopathy. We evaluated 7 patients for the treatment of radiculopathy. The CT features of lateral cervical disc herniation include: (1) plain CT reveals a soft tissue mass compatible with laterally herniated disc material within the intervertebral foramen; (2) plain CT shows a soft tissue mass, which implies a fragmented disc, in the lateral recess; (3) CT with the intravenous administration of the contrast medium shows no delineation of the nerve root in the intervertebral foramen; and (4) CT metrizamide myelography demonstrates the filling defect of the root sleeve and hypertrophy of the nerve root. In those seven patients, all CT examinations were interpreted as positive for lateral disc herniation. There was a good correlation between the results of the neurologic examination and the CT findings. We wish to stress the usefulness of CT in the diagnosis of lateral cervical disc herniation. (author)

  7. Painful, degenerating intervertebral discs up-regulate neurite sprouting and CGRP through nociceptive factors

    Science.gov (United States)

    Krock, Emerson; Rosenzweig, Derek H; Chabot-Doré, Anne-Julie; Jarzem, Peter; Weber, Michael H; Ouellet, Jean A; Stone, Laura S; Haglund, Lisbet

    2014-01-01

    Intervertebral disc degeneration (IVD) can result in chronic low back pain, a common cause of morbidity and disability. Inflammation has been associated with IVD degeneration, however the relationship between inflammatory factors and chronic low back pain remains unclear. Furthermore, increased levels of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) are both associated with inflammation and chronic low back pain, but whether degenerating discs release sufficient concentrations of factors that induce nociceptor plasticity remains unclear. Degenerating IVDs from low back pain patients and healthy, painless IVDs from human organ donors were cultured ex vivo. Inflammatory and nociceptive factors released by IVDs into culture media were quantified by enzyme-linked immunosorbent assays and protein arrays. The ability of factors released to induce neurite growth and nociceptive neuropeptide production was investigated. Degenerating discs release increased levels of tumour necrosis factor-α, interleukin-1β, NGF and BDNF. Factors released by degenerating IVDs increased neurite growth and calcitonin gene-related peptide expression, both of which were blocked by anti-NGF treatment. Furthermore, protein arrays found increased levels of 20 inflammatory factors, many of which have nociceptive effects. Our results demonstrate that degenerating and painful human IVDs release increased levels of NGF, inflammatory and nociceptive factors ex vivo that induce neuronal plasticity and may actively diffuse to induce neo-innervation and pain in vivo. PMID:24650225

  8. Glucosamine and chondroitin sulfate supplementation to treat symptomatic disc degeneration: Biochemical rationale and case report

    Directory of Open Access Journals (Sweden)

    van de Nes Jos CM

    2003-06-01

    Full Text Available Abstract Background Glucosamine and chondroitin sulfate preparations are widely used as food supplements against osteoarthritis, but critics are skeptical about their efficacy, because of the lack of convincing clinical trials and a reasonable scientific rationale for the use of these nutraceuticals. Most trials were on osteoarthritis of the knee, while virtually no documentation exists on spinal disc degeneration. The purpose of this article is to highlight the potential of these food additives against cartilage degeneration in general, and against symptomatic spinal disc degeneration in particular, as is illustrated by a case report. The water content of the intervertebral disc is a reliable measure of its degeneration/ regeneration status, and can be objectively determined by Magnetic Resonance Imaging (MRI signals. Case presentation Oral intake of glucosamine and chondroitin sulfate for two years associated with disk recovery (brightening of MRI signal in a case of symptomatic spinal disc degeneration. We provide a biochemical explanation for the possible efficacy of these nutraceuticals. They are bioavailable to cartilage chondrocytes, may stimulate the biosynthesis and inhibit the breakdown of their extracellular matrix proteoglycans. Conclusion The case suggests that long-term glucosamine and chondroitin sulfate intake may counteract symptomatic spinal disc degeneration, particularly at an early stage. However, definite proof requires well-conducted clinical trials with these food supplements, in which disc de-/regeneration can be objectively determined by MRI. A number of biochemical reasons (that mechanistically need to be further resolved explain why these agents may have cartilage structure- and symptom-modifying effects, suggesting their therapeutic efficacy against osteoarthritis in general.

  9. Lumbar Disc and Facet Degeneration: Correlation with Age and Facet Orientation

    OpenAIRE

    ÇUBUK, RAHMİ; KOZAKÇIOĞLU, MERAL; TASALI, NURİ; Atalay, Ayçe; ÇELİK, LEVENT

    2009-01-01

    Objectives: The influence of age on orientation of the facet joint remains controversial. We aimed to examine facet joint degeneration, orientation and their relationships with disc degeneration in a group of patients in different age groups. Patients and Methods: The study included 106 patients with low back pain and/or leg symptoms who had undergone magnetic resonance imaging of L1-S1 lumbar segments. For evaluation of osteoarthritis of the facet joints grading described by Weisha...

  10. Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion

    Science.gov (United States)

    Yang, Li-Li; Liu, Zu-De; Yuan, Wen

    2016-01-01

    Objectives Cervical disc arthroplasty (CDA) with Discover prosthesis or anterior cervical discectomy and fusion (ACDF) with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM). However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM. Methods A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score and Neck Disability Index (NDI). For radiographic assessment, the overall sagittal alignment (OSA), functional spinal unit (FSU) angle, and range of motion (ROM) at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded. Results Both treatments significantly improved all clinical parameters (P 0.05). Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05). However, significant differences occurred in prosthesis migration in CDA group. Conclusions The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the postoperative early-term follow-up. PMID:27441736

  11. An animal model to create intervertebral disc degeneration characterized by radiography and molecular biology

    Institute of Scientific and Technical Information of China (English)

    Zhengming Sun; Miao Liu; Yingang Zhang

    2008-01-01

    Objectives: To develop a rabbit model of intervertebral disc degeneration that more exactly simulates the pathological changes of human intervertebral disc degeneration. Methods: Twelve New Zealand white rabbits were utilized to establish three different disc injury models according to the following protocol; group A: anulus punctures were done with a 18-gauge needle at L2-L3 and L5-L6; Group B: intradiscal injection of interleukin-l IL-lβ with a 23-gauge needle at L3-L4; and Group C: intradiscal injection of phosphate buffer saline(PBS) with a 23-gange needle at L4-L5. The L1-L2 level was used as a control. Rabbits were killed after 24 weeks. The intervertebral disc height was measured by lateral plain radiographs. After the radiographic measurements were obtained, the intervertebral discs were removed and analyzed for DNA, sulfated glycosaminoglycan(s-GAG) and water contents of nucleus puiposus. Results: The intervertebral disc height, s-GAG, and water contents in anulus needle punctures were significantly decreased in Group A, but the DNA content in the nucleus pulposus was significantly increased when compared to the control. The significant decrease of disc height and water contents were demonstrated, only the s-GAG and DNA contents did not show a significant difference in Group B when compared to the control. The significant decrease of disc height, s-GAG, water, and DNA contents did not show in Group C when compared to the control. Conclusion: The 18-gauge puncture models produced the most consistent disc degeneration in the rabbit lumbar spine.

  12. Poroelastic behaviour of the degenerating human intervertebral disc: a ten-day study in a loaded disc culture system

    Directory of Open Access Journals (Sweden)

    KS Emanuel

    2015-06-01

    Full Text Available The intervertebral disc (IVD allows flexibility to the vertebral column, and transfers the predominant axial loads during daily activities. Its axial biomechanical behaviour is poroelastic, due to the water-binding and releasing capacity of the nucleus pulposus. Degeneration of the intervertebral disc presumably affects both the instantaneous elastic response to the load on the IVD and the subsequent interstitial flow of fluid. This study aims to quantify the poroelastic behaviour of the IVD and its change with degeneration, as defined by the magnetic resonance imaging-based Pfirrmann Score (PS. For a period of ten days, 36 human lumbar IVDs were loaded with a simulated physiological axial loading regime, while deformation was monitored. The IVDs responded to the loads with instantaneous elastic and slow poroelastic axial deformation. Several mechanical parameters changed throughout the first five days of the experiment, until the IVDs settled into a dynamic equilibrium. In this equilibrium, degeneration was significantly related to a decrease in disc height loss during the daytime high load phase (ρ = -0.49, and to a decrease in the rate of this deformation during the final half hour of each day (ρ = -0.53. These properties were related to the nucleus glycosaminoglycan/hydroxyproline (GAG/HYP ratio, rather than GAG content alone, indicating that remodelling of the extracellular matrix reduces poroelastic properties of the IVD. This implies that the degenerated discs have a reduced capacity to bind water and/or a reduced resistance against fluid flow. The resulting loss in hydrostatic pressure may further change cell behaviour in the nucleus pulposus.

  13. Cervical Disc Herniation as a Cause of Brown-Séquard Syndrome

    OpenAIRE

    Choi, Kyeong Bo; Lee, Choon Dae; Chung, Dai-Jin; Lee, Sang-Ho

    2009-01-01

    The possible causes of Brown-Séquard Syndrome (BSS) have been frequently observed with spinal trauma and extramedullary spinal tumors, but the cervical disc herniation to cause BSS is rare. The authors present five cases of patients who were diagnosed with BSS resulting from cervical disc herniation, and the results of the literature in view of their distinctive symptoms and clinical outcomes. Postoperatively, the patients showed complete or almost complete recovery from their motor and senso...

  14. Removal versus preservation of the posterior longitudinal ligament in Bryan cervical disc arthroplasty

    Institute of Scientific and Technical Information of China (English)

    YANG Da-long; DING Wen-yuan; ZHANG Ying-ze; ZHANG Wei; XU Jia-xin; SHEN Yong

    2013-01-01

    Background Bryan cervical disc arthroplasty can be used to restore and maintain the mobility and function of the involved cervical spinal segments.The efficiency of posterior longitudinal ligament (PLL) resection in anterior cervical decompression and fusion has been demonstrated.However,no clinical reports have compared PLL removal with preservation in Bryan cervical disc arthroplasty.This study aimed to assess the role of removal of PLL in Bryan cervical disc arthroplasty at an 18-month follow-up.Methods We performed a prospective investigation of clinical and radiological outcomes in patients after Bryan cervical disc arthroplasty.Sixty patients who underwent Bryan cervical disc arthroplasty were included.The PLL was removed in 35 patients (investigational group) and preserved in 25 patients (control group).All of the patients were followed up for more than 18 months.Clinical (Japanese Orthopedic Association score and Visual Analogue Scale pain score) and radiological (functional spinal unit (FSU) angle,range of movement (ROM),and diameter of the spinal cord) parameters were compared between the two groups before and after surgery (18 months).Results Clinical outcomes in the investigational group were significantly superior to those in the control group.There were no significant differences in the FSU angle and ROM (P=-0.41 and 0.16,respectively) between the two groups.However,the increase in diameter of the spinal cord in the investigational group was significantly greater than that in the control group (P <0.01).Conclusions Removal of the PLL can improve the clinical outcomes of Bryan cervical disc arthroplasty.This procedure does not have a large effect on imbalance and motion of the cervical spine.

  15. Initial study of the degeneration of lumbar intervertebral discs by magnetic resonance diffusion tensor imaging

    International Nuclear Information System (INIS)

    Objective: To evaluate the earlier changes of degeneration discs in vivo using magnetic resonance diffusion tensor imaging (DTI). Methods: From September 2010 to March 2011,88 consecutive outpatients [age 16-63 years, mean age (37 ± 13) years] were enrolled in this study. The excluded criteria were as follows: spinal deformity, spinal tumors and post-operation of spine. The mean diffusion (MD) and fractional anisotropy (FA) values on DTI images of 428 intervertebral discs which without susceptibility artifacts were measured. Fiber track (FT) images of annulus of intervertebral discs were analyzed. MD and FA were also measured on FT. The quartile and median were used to record the non-normal distribution dates. The Chi-square test statistic was applied by SPSS11.0 software package. Results: Annulus fibrosis type had closely related to the Pfirrmann grading. Three types were divided based on FT charts of degenerated intervertebral disc. Intact type was noted in 135 discs, Pfirrmann Ⅱ level has a high percentage (92 discs, 68.15%) in this type; Scrambled type was noted in 195 discs, Pfirrmann Ⅲ and Ⅳ level were accounted for 63.07% (123 discs); Conglomerate type was noted in 98 discs, the Pfirrmann Ⅳ and Ⅴ level were accounted for 83.68% (82 discs) (Mantel-Haenszel test, χ2=183.90, P <0.01). Different annulus types had different MD and FA values. The median (range) of FA of complete, messy and clumps type fibrous ring were 0.32 (0.29-4.35), 0.35 (0.33-0.38), 0.54 (0.46-0.62). The corresponding median(range)of MD were 12.40 (11.50-13.20)×10-10, 11.10(9.92-12.00) × 10-10, 6.30 (5.03-7.72) × 10-10 mm2/s. Scrambled annulus fibers had lower MD values and higher FA values,which had significant difference (χ2=219.74, 243.88, P<0.01). Conclusions: DTI is a non-invasive method to assess intervertebral disc structural changes in vivo. MD and FA values are helpful to evaluate the intervertebral disc degeneration. (authors)

  16. Evaluation of the kinesthetic sense and function of the hand in early period in operated cervical disc hernia

    OpenAIRE

    Kara, Býlge; Yildirim, Yücel; Karadýbak, Dýdem; Acar, Ümýt

    2005-01-01

    A prospective study made into cervical disc hernias. To determine the kinesthetic sense and hand functions, which are important for the patients with cervical disc hernia to return to work life and daily activities that need skill. Neurosurgical department. Data Symptoms in cervical disc hernias and hand functions are affected depending on long-term pain. The evaluation of the hand is essential in assessing the patients’ overall recovery and ability to return to daily activities and work life...

  17. Comparison of Lumbar Disc Herniation and Degeneration Relationship with the Sagittal Morphology of the Spine

    Directory of Open Access Journals (Sweden)

    Emre Delen

    2016-01-01

    Full Text Available In this study, the relationship between the lower intervertebral disc herniation and the degeneration of the spine with the sagittal morphological values were investigated. The data on this study is obtained retrospectively from patients who were operated in our center with the diagnosis of lower level lumbar disc herniation. A total of 117 patients, 75 female and 42 male are included. Patients are divided into two groups as with degeneration (Pfirmann stage III-IV-V and without degeneration (Pfirmann stage I-II. Among 117 patients, 13 were in the with degeneration group, while 104 were in the without degeneration group. The mean age of the first group was 43.0 (± 11.2 years, while the second group had a mean age of 45.3 (± 11.4 years and there were not a statistically significant differences between them (P > 0.05. Mean lumbar lordosis angle was 23.30 (± 8.92 degree in the first group and 28.81 (± 9.17 degree in the without dejeneration group, thus a lower degree was observed in the group with degeneration (P = 0.050. Segmental lordosis angle was 24.69 (± 8.91 and 28.17 (± 5.75 degree respectively, in the group with degeneration the angle value was lower (P = 0.088. The sacral surface angle in the group with degeneration was 99.51 (± 5.36 degree and in the second group it was 100.56 (± 6.03 degree. Nevertheless the difference was not statistically significant (P = 0.509. The sacral kyphosis angle is determined as 170.13 (± 5.41 degree and 155.59 (± 45.96 degree in the two groups respectively and there was statistically significant difference between them (P = 0.059. For cases with lower level lumbar disc herniation there exists a significant relationship between the disc herniation and degeneration, therefore the lumbar lordosis and the segmental lordosis angles are lower in patients with degeneration.

  18. In-vivo T2-relaxation times of asymptomatic cervical intervertebral discs

    International Nuclear Information System (INIS)

    Limited research exists on T2-mapping techniques for cervical intervertebral discs and its potential clinical utility. The objective of this research was to investigate the in-vivo T2-relaxation times of cervical discs, including C2-C3 through C7-T1. Ten asymptomatic subjects were imaged using a 3.0 T MR scanner and a sagittal multi-slice multi-echo sequence. Using the mid-sagittal image, intervertebral discs were divided into five regions-of-interest (ROIs), centered along the mid-line of the disc. Average T2 relaxation time values were calculated for each ROI using a mono-exponential fit. Differences in T2 values between disc levels and across ROIs of the same disc were examined. For a given ROI, the results showed a trend of increasing relaxation times moving down the spinal column, particularly in the middle regions (ROIs 2, 3 and 4). The C6-C7 and C7-T1 discs had significantly greater T2 values compared to superior discs (discs between C2 and C6). The results also showed spatial homogeneity of T2 values in the C3-C4, C4-C5, and C5-C6 discs, while C2-C3, C6-C7, and C7-T1 showed significant differences between ROIs. The findings indicate there may be inherent differences in T2-relaxation time properties between different cervical discs. Clinical evaluations utilizing T2-mapping techniques in the cervical spine may need to be level-dependent. (orig.)

  19. In-vivo T2-relaxation times of asymptomatic cervical intervertebral discs

    Energy Technology Data Exchange (ETDEWEB)

    Driscoll, Sean J.; Mao, Haiqing; Li, Guoan [Massachusetts General Hospital/Harvard Medical School, Bioengineering Laboratory, Department of Orthopaedic Surgery, Boston, MA (United States); Zhong, Weiye [Massachusetts General Hospital/Harvard Medical School, Bioengineering Laboratory, Department of Orthopaedic Surgery, Boston, MA (United States); Second Xiangya Hospital and Central South University, Department of Spinal Surgery, Changsha, Hunan (China); Torriani, Martin [Massachusetts General Hospital/Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Wood, Kirkham B.; Cha, Thomas D. [Massachusetts General Hospital/Harvard Medical School, Spine Service, Department of Orthopaedic Surgery, Boston, MA (United States)

    2016-03-15

    Limited research exists on T2-mapping techniques for cervical intervertebral discs and its potential clinical utility. The objective of this research was to investigate the in-vivo T2-relaxation times of cervical discs, including C2-C3 through C7-T1. Ten asymptomatic subjects were imaged using a 3.0 T MR scanner and a sagittal multi-slice multi-echo sequence. Using the mid-sagittal image, intervertebral discs were divided into five regions-of-interest (ROIs), centered along the mid-line of the disc. Average T2 relaxation time values were calculated for each ROI using a mono-exponential fit. Differences in T2 values between disc levels and across ROIs of the same disc were examined. For a given ROI, the results showed a trend of increasing relaxation times moving down the spinal column, particularly in the middle regions (ROIs 2, 3 and 4). The C6-C7 and C7-T1 discs had significantly greater T2 values compared to superior discs (discs between C2 and C6). The results also showed spatial homogeneity of T2 values in the C3-C4, C4-C5, and C5-C6 discs, while C2-C3, C6-C7, and C7-T1 showed significant differences between ROIs. The findings indicate there may be inherent differences in T2-relaxation time properties between different cervical discs. Clinical evaluations utilizing T2-mapping techniques in the cervical spine may need to be level-dependent. (orig.)

  20. Cross-sectional association between urinary type II collagen. C-terminal telopeptide concentration and radiographic spinal disc degeneration

    International Nuclear Information System (INIS)

    When degraded, type II collagen, which is contained in large quantities in the cartilage and intervertebral discs, produces a C-terminal peptide (type II collagen C terminal telopeptide, CTX-II), which is excreted in the urine. It has been reported that CTX-II is useful for evaluating the severity of cartilage degeneration and abrasion in the hip and knee joints, but shows no correlation with the severity of degeneration of intervertebral discs, which are mostly composed of type II collagen. The present study was performed to clarify whether urinary CTX-II was correlated with intervertebral X-ray findings. A cross-sectional study was performed to clarify correlations between urinary CTX-II and the progression of degeneration of each intervertebral disc on lumbar X-P films. The subjects of this study were 100 patients (400 intervertebral discs) aged≥40 years. They visited this hospital for the first time because of low backache. Intervertebral disc height, osteophyte length and Kellgren-Lawrence classification were measured to evaluate the degree of lumbar disc degeneration on X-ray films. The second freshly voided urine was used for measuring urinary CTX-II. The measurement results were investigated for correlations with disc height, osteophyte length, age, sex, body mass index (BMI), and lumbar MRI findings by cross-sectional analysis. The t-test and Kruskal-Wallis-test were used for statistical analysis of data. Urinary CTX-II was not correlated with age or BMI but was significantly higher in females than in males. It was only correlated with the degeneration of L2/3 and 3/4 discs and showed a significant difference between lower, medium, and higher disc groups. It was not correlated with osteophyte length or lumbar MRI findings. Urinary CTX-II was only correlated with L2/3 and 3/4 disc degeneration. This was presumably ascribable to the focus and distance during radiography. Osteophyte formation is a phenomenon secondary to intervertebral disc degeneration

  1. Observations on morphologic changes in the aging and degenerating human disc: Secondary collagen alterations

    Directory of Open Access Journals (Sweden)

    Hanley Edward N

    2002-03-01

    Full Text Available Abstract Background In the annulus, collagen fibers that make up the lamellae have a wavy, planar crimped pattern. This crimping plays a role in disc biomechanical function by allowing collagen fibers to stretch during compression. The relationship between morphologic changes in the aging/degenerating disc and collagen crimping have not been explored. Methods Ultrastructural studies were performed on annulus tissue from 29 control (normal donors (aged newborn to 79 years and surgical specimens from 49 patients (aged 16 to 77 years. Light microscopy and specialized image analysis to visualize crimping was performed on additional control and surgical specimens. Human intervertebral disc tissue from the annulus was obtained in a prospective morphologic study of the annulus. Studies were approved by the authors' Human Subjects Institutional Review Board. Results Three types of morphologic changes were found to alter the crimping morphology of collagen: 1 encircling layers of unusual matrix disrupted the lamellar collagen architecture; 2 collagen fibers were reduced in amount, and 3 collagen was absent in regions with focal matrix loss. Conclusions Although proteoglycan loss is well recognized as playing a role in the decreased shock absorber function of the aging/degenerating disc, collagen changes have received little attention. This study suggests that important stretch responses of collagen made possible by collagen crimping may be markedly altered by morphologic changes during aging/degeneration and may contribute to the early tissue changes involved in annular tears.

  2. A role for TNFα in intervertebral disc degeneration: A non-recoverable catabolic shift

    International Nuclear Information System (INIS)

    Highlights: ► TNFα induced catabolic changes similar to human intervertebral disc degeneration. ► The metabolic shift induced by TNFα was sustained following removal. ► TNFα induced changes suggestive of cell senescence without affecting cell viability. ► Interventions are required to stimulate anabolism and increase cell proliferation. -- Abstract: This study examines the effect of TNFα on whole bovine intervertebral discs in organ culture and its association with changes characteristic of intervertebral disc degeneration (IDD) in order to inform future treatments to mitigate the chronic inflammatory state commonly found with painful IDD. Pro-inflammatory cytokines such as TNFα contribute to disc pathology and are implicated in the catabolic phenotype associated with painful IDD. Whole bovine discs were cultured to examine cellular (anabolic/catabolic gene expression, cell viability and senescence using β-galactosidase) and structural (histology and aggrecan degradation) changes in response to TNFα treatment. Control or TNFα cultures were assessed at 7 and 21 days; the 21 day group also included a recovery group with 7 days TNFα followed by 14 days in basal media. TNFα induced catabolic and anti-anabolic shifts in the nucleus pulposus (NP) and annulus fibrosus (AF) at 7 days and this persisted until 21 days however cell viability was not affected. Data indicates that TNFα increased aggrecan degradation products and suggests increased β-galactosidase staining at 21 days without any recovery. TNFα treatment of whole bovine discs for 7 days induced changes similar to the degeneration processes that occur in human IDD: aggrecan degradation, increased catabolism, pro-inflammatory cytokines and nerve growth factor expression. TNFα significantly reduced anabolism in cultured IVDs and a possible mechanism may be associated with cell senescence. Results therefore suggest that successful treatments must promote anabolism and cell proliferation in

  3. Percutaneous injection of intradiscal space with O2-O3 mixture to treat cervical disc herniation

    International Nuclear Information System (INIS)

    Objective: To evaluate the security and therapeutic effect for the treatment of cervical disc herniation with O2-O3 mixture. Methods: Thirty-two patients with cervical herniated discs verified by MRI were selected in study, and all patients presented the symptoms of upper limb, cervical and shoulder areas pain. The procedure was guided by DSA and their puncture route was defined as the right common cervical artery and trachea clearance. 1.5-3.0 ml O2-O3 mixture gas at (30-50) μg/ml was injected into every herniated disc space and 3-5 ml mixture gas was injected in paraspinal space. Results: Thirty-two patients were followed up from 3 to 32 months after treatment. The therapeutic effect showed that 17 cases (53.1%) had excellent recovery, 8 cases (25.0%) had significant relief of symptoms, and 7 cases (21.9%) got failure in treatment. No serious complication occurred. Conclusion: The therapeutic method developed by using O2-O3 mixture injection in cervical intradiscal space was a safe and effective method for the treatment of the cervical disc herniation. (authors)

  4. ACDR 和 ACDF 治疗单节段颈椎间盘突出症的对比分析%Comparative analysis of ACDR and ACDF in the treatment of single segmental cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    黄长安; 李军; 袁文旗; 周立

    2015-01-01

    目的:对比分析颈椎前路椎间盘切除植骨融合术( ACDF)和颈椎人工椎间盘置换术( ACDR)%Objective To compare the effect of anterior cervical discectomy and interbody fusion(ACDF) and artificial cervical disc replacement(ACDR) in the treatment of single segmental cervical disc herniation.Methods A total of 81 patients with single segmental cervical disc herniation were collected in our hospital from January 2010 to June 2014, in which 40 patients received ACDF surgery(fusion group) and other 41 patients underwent ACDR sur-gery(permutation group).The changes of activity were compared between the two groups before and the last follow-up after the surgery.Results There were significant differences in the changes of activity between the two groups at the last time of follow-up after the surgery(P <0.01).For each group, the activity improved at the end of the follow-up compared with that before the surgery(P <0.01).Conclusion Both ACDR and ACDF are effective in the treatment of single segmental cervical disc herniation, which improves the activity of cervical disc herniation.ACDR also makes the surgery adjacent segments of the compensatory activity increased, and therefore may prevent adjacent segment de-generation.

  5. The Use of A Hollow Polymethylmethacrylate Cervical Spacer with Plating in the Treatment of Single Level Cervical Disc Disease

    Directory of Open Access Journals (Sweden)

    Jyi-Feng Chen

    2009-08-01

    Full Text Available Background: At present, the use of a cervical cage and plating has become an acceptedand widely practiced surgical intervention for the treatment of cervicalspondylosis and disc herniation. Polymethylmethacrylate (PMMA bonecement has been used in cervical disc disease as a spacer, with good longterm outcomes, but the method does not result in solid bone fusion in allcases.Methods: A prospective study was performed with 92 consecutive patients who underwent single-level anterior cervical discectomy and fusion (ACDF with ahollow PMMA spacer, cancellous allograft and titanium cervical plate stabilization between January 2002 and December 2003. Patients were followedfor a minimum of 2 years.Results: The surgical procedures used were technically successful for all patients, andthere were no major complications related to anesthesia or the overall surgical procedure. The fusion rate was 89.8% at the 12-month follow-up, and100% at the 24-month follow-up. The mean intervertebral disc height was6.5 1.5 mm and regained height was 3.4 1.3 mm at the 24-month follow-up. The mean segmental lordotic angle was 3.7 2.0° with an increaseof 6.1 2.3° at the 24-month follow-up. There was no hollow PMMA spacer dislodgment or failure. However, 5 (5.4% patients had screw looseningand 3 (3.3% patients underwent a secondary operation for removal of theplate and screws.Conclusions: The procedure for a single-level ACDF with a hollow PMMA spacer, cancellous allograft and titanium cervical plate stabilization is safe and effective.There were no complications related to the hollow PMMA spacer. This procedure has a high fusion rate, and can restore disc height and maintain normal cervical lordosis. This method achieves results similar to those of othermethods.

  6. Acute mechanical injury of the human intervertebral disc: link to degeneration and pain

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    B Alkhatib

    2014-09-01

    Full Text Available Excessive mechanical loading or acute trauma to intervertebral discs (IVDs is thought to contribute to degeneration and pain. However, the exact mechanisms by which mechanical injury initiates and promotes degeneration remain unclear. This study investigates biochemical changes and extracellular matrix disruption in whole-organ human IVD cultures following acute mechanical injury. Isolated healthy human IVDs were rapidly compressed by 5 % (non-injured or 30 % (injured of disc height. 30 % strain consistently cracked cartilage endplates, confirming disc trauma. Three days post-loading, conditioned media were assessed for proteoglycan content and released cytokines. Tissue extracts were assessed for proteoglycan content and for aggrecan integrity. Conditioned media were applied to PC12 cells to evaluate if factors inducing neurite growth were released. Compared to controls, IVD injury caused significant cell death. Injury also caused significantly reduced tissue proteoglycan content with a reciprocal increase of proteoglycan content in culture media. Increased aggrecan fragmentation was observed in injured tissue due to increased matrix metalloproteinase and aggrecanase activity. Injured-IVD conditioned media contained significantly elevated interleukin (IL-5, IL-6, IL-7, IL-8, MCP-2, GROα, and MIG, and ELISA analysis showed significantly increased nerve growth factor levels compared to non-injured media. Injured-disc media caused significant neurite sprouting in PC12 cells compared to non-injured media. Acute mechanical injury of human IVDs ex vivo initiates release of factors and enzyme activity associated with degeneration and back pain. This work provides direct evidence linking acute trauma, inflammatory factors, neo-innervation and potential degeneration and discogenic pain in vivo.

  7. Glucosamine and chondroitin sulfate supplementation to treat symptomatic disc degeneration: Biochemical rationale and case report

    OpenAIRE

    van de Nes Jos CM; Wuisman Paul IJM; van Blitterswijk Wim J

    2003-01-01

    Abstract Background Glucosamine and chondroitin sulfate preparations are widely used as food supplements against osteoarthritis, but critics are skeptical about their efficacy, because of the lack of convincing clinical trials and a reasonable scientific rationale for the use of these nutraceuticals. Most trials were on osteoarthritis of the knee, while virtually no documentation exists on spinal disc degeneration. The purpose of this article is to highlight the potential of these food additi...

  8. Detection of bacterial DNA in painful degenerated spinal discs in patients without signs of clinical infection

    OpenAIRE

    Fritzell, Peter; Bergström, Tomas; Welinder-Olsson, Christina

    2004-01-01

    A local inflammatory and potentially painful response, of which the ultimate cause is unknown, has been described in nervous tissues in contact with degenerated disc material in patients with low back and leg pain. With the rationale that a possible cause of such inflammation could be bacterial infection, we utilized PCR (polymerase chain reaction) amplification of the 16S rRNA (ribosomal RNA) gene followed by gene sequencing, to investigate whether bacterial DNA might be detected in the dege...

  9. Treatment of 116 Cases of Cervical Intervertebral Disc Protrusion by Tuina

    Institute of Scientific and Technical Information of China (English)

    WANG Guang-zong; XIAO Yuan-chun

    2007-01-01

    Objective: To observe the clinical efficacy of uplifting massage therapy in the treatment of cervical intervertebral disc protrusion and study the effectiveness of this massage therapy for cervical intervertebral disc protrusion. Methods: 116 subjects were randomized into two groups: treatment group in which 60 cases were treated by uplifting massage therapy and conventional massage, and control group in which 56 cases were treated by simple conventional massage. Results: After 1-2 courses of treatment, the total effective rate was 95.0% in treatment group and 80.4% in control group; the former rate was higher than the latter one(P<0.05).Conclusion: The uplifting massage therapy combined with conventional massage has better effects than simple conventional massage in the treatment of cervical intervertebral disc protrusion.

  10. Surgical results of myelopathy secondary to the cervical disc herniation and the availability of CTD

    Energy Technology Data Exchange (ETDEWEB)

    Sho, Tomoya; Kataoka, Osamu; Washimi, Masatoshi; Fujita, Masayuki; Bessho, Yasuo (National Kobe Hospital, Hyogo (Japan))

    1990-08-01

    This study evaluated the contribution of computed tomographic discography (CTD) to the surgical indications and selection of surgical techniques in cervical disc herniation. The study population consisted of 73 patients who were diagnosed as having cervical disc herniation by CTD: Of them, hernia mass was confirmed by surgery in 64 patients (a concordance rate of 88% between CTD and surgical findings). In evaluable 40 patients receiving computed tomographic myelography (CTM), the rate of flattened spinal cord on CTM was significantly correlatd with postoperative prognosis. Flattened spinal cord was favorably improved. Higher preoperative flat rate was associated with severer cervical disc herniation. CTD provided the information concerning the positional relation in the posterior longitudinal ligament of hernia mass. Preoperative severity, preoperative rate of flattened spinal cord, and the site of protrusion of hernia mass were independent of surgical outcome. (N.K.).

  11. Surgical results of myelopathy secondary to the cervical disc herniation and the availability of CTD

    International Nuclear Information System (INIS)

    This study evaluated the contribution of computed tomographic discography (CTD) to the surgical indications and selection of surgical techniques in cervical disc herniation. The study population consisted of 73 patients who were diagnosed as having cervical disc herniation by CTD: Of them, hernia mass was confirmed by surgery in 64 patients (a concordance rate of 88% between CTD and surgical findings). In evaluable 40 patients receiving computed tomographic myelography (CTM), the rate of flattened spinal cord on CTM was significantly correlatd with postoperative prognosis. Flattened spinal cord was favorably improved. Higher preoperative flat rate was associated with severer cervical disc herniation. CTD provided the information concerning the positional relation in the posterior longitudinal ligament of hernia mass. Preoperative severity, preoperative rate of flattened spinal cord, and the site of protrusion of hernia mass were independent of surgical outcome. (N.K.)

  12. Technique and results of the spinal computed tomography in the diagnosis of cervical disc disease

    International Nuclear Information System (INIS)

    We give a description of a technique of the patient's positioning with traction of the arms during the cervical spinal computed tomography which allows to draw the shoulders downwards by about one to three cervical segments. By this method the quality of the images can be improved in 96% in the cervical segment 6/7 and in 81% in the cervical/thoracal segment 7/1 to such a degree that a reliable judgement of the soft parts in the spinal canal becomes possible. The diagnostic reliability of the computed tomography of the cervical disc herniation is thus improved so that the necessity of a myelography is decreasing. The results of 396 cervical spinal computed tomographies are presented. (orig.)

  13. A Rare Case of Near Complete Regression of a Large Cervical Disc Herniation without Any Intervention Demonstrated on MRI

    Directory of Open Access Journals (Sweden)

    Parag Suresh Mahajan

    2014-01-01

    Full Text Available There are very few reported cases of regression of large cervical disc herniation without any intervention—the so-called spontaneous regression, demonstrated using MRI. We report a rare and interesting case of MRI that demonstrated near complete regression of a large herniated cervical intervertebral disc, without any surgical treatment.

  14. Comparative role of disc degeneration and ligament failure on functional mechanics of the lumbar spine.

    Science.gov (United States)

    Ellingson, Arin M; Shaw, Miranda N; Giambini, Hugo; An, Kai-Nan

    2016-07-01

    Understanding spinal kinematics is essential for distinguishing between pathological conditions of spine disorders, which ultimately lead to low back pain. It is of high importance to understand how changes in mechanical properties affect the response of the lumbar spine, specifically in an effort to differentiate those associated with disc degeneration from ligamentous changes, allowing for more precise treatment strategies. To do this, the goals of this study were twofold: (1) develop and validate a finite element (FE) model of the lumbar spine and (2) systematically alter the properties of the intervertebral disc and ligaments to define respective roles in functional mechanics. A three-dimensional non-linear FE model of the lumbar spine (L3-sacrum) was developed and validated for pure moment bending. Disc degeneration and sequential ligament failure were modelled. Intersegmental range of motion (ROM) and bending stiffness were measured. The prediction of the FE model to moment loading in all three planes of bending showed very good agreement, where global and intersegmental ROM and bending stiffness of the model fell within one standard deviation of the in vitro results. Degeneration decreased ROM for all directions. Stiffness increased for all directions except axial rotation, where it initially increased then decreased for moderate and severe degeneration, respectively. Incremental ligament failure produced increased ROM and decreased stiffness. This effect was much more pronounced for all directions except lateral bending, which is minimally impacted by ligaments. These results indicate that lateral bending may be more apt to detect the subtle changes associated with degeneration, without being masked by associated changes of surrounding stabilizing structures. PMID:26404463

  15. Characteristics of stem cells derived from the degenerated human intervertebral disc cartilage endplate.

    Directory of Open Access Journals (Sweden)

    Lan-Tao Liu

    Full Text Available Mesenchymal stem cells (MSCs derived from adult tissues are an important candidate for cell-based therapies and regenerative medicine due to their multipotential differentiation capability. MSCs have been identified in many adult tissues but have not reported in the human intervertebral disc cartilage endplate (CEP. The initial purpose of this study was to determine whether MSCs exist in the degenerated human CEP. Next, the morphology, proliferation capacity, cell cycle, cell surface epitope profile and differentiation capacity of these CEP-derived stem cells (CESCs were compared with bone-marrow MSCs (BM-MSCs. Lastly, whether CESCs are a suitable candidate for BM-MSCs was evaluated. Isolated cells from degenerated human CEP were seeded in an agarose suspension culture system to screen the proliferative cell clusters. Cell clusters were chosen and expanded in vitro and were compared with BM-MSCs derived from the same patient. The morphology, proliferation rate, cell cycle, immunophenotype and stem cell gene expression of the CESCs were similar to BM-MSCs. In addition, the CESCs could be induced into osteoblasts, adipocytes, chondrocytes, and are superior to BM-MSCs in terms of osteogenesis and chondrogenesis. This study is first to demonstrate the presence of stem cells in the human degenerated CEP. These results may improve our understanding of intervertebral disc (IVD pathophysiology and the degeneration process, and could provide cell candidates for cell-based regenerative medicine and tissue engineering.

  16. Cervical Disc Deformation During Flexion–Extension in Asymptomatic Controls and Single-Level Arthrodesis Patients

    OpenAIRE

    Anderst, William; Donaldson, William; Lee, Joon; Kang, James

    2013-01-01

    The aim of this study was to characterize cervical disc deformation in asymptomatic subjects and single-level arthrodesis patients during in vivo functional motion. A validated model-based tracking technique determined vertebral motion from biplane radiographs collected during dynamic flexion–extension. Level-dependent differences in disc compression–distraction and shear deformation were identified within the anterior and posterior annulus (PA) and the nucleus of 20 asymptomatic subjects and...

  17. A reappraisal of the diagnosis in cervical disc disease: The posterior longitudinal ligament perforated or not

    International Nuclear Information System (INIS)

    Herniated nuclear material of the cervical disc often perforates the posterior longitudinal ligament. Of 22 patients who were operated on by an anterior approach, 10 were of this type (the subligamentous type of cervical disc protrusion), while in the remaining 12 patients and 15 discs the protruded disc caused no tear in the ligament (the epiligamentous type). Myelography and CT myelography of these patients were reviewed. On CT myelography a localized and sharply demarcated excavation of the metrizamide ring was commonly found in the subligamentous type. Myelographic lateral view in this group shows a moderate or large indentation of the metrizamide column, since the herniated nucleus pulposus sometimes migrates caudally or cephalically. A small myelographic deformity coupled with diffuse excavation of the metrizamide ring on a CT myelogram leads us to the diagnosis of the epiligamentous type of cervical disc protrusion. In such cases, excision of the ligament is unnecessary during exploration of the discs, except when there is marked depression in the posterior longitudinal ligament. Presurgical recognition of both anatomical processes must be stressed for anterior discectomy. (orig.)

  18. Reappraisal of the diagnosis in cervical disc disease: The posterior longitudinal ligament perforated or not

    Energy Technology Data Exchange (ETDEWEB)

    Isu, Toyohiko; Iwasaki, Yoshinobu; Abe, Hiroshi; Tashiro, Kunio; Miyasaka, Kazuo; Ito, Terufumi

    1986-05-01

    Herniated nuclear material of the cervical disc often perforates the posterior longitudinal ligament. Of 22 patients who were operated on by an anterior approach, 10 were of this type (the subligamentous type of cervical disc protrusion), while in the remaining 12 patients and 15 discs the protruded disc caused no tear in the ligament (the epiligamentous type). Myelography and CT myelography of these patients were reviewed. On CT myelography a localized and sharply demarcated excavation of the metrizamide ring was commonly found in the subligamentous type. Myelographic lateral view in this group shows a moderate or large indentation of the metrizamide column, since the herniated nucleus pulposus sometimes migrates caudally or cephalically. A small myelographic deformity coupled with diffuse excavation of the metrizamide ring on a CT myelogram leads us to the diagnosis of the epiligamentous type of cervical disc protrusion. In such cases, excision of the ligament is unnecessary during exploration of the discs, except when there is marked depression in the posterior longitudinal ligament. Presurgical recognition of both anatomical processes must be stressed for anterior discectomy.

  19. Rabbit model of intervertebral disc degeneration by external compression device characterized by X-ray, MRI, histology, and cell viability

    OpenAIRE

    Ismail Ismail; Hee H. Tak; James C. Goh; Wang S. Chang; Wong H. Kit

    2006-01-01

    Appropriate experimental animal models, which mimic the degenerative process occurring in human intervertebral disc (IVD) breakdown and can be used for new treatment studies such as tissue engineering or disc distraction are lacking. We studied the external compression device that used by Kroeber et al to create intervertebral disc degeneration in rabbit model characterized by X-ray, MRI, Histology, and Cell Viability. Ten NZW rabbit were randomly assigned to one of five groups. Intervertebra...

  20. Histological analysis of surgical lumbar intervertebral disc tissue provides evidence for an association between disc degeneration and increased body mass index

    Directory of Open Access Journals (Sweden)

    Weiler Christoph

    2011-11-01

    Full Text Available Abstract Background Although histopathological grading systems for disc degeneration are frequently used in research, they are not yet integrated into daily care routine pathology of surgical samples. Therefore, data on histopathological changes in surgically excised disc material and their correlation to clinical parameters such as age, gender or body mass index (BMI is limited to date. The current study was designed to correlate major physico-clinical parameters from a population of orthopaedic spine center patients (gender, age and BMI with a quantitative histologic degeneration score (HDS. Methods Excised lumbar disc material from 854 patients (529 men/325 women/mean age 56 (15-96 yrs. was graded based on a previously validated histologic degeneration score (HDS in a cohort of surgical disc samples that had been obtained for the treatment of either disc herniation or discogenic back pain. Cases with obvious inflammation, tumor formation or congenital disc pathology were excluded. The degree of histological changes was correlated with sex, age and BMI. Results The HDS (0-15 points showed significantly higher values in the nucleus pulposus (NP than in the annulus fibrosus (AF (Mean: NP 11.45/AF 7.87, with a significantly higher frequency of histomorphological alterations in men in comparison to women. Furthermore, the HDS revealed a positive significant correlation between the BMI and the extent of histological changes. No statistical age relation of the degenerative lesions was seen. Conclusions This study demonstrated that histological disc alterations in surgical specimens can be graded in a reliable manner based on a quantitative histologic degeneration score (HDS. Increased BMI was identified as a positive risk factor for the development of symptomatic, clinically significant disc degeneration.

  1. Follow-up Study on the Motion Range after Treatment of Degenerative Disc Disease with the Bryan Cervical Disc Prosthesis

    Institute of Scientific and Technical Information of China (English)

    YANG Shuhua; HU Yong; ZHAO Jijun; HE Xianfeng; LIU Yong; XU Weihua; DU Jingyuan; FU Dehao

    2007-01-01

    This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients' ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months (with a mean of 5.2 months). Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130±50 min and the time of two-level surgery was 165±53 min on average (from skin incision to skin suturing).Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores (JOA scores) increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68° (3.6°-6.1°) in flexion and extension position and 3.51° (2.5°-4.6°) 3.42° (2.6°-4.3°) in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm) in 2 of 14 levels and between 1.5 mm and 3 mm) in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.

  2. Relationship of modic type 1 change with disc degeneration: a prospective MRI study

    International Nuclear Information System (INIS)

    The objective was to study the natural course of Modic type 1 change (M1) in relation to lumbar disc degeneration. Twenty-four chronic low back pain (LBP) patients with M1 on lumbar spine were selected from 1,015 patients with magnetic resonance imaging from a follow-up study lasting for 18-74 months. Exclusion criteria were any other specific back disorder, age ≥60 years, or a recent spine operation. The association between the development of M1 and degenerative disc changes was studied using multivariate modeling (complex samples logistic regression). At baseline, 20 of 28 (71%) disc spaces with M1 had a decreased disc height (DH) and 16 of 28 (57%) a dark nucleus pulposus, but ten of 28 (36%) a very dark annulus fibrosus and a paradoxically bright nucleus pulposus albeit decreased DH. During follow-up, DH decreased in 13 of 28 (46%) and signal intensity of nucleus pulposus (DSI) in eight of 28 (29%) disc spaces with M1, but it increased in four (14%) discs. In those without M1, only few changes occurred. The larger the M1, the more likely was the DH low or decreased further. Both the presence and changes in M1 were associated with a decrease in DH and changes in DSI and bulges. The degenerative process in discs with adjacent M1 seems to be accelerated and leads to advanced and deforming changes with special morphologic features. M1 may be a sign of a pathologic degenerative process in the discovertebral unit. (orig.)

  3. Relationship of modic type 1 change with disc degeneration: a prospective MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Luoma, Katariina [Helsinki University Central Hospital, Helsinki and Uudenmaa District University Hospitals, Helsinki (Finland)]|[Peijas Hospital, Helsinki University Central Hospitals, Department of Radiology, Vantaa (Finland); Vehmas, Tapio [Institute of Occupational Health, Helsinki (Finland); Groenblad, Mats; Kaeaepae, Eeva [Helsinki and Uudenmaa District University Hospitals, Helsinki University Central Hospital, Department of Physical Medicine and Rehabilitation, Helsinki (Finland); Kerttula, Liisa [Helsinki University Central Hospital, Helsinki and Uudenmaa District University Hospitals, Helsinki (Finland)

    2009-03-15

    The objective was to study the natural course of Modic type 1 change (M1) in relation to lumbar disc degeneration. Twenty-four chronic low back pain (LBP) patients with M1 on lumbar spine were selected from 1,015 patients with magnetic resonance imaging from a follow-up study lasting for 18-74 months. Exclusion criteria were any other specific back disorder, age {>=}60 years, or a recent spine operation. The association between the development of M1 and degenerative disc changes was studied using multivariate modeling (complex samples logistic regression). At baseline, 20 of 28 (71%) disc spaces with M1 had a decreased disc height (DH) and 16 of 28 (57%) a dark nucleus pulposus, but ten of 28 (36%) a very dark annulus fibrosus and a paradoxically bright nucleus pulposus albeit decreased DH. During follow-up, DH decreased in 13 of 28 (46%) and signal intensity of nucleus pulposus (DSI) in eight of 28 (29%) disc spaces with M1, but it increased in four (14%) discs. In those without M1, only few changes occurred. The larger the M1, the more likely was the DH low or decreased further. Both the presence and changes in M1 were associated with a decrease in DH and changes in DSI and bulges. The degenerative process in discs with adjacent M1 seems to be accelerated and leads to advanced and deforming changes with special morphologic features. M1 may be a sign of a pathologic degenerative process in the discovertebral unit. (orig.)

  4. REHABILITATION THERAPY VERSUS DRUG THERAPY IN PATIENTS WITH LUMBAR DISC DEGENERATION

    Directory of Open Access Journals (Sweden)

    BROSCATEAN, Emanuela-Flavia

    2013-12-01

    Full Text Available Lumbar disc degeneration is a disorder whose clinical manifestations are represented by episodic pain in the lumbar spine, without lumbar blockage and minor muscle contraction. Because lumbalgia caused by lumbar disc degeneration is not always very high intensity pain, the easiest to apply treatment is drug therapy. The aim of this study was to analyze the potential role of rehabilitation treatment in the recovery of patients and the prevention of complications compared to drug therapy alone. The study included 28 patients (17 women and 11 men aged between 23-60 years, assigned to two groups: 20 patients who received rehabilitation treatment (consisting of massage, kinesiotherapy, hydrokinesiotherapy, electrotherapy and medication and 8 patients who received drug treatment consisting of anti-inflammatory and analgesic drugs. The treatment duration was 10 days. For the evaluation of pain, the visual analogue scale was used, for the degree of disability, the Oswestry questionnaire, and for joint mobility and muscle strength, articular and muscular testing. At the end of treatment, the study group compared to the control group had a statistically significant result for pain (p=0.001, as well as for the Oswestry score (p=0.030. The mean age of the patients was 35.51±3.026, which shows an increased incidence among young adults. A possible connection between the development of the disease in women and age less than 45 years was also investigated, but the result was not statistically significant, p=0.22. Our data suggest the fact that rehabilitation treatment plays an important role in the reduction of pain and the improvement of the quality of life of patients with lumbar disc degeneration by decreasing the degree of disability. In the future, it can be proposed to monitor patients with lumbar disc degeneration over a longer time period in order to see the effects of kinetic rehabilitation programs in relation to the delay of chronicization. As

  5. Follow-up radiographs of the cervical spine after anterior fusion with titanium intervertebral disc

    International Nuclear Information System (INIS)

    Purpose: We examined the postoperative changes of the cervical spine after treatment of cervical nerve root compression with anterior cervical discectomy and fusion with a new titanium intervertebral disc. Patients and Methods: 37 patients were examined prior to, as well as 4 days, 6 weeks, and 7 months after surgery. Lateral view X-rays and functional imaging were used to evaluate posture and mobility of the cervical spine, the position of the implants, and the reactions of adjacent bone structures. Results: Implantation of the titanium disc led to post-operative distraction of the intervertebral space and slight lordosis. Within the first 6 months a slight loss of distraction and re-kyphosis due to impression of the implants into the vertebral end-plates were found in all patients. We noted partial infractions into the vertebral end-plates in 10/42 segments and slight mobility of the implants in 14/42 segments. Both groups of patients showed reactive spondylosis and local symptoms due to loosening of the implants. The pain subsided after onset of bone bridging and stable fixation of the loosened discs. Conclusions: The titanium intervertebral disc provides initial distraction of the fusioned segments with partial recurrence of kyphosis during the subsequent course. Loosening of the implants with local symptoms can be evaluated with follow-up X-rays and functional imaging. (orig.)

  6. Cervical disc herniation presenting with neck pain and contralateral symptoms: a case report

    Directory of Open Access Journals (Sweden)

    Yeung Jacky T

    2012-06-01

    Full Text Available Abstract Introduction Cervical disc herniation often results in neck and arm pain in patients as a result of direct impingement of nerve roots and associated inflammatory processes. The clinical presentation usually corresponds with the side of herniation and ipsilateral symptoms predominate the clinical picture. Case presentation A 35-year-old Caucasian man presented to our facility with neck pain and left-sided upper and lower extremity pain. A magnetic resonance imaging scan revealed a right paramedian herniated disc at the C5 to C6 level. All other cervical levels were normal without central canal stenosis or neural foraminal stenosis. Results from magnetic reasonance imaging scans of the brain and lumbar spine were negative. An anterior cervical discectomy was performed at the C5 to C6 level, and an inter-body graft and plate were placed. Our patient had complete resolution of his neck and left arm pain. Conclusions Anterior discectomy and fusion of the cervical spine resulted in complete resolution of our patient’s neck and left arm symptoms and improvement of his contralateral left leg pain. Cervical disc herniation may present with contralateral symptoms that are different from the current perception of this disease.

  7. MULTIMODAL PHYSIOTHERAPEUTIC APPROACH IN TREATING A PATIENT WITH ACUTE CERVICAL DISC PROLAPSE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rathish Manickam

    2015-12-01

    Full Text Available Background and Purpose: Cervical disc prolapse is one of the leading cause of morbidity and affecting the patients routine work of their ADL. Due to severity of symptoms and patients feeling of insecurity, physiotherapeutic conservative approach is questionable and has become challengeable against surgery. The purpose of this case report is to explore the efficacy of multimodal physiotherapeutic approach in treating a patient with acute cervical disc prolapse. Case Description: 33 year old male patient was diagnosed with acute cervical disc prolapse and the pain was radiating to the right upper limb associated with numbness. The patient was given initially physiotherapeutic modalities like cryotherapy, ultrasound and mechanical traction to reduce pain. Muscle Energy Technique was also implemented for initial days along with cryotherapy based on cryokinetics concept to enhance movements of cervical spine. Mckenzie exercises with appropriate techniques was administered for 10 days along with retraction exercise, basic ROM and neck isometrics as a home program. The patient received treatment for a period of 12 days. Outcome Measures: The outcome measures used were Numeric Pain Rating Scale, Neck Disability Index, Tampa Scale for Kinesiophobia, and Cervical ROM. Conclusion: Multimodal physiotherapeutic approach along with Mckenzie technique played a significant role in alleviating pain, numbness and improvement of the patient functionally for return to his normal work.

  8. Modic改变在腰椎间盘退变中的意义%The significance of Modic change in lumbar disc degeneration

    Institute of Scientific and Technical Information of China (English)

    马铮; 丁文元; 杨大龙; 孙亚澎; 张立军

    2013-01-01

    Concerning the Modic change of lumbar spinal endplate, the Modic change types, forming causes, and the relationship between Modic change and degenerative lumbar diseases have been studied from anatomy, pathology, molecular biology and many other aspects at present. The degeneration of lumbar disc is a high risk factor of the Modic change. The degeneration of lumbar disc usually starts from cartilage endplate degeneration. The injury of cartilage endplate could accelerate the degeneration of lumbar disc. This article reviews the significance of Modic change of lumbar spinal endplate in lumbar disc degeneration. The cause of Modic change of the endplate, pathological change, the influence of inflammatory mediators on the endplate and the significance of Modic change in the treatment of degenerative lumbar diseases are summarized to analyze the relationship between the degeneration of lumbar disc and Modic change of endplate and to describe the influence of Modic change in the treatment of degenerative lumbar disc diseases.

  9. Genetic risk factors of disc degeneration among 12-14-year-old Danish children

    DEFF Research Database (Denmark)

    Eskola, Pasi J.; Kjær, Per; Daavittila, Iita M.;

    2010-01-01

    The objective of the present study was to examine the associations between eleven putative predisposing single nucleotide polymorphisms (COL9A3, COL11A2, IL1A, IL1B, IL6 and VDR) and early disc degeneration (DD). The population consisted of 12 to 14-year-old Danish children (N=352). DD was...... evaluated from magnetic resonance im- ages (MRI). We analysed the association between DD and single nucleotide polymorphisms or haplotypes using logis- tic regression analyses. Of the 352 children studied, 73 boys and 81 girls had no MRI changes, while 30 boys and 36 girls had lumbar DD. Among girls, IL1A...

  10. The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis.

    Science.gov (United States)

    Yu, Cheng-Cheng; Hao, Ding-Jun; Ma, Yu-Li; Huang, Da-Geng; Li, Hou-Kun; Feng, Hang; Hou, Qian

    2016-01-01

    BACKGROUND Cervical disc replacement (CDR) has been widely used to restore and maintain mobility and function of the treated and adjacent motion segments. Posterior longitudinal ligament (PLL) resection has been shown to be efficient in anterior cervical decompression and fusion. However, less is known about the biomechanical effect of PLL removal versus preservation in cervical disc arthroplasty. MATERIAL AND METHODS Three motion segments of 24 ovine cervical spines (C2-C5) were evaluated in a robotic spine system with axial compressive loads of 50 N. These cervical spines were divided in three groups according to the following conditions: (1) intact spine, (2) C3/C4 CDR with the Prestige LP prosthesis and PLL preservation, and (3) C3/C4 CDR with the Prestige LP prosthesis and PLL removal. The ranges of motion (ROMs) were recorded and analyzed in each group. RESULTS The C3/C4 ROM in group 3 (CDR with PLL removed) increased significantly in flexion-extension and axial rotation compared with group 1 (intact spine). Moreover, in flexion-extension, the mean total ROM was significantly larger in group 3 than in group 1. All the ROM observed in group 2 (CDR with PLL preserved) did not significantly differ from the ROM observed in group 1. CONCLUSIONS Compared with intact spines, CDR with PLL removal partly increased ROM. Moreover, the ROM in CDR with PLL preservation did not significantly differ from the ROM observed in intact spines. The PLL appears to contribute to the balance and stability of the cervical spine and should thus be preserved in cervical disc replacement provided that the posterior longitudinal ligament is not degenerative and the compression can be removed without PLL takedown. PMID:27243444

  11. The Effect of the PEEK Cage on the Cervical Lordosis in Patients Undergoing Anterior Cervical Discectomy

    OpenAIRE

    Salih Gulsen

    2015-01-01

    BACKGROUND: Loss of cervical lordosis is a significant factor in the development of degeneration of the spine with aging. This degenerative changings of the cervical spine would cause pressure effect on the cervical root and/or medulla spinalis. AIM: Our goal is to understand the effect of the PEEK cage on cervical lordosis in the early postoperative period. Also, to interpret the effects of one- level, two- level, three-level and four- level disc pathologies on cervical lordosis. MAT...

  12. Analysis of cytokines in the spinal fluid of patients with intervertebral disc degeneration. Characteristics of matrix metalloproteinases

    International Nuclear Information System (INIS)

    Spinal fluid was collected from 26 patients with degenerative disc diseases (11 with lumbar disc herniation and 15 with lumbar spinal canal stenosis) and 4 healthy subjects when myelography or spinal anesthesia for surgery was performed, and the levels of major cytokines that are known to cause disc degeneration were measured. Cell cytometry and fractionation were performed. Levels of IL-1β and TNF-α, TGF-β were analyzed by ELISA; matrix metalloprotease (MMP)-3 and MMP-9, a tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2 by enzyme immunoassay; and IL-6 by chemiluminescent enzyme immunoassay. Disc degeneration was evaluated by MRI and classified into 5 grades (from 0 to 4). In the clinical evaluations prior to and post-surgery, the Japanese Orthopaedic Association scoring system was used. The levels of MMPs in the spinal fluid from the patients with lumbar disc herniation and lumbar spinal canal stenosis were significantly higher than those in the spinal fluid from healthy subjects. The severity of disc degeneration was not associated with the levels of MMPs. Of the patients with lumbar spinal canal stenosis, levels of MMPs were higher in patients with cauda equina syndrome than in patients with radiculopathy. The levels of IL-6 and TIMP-1 were significantly higher in patients with lumbar spinal canal stenosis (in both patients with cauda equina syndrome and those with radiculopathy) than in those with lumbar disc herniation. There was no significant difference between patients with lumbar spinal canal stenosis and those with lumbar disc herniation with respect to the number of cells and cell fractions. These results indicate that MMPs, TIMPs and the above-mentioned cytokines are also produced in the spinal canal and are involved in the degeneration of discs and spinal nerves. (author)

  13. Best Paper NASS 2013: Link-N can stimulate proteoglycan synthesis in the degenerated human intervertebral discs

    Directory of Open Access Journals (Sweden)

    R Gawri

    2013-09-01

    Full Text Available Intervertebral disc (IVD degeneration is the most common cause of back pain. Presently there is no medical treatment, leaving surgery as the only offered option. Here we evaluate the potential of Link-N to promote extracellular matrix regeneration in human IVDs. Human disc cells cultured in alginate and intact human discs were exposed to a combination of Link-N and 35SO4 in the presence or absence of interleukin (IL-1, and the effect on proteoglycan synthesis was evaluated. In addition, message levels of aggrecan, matrix metalloproteinase (MMP-3, MMP-13, a Disintegrin And Metalloproteinase with Thrombospondin Motifs (ADAMTS-4 and ADAMTS-5 were evaluated in alginate cultures. Human disc cells responded in a dose dependent manner with maximal proteoglycan synthesis at 1 µg/mL Link-N. Link-N treatment also induced proteoglycan synthesis in intact human discs, and a prolonged effect was found up to one week after Link-N treatment. Message levels of proteinases were decreased by Link-N in the presence of IL-1. Thus, Link-N can promote proteoglycan synthesis and deplete proteinase expression in adult human discs. Link-N could therefore be a promising candidate for biologically-induced disc repair, and could provide an alternative to surgical intervention for early stage disc degeneration.

  14. Running Exercise Alleviates Pain and Promotes Cell Proliferation in a Rat Model of Intervertebral Disc Degeneration

    Directory of Open Access Journals (Sweden)

    Shuo Luan

    2015-01-01

    Full Text Available Chronic low back pain accompanied by intervertebral disk degeneration is a common musculoskeletal disorder. Physical exercise, which is clinically recommended by international guidelines, has proven to be effective for degenerative disc disease (DDD patients. However, the mechanism underlying the analgesic effects of physical exercise on DDD remains largely unclear. The results of the present study showed that mechanical withdrawal thresholds of bilateral hindpaw were significantly decreased beginning on day three after intradiscal complete Freund’s adjuvant (CFA injection and daily running exercise remarkably reduced allodynia in the CFA exercise group beginning at day 28 compared to the spontaneous recovery group (controls. The hindpaw withdrawal thresholds of the exercise group returned nearly to baseline at the end of experiment, but severe pain persisted in the control group. Histological examinations performed on day 70 revealed that running exercise restored the degenerative discs and increased the cell densities of the annulus fibrosus (AF and nucleus pulposus (NP. Furthermore, immunofluorescence labeling revealed significantly higher numbers of 5-bromo-2-deoxyuridine (BrdU-positive cells in the exercise group on days 28, 42, 56 and 70, which indicated more rapid proliferation compared to the control at the corresponding time points. Taken together, these results suggest that running exercise might alleviate the mechanical allodynia induced by intradiscal CFA injection via disc repair and cell proliferation, which provides new evidence for future clinical use.

  15. Familial history, age and smoking are important risk factors for disc degeneration disease in Arabic pedigrees

    International Nuclear Information System (INIS)

    The present study used computed tomography imaging to evaluate the extent and pattern of the intergenerational transmission of spinal disc degeneration disease (DDD) in complex pedigrees. Contribution of a number of the potential covariates was also studied using univariate and multivariate logistic regression analysis, as well as two types of complex segregation analysis models. Among 161 individuals studied, DDD was diagnosed in 60 individuals. The number of protruded discs varied from 1 to 4, mostly in lumbar or lumbosacral regions. The average age at onset of the disease was similar for both women (36.0 years) and men (34.8 years). The proportion of the individuals affected by the DDD status of their parents ranged from 10% in families of two healthy parents to 55.5% of two affected parents (p < 0.01). The results of the logistic regression analyses and complex segregation analysis were qualitatively the same: DDD status of parents, age and smoking were the main risk factors for disc herniation in the Arabic families we examined. All analyses showed a predominating role of the family history as a risk factor for DDD in offsprings. It showed, for example, four times higher risk at age 50 for individuals with two affected parents vs. those who have two non-affected parents. However, the results of models-fitting genetic analysis, did not confirm a monogenic Mendelian pattern of inheritance

  16. Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Surgery for Adjacent Segment Degeneration and Recurrent Disc Herniation

    OpenAIRE

    Huan-Chieh Chen; Chih-Hsun Lee; Li Wei; Tai-Ngar Lui; Tien-Jen Lin

    2015-01-01

    Objective. The goal of the present study was to examine the clinical results of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar surgery for patients with adjacent segment degeneration (ASD) and recurrence of disc herniation. Methods. From December 2011 to November 2013, we collected forty-three patients who underwent repeated lumbar surgery. These patients, either received PELD (18 patients) or repeated open lumbar surgery (25 patients), due to ASD or recurrence of disc herni...

  17. Biomechanical analysis of the camelid cervical intervertebral disc

    OpenAIRE

    Dean K. Stolworthy; R. Amy Fullwood; Tyler M. Merrell; Bridgewater, Laura C.; Anton E. Bowden

    2015-01-01

    Chronic low back pain (LBP) is a prevalent global problem, which is often correlated with degenerative disc disease. The development and use of good, relevant animal models of the spine may improve treatment options for this condition. While no animal model is capable of reproducing the exact biology, anatomy, and biomechanics of the human spine, the quality of a particular animal model increases with the number of shared characteristics that are relevant to the human condition. The purpose o...

  18. Disc degeneration and chronic low back pain: an association which becomes nonsignificant when endplate changes and disc contour are taken into account

    International Nuclear Information System (INIS)

    The objective of this study was to assess the association between severe disc degeneration (DD) and low back pain (LBP). A case-control study was conducted with 304 subjects, aged 35-50, recruited in routine clinical practice across six hospitals; 240 cases (chronic LBP patients with a median pain duration of 46 months) and 64 controls (asymptomatic subjects without any lifetime history of significant LBP). The following variables were assessed once, using previously validated methods: gender, age, body mass index (BMI), lifetime smoking exposure, degree of physical activity, severity of LBP, disability, and findings on magnetic resonance (MRI) (disc degeneration, Modic changes (MC), disc protrusion/hernia, annular tears, spinal stenosis, and spondylolisthesis). Radiologists who interpreted MRI were blinded to the subjects' characteristics. A multivariate logistic regression model assessed the association between severe DD and chronic LBP, adjusting for gender, age, BMI, physical activity, MC, disc protrusion/hernia, and spinal stenosis. Severe DD at ≥1 level was found in 46.9 % of the controls and 65.8 % of the cases. Crude odds ratio (95 % CI), for suffering chronic LBP when having severe DD, was 2.06 (1.05; 4.06). After adjusting for ''MC'' and ''disc protrusion/hernia,'' it was 1.81 (0.81; 4.05). The association between severe DD and LBP ceases to be significant when adjusted for MC and disc protrusion/hernia. These results do not support that DD as a major cause of chronic LBP. (orig.)

  19. 突出的颈椎间盘组织炎症反应机制研究%Study on inflammatory mechanism of herniated cervical intervertebral discs from patients with cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    彭宝淦; 王占朝; 唐家广; 侯树勋; 吴仕良

    2003-01-01

    Aim To study the inflammatory mechanism of herniatedcervical intervertebral discs from patients with cervical spondyloticmyelopathy, and the roles of the inflammation in the cervical disc degenera-tion and cervical spondylosis. Methods 35 herniated cervical discs wereobtained fron 31 patients with cervical spondylotic myeloyathy during theanterior cervical surgery. 7 normal, nondegenerated cervical discs(controlgroup) were obtained from three fresh cadavers. All discs were divided intotwo samples, one of which was used as histological examination, and theother was used to detect contents of IL-1α. IL-6 and TNF-α biochemi-cally. Results In 35 herniated cervical discs, 18(51% ) were shownabundant inflammatory cell infiltrates in margin of herniated discs; 17(49%) no inflammatory cell infiltrates; normal discs also no any inflam-matory cell infiltrates. Biochemical assay indicated IL-1 α, IL-6 and TNF-αin cervical spondylotic myelopathy was (10.4 ± 1.9), (7.7 ± 2. 1 ) and(7.5 ± 1.7) pg/g respectively and those in noninflammatory infiltrates groupwas (10.2 ± 1.6), (6.7 ± 2.6) and (7.0 ± 1.8) pg/g respectively and thosein the control group was (2.0±0.9), (1.2±1.0) and (1.3±0.8)pg/g.The contents of cytokine IL-1α, IL-6 and TNF-α were obviously higher thanthat of normal discs( P =0. 000 1, t = 11. 359 1, 7. 951 0, 9. 372 8), andthere were no differences in the contents of cytokines between discs withinflammatory cell infiltrates and discs with no inflammatory cell infiltrates(P> 0.05, t=0.6120, 2.6204, 1.7394).Conelusion Herniatedcervical disc from the cervical spondylotic myelopathy was inflammatory, andinflammation may play an important role in cervical disc degeneration and inpathogenesis of cervical spondylosis.%目的研究颈椎病发生中突出颈椎间盘组织的炎症反应机制及其在颈椎间盘退行性变和颈椎病发病中的作用.方法临床收集了31例脊髓型颈椎病患者的35个突出的颈椎间盘标本和3

  20. Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

    Directory of Open Access Journals (Sweden)

    Jun Dong

    2015-07-01

    Full Text Available OBJECTIVE: To determine the range of motion and stability of the human cadaveric cervical spine after the implantation of a novel artificial disc and vertebra system by comparing an intact group and a fusion group. METHODS: Biomechanical tests were conducted on 18 human cadaveric cervical specimens. The range of motion and the stability index range of motion were measured to study the function and stability of the artificial disc and vertebra system of the intact group compared with the fusion group. RESULTS: In all cases, the artificial disc and vertebra system maintained intervertebral motion and reestablished vertebral height at the operative level. After its implantation, there was no significant difference in the range of motion (ROM of C3-7 in all directions in the non-fusion group compared with the intact group (p>0.05, but significant differences were detected in flexion, extension and axial rotation compared with the fusion group (p<0.05. The ROM of adjacent segments (C3-4, C6-7 of the non-fusion group decreased significantly in some directions compared with the fusion group (p<0.05. Significant differences in the C4-6 ROM in some directions were detected between the non-fusion group and the intact group. In the fusion group, the C4-6 ROM in all directions decreased significantly compared with the intact and non-fusion groups (p<0.01. The stability index ROM (SI-ROM of some directions was negative in the non-fusion group, and a significant difference in SI-ROM was only found in the C4-6 segment of the non-fusion group compared with the fusion group. CONCLUSION: An artificial disc and vertebra system could restore vertebral height and preserve the dynamic function of the surgical area and could theoretically reduce the risk of adjacent segment degeneration compared with the anterior fusion procedure. However, our results should be considered with caution because of the low power of the study. The use of a larger sample should be

  1. Incidence and risk factors analysis of heterotopic ossification after cervical disc replacement

    Institute of Scientific and Technical Information of China (English)

    Qi Min; Chen Huajiang; Cao Peng; Tian Ye; Yuan Wen

    2014-01-01

    Background Cervical disc replacement (CDR) as a substitute for traditional fusion surgery has been widely used in treating degenerative cervical disc diseases.The objectives of this study were to assess the clinical and radiological findings for patients with heterotopic ossification (HO) following CDR and to detect the risk factors of HO after CDR.Methods A total of 125 patients with symptomatic cervical single-or double-level disc diseases,who underwent CDR procedure with Discover prosthesis in Department of Spine Surgery,Changzheng Orthopedics Hospital from March 2009 to March 2011,were enrolled in this retrospective study.Occurrence of HO was defined by the McAfee classification on cervical lateral X-rays in this study.Prosthesis vertebral ratio (PVR) was used to determine the matching degree between the cervical disc prosthesis and cervical vertebra.Logistic regression analyses were performed to determine the risk factors of HO.Variables evaluated for their association with HO occurrence included age,gender,high-intensity signal in spinal cord,preoperative range of motion (ROM),postoperative ROM,operation level number,and PVR.Results Mean follow-up time was (26.4±5.8) months.All the patients had significant symptoms and neurological function improvements during the follow-up period.The ROM of the operated segment from the preoperative period to the last follow-up was relatively well maintained.The rate of HO in this cohort of patients,who underwent Discover disc,was 27.92% per surgical level and 24.8% per patient by the last follow-up.There were 19 patients (19.79%) with HO in the single-level group while 12 patients (41.38%) in the double-level group.Conclusions We identified preoperative high-intensity signal in spinal cord,postoperative ROM of surgical level,number of operation level,and PVR as significant risk factors for postoperative HO occurrence.

  2. Single level cervical disc herniation: A questionnaire based study on current surgical practices

    Directory of Open Access Journals (Sweden)

    Abrishamkar Saeid

    2009-01-01

    Full Text Available Background: Operative procedures like simple discectomy, with or without fusion and with or without instrumentation, for single level cervical disc herniation causing neck pain or neurological compromise have been described and are largely successful. However, there is a debate on definitive criteria to perform fusion (with or without instrumentation for single level cervical disc herniation. Hence, we conducted a questionnaire based study to elicit the opinions of practicing neurosurgeons. Materials and Methods: About 148 neurosurgeons with atleast 12 years of operative experience on single level cervical disc herniation, utilizing the anterior approach, were enrolled in our study. All participating neurosurgeons were asked to complete a practice based questionnaire. The responses of 120 neurosurgeons were analysed. Results: The mean age of enrolled surgeons was 51 yrs (range 45-73 with mean surgical experience of 16.9 yrs (range 12-40 yrs on single level cervical disc herniation. Out of 120 surgeons 10(8% had 15-25 years experience and always preferred fusion with or without instrumentation and six (five per cent with 17-27 yrs experience had never used fusion techniques. However, 104 (87% surgeons with 12-40 yrs experience had their own criteria based on their experiences for performing fusion with graft and instrumentation (FGI, while. 85 (75% preferred auto graft with cage. Conclusions: Most of surgeons performed FGI before the age of 40, but for others, patient criteria such as job (heavier job, physical examination (especially myelopathy and imaging findings (mild degenerative changes on X-ray and signal change in the spinal cord on MRI were considered significant for performing FGI.

  3. Systematic review of anterior interbody fusion techniques for single- and double-level cervical degenerative disc disease

    NARCIS (Netherlands)

    Jacobs, W.; Willems, P.C.P.H.; Kruyt, M.; Limbeek, J. van; Anderson, P.G.; Pavlov, P.; Bartels, R.H.M.A.; Oner, C.

    2011-01-01

    STUDY DESIGN: A systematic review of randomized controlled trials. OBJECTIVE: To determine which technique of anterior cervical interbody fusion (ACIF) gives the best outcome in patients with cervical degenerative disc disease. SUMMARY OF BACKGROUND DATA: The number of surgical techniques for decomp

  4. Anterior approach on protrusion of intervertebral disc and early rehabilitation training after operation%颈椎间盘突出症的前路手术与术后早期康复训练

    Institute of Scientific and Technical Information of China (English)

    方军; 高克海; 李华壮; 褚俊良

    2002-01-01

    Backgroud: The main causes of protrusion of cervical intervertebral disc are degenerations such as osteophymas on degenerated protruded intervertebral disc and vertebral body anterior to vertebral canal. Decompression via cervical anterior approach and fusion of implanted bone are effective methods. And it is very important for surgical effect and functional restoration to make sufficient preoperative preparation and consummate postoperative rehabilitation.

  5. Cervical spine disc herniation at C2-C3 level: Study of a Clinical Observation and Literature Review

    Directory of Open Access Journals (Sweden)

    Oka Dominique N'Dri

    2015-12-01

    Full Text Available Cervical C2-C3 herniated disc is rare. It is characterized by its clinical polymorphism. Several surgical approaches have been described for the discectomy of a herniated disc. This work aims at discussing through personal observations and literature review clinical semiology and surgical treatment.

  6. Artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation:a 3-year follow-up%颈椎人工间盘置换与前路减压融合修复单节段颈椎间盘突出症:3年随访

    Institute of Scientific and Technical Information of China (English)

    程俊杰; 眭江涛; 马原; 田慧中

    2015-01-01

    stages. Artificial disc replacement can not only play a role in mitigation of cervical disease neurological symptoms and signs, but also maintain stability and semental activity of cervical spine, and reduce secondary adjacent segmental degeneration. These two methods which applied in cervical degenerative intervertebral disc herniation stil remain controversial. OBJECTIVE:To investigate the short-term effect of artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation. METHODS:Total y 48 patients with single segment radiculopathy or myelopathy cervical diseases induced by cervical disc herniation that required surgery and received a three-month fol ow-up were included and retrospectively analyzed. These patients were divided into replacement group (n=21) and fusion group (n=27) according to the different repair programs. Patients in the replacement group were subjected to Prestige LP cervical artificial disc replacement, and patients in the fusion group were subjected to disc fusion using interbody fusion cage of Johnson or al ogeneic fibularing. They were fol owed up at 1 week, 3, 6, 12, 24, 36 months after treatment. Complications were recorded during the fol ow-up. The pain of patients was evaluated using neck and upper limb pain visual analogue scale scores. The therapeutic effect was evaluated using Japanese Orthopaedic Association (JOA) score. The clinical symptoms improvement and daily functional status of patients after treatment were evaluated using cervical disability index. RESULTS AND CONCLUSION:During the final fol ow-up, the fusion rate in fusion group was 93%(25/27). Comparisons between groups:at the 1 week and final fol ow-up after treatment, the visual analog scale scores of neck and upper limbs and cervical dysfunction indexes were al lower than those before treatment;the Japanese Orthopaedic Association scores were higher than those before treatment (P0.05). The

  7. Ozone Therapy and Its Effect on Cervical - Lumbar Disc Herniation

    OpenAIRE

    Korkut, Yasemin; Ayada, Ceylan; Toru, Ümran

    2015-01-01

    Ozone consists of three oxygen atoms and is a colorless gas that is heavier than air with a pungent smell. Medical ozone is administered to the patient always in the form of a mixture of pure oxygen and pure ozone and in a certain concentration. The ozone gas, which can be used in many types of diseases, is preferred as its side effects are at minimal rate. There are different forms of medical ozone application. Cervical and lumbar pains are located in the first row of the reasons for applyin...

  8. Clinical and Radiological Comparison of Femur and Fibular Allografts for the Treatment of Cervical Degenerative Disc Diseases

    OpenAIRE

    Oh, Hyeong-Seok; Shim, Chan Shik; Kim, Jin-Sung; Lee, Sang-Ho

    2013-01-01

    Objective This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating. Methods A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with ...

  9. Cervical disc herniation. Follow-up studies on morphological changes seen by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Kensei; Ohashi, Teruaki; Ishibashi, Kazumasa; Abe, Jun; Morita, Masakazu; Hirohashi, Akiyuki; Satou, Kimiaki; Ishida, Hyota; Inoue, Akio [Kurume Univ., Fukuoka (Japan). School of Medicine

    1996-03-01

    In recent years, many authors have reported that an extruded lumbar intervertebral disc was absorbed through phagocytosis and dehydration. However, absorption of an extruded cervical intervertebral disc has rarely been reported. We have investigated the follow-up MRI of all 24 patients with cervical disc herniation seen between 1991 and 1995. Of these, 8 patients with radiculopathy and 7 with myelopathy had been treated nonoperatively, and a further 9 patients with severe myelopathy had undergone expansive laminoplasty. In follow-up MRI, a reduction in the size of the extruded disc was seen in 5 of the 15 nonoperative patients and in 8 of the 9 operative patients. The 9 operative patients showed a mean recovery rate of 68.4{+-}15.2% (range from 44 to 90%) according to their JOA score. In the nonoperative group, recovery of symptoms was seen in all 5 patients with reduction, and in only 4 of 10 patients with nonreduction. The initial MRI of the 5 patients with reduction was taken between 2 and 7 weeks (mean 4 weeks) after onset, and between 1 month and 14 years (mean 13 months, not including the one at 14 years) after onset in the 10 patients with nonreduction. The initial MRI of the 9 operative patients was taken between 1 month and 6 years (mean 14 months after onset). The pathomechanism for disc reduction was concluded to have been the same as for lumbar disc herniation in the nonoperative patients. However, the pathomechanism in the operative patients was inconclusive and was likely to be different from that in the nonoperative patients. (author).

  10. Cervical disc herniation. Follow-up studies on morphological changes seen by MRI

    International Nuclear Information System (INIS)

    In recent years, many authors have reported that an extruded lumbar intervertebral disc was absorbed through phagocytosis and dehydration. However, absorption of an extruded cervical intervertebral disc has rarely been reported. We have investigated the follow-up MRI of all 24 patients with cervical disc herniation seen between 1991 and 1995. Of these, 8 patients with radiculopathy and 7 with myelopathy had been treated nonoperatively, and a further 9 patients with severe myelopathy had undergone expansive laminoplasty. In follow-up MRI, a reduction in the size of the extruded disc was seen in 5 of the 15 nonoperative patients and in 8 of the 9 operative patients. The 9 operative patients showed a mean recovery rate of 68.4±15.2% (range from 44 to 90%) according to their JOA score. In the nonoperative group, recovery of symptoms was seen in all 5 patients with reduction, and in only 4 of 10 patients with nonreduction. The initial MRI of the 5 patients with reduction was taken between 2 and 7 weeks (mean 4 weeks) after onset, and between 1 month and 14 years (mean 13 months, not including the one at 14 years) after onset in the 10 patients with nonreduction. The initial MRI of the 9 operative patients was taken between 1 month and 6 years (mean 14 months after onset). The pathomechanism for disc reduction was concluded to have been the same as for lumbar disc herniation in the nonoperative patients. However, the pathomechanism in the operative patients was inconclusive and was likely to be different from that in the nonoperative patients. (author)

  11. Posteriorly Directed Shear Loads and Disc Degeneration Affect the Torsional Stiffness of Spinal Motion Segments A Biomechanical Modeling Study

    NARCIS (Netherlands)

    Homminga, Jasper; Lehr, Anne M.; Meijer, Gerdine J. M.; Janssen, Michiel M. A.; Schlosser, Tom P. C.; Verkerke, Gijsbertus J.; Castelein, Rene M.

    2013-01-01

    Study Design. Finite element study. Objective. To analyze the effects of posterior shear loads, disc degeneration, and the combination of both on spinal torsion stiffness. Summary of Background Data. Scoliosis is a 3-dimensional deformity of the spine that presents itself mainly in adolescent girls

  12. Nucleoplasty as a therapeutic option for lumbar disc degeneration related pain: a retrospective study of 396 cases

    Directory of Open Access Journals (Sweden)

    José Lourenço Kallás

    2013-01-01

    Full Text Available OBJECTIVES: To make a retrospective analysis and evaluate a clinical response to the control of disc degeneration related pain of 396 patients submitted to percutaneous lumbar nucleoplasty; and to make a record of visual analogical scale (VAS up to a three-year follow-up after the surgical procedure. METHODS: Analysis of VAS score in 396 patients with lumbar disc degeneration related pain, according to anamnesis, clinical examination and magnetic resonance imaging (MRI, without improvement of previous clinical treatment, submitted to percutaneous nucleoplasty. RESULTS: A total of 26% of the patients presented 100% remission of pain or paresthesia, of whom 75% showed at least 50% of pain improvement. The median VAS pain improvement was about 67%. CONCLUSIONS: The median VAS improvement in inferior disc levels was higher than four points. The VAS showed improvement of the pain and paresthesia up to a three-year follow up after the surgical procedure.

  13. Research progress on Hybrid surgery treating multilevel cervical degenerative disc diseases%Hybrid术式治疗多节段颈椎退行性疾病的研究进展

    Institute of Scientific and Technical Information of China (English)

    张耐洋(综述); 彭宝淦(审校)

    2016-01-01

    Nowdays, anterior cervical discectomy and fusion (ACDF) and cervical artificial disc replacement (CADR) are the most accepted procedure to treat multilevel cervical degenerative disc diseases. However, ACDF reduces the motion of the cervical spine and accelerates adjacent level degeneration. Strict indications and hyper-mobility of the operative levels may limit the application of multilevel CADR. Some experts put forward the method of Hybrid surgery incorporating ACDF and CADR. The purpose of this study is to review the progress of Hybrid surgery treating multilevel cervical degenerative disc diseases.%目前对于多节段颈椎退变性疾病的治疗术式中以颈前路减压植骨融合内固定术(anterior cervical discectomy and fusion,ACDF)和颈椎间盘置换术(cervical artificial disc replacement,CADR)为主,然而ACDF消除了颈椎融合节段的活动度,加速了颈椎临近节段的退变;CADR的适应证狭窄并且手术节段的活动度不理想。所以有学者提出在治疗多节段颈椎退行性疾病中将ACDF和CADR结合起来即Hybrid术式,笔者就目前Hybrid术式治疗多节段颈椎退行性疾病的研究进展做一综述。

  14. Discover人工颈椎间盘置换治疗颈椎间盘退变性疾病的临床疗效%Outcome of discover cervical artificial disc replacement for degenerativedisc disease of the cervical spine

    Institute of Scientific and Technical Information of China (English)

    何智勇; 李开南; 聂海; 母建松; 兰海

    2012-01-01

    Objective To estimate the clinical effects on Discover cervical artificial disc replacement for degenerative disc disease of the cervical spine. Methods A total of 20 patients with cervical disc degeneration, whose pain is not relieved adequately with six weeks of conservative care and daily activities become difficult, were chosed in this study between January 2007 and August 2011. The clinical outcomes were assessed using neck disable index (NDI) and visual analogue scale ( VAS) and Odora scale before surgery and 1、6、12、24 months after surgery. Imageological examination included X ray, cervical CT scanning and MR imaging. Results There are 26 levels in 20 patients performing cervical disc replacement and the follow-up period was 24 months. The NDI, VAS of neck pain, VAS of arm pain were from (23. 82 ±2. 87)、(5.90 ±0. 35)、(5. 91 ±1.63) before sugery to (5. 21 ± 1. 12)、(1. 62 ±0. 87)、(0. 97 ±0. 65) 2 years after sugery. Odom scale were excellent or good in all palienls. The operation time was 60-210 minutes and the estimated blood loss was 70 - 350 milliliter. The motion function of cervical artificial disc implanted was very good with imageology evaluation. The prosthesis moved forward 3 mm in one patient, and another patient had heterotopic ossification 12 months after surgery. Conclusion Discover cervical artificial disc replacement for degenerative disc disease of the cervical spine is safe and effective, however, further study should be conducted to determine the long term outcome.%目的 评价Discover人工颈椎间盘置换治疗颈椎间盘退变性疾病的临床疗效.方法 2007年1月~2011年8月,20例颈椎间盘退变突出经保守治疗无效的患者行人工颈椎间盘置换术.患者术前、术后1、6、12、24个月时使用颈椎功能障碍指数(neck disable index,NDI)、疼痛视觉模拟疼痛量表(visual analogue scale,VAS)进行疗效评估,手术效果采用Odom法评价.影像学检查包括颈椎动力位X

  15. Aquaporin 3 protects against lumbar intervertebral disc degeneration via the Wnt/β-catenin pathway.

    Science.gov (United States)

    Xie, Huanxin; Jing, Yongbin; Xia, Jingjun; Wang, Xintao; You, Changcheng; Yan, Jinglong

    2016-03-01

    Previous studies have demonstrated that the expression of aquaporin 3 (AQP3), a water channel which promotes glycerol permeability and water transport across cell membranes, is reduced in degenerative lumbar intervertebral disc (IVD) tissues. However, the role of AQP3 in the pathogenesis of IVD degeneration has not recieved much scholarly attention. The objective of the present study was to investigate the effect of AQP3 on cell proliferation and extracellular matrix (ECM) degradation in human nucleus pulposus cells (hNPCs) using gain-of-function and loss-of-function experiments, and to determine whether Wnt/β-catenin signaling is involved in the effect of AQP3 on IVD degeneration. hNPCs were transfected with the AQP3-pcDNA3.1 plasmid or AQP3 siRNA to overexpress or suppress AQP3. An MTT assay was performed to determine cell proliferation, and we found that AQP3 promoted hNPC proliferation. The expression of aggrecan, a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)4 and ADAMTS5 was detected using western blot analysis, to examine the effect of AQP3 on ECM degradation in hNPCs. The results revealed that AQP3 inhibited ECM degradation in hNPCs. In addition, we found that Wnt/β-catenin signaling was suppressed by AQP3. However, the effect of AQP3 on hNPC proliferation and ECM degradation was reversed by treatment with lithium chloride, a known activator of Wnt/β‑catenin signaling. In conclusion, using in vitro and in vivo tests, we have reported for the first time, to the best of our knowledge, that AQP3 exerts protective effects against IVD degeneration, and these are effected, at least partially, through the inhibition of Wnt/β-catenin signaling. PMID:26820815

  16. Cervical Spine Disc Deformation During In Vivo Three-Dimensional Head Movements.

    Science.gov (United States)

    Anderst, William; Donaldson, William; Lee, Joon; Kang, James

    2016-05-01

    Although substantial research demonstrates that intervertebral disc cells respond to mechanical signals, little research has been done to characterize the in vivo mechanical environment in the disc tissue. The objective of this study was to estimate cervical disc strain during three-dimensional head movements. Twenty-nine young healthy adults performed full range of motion flexion/extension, lateral bending, and axial rotation of the head within a biplane radiography system. Three-dimensional vertebral kinematics were determined using a validated model-based tracking technique. A computational model used these kinematics to estimate subject-specific intervertebral disc deformation (C3-4 to C6-7). Peak compression, distraction and shear strains were calculated for each movement, disc level, and disc region. Peak compression strain and peak shear strain were highest during flexion/extension (mean ± 95% confidence interval) (32 ± 3 and 86 ± 8%, respectively), while peak distraction strain was highest during lateral bending (57 ± 5%). Peak compression strain occurred at C4-5 (33 ± 4%), while peak distraction and shear strain occurred at C3-4 (54 ± 8 and 83 ± 11%, respectively). Peak compression, distraction, and shear strains all occurred in the posterior-lateral annulus (48 ± 4, 80 ± 8, and 109 ± 12%, respectively). These peak strain values may serve as boundary conditions for in vitro loading paradigms that aim to assess the biologic response to physiologic disc deformations. PMID:26271522

  17. Cervical spine degenerative changes (narrowed intervertebral disc spaces and osteophytes) in coal miners

    International Nuclear Information System (INIS)

    A series of 685 x-rays films of the cervical spine obtained in coal miners was analyzed to explore the occurrence of narrowed disc spaces and osteophytes in this occupational group, and to examine the association of x-rays changes with age, duration of employment, and duration of occupational exposure to hand-arm vibration. All data were extracted from individual medical files of coal miners examined for suspected hand-arm vibration-related disorders in 1989-1999 at the Occupational Medicine Center in Katowice. The narrowed intervertebral disc spaces were found in 188 coal miners (26.9%) and osteophytes in 332 coal miners (47.5%). The occurrence of degenerative changes in coal miners was similar to that observed in a small group of 68 blue-collar workers (no exposure to hand-arm vibration) employed in the coal industry. Univariate comparisons showed that intervertebral disc spaces and osteophytes were more frequent among older subjects and among subjects with longer duration of employment. The results of logistic regression analysis confirmed statistically significant effect of age, but not of other factors included in the model. When both x-ray changes were grouped together (a combined dependent variable) age remained the only statistically significant explanatory variable. The findings do not support the view that the examined degenerative changes in cervical spine are more prevalent in coal miners and depend on duration of physical work or local exposure to hand-arm vibration in this occupational group. (author)

  18. Outcomes of conservative treatment for cervical myelopathy caused by soft disc herniation

    International Nuclear Information System (INIS)

    The purposes of this study are to delineate the clinical course and MRI findings of patients with disc hernias which regressed spontaneously and to determine who is eligible for conservative treatment. Twenty-three patients with mild cervical myelopathy (initial Japanese Orthopedic Association (JOA) scores >10) caused by soft disc herniation were treated conservatively for more than two years (13 males, 10 females, mean age 50, mean follow-up 3.6 years). The investigated items included JOA scores and MRI findings (morphology of disc herniation). Morphology of disc herniation was classified into focal type (herniated mass persisting at the intervertebral level) and diffuse type (herniated mass migrating rostrally or caudally) in the sagittal plane and median type or paramedian type in the axial plane. The mean JOA scores were 13.4±1.5 before treatment, and 16.0±1.0 at follow-up. Regression of herniation was observed in 14 patients (Group A), while no regression was seen in 9 patients (Group B). The JOA scores were 13.7±1.5 (Group A) and 14.0±1.6 (Group B) before treatment, and 16.3±1.6 and 15.7±1.2 at follow-up, respectively. On sagittal MR images, diffuse-type herniation was observed in 9 patients (64%) and focal-type in 5 (36%) in Group A, and 3 (33%) and 6 (67%) in Group B, respectively. On axial images, median-type herniation was observed in 10 patients (71%), and paramedian-type in 4 (29%) in Group A, and 6 (67%) and 3 (33%) in Group B, respectively. Spontaneous soft disc regression in patients with cervical myelopathy was observed in more than half of those treated conservatively for longer than 2 years. Conservative treatment can be recommended for patients with mild cervical myelopathy, especially when caused by median-and/or diffuse-type disc hernia, although close observation is mandatory. (author)

  19. Disc degeneration and chronic low back pain: an association which becomes nonsignificant when endplate changes and disc contour are taken into account

    Energy Technology Data Exchange (ETDEWEB)

    Kovacs, Francisco M. [Fundacion Kovacs, Departamento Cientifico, Palma de Mallorca (Spain); Fundacion Kovacs, Spanish Back Pain Research Network, Palma de Mallorca (Spain); Arana, Estanislao [Fundacion Kovacs, Spanish Back Pain Research Network, Palma de Mallorca (Spain); Fundacion Instituto Valenciano de Oncologia, Servicio de Radiologia, Valencia (Spain); Royuela, Ana [CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid (Spain); Hospital Ramon y Cajal, Unidad de Bioestadistica Clinica, IRYCIS, Madrid (Spain); Estremera, Ana; Amengual, Guillermo; Sarasibar, Helena; Martinez, Carmen [Fundacion Kovacs, Spanish Back Pain Research Network, Palma de Mallorca (Spain); Hospital Son Llatzer, Palma de Mallorca (Spain); Asenjo, Beatriz [Fundacion Kovacs, Spanish Back Pain Research Network, Palma de Mallorca (Spain); Hospital Carlos Haya, Malaga (Spain); Galarraga, Isabel [Fundacion Kovacs, Spanish Back Pain Research Network, Palma de Mallorca (Spain); Hospital de Manacor, Manacor, Mallorca (Spain); Alonso, Ana [Fundacion Kovacs, Spanish Back Pain Research Network, Palma de Mallorca (Spain); Fundacion Jimenez Diaz, Madrid (Spain); Casillas, Carlos [Fundacion Kovacs, Spanish Back Pain Research Network, Palma de Mallorca (Spain); Instituto de Traumatologia Union de Mutuas, Castellon (Spain); Muriel, Alfonso; Abraira, Victor [Hospital Ramon y Cajal, Unidad de Bioestadistica Clinica, IRYCIS, Madrid (Spain); CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid (Spain)

    2014-01-15

    The objective of this study was to assess the association between severe disc degeneration (DD) and low back pain (LBP). A case-control study was conducted with 304 subjects, aged 35-50, recruited in routine clinical practice across six hospitals; 240 cases (chronic LBP patients with a median pain duration of 46 months) and 64 controls (asymptomatic subjects without any lifetime history of significant LBP). The following variables were assessed once, using previously validated methods: gender, age, body mass index (BMI), lifetime smoking exposure, degree of physical activity, severity of LBP, disability, and findings on magnetic resonance (MRI) (disc degeneration, Modic changes (MC), disc protrusion/hernia, annular tears, spinal stenosis, and spondylolisthesis). Radiologists who interpreted MRI were blinded to the subjects' characteristics. A multivariate logistic regression model assessed the association between severe DD and chronic LBP, adjusting for gender, age, BMI, physical activity, MC, disc protrusion/hernia, and spinal stenosis. Severe DD at ≥1 level was found in 46.9 % of the controls and 65.8 % of the cases. Crude odds ratio (95 % CI), for suffering chronic LBP when having severe DD, was 2.06 (1.05; 4.06). After adjusting for ''MC'' and ''disc protrusion/hernia,'' it was 1.81 (0.81; 4.05). The association between severe DD and LBP ceases to be significant when adjusted for MC and disc protrusion/hernia. These results do not support that DD as a major cause of chronic LBP. (orig.)

  20. The Effect of Electroacupuncture on the Extracellular Matrix Synthesis and Degradation in a Rabbit Model of Disc Degeneration

    Directory of Open Access Journals (Sweden)

    Guo-fu Huang

    2014-01-01

    Full Text Available The present study was aimed at determining if the electroacupuncture (EA is able to protect degenerated disc in vivo. New Zealand white rabbits (n=40 were used for the study. The rabbits were randomly assigned to four groups. EA intervention was applied to one of the four groups. Magnetic resonance imaging and Pfirrmann’s classification were obtained for each group to evaluate EA treatment on the intervertebral disc degeneration. Discs were analyzed using immunofluorescence for the labeling of collagens 1 and 2, bone morphogenetic protein-2 (BMP-2, matrix metalloproteinase-13 (MMP-13, and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1. For protein expression analysis, western blot was used for biglycan and decorin. Outcomes indicated that EA intervention decreased the grades compared with the compressed disc. Immunofluorescence analysis showed a significant increase of collagens 1 and 2, TIMP-1, and BMP-2 positive cells, in contrast to MMP-13 after EA treatment for 28 days. The protein expression showed a sign of regeneration that decorin and biglycan were upregulated. It was concluded that EA contributed to the extracellular matrix (ECM anabolic processes and increased the ECM components. MMPs and their inhibitors involved in the mechanism of EA intervention on ECM decreased disc. It kept a dynamic balance between ECM synthesis and degradation.

  1. Brachioradial pruritus in a patient with cervical disc herniation and Parsonage-Turner syndrome*

    Science.gov (United States)

    Carvalho, Sandrina; Sanches, Madalena; Alves, Rosário; Selores, Manuela

    2015-01-01

    Brachioradial pruritus is a chronic sensory neuropathy of unknown etiology which affects the skin of the shoulders, arms and forearms on the insertion of the brachioradialis muscle. We describe the case of a 60-yearold woman recently diagnosed with multiple myeloma who refers paresis, severe pruritus and itching lesions on the right arm with 6 months of evolution. Investigation led to a diagnosis of Brachioradial pruritus consequent to the presence of cervical disc herniation and Parsonage-Turner syndrome. The patient started gabapentin 900mg/day with good control of itching. Corticosteroids and antihistamines are often ineffective in the treatment of BP. Gabapentin has been used with encouraging results. All patients with Brachioradial pruritus should be evaluated for cervical spine injuries. PMID:26131874

  2. Motion analysis of total cervical disc replacements using computed tomography: Preliminary experience with nine patients and a model

    Energy Technology Data Exchange (ETDEWEB)

    Svedmark, Per (Div. of Orthopedics, Dept. of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (Sweden); Stockholm Spine Center, Lowenstromska Hospital, Stockholm (Sweden)), email: per.svedmark@spinecenter.se; Lundh, Fredrik; Olivecrona, Henrik (Div. of Orthopedics, Dept. of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (Sweden)); Nemeth, Gunnar (Capio group, Stockholm (Sweden)); Noz, Marilyn E. (Dept. of Radiology, New York Univ. School of Medicine, New York (United States)); Maguire Jr, Gerald Q. (School of Information and Communication Technology, Royal Inst. of Technology, Kista (Sweden)); Zeleznik, Michael P. (Saya Systems Inc., Salt Lake City (United States))

    2011-12-15

    Background. Cervical total disc replacement (CTDR) is an alternative to anterior fusion. Therefore, it is desirable to have an accurate in vivo measurement of prosthetic kinematics and assessment of implant stability relative to the adjacent vertebrae. Purpose. To devise an in vivo CT-based method to analyze the kinematics of cervical total disc replacements (CTDR), specifically of two prosthetic components between two CT scans obtained under different conditions. Material and Methods. Nine patients with CTDR were scanned in flexion and extension of the cervical spine using a clinical CT scanner with a routine low-dose protocol. The flexion and extension CT volume data were spatially registered, and the prosthetic kinematics of two prosthetic components, an upper and a lower, was calculated and expressed in Euler angles and orthogonal linear translations relative to the upper component. For accuracy analysis, a cervical spine model incorporating the same disc replacement as used in the patients was also scanned and processed in the same manner. Results. Analysis of both the model and patients showed good repeatability, i.e. within 2 standard deviations of the mean using the 95% limits of agreement with no overlapping confidence intervals. The accuracy analysis showed that the median error was close to zero. Conclusion. The mobility of the cervical spine after total disc replacement can be effectively measured in vivo using CT. This method requires an appropriate patient positioning and scan parameters to achieve suitable image quality

  3. Choice of surgical approach for ossification of the posterior longitudinal ligament in combination with cervical disc hernia

    OpenAIRE

    Yang, Hai-song; Chen, De-yu; Lu, Xu-hua; Yang, Li–li; Yan, Wang-Jun; Yuan, Wen; Chen, Yu

    2009-01-01

    Ossification of the posterior longitudinal ligament (OPLL) is a common spinal disorder that presents with or without cervical myelopathy. Furthermore, there is evidence suggesting that OPLL often coexists with cervical disc hernia (CDH), and that the latter is the more important compression factor. To raise the awareness of CDH in OPLL for spinal surgeons, we performed a retrospective study on 142 patients with radiologically proven OPLL who had received surgery between January 2004 and Janua...

  4. Asporin, a susceptibility gene in osteoarthritis, is expressed at higher levels in the more degenerate human intervertebral disc

    OpenAIRE

    Gruber, Helen E.; Ingram, Jane A; Hoelscher, Gretchen L; Zinchenko, Natalia; Hanley, Edward N; Sun, Yubo

    2009-01-01

    Introduction Asporin, also known as periodontal ligament-associated protein 1 (PLAP1), is a member of the family of small leucine-rich proteoglycan (SLRP) family. It is present within the cartilage extracellular matrix (ECM), and is reported to have a genetic association with osteoarthritis. Its D14 allele has recently been found to be associated with lumbar disc degeneration in Asian subjects. There have been no studies, however, of this gene's normal immunohistochemical localization within ...

  5. Anterior Cervical Surgery Cervical Disc Experience%颈椎前路手术治疗颈椎间盘突出症体会

    Institute of Scientific and Technical Information of China (English)

    吴向东; 刘绍武; 唐佩福

    2012-01-01

    Objective:Observation of the anterior cervical surgical treatment of cervical disc herniation .Methods:52cases of cervical disc herniation, anterior cervical decompression, bone graft and application of cervical locking anterior plate internal fixation. Results:46 cases after 2~ 18months, anaverage of 8.2 months of follow-up of all cases of graft to achieve bone fusion, the integration time of 12 ~ 16 weeks, with an average of 12.6 weeks, 100% of the fusion rate; MRI examination of spinal cord deformation. The compression performance of spinal cord function tests, with the exception of three cases of unsatisfactory outside. The results were satisfactory in all cases bone graft. Conclusion:Indications to choose the right anterior cervical decompression surgery bone graft and plate system is simple and can provide a fixed segmental stability, conducive to the recovery of neurological function, applicable to the treatment of cervical disc herniation, cervical trauma. Anterior cervical surgery for two cervical disc, three vertebrae. Power and restricted anterior cervical fixation materials was no significant differencein clinical therapy.%目的:观察颈椎前路手术治疗颈椎间盘突出症的疗效.方法:对52例颈椎间盘突出症,行颈椎前路减压、植骨并应用锁定型颈椎前路钢板内固定.结果:46例经过2~18个月、平均8.2月的随访,所有病例植骨均达到骨性融合,融合时间12~16周,平均12.6周,融合率100%;MRI检查无脊髓变形、受压表现,脊髓功能检查,除3例不理想外.所有病例植骨疗效满意.结论:适应症选择正确,颈椎前路手术减压植骨、钢板系统操作简单,可提供有效的固定节段稳定性,利于神经功能恢复,适用于颈椎间盘突出症、颈椎外伤的治疗.颈椎前路手术适用于2个颈椎间盘,3个椎体.动力性和限制性颈椎前路内固定材料在临床治疗疗效上无明显差别.

  6. BMP7 enhances the effect of BMSCs on extracellular matrix remodeling in a rabbit model of intervertebral disc degeneration.

    Science.gov (United States)

    Xu, Jun; E, Xiao-Qiang; Wang, Nan-Xiang; Wang, Mo-Nan; Xie, Huan-Xin; Cao, Yan-Hui; Sun, Li-Hua; Tian, Jun; Chen, Hua-Jiang; Yan, Jing-Long

    2016-05-01

    Intervertebral discs (IVDs) provide stability and flexibility to the spinal column; however, IVDs, and in particular the nucleus pulposus (NP), undergo a degenerative process characterized by changes in the disc extracellular matrix (ECM), decreased cell viability, and reduced synthesis of proteoglycan and type II collagen. Here, we investigated the efficacy and feasibility of stem cell therapy using bone marrow mesenchymal stem cells (BMSCs) over-expressing bone morphogenetic protein 7 (BMP7) to promote ECM remodeling of degenerated IVDs. Lentivirus-mediated BMP7 over-expression induced differentiation of BMSCs into an NP phenotype, as indicated by expression of the NP markers collagen type II, aggrecan, SOX9 and keratins 8 and 19, increased the content of glycosaminoglycan, and up-regulated β-1,3-glucuronosyl transferase 1, a regulator of chondroitin sulfate synthesis in NP cells. These effects were suppressed by Smad1 silencing, indicating that the effect of BMP7 on ECM remodeling was mediated by the Smad pathway. In vivo analysis in a rabbit model of disc degeneration showed that implantation of BMSCs over-expressing BMP7 promoted cell differentiation and proliferation in the NP, as well as their own survival, and these effects were mediated by the Smad pathway. The results of the present study indicate the beneficial effects of BMP7 on restoring ECM homeostasis in NP cells, and suggest potential strategies for improving cell therapy for the treatment of disc diseases. PMID:26929154

  7. Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament

    Directory of Open Access Journals (Sweden)

    Dachuan Wang

    2014-01-01

    Full Text Available Intradural herniation of a cervical disc is rare; less than 35 cases have been reported to date. A 52-year-old man with preexisting ossification of posterior longitudinal ligament developed severe neck pain with Lt hemiparesis while asleep. Neurological exam was consistent with Brown-Séquard syndrome. Magnetic resonance images showed a C5-6 herniated disc that was adjacent to the ossified ligament and indenting the cord. The mass was surrounded by cerebrospinal fluid signal intensity margin, and caudally the ventral dura line appears divided into two, consistent with the “Y-sign” described by Sasaji et al. Cord edema were noted. Because of preexisting canal stenosis and spinal cord at risk, a laminoplasty was performed, followed by an anterior C6 corpectomy. Spot-weld type adhesions of the posterior longitudinal ligament to the dura was noted, along with a longitudinal tear in the dura. An intradural extra-arachnoid fragment of herniated disc was removed. Clinical exam at 6 months after surgery revealed normal muscle strength but persistent mild paresthesias. It is difficult to make a definite diagnosis of intradural herniation preoperatively; however, the clinical findings and radiographic signs mentioned above are suggestive and should alert the surgeon to look for an intradural fragment.

  8. 腰椎间盘髓核退变的MRI研究%MRI study on nucleus pulposus degeneration of lumbar intervertebral discs

    Institute of Scientific and Technical Information of China (English)

    孔庆奎; 张立涛; 谢元忠; 付孟莉; 武玉恒; 程琮; 陈绪珠

    2011-01-01

    Objective The purpose of this study was to correlate T2 signal intensity values in nu-cleus pulposus of lumbar discs with patient age , gender and stage of nucleus pulposus degeneration .Methods Lumbar imaging findings of 422 cases subjects were retrospectively reviewed through T 2 signal in-tensity values of nucleus pulposus evaluated based on the signal intensity values of MR T 2-weighted mid-sag-ittal images of the lumbar spine,the t2 signal intensity values at all five lumbar levels (from L5-S1 to L1-L2)between male and female were used independent sample t-test and the Spearman correlation analysis.The age and grade of nucleus pulposus of disc degeneration and T 2 signal intensity values were estimated by calculat-ing and Chi-square test and the Spearman correlation analysis .The t-test was used to correlate the different anatomic levels of disc degeneration;T2 signal intensity values among the five different anatomic levels using non-parametric correlation analysis.Results There were significantly differences in T2 signal intensity val-ues of nucleus pulposus at the same grade and anatomic level between male and female .Advanced with age,T2 signal intensity values of nucleus pulposus decreased and stage of disc degeneration increased according -ly.T2 signal intensity values may represent the nucleus pulposus degeneration of interverterbral disc .L4-L5 was the highest incidence among the nucleus pulposus degeneration of intervertebral disc .Conclusions The T2 signal intensity values based approach may be a feasible and practical tool to determine nucleus pulposus degeneration.T2 signal intensity values of nucleus pulposus of lumbar intervertebral disc are correlated with grade of degeneration and patient age .

  9. Intra- and inter-observer reliability of MRI examination of intervertebral disc abnormalities in patients with cervical myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Braga-Baiak, Andresa [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Post-graduation Program, Department of Radiology, University of Sao Paulo (Brazil); Shah, Anand [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Pietrobon, Ricardo [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Department of Surgery, Duke University Medical Center, Durham, NC (United States); Braga, Larissa [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); University of Nebraska Medical Center, Lincoln NE (United States); Neto, Arnolfo Carvalho [Clinica DAPI, Curitiba (Brazil); Section of Diagnostic Radiology, Department of Internal Medicine, Universidade Federal do Parana (Brazil); Cook, Chad [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Division of Physical Therapy, Duke University Medical Center, Durham, NC (United States)], E-mail: chad.cook@duke.edu

    2008-01-15

    Purpose: Intervertebral cervical disc herniation (CDH) is a relatively common disorder that can coexist with degenerative changes to worsen cervicogenic myelopathy. Despite the frequent disc abnormalities found in asymptomatic populations, magnetic resonance imaging (MRI) is considered excellent at detecting cervical spine myelopathy (CSM) associated with disc abnormality. The objective of this study was to investigate the intra- and inter-observer reliability of MRI detection of CSM in subjects who also had co-existing intervertebral disc abnormalities. Materials and methods: Seven experienced radiologists reviewed twice the MRI of 10 patients with clinically and/or imaging determined myelopathy. MRI assessment was performed individually, with and without operational guidelines. A Fleiss Kappa statistic was used to evaluate the intra- and inter-observer agreement. Results: The study found high intra-observer percent agreement but relatively low Kappa values on selected variables. Inter-observer reliability was also low and neither observation was improved with operational guidelines. We believe that those low values may be associated with the base rate problem of Kappa. Conclusion: In conclusion, this study demonstrated high intra-observer percent agreement in MR examination for intervertebral disc abnormalities in patients with underlying cervical myelopathy, but differing levels of intra- and inter-observer Kappa agreement among seven radiologists.

  10. The imbalance between TIMP3 and matrix-degrading enzymes plays an important role in intervertebral disc degeneration.

    Science.gov (United States)

    Li, Yan; Li, Kang; Han, Xiuguo; Mao, Chuanyuan; Zhang, Kai; Zhao, Tengfei; Zhao, Jie

    2016-01-15

    It is well-known that one of the most important features of intervertebral disc degeneration (IDD) is the extracellular matrix (ECM) degradation. Collagen and aggrecan are major components of ECM; the degradation of ECM in intervertebral discs (IVDs) is closely related to the activities of collagenase and aggrecanase. TIMP-3 is the most efficient inhibitor of aggrecanase in IVD. However, only few studies focus on the potential relationship between TIMP-3 and IDD. In our study, we found TIMP-3 gene expression was decreased after stimulating with LPS in rat nucleus pulposus (NP) cells. Then we used a lentivirus vector to reconstruct rat NP cells which high expressed TIMP-3 gene (LV-TIMP3). The upregulation of MMPs and ADAMTSs induced by LPS was significantly inhibited in LV-TIMP3 cells. After overexpression of TIMP-3, the aggrecan breakdown caused by LPS was also reduced in both monolayer culture and three-dimension culture model. To further study the relation between TIMP-3 and IDD, we collected human NP tissue samples of different degenerative degrees. Real-time PCR and immunohistochemical staining showed that the expression of TIMP-3 was negatively correlated with the degree of intervertebral disc degeneration, while MMP-1 and ADAMTS-4 were markedly increased in degenerative IVD. Taken together, our results suggest that the imbalance between aggrecanase and TIMP-3 may play an important role in the pathogenesis of IDD and therefore be a potential therapeutic target for treating IDD. PMID:26686417

  11. Lentivirus-mediated TGF-β3, CTGF and TIMP1 gene transduction as a gene therapy for intervertebral disc degeneration in an in vivo rabbit model

    Science.gov (United States)

    LIU, YONG; YU, TAO; MA, XUE-XIAO; XIANG, HONG-FEI; HU, YOU-GU; CHEN, BO-HUA

    2016-01-01

    The present study examined the effects of transforming growth factor (TGF)-β3, connective tissue growth factor (CTGF) and tissue inhibitor of metalloproteinase 1 (TIMP1) gene transduction, using a lentiviral vector, on rabbit intervertebral disc degeneration in vivo, with the intention of investigating their potential use in gene therapy. A model of lumbar intervertebral disc degeneration was created by needle puncture into the annulus fibrosus of 15 New Zealand white rabbits. Empty lentivirus or recombinant lentiviral plasmid lenti-TGFβ3-P2A-CTGF-T2A-TIMP1 was injected into degenerative lumbar intervertebral discs (representing the control and experimental groups, respectively), whilst untreated degenerative lumbar intervertebral discs served as the puncture group. After 16 and 20 weeks, magnetic resonance imaging (MRI) was conducted and the changes in intensity on micrographs of degenerative intervertebral discs were measured. The mRNA levels of aggrecan and type II collagen in nucleus pulposus tissue were determined by reverse transcription-polymerase chain reaction, and protein expression levels of type II collagen and aggrecan were determined by western blot analysis. MRI results indicated that intervertebral disc degeneration was ameliorated in the experimental group when compared with the control and the puncture group. Furthermore, the expression levels of type II collagen and aggrecan in the puncture and control groups were significantly lower than in the experimental group (P<0.05). In conclusion, lenti-TGFβ3-P2A-CTGF-T2A-TIMP1 co-transduction can promote synthesis of aggrecan and type II collagen in degenerative intervertebral discs, thereby delaying intervertebral disc degeneration. These results indicate the potential of gene therapy in treatment of intervertebral disc degeneration. PMID:27073456

  12. Computer aided vertebral visualization and analysis: a methodology using the sand rat, a small animal model of disc degeneration

    Directory of Open Access Journals (Sweden)

    Hanley Edward N

    2003-03-01

    Full Text Available Abstract Background The purpose of this study is to present an automated system that analyzes digitized x-ray images of small animal spines identifying the effects of disc degeneration. The age-related disc and spine degeneration that occurs in the sand rat (Psammomys obesus has previously been documented radiologically; selected representative radiographs with age-related changes were used here to develop computer-assisted vertebral visualization/analysis techniques. Techniques presented here have the potential to produce quantitative algorithms that create more accurate and informative measurements in a time efficient manner. Methods Signal and image processing techniques were applied to digitized spine x-ray images the spine was segmented, and orientation and curvature determined. The image was segmented based on orientation changes of the spine; edge detection was performed to define vertebral boundaries. Once vertebrae were identified, a number of measures were introduced and calculated to retrieve information on the vertebral separation/orientation and sclerosis. Results A method is described which produces computer-generated quantitative measurements of vertebrae and disc spaces. Six sand rat spine radiographs illustrate applications of this technique. Results showed that this method can successfully automate calculation and analysis of vertebral length, vertebral spacing, vertebral angle, and can score sclerosis. Techniques also provide quantitative means to explore the relation between age and vertebral shape. Conclusions This method provides a computationally efficient system to analyze spinal changes during aging. Techniques can be used to automate the quantitative processing of vertebral radiographic images and may be applicable to human and other animal radiologic models of the aging/degenerating spine.

  13. Early results and review of the literature of a novel hybrid surgical technique combining cervical arthrodesis and disc arthroplasty for treating multilevel degenerative disc disease: opposite or complementary techniques?

    OpenAIRE

    Barbagallo, Giuseppe M. V.; Assietti, Roberto; Corbino, Leonardo; Olindo, Giuseppe; Foti, Pietro V.; Russo, Vittorio; Albanese, Vincenzo

    2009-01-01

    We report the clinical and radiological results on the safety and efficacy of an unusual surgical strategy coupling anterior cervical discectomy and fusion and total disc replacement in a single-stage procedure, in patients with symptomatic, multilevel cervical degenerative disc disease (DDD). The proposed hybrid, single-stage, fusion–nonfusion technique aims either at restoring or maintaining motion where appropriate or favouring bony fusion when indicated by degenerative changes. Twenty-fou...

  14. Genetic Polymorphisms of Interleukin-1 Alpha and the Vitamin D Receptor in Mexican Mestizo Patients with Intervertebral Disc Degeneration

    OpenAIRE

    Cervin Serrano, Salvador; González Villareal, Dalia; Aguilar-Medina, Maribel; Romero-Navarro, Jose Guillermo; Romero Quintana, Jose Geovanni; Arámbula Meraz, Eliakym; Osuna Ramírez, Ignacio; Picos-Cárdenas, Veronica; Granados, Julio; Estrada-García, Iris; Sánchez-Schmitz, Guzman; Ramos-Payán, Rosalío

    2014-01-01

    Intervertebral disc degeneration (IDD) is the most common diagnosis in patients with back pain, a leading cause of musculoskeletal disability worldwide. Several conditions, such as occupational activities, gender, age, and obesity, have been associated with IDD. However, the development of this disease has strong genetic determinants. In this study, we explore the possible association between rs1800587 (c.-949C>T) of interleukin-1 alpha (IL1A) and rs2228570 (c.2T>V) and rs731236 (c.1056T>C) o...

  15. Stem Cell Therapies for Intervertebral Disc Degeneration: Immune Privilege Reinforcement by Fas/FasL Regulating Machinery.

    Science.gov (United States)

    Ma, Chi-Jiao; Liu, Xu; Che, Lu; Liu, Zhi-Heng; Samartzis, Dino; Wang, Hai-Qiang

    2015-01-01

    As a main contributing factor to low back pain, intervertebral disc degeneration (IDD) is the fundamental basis for various debilitating spinal diseases. The pros and cons of current treatment modalities necessitate biological treatment strategies targeting for reversing or altering the degeneration process in terms of molecules or genes. The advances in stem cell research facilitate the studies aiming for possible clinical application of stem cell therapies for IDD. Human NP cells are versatile with cell morphology full of variety, capable of synthesizing extracellular matrix components, engulfing substances by autophagy and phagocytosis, mitochondrial vacuolization indicating dysfunction, expressing Fas and FasL as significant omens of immune privileged sites. Human discs belong to immune privilege organs with functional FasL expression, which can interact with invasive immune cells by Fas-FasL regulatory machinery. IDD is characterized by decreased expression level of FasL with dysfunctional FasL, which in turn unbalances the interaction between NP cells and immune cells. Certain modulation factors might play a role in the process, such as miR-155. Accumulating evidence indicates that Fas-FasL network expresses in a variety of stem cells. Given the expression of functional FasL and insensitive Fas in stem cells (we term as FasL privilege), transplantation of stem cells into the disc may regenerate the degenerative disc by not only differentiating into NP-like cells, increasing extracellular matrix, but also reinforce immune privilege via interaction with immune cells by Fas-FasL network. PMID:25381758

  16. Rabbit model of intervertebral disc degeneration by external compression device characterized by X-ray, MRI, histology, and cell viability

    Directory of Open Access Journals (Sweden)

    Ismail Ismail

    2006-12-01

    Full Text Available Appropriate experimental animal models, which mimic the degenerative process occurring in human intervertebral disc (IVD breakdown and can be used for new treatment studies such as tissue engineering or disc distraction are lacking. We studied the external compression device that used by Kroeber et al to create intervertebral disc degeneration in rabbit model characterized by X-ray, MRI, Histology, and Cell Viability. Ten NZW rabbit were randomly assigned to one of five groups. Intervertebral disc VL4-L5 are compressed using an external loading device, 1.9 MPa. First group rabbit are loaded for 14 days, second loaded for 28 days, thirth group are loaded for 14 days, and unloaded for 14 days, fourth group loaded for 28 days and unloaded for 28 days. The fifth group, rabbits underwent a sham operation. Additional, rabbits were used as sample for cell viability study. In disc height : sample in group one have biggest decreasing of disc height, that is 23.9 unit. In MRI assessment, the worst grade is grade 3. In histological score, the worst group is group three (58.69, and the best is group 4 (45.69. Group one have the largest dead cell, that are 403.5, and the smallest is group four (124.75. Trypan blue staining showed that group four have better viable cell (91.1 compare than group three (86.4. The study conclude disc degeneration can be created by external axial loading for 14 days in rabbit intervertebral disc. Duration of 28 days unloading gave better result for cells to recover. (Med J Indones 2006; 15:199-207  Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Keywords: Rabbit model –intervertebral disc degeneration- external compression device-X-ray, MRI, Histology, and Cell viabilty /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso

  17. On the relative relevance of subject-specific geometries and degeneration-specific mechanical properties for the study of cell death in human intervertebral disc models

    Directory of Open Access Journals (Sweden)

    Andrea eMalandrino

    2015-02-01

    Full Text Available Capturing patient- or condition-specific intervertebral disc (IVD properties in finite element models is outmost important in order to explore how biomechanical and biophysical processes may interact in spine diseases. However, disc degenerative changes are often modelled through equations similar to those employed for healthy organs, which might not be valid. As for the simulated effects of degenerative changes, they likely depend on specific disc geometries. Accordingly, we explored the ability of continuum tissue models to simulate disc degenerative changes. We further used the results in order to assess the interplay between these simulated changes and particular IVD morphologies, in relation to disc cell nutrition, a potentially important actor in disc tissue regulation. A protocol to derive patient-specific computational models from clinical images was applied to different spine specimens. In vitro IVD creep tests were used to optimize poro-hyperelastic input material parameters in these models, in function of the IVD degeneration grade. The use of condition-specific tissue model parameters in the specimen-specific geometrical models was validated against independent kinematic measurements in vitro. Then, models were coupled to a transport-cell viability model in order to assess the respective effects of tissue degeneration and disc geometry on cell viability. While classic disc poromechanical models failed in representing known degenerative changes, additional simulation of tissue damage allowed model validation and gave degeneration-dependent material properties related to osmotic pressure and water loss, and to increased fibrosis. Surprisingly, nutrition-induced cell death was independent of the grade-dependent material properties, but was favoured by increased diffusion distances in large IVDs. Our results suggest that in situ geometrical screening of IVD morphology might help to anticipate particular mechanisms of disc degeneration.

  18. The natural history and clinical syndromes of degenerative cervical spondylosis.

    LENUS (Irish Health Repository)

    Kelly, John C

    2012-01-01

    Cervical spondylosis is a broad term which describes the age related chronic disc degeneration, which can also affect the cervical vertebrae, the facet and other joints and their associated soft tissue supports. Evidence of spondylitic change is frequently found in many asymptomatic adults. Radiculopathy is a result of intervertebral foramina narrowing. Narrowing of the spinal canal can result in spinal cord compression, ultimately resulting in cervical spondylosis myelopathy. This review article examines the current literature in relation to the cervical spondylosis and describes the three clinical syndromes of axial neck pain, cervical radiculopathy and cervical myelopathy.

  19. Effect of Lumbar Disc Degeneration and Low-Back Pain on the Lumbar Lordosis in Supine and Standing

    DEFF Research Database (Denmark)

    Hansen, Bjarke B; Bendix, Tom; Grindsted, Jacob;

    2015-01-01

    STUDY DESIGN: Cross-sectional study. OBJECTIVE: To examine the influence of low-back pain (LBP) and lumbar disc degeneration (LDD) on the lumbar lordosis in weight-bearing positional magnetic resonance imaging (pMRI). SUMMARY OF BACKGROUND DATA: The lumbar lordosis increases with a change of...... position from supine to standing and is known as an essential contributor to dynamic changes. However, the lordosis may be affected by disc degeneration and pain. METHODS: Patients with LBP >40 on a 0 to 100 mm Visual Analog Scale (VAS) both during activity and rest and a sex and age-decade matching...... control group without LBP were scanned in the supine and standing position in a 0.25-T open MRI unit. LDD was graded using Pfirrmann's grading-scale. Subsequently, the L2-to-S1 lumbar lordosis angle (LA) was measured. RESULTS: Thirty-eight patients with an average VAS of 58 (±13.8) mm during rest and 75...

  20. 2D segmentation of intervertebral discs and its degree of degeneration from T2-weighted magnetic resonance images

    Science.gov (United States)

    Castro-Mateos, Isaac; Pozo, José Maria; Lazary, Aron; Frangi, Alejandro F.

    2014-03-01

    Low back pain (LBP) is a disorder suffered by a large population around the world. A key factor causing this illness is Intervertebral Disc (IVD) degeneration, whose early diagnosis could help in preventing this widespread condition. Clinicians base their diagnosis on visual inspection of 2D slices of Magnetic Resonance (MR) images, which is subject to large interobserver variability. In this work, an automatic classification method is presented, which provides the Pfirrmann degree of degeneration from a mid-sagittal MR slice. The proposed method utilizes Active Contour Models, with a new geometrical energy, to achieve an initial segmentation, which is further improved using fuzzy C-means. Then, IVDs are classified according to their degree of degeneration. This classification is attained by employing Adaboost on five specific features: the mean and the variance of the probability map of the nucleus using two different approaches and the eccentricity of the fitting ellipse to the contour of the IVD. The classification method was evaluated using a cohort of 150 intervertebral discs assessed by three experts, resulting in a mean specificity (93%) and sensitivity (83%) similar to the one provided by every expert with respect to the most voted value. The segmentation accuracy was evaluated using the Dice Similarity Index (DSI) and Root Mean Square Error (RMSE) of the point-to-contour distance. The mean DSI ± 2 standard deviation was 91:7% ±5:6%, the mean RMSE was 0:82mm and the 95 percentile was 1:36mm. These results were found accurate when compared to the state-of-the-art.

  1. Longitudinal Comparison of Enzyme- and Laser-Treated Intervertebral Disc by MRI, X-Ray, and Histological Analyses Reveals Discrepancies in the Progression of Disc Degeneration: A Rabbit Study

    Science.gov (United States)

    Colombier, Pauline; Lesoeur, Julie; Youl, Samy; Madec, Stéphane; Gauthier, Olivier; Hamel, Olivier; Guicheux, Jérôme; Clouet, Johann

    2016-01-01

    Regenerative medicine is considered an attractive prospect for the treatment of intervertebral disc (IVD) degeneration. To assess the efficacy of the regenerative approach, animal models of IVD degeneration are needed. Among these animal models, chemonucleolysis based on the enzymatic degradation of the Nucleus Pulposus (NP) is often used, but this technique remains far from the natural physiopathological process of IVD degeneration. Recently, we developed an innovative animal model of IVD degeneration based on the use of a laser beam. In the present study, this laser model was compared with the chemonucleolysis model in a longitudinal study in rabbits. The effects of the treatments were studied by MRI (T2-weighted signal intensity (T2wsi)), radiography (IVD height index), and histology (NP area and Boos' scoring). The results showed that both treatments induced a degeneration of the IVD with a decrease in IVD height and T2wsi as well as NP area and an increase in Boos' scoring. The enzyme treatment leads to a rapid and acute process of IVD degeneration. Conversely, laser radiation induced more progressive and less pronounced degeneration. It can be concluded that laser treatment provides an instrumental in vivo model of slowly evolving IVD degenerative disease that can be of preclinical relevance for assessing new prophylactic biological treatments of disc degeneration. PMID:27247937

  2. Construction of recombinant baculovirus Ac-CMV-hSox9 for gene therapy of intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    LIU Xiao-yun; YANG Shu-hua; LIANG Chang-yong; SONG Jian-hua; LI Kang-hua; CHEN Xin-wen

    2007-01-01

    Objective: To construct the recombinant baculovirus Ac-cytomegalovirus (CMV)-hSox9 for gene therapy of intervertebral disc degeneration. Methods: Bac-to-Bac system was used for the construction of baculovirus Ac-CMV-hSox9. The cDNA of hSox9 was first cloned into a plasmid vector under the control of CMV promotor to generate the donor plasmid pFastBacDul-green fluorescene protein (GFP)-CMV (pFGC)-hSox9.The resultant plasmid was transformed into DH10Bac cells and then the transformation mixture was spread on Luria-Bertani (LB) agarose culture medium containing isopropyl-β-D-thiogalactoside (IPTG), X-gal, gentamicin, kanamycin and tetracycline.The white colonies were selected and cultured for amplification, and the hSox9Bacmid DNA was extracted. After verification, recombinant baculovirus Ac-CMV-hSox9 was obtained through transfecting Sf 21 cells.The expression of hSox9 gene in the intervertebral disc cells in rabbits was determined by Western blotting and immunohistochemical staining.Results: Polymerase chain reaction (PCR) confirmed the presence of hSox9 gene in the recombinant baculovirus and the Sf 21 cells transfected by the baculovirus showed the expression of fluorescence protein.Western blotting and immunohistochemical staining analysis indicated that exogenous hSox9 gene was expressed in the disc cells.Conclusions: The successful construction of the recombinant baculovirus Ac-CMV-hSox9 and the confirmation of the target gene expression provides a novel expression vector system for basic research and clinical treatment of intervertebral degenerative disc disease.

  3. 人工颈椎椎间盘置换与颈前路减压融合术治疗脊髓型颈椎病的疗效分析%Comparison of artifical cervical disc replacement versus anterior discectomy and fusion for the treatment of cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    杨兴; 薛峰; 盛晓文; 彭育沁; 陈兵乾

    2012-01-01

    .05 ); but the ROM of the adjacent segments in artifical cervical disc replacement group were less than the ACDF group, and the difference was statistically significant ( P <0. 05 ). Conclusion The artifical cervical disc replacement can avoid the degeneration of adjacent segments and its early and midterm outcomes for the treatment of cervical spondylotic myelopathy are satisfactory, but the long-term effects still need studed.

  4. Value of preoperative cervical discography

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jong Won; Kim, Sung Hyun; Lee, Joon Woo [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)] (and others)

    2006-07-15

    The aim of this study was to describe the method and the value of cervical discography as correlated with the MR findings. Twenty-one discs in 11 consecutive patients who underwent cervical discography were analyzed. MR and CT discography (CTD) were performed in all patients. Discography was performed after swallowing barium for visualizing the pharynx and the esophagus to prevent penetration. We also analyzed the preceding causes of the subjects' cervical pain. The results of the pain provocation test were classified into concordant pain, discordant pain and a negative test. MRI was analyzed according to the T2-signal intensity (SI) of the disc, disc height, annular bulging and disc herniation. The CTD was analyzed for degeneration or radial tear of the disc, epidural leakage of the contrast agent and pooling of the contrast agent at the periphery of the disc. The pain provocation tests were correlated with the MR and CTD findings. We used the chi-square test to analyze the results. Concordant pain was observed in 14 cases, discordant pain in 3 cases and there were negative tests in 4 cases. There were no complications related to the procedure. Four patients had undergone anterior cervical fusion and four patients that developed after traffic injuries. The decreased T2-SI and annular bulging on MRI, disc degeneration and peripheral pooling of the contrast agent on CT were significantly correlated with pain provocation. When the diagnosis of disc disease is difficult with performing MRI, cervical discography with using swallowed barium solution to reduce the penetration of the esophagus or hypopharynx may play be helpful. The decreased T2-SI and annular bulging on MRI correlated significantly with a positive result on the pain provocation test.

  5. 腰椎间盘退变CT表现及分期探讨%CT manifestation and staging investigation of lumbar disc degeneration

    Institute of Scientific and Technical Information of China (English)

    吴涛; 贺才标

    2015-01-01

    Objective To investigate the CT features and necessity of staging of lumbar disc degeneration, in order to enhance understanding of CT manifestations of lumbar disc. Methods There were 550 patients with lumbar disc degeneration receiving CT scanning for diagnosis, and a retrospective analysis was made on their clinical data. Results There were 82 cases with lumbar disc degeneration, 123 cases with lumbar disc bulge, 211 cases with lumbar disc herniation, 45 cases with herniated lumbar disc (with sguestration), 5 cases with lumbar disc calcification, and 84 cases with lumbar disc compound change. Conclusion CT is the preferred method in diagnosis of lumbar disc degeneration. Different manifestations in degeneration staging have closely internal link with each other. Manifestation degree is correlated with clinical symptom, and its staging can provide guidance for the best choice of treatment method.%目的:探讨腰椎间盘退变的CT特点及分期的必要性,以提高对腰椎间盘CT各种表现的认识。方法550例腰椎间盘退变患者,均经CT扫描确诊,对其临床资料进行回顾性分析。结果腰椎间盘变性82例,腰椎间盘膨出123例,腰椎间盘突出211例,腰椎间盘脱出(含髓核游离)45例,腰椎间盘钙化5例,腰椎间盘复合性改变84例。结论 CT是诊断腰椎间盘退变的首选方法,退变分期CT表现各不相同,彼此存在密不可分的内在联系,表现程度与临床症状呈一定的相关性,分期可以指导临床选择最佳的治疗方案。

  6. Biomechanics of a Fixed–Center of Rotation Cervical Intervertebral Disc Prosthesis

    OpenAIRE

    Crawford, Neil R; Baek, Seungwon; Sawa, Anna G.U.; Safavi-Abbasi, Sam; Sonntag, Volker K.H.; Duggal, Neil

    2012-01-01

    Background Past in vitro experiments studying artificial discs have focused on range of motion. It is also important to understand how artificial discs affect other biomechanical parameters, especially alterations to kinematics. The purpose of this in vitro investigation was to quantify how disc replacement with a ball-and-socket disc arthroplasty device (ProDisc-C; Synthes, West Chester, Pennsylvania) alters biomechanics of the spine relative to the normal condition (positive control) and si...

  7. Demonstration of changes in the bone marrow associated with disc degeneration by MRT

    Energy Technology Data Exchange (ETDEWEB)

    Kahn, T.; Weigert, F.; Reiser, M.; Heuck, A.; Allgayer, B.; Lehner, K.

    1987-09-01

    Amongst 214 patients with degenerative disc disease, MRT showed focal fat deposition in the vertebral marrow close to the end plate in 87 (41%). The appearances and distribution of these zones is described. Recognition of these common changes is important in differential diagnosis between inflammatory and neoplastic processes.

  8. The demonstration of changes in the bone marrow associated with disc degeneration by MRT

    International Nuclear Information System (INIS)

    Amongst 214 patients with degenerative disc disease, MRT showed focal fat deposition in the vertebral marrow close to the end plate in 87 (41%). The appearances and distribution of these zones is described. Recognition of these common changes is important in differential diagnosis between inflammatory and neoplastic processes. (orig.)

  9. Cervical myelopathy due to single level disc herniation presenting as intramedullary mass lesion: What to do first?

    Directory of Open Access Journals (Sweden)

    Murat Sakir Eksi

    2015-01-01

    Full Text Available Cervical myelopathy (CM is mostly a degenerative process ending in myelopathic and/or radiculopathic syndromes. On T2-weighted magnetic resonance imaging (MRI, CM appears as a hyperintense area near the spondylotic spine. This high intensity signal depends on the impact of outer forces and their duration. It also determines the prognosis of the surgical candidate. A 40-year-old male patient admitted to our clinic with right upper extremity weakness and hypoesthesia that had started 2 months earlier. On neurological examination there was 2/5 motor weakness of right biceps brachii, and hypoesthesia over right C6 dermatome. Right upper extremity deep tendon reflexes were hypoactive, but lower ones were hyperactive. After clinical and radiological work-up, preliminary diagnosis was directed to a spinal intramedullary tumor. Total resection of the herniated cervical disc fragment and the mass lesion was managed. Pathology of the mass lesion was compatible with subacute infarct tissue and inflammatory response. Final diagnosis was CM under effect of cervical disc herniation. Contrast-enhanced spinal cord myelopathic lesions are very rare and resemble much more tumors and inflammatory processes. However, the principal treatment approach totally differs depending on pathology. When there are both a disc herniation and a high clinical suspicion; biopsy should be delayed. The most probable solution will be surgery for the disc disease with thorough preoperative scanning of vascular malformations; clinical and radiological close follow-up after surgery. Biopsy or surgical resection can be performed if patient deteriorates despite the primary surgery.

  10. Intervertebral disc degeneration and bone density in degenerative lumbar scoliosis: a comparative study between patients with degenerative lumbar scoliosis and patients with lumbar stenosis

    Institute of Scientific and Technical Information of China (English)

    DING Wen-yuan; YANG Da-long; CAO Lai-zhen; SUN Ya-peng; ZHANG Wei; XU Jia-xin; ZHANG Ying-ze; SHEN Yong

    2011-01-01

    Background Degenerative lumbar scoliosis is common in older patients.Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis.A means of quantifying the relative signal intensity for degenerative disc disease has not been previously discussed.The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study.Methods From January 2001 to August 2010,96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls.Cobb angle,height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides,the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group.The height of L2/L3,L3/L4,L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group.The grade of intervertebral disc degeneration was evaluated using T2WI sagittal images in both groups.The bone density of lumbar vertebrae was measured with dual-energy X-ray.Results In scoliosis group,the intervertebral disc height on the convex side was greater than the height on the concave side (P <0.001 ).The vertebral body height on the convex side was greater than the height on the concave side (P=0.016).There was a significant difference between the scoliosis group and the control group (P=0.003),and between T-value and the rate of osteoporosis between the two groups (both P <0.001).Results were verified using multiple linear regression analysis.Conclusions Degenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces.There is a positive correlation between the angle of scoliosis and

  11. BMP-2 and BMP-2/7 Heterodimers Conjugated to a Fibrin/Hyaluronic Acid Hydrogel in a Large Animal Model of Mild Intervertebral Disc Degeneration.

    Science.gov (United States)

    Peeters, Mirte; Detiger, Suzanne E L; Karfeld-Sulzer, Lindsay S; Smit, Theo H; Yayon, Avner; Weber, Franz E; Helder, Marco N

    2015-01-01

    Intervertebral disc (IVD) degeneration is etiologically associated with low back pain and is currently only treated in severe cases with spinal fusion. Regenerative medicine attempts to restore degenerated tissue by means of cells, hydrogels, and/or growth factors and can therefore be used to slow, halt, or reverse the degeneration of the IVD in a minimally invasive manner. Previously, the growth factors bone morphogenetic proteins 2 and 7 (BMP-2, -7) were shown to enhance disc regeneration, in vitro and in vivo. Since BMPs have only a short in vivo half-life, and to prevent heterotopic ossification, we evaluated the use of a slow release system for BMP-2 homodimers and BMP-2/7 heterodimers for IVD regeneration. BMP growth factors were conjugated to a fibrin/hyaluronic acid (FB/HA) hydrogel and intradiscally injected in a goat model of mild IVD degeneration to study safety and efficacy. Mild degeneration was induced in five lumbar discs of seven adult Dutch milk goats, by injections with the enzyme chondroitinase ABC. After 12 weeks, discs were treated with either FB/HA-hydrogel only or supplemented with 1 or 5 μg/mL of BMP-2 or BMP-2/7. BMPs were linked to the FB/HA hydrogels using a transglutaminase moiety, to be released through an incorporated plasmin cleavage site. After another 12 weeks, goats were sacrificed and discs were assessed using radiography, MRI T2* mapping, and biochemical and histological analyses. All animals maintained weight throughout the study and no heterotopic bone formation or other adverse effects were noted during follow-up. Radiographs showed significant disc height loss upon induction of mild degeneration. MRI T2* mapping showed strong and significant correlations with biochemistry and histology as shown before. Surprisingly, no differences could be demonstrated in any parameter between intervention groups. To our knowledge, this is the first large animal study evaluating BMPs conjugated to an FB/HA-hydrogel for the treatment of

  12. Single-level cervical radiculopathy: clinical outcome and cost-effectiveness of four techniques of anterior cervical discectomy and fusion and disc arthroplasty.

    Science.gov (United States)

    Bhadra, Arup K; Raman, A S; Casey, Adrian T H; Crawford, R J

    2009-02-01

    Although there are several accepted methods of surgical treatment for single-level cervical radiculopathy, the choice depend on the surgeon's preference. The techniques may vary in peri-operative morbidity, short- and long-term outcome, but no study so far has analyzed their cost-effectiveness. This study might give some insight in balancing cost and effectiveness and deciding the right technique. Sixty consecutive patients (15 each group), mean age 36 (range 24-76 years) with single-level cervical disc disease underwent surgical treatment with four different techniques in two centers over the period of 1999-2005. The four groups were--(1) plate and tricortical autograft, (2) plate, cage, and bone substitute, (3) cage only, and (4) disc arthroplasty. The data was collected prospectively according to our protocol and subsequently analyzed. The clinical outcome was assessed comparing visual analog scale (VAS) of neck pain and, short form 12 (SF12) questionnaire both pre- and postoperatively. The radiological assessment was done for fusion rate and postoperative related possible complications at 3 months, 6 months, 1 year, and final follow-up. The cost analysis was done calculating the operative time, hospital stay, implant cost together. The mean follow-up period was 31 months (range 28-43 months). The clinical outcome in terms of VAS of neck and arm pain and SF12 physical and mental score improvement (P=0.001) were comparable with all four techniques. The radiological fusion rate was comparable to current available data. As the hospital stay was longer (average 5 days) with plate and autograft group, the total cost was maximum (average 2,920 pound sterling) with this group. There was satisfactory clinical and radiological outcome with all four techniques. Using the cage alone was the most cost-effective technique, but the disc arthroplasty was comparable to the use of cage and plate. Anterior cervical discectomy and fusion is an established surgical treatment for

  13. Surgical treatment of cervical disc herniation%颈椎间盘突出症的手术治疗

    Institute of Scientific and Technical Information of China (English)

    吴洁石; 包聚良; 徐瑞生; 陆华; 王刊石; 王雪松; 薛骏

    2012-01-01

    目的 探讨颈椎间盘突出症的临床病理特点、临床分型及手术要点.方法 回顾性分析1999年1月至2010年10月接受手术治疗的颈椎间盘突出症患者的临床资料.结果 颈椎间盘突出症128例,均经手术治疗.其中脊髓型96例,神经根型22例,混合型10例.脊髓型和混合型颈椎间盘突出症使用JOA评分,由术前(12.30±1.05)分至术后(16.70±1.11)分.神经根型颈椎间盘突出症使用VSA评分:由术前(8.10±1.37)分至术后(0.30±0.19)分.结论 认识其游离压迫物和硬膜囊、后纵韧带、神经结构之间的相互关系,正确选择手术方案和手术细节可以确保手术安全性和有效率.%Objective To study the pathology,clinical classification and surgical treatment of cervical disc herniation.Methods The clinical data of patients of cervical disc herniation from January 1999 to October 2010 were collected.Results All the 128 cases of cervical disc herniation were surgically treated.Among the 128 cases,96 cases with myelopathy,22 cases with radiculopathy and 10 cases with both.JOA and VSA scores were used to evaluate the surgical effectiveness respectively for myelopathy and radiculopathy.JOA score was improved from 12.30 ± 1.05 before to 16.70 ± 1.11after operation.VSA score was improved from 8.10 ± 1.37 before to 0.30 ±0.19 after operation.Conclusions The high safety and effectiveness of surgery for cervical disc herniation could be achieved both by the awareness of the pathological characteristics of how the sequestrated disc materical relates to the nerve structure in the canal and by paying attention to specific operation details.

  14. Organ Culture Bioreactors – Platforms to Study Human Intervertebral Disc Degeneration and Regenerative Therapy

    OpenAIRE

    Gantenbein, Benjamin; Illien-Jünger, Svenja; Chan, Samantha CW; Walser, Jochen; Haglund, Lisbet; Ferguson, Stephen J; Iatridis, James C.; Grad, Sibylle

    2015-01-01

    In recent decades the application of bioreactors has revolutionized the concept of culturing tissues and organs that require mechanical loading. In intervertebral disc (IVD) research, collaborative efforts of biomedical engineering, biology and mechatronics have led to the innovation of new loading devices that can maintain viable IVD organ explants from large animals and human cadavers in precisely defined nutritional and mechanical environments over extended culture periods. Particularly in...

  15. 颈椎间盘突出症合并腰椎间盘突出症的非手术治疗效果分析%Effect of non-operative treatments on herniation of cervical disc complicated by prolapse of lumbar intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ Background: There are many reports about the operative or non- operative treatments of herniation of cervical disc or prolapse of lumbar intervertebral disc, but few about the non- operative treatments curative effect and attentive affairs of their combination. Objective: To study the non- operative treatments' curative effect of herniation of cervical disc combined with prolapse of lumbar intervertebral disc. Design: To make retrospective survey and study of non- operative treatments' curative effect of herniation of cervical disc combined with prolapse of lumbar intervertebral disc. Unit: First Affiliated Hospital of Anhui Medical University. Subject: From February 1990 to February 1998, 55 patients were with the complication, occupied 15. 41% of the simple cervical disc, and 9. 34% of the simple lumbar intervertebral disc.

  16. Teichm\\"uller Discs with Completely Degenerate Kontsevich-Zorich Spectrum

    CERN Document Server

    Aulicino, David

    2012-01-01

    We reduce a question of Eskin-Kontsevich-Zorich and Forni-Matheus-Zorich, which asks for a classification of all SL(2,R)-invariant ergodic probability measures with completely degenerate Kontsevich-Zorich spectrum, to a conjecture of M\\"oller's. Let $\\mathcal{D}_g(1)$ be the subset of the moduli space of Abelian differentials $\\mathcal{M}_g$ whose elements have period matrix derivative of rank one. There is an SL(2,R)-invariant ergodic probability measure $\

  17. Acute spontaneous cervical disc herniation causing rapidly progressive myelopathy in a patient with comorbid ossified posterior longitudinal ligament: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Harrison J Westwick

    2014-01-01

    Full Text Available Background: Ossification of the posterior longitudinal ligament (OPLL and cervical disc herniation are commonly encountered neurosurgical conditions. Here we present an unusual case of nontraumatic rapidly progressive myelopathy due to cervical disc herniation with comorbid OPLL and conduct a literature review focusing on the frequency and management of disc herniations with OPLL. Case Description: A 52-year-old healthy female presented with a 72-h history of rapid progression of dense quadriparesis with sensory deficits, with a precedent 4-week history of nontraumatic midline neck pain. Clinical examination revealed profound motor deficits below the C5 myotome. Spinal neuroimaging revealed OPLL (computed tomography [CT] and a cervical disc herniation spanning from C4/5 to C5/6 with significant retrovertebral disease (magnetic resonance imaging [MRI]. Operative management involved an anterior cervical corpectomy and instrumented fusion, with removal of both the sequestered disc material and the locally compressive OPLL. The patient recovered full motor function and independent ambulation with no residual signs or symptoms of myelopathy at the time of discharge. Conclusion: This unique case of a spontaneous cervical disc herniation in the context of OPLL causing rapidly progressive myelopathy illustrates the complementarity of CT and MRI in diagnosing the underlying cause of a rapidly progressive neurologic deficit in the absence of antecedent trauma. Though the optimal surgical management of such pathology remains uncertain; in this case, the anterior approach was motivated by the significant retrovertebral ventrally compressive sequestrum, and provided for excellent neurologic outcome. This article also reviews the occurrence/management of such acute cervical discs with OPLL.

  18. Five-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled, multicenter investigational device exemption clinical trial.

    Science.gov (United States)

    Radcliff, Kris; Coric, Domagoj; Albert, Todd

    2016-08-01

    OBJECTIVE The purpose of this study was to report the outcome of a study of 2-level cervical total disc replacement (Mobi-C) versus anterior cervical discectomy and fusion (ACDF). Although the long-term outcome of single-level disc replacement has been extensively described, there have not been previous reports of the 5-year outcome of 2-level cervical disc replacement. METHODS This study reports the 5-year results of a prospective, randomized US FDA investigational device exemption (IDE) study conducted at 24 centers in patients with 2-level, contiguous, cervical spondylosis. Clinical outcomes at up to 60 months were evaluated, including validated outcome measures, incidence of reoperation, and adverse events. The complete study data and methodology were critically reviewed by 3 independent surgeon authors without affiliation with the IDE study or financial or institutional bias toward the study sponsor. RESULTS A total of 225 patients received the Mobi-C cervical total disc replacement device and 105 patients received ACDF. The Mobi-C and ACDF follow-up rates were 90.7% and 86.7%, respectively (p = 0.39), at 60 months. There was significant improvement in all outcome scores relative to baseline at all time points. The Mobi-C patients had significantly more improvement than ACDF patients in terms of Neck Disability Index score, SF-12 Physical Component Summary, and overall satisfaction with treatment at 60 months. The reoperation rate was significantly lower with Mobi-C (4%) versus ACDF (16%). There were no significant differences in the adverse event rate between groups. CONCLUSIONS Both cervical total disc replacement and ACDF significantly improved general and disease-specific measures compared with baseline. However, there was significantly greater improvement in general and disease-specific outcome measures and a lower rate of reoperation in the 2-level disc replacement patients versus ACDF control patients. Clinical trial registration no. NCT00389597

  19. M obi-C 颈椎人工间盘置换治疗单节段颈椎间盘突出症的效果%Effect of Mobi-C cervical artificial disc replacement in the treatment of single proplase of cervical intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    柳达; 黄瑛; 李彬; 贾长青; 许晓军; 梁峰; 付勤

    2013-01-01

    Objective:To research the short-term effect of Mobi-C cervical artificial disc replacement (CADR) therapy in patients with single proplase of cervical intervertebral disc .Methods:Mobi-C artificial cervical disc was applied to treat 12 cases of single proplase of cervical intervertebral disc .The data about clinical observation , imaging evaluation and questionnaire were collected at preoperative , postoperative ( 1-2 days ) and the end follow-up.Results:The patients were followed up for 6 to 24 months,average 13 months.All the patients were satisfactory to the outcome , excellent in 10 cases and good in 2 cases according to Odom criterion .The pain in upper limb and neck were significantly relieved, the VAS score immediately decreased 5.8 points after operation(P<0.05), and 5.5 points at the last follow-up(P<0.05).NDI and SF-36 improved obviously,which meant the patient′s quality of life improved obviously .Degeneration at the adjacent segments was not found in addition to 3 patient with heterotopic ossification .Conclusions:Mobi-C CADR therapy reserving mobility of cervical spine has a good effect in the early stage , and can improve the quality of life of the patients .%目的:探讨Mobi-C颈椎人工间盘置换治疗单节段颈椎间盘突出症的近期效果。方法:对应用Mobi-C颈椎人工间盘置换治疗的12例单节段颈椎间盘突出症患者于术前、术后(1~2 d )及末次随访时进行全面的影像学和临床评价,并进行问卷调查。结果:本组病例随访6~24月,平均13个月。 Odom临床疗效评价优10例,良2例。患者的颈部及上肢疼痛明显缓解,VAS评分术后下降了5.8分(P<0.05),末次随访时下降了5.5分(P<0.05)。颈椎功能障碍指数(NDI)和SF-36生活质量量表评分明显改善,患者的生活质量明显提高。除3例患者发生异位骨化外,未发现相邻节段退变加速。结论:保留颈椎活动度的Mobi-C颈椎人工间

  20. CLINICAL COMPARISION OF THE TREATMENT OF CERVICAL PROLAPSE OF INTERVERTEBRAL DISC BY USING CAGE OR TITANIUM PLATE

    Institute of Scientific and Technical Information of China (English)

    Yang Pei; Wang Kunzheng; Gong Fuliang; Wang Chunsheng; Shi Zhibin

    2006-01-01

    Objective To compare the clinical effects of treating cervical prolapse of intervertebral disc by using Solis cage, titanium cage and autogenous iliac crest graft (AICG) combined with titanium plate. Methods 64 cases of cervical prolapse of intervertebral disc were analyzed retrospectively. All the patients were followed up for about one year. Group A is composed of 20 patients (30 intervertebral spaces) treated with microdiscectomy and Solis cage fusion;group B is composed of 21 patients(22 intervertebral spaces) treated with titanium cage and group C is involved of 23patients(28 intervertebral spaces) which were dealt with AICG combined with titanium plate. The differences in the to-tal X ray exposure time, time working on iliac bone, incidence of complications, fusion rate, incidence of JOA score recovery rate more than 50 % and rehabilitation time of the three groups are analyzed. Results All indexes from group A and B were more satisfactory than those from group C (P<0. 05). The statistic analysis results of the incidence of complications of cervical part, rehabilitation time in group A are 5.0± 1.8, 5.1 ± 1.2; and that is 14.3±2.6, 7.5 ± 1.6and 26.1±6.2, 8.6±2.3 in group B and group C respectively. There is significant difference between group A and group B on the incidence of complications of cervical part and rehabilitation time (P<0.05). Results of the incidence of JOA score recovery rate > 50 % in group A(95.8 ± 3.2) was more satisfactory than that in group B(93.6 ± 2.9),while there was no statistical difference between group A and group B (P>0.05). Conclusion The Solis cage is better in treating the cervical prolapse of intervertebral disc than other ways. Also, it makes the operation easier, rehabilitation time shorter, and it causes fewer complications.

  1. Narrowing of lumbar spinal canal predicts chronic low back pain more accurately than intervertebral disc degeneration: a magnetic resonance imaging study in young Finnish male conscripts.

    Science.gov (United States)

    Visuri, Tuomo; Ulaska, Jaana; Eskelin, Marja; Pulkkinen, Pekka

    2005-11-01

    The objective of this magnetic resonance imaging study was to evaluate the role of degenerative changes, developmental spinal stenosis, and compression of spinal nerve roots in chronic low back (CLBP) and radicular pain in Finnish conscripts. The degree of degeneration, protrusion, and herniation of the intervertebral discs and stenosis of the nerve root canals was evaluated, and the midsagittal diameter and cross-sectional area of the lumbar vertebrae canal were measured in 108 conscripts with CLBP and 90 asymptomatic controls. The midsagittal diameters at L1-L4 levels were significantly smaller in the patients with CLBP than in the controls. Moreover, degeneration of the L4/5 disc and protrusion or herniation of the L5/S1 disc and stenosis of the nerve root canals at level L5/S1 were more frequent among the CLBP patients. Multifactorial analysis of the magnetic resonance imaging findings provided a total explanatory rate of only 33%. Narrowing of the vertebral canal in the anteroposterior direction was more likely to produce CLBP and radiating pain than intervertebral disc degeneration or narrowing of the intervertebral nerve root canals. PMID:16450819

  2. Aging affects response to cyclic tensile stretch: paradigm for intervertebral disc degeneration

    Directory of Open Access Journals (Sweden)

    H Cho

    2011-09-01

    Full Text Available Much evidence supports a fundamental role for mechanical forces in modulating differentiation, homeostasis, and remodelling of musculoskeletal cells. Little is known, however, regarding mechanobiology and gene expression of intervertebral disc (IVD cells from older individuals. To characterise the effect of mechanical stimulation on cells from older discs, an in vitro study of IVD cells harvested from different aged pigs was conducted to measure extracellular matrix (ECM gene expression in response to cyclic tensile stress (CTS. Gene expression of annulus fibrosus (AF cells from IVDs of mature and older pigs was quantified for the predominant ECM genes; type I collagen, type II collagen and aggrecan, and matrix metalloproteinase 1 (MMP-1, a collagenase that degrades fibrillar collagens.AF cells cultured on flexible-bottom plates were stretched 10 % at 0.5 Hz frequency. After 24 h, gene expression was assayed using reverse transcriptase polymerase chain reaction (RT-PCR. Basal mRNA levels without stretching for type II collagen and aggrecan were lower in older annular cells whereas MMP-1 levels were higher compared to mature cells. Following CTS, an adaptive response was elicited in annular cells from both age groups. ECM protein genes were upregulated, whereas MMP-1 was downregulated. The magnitude of response was significantly greater in older cells as compared to mature cells. These data suggest that the cells from the AF of older animals manifest lower basal levels of mRNA for type II collagen and aggrecan and higher levels of MMP-1 possibly due to decreased tensile stress experienced in vivo and is not the result of reduced capacity for response.

  3. Total disc replacement.

    Science.gov (United States)

    Vital, J-M; Boissière, L

    2014-02-01

    Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. PMID:24412045

  4. Magnetic resonance imaging evaluation after implantation of a titanium cervical disc prosthesis: a comparison of 1.5 and 3 Tesla magnet strength

    OpenAIRE

    Sundseth, Jarle; Jacobsen, Eva A.; Kolstad, Frode; Nygaard, Oystein P.; Zwart, John A.; Hol, Per K.

    2013-01-01

    Purpose Cervical disc prostheses induce significant amount of artifact in magnetic resonance imaging which may complicate radiologic follow-up after surgery. The purpose of this study was to investigate as to what extent the artifact, induced by the frequently used Discover® cervical disc prosthesis, impedes interpretation of the MR images at operated and adjacent levels in 1.5 and 3 Tesla MR. Methods Ten subsequent patients were investigated in both 1.5 and 3 Tesla MR with standard image seq...

  5. A game of two discs: a case of non-contiguous and occult cervical spine injury in a rugby player.

    Science.gov (United States)

    O'Sullivan, Michael D; Piggot, Robert; Jaddan, Mutaz; McCabe, John P

    2016-01-01

    The aim of this case report was to highlight the application of magnetic resonance imaging (MRI) in elucidating serious and occult injuries in a single case of hyperflextion injury of a patient cervical spine (C-Spine). A chart and radiology review was performed to establish the sequence of care and how the results of imaging studies influenced the clinical management in this trauma case. Plain radiographs and computed tomography (CT) imaging modalities of the C-Spine revealed bilateral C4/C5 facetal subluxation with no obvious fractures; however, the MR imaging of the C-Spine revealed a non-contiguous and occult injury to C6/C7 disc with a posterior annular tear and associated disc extrusion. This altered the operative intervention that was initially planned. MR imaging proved an invaluable diagnostic addition in this particular case of cervical trauma in a rugby player following a hyperflextion injury, by revealing a serious non-contiguous and occult injury of the C-Spine. PMID:26980714

  6. 人工颈椎间盘置换术患者围手术期护理体会%Cervical intervertebral disc arthroplasty patients perioperative nursing experience

    Institute of Scientific and Technical Information of China (English)

    刘丹

    2015-01-01

    颈椎间盘突出症是一种常见的退化性病变,它可以引起脊髓和神经根病变,脊髓病变甚至可能造成四肢运动功能损害、感觉异常等。人工间盘的设计理念之一是保留手术节段的活动,另一设计理念是降低临近节段退变的发生,它既能保持脊柱节段的稳定性和活动功能,又能避免临近关节受到连累,对于提高患者生活质量有实际意义。2013年11月,我科成功为一名严重脊髓型颈椎病患者实施了经颈前路减压、人工椎间盘置换术,围手术期的系统、精密的观察和护理,对手术成功起到重要作用,术后患者恢复良好,患者及其家属对手术效果均感到满意,现总结护理经验如下。%The cervical intervertebral disc herniation is a common degradation lesions, it can cause spinal cord and nerve root lesions, limb motor function caused by spinal cord lesions and may even damage, paresthesia, etc. Between artificial disc is one of the design concept of conservative surgery section of the activity, a design concept is to reduce the happening of the adjacent segment degeneration, it can maintain the stability of the spinal segment and function of activity, and can avoid near joints, small area, to improve the patients quality of life has a practical significance. In November 2013, I division success as a serious spondylotic myelopathy successfully implemented by decompression and anterior portion of artificial intervertebral disc replacement, through system, precision of perioperative observation and nursing care, for the success rate of surgery play an important role, the patient recovered well postoperatively, patients and their families were satisfied with the surgical effects are, summarized nursing experience is as follows.

  7. Genetic Polymorphisms of Interleukin-1 Alpha and the Vitamin D Receptor in Mexican Mestizo Patients with Intervertebral Disc Degeneration

    Directory of Open Access Journals (Sweden)

    Salvador Cervin Serrano

    2014-01-01

    Full Text Available Intervertebral disc degeneration (IDD is the most common diagnosis in patients with back pain, a leading cause of musculoskeletal disability worldwide. Several conditions, such as occupational activities, gender, age, and obesity, have been associated with IDD. However, the development of this disease has strong genetic determinants. In this study, we explore the possible association between rs1800587 (c.-949C>T of interleukin-1 alpha (IL1A and rs2228570 (c.2T>V and rs731236 (c.1056T>C of vitamin D receptor (VDR gene polymorphisms and the development of IDD in northwestern Mexican Mestizo population. Gene polymorphisms were analyzed by polymerase chain reaction followed by restriction fragment length polymorphism, in two groups matched by age and gender: patients with symptomatic lumbar IDD n=100 and subjects with normal lumbar-spine MRI-scans n=100. Distribution of the mutated alleles in patients and controls was 27.0% versus 28.0% P=0.455 for T of rs1800587 (IL1A; 53.0% versus 58.0% P=0.183 for V of rs2228570 (VDR; and 18.0% versus 21.0% P=0.262 for C of rs731236 (VDR. Our results showed no association between the studied polymorphisms and IDD in this population. This is the first report on the contribution of gene polymorphisms on IDD in a Mexican population.

  8. ISSLS PRIZE WINNER: INHIBITION OF NF-κB ACTIVITY AMELIORATES AGE-ASSOCIATED DISC DEGENERATION IN A MOUSE MODEL OF ACCELERATED AGING

    Science.gov (United States)

    Nasto, Luigi A.; Seo, Hyoung-Yeon; Robinson, Andria R.; Tilstra, Jeremy S.; Clauson, Cheryl L.; Sowa, Gwendolyn A.; Ngo, Kevin; Dong, Qing; Pola, Enrico; Lee, Joon Y.; Niedernhofer, Laura J.; Kang, James D.; Robbins, Paul D.; Vo, Nam V.

    2012-01-01

    Study Design NF-κB activity was pharmacologically and genetically blocked in an accelerated aging mouse model to mitigate age-related disc degenerative changes. Objective To study the mediatory role of NF-κB signaling pathway in age-dependent intervertebral disc degeneration. Summary of Background Data Aging is a major contributor to intervertebral disc degeneration (IDD), but the molecular mechanism behind this process is poorly understood. NF-κB is a family of transcription factors which play a central role in mediating cellular response to damage, stress, and inflammation. Growing evidence implicates chronic NF-κB activation as a culprit in many aging-related diseases, but its role in aging-related IDD has not been adequately explored. We studied the effects of NF-κB inhibition on IDD using a DNA repair-deficient mouse model of accelerated aging (Ercc1-/Δ mice) previously been reported to exhibit age-related IDD. Methods Systemic inhibition of NF-κB activation was achieved either genetically by deletion of one allele of the NF-κB subunit p65 (Ercc1-/Δp65+/- mice) or pharmacologically by chronic intra-peritoneal administration of the Nemo Binding Domain (8K-NBD) peptide to block the formation of the upstream activator of NF-κB, IκB Inducible Kinase (IKK), in Ercc1-/Δ mice. Disc cellularity, total proteoglycan content and proteoglycan synthesis of treated mice and untreated controls were assessed. Results Decreased disc matrix proteoglycan content, a hallmark feature of IDD, and elevated disc NF-κB activity were observed in discs of progeroid Ercc1-/Δ mice and naturally aged wild-type compared to young WT mice. Systemic inhibition of NF-κB by the 8K-NBD peptide in Ercc1-/Δ mice increased disc proteoglycan synthesis and ameriolated loss disc cellularity and matrix proteoglycan. These results were confirmed genetically by using the p65 haploinsufficient Ercc1-/Δp65+/- mice. Conclusion These findings demonstrate that the IKK/NF-κB signaling pathway

  9. Radiographic findings of degeneration in cervical spines of middle-aged soccer players

    International Nuclear Information System (INIS)

    Twelve amateur veteran soccer players (average age 40.1 ± 5.4 years), who began playing in their teens and who were admitted with symptoms most likely to be related to cervical spondylosis, were examined by cervical radiography. Abnormal radiographic findings included: calcification of anterior longitudinal ligament (25%), anterior (75%) and posterior vertebral spurs (75%), ossicle between spinous processes (75%), calcification of nuchal ligament (Barsony) (58%), ossicle on spinous process (25%), and bony spur of Luschka's joints (83%). It was shown in the stress distribution by finite element method analysis that the stress in heading the ball was applied mainly to the lower parts of the cervical spine. The results of this analysis also corresponded well with some of the radiographic findings. (orig.)

  10. Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Ji Sook; Cha, Jang Gyu [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Han, Jong Kyu [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kim, Hyun Joo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

    2015-08-15

    To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI.

  11. Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

    International Nuclear Information System (INIS)

    To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI

  12. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease (Review)

    NARCIS (Netherlands)

    Jacobs, W.; Willems, P.C.P.H.; Limbeek, J. van; Bartels, R.H.M.A.; Pavlov, P.; Anderson, P.G.; Oner, C.

    2011-01-01

    BACKGROUND: The number of surgical techniques for decompression and solid interbody fusion as treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques remains unclear. OBJECTIVES: To determine which technique of anterior interbody fusion

  13. In vitro assessment of biomaterial-induced remodeling of subchondral and cancellous bone for the early intervention of joint degeneration with focus on the spinal disc

    Science.gov (United States)

    McCanless, Jonathan D.

    Osteoarthritis-associated pain of the spinal disc, knee, and hip derives from degeneration of cartilagenous tissues in these joints. Traditional therapies have focused on these cartilage (and disc specific nucleus pulposus) changes as a means of treatment through tissue grafting, regenerative synthetic implants, non-regenerative space filling implants, arthroplasty, and arthrodesis. Although such approaches may seem apparent upon initial consideration of joint degeneration, tissue pathology has shown changes in the underlying bone and vascular bed precede the onset of cartilaginous changes. It is hypothesized that these changes precedent joint degeneration and as such may provide a route for early prevention. The current work proposes an injectable biomaterial-based therapy within these subchondral and cancellous bone regions as a means of preventing or reversing osteoarthritis. Two human concentrated platelet releasate-containing alginate hydrogel/beta-tricalcium phosphate composites have been developed for this potential biomaterial application. The undertaking of assessing these materials through bench-, in vitro, and ex vivo work is described herein. These studies showed the capability of the biomaterials to initiate a wound healing response in monocytes, angiogenic and differentiation behavior in immature endothelial cells, and early osteochondral differentiation in mesenchymal stem cells. These cellular activities are associated with fracture healing and endochondral bone formation, demonstrating the potential of the biomaterials to induce osseous and vascular tissue remodeling underlying osteoarthritic joints as a novel therapy for a disease with rapidly growing healthcare costs.

  14. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease

    NARCIS (Netherlands)

    Jacobs, Wilco; Willems, Paul C.; van Limbeek, Jacques; Bartels, Ronald; Pavlov, Paul; Anderson, Patricia G.; Oner, Cumhur

    2011-01-01

    Background The number of surgical techniques for decompression and solid interbody fusion as treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques remains unclear. Objectives To determine which technique of anterior interbody fusion g

  15. Potential Role of lncRNAs in Contributing to Pathogenesis of Intervertebral Disc Degeneration Based on Microarray Data

    Science.gov (United States)

    Chen, Yu; Ni, Haijian; Zhao, Yingchuan; Chen, Kai; Li, Ming; Li, Cheng; Zhu, Xiaodong; Fu, Qiang

    2015-01-01

    Background Our study intended to identify potential long non-coding RNAs (lncRNAs) and genes, and to elucidate the underlying mechanisms of intervertebral disc degeneration (IDD). Material/Methods The microarray of GSE56081 was downloaded from the Gene Expression Omnibus database, including 5 human control nucleus pulposus tissues and 5 degenerative nucleus pulposus tissues, which was on the basis of GPL15314 platform. Identification of differentially expressed lncRNAs and mRNAs were performed between the 2 groups. Then, gene ontology (GO) and pathway enrichment analyses were performed to analyze the biological functions and pathways for the differentially expressed mRNAs. Simultaneously, lncRNA-mRNA weighted coexpression network was constructed using the WGCNA package, followed by GO and KEGG pathway enrichment analyses for the genes in the modules. Finally, the protein-protein interaction (PPI) network was visualized. Results A total of 135 significantly up- and 170 down-regulated lncRNAs and 2133 significantly up- and 1098 down-regulated mRNAs were identified. Additionally, UBA52 (ubiquitin A-52 residue ribosomal protein fusion product 1), with the highest connectivity degree in PPI network, was remarkably enriched in the pathway of metabolism of proteins. Eight lncRNAs – LINC00917, CTD-2246P4.1, CTC-523E23.5, RP4-639J15.1, RP11-363G2.4, AC005082.12, MIR132, and RP11-38F22.1 – were observed in the modules of lncRNA-mRNA weighted coexpression network. Moreover, SPHK1 in the green-yellow module was significantly enriched in positive regulation of cell migration. Conclusions LncRNAs LINC00917, CTD-2246P4.1, CTC-523E23.5, RP4-639J15.1, RP11-363G2.4, AC005082.12, MIR132, and RP11-38F22.1 were differentially expressed and might play important roles in the development of IDD. Key genes, such as UBA52 and SPHK1, may be pivotal biomarkers for IDD. PMID:26556537

  16. Analysis of amelioration of neurological function on cervical degeneration disease after treatment with cervical spine locking plate%颈椎带锁钢板内固定术对颈椎退变性疾病神经功能改善的分析

    Institute of Scientific and Technical Information of China (English)

    赖志军; 谢惠缄; 谢唏衷; 肖建如

    2002-01-01

    Objective To discuss the clinical effect of treatment with anterior decompression, bone graft and cervical locking plate fixation for cervical degeneration disease.Method 23 patients with cervical spondylotic myelopathy and cervical ossification of the posterior longitudinal ligament have undergone the treatment of anterior cervical spine locking plate fusion.Neurological signs and symptoms were evaluated before and after surgery, and mean follow up time was 11.3 months.Result In all cases,radiography demonstrated a solid bony fusion.Additional general complications include a large wound hematoma in one and hoarseness in one.All patients' neurological function were improved.Conclusion The clinical effect of treatment with anterior decompression, bone graft and cervical locking plate fixation for cervical degeneration disease is satisfactory.

  17. Two cases of cervical disc disease with intramedullary pathological changes, which are responsible for their neurological syndromes, on delayed CT myelography

    International Nuclear Information System (INIS)

    We report two cases of cervical disc disease with myelopathy classified as of motor system syndrome type showing small contrast accumulation within the spinal cord on delayed CT myelography. In our two cases, high density spots on delayed CT myelography were bilaterally localized within the spinal cord, and believed represent pathological changes of the spinal cord, such as collection of microcavities or cystic necrosis. In case 1, the high density areas seemed to be localized in the anterior horn and corticospinal tract, and in case 2, they seemed to be localized in the corticospinal tract. The patient in case 1 produced signs and symptoms resembling motor neurone disease and lesion could not be differentiated from the latter. Delayed CT myelography showed that the cause of the upper limb amyotrophy was attributed to an anterior horn disorder and that of pyramidal tract sign to a corticospinal tract disorder. Therefore, we could differentiate the lesion from motor neurone disease on delayed CT myelography in case 1. In conclusion, we emphasize that delayed CT myelography can demonstrate the intramedullary pathological changes in the cervical disc disease and is useful in distinguishing between cervical disc disease simulating motor neurone disease and the latter. (author)

  18. Correlations between quantitative T2 and T1ρ MRI, mechanical properties and biochemical composition in a rabbit lumbar intervertebral disc degeneration model.

    Science.gov (United States)

    Gullbrand, Sarah E; Ashinsky, Beth G; Martin, John T; Pickup, Stephen; Smith, Lachlan J; Mauck, Robert L; Smith, Harvey E

    2016-08-01

    Improved diagnostic measures for intervertebral disc degeneration are necessary to facilitate early detection and treatment. The aim of this study was to correlate changes in mechanical and biochemical properties with the quantitative MRI parameters T2 and T1ρ in rabbit lumbar discs using an ex vivo chymopapain digestion model. Rabbit lumbar spinal motion segments from animals less than 6 months of age were injected with 100 μl of saline (control) or chymopapain at 3, 15, or 100 U/ml (n = 5 per group). T2 and T1ρ MRI series were obtained at 4.7T. Specimens were mechanically tested in tension-compression and creep. Normalized nucleus pulposus (NP) water and GAG contents were quantified. Stepwise multiple linear regression was performed to determine which parameters contributed significantly to changes in NP T2 and T1ρ. When all groups were included, multiple regression yielded a model with GAG, compressive modulus, and the creep time constants as variables significantly impacting T2 (multiple r(2)  = 0.64, p = 0.006). GAG and neutral zone (NZ) modulus were identified as variables contributing to T1ρ (multiple r(2)  = 0.28, p = 0.08). When specimens with advanced degeneration were excluded from the multiple regression analysis, T2 was significantly predicted by compressive modulus, τ1, and water content (multiple r(2)  = 0.71, p = 0.009), while no variables were significant predictors in the model for T1ρ. These results indicate that quantitative MRI can detect changes in the mechanical and biochemical properties of the degenerated disc. T2 may be more sensitive to early stage degenerative changes than T1ρ, while both quantitative MRI parameters are sensitive to advanced degeneration. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1382-1388, 2016. PMID:27105019

  19. The development of a posterior dynamic stabilisation implant indicated for thoraco-lumbar disc degeneration / Christopher Daniel (Chris) Parker

    OpenAIRE

    Parker, Christopher Daniel

    2013-01-01

    Posterior lumbar spinal dynamic stabilisation devices are intended to relieve the pain of spinal segments while prolonging the lifespan of adjacent intervertebral discs. This study focuses on the design of such a device, one that has the correct stiffness to stabilise the spinal segment by the correct amount. An initial literature survey covers contemporary topics related to the lumbar spine. Included topics are lumbar anatomy and kinematics, pathology of degenerative disc dise...

  20. Comparison of wear behaviors for an artificial cervical disc under flexion/extension and axial rotation motions.

    Science.gov (United States)

    Wang, Song; Song, Jian; Liao, Zhenhua; Feng, Pingfa; Liu, Weiqiang

    2016-06-01

    The wear behaviors of a ball-on-socket (UHMWPE-on-Ti6Al4V) artificial cervical disc were studied with 1.5MC (million cycles) wear simulation under single flexion/extension and axial rotation motion and their composite motion. The wear rates, wear traces, and contact stress were analyzed and contrasted based on mass loss, optical microscopy and SEM as well as 3D profilometer, and ANSYS software, respectively. A much higher wear rate and more severe wear scars appeared under multi-directional motion. Flexion/extension motion of 7.5° lead to more severe wear than that under axial rotation motion of 4°. The above results were closely related to the contact compression stress and shear stress. The wear surface in FE motion showed typical linear wear scratches while revealing obvious arc-shaped wear tracks in AR motion. However, the central zone of both ball and socket components revealed more severe wear tracks than that in the edge zone under these two different motions. The dominant wear mechanism was plowing/scratching and abrasive wear as well as a little oxidation wear for the titanium socket while it was scratching damage with adhesive wear and fatigue wear due to plastic deformation under cyclic load and motion profiles for the UHMWPE ball. PMID:27040218

  1. Collagen turnover in normal and degenerate human intervertebral discs as determined by the racemization of aspartic acid

    NARCIS (Netherlands)

    Sivan, S.-S.; Wachtel, E.; Tsitron, E.; Sakkee, N.; Ham, F. van der; Groot, J.de; Roberts, S.; Maroudas, A.

    2008-01-01

    Knowledge of rates of protein turnover is important for a quantitative understanding of tissue synthesis and catabolism. In this work, we have used the racemization of aspartic acid as a marker for the turnover of collagen obtained from healthy and pathological human intervertebral disc matrices. We

  2. Electroacupuncture inhibits apoptosis in annulus fibrosis cells through suppression of the mitochondria-dependent pathway in a rat model of cervical intervertebral disc degradation

    Directory of Open Access Journals (Sweden)

    Jun Liao

    2012-01-01

    Full Text Available The purpose of this study was to investigate whether treatment with electroacupuncture (EA inhibited mitochondria-dependent apoptosis in annulus fibrosis (AF cells in a rat model of cervical intervertebral disc degradation induced by unbalanced dynamic and static forces. Forty Sprague-Dawley rats were used in this study, of which 30 underwent surgery to induce cervical intervertebral disc degradation, 10 rats received EA at acupoints Dazhui (DU 14 and Shousanli (LI 10. TUNEL staining was measured to assess apoptosis in AF cells, immunohistochemistry was used to examine Bcl-2 and Bax expression, colorimetric assays were used to determine caspase 9 and caspase 3 activities and RT-PCR and western blotting were used to assess the mRNA and protein expression of Crk and ERK2. Treatment with EA reduced the number of AF-positive cells in TUNEL staining, increased Bcl-2-positive cells and decreased Bax-positive cells in immunohistochemical staining, significantly inhibited the activation of caspases-9 and -3, and enhanced the mRNA and protein expression of Crk and ERK2. Our data show that EA inhibits AF cell apoptosis via the mitochondria-dependent pathway and up-regulates Crk and ERK2 expression. These results suggest that treatment with may be a good alternative therapy for preventing cervical spondylosis.

  3. Biomechanics of Hybrid Anterior Cervical Fusion and Artificial Disc Replacement in 3-Level Constructs: An In Vitro Investigation

    OpenAIRE

    Liao, Zhenhua; Fogel, Guy R.; Pu, Ting; Gu, Hongsheng; Liu, Weiqiang

    2015-01-01

    Background The ideal surgical approach for cervical disk disease remains controversial, especially for multilevel cervical disease. The purpose of this study was to investigate the biomechanics of the cervical spine after 3-level hybrid surgery compared with 3-level anterior cervical discectomy and fusion (ACDF). Material/Methods Eighteen human cadaveric spines (C2-T1) were evaluated under displacement-input protocol. After intact testing, a simulated hybrid construct or fusion construct was ...

  4. Artroplastia total de disco cervical com prótese de Bryan: resultados clínicos e funcionais Artroplastía cervical total con prótesis de Bryan: resultados clínicos y funcionales Cervical total disc arthroplasty with Bryan disc: clinical and functional outcomes

    Directory of Open Access Journals (Sweden)

    Eduardo Machado de Menezes

    2012-09-01

    resultados buenos y excelentes, 10% satisfactorios y el 7% malos. Hubo sólo una complicación (3%, que se revirtió con artrodesis anterior. CONCLUSIONES: La artroplastia discal cervical ha demostrado ser un método seguro y eficaz para el tratamiento de casos seleccionados de hernia de disco cervical asociada a la radiculopatía y/o a compresión de la médula espinal en el corto y mediano plazo.OBJECTIVE: To evaluate results of cervical disc arthroplasty with the Bryan prosthesis for treatment of cervicobrachial pain (radiculopathy and spinal cord compression (myelopathy. METHODS: From 2002 to 2007, the CECOL surgical staff has operated 65 patients. Only 28 patients were found in 2010 to a new data collection. The pre- and post-operative evaluation was conducted using the CSOQ questionnaire (Cervical Spine Outcomes Questionnaire. Odom criteria were used only in the postoperative evaluation. Both were translated and adapted to local culture. RESULTS: There was a significant symptomatic and functional improvement in most patients. The reduction of neck pain (axial and brachial pain (radicular was similar. Odom criteria showed 82.1% good and excellent results, 10% satisfactory and 7% poor. There was only one complication (3% which was reversed with anterior arthrodesis. CONCLUSIONS: The total cervical disc arthroplasty has proved to be a safe and effective method to treat selected cases of cervical disc herniation with radiculopathy and/or myelopathy in the short and medium term.

  5. CLINICAL STUDY OF PERCUTANEOUS CERVICAL DISCECTOMY WITH OZONE INJECTION IN TREATING CERVICAL DISC HERNIATION%经皮旋切术配合臭氧注射治疗颈椎间盘突出症的临床研究

    Institute of Scientific and Technical Information of China (English)

    张强; 刘萍; 张敏

    2013-01-01

    Objective:To evaluate the effect of percutaneous cervical discectomy with ozone injection in treating cervical disc herniation.Methods:Eighty-six patients were randomly divided into 2 groups with different treatment methods:40 patients were treated by percutaneous cervical discectomy with ozone injection (group A),46 patients were treated by percutaneous cervical discectomy only (group B).The visual analogue scale (VAS) and clinical efficacy for patients in the two groups were analyzed.Results:In both groups,the VAS scores were significantly decreased after treatment (P < 0.05),while the VAS score for group A was superior to group B.For clinical efficacy,the effective rate for group A (90.0%,36/40) was superior to group B (69.6%,32/46) (P < 0.05).Conclusion:Percutaneous cervical discectomy with ozone injection was superior to single percutaneous cervical discectomy in decreasing VAS scores and the clinical efficacy for patients with cervical disc herniation.%目的:评价经皮旋切术配合臭氧注射治疗颈椎间盘突出症患者的疗效.方法:将86例颈椎间盘突出症患者随机分为2组,即使用经皮穿刺旋切术配合臭氧注射治疗(A组)40例及单纯旋切术(B组)46例.分析两组患者的视觉模拟评分(visual analogue scale,VAS)及临床疗效.结果:两组治疗后VAS评分均显著降低(P<0.05),A组优于B组(P<0.05).临床疗效方面,A组有效率90.0%(36/40),优于B组69.6%(32/46)(P<0.05).结论:经皮旋切术配合臭氧注射治疗颈椎间盘突出症在降低患者的VAS评分及临床疗效方面优于单纯旋切术.

  6. Effects of single injection of local anesthetic agents on intervertebral disc degeneration: ex vivo and long-term in vivo experimental study.

    Directory of Open Access Journals (Sweden)

    Koji Iwasaki

    Full Text Available Analgesic discography (discoblock can be used to diagnose or treat discogenic low back pain by injecting a small amount of local anesthetics. However, recent in vitro studies have revealed cytotoxic effects of local anesthetics on intervertebral disc (IVD cells. Here we aimed to investigate the deteriorative effects of lidocaine and bupivacaine on rabbit IVDs using an organotypic culture model and an in vivo long-term follow-up model.For the organotypic culture model, rabbit IVDs were harvested and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine or 0.5% bupivacaine. Nucleus pulposus (NP cell death was measured using confocal microscopy. Histological and TUNEL assays were performed. For in vivo study, each local anesthetic was injected into rabbit lumbar IVDs under a fluoroscope. Six or 12 months after the injection, each IVD was prepared for magnetic resonance imaging (MRI and histological analysis.In the organotypic culture model, both anesthetic agents induced time-dependent NP cell death; when compared with injected saline solution, significant effects were detected within 7 days. Compared with the saline group, TUNEL-positive NP cells were significantly increased in the bupivacaine group. In the in vivo study, MRI analysis did not show any significant difference. Histological analysis revealed that IVD degeneration occurred to a significantly level in the saline- and local anesthetics-injected groups compared with the untreated control or puncture-only groups. However, there was no significant difference between the saline and anesthetic agents groups.In the in vivo model using healthy IVDs, there was no strong evidence to suggest that discoblock with local anesthetics has the potential of inducing IVD degeneration other than the initial mechanical damage of the pressurized injection. Further studies should be performed to investigate the deteriorative effects of the local injection of analgesic agents

  7. Differences between C3-4 and other subaxial levels of cervical disc arthroplasty: more heterotopic ossification at the 5-year follow-up.

    Science.gov (United States)

    Chang, Peng-Yuan; Chang, Hsuan-Kan; Wu, Jau-Ching; Huang, Wen-Cheng; Fay, Li-Yu; Tu, Tsung-Hsi; Wu, Ching-Lan; Cheng, Henrich

    2016-05-01

    OBJECTIVE Several large-scale clinical trials demonstrate the efficacy of 1- and 2-level cervical disc arthroplasty (CDA) for degenerative disc disease (DDD) in the subaxial cervical spine, while other studies reveal that during physiological neck flexion, the C4-5 and C5-6 discs account for more motion than the C3-4 level, causing more DDD. This study aimed to compare the results of CDA at different levels. METHODS After a review of the medical records, 94 consecutive patients who underwent single-level CDA were divided into the C3-4 and non-C3-4 CDA groups (i.e., those including C4-5, C5-6, and C6-7). Clinical outcomes were measured using the visual analog scale for neck and arm pain and by the Japanese Orthopaedic Association scores. Postoperative range of motion (ROM) and heterotopic ossification (HO) were determined by radiography and CT, respectively. RESULTS Eighty-eight patients (93.6%; mean age 45.62 ± 10.91 years), including 41 (46.6%) female patients, underwent a mean follow-up of 4.90 ± 1.13 years. There were 11 patients in the C3-4 CDA group and 77 in the non-C3-4 CDA group. Both groups had significantly improved clinical outcomes at each time point after the surgery. The mean preoperative (7.75° vs 7.03°; p = 0.58) and postoperative (8.18° vs 8.45°; p = 0.59) ROMs were similar in both groups. The C3-4 CDA group had significantly greater prevalence (90.9% vs 58.44%; p = 0.02) and higher severity grades (2.27 ± 0.3 vs 0.97 ± 0.99; p = 0.0001) of HO. CONCLUSIONS Although CDA at C3-4 was infrequent, the improved clinical outcomes of CDA were similar at C3-4 to that in the other subaxial levels of the cervical spine at the approximately 5-year follow-ups. In this Asian population, who had a propensity to have ossification of the posterior longitudinal ligament, there was more HO formation in patients who received CDA at the C3-4 level than in other subaxial levels of the cervical spine. While the type of artificial discs could have confounded the

  8. Follow-up radiographs of the cervical spine after anterior fusion with titanium intervertebral disc; Roentgen-Verlaufsuntersuchung der Halswirbelsaeule nach anteriorer Fusion mit Titaninterponaten

    Energy Technology Data Exchange (ETDEWEB)

    Biederer, J.; Hutzelmann, A.; Heller, M. [Kiel Univ. (Germany). Klinik fuer Diagnostische Radiologie; Rama, B. [Paracelsus Klinik, Osnabrueck (Germany). Klinik fuer Neurochirurgie

    1999-08-01

    Purpose: We examined the postoperative changes of the cervical spine after treatment of cervical nerve root compression with anterior cervical discectomy and fusion with a new titanium intervertebral disc. Patients and Methods: 37 patients were examined prior to, as well as 4 days, 6 weeks, and 7 months after surgery. Lateral view X-rays and functional imaging were used to evaluate posture and mobility of the cervical spine, the position of the implants, and the reactions of adjacent bone structures. Results: Implantation of the titanium disc led to post-operative distraction of the intervertebral space and slight lordosis. Within the first 6 months a slight loss of distraction and re-kyphosis due to impression of the implants into the vertebral end-plates were found in all patients. We noted partial infractions into the vertebral end-plates in 10/42 segments and slight mobility of the implants in 14/42 segments. Both groups of patients showed reactive spondylosis and local symptoms due to loosening of the implants. The pain subsided after onset of bone bridging and stable fixation of the loosened discs. Conclusions: The titanium intervertebral disc provides initial distraction of the fusioned segments with partial recurrence of kyphosis during the subsequent course. Loosening of the implants with local symptoms can be evaluated with follow-up X-rays and functional imaging. (orig.) [German] Ziel: An Patienten mit zervikalen Kompressionssyndromen wurden Stellung und Funktion der Halswirbelsaeule nach Diskektomie und Fusion mit einem neuartigen Titaninterponat untersucht. Patienten und Methoden: Bei 37 Patienten (42 Segmente) wurden praeoperativ sowie 4 Tage, 6 Wochen und 7 Monate postoperativ mit seitlichen Uebersichts- und Funktionsaufnahmen Stellung und Mobilitaet der HWS beurteilt. Erfasst wurden Lageveraenderungen des Titaninterponates und die Reaktion der angrenzenden Wirbelkoerperabschlussplatten. Ergebnisse: Das Titaninterponat bewirkte postoperativ eine

  9. 金属橡胶角度人工颈椎间盘植入后颈椎的稳定性变化%Cervical stability changes following metal rubber cervical disc replacement

    Institute of Scientific and Technical Information of China (English)

    柏传毅; 卫文博; 党晓谦; 王坤正

    2015-01-01

    BACKGROUND:Previous studies designed and made titanium metal rubber cervical disc prosthesis, and performed feasible studies on its effect on movement and stress distribution by replicating intervertebral discs. OBJECTIVE:To further observe the changes in the stability of goat cervical vertebra after metal rubber cervical disc replacement. METHODS:Nine goats were randomly divided into experimental group (n=6) and normal control group (n=3). Goats in the experimental group received metal rubber cervical disc replacement at C4/5segment. Goats in the normal control group did not receive any treatment. Radiographic data at anteroposterior and lateral position, hyperextension and excessive flexion were taken to measure intervertebral height, range of motion and intervertebral angle at C4/5 segment before operation, immediately, 4, 8, 12 weeks after operation. Subsequently, slicing and embedding of hard tissue at surgical segment, picric acid-acid fuchsin staining and scanning electron microscopy were conducted.RESULTS AND CONCLUSION:No significant difference in the intervertebral height and spinal range of motion at C4/5 segment at different time points was detected between postoperative results in the experimental group and preoperative results in the experimental group, normal control group. The intervertebral height at C4/5 segment was higher immediately, 4 and 8 weeks after surgery than preoperative result in the experimental group (P 0.05).术后4周时,手术组骨尚未与假体边缘接触;8周时骨与假体边缘间隙缩小,假体边缘有少量新生骨附着;12周时,假体表面有少量骨细胞存在,假体内部已有新生骨组织长入.表明金属橡胶角度人工椎间盘植入椎间隙后短期可维持椎间隙高度和活动度,与椎体结合牢固.

  10. 椎体入路经皮内镜髓核摘除术治疗颈椎间盘突出症%Percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    楚磊; 刘超; 陈亮; 柯珍勇; 陈富; 邓忠良

    2016-01-01

    Objective To evaluate the feasiblility and efifcacy of percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical disc herniation.Methods From September 2013 to July 2014, 9 patients suffering cervical disc herniation received anterior transcorporeal approach for cervical disc herniation in the second Afifliated Hospital of Chongqing Medical University including 4 males, 5 females, with the average age of ( 44.5 ± 12.4 ) years ( range 24 - 68 years ). Levels of herniation: C3-4: 1, C4-5: 3, C5-6: 4, C6-7: 1. Percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical disc herniation: Guide wire was inserted between carotid sheath and tracheal esophageal sheath to the vertebra, then working trocar was applied. Burrs was used to make osseous channel in order to achieve access to the target. Herniated fragments and osteophyte were removed, and spinal cord and nerve roots were decompressed through the osseous channel. Operation time, amount of removed disc fragments and operation-related complications were observed and recorded. Clinical results were evaluated with VAS of shoulders and arms at one day before surgery, and postoperatively 1 day, 1 week, 1 month, 3 months 6 months. The follow-up included AP, lateral and dynamic X-ray of cervical spine, cervical CT and MRI.Results The surgeries were successfully performed for all the 9 patients, with an average operation time of ( 81.5 ± 23.4 ) min and an average amount of herniated disc fragments of ( 0.5 ± 0.2 ) g. One patient developed postoperative headache. One patient reported transient postoperative quadriplegia. Vertebral collapse were observed in 2 patients. The VAS was ( 75 ± 10 ) points before surgery, and respectively ( 32 ± 4 ) points, ( 22 ± 3 ) points, ( 19 ± 2 ) points, ( 16 ± 2 ) points and ( 8 ± 2 ) points at postoperatively 1 day, 1 week, 1 month, 3 months and 6 months. The VAS scores in follow-up were different from the one at

  11. Comparison of Modic Changes in the Lumbar and Cervical Spine, in 3167 Patients with and without Spinal Pain

    OpenAIRE

    Sheng-yun, Li; Letu, Suyou; JIAN, CHEN; Mamuti, Maiwulanjiang; Jun-Hui, Liu; Zhi, Shan; Chong-yan, Wang; Shunwu, Fan; Zhao, Fengdong

    2014-01-01

    Background Context There are few comparisons of Modic changes (MCs) in the lumbar and cervical spine. Purpose Compare the prevalence of MCs in the lumbar and cervical spine, and determine how MC prevalence depends on spinal pain, age, disc degeneration, spinal level, and the presence or absence of kyphosis. Study Design Retrospective clinical survey. Materials and Methods Magnetic resonance images (MRIs) were compared from five patient groups: 1. 1223 patients with low-back pain/radiculopathy...

  12. The relationship between pregnancy-associated plasma protein-A (PAPP-A) and human intervertebral disc degeneration

    OpenAIRE

    Gruber, H E; Buchanan, Laura; Ingram, Jane A; Zinchenko, Natalia; Norton, H. James; Hanley Jr, Edward N

    2010-01-01

    Pregnancy-associated plasma protein-A (PAPP-A), a metalloproteinase expressed by a number of cell types, has the important role of cleaving insulin-like growth factor (IGF)-binding protein-2, -4 and -5 in the extracellular matrix and thus freeing up IGF and making it available to cells. The objective of the present study was to utilize immunocytochemical analysis to determine the proportion of PAPP-A-positive cells in a large group of disc specimens which covered the ...

  13. The safety and efficacy of mesenchymal stem cells for prevention or regeneration of intervertebral disc degeneration: a systematic review

    OpenAIRE

    Yim, RLH; Lee, JTY; Vavken, P; Samartzis, D

    2013-01-01

    INTRODUCTION: Mesenchymal stem cells (MSCs) have been used to halt the progression or regenerate the disc with hopes to prevent or treat discogenic back pain. However, the safety and efficacy of the use of MSCs for such treatment in animal and human models at short and long term assessment (i.e. greater than 48 weeks) have not been systematically addressed. This study addressed a systematic review of comparative controlled studies addressing the use of MSCs to that of no treatment/saline for ...

  14. Pure traumatic upper cervical disc herniation causing spinal cord injury: a case report and review of literature

    OpenAIRE

    Sharifi, Guive; Mosavi, Seyed Ali; Shafieezad, Misagh; Asgari Nosari, Massoud

    2012-01-01

    Abstract: One third of all spinal injuries involve cervical vertebrae, and the impact of injury to the cervical spinal cord is profound and requires systemic treatment. The role and timing of surgical decompression after an acute spinal cord injury (SCI) remains one of the most controversial topics pertaining to spinal surgery. Lack of controlled, prospective, multicenter clinical studies has contributed to confusion in optimal treatment methods for patients with injuries of the cervical spin...

  15. Excessive distraction of lumbar disc space induces early degeneration of the adjacent segment after posterior lumbar interbody fusion (PLIF)

    International Nuclear Information System (INIS)

    Posterior lumbar interbody fusion (PLIF) for lumbar spondylolisthesis usually results in an excellent outcome, but the problem of so-called adjacent segment disease (ASD) remains unresolved. ASD at L3/4 was investigated in 85 patients with LA spondylolisthesis treated by L4/5 PLIF with uniform pedicle screws and interbody cages who had been followed up for more than two years (mean, 38.8±17.1 months). The patients were divided into three groups according to the final outcome: a group without ASD (n=58), a group with radiological ASD (n=14), and a group with clinical ASD (n=13). Eleven patients in the third group were reoperated to treat L3/4 lesions. L4-5 disc height distraction by cage insertion in the three groups was 3.1 mm, 4.4 mm, and 6.2 mm, respectively, and the latter two values were significantly higher than the first value. Excessive distraction of the L4/5 disc space proved to be a significant risk factor for radiological and clinical ASD at L3/4. (author)

  16. Management of cervical disc herniation with nonfusion surgical technique%非融合手术治疗颈椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    任先军; 王卫东; 初同伟; 王建; 李长青; 蒋涛; 郝勇; 张年春

    2008-01-01

    Objective To evaluate the clinical restdts of Bryan cervical disc prosthesis in treatment of cervical disc herniation. Methods There were 34 patients with cervical disc herniation.There were 13 females and 21 males at age range of 31-57 years(mean43 years).The herniated disc was located at C3-4 in 2 patients,at C4-5 in 4,at C5-6 in 22,at C6-7 in 1,at C4-5,5-6 in 2,C3.4.5-6 in 2 and C5-6,6-7 in 1.There were 14 patients with myelopathy and 20 with radiculopathy.A total of 39 sets of Bryan cervical disc prosthesis were implanted,with single level disc replaced in 29 patients and bi-level in 5.The Bryan cervical disc prosthesis contained a proprietary,low-friction,wear-resistant,unique polyurethane nucleus and a titanium plate(shells)that included convex porous ingrowth surfaces,to allow bony fixation to the adjacent vertebral endplates.The level of stableness and mobility at the implanting location were observed on dynamic radiograph postoperatively.The nerve function was evaluated by CSM40 score. Results The average follow-up was 14 months(3-42 months),which showed significant improvement in neurological symptoms in.all patients.Radicular pain for patients suffering from raduculopathy was relieved completely.The average CSM40 score was improved by 8.5 points.with efficiency rate of 100%.There was no prosthesis displacement or loosening in all patients,with mean range of motion(ROM)for 9.3 degrees at implant level on the flexion-extension radiographs. ConclusionImplantation of cervical disc prosthesis Can attain deftnite stabilization and satisfactory mobility,significantly improve neurological symptom and hence provides a new effective treatment for cervical disc herniation.%目的 探讨Bryan人工颈椎间盘假体置换治疗颈椎间盘突出症的临床效果.方法 本组34例颈椎间盘突出症患者,其中男21例,女13例;年龄31~57岁,平均43岁.突出部位:C3~4 2例,C4~5 4例,C5~6 22例,C6~7 1例,C4~5,5~6 2例,C3~4,5~6 2例,C5~6,6

  17. Occipitocervical fusion angle and lower cervical spine degeneration in patients with craniocervical junction malformation%枕颈融合角度与颅颈交界区畸形患者下颈椎退变的关系

    Institute of Scientific and Technical Information of China (English)

    王鑫鑫; 王利民; 王卫东; 刘屹林

    2014-01-01

    背景:枕颈融合是颅颈交界区畸形的主要治疗方法。对于非骨质疏松症患者,颈椎的退变主要表现在椎间盘,而椎体的高度基本保持恒定不变,所以可用颈椎间盘高度和与颈椎体高度和的比值(S值)衡量颈椎的退变,S值越小则颈椎退变越严重。  目的:测量颅颈畸形枕颈融合内固定患者的颈椎侧位X射线片,分析融合过程中枕颈固定角度和融合后下颈椎退变的关系,确定最佳枕颈融合角度范围。  方法:纳入因颅颈畸形行枕颈融合患者21例,根据融合后即刻枕颈角度(0c-C2角度),将颅颈畸形枕颈融合患者分为3组,即枕颈角9°-22°组、枕颈角22°组,其中融合后即刻0c-C2角度在9°-22°属于正常范围。测量融合前及融合后终末随访时各组S值及JOA评分,并进行统计学比较。  结果与结论:融合前枕颈角9°-22°组、枕颈角22°组JOA评分分别为(7.3±1.7)分、(7.2±1.6)分、(7.3±1.5)分,融合后随访分别为(14.2±1.5)分、(13.5±1.6)分、(13.3±1.5)分,3组 JOA 评分均有明显改善,枕颈角9°-22°组JOA改善程度明显较枕颈角22°组好。融合前S值枕颈角9°-22°组、枕颈角22°组分别为0.440±0.017,0.441±0.016,0.440±0.018,3组间差异无显著性意义。枕颈角9°-22°组融合后终末随访S值与融合前S值差异无显著性意义,枕颈角22°组融合后终末随访S值均较其融合前S值明显减小。提示枕颈融合内固定时枕颈角应尽量在正常范围内,超过或小于正常范围均会加速下颈椎的退变进程。%BACKGROUND:Occipitocervical fusion is a major method for malformation of craniocervical junction. In patients without osteoporosis, the degeneration of cervical vertebra mainly presents in the intervertebral disk. The height of the vertebral body is constant basical y. Thus, the ratio (S value) of the height of cervical disc and the height of cervical

  18. Herniated Cervical Disc

    Science.gov (United States)

    ... doctor, with the help of a nurse or physical therapist, may also begin education and training on specific ... performed at home or you may visit a physical therapist for a more specific program to meet your ...

  19. 以咽异物感为表现的食管型颈椎病1例%One cases of esophageal cervical spondylosis with pharyngeal foreign body sensation

    Institute of Scientific and Technical Information of China (English)

    齐志勇; 张治平; 呼和牧仁; 鄂建新

    2012-01-01

    The patient was treated as pharyngeal foreign body sensation for six months. Laryngeal endosco-pys one about 1 cmX2 cmX2 cm,hard.smooth bulge in hypopharyngeal wall at the plane of epiglottis valley. The cervical MRI showed that the C3-C4 disc herniation and degeneration of the C3-C4 vertebrae. Cervical CT showed the C3-C4 disc osteophyte formation and forward bulge. After orthopedic consultation, the patient was diagnosed as esophageal cervical spondylosis. C3-C4 diskectomy and vertebral interbody bone grafted with plate fixation were undertaken. At postoperational day 2, the pharyngeal foreign body sensation disappeared.

  20. Percutaneous minimally invasive techniques in the treatment of cervical disc herniation%经皮微创技术治疗颈椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    杨波; 谢景开; 尹飚; 宋磊; 方世兵; 万盛钰; 李健

    2011-01-01

    目的 比较经皮颈椎间盘切除术(percutaneous cervical discectomy,PCD)、经皮颈椎间盘髓核成形术(percutaneous cervical disc nucleoplasty,PCN)与联合使用两种微创技术(percutaneous cervical discectomy and nucleoplasty,PCDN)治疗颈椎间盘突出症的临床疗效及其对颈椎稳定性的影响.方法 回顾性分析2003年2月至2011年4月收治的退变性颈椎间盘突出症患者171例.年龄21~74岁,平均47.8岁.171例患者分为三组:PCD组97例,男53例,女44例;PCN组50例,男29例,女21例;PCDN组24例,男15例,女9例.比较三组的临床效果及颈椎稳定性.结果 所有病例中位随访4.1年:PCD组4.2年,PCN组2.6年,PCDN组3.3年.三组手术均获成功.三组手术临床效果(JOA评分),经手术前后配对t检验示差异均有统计学意义(PCD:t=21.85,P<0.05;PCN:t=14.50,P<0.05;PCDN:t=8.56,P<0.05),即三组均有效;三组间手术临床效果(JOA评分治疗改善率)经单因素方差分析,差异无统计学意义(F=2.19,P=0.12).按照Odom标准评定优良率:PCD组为81.35%,PCN组为82.44%,PCDN组为83.19%.三组手术后均无颈椎不稳病例发生,手术前后颈椎稳定性比较,差异均无统计学意义(P>0.05).结论 应用PCD、PCN以及联合使用这两种微创技术的PCDN治疗颈椎间盘突出症的临床疗效优良,对颈椎稳定性影响小,不会造成颈椎失稳的发生.%Objective To compare the therapeutic effects of percutaneous cervical discectomy (PCD group),percutaneous cervical disc nucleoplasty(PCN) and the association of them (PCDN) for the treatment of cervical intervertebral disk displacement and instability of cervical vertebral column.Methods From February 2003 to April 2011,171 consecutive patients with cervical disc herniation have presented at the authors' hospital and were retrospectively studied.The average age of patients was 47.8 years (ranged,21-74).Ninety-seven cases were treated with PCD,50 cases with PCN,and the other 24 cases with PCDN

  1. Research Progress of Intervertebral Disc Degeneration Treatment Using Mesenchymal Stem Cells and Their Differentiated Cells%间充质干细胞及其分化细胞治疗椎间盘退变的相关研究

    Institute of Scientific and Technical Information of China (English)

    祝福贵

    2013-01-01

    Intervertebral disc degeneration is a disease of the spine caused by various factors, where there is no effective treatment at the moment. Recently, disc degeneration treatment using mesenchymal stem cell and the differentiated cells has been paid more and more attention. Mesenchymal stem cell may cure the degenerated intervertebral disc through increasing extracellular matrix synthesis,which either benefits from its interplay with nucleus pulposus cell and proliferation or differentiated mesenchymal stem cell. Here is to make a review on the status and progress of intervertebral disc degeneration treatment using mesenchymal stem cells and the differentiated cells.%椎间盘退变(IDD)是由诸多因素作用而导致的脊柱疾病,目前尚无高效的治疗方法.然而,间充质干细胞及其分化细胞治疗IDD的研究越来越受到重视.间充质干细胞可能通过与髓核细胞的相互作用及细胞本身增殖使外基质合成增加来修复退变椎间盘,但也可能是通过分化为其他细胞来修复退变椎间盘.现就近年来国内外间充质干细胞及其分化细胞治疗IDD的研究现状及其进展予以综述.

  2. Design and fabrication of 3D-printed anatomically shaped lumbar cage for intervertebral disc (IVD) degeneration treatment.

    Science.gov (United States)

    Serra, T; Capelli, C; Toumpaniari, R; Orriss, I R; Leong, J J H; Dalgarno, K; Kalaskar, D M

    2016-01-01

    Spinal fusion is the gold standard surgical procedure for degenerative spinal conditions when conservative therapies have been unsuccessful in rehabilitation of patients. Novel strategies are required to improve biocompatibility and osseointegration of traditionally used materials for lumbar cages. Furthermore, new design and technologies are needed to bridge the gap due to the shortage of optimal implant sizes to fill the intervertebral disc defect. Within this context, additive manufacturing technology presents an excellent opportunity to fabricate ergonomic shape medical implants. The goal of this study is to design and manufacture a 3D-printed lumbar cage for lumbar interbody fusion. Optimisations of the proposed implant design and its printing parameters were achieved via in silico analysis. The final construct was characterised via scanning electron microscopy, contact angle, x-ray micro computed tomography (μCT), atomic force microscopy, and compressive test. Preliminary in vitro cell culture tests such as morphological assessment and metabolic activities were performed to access biocompatibility of 3D-printed constructs. Results of in silico analysis provided a useful platform to test preliminary cage design and to find an optimal value of filling density for 3D printing process. Surface characterisation confirmed a uniform coating of nHAp with nanoscale topography. Mechanical evaluation showed mechanical properties of final cage design similar to that of trabecular bone. Preliminary cell culture results showed promising results in terms of cell growth and activity confirming biocompatibility of constructs. Thus for the first time, design optimisation based on computational and experimental analysis combined with the 3D-printing technique for intervertebral fusion cage has been reported in a single study. 3D-printing is a promising technique for medical applications and this study paves the way for future development of customised implants in spinal

  3. Discover颈人工椎间盘置换术联合颈椎前路减压融合术治疗颈椎病的临床疗效%The clinic effect of discover cervical artificial disc replacement combined with anterior cervical decompression and fusion in treatment of cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    吴兴林

    2014-01-01

    Objective To explore the clinic effect of discover cervical artificial disc replacement combined with anterior cervical decompression and fusion in treatment of cervical spondylosis. Methods 96 patients were selected from our hospital,and the they were evenly divied into two group by random,experimental group patients were treated with discover cervical artificial disc replacement combined with anterior cervical decompression,the control group patients were treated with anterior cervical decompression and fusion.Compared and analyzed the two groups'cervical spine,the average hospital stay,postoperative cervical fixation time,normal activity recovery time and clinical effect after treatment. Results The experimental group's cervical average activity was (44.6±4.7) degree which was higher than control group,and the difference was significantly(P < 0.05);The experimental group was shorter than control group in average hospital stay,postoperative cervical fixation time,normal activity recovery time,and the difference was significantly(P < 0.05);Experimental group's total effective rate was 97.9% which was higher than the control group(87.5%),and the difference was significantly(P<0.05). Conclusion Discover cervical artificial disc replacement combined with anterior cervical decompression and fusion can reduce the average hospital stay,postoperative cervical fixation time,normal activity recovery time,can ensure the patients's cervical average activity to recover normal,and can improve the clinical effect.%目的:探讨分析Discover颈人工椎间盘置换术联合颈椎前路减压融合术的临床疗效。方法选择我院96例患者,将其随机均分为两组,实验组行Discover颈人工椎间盘置换术联和颈椎前路减压融合术治疗;对照组行颈椎前路减压融合术治疗,比较患者术后颈椎活动度、平均住院时间、术后颈椎固定时间、恢复正常活动时间以及患者临床疗效,并进行统计学分析。

  4. Nucleoplasty as a therapeutic option for lumbar disc degeneration related pain: a retrospective study of 396 cases Nucleoplastia como opção terapêutica para dor relacionada à degeneração do disco lombar: um estudo retrospectivo de 396 casos

    OpenAIRE

    José Lourenço Kallás; Bruno Loyola Godoy; Cesar Fantezia Andraus; Felipe Gonçalves de Carvalho; Maria Emilia Cosenza Andraus

    2013-01-01

    OBJECTIVES: To make a retrospective analysis and evaluate a clinical response to the control of disc degeneration related pain of 396 patients submitted to percutaneous lumbar nucleoplasty; and to make a record of visual analogical scale (VAS) up to a three-year follow-up after the surgical procedure. METHODS: Analysis of VAS score in 396 patients with lumbar disc degeneration related pain, according to anamnesis, clinical examination and magnetic resonance imaging (MRI), without improvement ...

  5. Minimizing cryopreservation-induced loss of disc cell activity for storage of whole intervertebral discs

    OpenAIRE

    SCW Chan; SKL Lam; VYL Leung; Chan, D.; KDK Luk; KMC Cheung

    2010-01-01

    Severe intervertebral disc (IVD) degeneration often requires disc excision and spinal fusion, which leads to loss of spinal segment mobility. Implantation of an allograft disc or tissue engineered disc construct emerges as an alternative to artificial disc replacement for preserving the motion of the degenerated level. Establishment of a bank of cadaveric or engineered cryopreserved discs enables size matching, and facilitates clinical management. However, there is a lack of understanding of ...

  6. Cervical radiculopathy.

    Science.gov (United States)

    Iyer, Sravisht; Kim, Han Jo

    2016-09-01

    Cervical radiculopathy is a common clinical scenario. Patients with radiculopathy typically present with neck pain, arm pain, or both. We review the epidemiology of cervical radiculopathy and discuss the diagnosis of this condition. This includes an overview of the pertinent findings on the patient history and physical examination. We also discuss relevant clinical syndromes that must be considered in the differential diagnosis including peripheral nerve entrapment syndromes and shoulder pathology. The natural history of cervical radiculopathy is reviewed and options for management are discussed. These options include conservative management, non-operative modalities such as physical therapy, steroid injections, and operative intervention. While the exact indications for surgical intervention have not yet been elucidated, we provide an overview of the available literature regarding indications and discuss the timing of intervention. The surgical outcomes of anterior cervical decompression and fusion (ACDF), cervical disc arthroplasty (CDA), and posterior cervical foraminotomy (PCF) are discussed. PMID:27250042

  7. Fatores genéticos e ambientais envolvidos na degeneração do disco intervertebral Genetic and environmental factors involved on intervertebral disc degeneration

    Directory of Open Access Journals (Sweden)

    Francine Teresa Brioni Nunes

    2007-01-01

    Full Text Available A etiologia da degeneração do disco intervertebral (DDI ainda não está totalmente esclarecida. O gene do receptor da vitamina D (VDR tem sido apontado como um dos possíveis envolvidos no surgimento das discopatias. Por outro lado, este estudo relaciona pela primeira vez, a participação dos genes das glutatião transferases M1 e T1 (GSTT1 e GSTM1, responsáveis pela inativação dos componentes do cigarro, na DDI. Foi extraído DNA de leucócitos de 66 pacientes e 88 controles, pareados por gênero e idade. O polimorfismo VDR-FokI foi amplificado por reação em cadeia da polimerase (PCR seguido de restrição com a enzima FokI. Os polimorfismos das GSTT1/M1 foram determinados por meio da PCR multiplex. A história familial e a gravidade da doença se destacaram nos pacientes portadores do alelo f do gene VDR-FokI (P=0,000 e 0,0012, respectivamente. A idade de surgimento da doença mostrou-se precoce nos indivíduos com genótipo _/f (média de 26 anos. Foi encontrada associação do polimorfismo FokI com a degeneração precoce e gravidade da DDI, sendo que o hábito de fumar também interferiu nesse processo, independente da presença ou não do genótipo favorável para GSTT1/M1.The etiology of intervertebral disc degeneration (IDD has not been fully clarified yet. Vitamin D receptor’s gene (VDR has been suggested as one of the potential entities involved in disc pathologies onset. On the other hand, this study correlates, for the first time, glutathione transferases M1 and T1 genes (GSTT1 and GSTM1 participation, which are responsible for cigarette components’ inactivation, in IDD. DNA was extracted from leukocytes of 66 patients and 88 controls, paired by gender and age. The VDR-Fokl polymorphism was amplified by polymerase chain reaction (PCR followed by restriction with Fokl enzyme. GSTT1/M1 polymorphisms were determined by means of PCR multiplex. Family history and disease severity were highlighted in patients carrying the f

  8. Blocking the Function of Inflammatory Cytokines and Mediators by Using IL-10 and TGF-β: A Potential Biological Immunotherapy for Intervertebral Disc Degeneration in a Beagle Model

    Directory of Open Access Journals (Sweden)

    Wei Li

    2014-09-01

    Full Text Available The debilitating effects of lower back pain are a major health issue worldwide. A variety of factors contribute to this, and oftentimes intervertebral disk degeneration (IDD is an underlying cause of this disorder. Inflammation contributes to IDD, and inflammatory cytokines such as tumor necrosis factor (TNF-α and interleukin (IL-1β, play key roles in the pathology of IDD. Therefore, the development of treatments that inhibit the expression and/or effects of TNF-α and IL-1β in IDD patients should be a promising therapeutic approach to consider. This study characterized the potential to suppress inflammatory cytokine production in degenerative intervertebral disc (NP cells by treatment with IL-10 and TGF-β in a canine model of IDD. IDD was induced surgically in six male beagles, and degenerative NP cells were isolated and cultured for in vitro studies on cytokine production. Cultured degenerative NP cells were divided into four experimental treatment groups: untreated control, IL-10-treated, TGF-β-treated, and IL-10- plus TGF-β-treated cells. Cultured normal NP cells served as a control group. TNF-α expression was evaluated by fluorescence activated cell sorting (FACS analysis and enzyme-linked immunosorbent assay (ELISA; moreover, ELISA and real-time PCR were also performed to evaluate the effect of IL-10 and TGF-β on NP cell cytokine expression in vitro. Our results demonstrated that IL-10 and TGF-β treatment suppressed the expression of IL-1β and TNF-α and inhibited the development of inflammatory responses. These data suggest that IL-10 and TGF-β should be evaluated as therapeutic approaches for the treatment of lower back pain mediated by IDD.

  9. 颈椎有限元模型的应用进展%Application progress of finite element model in cervical spine

    Institute of Scientific and Technical Information of China (English)

    周毅强; 张建新; 林蔚莘

    2014-01-01

    有限元分析法(FEA)是一种在生物力学领域广泛应用的研究方法.近年来,颈椎有限元模型已被广泛应用于研究颈椎损伤、颈椎退变及模拟各种颈椎手术,已日趋完善.回顾了颈椎有限元模型的发展,介绍了颈椎有限元建模与分析在颈椎损伤、人工椎间盘置换、椎间植骨融合、颈椎退变及颈椎失稳等方面的应用进展,展望了未来的发展趋势.%Finite element analysis (FEA) is broadly used in biomechanics.Being widely used in clinical studies on cervical spine injury,cervical degeneration and stimulating a variety of cervical spine surgeries,cervical finite element model is becoming more and more accurate in recent years.This paper aims to review the development of cervical finite element model,to introduce the application progress of the modeling and analysis in cervical spine injury,cervical disc arthroplasty,cervical interbody fusion,cervical degeneration and cervical instability,and to prospect the foreground of cervical finite element model in future.

  10. MRI Analysis of Morphological Structure in Protrusion of cervical Disc under Different Directions of Traction%不同牵引方向对颈椎间盘突出症形态结构影响的MRI影像学分析

    Institute of Scientific and Technical Information of China (English)

    刘世文; 宋洪臣; 赵国库

    2001-01-01

    目的:比较不同牵引方向对颈椎间盘突出症(PCD)的颈椎形态结构的影响。方法:借助MRI影像扫描分析不同牵引方向对突出间盘的运动、脊髓受压指数、椎间隙的变化及伴有变性病例的影响。结果:各种牵引方向对间盘突出的作用是不同的,屈曲牵引使间盘部分还纳最为明显;脊髓受压指数在屈伸方向牵引最低;伸展牵引时间盘突出缩小组的后缘椎间隙减小明显;屈曲牵引时间盘缩小组与无变化组的后缘变化差异不大,两种牵引方向对前缘影响均无差异;各种方向牵引伴有变性者的形态变化不明显。结论:PCD改变了正常椎关节的微细形态结构,对常规牵引方向的规律宜灵活运用;脊髓受压指数比间盘突出大小更能反映脊髓受损的实质;牵引对伴有变性者影响可能不大。%Objective The purpose of this study was to compare the functional and morphological changes in the cervical spine with protrusion of cervical disc (PCD) under different directions of traction. Methods MRI scanning was used to study the effect of different directions of traction on the movement of protrusive disc,compression index of spinal cord and changes of intervetebral space,as well as the cases with degeneration. Results Differences were found in the effect of different directions of traction. Most significant partial reduction of the protrusive disc was experienced in flexion traction. Both flexion and extension traction caused significant decrease in the index of compression of spinal cord. Extension traction caused marked narrowing of the posterior intervertebral space in the group with decreased disc size,while no difference between the groups with and without decreased disc size when given flexion traction. There was no difference in the anterior intervertebral space between the two directions of traction. No morphological change was observed in cases with degeneration using

  11. Preliminary clinical outcomes of traumatic cervical herniation by artificial cervical disc replacement%人工椎间盘置换治疗外伤性颈椎椎间盘突出症的初期临床疗效

    Institute of Scientific and Technical Information of China (English)

    欧云生; 刘显宏; 权正学; 唐可; 罗小辑; 蒋电明; 安洪

    2011-01-01

    Objective To observe the preliminary outcomes of traumatic cervical hemiation treated by artificial cervical disc replacement (ACDR). Methods Clinical data of 8 patients with traumatic cervical hemiation undergoing ACDR from April 2007 to February 2011 were studied retrospectively. All the patients were assessed by clinical observation and radiological studies preoperatively, in 3 and 6 months postoperatively, and at the end of follow-up. Clinical outcome was evaluated using Japanese Orthopaedic Association (JOA) score, neck disabiliy index (NDI) criteria, and visual analog scale (VAS). Functional spinal unit range of motion (ROM) was also measured in the reontgenographs at anteroposterior and lateral, bending and extending positions. Results All cases were followed up for 6-36 months (mean 15 months). The JOA, NDI, VAS ( neck pain and arm pain) and cervical unit ROM were all significantly improved after operation ( P <0.05). No neurological or vascular complication was found in these 8 cases. The disc height and stability of cervical vertebra were maintained in the reontgenographs taken at the final follow-up. One case was found having artificial cervical prosthesis antedisplacement 1 mm 42 d after operation, and the distance of antedisplacement was not increased at the final follow-up. There was no subsidence, loosening, excursion, or heterotopic ossification in the other 7 patients. Conclusion As long as indication is correctly chosen, satisfactory outcomes will be achieved for traumatic cervical hemiation by ACDR.%目的 观察人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)治疗外伤性颈椎椎间盘突出症的初期临床疗效.方法 对8例行ACDR的外伤性颈椎椎间盘突出症患者的临床资料进行随访分析.临床疗效评价包括术前、术后3个月、术后6个月及末次随访时的日本骨科学会(Japanese Orthopaedic Association,JOA)评分、颈椎功能障碍指数( neck disabiliy index,NDI)评分

  12. 人颈椎椎体终板软骨细胞退变模型的建立及其意义%Establishment and significance of an in vitro model of degeneration of human cervical endplate chondrocytes

    Institute of Scientific and Technical Information of China (English)

    徐宏光; 彭红心; 程加峰; 吕坤

    2011-01-01

    .The morphological appearances,growth curve and biological characteristics of endplate chondrocytes from normal and degenerative cartilage endplate were observed by inverted phase contrast microscope,HE staining,MTT,teluidine blue staining and reverse transcription-polymerase chain reaction (RT-PCR)respectively.RT-PCR was used to detect the mRNA expression of aggrecan,type Ⅱ collagen and type Ⅰcollagen.Results The endplate chondrocytes expressed aggrecan,type Ⅱ collagen and type Ⅰ collagen.The phenotypes and biological characteristics were similar to those of articular chondrocytes.The morphological appearance of primary endplate chondrocytes in the control group were mostly polygons,nucelus with round or ellipse,sometimes nuclei,vacuolus in intracytoplasm,expressing a high proliferating rate.The cells of the experiment group were fusiform and their proliferating rates decreased.Compared with the control group,the mRNA expression of aggrecan ( 0.695 ± 0.052 vs 0.950 ± 0.032,t =7.263,P =0.002) and type Ⅱ collagen (0.726 ± 0.035,0.907 ± 0.078,t =3.681,P =0.021 ) markedly decreased.And the mRNA expression of type Ⅰ collagen (0.795 ±0.028 vs 0.552 ±0.070,t =-5.560,P =0.005 )increased in the experiment group.Conclusion A degenerative cell model of human cervical endplate chondrocytes has been established successfully in vitro.It may offer the cytological rationales for exploring the mechanism of intervertebral disc degeneration.And the previous restrictions of studying only the model of animal cells shall be resolved.

  13. Adjacent segment disease after anterior cervical decompression and fusion: analysis of risk factors on X-ray and magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Zhao Yanbin; Sun Yu; Zhou Feifei; Wang Shaobo; Zhang Fengshan; Pan Shengfa

    2014-01-01

    Background Adjacent segment disease (ASD) is common after cervical fusion.The aim of this study was to evaluate the risk factors for ASD on X-ray and magnetic resonance imaging (MRI).Methods Patients included in this study had received revision surgeries after developing symptomatic ASD following anterior decompression and fusion.A control group that had not developed ASD was matched 1:1 by follow-up time and fusion segments.Plate-to-disc distances (PDDs),developmental cervical canal stenosis on X-ray,cervical disc degeneration grading,and cervical disc bulge impingements on preoperative MRI were measured and compared between the ASD group and the control group.Results Thirty-four patients with complete radiographic data were included in the ASD group.The causative segments of ASD included nine cases of C3-4,18 cases of C4-5,three cases of C5-6,and four cases of C6-7.The ASD occurred at the upper adjacent segments in 26 patients and at the lower adjacent segments in eight patients.PDD distributions were similar between the ASD group and the control group.Developmental cervical canal stenosis was a risk factor for ASD,with an odd ratio value of 2.88.Preoperative cervical disc degenerations on MRI were similar between the ASD group and the control group.In the upper-level ASD group,the disc bulge impingement was (19.7±9.7)%,which was significantly higher than that of the control group of (11.8±4.8)%.Conclusions ASD was more likely to develop above the index level of fusion.Developmental cervical canal stenosis and greater disc bulge impingement may be risk factors for the development of ASD.

  14. Yoga and disc degenerative disease in cervical and lumbar spine: an MR imaging-based case control study

    OpenAIRE

    Jeng, Chin-Ming; Cheng, Tzu-Chieh; Kung, Ching-Huei; Hsu, Hue-Chen

    2010-01-01

    The objective of the current study was to find out whether yoga practice was beneficial to the spine by comparing degenerative disc disease in the spines of long-time yoga practitioners and non-yoga practicing controls, using an objective measurement tool, magnetic resonance imaging. This matched case–control study comprised 18 yoga instructors with teaching experience of more than 10 years and 18 non-yoga practicing asymptomatic individuals randomly selected from a health checkup database. A...

  15. Clinical outcome of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis: A midterm follow-up%Bryan人工颈椎间盘置换治疗颈椎病的中期临床随访

    Institute of Scientific and Technical Information of China (English)

    丁琛; 孔清泉; 刘浩; 胡韬; 石锐; 李涛; 洪瑛; 宋跃明; 刘立岷; 曾建成

    2011-01-01

    BACKGROUND: Although the short-term clinical efficacy of Bryan artificial cervical disc replacement is generally acknowledged by most spinal surgeons, the midterm and long term clinical results and complications are still unclear.OBJECTIVE: To summarize midterm term clinical results of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis.METHOD: From November 2004 to December 2007, 34 patients had Bryan cervical disc replacement in Department of Orthopedics, West China Hospital were selected, including 30 cases with single replacement and 4 cases with bi-level replacement. Clinical result was evaluated by SF-36 score, JOA score, and neck/arm pain VAS scores. And the data was collected before surgery and at 7 days, 3, 6, 12, 24, 36 and 48 months after surgery. Neutral lateral and dynamic cervical radiographs were made to measure the flexion-extension range of motion (ROM) of operative segment, adjacent segments and C2-7 segment, the intervertebral height of operative and adjacent segments, and the translation of operative level. The intraoperative and postoperative complications were recorded and analyzed.RESULTS AND CONCLUSION: The neurological symptoms of each patient were alleviated notably. The postoperative SF-36physical component score and SF-36 mental component score, JOA score, NDI score and neck/arm pain VAS scores were significantly improved compared with those of the preoperative (P < 0.05), but no statistical significance were noted between each time point after 3-month follow-up (P > 0.05). Each implanted prosthesis preserved the ROM>2° at each follow-up time point,and no heterotopic ossification or spontaneous fusion was found at the operative segment. At 48-month follow-up,flexion-extension ROM of operative segment and C2-7 segment slightly increased but showed no statistical significance compared with the preoperative counterparts (P > 0.05); ROM of upper and lower adjacent segments also showed no statistical

  16. INFLUENCE OF INTRAOPERATIVE CERVICAL POSTURE IN SINGLE SEGMENTAL CERVICAL DISC REPLACEMENT ON RESTORATION OF CERVICAL CURVE IN NEUTRAL POSITION%单节段颈椎间盘置换术中颈椎体位对术后颈椎中立位生理轴线重建的影响

    Institute of Scientific and Technical Information of China (English)

    洪瑛; 邓宇骁; 刘浩; 龚仁蓉; 安晶晶; 龚全; 李涛; 宋跃明

    2013-01-01

    目的 探讨颈椎间盘置换术(cervical disc replacement,CDR)术中体位与术后早期颈椎中立位生理轴线重建的相关性. 方法 回顾性分析2008年1月-2010年8月51例采用PRESTIGE LP椎间盘假体行单节段CDR患者的临床资料,术中患者取仰卧位,颈枕置于颈后部维持颈椎前弓.男28例,女23例;年龄30~64岁,平均45岁.其中脊髓型颈椎病32例,神经根型颈椎病7例,混合型颈椎病12例.病程3~48个月,平均15个月.手术节段:C4、55例,C5、6 42例,C6、74例.收集患者术前、术中及术后3个月颈椎中立位、侧位X线片,分别测量颈椎整体序列(C2~7)、目标脊柱功能单位(functional spinal unit,FSU)及目标椎间隙的Cobb角.计算术中与术前的角度差(差值)及术后早期(3个月)与术前的角度差(改善值),对不同平面Cobb角差值和改善值进行线性相关及线性回归分析. 结果 与术前相比,术中及术后3个月时颈椎Cobb角均显著增大(P< 0.05).其中颈椎整体序列、目标FSU及目标椎间隙的Cobb角差值分别为(6.72±9.13)、(2.10±5.12)、(3.33±3.75)°;术后3个月Cobb角的改善值分别为(6.30±7.28)、(3.99±5.37)、(4.29±5.36)°.目标FSU的Cobb角改善值与目标椎间隙Cobb角改善值比较差异无统计学意义(t=-0.391,P=0.698),与颈椎整体序列Cobb角改善值比较差异有统计学意义(t=-2.623,P=0.012);目标椎间隙角度改善与整体序列角度改善比较差异无统计学意义(t=-1.917,P=0.061).颈椎整体序列、目标FSU、目标椎间隙的术中颈椎Cobb角差值与术后早期颈椎Cobb角改善值3对变量之间均存在线性相关及线性回归关系(P<0.05). 结论 CDR术中颈椎位置保持在较术前中立位轻度后伸的位置是术后早期颈椎维持正常生理前凸的一个重要因素.%Objective To study the correlation between the cervical posture in the cervical disc replacement (CDR) and the cervical curve restoration in neutral position

  17. Bryan cervical disc replacement,a five-year follow-up results%Bryan颈椎人工椎间盘置换术后5年随访结果

    Institute of Scientific and Technical Information of China (English)

    孙宇; 赵衍斌; 周非非; 张凤山; 潘胜发; 刘忠军

    2012-01-01

    Objective:To investigate the five years' follow-up outcomes of cervical arthroplasty with Bryan disc prosthesis.Method: 70 patients have reached a postoperative period of 5 years since admission of this approach into our hospital in December 2003.57 patients obtained 57-69 months'(average,60 months) follow-up.There were 47 single-level, 9 two-level and 1 three-level arthroplasties.The surgical levels included C3/4(5 cases) ,C4/5 (10 cases) ,C5/6(45 cases) and C6/7(8 cases).The clinical evaluation included mJ0A,VAS and NDI score at pre-operation and final follow-up,Odom's grading criteria at final follow-up.Radiographic evaluation included flexion/extension lateral view at operation level and heterotopic ossification around the prosthesis according to McAfee classification on lateral view X-ray.The adjacent segment degeneration was noted according to Miyazaki classification on MRI T2 weighted images.The invasion ratio of disc protrusion to the spinal canal at adjacent levels was recorded on mid-sagittal MRI T2 weighted images.Result: (1 )The mJOA score was 13.4+1.9 of baseline and 16.1±1.1 at final follow-up.The improvement rate was 75.0%.The VAS for arm pain was 3.3±1.9 of baseline and 0.9±1.2 at final follow-up;the VAS for neck pain was 3.0±1.5 of baseline and 1.6±1.4 at final follow-up; the NDI score was 14.8±8.6 of baseline and 5.7±4.2 at final follow-up. All above-mentioned results showed statistical significance (P0.05).The heterotopic ossification around the prosthesis was noted in 12 of 30(40%) segments,and 3(10%) segments lost movement at final follow-up.(3)25 patients gained MRI follow-up.7 of 50(14%) adjacent segments had nonsymptomatic disc degeneration to one grade.The invasion ratio of disc protrusion to the spinal canal at adjacent level increased 0.3%-0.5% every year.Conclusion:Cervical arthroplasty with Bryan disc prosthesis provides a favorable clinical and radiological outcome at an average of five years' follow-up. The motion of operated

  18. Peripheral Disc Margin Shape and Internal Disc Derangement: Imaging Correlation in Significantly Painful Discs Identified at Provocation Lumbar Discography

    OpenAIRE

    Bartynski, W.S.; Rothfus, W.E.

    2012-01-01

    Annular margin shape is used to characterize lumbar disc abnormality on CT/MR imaging studies. Abnormal discs also have internal derangement including annular degeneration and radial defects. The purpose of this study was to evaluate potential correlation between disc-margin shape and annular internal derangement on post-discogram CT in significantly painful discs encountered at provocation lumbar discography (PLD).

  19. A game of two discs: a case of non-contiguous and occult cervical spine injury in a rugby player

    OpenAIRE

    O'Sullivan, Michael D.; Piggot, Robert; Jaddan, Mutaz; McCabe, John P.

    2016-01-01

    The aim of this case report was to highlight the application of magnetic resonance imaging (MRI) in elucidating serious and occult injuries in a single case of hyperflextion injury of a patient cervical spine (C-Spine). A chart and radiology review was performed to establish the sequence of care and how the results of imaging studies influenced the clinical management in this trauma case. Plain radiographs and computed tomography (CT) imaging modalities of the C-Spine revealed bilateral C4/C5...

  20. Risk Factors for the Development of Adjacent Segment Disease Following Anterior Cervical Arthrodesis

    Directory of Open Access Journals (Sweden)

    Ezgi Akar

    2015-06-01

    Full Text Available Aim: The aim of this study was to clinically and radiologically evaluate the efficacy of anterior cervical discectomy and fusion (ACDF in the treatment of adjacent level degeneration. Methods: We retrospectively evaluated 89 patients (55 females, 34 males who underwent ACDF. Adjacent segment degeneration findings were evaluated by investigating new osteophyte formation, growth of existing osteophytes, ossification of the anterior longitudinal ligament, presence of intervertebral disc space narrowing, sagittal alignment and range of motion (ROM using serial radiographs and magnetic resonance imaging. Results: The mean age of the 89 patients was 41.3 (24-76 years. The mean follow-up duration was 34.3 (12-64 months. Radiographic evidence of adjacent segment degeneration was observed in 12 patients (13.4%. Nine (75% patients had new complaints. Of the patients who had degenerative changes, 7 were (58% were male, 5 (42% were female; the mean age was 46 (30- 62 years. It was observed that the level of fusion and the number of fusion did not increase the adjacent segment degeneration. All of 12 patients were observed to have a non lordotic cervical spine and increased ROM. Conclusion: Development of degeneration at the level adjacent to region anterior cervical discectomy and fusion performed is higher compared to non-adjacent levels. The level of fusion and the number of fusion levels have no effect on the development of degeneration. (The Medical Bulletin of Haseki 2015; 53:120-3

  1. Cervical motion segment replacement

    OpenAIRE

    Bryan, Vincent E.

    2002-01-01

    When symptoms bring to light a cervical spine degenerative disc process that requires surgical intervention, a symptom relieving procedure such as decompression, followed by functional restoration, arthroplasty, offers the benefit of prophylaxis of accelerated spondylosis at the operated level. In addition, by altering the biomechanical stress factors at adjacent levels, theoretically it should offer prophylactic benefit at these levels as well. The design requirements for a cervical disc pro...

  2. The anterior operation for cervical ossification of posterior longitudinal ligament combined with adjacent disc herniation%前路手术治疗合并邻近椎间盘突出的颈椎后纵韧带骨化症

    Institute of Scientific and Technical Information of China (English)

    任斌; 蔡林; 陈志龙; 王建平; 胡超; 张桃根

    2012-01-01

    Objective To investigate the efficacy and the selection of surgery time of anterior operation for cervical ossification of posterior longitudinal ligament combined with cervical disc herniation. Methods Totally 24 cases of cervical ossification of posterior longitudinal ligament combined with cervical disc herniation underwent anterior operation in our department from January 2005 to January 2011. There were 21 males and 3 females. The mean age was 52 years old (range; 40-68 years). Preoperatively, 2-3 ossified segments of the posterior longitudinal ligament combined with contiguous cervical herniated disc compressing the spinal cord were revealed through cervical X-ray film, CT and MRI examinations. All patients were treated with the anterior cervical subtotal corpectomy combined with the discectomy of contiguous cervical herniated disc by the cage fusion surgery of internal fixation for reconstruction. The preoperative and postoperative Japanese Orthopaedic Association (JOA) scores were analyzed and compared, and the improvement rate was also calculated. Results All patients were followed up for an average period of 22 months (range; 8-36 months). The mean JOA score of neurological function was preoperatively 7.5 points (range; 4-13 points). The mean JOA score was postoperatively 13.6 points (range; 10-16 points). The mean improvement rate of neurological function was 65.6% (range; 32%-81%). The efficacy of 7 cases was excellent, 12 cases good, 5 cases fair and none bad. The excellence rate was 79.1%. Conclusions Cervical ossification of posterior longitudinal ligament often combines with contiguous cervical herniated disc resulting in spinal cord injury. To avoid the sharp deterioration of spinal cord function, early surgical intervention should be taken. The anterior cervical subtotal corpectomy combined with the discectomy of contiguous cervical herniated disc by the cage fusion surgery of internal fixation for reconstruction in the treatment of cervical

  3. Simulation of cervical disc replacement with computer assistant three-dimensional reconstruction%三维重建仿真模拟手术辅助颈椎间盘置换

    Institute of Scientific and Technical Information of China (English)

    方国芳; 雷高; 罗德民; 宋志会; 薛厚军; 敖俊; 林荔军

    2011-01-01

    BACKGROUND: The cervical disc replacement requires standard operational procedure to reduce complications such as prosthetic subsidence, ectopic ossification or prosthetic dislocation. Individuated three-dimensional (3-D) reconstruction of cervical disc replacement can simulate structures of cervical disc, which is benefit for precise operation.OBJECTIVE: To study the method of computer assistant simulating the cervical disc replacement and clinic application.METHODS: A 42 years old male with C4-5 disc protrusion was selected. 64-row CT scan was performed before replacement,which was reconstructed using 3-D geometry. The interspace between 4/5, size of Cs upper endplate, and C4 low endplate was calculated. The interspace was enlarged and a prosthesis with appreciate size was choose. The cervical disc replacement was simulated by scanCAD software and the prosthetic size was modified, and then the procedure performed in operation.RESULTS AND CONCLUSION : It could reduce placement times effectively by simulating cervical disc replacement operation and design prosthetic sizes, which was convenient for operation and obtained good clinical curative effects. 3-D reconstruction simulating operation can measure the size of end plate and interspace of inter vertebra accuracy. The data were reliable and the operation could harvest satisfactory results.%背景:人工颈椎间盘置换要求具有规范的操作程序,这样才能减少置入假体下沉、异位骨化、假体脱位等并发症.个体化的颈椎三维模型重建模型能够模拟自身颈椎间盘的真实结构,有利于人工颈椎间盘置换过程的精准操作.目的:分析颈椎间盘置换手术模拟的方法及临床应用.方法:选择42岁男性患者资料,颈椎间突出症(C4/5)脊髓型,颈椎间盘置换前行颈椎64排CT平扫,进行三维几何重建,测量C4/5间盘间隙,C5上终板,C4下终板尺寸,并适当撑开椎间隙,选择合适的假体尺寸,在scanCAD软件中模拟手术,

  4. MRI findings in the diagnosis of the end-plate osteochondritis with lumbar disc degeneration in 114 patients%114例腰椎间盘退变伴终板骨软骨炎的MRI诊断分析

    Institute of Scientific and Technical Information of China (English)

    陈小余; 宋学文; 肖红

    2011-01-01

    Objective To investigate MRI findings and chinical significance of lumbar disc degeneration with endplate osteo chondritis.Methods MRI features of 114 cases from endplate osteochondritis in lumbar disc degeneration were retrospectively an alyzed.Results 234 endplate osteochondritis were diagnosed in 114 cases of lumbar disc degeneration.And they were classified in to 3 types according to Modic classification,in which 82 cases(35%) were Modic type Ⅰ ,136 cases(58.1% ) were Modic type Ⅱ ,and 16 cases( 6.8% ) were Modic type Ⅲ .There are 72 cases( 63.2% ) from single endplate osteochondritis and 42 cases(36.8% ) from multiple endplate osteochondritis.The lesions were usually found in the lower lumbar spine.Conclusion End-plate osteochondritis was one of the main reasons causing low back pain.And MRI is the best way to detect the lesion and reflect its pathological foundation.%目的 探讨腰椎间盘退变伴终板骨软骨炎的磁共振成像(MRI)表现及临床意义.方法 回顾性分析经临床及影像学确诊114例腰椎间盘退变伴终板骨软骨炎的MRI表现.结果 114例病例中共累及终板234个,按Modic分型其中Ⅰ型82个(35%);Ⅱ型136个(58.1%);Ⅲ型16个(6.8%);单发累及72例(63.2%),多发累及42例(36.8%);病变好发于下腰段.结论 腰椎间盘退变伴终板骨软骨炎是造成临床上腰痛的重要原因之一,MRI是该病的有效检查方法,能够反映该病的临床特点.

  5. Treatment of Cervical Intervertebral Disc Herniation by Radio Frequency Target Combined with Collagenase%射频靶点结合胶原酶治疗颈椎间盘突出症研究

    Institute of Scientific and Technical Information of China (English)

    肖林; 王娴默; 黄亮; 徐澄; 张忠贵; 陈爱萍

    2013-01-01

    Objective To observe the treatment effect of radio frequency target combined with collagenase in treatment of cervical intervertebral disc herniation. Methods From March 2011 to September 2011, 40 patients with cervical intervertebral disc herniation were divided into 2 groups: Group A and Group B. Patients in Group A were given radio frequency target radiofrequency for treatment of the cervical intervertebral disc herniation and patients in Group B of 20 were given radio frequency target combined with collagenase for treatment of cervical intervertebral disc herniation. Results 40 patients were followed up for 6 months. At the 1st week and 6 months after surgery, the VAS score difference between before and after surgery in patients were compared between two groups by t test. There was no statistically significant difference at the 1st week after surgery between two groups (P>0.05), while 6 months after surgery, there was statistically significant difference between two groups (P<0.05) .Conclusion Radio frequency target combined with collagenase for treatment of cervical intervertebral disc herniation can alleviate the pain symptoms of patients,and the short-term and long-term curative effect is very good. The long-term curative effect has statistically significant difference with pure target radiofrequency ablation treatment. Radio frequency target combined with collagenase for treatment of cervical intervertebral disc herniation has good safety, few side effects, low risks and good short-term and long-term curative effect, so it deserves to be generalized.%目的观察颈椎间盘靶点射频消融术结合胶原酶治疗的疗效.方法将2011年3~9月收治的40例颈椎间盘突出患者分2组,A组20例使用颈椎间盘靶点射频消融治疗,B组20例行颈椎间盘靶点射频消融术结合胶原酶治疗颈椎间盘突出症.结果40例患者术后1周,6个月后使用VAS评分对比术前VAS评分差值行t检验.术后1周2组对比差

  6. Anterior surgery for the treatment of acute single segment 30 cases of cervical disc%前路手术治疗急性单节段颈椎间盘突出30例

    Institute of Scientific and Technical Information of China (English)

    吴成如; 张诗虎

    2013-01-01

    目的 研究探讨前路颈椎间盘切除+椎间融合器+钛板内固定治疗急性颈椎间盘突出症的效果.方法 采用前路手术对我科2008-03-2011-03收治的30例急性颈椎间盘突出症患者进行治疗,所有患者均获得平均15个月的随访,根据术后摄片及JOA评分判断疗效.结果 在随访过程中,所有患者均未出现临床并发症,术后摄片显示均获得骨性融合,依据JOA评分标准:优(改善率大于75%)20例,良(改善率50~75%)8例,好转(改善率25~50%)2例.结论 该方法治疗急性颈椎间盘突出症可达到充分减压、重建颈椎生理曲度、恢复椎间隙高度、椎体间高融合率、颈椎牢固固定的作用.而且该术式操作简单,手术时间短、出血少、并发症少,是治疗急性颈椎间盘突出一种可靠方法.%Objective research and discuss the effect of the treatment of acute cervical disc herniation by using anterior cervical discectomy, Intervertebral fusion and Internal fixation with titanium plate. Methods 30 cases of patients with acute cervical disc herniation in our department in March 2008-March 2011 were treated by using anterior surgery,all patients received an average of 15 months of follow-up visit,then judge the curative effect according to postoperative radiography and JOA scores. Results In the process of follow-up, all patients did not show clinical complications, postoperative radiography showed bony fusion,according to JOA scoring criteria, optimal (improvement rate more than 75%) 20 cases, fine (improvement rate 50%~75%) 8 cases,improved (improvement rate 25%-50%) 2 cases. Conclusion the treatment of acute cervical disc herniation can achieve full decompression, reconstruction of cervical physiological curvature, restore interverte-bral disc height,high fusion rate between the vertebral bodies, cervical vertebra firmly fixed. And the operation is simple,short operation time,less bleeding,fewer complications,so the treatment of acute

  7. Síndrome de Brown-Séquard por hérnia discal cervical a duplo nível: caso clínico e revisão da literatura Síndrome de Brown-Séquard por hernia discal cervical en nivel doble: caso clínico y revisión de la literatura Brown-Séquard syndrome by double level cervical disc herniation: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jorge Miguel Silva Ribeiro Olliveira Alves

    2012-09-01

    paciente con síndrome de Brown-Séquard por hernia de disco cervical.This article presents a case in which Brown-Séquard syndrome resulted from a double level cervical disc herniation. A 40-year-old man without previous history of cervical pathology, presented with insidious right arm and leg paresis associated with associated with decreased pain and thermal sensitivity in the left hemibody after diving which caused indirect trauma of the cervical spine. Magnetic resonance imaging of the cervical spine showed double level disc herniation in C4-C5 and C5-6 with compression of the right half of spinal cord and hyperintensity in T2-weighted images. After a complete decompression of neural structures, a double level interbody fusion was performed. There was partial recovery of neurological status after a long period of physical therapy. Early surgical intervention and prompt rehabilitation are paramount to achieve neurological recovery in patients with Brown-Séquard syndrome resulting from a cervical disc herniation.

  8. A meta-analysis of clinical effects of Bryan cervical disc replacement versus anterior cervical discectomy and fusion%Bryan颈椎间盘置换与颈前路间盘切除植骨融合疗效的系统分析

    Institute of Scientific and Technical Information of China (English)

    李德毅; 张旭; 刘川; 吴继生

    2013-01-01

    BACKGROUND:Bryan cervical disc replacement and anterior cervical discectomy and fusion have a dispute in the treatment of cervical spondylosis. OBJECTIVE:To evaluate the clinical effects of Bryan cervical disc replacement and anterior cervical discectomy and fusion by meta-analysis, thereby providing clinical evidence for treatment strategy of cervical spondylosis. METHODS:The authors searched Medline, PubMed, EMBASE, OVID, CBM, CNKI and also searched manual y seven relevant Chinese orthopedic journals for articles pertinent to clinical research of Bryan cervical disc replacement and anterior cervical discectomy and fusion. Extracted data included the range of motion of the cervical spine, visual analog scale score, neck disability index, the Japanese Orthopaedic Association score. Meta-analysis and forest plots were conducted with RevMan4.2.2 Software. RESULTS AND CONCLUSION:There are eight articles in the meta-analysis, including 883 patients (430 patients receiving Bryan cervical disc replacement, and 453 patients receiving anterior cervical discectomy and fusion). Meta-analysis did detect statistical y significant differences in the range of motion of the cervical spine at 3 months and 24 months postoperatively between the two groups, but did not detect statistical y significant differences in visual analog scale score, neck disability index, the Japanese Orthopaedic Association score between the two groups. These findings indicate that Bryan cervical disc replacement is superior to anterior cervical discectomy and fusion in the range of motion of the cervical spine. However, the current literature offers no evidence to support superiority of the Bryan cervical disc replacement over the anterior cervical discectomy and fusion.%背景:Bryan颈椎间盘置换与颈前路间盘切除植骨融合治疗颈椎病的临床疗效存在争议。  目的:应用 Meta 分析方法,评价 Bryan 颈椎间盘置换与颈前路间盘切除植骨融合治疗颈椎病

  9. MC+PEEK融合器在颈椎间盘突出症手术中的临床应用%Clinical application of MC+PEEK cage in cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    江兵; 刘立明; 曹燕庆; 潘宏; 金卫国; 章小军; 陶岳峰; 刘镇

    2012-01-01

    Objective To evaluate the clinical results of surgical treatment for cervical disc herniation with stand-alone MC+ PEEK cage without anterior cervical plating. Methods All of 44 patients with cervical disc herniation were reconstructed after discectomy with the cage filled with autogenous cancellous illic-bone graft. Recovery of nerve function was observed by JOA score and every patient was followed up by X-ray. Results All patients were followed up for an average time of 26 months (from 6 to 40 months). The average time of bone graft fusion was 4.5 months. No dislocation or dislodging of the cage was seen by X-ray every 3 days and 3,6,12,18,24,36 months, and the heights of intervertebral spaces were restored. The complications of internal fixation were not found. The average JOA was 10.20 before operation and 16.30 after operation. Conclusion Using this new cage, cervical disc herniation can be safely treated without the need of anterior cervical plating, and the surgery is minimally invasive and can exclude complications of internal fixation.%目的 评价一种单独使用无前方钢板的MC+PEEK融合器在颈椎间盘突出症前路手术中应用的临床效果.方法 对颈椎间盘突出症44例采用椎间盘摘除,应用该融合器内植自体髂骨行椎间融合术,以术后X线片和JOA评分评价疗效.结果 本组获随访6~40个月,平均26个月,植骨融合时间平均4.5个月,术后3d和3、6、12、18、24、36个月复查X线片未见融合器松动和移位,病变椎间隙高度恢复正常,未出现相关内固定并发症,JOA评分由术前平均10.20分恢复到术后平均16.30分.结论 采用此融合器无需使用前方钢板,手术创伤小,避免了内固定相关并发症的发生,是治疗颈椎间盘突出症的一种理想方法.

  10. Anterior cervical discectomy and fusion for noncontiguous cervical spondylotic myelopathy

    Directory of Open Access Journals (Sweden)

    Sun Qizhi

    2016-01-01

    Full Text Available Background: Noncontiguous cervical spondylotic myelopathy (CSM is a special degenerative disease because of the intermediate normal level or levels between supra and infraabnormal levels. Some controversy exists over the optimal procedure for two noncontiguous levels of CSM. The study was to evaluate the outcomes of the anterior cervical discectomy and fusion (ACDF with zero-profile devices for two noncontiguous levels of CSM. Materials and Methods: 17 consecutive patients with two noncontiguous levels of CSM operated between December 2009 and August 2012 were included in the study. There were 12 men and 5 women with a mean age of 60.7 years (range 45-75 years. Involved disc levels were C3/4 and C5/6 in 11 patients and C4/5 and C6/7 in six patients. Preoperative plain radiographs, computed tomography (CT with 3-D reconstruction and magnetic resonance imaging (MRI of the cervical spine were taken in all patients. All radiographs were independently evaluated by 2 spine surgeons and 1 radiologist. The outcomes were assessed by the average operative time, blood loss, Japanese Orthopedic Association (JOA score, improvement rate, neck dysfunction index (NDI, swallowing quality of life (SWAL-QOL score, the cervical lordosis and complications. Results: The mean followup was 48.59 months (range 24-56 months. The average operative time and blood loss was 105.29 min and 136.47 ml, respectively. The preoperative JOA score was 8.35, which significantly increased to 13.7 at the final followup ( P 0.05. Cerebrospinal fluid leak, dysphagia and radiological adjacent segment degeneration occurred in one patient, respectively. Conclusion: The ACDF with zero-profile devices is generally effective and safe in treating two noncontiguous levels of CSM.

  11. Parametric T2 and T2* mapping techniques to visualize intervertebral disc degeneration in patients with low back pain: initial results on the clinical use of 3.0 Tesla MRI

    International Nuclear Information System (INIS)

    To assess, compare and correlate quantitative T2 and T2* relaxation time measurements of intervertebral discs (IVDs) in patients suffering from low back pain, with respect to the IVD degeneration as assessed by the morphological Pfirrmann Score. Special focus was on the spatial variation of T2 and T2* between the annulus fibrosus (AF) and the nucleus pulposus (NP). Thirty patients (mean age: 38.1 ± 9.1 years; 20 female, 10 male) suffering from low back pain were included. Morphological (sagittal T1-FSE, sagittal and axial T2-FSE) and biochemical (sagittal T2- and T2* mapping) MRI was performed at 3 Tesla covering IVDs L1-L2 to L5-S1. All IVDs were morphologically classified using the Pfirrmann score. Region-of-interest (ROI) analysis was performed on midsagittal T2 and T2* maps at five ROIs from anterior to posterior to obtain information on spatial variation between the AF and the NP. Statistical analysis-of-variance and Pearson correlation was performed. The spatial variation as an increase in T2 and T2* values from the AF to the NP was highest at Pfirmann grade I and declined at higher Pfirmann grades II-IV (p < 0.05). With increased IVD degeneration, T2 and T2* revealed a clear differences in the NP, whereas T2* was additionally able to depict changes in the posterior AF. Correlation between T2 and T2* showed a medium Pearson's correlation (0.210 to 0.356 [p < 0.001]). The clear differentiation of IVD degeneration and the possible quantification by means of T2 and fast T2* mapping may provide a new tool for follow-up therapy protocols in patients with low back pain. (orig.)

  12. Parametric T2 and T2* mapping techniques to visualize intervertebral disc degeneration in patients with low back pain: initial results on the clinical use of 3.0 Tesla MRI

    Energy Technology Data Exchange (ETDEWEB)

    Welsch, Goetz Hannes [Medical University of Vienna, MR Center - High Field MR, Department of Radiology, Vienna (Austria); University of Erlangen, Department of Trauma Surgery, Erlangen (Germany); Trattnig, Siegfried; Goed, Sabine; Stelzeneder, David [Medical University of Vienna, MR Center - High Field MR, Department of Radiology, Vienna (Austria); Paternostro-Sluga, Tatjana [Medical University of Vienna, Department of Physical Therapy, Vienna (Austria); Bohndorf, Klaus [Klinikum Augsburg, Department of Radiology, Augsburg (Germany); Mamisch, Tallal Charles [Medical University of Vienna, MR Center - High Field MR, Department of Radiology, Vienna (Austria); University of Berne, Department of Orthopedic Surgery, Berne (Switzerland)

    2011-05-15

    To assess, compare and correlate quantitative T2 and T2* relaxation time measurements of intervertebral discs (IVDs) in patients suffering from low back pain, with respect to the IVD degeneration as assessed by the morphological Pfirrmann Score. Special focus was on the spatial variation of T2 and T2* between the annulus fibrosus (AF) and the nucleus pulposus (NP). Thirty patients (mean age: 38.1 {+-} 9.1 years; 20 female, 10 male) suffering from low back pain were included. Morphological (sagittal T1-FSE, sagittal and axial T2-FSE) and biochemical (sagittal T2- and T2* mapping) MRI was performed at 3 Tesla covering IVDs L1-L2 to L5-S1. All IVDs were morphologically classified using the Pfirrmann score. Region-of-interest (ROI) analysis was performed on midsagittal T2 and T2* maps at five ROIs from anterior to posterior to obtain information on spatial variation between the AF and the NP. Statistical analysis-of-variance and Pearson correlation was performed. The spatial variation as an increase in T2 and T2* values from the AF to the NP was highest at Pfirmann grade I and declined at higher Pfirmann grades II-IV (p < 0.05). With increased IVD degeneration, T2 and T2* revealed a clear differences in the NP, whereas T2* was additionally able to depict changes in the posterior AF. Correlation between T2 and T2* showed a medium Pearson's correlation (0.210 to 0.356 [p < 0.001]). The clear differentiation of IVD degeneration and the possible quantification by means of T2 and fast T2* mapping may provide a new tool for follow-up therapy protocols in patients with low back pain. (orig.)

  13. Spontaneous regression of an intraspinal disc cyst

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P.; Eerens, I.; Wilms, G. [University Hospital, Leuven (Belgium). Dept. of Radiology; Goffin, J. [Dept. of Neurosurgery, University Hospitals, Leuven (Belgium)

    2001-11-01

    We present a patient with a so-called disc cyst. Its location in the ventrolateral epidural space and its communication with the herniated disc are clearly shown. The disc cyst developed rapidly and regressed spontaneously. This observation, which has not been reported until now, appears to support focal degeneration with cyst formation as the pathogenesis. (orig.)

  14. Failure of cervical arthroplasty in a patient with adjacent segment disease associated with Klippel-Feil syndrome

    Directory of Open Access Journals (Sweden)

    Ioannis D Papanastassiou

    2011-01-01

    Full Text Available Cervical arthroplasty may be justified in patients with Klippel-Feil syndrome (KFS in order to preserve cervical motion. The aim of this paper is to report an arthroplasty failure in a patient with KFS. A 36-year-old woman with KFS underwent two-level arthroplasty for adjacent segment disc degeneration. Anterior migration of the cranial prosthesis was encountered 5 months postoperatively and was successfully revised with anterior cervical fusion. Cervical arthroplasty in an extensively stiff and fused neck is challenging and may lead to catastrophic failure. Although motion preservation is desirable in KFS, the special biomechanical features may hinder arthroplasty. Fusion or hybrid constructs may represent more reasonable options, especially when multiple fused segments are present.

  15. 前路减压植骨融合内固定术治疗颈椎间盘突出症的疗效分析%Analysis of anterior cervical decompression and autograft fusion combined with internal fixation in the treatment of cervical disc protrusion

    Institute of Scientific and Technical Information of China (English)

    杨朝晖; 吴险峰; 邹磊

    2013-01-01

    Objective To explore the clinical outcome of treatment of the anterior cervical discertomy and fusion with rigid plate fixation for cervical disc herniation. Methods Twenty five patients with cervical disc herniation had been treated by multilevel anterior cervical discectomy and fusion with rigid plate fixation from Oct 2008 to Oct 2011. Results All patients had been followed - up for 8 to 24 months ( I I months in average ). Bone union was achieved in all patients. All cases were scored after operation to assess the curative effect. There were 15 cases that belonged to the excellent, 8 to the good, 2 to the fair and 0 to the poor based on the Jndet criteria. The good and excellence rate was 92% in patients. Conclusion The treatment of traumatic cervical disc protrusion with anterior cervical decompression and bone autograft fusion combined with internal fixation has satisfactory clinical effect with fewer complications.%目的 探讨前路减压植骨融合钢板内固定治疗颈椎间盘突出症的疗效.方法 对收治的25例颈椎椎间盘突出症患者行颈椎前路减压,取自体髂骨植骨融合内固定治疗.结果 本组患者均获得随访,随访时间8~24个月,平均11个月.植骨均达到骨性愈合,无骨不连发生.25例患者神经功能获得改善,根据JOA神经功能评定标准,优15例,良8例,可2例,差0例,优良率92%.结论 颈椎前路减压、椎间盘切除、植骨融合钢板内固定是治疗颈椎间盘突出症的一种有效方法.

  16. Curative effect evaluation and complication analysis of Bryan artificial cervical disc replacement%Bryan人工颈椎间盘置换术后疗效评价及并发症分析

    Institute of Scientific and Technical Information of China (English)

    蓝旭; 许建中; 刘雪梅; 葛宝丰

    2013-01-01

    To observe the curative effects and complications nf Bryan cervical disc replacement for cervical disc herniation. Methods:From Jannary 2005 to December 2008,39 patients with cervical disc herniation were treated with Bryan cervical disc replacement. There were 20 males and 19 females,with an average age of 47 years old (ranged ,35 to 59). Spinal compression symptom (20 cases) and nerve root symptom (19 eases) were main clinical symptoms. Single level disc was replaced in 35 cases and two-level replaced in 4 cases. Offset and activity of prosthesis, cervical physiological curvature, heterotopic ossification, prosthetic fusion were observed by dynamic X-ray. According to Odom's standard and JOA score, nerve function were evaluated;and depending on NDI standard,clinical symptom and daily function status were recorded. Results: All the patients were followed up from 16 to 36 months with an average of 24 months. Nerve function obviously improved and radiating pain of upper limb completely relieved. No patient with prosthetic anterior-posterior offset more than 2 mm was found. Prosthetic flexion and extention angle was(8.5±1.8)°,left and right flexion range respectively were (3.5±1.2)° and (3.3±1.5)°. Cervical physiological curvature improved obviously or recovered normally. Three cases occurred in heterotopic ossification and 2 cases occurred in prosthetic fusion. According to Odom's standard,25 cases got an excellent results,9 good,5 fair,the rate of excellent and good was 87.2%. JOA score increased from preoperative(8.26±1.32) to (15.71±1.89) at final follow-up and NDI decreased from preoperative (43.7±3.8) to (20.1±2.9) at final follow-up. Conclusion: Treatment of cervical disc herniation with Bryan cervical disc replacement can get the good curative effects,which can obtain good nerve functional recovery,cervical stability and activity. Nevertheless, the operation has typical complication such as heterotopic ossification and prosthetic fusion. Thus.it is

  17. 腰椎间盘退变中椎体终板骨软骨炎的低场MRI表现%Low field MRI findings of vertebral end-plate osteochondritis in lumbar disc degeneration

    Institute of Scientific and Technical Information of China (English)

    许思祥

    2011-01-01

    目的 探讨腰椎间盘退变中椎体终板骨软骨炎的磁共振成像(MRI)表现及其临床意义.方法 搜集2008年3月~2009年3月间经临床及影像学诊断的腰椎椎体终板骨软骨炎115例,累及235处腰椎终板,全部病例均有不同程度的临床症状.回顾性分析终板及邻近椎体骨质信号改变.结果 115例椎体终板骨软骨炎患者中,有235处终板信号异常,按Modic分型,其中Ⅰ型改变有91处(占38.7%);Ⅱ型改变有120处(占51.1%),Ⅲ型改变有24处(占10.2%).伴随改变:合并椎间盘膨出23处,突出97处,脱出6处,Schmorls结节68处,椎体滑脱7处,压缩性骨折4处.结论 终板骨软骨炎是造成临床局部疼痛的原因之一,低场MRI能清楚显示腰椎间盘退变中椎体终板炎各期的信号特点,对病灶的显示满意,是检查本病的最佳方法.%Aim To explore the magnetic resonance imaging ( MRI ) performance and clinical significance of vertebral end-plate osteochondritis in lumbar disc degeneration. Methods 115 cases of vertebral end-plate osteochondritis were collected by the clinical and imaging diagnosis from Mar. 2008 to Mar. 2009 ,involving 235 lumbar end-plates. All patients had various degrees of clinical symptoms. The signal change of vertebral end-plate and adjacent bones was analyzed. Results In 115 cases of vertebral end-plate osteochondritis , there were 235 end-plates signal abnormalities. According to Modic categorization, there were 91 cases( 38. 7% ) of Modic type Ⅰ .120 cases (51. 1% ) Modic type Ⅱ and 24 cases( 10. 2% ) Modic type Ⅲ. Accompanied changes were merge disc bulges 23 cases, disc herniations 97 cases , disc extrusions 6 cases , Schmorls nodules 68 cases , vertebral spondylolisthesis 7 cases , and compression fractures 4 cases. Conclusion The end-plate osteochondritis is one of the reasons to cause the clinical local pain. Low field MRI can clearly showed the signal characteristics of end-plate osteochondritis phases in

  18. Artroplastia total de disco cervical com prótese de Bryan: resultados clínicos e funcionais Artroplastía cervical total con prótesis de Bryan: resultados clínicos y funcionales Cervical total disc arthroplasty with Bryan disc: clinical and functional outcomes

    OpenAIRE

    Eduardo Machado de Menezes; Rafael Ozório Rocha; Aline Aparecida Depiante Moreira; Deusdeth Gomes Nascimento; Antonio Eulálio Pedrosa Araujo; Luiz Carlos Santeli Maia

    2012-01-01

    OBJETIVO: Avaliar resultados da artroplastia total disco cervical com a prótese de Bryan para tratamento da cervicobraquialgia (radiculopatia) e da mielopatia compressiva. MÉTODOS: No período de 2002 a 2007, a equipe da CECOL operou 65 pacientes. Somente 28 pacientes foram localizados em 2010 para uma nova coleta de dados. Foi feita avaliação pré e pós-operatória, utilizando-se o questionário CSOQ (Cervical Spine Outcomes Questionnaire). Os critérios de Odom foram utilizados somente na avalia...

  19. Cerebellar Degeneration

    Science.gov (United States)

    ... and olivopontocerebellar degeneration, progressive degenerative disorders in which cerebellar degeneration is a key feature Friedreich’s ataxia, and other spinocerebellar ataxias, which are caused by ...

  20. A minimally invasive in-fiber Bragg grating sensor for intervertebral disc pressure measurements

    International Nuclear Information System (INIS)

    We present an in-fiber Bragg grating (FBG) based intervertebral disc (IVD) pressure sensor that has pressure sensitivity seven times greater than that of a bare fiber, and a major diameter and sensing area of only 400 µm and 0.03 mm2, respectively. This is the only optical, the smallest and the most mechanically compliant disc pressure sensor reported in the literature. This is also an improvement over other FBG pressure sensors that achieve increased sensitivity through mechanical amplification schemes, usually resulting in major diameters and sensing lengths of many millimeters. Sensor sensitivity is predicted using numerical models, and the predicted sensitivity is verified through experimental calibrations. The sensor is validated by conducting IVD pressure measurements in porcine discs and comparing the FBG measurements to those obtained using the current standard sensor for IVD pressure. The predicted sensitivity of the FBG sensor matched with that measured experimentally. IVD pressure measurements showed excellent repeatability and agreement with those obtained from the standard sensor. Unlike the current larger sensors, the FBG sensor could be used in discs with small disc height (i.e. cervical or degenerated discs). Therefore, there is potential to conduct new measurements that could lead to new understanding of the biomechanics

  1. Comparison between Two Minimally Invasive Approaches for Contained Cervical Disc Herniation%2种微创方法治疗包容型颈椎间盘突出症的比较

    Institute of Scientific and Technical Information of China (English)

    莫世奋; 李健; 曾勉东; 黄海; 吕玉明; 杨波

    2012-01-01

    Objective To compare the efficacy of percutaneous cervical discectomy (PCD) and percutaneous coblation nucleoplasty (PCNP) for contained cervical disc herniation, and their complications and influence on the stability of the cervical vertebrae. Methods From January 2006 to June 2010, 94 patients with contained cervical herniation were admitted to our hospital, of whom 53 patients received PCD, the other 41 underwent PCNP. The efficacy, complications, and postoperative stability of the cervical vertebrae of the two procedures were compared. Results The mean follow-up time of the PCD group was 13 months (ranged from 5 to 21 months) and that of the PCNP group was 11 months (ranged from 7 to 15 months). The excellent and good rate at one week, six months and one year postoperation were 83.0% and 80.5% (x2 =0.010, P =0.944) , 81. 1% and 78.0% (x2 = 0. 136, P =0.712) , and 78.4% and 74. 4% (x2 = 0. 205, P=0.651) respectively in the PCD and PCNP groups, by modified MacNab criterion. During the follow-up, 3 patients (5. 7% ) in the PCD group and 2 patients (4. 9% ) in the PCNP group were converted to anterior cervical discectomy and fusion ( ACDF) because of recurrent disc herniation. No patients had discitis or abscess formation after the surgery. The preoperative, and 1-week, half-year, and 1-year postoperative intervertebral height (IVH) were (7.14±0.84) mm, (7.12±0.93) mm, (7.09±0.78) mm, and (7.11±0.82) mm in the PCD group, respectively, which were not significantly different from those of the PCNP group [ (7.32 ±0.95) mm, (7.23 ±0.87) mm, (7.21 ±0.81) mm, and (7.22 ± 0.91) mm, P>0.05]. No signs suggested unstable cervical vertebrae after the surgery. Conclusions Both PCD and PCNP can relieve the symptoms of contained cervical disc herniation quickly with a low rate of compilation and little change of IVH postoperation, without influencing cervical stability. They are safe and effective approaches for percutaneous disc decompression.%目的 比较经皮

  2. Cervical facet dislocation adjacent to the fused motion segment

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2016-01-01

    Full Text Available This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B. Cervical computed tomography (CT indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D. In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation.

  3. Cervical facet dislocation adjacent to the fused motion segment.

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kuroiwa, Toshihiko

    2016-01-01

    This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation. PMID:26933361

  4. Cervical facet dislocation adjacent to the fused motion segment

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kuroiwa, Toshihiko

    2016-01-01

    This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation. PMID:26933361

  5. Acupuncture with Throat Fascia Dilatation Treatment for Cervical Intervertebral Disc Herniation:Clinical Observation of 30 Cases%针刺配合颈前筋膜扩张术治疗颈椎间盘突出症30例

    Institute of Scientific and Technical Information of China (English)

    孙飞; 赵树华

    2013-01-01

    Objective: To observe the curative effect of throat fascia dilatation treatment on cervical intervertebral disc herniation. Methods;90 patients with cervical intervertebral disc hemiation were randomly divided into neck expanding group (30 cases), acupuncture group (30 cases) , acupuncture plus neck expanding group (30 cases) , use the throat fascia dilatation, conventional acupuncture therapy, conventional acupuncture plus throat fascia dilatation, to observe the analgesic effect to time, curative effect to maintain time, brachial plexus pull test, comprehensive evaluation of curative effect. Results: Analgesic effect of the acupuncture plus neck expanding group needed less time to exert function compared with other two groups, curative effect held longer time than other two groups, analgesic effect, comprehensive evaluation of curative effect were better than the other two groups, and there was a significant difference( P < 0.01). Conclusion: Curative effect of acupuncture with throat fascia dilatation treatment on cervical intervertebral disc herniation is better than the simple acupuncture and throat fascia dilatation treatment.%目的:观察针刺配合颈前筋膜扩张术治疗颈椎间盘突出症的临床疗效.方法:将90例颈椎间盘突出症患者随机分为颈扩组(30例)、针刺组(30例)、联合组(30例),分别采用颈前筋膜扩张术、常规针刺治疗、常规针刺加颈前筋膜扩张术,观察各疗法的镇痛起效时间、疗效维持时间、臂丛牵拉试验,评价综合疗效.结果:联合组镇痛起效时间短于其他两组,疗效维持时间长于其他两组,镇痛效果、综合疗效评价均优于其他两组,差异均有显著统计学意义(P<0.01).结论:针刺配合颈前筋膜扩张术治疗颈椎间盘突出症临床疗效优于单纯针刺及颈前筋膜扩张术治疗.

  6. Unilateral Cervical Disc Protrusion Treated by Combination Method of Traction Rotation Finger- vibration and Abdominal Acupuncture%牵旋指振法结合腹针治疗单侧型颈椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    王渊; 牛文民

    2012-01-01

    目的:观察牵旋指振法结合腹针治疗单侧型颈椎间盘突出症的治疗效果.方法:将121名单侧型颈椎间盘突出症患者随机分为牵旋指振法结合腹针治疗组61例,常规推拿结合机械牵引针刺组对照组60例,分别于治疗2个疗程后,观察其疗效.结果:治疗组治愈率和总有效率分别为47.54%和91.80%,对照组治愈率和总有效率分别为31.66%和71.67%,两组比较差异有极其显著意义(P<0.01).结论:牵旋指振法结合腹针治疗单侧型颈椎间盘突出症疗效显著.%Objective: To observe the curative effect of unilateral cervical disc protrusion treated by the combination method of traction,rotation,finger- vibration and abdominal acupuncture. Methods-. 121 patients of unilateral cervical disc protrusion were divided into two groups at random,treatment group(including 61 patients treated by the combination method of traction,rotation, finger - vibration and abdominal acupuncture) and control group ( including 60 patients treated by the combination method of normal tuina therapy,mechanical traction and acupuncture). After two courses of treatment,we observed their curative effect. Results-. The curative ratio and total efficient ratio of treatment group respectively were 47. 54% and 91. 80% ,for control group were 31. 66% and 71.67%. There was remarkably significant difference between the two groups (P < 0. 01). Conclusion: There is prominent curative effect of unilateral cervical disc protrusion treated by the combination method of traction, rotation, finger - vibration and abdominal acupuncture.

  7. Clinical observation experience of radio frequency target ozone ablation treatment on cervical disc herniation%射频靶点臭氧消融术治疗颈椎间盘突出症临床观察体会

    Institute of Scientific and Technical Information of China (English)

    李靖; 吴成富; 余四海

    2014-01-01

    目的:探讨颈椎间盘突出症采取射频热凝靶点消融术联合臭氧进行治疗的细节及临床疗效。方法:2007年5月-2013年5月收治颈椎间盘突出症患者210例,回顾性分析经射频热凝靶点消融术复合臭氧的临床情况。患者在C臂机引导下,经颈前行颈椎间隙穿刺至靶点,感觉运动测试后,采用神经射频仪对靶点加热热凝,在70℃、80℃、86℃、90℃连续治疗4个周期,每周期60 s,最高温度点300 s。每个椎间盘给予45~50μg/mL 臭氧3 mL,对疗效、并发症进行观察分析。结果:本组经1年随访,优180例,良13例,可13例,差4例,优良率91.9%,术后吞咽疼痛30例,血肿2例,无脊髓损伤及椎间隙感染等并发症。结论:C臂引导下经颈前路穿刺射频热凝靶点热凝联合臭氧注射治疗颈椎间盘突出症是有效、安全的微创治疗,具有操作简单、效果好、并发症少等优点。%Objective:To explore the details and clinical curative effect of radio frequency thermosetting target ablation combined with ozone in the treatment of cervical disc herniation.Methods:210 patients with cervical disc herniation were selected from May 2007 to May 2013.The clinical circumstance of radio frequency thermosetting target ablation combined with ozone was retrospectively analyzed.Patients were guided under the C arm machine with cervical vertebra puncture to target through anterior portion,after sensorimotor tests,using nerve radiofrequency device on targets heating thermal coagulation,continuous treatment for 4 cycles at 70 ℃,80 ℃,86 ℃,90 ℃,60 s per cycle,and the highest temperature point was 300 s.Each disc was given 45 to 50 μg/mL ozone 3 mL.The effects and complications were observed and analyzed.Results:The group after 1 year of follow-up,180 cases were excellent;13 cases were good;13 cases were ok;4 cases were poor;the excellent and good rate was 91.9%.30 cases were swallowing pain

  8. Lumbar Degenerative Disc Disease: Current and Future Concepts of Diagnosis and Management

    OpenAIRE

    Fadi Taher; David Essig; Lebl, Darren R.; Hughes, Alexander P.; Sama, Andrew A.; Cammisa, Frank P.; Girardi, Federico P.

    2012-01-01

    Low back pain as a result of degenerative disc disease imparts a large socioeconomic impact on the health care system. Traditional concepts for treatment of lumbar disc degeneration have aimed at symptomatic relief by limiting motion in the lumbar spine, but novel treatment strategies involving stem cells, growth factors, and gene therapy have the theoretical potential to prevent, slow, or even reverse disc degeneration. Understanding the pathophysiological basis of disc degeneration is essen...

  9. 人工间盘置换治疗颈椎病近期疗效及并发症分析%Analysis of Recent Curative Effects and Complications on Artiifcial Disc Replacement in the Treatment of Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    夏伊明; 仇立春; 韩学明; 赵疆; 吴鹏; 李威

    2014-01-01

    目的::评估15例Bryan人工颈椎间盘置换术治疗颈椎病的近期疗效,分析容易出现的并发症。方法:2011年1月至2013年10月,我院和镇江康复医疗集团医院、自治区中医院共同完成15例单节段Bryan人工颈椎间盘置换术,其中男6例,女9例;年龄33~57岁,平均45.2岁。脊髓型颈椎病7例,神经根型颈椎病6例,混合型2例。结果:全部病例随访6~18个月,平均随访13.2月。脊髓型颈椎病患者术前JOA评分为(8.5±1.0)分,末次随访时为(15.5±1.0)分,与术前比较有显著性差异(P<0.01)。颈痛视觉评分(VAS)、颈肩障碍疼痛指数(NDI)与术前相比均具有统计学意义(P<0.05)。神经根型颈椎病患者的症状完全消失。所有病例未见假体下沉、移位以及症状加重者。1例患者术后14个月随访时发现假体周围有异位骨化形成,2例术后置换节段出现颈椎曲度反曲后凸,随访后无明显改善。结论:Bryan人工颈椎间盘置换术治疗颈椎间盘疾患可取得良好的临床疗效,由于其手术操作较为复杂,并发症发生率较多,应重视手术适应证的选择和规范的手术操作。%[ABSTRACT]Objective: Appraised 15 examples Bryan artificial neck intervertebral disc replaces the short-term curative effect which the technique treatment cervical vertebra gets sick, the complication which the analysis often appears. Methods: From January,2011 to October, 2013,my courtyard and Zhenjiang Recovery Medical service Group Hospital,the autonomous region Chinese medicine hospital together completes 15 example single stage Bryan artificial neck intervertebral disc to replace the technique, in which male 6 examples, female 9 examples;Age 33~57 year old, average 45.2 years old.The spinal cord cervical vertebra gets sick 7 examples,the nerve root cervical vertebra gets sick 6 examples, the mixed 2 examples. Results:All patients were followed up for 6~18 months

  10. 儿童颈椎间盘钙化伴髓核疝(附八例报告)%Calcification of Intervertebral Discs in Cervical Spine With Herniation of Nucleus Pulposus in Children

    Institute of Scientific and Technical Information of China (English)

    王舒; 吴秀芬; 朱葆伦; 周坤祥

    1991-01-01

    儿童椎间盘钙化是一种具有较明确的临床症状及X线表现的综合征.病程经过良好,钙化可自然吸收.钙化可见于脊柱任何水平,但好发于颈部.作者报道8例儿童颈椎间盘钙化,6例伴有髓核前疝.结合文献报道,对本病的症状、X线表现等进行讨论.%Eight cases with calcification of intervertebral discs in cervical spine are reported.Among them,six had anterior herniation of the nucleus pulposus.Symptoms disappeared within one to four weeks after cervical traction.The calcification was gradually absorbed,but the adjacent vertebral alterations were still in existence on X-ray film one year later.The etiology,clinical.manifestations and X-ray findings are briefly discussed.

  11. Adrenoleukodystrophy manifesting as spinocerebellar degeneration

    Directory of Open Access Journals (Sweden)

    Mishra Sanjay

    2006-01-01

    Full Text Available X-linked adrenoleukodystrophy (XALD is an inherited disorder of peroxisomal metabolism. Atypical presentations have been occasionally reported in literature. However, extrapyramidal and cerebellar manifestations are distinctly rare. We report a patient of X-linked adrenoleukodystrophy with cranial and cervical dystonia and neurological presentation resembling spinocerebellar degeneration followed by a brief review of relevant literature.

  12. 人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病%Artificial Disc Replacement Combined with Anterior Cervical Decompression and Autograft Bone Fusion for the Treatment of Multi-segment Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    廖维峰; 肖晟; 黄象望; 刘向阳; 张毅; 向铁城

    2014-01-01

    [目的]探讨人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病的临床疗效。[方法]湖南省人民医院2008年2月至2012年6月收治的12例多节段颈椎病手术病例,均行人工椎间盘置换加颈前路椎体次全切减压植骨融合术,随访时间为12~18个月,平均随访15.5个月,均摄术前、术后及末次随访时的颈椎正侧位及颈椎过伸过屈位X线片及磁共振检查,观察植骨融合、内固定及人工椎间盘的情况,以JO A评分评价神经功能改善情况。[结果]所有病例内置物无松动、移位,植骨融合时间在3~6个月,平均4.9个月。置换间隙活动度术后1年时为12.5°±5.0°,与术前(12.3°±4.9°)比较无统计学差异(P>0.05)。术前JOA 评分平均为9.3分,术后6个月时平均为16.1分,平均改善率为91.2%。[结论]人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病近期疗效满意,是治疗多节段颈椎病的一种可行方法。%[Objective]To explore the clinical efficacy of cervical artificial disc replacement combined with anterior cervical decompression and autograft bone fusion for the treatment of multi -segment cervical spon-dylosis .[Methods]Twelve patients with multi- segment cervical spondylosis operated in Hunan provincial people's hospital from Feb .2008 to June 2012 underwent cervical artificial disc replacement combined with an-terior cervical decompression and autograft bone fusion .The follow up time was 12~18 months(average 15 .5 months) .Cervical MRI and X-ray films of cervical normal lateral position ,hyperextension and hyperflexion position were performed before and after operation and at the last time of follow up .Bone fusion ,internal fixa-tion and artificial disc were observed .JOA score was used to evaluate the improvement of neurological func-tion .[Results]No loosening and displacement of

  13. Influence of degenerative changes of intervertebral disc

    OpenAIRE

    Wang, Yi; Chen, Hai-Bin; Zhang, Ling; ZHANG Li-ying; Liu, Jing-cheng; WANG Zheng-guo

    2012-01-01

    【Abstract】Objective: To investigate the material properties of normal and degenerated intervertebral discs (IVDs) and examine the effect of degenerative changes on IVD pathology. Methods: A computer-based online search was under-taken to identify English articles about material properties of IVDs published from January 1950 to 2011 in PubMed database. The retrieved keywords included material properties, intervertebral disc and degeneration. Based on the principle...

  14. Subendplate microcirculation disturbance directly contributes to intervertebral disc degeneration%椎体终板下微循环障碍直接导致椎间盘退变的实验研究

    Institute of Scientific and Technical Information of China (English)

    郑召民; 吕游; 陈辉; 刘辉; 张奎渤; 李佛保

    2008-01-01

    Objective To build subendplate microcirculation disturbance animal model and to investigate the potential pathogenesis of intervertebral disc degeneration(IVDD).Methods Twenty four New Zealand white rabbits were divided into treatment group(Group A)and control group(Group B).In Group A,animals received endotoxin and corticosteroid application to build subendplate microcirculation disturbance animal model,validated by microthrombus staining.In Group B,animals were given no drug,but standard feeding.After 3 month,the extent of IVDD was evaluated by the water content,biochemistry analysis,and morphology.Results Subendplate microthrombus staining confirmed the exist of microcirculation disturbance.The water content and biochemistry components content of disc in Group A were lower than those of disc in Group B.and IVDD was observed in morphology.Conclusion Subendplate microcirculation disturbance can directly contribute to IVDD,the nutrients diffusion barrier is the potential pathogenesis of IVDD.%目的 通过建立椎体终板下微循环障碍动物模型,探讨椎间盘退变发病的可能机制.方法 将24只新西兰白兔随机分为实验组和对照组,实验组采用联合应用内毒素与激素的方法制备典型椎体终板下微循环障碍模型,并通过终板微血栓染色证实;对照组为阴性空白对照,不给予任何药物干扰,仅标准饲料喂养.3个月后分析实验组和对照组动物椎间盘的水含量、生化成分含量和组织形态学,从而评估椎间盘的退变程度.结果 终板微血栓染色证实实验组成功构建椎体终板下微循环障碍模型,3个月后实验组动物椎间盘水含量、生物化学成分含量均低于对照组,椎间盘切片染色可见椎间盘退变的表现.结论 椎体终板下微循环障碍可直接导致椎间盘退变,椎间盘营养供给障碍是椎间盘退变的发病机制之一.

  15. Requirements for an artificial intervertebral disc

    NARCIS (Netherlands)

    Eijkelkamp, MF; van Donkelaar, CC; Veldhuizen, AG; van Horn, [No Value; Huyghe, JM; Verkerke, GJ

    2001-01-01

    Intervertebral disc degeneration is an important social and economic problem. Presently available artificial intervertebral discs (AIDs) are insufficient and the main surgical intervention is still spinal fusion. The objective of the present study is to present a list of requirements for the develop

  16. Clinical report in treating cervical disc herniation by nucleoplasty of percutaneous radiofrequency abrasion%多靶点射频消融术治疗颈椎间盘突出症临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    卫秀洋; 陈勇忠; 周清碧; 王金星; 陈庆泉

    2013-01-01

    目的 探讨射频消融髓核成形术治疗颈椎间盘突出症的临床疗效.方法 回顾2009 年10月~2010年10月福州总医院476医院应用经皮穿刺多靶点射频消融髓核成形术治疗颈椎间盘突出症168 例.按Macnab 疗效评定标准和视觉模拟评分法(VAS),对比患者手术前后及随访时进行疗效评定.结果 按Macnab 疗效评分标准,术后即刻优76例,良64例,可22例,差6例,优良率为83.33%.本组术前VAS评分为(6.76±0.52)分,术后即刻为(2.15±0.58)分,术后3个月为(2.68±0.56)分,术后1年为(2.95±0.63)分,术后即刻、术后3个月、术后1年评分与术前比较差异有高度统计学意义(P < 0.01).结论 射频消融髓核成形术治疗颈椎病具有操作简单、安全微创、并发症少、起效快及近、中期疗效满意等特点,是治疗轻度颈椎间盘突出症较好的方法.%Objective To observe therapeutic effect of radiofrequency ablation nucleoplasty on cervical disc herniation. Methods From October 2009 to October 2010, 168 patient with cervical disc herniation were analyzed NO.476 Hospital of PLA, who were treated by percutaneous multi-target radiofrequency ablation nucleoplasty treatment. Therapeutic effects were evaluated before and after surgery, 3 month and 12 month by using the average scores of VAS and Mac-nab evaluation standard. Results All cases were followed-up from immediate postoperative to 12 months after operation. According to Macnab efficacy score, the immediate postoperative period were excellent in 76 cases, good in 64 cases, maybe 22 cases and poor in 6 cases, the total good rate of 83.33%. The preoperative VAS score was (6.76±0.52) scores, immediately after was (2.15 ±0.58) scores, 3 months after surgery was (2.68 ±0.56) scores, after an annual was (2.95±0.63) scores. There were significant difference between preoperative surgery and intraoperative immediately after surgery, 3 months after surgery, 1 year after surgery (P < 0

  17. Magnetic resonance imaging of cervical myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Chosa, Hirofumi; Yamano, Kouichirou; Ihara, Fumitoshi; Ueda, Yoshiaki; Maekawa, Masayuki; Tokuhisa, Ginichirou; Kuwano, Tadashi; Kamo, Yoshi; Nomura, Shigeharu (Kyushu Rosai Hospital, Fukuoka (Japan))

    1990-03-01

    Forty-three patients operated for cervical myelopathy were examined with a 1.5 T magnetic resonance imaging. Cord compression was demonstrated directly on the sagittal image in cases of cervical disc herniation, cervical spondylosis and O.P. L.L. Herniated disc material was seen positive on axial image. But factors of cord compression in cases of cervical spondylosis and O.P. L.L. were not clearly confirmed, so additional examinations such as myelogram, tomogram and CT was needed. (author).

  18. The delayed post-injury administration of soluble fas receptor attenuates post-traumatic neural degeneration and enhances functional recovery after traumatic cervical spinal cord injury.

    Science.gov (United States)

    Robins-Steele, Sherri; Nguyen, Dung Hoang; Fehlings, Michael G

    2012-05-20

    Spinal cord injury (SCI) is a devastating condition that currently lacks clinically-relevant and effective neuroprotective therapeutic options. Optimal therapeutic agents for clinical translation should show efficacy in a cervical compression/contusion model using a clinically-relevant post-injury therapeutic time window. To date, few compounds have met that rigorous standard. The objective of this work was to evaluate the efficacy of delayed post-injury administration of soluble Fas receptor (sFasR) via intrathecal catheter following acute cervical SCI in a clinically-relevant contusion/compression model. Female Wistar rats were given a C7-T1 moderately severe clip compression injury, followed by either 8-h or 24-h delayed treatment initiation. Long-term neurobehavioral analysis of motor recovery and neuropathic pain development was undertaken. The extent of oligodendrocyte and neuron survival was assessed in peri-lesional cord sections 8 weeks post-SCI. This was complemented by an evaluation of the level of tissue preservation at and adjacent to the site of injury. In animals treated with sFasR delayed 8 h post-injury, significant behavioral effects were observed, coinciding with enhanced cell survival, peri-lesional tissue sparing, and enhanced integrity of descending fiber tracts compared to control treatments. Animals treated with sFasR delayed by 24 h showed more modest improvements in behavioral recovery, and had consistent improvements in cell survival and tissue preservation. This work has shown for the first time that the Fas-mediated apoptotic pathway can be therapeutically targeted in a clinically-relevant time window post-SCI. PMID:22260324

  19. Preliminary results of Activ C artificial disc replacement for cervical spondylosis%Activ C人工椎间盘置换术治疗颈椎病的早期疗效

    Institute of Scientific and Technical Information of China (English)

    赵耀; 刘屹林; 王利民; 谭洪宇; 王卫东; 廖文胜; 鲍恒

    2012-01-01

    目的:观察Activ C人工椎间盘置换术治疗颈椎病的早期临床疗效,分析其临床应用价值.方法:2009年11月~2011年3月在我院接受Activ C人工椎间盘置换术并获得随访的颈椎病患者共43例(45个节段),平均年龄48.3岁,其中男18例,女25例,脊髓型颈椎病22例,神经根型颈椎病16例,混合型颈椎病5例;单节段置换41例(C3/4 2例,C4/5 17例,C5/6 21例,C6/7 1例),双节段置换2例(C4/5和C5/6 1例,C5/6和C6/7 1例).采用日本骨科协会JOA评分、颈椎活动障碍指数(NDI)和疼痛视觉模拟评分(VAS)评价术后症状改善程度,比较手术前后的颈椎曲度、手术节段及邻近上下节段活动度变化,观察统计手术并发症情况.结果:术后随访8~24个月,平均13.8个月.患者的JOA评分、NDI、颈部VAS评分、上肢VAS评分分别由术前的8.2±0.7、35.3±4.7、6.8±1.1和6.5±1.2分显著改善至末次随访时的14.7±0.4、16.2±3.4、1.3±0.8和1.8±0.9分(P均<0.05).颈椎生理曲度术前为7.97°±4.49°,末次随访时为9.15°±3.85°,手术前后无明显差异(P>0.05).置换节段活动度较术前明显增加(P<0.01),邻近上下节段活动度手术前后差异无统计学意义(P>0.05).术后人工椎间盘活动良好,无塌陷或移位,随访期间未见邻近节段明显退变,2例分别在术后7个月和10个月时异位骨化形成.结论:Activ C人工椎间盘置换术可有效改善颈椎病患者的临床症状,维持颈椎的生理曲度和活动度,早期临床疗效满意.%Objectives: To investigate the early clinical effects of cervical Activ C artificial disc replacement. Methods: 43 patients(mean age 48.3 years; 18 males and 25 females) of cervical spondylosis with a total of 45 levels involved underwent anterior cervical decompression and Activ C implantation between November 2009 and March 2011. There were 22 cases of cervical spondylotic myelopathy, 16 cases of cervical spondy-lotic radiculopathy and 5 cases of mixed

  20. MR findings of degenerative changes of nucleus pulposus in lumbar spine: sequential changes after disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Joon [Choong-Ang Gil Hospital, Seoul (Korea, Republic of); Cha, Yoo Mi; Hwang, Hee Young [College of Medicine, Dankook University, Chenoan (Korea, Republic of)

    1994-04-15

    To evaluate the relationship between MR changes of the nucleus pulposus and the time interval after traumatic disc herniation. T2-weighted MR images of 132 patients with back pain and/or sciatica were reviewed. The changes of signal intensity, central cleft and height of the nucleus pulposus were used as criteria of disc degeneration and they were graded as normal, mild, moderate and severe degree of degeneration. Putting these criteria together we provided integrated grade of degeneration of the nucleus pulposus(grade 0-3). To get the preliminary data for normal and age-related disc degeneration, we measured the disc height by age groups and disc levels and analyzed the relationship between the age of the patients and the signal intensity, cleft and height in normal disc levels of the 132 patients. In 68 patients of 88 levels disc herniation, we analyzed the relationship between symptom duration and the degree of degeneration. Among these 68 patients we selected 14 patients(16 levels) who were under 30 years of age and had history of recent trauma to minimize data distortion from age related degeneration and ambiguity of initiation point of degeneration. In this group we analyzed the relationship between the time period after traumatic disc herniation and the degree of degeneration. The age of the patient had close relationship with the grade of signal intensity, central cleft, and disc height and grade of degeneration of the nucleus pulposus in normal discs. In 88 levels of herniated discs, the duration of symptom and degree of degeneration showed moderate correlation. In 14 patients of disc herniation who were under 30 years old and had trauma history in recent 2 years, grade 1 disc degeneration occurred in average 3.7 months after trauma. Although it was difficult to proceed statistical analysis in the last group because of small patients number, the degree of degeneration of nucleus pulposus had close relationship with the duration after traumas or duration of

  1. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  2. Treatment of Cervicogenic Headache with Cervical Epidural Steroid Injection

    OpenAIRE

    Wang, Eugene; Wang, Dajie

    2014-01-01

    Cervicogenic headache (CGH) is defined as referred pain from various cervical structures innervated by the upper three cervical spinal nerves. Such structures are potential pain generators, and include the atlanto-occipital joint, atlantoaxial joint, C2-3 zygapophysial joint, C2-3 intervertebral disc, cervical myofascial trigger points, as well as the cervical spinal nerves. Various interventional techniques, including cervical epidural steroid injection (CESI), have been proposed to treat th...

  3. Analysis of mid-long term clinical efficacy and complications of Bryan artificial cervical disc replacement%Bryan人工颈椎椎间盘置换术后中长期临床疗效及相关问题分析

    Institute of Scientific and Technical Information of China (English)

    蒋涛; 任先军; 王卫东; 初同伟; 李长青

    2011-01-01

    目的 探讨Bryan人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)治疗颈椎椎间盘突出症的中长期临床疗效及并发症发生情况.方法 回顾分析13例颈椎椎间盘突出症患者,采用Bryan ACDR治疗,单节段11例,双节段2例,共置换了15个节段.术后定期随访,依照Odom评级和日本骨科学会(Japanese Orthopaedic Association,JOA)评分评定临床疗效和神经功能改善情况,通过影像学资料观察假体位移、假体周围骨吸收、异位骨化、假体活动度及颈椎生理曲度变化.结果 经过5年以上的随访,患者神经症状有明显缓解,Odom评级临床优良率达到92.3%,JOA评分由术前的11.6分增加到的15.6分.术后X线片示假体稳定,没有出现假体前后位移>2mm.术后1例出现自发性融合;1例在置换节段上位椎体前下缘有明显骨吸收,接近2.5mm,并伴椎体后缘的异位骨化.末次随访时置换假体活动度平均为9.2°,邻近节段活动度与术前相当.结论 通过5~7年的中长期随访,Bryan ACDR术治疗颈椎椎间盘突出症具有较好的临床疗效,并发症少,安全可靠.%Objective To evaluate the mid-long term clinical efficacy and complications of Bryan artificial cervical arthro-plasty replacement (ACDR) for treatment of cervical disc herniation. Methods Thirteen cases of cervical disc herniation were retrospectively analyzed. A total of 15 sets of Bryan cervical disc prosthesis were implanted into 13 cases, including single level disc replacement in 11 cases and bi-level in 2 cases. During follow-up, the clinical efficacy and neurological function were evaluated by Odom's criteria and Japanese Orthopaedic Association (JOA)score; the mobility, resorption, heteropic ossification, physiological lordosis and range of motion of the implanted and adjacent segment were observed on dynamic radiograph. Results After more than 5 years of follow-up, all cases showed significant improvement in neurological

  4. 人工颈椎间盘与颈椎动态稳定器治疗颈椎病的早中期临床疗效和影像学分析%A comparison of cervical disc arthroplasty versus dynamic cervial implant in the treatment of cervical spondylopathy:a clinical and radiological study

    Institute of Scientific and Technical Information of China (English)

    关立; 陈小龙; 海涌; 刘玉增; 汪文龙; 于志毅

    2015-01-01

    ;两组患者术后6个月和末次随访与术前比较,差异均有统计学意义(P<0.01),但两组间术前及术后末次随访时差异无统计学意义(P>0.05);两组患者术前、术后6个月及末次随访时对比,手术节段椎间隙高度、手术节段和相邻节段椎间活动度差异无统计学意义(P>0.05)。Prodisc-C 组术后末次随访发现3例异位骨化,2例假体前移1 mm,DCI 组未出现异位骨化和假体移动。结论 Prodisc-C 人工颈椎间盘与 DCI 治疗颈椎病均能保留颈椎活动度,恢复和维持椎间隙高度和颈椎生理弧度,早中期疗效满意。%Objective To evaluate the clinical and radiological outcomes of cervical disc arthroplasty by Prodisc-C versus dynamic cervial implant ( DCI ) in the treatment of cervical spondylopathy.Methods All cervical spondylopathy cases undergoing cervical disc arthroplasty by Prodisc-C or dynamic cervial implant between February 2011 and February 2013 were analyzed retrospectively. There were 16 patients in anterior cervical disc arthroplasty group ( male 8, female 8 ). Age averaged 44 years ( range: 32-54 years ). There were 10 cases with cervical spondylotic myelopathy, and 6 cases with radicular spondylosis. In dynamic cervical implant group were 10 cases ( male 6, female 4 ). Age averaged 44.5 years ( range: 33-55 years ). There were 7 cases of cervical spondylotic myelopathy, and 3 cases of radicular spondylosis. Parameters as gender, age, operation time and blood loss of all the patients were analyzed. The patients were followed 1 month, 3 months, 6 months, 12 months and 24 months postoperatively. Neck disability index ( NDI ), Japanese Orthopaedic Association ( JOA ) Score and Visual Analogue Scale ( VAS ) were used to evaluate the clinical outcomes of the two groups. Anterioposterior and lateral X-ray, hyperextension and hyperflexion X-ray films before and after surgery were analyzed and cervical lordosis, the height of disc, range of motion

  5. Neuronal degeneration in spinal multiple sclerosis

    OpenAIRE

    Bernhardt, Lydia

    2010-01-01

    To elucidate neuronal degeneration in spinal multiple sclerosis the spinal cord of 27 post mortem patients of the years 1997 to 2000 was investigated in comparison to 29 controls matched for sex, age and year of death. In addition to immunohistochemical examinations and demonstration of pathological cell changes, we also quantified the neurons of the cervical and thoracic spinal cord. In comparison to controls, MS-patients show a significant loss of 43% of the cervical neurons and a signif...

  6. Cervical spinal cord compression after thyroidectomy under general anesthesia.

    Science.gov (United States)

    Yao, Wenlong; Qiu, Jin; Zhou, Zhiqiang; Zhang, Lin; Zhang, Chuanhan

    2014-02-01

    Cervical spinal cord injury is a rare but serious complication after general anesthesia. The risk factors include traumatic cervical injury, cervical spine instability, and difficult airway management. It has also occurred in the absence of cervical instability. Here we report a patient who had a history of intermittent neck pain without numbness. Preoperative radiologic examinations showed degenerative changes in the cervical spine. She developed progressive tingling and numbness in her limbs after thyroidectomy under general anesthesia. Magnetic resonance imaging showed a cervical disc protruding into the canal at C5-C6, which was considered to be induced by surgical positioning. She recovered after anterior cervical decompression and internal fixation surgery. PMID:23828450

  7. Intervertebral disc calcification in a child

    Directory of Open Access Journals (Sweden)

    Ahemad Athar

    2008-01-01

    Full Text Available Disc calcification in children is a rare condition of which only approximately 200 cases have been reported worldwide and one from India and we report one such case. A five year-old boy presented with neck pain, torticollis and limitations of cervical motions following a fall while playing 3 months back. He had low grade fever cervical lymphadenopthy, paraspinal muscle spasm. His blood counts and ESR was raised. Fine needle aspiration cytology of lymph node revealed reactive lymphadenitis. His cervical radiograph slowed calcification of C 6-7. MRI scan showed hypointense signals in C6-C7 and D5-D6 disc on both T1 and T2 W images. Cerebrospinal fluid examination was normal. He improved on analgesics, bed rest and cervical traction.

  8. A eficácia da terapia manual em indivíduos cefaleicos portadores e não-portadores de degeneração cervical: análise de seis casos The effectiveness of manual therapy in indiv iduals with headaches, with and without cervical degeneration: analysis of six cases

    Directory of Open Access Journals (Sweden)

    JGS Morelli

    2007-08-01

    diagnosed with TTH who underwent a Physical Therapy treatment protocol consisting of manual therapy. METHOD: Six individuals were followed up (three with associated vertebral abnormalities and three with no abnormalities. Five participants were women and one was a man. They underwent treatment consisting of ten sessions of manual cervical traction, stretching, vertebral mobilization and massage. Pain intensity was assessed using a visual analog scale (VAS and the pain threshold for pressure on the upper trapezius muscle was measured using an analog pressure algometer (PDT; pain detection threshold. The data were graphically displayed in a multiple baseline system and during a follow-up period. RESULTS: Even though this treatment showed positive results in all cases, in relation to pain intensity, greater difficulty in completely relieving the symptoms was found among the individuals who did not have vertebral abnormalities. With regard to PDT, it was found that individuals with cervical degeneration presented greater improvement.

  9. Influence of degenerative changes of intervertebral disc

    Directory of Open Access Journals (Sweden)

    WANG Yi

    2012-04-01

    Full Text Available 【Abstract】Objective: To investigate the material properties of normal and degenerated intervertebral discs (IVDs and examine the effect of degenerative changes on IVD pathology. Methods: A computer-based online search was under-taken to identify English articles about material properties of IVDs published from January 1950 to 2011 in PubMed database. The retrieved keywords included material properties, intervertebral disc and degeneration. Based on the principles of reliability, advancement and efficiency, the obtained data were primarily examined, and the original source was retrieved to read the full-text. Repetitive articles were excluded. The data of material properties of normal and degenerated IVDs were summarized and analyzed by meta-analysis. Results: The data of Young's modulus, Poisson's ratio, shear modulus, hydraulic permeability and intradiscal pres-sure of normal and degenerated IVDs were obtained. Com-pared with normal IVDs, the Young's modulus and shear modulus of annulus fibrosus and nucleus pulposus were higher in degenerated IVDs, the Poisson's ratio was lower while the hydraulic permeability and intradiscal pressure were higher. Besides, the degeneration-related alterations in IVDs had an influence both on itself and other spinal structures, leading to diseases such as bulging disc, discogenic pain and spinal stenosis. Meanwhile, the heavy mechanical loading and injury indicated important pathways to IVD degeneration. Conclusions: To a certain extent, the degenerative changes of IVD influence its material properties. And the degeneration-related alterations of composition can cause structural failure of IVDs, leading to injuries and diseases. Key words: Intervertebral disc; Mechanical phenomena; Degeneration; Elastic modulus; Permeability; Pathology

  10. Late Results of Anterior Cervical Discectomy and Fusion with Interbody Cages

    OpenAIRE

    Dağlı, Murat; Er, Uygur; Şimşek, Serkan; Bavbek, Murad

    2013-01-01

    Study Design Retrospective analysis. Purpose To evaluate the effectiveness of anterior cervical discectomy with fusion for degenerative cervical disc disease. Overview of Literature Anterior spinal surgery originated in the mid-1950s and graft for fusion was also employed. Currently anterior cervical microdiscectomy and fusion with an intervertebral cage is a widely accepted procedure for treatment of cervical disc hernia. Artificial grafts and cages for fusion are preferred because of their ...

  11. The degenerative cervical spine.

    Science.gov (United States)

    Llopis, E; Belloch, E; León, J P; Higueras, V; Piquer, J

    2016-04-01

    Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management. PMID:26878769

  12. Genome-Wide Association Study in Dachshund: Identification of a Major Locus Affecting Intervertebral Disc Calcification

    DEFF Research Database (Denmark)

    Mogensen, Mette Sloth; Karlskov-Mortensen, Peter; Proschowsky, Helle Friis;

    2011-01-01

    Intervertebral disc calcification and herniation commonly affects Dachshund where the predisposition is caused by an early onset degenerative process resulting in disc calcification. A continuous spectrum of disc degeneration is seen within and among clog breeds, suggesting a multifactorial...... etiology. The number of calcified discs at 2 years of age determined by a radiographic evaluation is a good indicator of the severity of disc degeneration and thus serves as a measure for the risk of developing intervertebral disc herniation. The aim of the study was to identify genetic variants associated...... with intervertebral disc calcification in Dachshund through a genome-wide association (GWA) study. Based on thorough radiographic examinations, 48 cases with >= 6 disc calcifications or surgically treated for disc herniation and 46 controls with 0-1 disc calcifications were identified. GWA using the...

  13. Estudo comparativo dos mecanorreceptores dos discos intervertebrais normais e degenerados da coluna lombar de humanos pela radiografia, ressonância magnética e estudo anatomopatológico Comparative study of normal and degenerated intervertebral discs' mechanoreceptors of human lumar spine X-ray, magnetic resonance and anatomopathologic study

    Directory of Open Access Journals (Sweden)

    Valdeci Manoel de Oliveira

    2007-01-01

    Full Text Available Os autores fizeram um estudo da coluna lombar de humanos, objetivando avaliar e determinar os diferentes tipos de fibras nervosas no disco intervertebral normal e no degenerado. Foram usadas dez colunas lombares de cadáveres com aproximadamente 48 a 72 horas de óbito. As peças foram submetidas a exames de radiografia simples e ressonância magnética. Após os exames, os discos foram classificados em normais e degenerados. Em seguida, foram dissecados, divididos em regiões anterior e posterior, incluídos em parafina e realizado estudo de imuno-histoquímica com a proteína S100. Com o auxílio de um programa de computador Image-Pro Plus (media cybernetics®, as fibras nervosas tiveram seu diâmetro medidos em micrômetros e classificadas em quatro tipos de fibras. Foram encontrados quatro tipos de fibras nervosas nas diferentes regiões discais. O número e o tipo de fibras variaram de acordo com a região e grau de degeneração do disco intervertebral. Concluíram que as fibras do tipo III são mais freqüentes na região anterior; as fibras dos tipos II e IV são mais freqüentes na região posterior, e as fibras do tipo I não apresentaram diferenças entre a região anterior e a posterior; além disso, o disco degenerado tem mais fibras nervosas que o disco normal.The authors conducted a study on human lumbar spine, aiming to assess and determine the different kinds of nervous fibers in normal and degenerated intervertebral discs. Ten cadaver’s lumbar spines with approximately 48 - 72 of death have been used. The pieces were submitted to simple X-ray and magnetic resonance tests. Subsequently to the tests, discs were divided into normal and degenerated. Then, they were dissected, divided into anterior and posterior according to the region, included in paraffin and an immunohistochemical study with S100 protein was performed. With the aid of Image-Pro Plus computer software (media cybernetics ®, nervous fibers’ diameters were

  14. Effects of Neonatal Enzyme Replacement Therapy and Simvastatin Treatment on Cervical Spine Disease in Mucopolysaccharidosis I Dogs

    Science.gov (United States)

    Chiaro, Joseph A; O’Donnell, Patricia; Shore, Eileen M; Malhotra, Neil R; Ponder, Katherine P; Haskins, Mark E; Smith, Lachlan J

    2014-01-01

    Mucopolysaccharidosis I (MPS I) is a lysosomal storage disease characterized by deficient α-L-iduronidase activity, leading to the accumulation of poorly degraded glycosaminoglycans (GAGs). Children with MPS I exhibit high incidence of spine disease, including accelerated disc degeneration and vertebral dysplasia, which in turn lead to spinal cord compression and kypho-scoliosis. In this study we investigated the efficacy of neonatal enzyme replacement therapy (ERT), alone or in combination with oral simvastatin (ERT+SIM) for attenuating cervical spine disease progression in MPS I, using a canine model. Four groups were studied: normal controls; MPS I untreated; MPS I ERT treated; and MPS I ERT+SIM treated. Animals were euthanized at one year-of-age. Intervertebral disc condition and spinal cord compression were evaluated from MRIs and plain radiographs, vertebral bone condition and odontoid hypoplasia were evaluated using microcomputed tomography, and epiphyseal cartilage to bone conversion was evaluated histologically. Untreated MPS I animals exhibited more advanced disc degeneration and more severe spinal cord compression than normal animals. Both treatment groups resulted in partial preservation of disc condition and cord compression, with ERT+SIM not significantly better than ERT alone. Untreated MPS I animals had significantly lower vertebral trabecular bone volume and mineral density, while ERT treatment resulted in partial preservation of these properties. ERT+SIM treatment demonstrated similar, but not greater, efficacy. Both treatment groups partially normalized endochondral ossification in the vertebral epiphyses (as indicated by absence of persistent growth plate cartilage), and odontoid process size and morphology. These results indicate that ERT begun from a very early age attenuates the severity of cervical spine disease in MPS I, particularly for the vertebral bone and odontoid process, and that additional treatment with simvastatin does not

  15. Cervical Spondylotic Myelopathy: Factors in Choosing the Surgical Approach

    OpenAIRE

    Yalamanchili, Praveen K.; Vives, Michael J.; Chaudhary, Saad B.

    2012-01-01

    Cervical spondylotic myelopathy is a progressive disease and a common cause of acquired disability in the elderly. A variety of surgical interventions are available to halt or improve progression of the disease. Surgical options include anterior or posterior approaches with and without fusion. These include anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, cervical disc replacement, laminoplasty, laminectomy with and without fusion, and combined approaches. Rec...

  16. Guillain-Barré Syndrome Combined with Acute Cervical Myelopathy

    OpenAIRE

    Abai, Siez; Kim, Sung Bum; Kim, Joo-Pyung; Lim, Young Jin

    2010-01-01

    Authors describe a patient who developed a myelopathy associated with Guillain-Barré syndrome and cervical myelopathy. We provide radiological evidence of non-compressive herniated cervical intervertebral disc with cord signal changes and show the clinical and electrophysiological result of coexisting Guillain-Barré syndrome and cervical myelopathy. We tried to introduce and review the case of Guillain-Barré syndrome which was combined with cervical myelopathy to let us recollect the presumpt...

  17. The Effect of the PEEK Cage on the Cervical Lordosis in Patients Undergoing Anterior Cervical Discectomy

    Directory of Open Access Journals (Sweden)

    Salih Gulsen

    2015-03-01

    CONCLUSION: We achieved better cervical lordotic angles at the postoperative period by implanting one-level, two-level, three-level or four-level PEEK cage filled with demineralized bone matrix. Also, the causes of cervical root and or medulla spinalis impingement were different in group1 and 2. While extruded cervical disc impingement was the first pathology in group 1, osteophyte formation was the first pathology in group 2.

  18. Spontaneous Regression of Lumbar Disc Herniation: Report of Two Cases

    OpenAIRE

    Mehmet ŞENOĞLU; Kasım Zafer YÜKSEL; Mürvet YÜKSEL

    2006-01-01

    Spontaneous disc regression is described in lumbar, thoracic, cervical regions and also in various clinical situations. Although, spontaneous regression of lumbar disc herniation is a well defined clinical situation, the exact mechanism has not been adequately clarified yet. Currently , there are some suggested hypotheses. In this study, two cases with the complaint of lumbar radiculopathy and spontaneous regression of the disc herniation during their follow-up period, relevant with their cli...

  19. Avaliação do tratamento da discopatia degenerativa cervical pela artrodese via anterior utilizando placas associadas a cages ou cages em peek isoladamente Evaluación del tratamiento de la enfermedad degenerativa del disco cervical por la artrodesis anterior utilizando placas asociadas con jaulas o jaulas en peec, aisladamente Evaluation of cervical degenerative disc disease treatment by anterior arthrodesis using plates associated with cages or cages in peek alone

    Directory of Open Access Journals (Sweden)

    André Rafael Hübner

    2011-01-01

    por el método de fijación con placas asociadas a jaulas - Grupo I - y 35 con las jaulas en PEEK, aisladamente - Grupo II. Se recolectarondatos de historial clínico, examen físico, puntuaciones de dolor (escala visual y analógica del dolor-EVA y función (criterios de Odom, SF-36, Índice de Discapacidad Cervical del pre y posoperatorio y exámenes de imagen. RESULTADOS: Se encontró un predominio de pacientes de sexo femenino en ambos grupos, con una edad promediode 55 años en el Grupo I y de 47 en el Grupo II. Ambos grupos mostraron una distribución similar en el número de niveles operados, así como de las complicaciones encontradas y de las puntuaciones de dolor, índice de discapacidad cervical y SF36 para el pre y posoperatorio. Hubo 97,1% para la fusión y 94,3% de buenos resultados en el Grupo I y el 100% de fusión, con 97% de buenos resultados en el Grupo II. CONCLUSIONES: El estudio comparativo de la utilización de placas con jaulas y estas en PEEK, aisladamente, presentó resultados similares y satisfactorios para los grupos estudiados, sin mostrar superioridad o inferioridad de un método sobre otro.OBJECTIVES: To comparatively evaluate the treatment of cervical degenerative disc disease by anterior approach using plates associated or cages and PEEK device alone. METHODS: A retrospective study comparing two groups of patients treated by anterior arthrodesis was performed. Seventy patients were randomly selected, 35 operated using plates associated with cages - Group I - and 35 with cages in PEEK alone - Group II. Medical history was obtained as well as physical examination, pain scores (pain visual analogue score and function scores (Odom's criteria, SF-36, Neck Disability Index and the pre and postoperative imaging studies. RESULTS: There was a predominance of female patients in both groups, with a mean age of 55 years in Group I and 47 in Group II. Both groups showed a similar distribution of the number of levels operated, as well as the

  20. Lumbar disc herniation: Is there an association between histological and magnetic resonance imaging findings?

    Directory of Open Access Journals (Sweden)

    Shiju A Majeed

    2016-01-01

    Conclusion: The study shows that the Pfirmann grading system, MCs and HDS can reliably be used as scoring systems for assessing lumbar disc degeneration. The radiological assessment can be used as a noninvasive tool to assess the probable change in content rather than the microstructure of a disc undergoing degeneration.

  1. Prodisc-C人工颈椎椎间盘置换的临床疗效观察和运动功能评估%Clinical efficiency and motor function assessment of Prodisc-C artificial cervical disc replacement

    Institute of Scientific and Technical Information of China (English)

    陈道森; 施荣茂; 周强; 罗飞; 代飞; 张劲松; 许建中

    2011-01-01

    目的 通过术后随访评价Prodisc-C人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)治疗颈椎病的临床疗效及其对颈椎置换节段、邻近节段运动功能的影响.方法 回顾性分析2009年8月~2011年2月行Prodisc-C ACDR治疗20例颈椎病患者,其中脊髓型9例、神经根型8例、混合型3例,单椎间盘置换17例、双椎间盘置换3例.患者术前行CT、MRI检查明确诊断,术前和术后定期行疼痛视觉模拟量表(visual analogue scale,VAS)和日本骨科学会(Japanese Orthopaedic Association,JOA)及摄颈椎X线片.结果 13例患者获得6~18个月随访.患者术前颈肩背疼痛、上下肢麻木、肌力减弱等不适症状均明显改善.术后VAS及JOA评分均较术前明显改善,差异有统计学意义(P<0.01);置换节段椎间活动度( range of motion,ROM)在术后1、3、6个月显著增大,与术前相比差异有统计学意义(P<0.01);在末次随访时仍大于术前,差异有统计学意义(P<0.05);上下位邻近节段椎间隙高度和椎间ROM与术前相比,差异无统计学意义(P>0.05).所有病例未见假体松动、移位和异位骨化.结论 Prodisc-C ACDR短期随访疗效优良,置换节段ROM增大,邻近节段椎间隙高度和椎间ROM维持在正常水平,但远期疗效还有待进一步随访观察.%Objective To evaluate the clinical efficacy of artificial cervical disc replacement (ACDR) with Prodisc-C and its effects on the motor function of the replaced level and adjacent segments. Methods A total of 20 patients who received ACDR with Prodisc-C from April 2009 to February 2011 were retrospectively analyzed. There were 9 patients with myelopathy, 8 with radiculopa-thy, and the left 3 with both symptoms. There were 17 participators received single level replacement, and the other 3 had 2 levels replaced. All the patients received CT and MRI preoperatively for accurate diagnosis. Visual analogue scale ( VAS) scores for neck and arm

  2. Autophagy: A double-edged sword in intervertebral disk degeneration.

    Science.gov (United States)

    Zhang, Shu-Jun; Yang, Wei; Wang, Cheng; He, Wen-Si; Deng, Hai-Yang; Yan, Yi-Guo; Zhang, Jian; Xiang, Yong-Xiao; Wang, Wen-Jun

    2016-06-01

    Autophagy is a homeostatic mechanism through which intracellular damaged organelles and proteins are degraded and recycled in response to increased metabolic demands or stresses. Although primarily cytoprotective, dysfunction of autophagy is often associated with many degenerative diseases, including intervertebral disc (IVD) degeneration (IDD). As a main contributing factor to low back pain, IDD is the pathological basis for various debilitating spinal diseases. Either higher or lower levels of autophagy are observed in degenerative IVD cells. Despite the precise role of autophagy in disc degeneration that is still controversial, with difference from protection to aggravation, targeting autophagy has shown promise for mitigating disc degeneration. In the current review, we summarize the changes of autophagy in degenerative IVD cells and mainly discuss the relationship between autophagy and IDD. With continued efforts, modulation of the autophagic process could be a potential and attractive therapeutic strategy for degenerative disc disease. PMID:27018178

  3. Experimental and clinical studies on dynamic circulation of intervertebral discs by radiation clearance method

    International Nuclear Information System (INIS)

    Few studies on the mechanism of dynamic circulation in intervertebral discs are reported. The purpose of this study is to clarify the dynamic mechanism of circulation in the lumbar intervertebra discs with radioisotope clearance, experimentally and clinically. Rabbits were used as experimental animals and were divided into two groups, normal and artificially injured. I131-sodium was injected into them and the clearance was followed. Injected I131-sodium was cleared in the order of; 1) discs with injured annulus fibrosus, 2) discs with injection of α-chymotrypsin, 3) discs with injuries in the border between vertebral body and annulus fibrosus, 4) and normal discs. Human degenerated discs were also used for this study. In the clinical cases, I131-sodium was cleared faster in the degenerated discs than in the normal. The pathway for I131-sodium to be cleared is supposed to be extravascular and interstitial spaces in the disc. (author)

  4. 臭氧联合靶点射频治疗颈椎间盘突出症手术护理模式及康复指导%Ozone combined target radiofrequency treatment of cervical intervertebral disc herniation surgery and rehabilitation nursing mode guidance

    Institute of Scientific and Technical Information of China (English)

    许玉红

    2015-01-01

    目的:探讨CT引导下臭氧联合靶点射频热凝治疗颈椎间盘突出症手术护理及康复指导模式。方法:对30例CT引导下臭氧联合靶点射频热凝治疗颈椎间盘突出症患者采用术前、术中、术后分阶段护理,并给以康复指导。结果:所有病例无任何手术相关并发症,临床康复满意。结论:手术分阶段护理和康复指导适用于臭氧联合靶点射频治疗颈椎间盘突出症手术。%Objective To explore the cT guided by ozone combined target radiofrequency thermal coagulation treatment of cervical intervertebral disc herniation surgery nursing and rehabilitation instruction mode.Methods Of 30 cases were treated by preoperative, intraoperative and postoperative nursing in stages, and rehabilitation guidance.Results All cases without any complications related to the operation and clinical recovery satisfaction.Conclusions Surgical nursing and rehabilitation instruction in stages is suitable for the joint of ozone target radiofrequency treatment of cervical intervertebral disc herniation surgery.

  5. Nucleoplasty as a therapeutic option for lumbar disc degeneration related pain: a retrospective study of 396 cases Nucleoplastia como opção terapêutica para dor relacionada à degeneração do disco lombar: um estudo retrospectivo de 396 casos

    Directory of Open Access Journals (Sweden)

    José Lourenço Kallás

    2013-01-01

    Full Text Available OBJECTIVES: To make a retrospective analysis and evaluate a clinical response to the control of disc degeneration related pain of 396 patients submitted to percutaneous lumbar nucleoplasty; and to make a record of visual analogical scale (VAS up to a three-year follow-up after the surgical procedure. METHODS: Analysis of VAS score in 396 patients with lumbar disc degeneration related pain, according to anamnesis, clinical examination and magnetic resonance imaging (MRI, without improvement of previous clinical treatment, submitted to percutaneous nucleoplasty. RESULTS: A total of 26% of the patients presented 100% remission of pain or paresthesia, of whom 75% showed at least 50% of pain improvement. The median VAS pain improvement was about 67%. CONCLUSIONS: The median VAS improvement in inferior disc levels was higher than four points. The VAS showed improvement of the pain and paresthesia up to a three-year follow up after the surgical procedure.OBJETIVOS: Analisar retrospectivamente a resposta clínica no controle da dor relacionada à degeneração discal em 396 pacientes submetidos à nucleoplastia percutânea lombar; e fazer um registro da escala analógica visual (EAV com seguimento de três anos após a cirurgia. MÉTODOS: Análise da EAV de 396 pacientes com diagnóstico de hérnia de disco, de acordo com anamnese, exame clínico e imagens por meio de ressonância magnética (RM, sendo que nenhum deles apresentou melhora com tratamento clínico prévio. Estes pacientes foram submetidos à nucleoplastia percutânea. O estudo utilizou, para avaliação, o registro de escala analógica visual (EAV durante seguimento de até três anos após o procedimento cirúrgico. RESULTADOS: Um total de 26% apresentou 100% de remissão da dor ou parestesia; 75% apresentaram pelo menos 50% de melhora da dor. A mediana da EAV de melhora da dor foi de aproximadamente 67%. CONCLUSÕES: Houve melhora da EAV, com mediana maior do que quatro pontos nos

  6. Nucleoplasty as a therapeutic option for lumbar disc degeneration related pain: a retrospective study of 396 cases Nucleoplastia como opção terapêutica para dor relacionada à degeneração do disco lombar: um estudo retrospectivo de 396 casos

    Directory of Open Access Journals (Sweden)

    José Lourenço Kallás

    2012-01-01

    Full Text Available OBJECTIVES: To make a retrospective analysis and evaluate a clinical response to the control of disc degeneration related pain of 396 patients submitted to percutaneous lumbar nucleoplasty; and to make a record of visual analogical scale (VAS up to a three-year follow-up after the surgical procedure. METHODS: Analysis of VAS score in 396 patients with lumbar disc degeneration related pain, according to anamnesis, clinical examination and magnetic resonance imaging (MRI, without improvement of previous clinical treatment, submitted to percutaneous nucleoplasty. RESULTS: A total of 26% of the patients presented 100% remission of pain or paresthesia, of whom 75% showed at least 50% of pain improvement. The median VAS pain improvement was about 67%. CONCLUSIONS: The median VAS improvement in inferior disc levels was higher than four points. The VAS showed improvement of the pain and paresthesia up to a three-year follow up after the surgical procedure.OBJETIVOS: Analisar retrospectivamente a resposta clínica no controle da dor relacionada à degeneração discal em 396 pacientes submetidos à nucleoplastia percutânea lombar; e fazer um registro da escala analógica visual (EAV com seguimento de três anos após a cirurgia. MÉTODOS: Análise da EAV de 396 pacientes com diagnóstico de hérnia de disco, de acordo com anamnese, exame clínico e imagens por meio de ressonância magnética (RM, sendo que nenhum deles apresentou melhora com tratamento clínico prévio. Estes pacientes foram submetidos à nucleoplastia percutânea. O estudo utilizou, para avaliação, o registro de escala analógica visual (EAV durante seguimento de até três anos após o procedimento cirúrgico. RESULTADOS: Um total de 26% apresentou 100% de remissão da dor ou parestesia; 75% apresentaram pelo menos 50% de melhora da dor. A mediana da EAV de melhora da dor foi de aproximadamente 67%. CONCLUSÕES: Houve melhora da EAV, com mediana maior do que quatro pontos nos

  7. 人脐带间充质干细胞移植修复兔退变椎间盘的初步研究%A preliminary study of transplantation of human umbilical cord mesenchymal stem cell in a rabbit model of intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    王彦强; 吕鹏飞; 张光武; 于明川; 田小雷; 刘正

    2014-01-01

    Background:A large amount of researches confirmed that bone marrow mesenchymal stem cells is able to differentiate into intervertebral disc cells both in vitro and in vivo, and preliminarily used for the treatment of intervertebral disc degeneration. Compared with bone marrow mesenchymal stem cells, human umbilical cord mesenchymal stem cells (UCMSCs) have ob-vious advantages:low cost, wide sources, not causing new trauma and pain for the donor, not involving ethical issues, stron-ger plasticity and amplification ability, non-tumorigenic activity and low-immunogenicity, no decrease of proliferation abili-ty or differentiation ability with passage number and body age increasing. Objective:The purpose of the study is to evaluate whether injections of UCMSCs had regenerative effects on intervertebral disc degeneration in a rabbit model. Methods:UCMSCs were cultured in vitro. Four continuous lumbar discs were injured by aspirating nucleus pulposus in rab-bits to induce disc degeneration and then the rabbits were treated by injection with UCMSCs or phosphate buffered saline (PBS). At 4, 8, and 12 weeks after initial injection, rabbits were performed by X-rays and magnetic resonance imaging (MRI), and ther they were sacrificed and the spine was extracted for detecting proteoglycan content. Results:DHI (disc height index) and proteoglycan content showed significantly lower in the degenerated group as compared with the control group, while the MRI grade showed the opposite change at 4, 8, and 12 weeks after initial injection (P Conclusions:The results of our study indicate that UCMSCs is a promising candidate for the treatment of the degenerative disc disease.%背景:大量研究证实,骨髓间充质干细胞在体外和体内均可向椎间盘样细胞分化,并初步用于治疗椎间盘退变。与骨髓间充质干细胞相比,人脐带间充质干细胞(UCMSCs)具有明显的优势:①成本较低;②来源丰富;③不会给捐献者造成新的

  8. Simulated Automobile and Rotary-Wing Aircraft Impacts: Dynamic Neck Response after Surgical Treatment for Cervical Spondylosis

    OpenAIRE

    White, Nicholas Alan

    2014-01-01

    Degeneration of the cervical spine is part of the normal aging process, usually occurring without clinical symptoms. Symptomatic degeneration most often occurs in the lower cervical spine, presenting as axial neck pain, radiculopathy, myelopathy, or any combination of the three. When conservative treatment does not adequately manage these symptoms, surgical intervention may be required. The longstanding surgical treatment for cervical degeneration is arthrodesis achieved through anterior cerv...

  9. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... are your thoughts on that? Well, the more athletic they are, the more I’m going to ... three weeks, and people are back to doing sports like. Now golf is not a very high- ...

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    Full Text Available ... the patients do so well right off the bat, you know, a little trouble swallowing maybe. I ... operations because they feel well right off the bat. So I’m taking out these pins. I ...

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    Full Text Available ... play tennis? When I can do things recreationally?” What are your thoughts on that? Well, the more athletic they ... near future of the state of the art. What are your thoughts on that, Bill? I really think this ...

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    Full Text Available ... Beutler is defining out, that’s the platysma muscle right there. He’ll divide that a little to ... catch on that a little bit different. But right now Dr. Beutler is exposing the spine. He’s ...

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    Full Text Available ... actually doing an operation like this. But by far and away, the most common problem that you ... technical aspect of putting the implant in is far greater than just putting in a piece of ...

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    Full Text Available ... and tingling in the hands and loss of motor strength. Is that typical of how this patient ... that’s where the problem is. That’s where we start getting patients that have a pinched nerve or ...

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    Full Text Available ... ultrahigh molecular weight polyethylene, and it’s a medical-grade plastic that’s really been made to sustain active ... bit. That’s just fluid to wash out any blood or bone wax or whatever, pieces of bone. ...

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    Full Text Available ... piece of what we call -- it’s a medical plastic. It’s ultrahigh molecular weight polyethylene, and it’s a medical-grade plastic that’s really been made to sustain active compression ...

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    Full Text Available ... which is kind of connective tissue that helps hold things together. It’s the very last layer before ... and allows the vertebrae to lock on or hold the implant tight so it has a good ...

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    Full Text Available ... pressure off that nerve. So a lot of times these patients present with significant pain not only ... so it doesn’t wiggle out. There are times during this operation we’re going to pushing ...

  1. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... are relatively fragile structures, and I want to protect them as best I can. So we just ... end plates and secure his position. That’s great, Bill. That does look good. Obviously this new technology ...

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    Full Text Available ... technically there’s sometimes a bit more of a challenge to it because you’re putting something that’s ... Well it’s not something you learn in med school. This is on operation kind that takes ... First, the primary chisel is inserted over the trial and advanced ...

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    Full Text Available ... everybody in the operating room today. And our staff here has really worked hard to make this ... I want to thank Dr. Beutler and his staff for helping out with a successful procedure. I’ ...

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    Full Text Available ... biting instrument and remove that. He has a large bone spur right here. This piece of bone ... is exiting right there, and there was a large piece of bone. We were fighting it as ...

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    Full Text Available ... like. Now golf is not a very high-impact game, but there’s a lot of bending, and ... extremely well. And, again, this is, I think, technology on the forefront that will become the state- ...

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    Full Text Available ... esophagus and the trachea because they are relatively fragile structures, and I want to protect them as ... an investigational group that was in the United States. There were 20 centers in the United States ...

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    Full Text Available ... like that. I sometimes tell people it’s crab meat. Do you do that, Walt? Yeah, I do. ... what you said, kind of looks like crab meat when it sticks back. And so what happens ...

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    Full Text Available ... want to put these in, so patients with osteoporosis or, you know, very, very severe stenosis. What ... this. As you said, if a person has osteoporosis and the bones are thin, or if a ...

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    Full Text Available ... where I have this awl. This is just something sharp so I can get a screw started ... down here. I’m just getting a little something started there. All right. So what we’re ...

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    Full Text Available ... Well it’s not something you learn in med school. This is on operation kind that takes experience, ... three weeks, and people are back to doing sports like. Now golf is not a very high- ...

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    Full Text Available ... at the fascia, which is kind of connective tissue that helps hold things together. It’s the very ... the spine itself. That’s this kind of whitish tissue. Rather than cutting it, I’m just actually ...

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    Full Text Available ... little smaller one, and this is that sizing business. So what I’m going to look at ... minimally invasive this procedure is. It’s such a small incision and such carpentry that can be done ...

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    Full Text Available ... he is goes to do is stick a screw into the bottom part of C6 and into ... just something sharp so I can get a screw started and we’ll put a screw in right there, and we’re going to ...

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    Full Text Available ... little to give him a little more visual aspect, and then he’ll find this sternocleidomastoid. Now ... part to heal. And the third and final aspect that he’s going to do is actually insert ...

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    Full Text Available ... neck out you can actually make out the definition of that muscle. He will split that muscle ... is an operation that I think will become standard, and state of the art. Right now we’ ...

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    Full Text Available ... and releasing pressure on the surrounding nerves and spinal cord. We’re going to do an image right ... so he can fully and thoroughly decompress the spinal cord exist. So he is right now working his ...

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    Full Text Available ... cord. So it’s sometimes a little bit more work. Well, there’s the space for where that nerve ... end plate forms the socket. The implant components work together with the surrounding spinal structures to provide ...

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    Full Text Available ... Yeah. They look -- the screws look good just looking at the fluoro image there. Why don’t ... incision. Well, it is. You know I guess looking at my thumbs, you can see that the ...

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    Full Text Available ... in there, but we’re able to avoid these with our dissection, and you’ll see that ... than cutting it, I’m just actually using these cotton balls to push them apart gently, and ...

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    Full Text Available ... the near future of the state of the art. What are your thoughts on that, Bill? I ... think will become standard, and state of the art. Right now we’re following these patients out ...

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    Full Text Available ... of the neck. There are some vital anatomic structures in there, but we’re able to avoid these with our ... make any difference. There aren’t really any structures that it would harm in any way. But when it does it in the back of ...

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    Full Text Available ... a small incision and such carpentry that can be done through a one, one-and-a-half-inch incision. Well, it is. You know I guess looking at ... could go more anterior, but it seems to be recessed. Do you think more anterior? No. Ideally that should work. Well that’s right on the border now. Yeah. Well ...

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    Full Text Available ... Beutler planned the incision with the use of X-Ray, placing a marker external to the skin to ... he wants to do is confirm it with X-Ray so that there’s no confusion to take the ...

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    Full Text Available ... have to mess with those today or any day. So can I have the nerve fork. I’ ... not to go to work for about ten days. I must say this patient here, he is ... that allow patients to go home the same day after these operations because they feel well right ...

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    Full Text Available ... Live” webcast presentation brought to you by Pinnacle Health in Harrisburg, Pennsylvania. “OR Live” makes it easy ... medical care. OR Live, the vision of improving health. Hi, my name is Walt Peppelman, and welcome. ...

  8. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... through a notch and allows the vertebrae to lock on or hold the implant tight so it ... doing now, this is a holding pin. This locks this jig into the vertebral body and allows ...

  9. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... socket implant that is composed of two cobalt chrome alloy end plates and a polyethylene insert. The ... is an operation that I think will become standard, and state of the art. Right now we’ ...

  10. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... your screen and open the door to informed medical care. OR Live, the vision of improving health. ... small piece of what we call -- it’s a medical plastic. It’s ultrahigh molecular weight polyethylene, and it’s ...

  11. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... is go through skin and down through the muscle that he was explaining called the “platysma muscle.” This is a very small muscle, very thin, and actually as you stretch your ...

  12. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... welcome. Today we’re going to have the opportunity to watch Dr. William Beutler perform a total ... of the nerve. So that’s what Dr. Beutler’s job is right now, is to remove all this ...

  13. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... incorporates this implant pretty quickly. Boy, that’s a good point. You know, folks would worry about where does this ... device, but you don’t even need that. You put that in there so good the first time, I don’t even think ...

  14. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... of the neck. There are some vital anatomic structures in there, but we’re able to avoid ... and the trachea because they are relatively fragile structures, and I want to protect them as best ...

  15. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... guy, and he wants to go back to work, you know, within a week or so. And so we’re -- his wife ... little bit. But people are up and at work and doing activities by around two, three weeks, and people are back to doing sports like. ...

  16. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... door to informed medical care. OR Live, the vision of improving health. Hi, my name is Walt ... door to informed medical care. “OR Live,” the vision of improving health. 11

  17. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... quite the opposite. It’s a very, very high success-rate operation. The clinical results and the FDA ... in the way of problems, and long-term success seems to be holding, so I’m very, ...

  18. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... first thing he will do is go through skin and down through the muscle that he was ... X-Ray, placing a marker external to the skin to help to delineate the exact trajectory into ...

  19. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... molecular weight polyethylene, and it’s a medical-grade plastic that’s really been made to sustain active compression and motion on this area for many, many, many year, decades. And so you can see when the components are placed in place that the body is able to maintain motion of the neck ...

  20. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... neck out you can actually make out the definition of that muscle. He will split that muscle ... Beutler is defining out, that’s the platysma muscle right there. He’ll divide that a little to ...

  1. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... Pinnacle Health in Harrisburg, Pennsylvania. “OR Live” makes it easy for you to learn more. Just click ... blood loss with this procedures and this approach. It’s actually a very dry procedure, and he’ll ...

  2. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... It has an outer rim of what we call the “annulus fibrosus.” And then the inside is ... the canal and explore out into what we call the foraminal region to make sure there’s no ...

  3. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... he will do is measure and get a trial implant. This implant will be approximately the size ... to be inserted at. After he places a trial and he’s happy with that, the next thing ...

  4. Cervical Cancer

    Science.gov (United States)

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

  5. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  6. 可注射型纤维蛋白凝胶转化生长因子β1复合骨髓间充质干细胞移植治疗椎间盘退变%Bone marrow mesenchymal stem cells combined with injectable fibrinous gel transforming growth factor-beta 1 transplantation for treatment of intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    吴健; 杨金华; 杨宗华; 王筱林; 张伟; 沈斐

    2011-01-01

    degeneration.METHODS: New Zealand white rabbits are randomly divided into three groups: degeneration model group, pure fibrinous gel group and MSCs+fibrinous gel group. The degeneration models were produced in three groups by means of puncturing the annulus fibrosus, then the pure fibrinous gel group and MSCs + fibrinous gel group were respectively transplanted with fibrinous gel TGF-β1 complex and MSCs + fibrinous gel TGF-β1 complex. CR, MRI and pathological examinations were carried out at 4, 8 and 12 weeks after transplant.RESULTS AND CONCLUSION: The disc height index obviously decreased in the degeneration model group and the pure fibrinous gel group, which is positively correlated with time; but the index decreased slowly in MSCs + fibrinous gel group (P <0.01). An immunohistochemistry study and a histological examination indicated a decreasing quantity of the nucleus pulposus cells and the content of type Ⅱ collagen in the degeneration model group, as well as an obviously increasing rate of cells apoptosis. The pure fibrinous gel group was similar to the degeneration model group. The MSCs + fibrinous gel group showed an obviously increasing quantity of nucleus pulposus cells and type Ⅱ collagen content compared with the degeneration group and the pure fibrinous gel group, while the cells apoptosis rate decreased. Bone marrow MSCs in combination with fibrinous gel TGF-β1 can prohibit intervertebral disc degeneration, but pure fibrinous gel TGF-β1 cannot.

  7. The effect of gamma irradiation on the biological properties of intervertebral disc allografts: in vitro and in vivo studies in a beagle model

    OpenAIRE

    Ding, Yu; Ruan, Dike; Luk, Keith D. K.; He, Qing; Wang, Chaofeng

    2014-01-01

    Study Design An animal experiment about intervertebral disc allograft. Objective To explore the feasibility to decellularize disc allografts treated by 6°Co Gamma Irradiation, and simultaneously, to assess the possibility to make use of the decellularized natural disc scaffold for disc degeneration biotherapy. Summary of Background Data Studies of both animal and human disc allograft transplantation indicated that the disc allograft may serve as a scaffold to undertake the physiological respo...

  8. THE CLINICAL EFFICACY OF INTRADISCAL OZONE INJECTION COMBINED WITH RADIOFREQUENCY THERMOCOAGULATION TECHNOLOGY IN THE TREATMENT OF CERVICAL DISC HERNIATION%CT引导下臭氧联合经皮射频热凝注射治疗颈椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    周伶; 李荣春

    2012-01-01

    目的:观察经皮穿刺盘内臭氧髓核化学溶解联合射频热凝治疗颈椎间盘突出症的临床效果.方法:颈椎间盘突出症患者528例,分为臭氧组264例,臭氧+射频组264例.均在CT引导下经颈前血管鞘和气管鞘之间穿刺入椎间盘髓核或突出物靶点.臭氧组每个盘内注射浓度为50 μg/ml的臭氧4ml.臭氧+射频组盘内注射浓度为50 μg/ml的臭氧后再行髓核或/和突出物射频热凝,设定最高温度为90℃,时间为4个周期.观察治疗后各个时期的疼痛视觉模拟评分(visual analoguescale,VAS)以及临床效果.记录治疗过程中及治疗后的并发症.结果:治疗后不同时期(24小时、1周、1个月、3个月及6个月)疼痛VAS评分与术前相比显著改善.且臭氧+射频组在治疗后3个月及6个月的VAS评分较臭氧组明显降低.治疗后6个月,臭氧组优良率为80.3%,臭氧+射频组优良率为86.5%.无一例发生严重并发症.结论:CT引导下经皮穿刺臭氧髓核化学溶解联合射频热凝是治疗颈椎间盘突出症有效的方法之一.%Objective: To observe the clinical efficacy of intradiscal ozone (O3) injection combined with radiofrequency (RF) thermocoagulation for the treatment of cervical disc hemiation. Methods: 528 patients with cervical disc herniation were randomly and evenly divided into two groups: O3 group (264 cases) and O3+RF group (264 cases). Under CT guiding, the needles were inserted into the nucleus pulposus and/or targets of cervical intervetebral disc through the path between anterior jugular tracheal sheath and vagina vasorum. In the O3 group, each disc was injected with ozone 50μg/ml (4 ml). In the O3+RF group, after injection of ozone 50μg/ml (4 ml), RF thermocoagulation was performed within nucleus pulposus and/or targets with the highest temperature of 90°C for 4 cycles. The VAS scores and complications were recorded at 24 h, 1 w, 1 month, 3 months and 6 months after treatment. Results: Compared with

  9. Macular degeneration (image)

    Science.gov (United States)

    Macular degeneration is a disease of the retina that affects the macula in the back of the eye. ... see fine details. There are two types of macular degeneration, dry and wet. Dry macular degeneration is more ...

  10. Biomechanics of Artificial Disc Replacements Adjacent to a 2-Level Fusion in 4-Level Hybrid Constructs: An In Vitro Investigation

    OpenAIRE

    Liao, Zhenhua; Fogel, Guy R.; Wei, Na; Gu, Hongsheng; Liu, Weiqiang

    2015-01-01

    Background The ideal procedure for multilevel cervical degenerative disc diseases remains controversial. Recent studies on hybrid surgery combining anterior cervical discectomy and fusion (ACDF) and artificial cervical disc replacement (ACDR) for 2-level and 3-level constructs have been reported in the literature. The purpose of this study was to estimate the biomechanics of 3 kinds of 4-level hybrid constructs, which are more likely to be used clinically compared to 4-level arthrodesis. Mate...

  11. Observation on effect of percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide treatment of cervical disc herniation%DSA引导下经皮穿刺髓核钳夹减压术联合臭氧治疗颈椎间盘突出症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴越宏; 符彦基; 庞亮明; 钟海英; 郭绍彬

    2016-01-01

    目的:观察颈椎间盘突出症于DSA引导下经皮穿刺髓核钳夹减压术联合臭氧治疗后的疗效。方法选取我院2012年5月~2015年6月间186例颈椎间盘突出症患者,所有患者均于DSA引导下经皮穿刺髓核钳夹减压术联合臭氧治疗,观察其治疗效果。结果186例患者治愈146例(78.5%),好转37例(19.8%),疗效不佳3例(1.6%),总有效率为98.4%。与治疗前比较,治疗后24 h、1周、l个月、3个月、6个月视觉模拟评分(VAS)降低,差异有统计学意义(P<0.05)。结论 DSA引导下经皮穿刺髓核钳夹联合臭气治疗颈椎间突出症创伤小、有效、安全,值得临床推广。%Objective To observe the effect of percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide in the treatment of cervical disc herniation.Methods To select 186 patients with cervical disc herniation in our hospital from May 2012 to June 2015, to treat with percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide in all patients, to observe the treatment effect.ResultsOf the 186 patients, the total effective rate was 98.4%, with cured 146 cases(78.5%), improvement 37 cases(19.8%), and poor therapeutic effect 3 cases(1.6%). The visual analogue score(VAS) after 24h, 1 week, 1 month, 3 months, 6 months treatment had reduced compared with which before treatment, the differences was statically significant(P<0.05).Conclusion Percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide in the treatment of cervical disc herniation has less trauma, is effective and safe, is worthy of clinical popularization.

  12. 胶原酶溶解术与射频热凝术治疗颈椎间盘突出症的对照研究%Comparison of the effects of collagenase chemonucleolysis and radiofrequency thermocoagula-tion in the treatment of cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    齐亮; 胡熙苒; 郭建; 黄桂明; 陈平国

    2014-01-01

    目的:比较胶原酶化学溶解术与射频热凝术治疗颈椎间盘突出症的临床疗效。方法158例颈椎间盘突出症患者分为2组,采用射频热凝术治疗72例;采用胶原酶化学溶解术治疗86例。于术后1周、1个月、3个月、6个月随访,根据MacNab疗效评定标准和VAS评分法,对治疗后优良率、总有效率和疼痛程度进行比较。结果胶原酶优良率及有效率明显高于射频组(P<0.05);VAS评分后,术后1周,射频组优于胶原酶组(P<0.01)。但6个月后胶原酶组优于射频组(P<0.05)。结论射频热凝术和胶原酶溶解术均为治疗颈椎间盘突出症的有效疗法。%Objective To compare and evaluate the effect of collagenase chemonucleolysis (CNL)and radiofrequency thermocoagulation in the treatment of cervical intervertebral disc hernia-tion. Methods 158 patients with cervical intervertebral disc herniation were divided into two groups based on the treatment they received.72 patients in A group were treated by radiofrequency thermocoagulation,and 86 patients in B group were treated by CNL. The total effective rate and pain degree were assessed according to MacNab criteria and VAS scoring after follow-up for one week, one month, three months and six months. Results The assessment of MacNab showed the effect of group B was better than group A after surgery (P<0.05). One week after treatment,the as-sessment of VAS showed that the effect of group A was better than group B after surgery (P<0.01), but 6 months after treatment, the effect of group B was better than group A (P<0.05). Conclusion The radiofrequency thermocoagulation and CNL are both effective in the treatment of cervical inter-vertebral disc herniation.

  13. Clinical effect of radiofrequency catheter ablation combined with ozone injection in the treatment of lumbar disc herniation of cervical spine%射频消融加臭氧注射微创技术治疗腰椎间盘突出症的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    杨劲松; 刘衡; 佟言

    2015-01-01

    Objective: To observe the clinical effect of radiofrequency ablation combined with ozone injection in the treat-ment of cervical intervertebral disc herniation.Methods: selected in our hospital in 2013 from August in August were 60 cases of cervical lumbar disc herniation patients, through the double chromosphere randomly divided into observation group (n = 30) and control group (n = 30), the clinical therapeutic effect of two groups of patients were compared and analyzed.Results: after treatment, the VAS score of the observation group was lower than that of the control group, the effective rate was 90%, higher than that of the control group 70% (P<0.05).Conclusion: in the treatment of cervical inter-vertebral disc herniation, the minimally invasive technique of radiofrequency ablation combined with improve the quality of life of patients. It is worthy of clinical application.%目的:观察分析腰椎间盘突出症患者采用射频消融加臭氧注射微创技术治疗的临床效果。方法:选取我院2013年8月-2014年8月收治的60例腰椎间盘突出症患者,通过双色球随机分组法分为观察组(n=30)及对照组(n=30),对照组患者采用常规治疗,观察组患者采用射频消融加臭氧注射微创技术治疗,对两组患者临床治疗效果进行比较和分析。结果:治疗后观察组患者VAS评分较对照组更低,治疗有效率90.00%,高于对照组70.00%(P<0.05)。结论:在腰椎间盘突出症治疗中,射频消融加臭氧注射微创技术可明显缓解腰椎间盘突出症状,减轻患者身心疼痛,提高临床治疗效果,进而改善患者生活质量,值得临床推广应用。

  14. Physiological loading can restore the proteoglycan content in a model of early IVD degeneration.

    Directory of Open Access Journals (Sweden)

    Rahul Gawri

    Full Text Available A hallmark of early IVD degeneration is a decrease in proteoglycan content. Progression will eventually lead to matrix degradation, a decrease in weight bearing capacity and loss of disc height. In the final stages of IVD degradation, fissures appear in the annular ring allowing extrusion of the NP. It is crucial to understand the interplay between mechanobiology, disc composition and metabolism to be able to provide exercise recommendations to patients with early signs of disc degeneration. This study evaluates the effect of physiological loading compared to no loading on matrix homeostasis in bovine discs with induced degeneration. Bovine discs with trypsin-induced degeneration were cultured for 14 days in a bioreactor under dynamic loading with maintained metabolic activity. Chondroadherin abundance and structure was used to confirm that a functional matrix was preserved in the chosen loading environment. No change was observed in chondroadherin integrity and a non-significant increase in abundance was detected in trypsin-treated loaded discs compared to unloaded discs. The proteoglycan concentration in loaded trypsin-treated discs was significantly higher than in unloaded disc and the newly synthesised proteoglycans were of the same size range as those found in control samples. The proteoglycan showed an even distribution throughout the NP region, similar to that of control discs. Significantly more newly synthesised type II collagen was detected in trypsin-treated loaded discs compared to unloaded discs, demonstrating that physiological load not only stimulates aggrecan production, but also that of type II collagen. Taken together, this study shows that dynamic physiological load has the ability to repair the extracellular matrix depletion typical of early disc degeneration.

  15. Efficacy of a Human Amniotic Tissue-derived Allograft, NuCel, in Patients Undergoing Posteriolateral Lumbar Fusions for Degenerative Disc Disease

    Science.gov (United States)

    2016-03-28

    Lumbar Degenerative Disc Disease; Spinal Stenosis; Spondylolisthesis; Spondylosis; Intervertebral Disk Displacement; Intervertebral Disk Degeneration; Spinal Diseases; Bone Diseases; Musculoskeletal Diseases; Spondylolysis

  16. Herniated lumbar disc

    OpenAIRE

    Jordon, Jo; Konstantinou, Kika; O'Dowd, John

    2011-01-01

    Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among people aged 30 to 50 years, with a male to female ratio of 2:1.

  17. Herniated Lumbar Disc

    Science.gov (United States)

    Herniated Lumbar Disc What is a herniated disc? Nonsurgical treatment Medication and pain management Surgery What can I expect after ... at and just below the waist. A herniated lumbar disc can press on the nerves in the spine ...

  18. Stem cells sources for intervertebral disc regeneration.

    Science.gov (United States)

    Vadalà, Gianluca; Russo, Fabrizio; Ambrosio, Luca; Loppini, Mattia; Denaro, Vincenzo

    2016-05-26

    Intervertebral disc regeneration field is rapidly growing since disc disorders represent a major health problem in industrialized countries with very few possible treatments. Indeed, current available therapies are symptomatic, and surgical procedures consist in disc removal and spinal fusion, which is not immune to regardable concerns about possible comorbidities, cost-effectiveness, secondary risks and long-lasting outcomes. This review paper aims to share recent advances in stem cell therapy for the treatment of intervertebral disc degeneration. In literature the potential use of different adult stem cells for intervertebral disc regeneration has already been reported. Bone marrow mesenchymal stromal/stem cells, adipose tissue derived stem cells, synovial stem cells, muscle-derived stem cells, olfactory neural stem cells, induced pluripotent stem cells, hematopoietic stem cells, disc stem cells, and embryonic stem cells have been studied for this purpose either in vitro or in vivo. Moreover, several engineered carriers (e.g., hydrogels), characterized by full biocompatibility and prompt biodegradation, have been designed and combined with different stem cell types in order to optimize the local and controlled delivery of cellular substrates in situ. The paper overviews the literature discussing the current status of our knowledge of the different stem cells types used as a cell-based therapy for disc regeneration. PMID:27247704

  19. Clinical study on the treatment of cervical disc herniation through the method of traction combined with muscle meridian manipulation%牵引配合经筋推拿治疗颈椎间盘突出症的临床研究

    Institute of Scientific and Technical Information of China (English)

    龚星军; 马文央; 王倩芬

    2011-01-01

    Objective: To observe the clinical curative effect of traction combined with muscle meridian manipulation on cervical disc herniation(CDH). Methods: 196 CDH patients met the criteria were randomly divided into 2 groups,98 cases in each group. Patients in treatment group were administrated with traction combined with muscle meridian manipulation, while the others in control group were administrated with traction combined with the specific electromagnetic wave. The curative effects of the patients were compared between the 2 groups after 2 course of treatment. Results: The curative effect of treatment group was better than that of control group and there was statistical difference between the two groups( Z = 5. 1.50, P = 0. 000). Conclusion :The method of traction combined with muscle meridian manipulation has definite curative effect on cervical disc herniation,it is worth popularizing in clinic.%目的:观察牵引配合经筋推拿治疗颈椎间盘突出症的临床疗效.方法:将符合标准的196例颈椎间盘突出症患者随机分为2组,每组98例.治疗组采用牵引配合经筋推拿治疗,对照组采用牵引结合特定电磁波治疗.治疗2个疗程后对比2组患者的疗效.结果:治疗组疗效优于对照组,差异有统计学意义(Z=5.150,P=0.000).结论:牵引配合经筋推拿治疗颈椎间盘突出症疗效确切,值得临床推广应用.

  20. Avaliação do tratamento da discopatia degenerativa cervical pela artrodese via anterior utilizando placas associadas a cages ou cages em peek isoladamente Evaluación del tratamiento de la enfermedad degenerativa del disco cervical por la artrodesis anterior utilizando placas asociadas con jaulas o jaulas en peec, aisladamente Evaluation of cervical degenerative disc disease treatment by anterior arthrodesis using plates associated with cages or cages in peek alone

    OpenAIRE

    André Rafael Hübner; Marcelo Ribeiro Mendes; Jean Carlo Frigotto Queruz; Jean Marcel Dambrós; Álvaro Diego Heredia Suárez; Leandro de Freitas Spinelli

    2011-01-01

    OBJETIVOS: Avaliar comparativamente o tratamento da discopatia degenerativa cervical por discectomia e artrodese cervical via anterior utilizando placas associadas a cages ou cages em PEEK isoladamente. MÉTODOS: Foi realizado um estudo retrospectivo comparativo entre dois grupos de pacientes operados pela técnica de discectomia e artrodese cervical via anterior. Foram selecionados aleatoriamente 70 pacientes, 35 operados com o método de fixação com placas associadas a cages - denominado Grupo...

  1. 2002 SSE Award Competition in Basic Science: Expression of major matrix metalloproteinases is associated with intervertebral disc degradation and resorption

    OpenAIRE

    Weiler, C.; Nerlich, A.; Zipperer, J.; Bachmeier, B.; Boos, N

    2002-01-01

    During the process of degeneration, the intervertebral disc (IVD) shows a progressive and significant reduction in height due to tissue resorption. Intradiscal clefts and tears are major hallmarks of disc degeneration. Matrix-degrading enzymes such as matrix metalloproteinases (MMPs) are assumed to play a pivotal role in disc tissue degradation and resorption. The objective of this study was therefore to investigate the potential role of MMPs in extracellular matrix degradation leading to dis...

  2. Operative techniques for cervical radiculopathy and myelopathy.

    LENUS (Irish Health Repository)

    Moran, C

    2012-02-01

    The surgical treatment of cervical spondylosis and resulting cervical radiculopathy or myelopathy has evolved over the past century. Surgical options for dorsal decompression of the cervical spine includes the traditional laminectomy and laminoplasty, first described in Asia in the 1970\\'s. More recently the dorsal approch has been explored in terms of minimally invasive options including foraminotomies for nerve root descompression. Ventral decompression and fusion techniques are also described in the article, including traditional anterior cervical discectomy and fusion, strut grafting and cervical disc arthroplasty. Overall, the outcome from surgery is determined by choosing the correct surgery for the correct patient and pathology and this is what we hope to explain in this brief review.

  3. Cells and Biomaterials for Intervertebral Disc Regeneration

    CERN Document Server

    Grad, Sibylle

    2010-01-01

    Disorders related to the intervertebral disc (IVD) are common causes of morbidity and of severe life quality deterioration. IVD degeneration, although in many cases asymptomatic, is often the origin of painful neck and back diseases. In Western societies IVD related pain and disability account for enormous health care costs as a result of work absenteeism and thus lost production, disability benefits, medical and insurance expenses. Although only a small percentage of patients with disc disorders finally will undergo surgery, spinal surgery has been one of the fastest growing disciplines in th

  4. Development of an in vitro model to test the efficacy of novel therapies for IVD degeneration

    OpenAIRE

    Le Maitre, Christine L; Fotheringham, Andrew P.; Anthony J Freemont; Hoyland, Judith A.

    2009-01-01

    Low back pain (LBP) is a major cause of disability worldwide that has been linked to intervertebral disc (IVD) degeneration. An improved understanding of the pathogenesis of disc degeneration is now developing, which is leading to the development of a number of possible future therapies targeted at the underlying pathology and regeneration strategies. Although results thus far are promising, the investigation of such therapies in an environment that mimics the mechanical environment of the hu...

  5. Cervical Cancer

    Science.gov (United States)

    ... to see your doctor. www.cdc.gov/cancer/knowledge 1-800-CDC-INFO Are there tests that can prevent cervical cancer or find it early? There are two tests that can either help prevent cervical cancer or find it early: • The Pap test (or Pap smear)looks for precancers, cell changes, on the cervix ...

  6. Proteomic signature of the murine intervertebral disc.

    Directory of Open Access Journals (Sweden)

    Matthew R McCann

    Full Text Available Low back pain is the most common musculoskeletal problem and the single most common cause of disability, often attributed to degeneration of the intervertebral disc. Lack of effective treatment is directly related to our limited understanding of the pathways responsible for maintaining disc health. While transcriptional analysis has permitted initial insights into the biology of the intervertebral disc, complete proteomic characterization is required. We therefore employed liquid chromatography electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS protein/peptide separation and mass spectrometric analyses to characterize the protein content of intervertebral discs from skeletally mature wild-type mice. A total of 1360 proteins were identified and categorized using PANTHER. Identified proteins were primarily intracellular/plasma membrane (35%, organelle (30%, macromolecular complex (10%, extracellular region (9%. Molecular function categorization resulted in three distinct categories: catalytic activity (33%, binding (molecule interactions (29%, and structural activity (13%. To validate our list, we confirmed the presence of 14 of 20 previously identified IVD-associated markers, including matrix proteins, transcriptional regulators, and secreted proteins. Immunohistochemical analysis confirmed distinct localization patterns of select protein with the intervertebral disc. Characterization of the protein composition of healthy intervertebral disc tissue is an important first step in identifying cellular processes and pathways disrupted during aging or disease progression.

  7. Incidence of secondary surgical procedures after cervical disc arthroplasty compared to fusion: a meta-analysis%颈椎人工椎间盘置换术与前路减压融合固定术再手术率的Meta分析

    Institute of Scientific and Technical Information of China (English)

    姜东杰; 顾庆国; 王占超; 王新伟; 袁文

    2015-01-01

    目的 比较颈椎人工椎间盘置换术与前路减压融合固定术治疗单节段颈椎病术后相邻节段和手术节段再手术的发生率.方法 计算机检索Pubmed、Medline、Ovid、Embase、Cochrane Library和中国生物医学文献数据库、万方、维普等数据库,英文检索词为"cervical"、"replacement OR arthroplasty OR prosthesis’,、"fusion OR arthrodesis","reoperation ORsecondary surgical procedure",中文检索词为"颈椎"、"间盘置换"、"融合"、"再手术".由2名评价者严格按照纳入及排除标准进行文献筛选,收集关于颈椎人工椎间盘置换术与前路减压融合固定术再手术发生率的前瞻性随机对照研究.根据Cochrane Reviews Handbook 5.1.0的RCT偏倚风险评价标准对纳入文献的偏倚风险进行独立评价,并采用Review Manager5.2软件进行统计分析相邻节段和手术节段的再手术发生率.结果12篇文献纳入研究,短期(2年)随机对照研究6篇,中远期(4~8.8年)随机对照研究6篇.4篇为低偏倚风险,7篇为中偏倚风险,1篇为高偏倚风险.Meta分析显示,短期随访结果 中两种术式在相邻节段的再手术发生率无明显差异,而中远期随访结果显示非融合组术后相邻节段再手术率低于融合组;非融合组手术节段再手术率均低于融合组.短期随访中两组患者采用Removal翻修方法的例数无差别;中远期随访中融合组患者采用该翻修方法进行翻修的人数多于非融合组.结论 非融合术式能在一定程度上降低相邻节段再手术的发生率,但是在短期(2年)内对降低邻近节段再手术的发生率效果并不明显.减少融合术后假关节形成是降低融合术式手术节段再手术率的有效方法.%Objective To compare the incidence of secondary surgical procedures after cervical disc arthroplasty vs anterior cervical discectomy with fusion in patients treated for symptomatic single level cervical spondylosis.Methods An online

  8. Macular Degeneration Partnership

    Science.gov (United States)

    AMD Macular Degeneration Partnership High Contrast Original + Font Size – Home About AMD Dry AMD Wet AMD Experience AMD Living with ... vision on a daily basis. AMD (Age Related Macular Degeneration) Partnership Listen AMD Month Public Service Announcement To ...

  9. Cervical Spondylotic Myelopathy: Factors in Choosing the Surgical Approach

    Directory of Open Access Journals (Sweden)

    Praveen K. Yalamanchili

    2012-01-01

    Full Text Available Cervical spondylotic myelopathy is a progressive disease and a common cause of acquired disability in the elderly. A variety of surgical interventions are available to halt or improve progression of the disease. Surgical options include anterior or posterior approaches with and without fusion. These include anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, cervical disc replacement, laminoplasty, laminectomy with and without fusion, and combined approaches. Recent investigation into the ideal approach has not found a clearly superior choice, but individual patient characteristics can guide treatment.

  10. Focus on research: Which disc is a candidate for biological repair?

    Institute of Scientific and Technical Information of China (English)

    彭宝淦

    2007-01-01

      Low back pain affects the majority of population at some point in their lives.Disc degeneration of lumbar spine has been considered as a main contributor to low back pain.Considering the high prevalence of low back pain in the population, treatment that aims to repair or regenerate the disc degeneration biologically appears promising as a future treatment option in humans.……

  11. Broken discs: warp propagation in accretion discs

    Science.gov (United States)

    Nixon, Christopher J.; King, Andrew R.

    2012-04-01

    We simulate the viscous evolution of an accretion disc around a spinning black hole. In general, any such disc is misaligned, and warped by the Lense-Thirring effect. Unlike previous studies, we use effective viscosities constrained to be consistent with the internal fluid dynamics of the disc. We find that non-linear fluid effects, which reduce the effective viscosities in warped regions, can promote breaking of the disc into two distinct planes. This occurs when the Shakura & Sunyaev dimensionless viscosity parameter α is ≲0.3 and the initial angle of misalignment between the disc and hole is ≳45°. The break can be a long-lived feature, propagating outwards in the disc on the usual alignment time-scale, after which the disc is fully co-aligned or counter-aligned with the hole. Such a break in the disc may be significant in systems where we know the inclination of the outer accretion disc to the line of sight, such as some X-ray binaries: the inner disc, and so any jets, may be noticeably misaligned with respect to the orbital plane.

  12. DSA引导下经皮穿刺髓核钳夹联合臭气消融治疗颈椎间盘突出症的临床研究%Clinical Study of DSA-guided Percutaneous Nucleus Pulposus Clamp Combined with Ozone Ablation in the ;Treatment of Cervical Intervertebral Disc Hemiation

    Institute of Scientific and Technical Information of China (English)

    吴越宏; 符彦基; 庞亮明; 郭绍彬; 钟海英; 黄煜华

    2015-01-01

    目的:研究DSA引导下经皮穿刺髓核钳夹联合臭氧消融治疗颈椎间盘突出症的临床意义。方法:选择颈C4/5、C5/6、C6/7、C7/T1椎间盘突出症患者86例作为研究对象,钳夹组(A组)43例C6/7或C7/T1椎间盘突出患者采用DSA引导下经皮穿刺髓核钳夹联合臭氧消融治疗,射频组(B组)43例C4/5或C5/6椎间盘突出患者采用髓核射频热凝消融联合臭气消融术。观察比较两组各个时期的疼痛视觉模拟评分(visual analogue scale,VAS)以及临床疗效。记录手术过程中及术后的并发症。结果:两组术后24 h、72 h、1周,4周、12周VAS评分均低于术前,A组术后4周及12周的VAS评分低于B组,比较差异均有统计学意义(P<0.05)。术后12周,A组优良率为91.3%,B组为80.5%,A组失败率为8.7%,B组为19.5%。两组均无严重并发症发生。结论:DSA引导下经皮穿刺髓核钳夹联合臭气消融术是目前治疗颈椎间盘突出症最安全、有效的治疗方法。%Objective:To study the clinical significance of DSA-guided percutaneous nucleus pulposus clamp combined with ozone ablation in the treatment of cervical disc hermiation.Method:86 patients with cervical intervertebral disc hermiation of C4/5,C5/6,C6/7 or C7/T1 were selected as the research objects.43 patients with cervical intervertebral disc hermiation of C6/7 or C7/T1 in the clamp group(group A)were treated with DSA-guided percutaneous nucleus pulposus clamp combined with ozone ablation.43 patients with cervical intervertebral disc hermiation of C4/5 or C5/6 in the radio frequency group(group B)were treated with radiofrequency thermocoagulation combined with ozone ablation.The VAS scores and clinical effects in different stages of the two groups were observed and compared.Complications during and after the operation were recorded.Result:24 hours,72 hours,1 week,4 weeks and 12 weeks after the operation,the VAS scores of the two groups

  13. Discussion on Non-surgery and Physical Therapy of Patients with Cervical Disc Herniation%论颈椎间盘突出症患者的非手术及理疗

    Institute of Scientific and Technical Information of China (English)

    谢昆岭

    2011-01-01

    本文主要探讨了椎间盘病学特征、病理特征、临床分型、临床症状与表现、非手术及治疗以及康复治疗的一些实际问题.%In this article, some practical problems of intervertebral disc, such as epidemiology characteristics, pathological features, clinical classification, clinical symptoms and performance, non-operative treatment and rehabilitation therapy were discussed.

  14. Can magnetic resonance imaging accurately predict concordant pain provocation during provocative disc injection?

    International Nuclear Information System (INIS)

    To correlate magnetic resonance (MR) image findings with pain response by provocation discography in patients with discogenic low back pain, with an emphasis on the combination analysis of a high intensity zone (HIZ) and disc contour abnormalities. Sixty-two patients (aged 17-68 years) with axial low back pain that was likely to be disc related underwent lumbar discography (178 discs tested). The MR images were evaluated for disc degeneration, disc contour abnormalities, HIZ, and endplate abnormalities. Based on the combination of an HIZ and disc contour abnormalities, four classes were determined: (1) normal or bulging disc without HIZ; (2) normal or bulging disc with HIZ; (3) disc protrusion without HIZ; (4) disc protrusion with HIZ. These MR image findings and a new combined MR classification were analyzed in the base of concordant pain determined by discography. Disc protrusion with HIZ [sensitivity 45.5%; specificity 97.8%; positive predictive value (PPV), 87.0%] correlated significantly with concordant pain provocation (P < 0.01). A normal or bulging disc with HIZ was not associated with reproduction of pain. Disc degeneration (sensitivity 95.4%; specificity 38.8%; PPV 33.9%), disc protrusion (sensitivity 68.2%; specificity 80.6%; PPV 53.6%), and HIZ (sensitivity 56.8%; specificity 83.6%; PPV 53.2%) were not helpful in the identification of a disc with concordant pain. The proposed MR classification is useful to predict a disc with concordant pain. Disc protrusion with HIZ on MR imaging predicted positive discography in patients with discogenic low back pain. (orig.)

  15. Can magnetic resonance imaging accurately predict concordant pain provocation during provocative disc injection?

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Chang Ho; Kim, Yun Hwan; Kim, Jung Hyuk; Chung, Kyoo Byung; Sung, Deuk Jae [Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea); Lee, Sang-Heon [Korea University Anam Hospital, Korea University College of Medicine, Department of Physical Medicine and Rehabilitation, Seoul (Korea); Derby, Richard [Spinal Diagnostics and Treatment Center, Daly City, CA (United States); Stanford University Medical Center, Division of Physical Medicine and Rehabilitation, Stanford, CA (United States)

    2009-09-15

    To correlate magnetic resonance (MR) image findings with pain response by provocation discography in patients with discogenic low back pain, with an emphasis on the combination analysis of a high intensity zone (HIZ) and disc contour abnormalities. Sixty-two patients (aged 17-68 years) with axial low back pain that was likely to be disc related underwent lumbar discography (178 discs tested). The MR images were evaluated for disc degeneration, disc contour abnormalities, HIZ, and endplate abnormalities. Based on the combination of an HIZ and disc contour abnormalities, four classes were determined: (1) normal or bulging disc without HIZ; (2) normal or bulging disc with HIZ; (3) disc protrusion without HIZ; (4) disc protrusion with HIZ. These MR image findings and a new combined MR classification were analyzed in the base of concordant pain determined by discography. Disc protrusion with HIZ [sensitivity 45.5%; specificity 97.8%; positive predictive value (PPV), 87.0%] correlated significantly with concordant pain provocation (P < 0.01). A normal or bulging disc with HIZ was not associated with reproduction of pain. Disc degeneration (sensitivity 95.4%; specificity 38.8%; PPV 33.9%), disc protrusion (sensitivity 68.2%; specificity 80.6%; PPV 53.6%), and HIZ (sensitivity 56.8%; specificity 83.6%; PPV 53.2%) were not helpful in the identification of a disc with concordant pain. The proposed MR classification is useful to predict a disc with concordant pain. Disc protrusion with HIZ on MR imaging predicted positive discography in patients with discogenic low back pain. (orig.)

  16. Gene expression of collagen types Ⅸ and X in the lumbar disc

    Institute of Scientific and Technical Information of China (English)

    西永明; 胡有谷; 吕振华; 郑红军; 陈岩; 齐宗华

    2004-01-01

    Objective: To study gene expression of collagen types IX and X in human lumbar intervertebral discs during aging and degeneration and to explore the role of collagen types IX and X in disc degeneration.Methods: Fetal, adult and pathologic specimens were subjected to in situ hybridization with cDNA probes to investigate mRNA-expressions of types IX and X collagen gene.Results: In fetal intervertebral discs, positive mRNA hybridization signals of type IX collagen were concentrated in the nucleus pulposus and the inner layer of anulns fibrosns. Interstitial matrix of the nucleus pulposns also showed positive type X collagen staining. Positive mRNA hybridization signals of types IX and X were not detected in the middle and outer layers of anulus fibrosus. In adult specimens, expression of type IX collagen mRNA was markedly decreased. No hybridization signals of type X collagen was observed. As for pathological specimens, there was no gene expression of type IX collagen. In severe degenerated discs from adults, there were focal positive expressions of type X collagen. Conclusions: Obvious changes of collagen gene expression occur with aging. Expression of type IX collagen decreases in adult and pathological discs. Results of type X collagen expression suggest that type X collagen is expressed only in older adult and senile discs (I. E., when disc degeneration has already reached a terminal stage ),indicating the terminal stage of degeneration.

  17. Síndrome de Brown-Séquard por hérnia discal cervical a duplo nível: caso clínico e revisão da literatura Síndrome de Brown-Séquard por hernia discal cervical en nivel doble: caso clínico y revisión de la literatura Brown-Séquard syndrome by double level cervical disc herniation: case report and review of the literature

    OpenAIRE

    Jorge Miguel Silva Ribeiro Olliveira Alves; Paulo Peixoto; Nuno Ferreira; Rui Martins; João Correia; Fernando Silva; Carlos de Sousa

    2012-01-01

    Descrição do caso clínico de um paciente com síndrome de Brown-Séquard por hérnia de disco cervical em duplo nível, 40 anos, do sexo masculino, sem história de patologia prévia da coluna cervical; teve início insidioso de paresia nos membros direitos, associada à diminuição da sensibilidade dolorosa e térmica do hemicorpo esquerdo, após mergulho que ocasionou trauma indireto da coluna cervical. A RM da coluna cervical mostrou hérnias discais paramedianas direitas nos níveis C4-C5 e C5-C6 com ...

  18. Spectroscopic Parameters of Lumbar Intervertebral Disc Material

    Science.gov (United States)

    Terbetas, G.; Kozlovskaja, A.; Varanius, D.; Graziene, V.; Vaitkus, J.; Vaitkuviene, A.

    2009-06-01

    needle can give additional information of needle position, assuring the needle tip is directed into intervertebral disc material. Spectroscopic analysis of intervertebral disc removed during open surgery, creates background for further investigation on intervertebral disc degeneration spectral classification.

  19. Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Bae, Sang Jin [Sanggyepaik Hospital, Inje University, Seoul (Korea, Republic of)

    2004-12-15

    We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, me