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Sample records for cervical disc degeneration

  1. Effect of Electro-acupuncture on Matrix Metalloproteinase in Degenerated Cervical Intervertebral Disc of Rats

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    SHI Zheng; HUANG Qiang; MA Xiao-peng; LIU Shi-min; LIU Hui-rong; ZHU Zhong-chun

    2007-01-01

    To observe the effect of electro-acupuncture on matrix metalloproteinase in degenerated cervical intervertebral disc rats.Methods:The rat model of cervical intervertebral disc degeneration was induced by unbalanced dynamic and static forces,then the rats were randomly allocated to model group,electro-acupuncture groupⅠ(acupoints Dazhu(BL 11) and Tianzhu(BL 10) were electro-acupunctured),and electro-acupuncture group Ⅱ(acupoints Dazhu (BL 11),Tianzhu(BL 10)and Shenshu(BL 23) were electro-acupunctured),with the normal rats as control.then the HE staining method was adopted to observe the morphological change of cervical intervertebral disc and the immunohistochemical staining method was used to detect the marx metalloproteinases-1(MMP-1) and matrix metalloproteinases-3(MMP-3) in cervical intervertebral disc.Results:The morphological observation showed that after electro-acupuncture treatment,the degrees of cervical intervertebral disc degeneration in electro-acupuncture groupⅠand electro-acupuncture group Ⅱ were alleviated,and the electro-acupuncture group Ⅱ was superior to electro-acupuncture group Ⅰ.The expressions of MMP-1 and MMP-3 in degenerated cervical intervertebral disc were increased(P<0.01),and after electro-acupuncture treatment,the expressions of MMP-1 and MMP-3 in degenerated cervical intervertebral disc were decreased,especially the electro-acupuncture group Ⅱpresented the better effect as compared with electro-acupuncture group Ⅰ(P<0.05).Conclusions:Electro-acupuncture at acupoints Dazhu (BL 11) and Tianzhu (BL 10) had a certain therapeutic effect on cervical intervertebral disc degeneration,and in combination with acupoint Shenshu(BL 23),this therapeutic effect could be enhanced,its action mechanism might be that electro-acupuncture can reduce the expressions of MMP-l and MMP-3 in degenerated cervical intervertebral disc,inhibit the degradation of matrix in intervertebral disc.so as to relieve cervical intervertebral disc

  2. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  3. The Incidence of Adjacent Segment Degeneration after Cervical Disc Arthroplasty (CDA): A Meta Analysis of Randomized Controlled Trials

    OpenAIRE

    Baohui Yang; Haopeng Li; Ting Zhang; Xijing He; Siyue Xu

    2012-01-01

    BACKGROUND: Cervical disc arthroplasty is being used as an alternative degenerative disc disease treatment with fusion of the cervical spine in order to preserve motion. However, whether replacement arthoplasty in the spine achieves its primary patient centered objective of lowering the frequency of adjacent segment degeneration is not verified yet. METHODOLOGY: We conducted a meta-analysis according to the guidelines of the Cochrane Collaboration using databases including PubMed, Cochrane Ce...

  4. Upper thoracic-spine disc degeneration in patients with cervical pain

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    Arana, Estanislao; Marti-Bonmati, Luis; Costa, Salvador [Department of Radiology, Clinica Quiron, Avda Blasco Ibanez 14, 46010, Valencia (Spain); Molla, Enrique [Department of Radiology, Clinica Quiron, Avda Blasco Ibanez 14, 46010, Valencia (Spain); Department of Morphological Sciences, University of Valencia, Valencia (Spain)

    2004-01-01

    To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established. One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6{+-}14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion. Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2-3 was the most commonly affected level of the upper thoracic spine, with 15 bulge/protrusions and one extrusion. Upper degenerative thoracic disc contour changes presented in older patients than the cervical levels (Student-Newman-Keuls test, P<0.001). Degenerative disc contour changes at the C7-T1, T1-2, T2-3 and T3-4 levels were significantly correlated (P=0.001), but unrelated to any other disc disease, patient's gender or age. Degenerative cervical disc disease was closely related together (P<0.001), but not with any thoracic disc. A statistically significant relation was found within the upper thoracic discs, reflecting common pathoanatomical changes. The absence of relation to cervical segments is probably due to differences in their pathomechanisms. (orig.)

  5. The incidence of adjacent segment degeneration after cervical disc arthroplasty (CDA: a meta analysis of randomized controlled trials.

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    Baohui Yang

    Full Text Available BACKGROUND: Cervical disc arthroplasty is being used as an alternative degenerative disc disease treatment with fusion of the cervical spine in order to preserve motion. However, whether replacement arthoplasty in the spine achieves its primary patient centered objective of lowering the frequency of adjacent segment degeneration is not verified yet. METHODOLOGY: We conducted a meta-analysis according to the guidelines of the Cochrane Collaboration using databases including PubMed, Cochrane Central Register of Controlled Trials and Embase. The inclusion criteria were: 1 Randomized, controlled study of degenerative disc disease of the cervical spine involving single segment or double segments using Cervical disc arthroplasty (CDA with anterior cervical discectomy and fusion (ACDF as controls; 2 A minimum of two-year follow-up using imaging and clinical analyses; 3 Definite diagnostic evidences for "adjacent segment degeneration" and "adjacent segment disease"; 4 At least a minimum of 30 patients per population. Two authors independently selected trials; assessed methodological quality, extracted data and the results were pooled. RESULTS: No study has specifically compared the results of adjacent segment degenerative; Two papers describing 140 patients with 162 symptomatic cervical segment disorders and compared the rate of postoperative adjacent segment disease development between CDA and ACDF treatments, three publications describing the rate of adjacent-segment surgery including 1273 patients with symptomatic cervical segments. The result of the meta-analysis indicates that there were fewer the rate of adjacent segment disease and the rate for adjacent-segment surgery comparing CDA with ACDF, but the difference was not statistically significant. CONCLUSIONS: Based on available evidence, it cannot be concluded, that CDA can significantly reduce the postoperative rate of the adjacent segment degenerative and adjacent segment disease. However, due

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

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    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.)

  7. Three-level cervical disc herniation

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    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.

  8. Prevalence of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion based on pre-operative MRI findings.

    Science.gov (United States)

    Lundine, Kristopher M; Davis, Gavin; Rogers, Myron; Staples, Margaret; Quan, Gerald

    2014-01-01

    Anterior cervical discectomy and fusion (ACDF) is a widely accepted surgical treatment for symptomatic cervical spondylosis. Some patients develop symptomatic adjacent segment degeneration, occasionally requiring further treatment. The cause and prevalence of adjacent segment degeneration and disease is unclear at present. Proponents for motion preserving surgery such as disc arthroplasty argue that this technique may decrease the "strain" on adjacent discs and thus decrease the incidence of symptomatic adjacent segment degeneration. The purpose of this study was to assess the pre-operative prevalence of adjacent segment degeneration in patients undergoing ACDF. A database review of three surgeons' practice was carried out to identify patients who had undergone a one- or two-level ACDF for degenerative disc disease. Patients were excluded if they were operated on for recent trauma, had an inflammatory arthropathy (for example, rheumatoid arthritis), or had previous spine surgery. The pre-operative MRI of each patient was reviewed and graded using a standardised methodology. One hundred and six patient MRI studies were reviewed. All patients showed some evidence of intervertebral disc degeneration adjacent to the planned operative segment(s). Increased severity of disc degeneration was associated with increased age and operative level, but was not associated with sagittal alignment. Disc degeneration was more common at levels adjacent to the surgical level than at non-adjacent segments, and was more severe at the superior adjacent level compared with the inferior adjacent level. These findings support the theory that adjacent segment degeneration following ACDF is due in part to the natural history of cervical spondylosis.

  9. Medium-term outcomes of artificial disc replacement for severe cervical disc narrowing

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    Chao-Hung Yeh

    2014-01-01

    Conclusions: Acceptable clinical outcome for treatment of severe cervical disc narrowing with cervical disc replacement technique has been performed in current study. Most patients maintained good postoperative mobility and no significant adjacent level degeneration were found. Cervical disc replacement may be applicable in treatment of severe cervical disc narrowing; however, longer follow-ups are required for ensuring the long-term efficacy of cervical disc replacement.

  10. Adjacent segment degeneration after single-level anterior cervical decompression and fusion: disc space distraction and its impact on clinical outcomes.

    Science.gov (United States)

    Li, Jia; Li, Yongqian; Kong, Fanlong; Zhang, Di; Zhang, Yingze; Shen, Yong

    2015-03-01

    The purpose of this study was to find whether excessive distraction of the disc space for cage insertion was a risk factor for adjacent segment degeneration (ASD) after anterior cervical decompression and fusion (ACDF). One hundred and sixteen consecutive patients who underwent ACDF for single-level cervical disc herniation between June 2006 and November 2008 were retrospectively reviewed. Preoperative, postoperative and final follow-up disc height (DH), sagittal segmental alignment (SSA), and sagittal alignment of the cervical spine (SACS) were measured and compared between the ASD group and non-ASD group. In 116 patients, ASD was radiographically proven in 28 (24.1%) patients. The clinical outcomes were significantly improved compared to the preoperative scores in both groups. However, the postoperative and final follow-up DH of the ASD group were significantly higher than in the non-ASD group (p<0.05). In addition, the postoperative DH was significantly correlated with the postoperative or final follow-up SSA (p<0.05). However, postoperative DH was not found to significantly correlate with postoperative or final follow-up SACS (p=0.072 and p=0.096, respectively). Multivariate analysis showed that postoperative DH was the most significant risk factor for ASD. The clinical outcomes of ACDF for single-level degenerative cervical disc disease were satisfactory. Postoperative DH (the distracted distance) had the greatest impact on the incidence of ASD. Excessive disc space distraction is a considerable risk factor for the development of radiographic ASD.

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

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    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.

  12. Intervertebral disc degeneration in dogs

    NARCIS (Netherlands)

    Bergknut, Niklas

    2011-01-01

    Back pain is common in both dogs and humans, and is often associated with intervertebral disc (IVD) degeneration. The IVDs are essential structures of the spine and degeneration can ultimately result in diseases such as IVD herniation or spinal instability. In order to design new treatments halting

  13. Disc degeneration: current surgical options

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    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.

  14. Medium-term outcomes of artificial disc replacement for severe cervical disc narrowing

    Institute of Scientific and Technical Information of China (English)

    Chao-Hung Yeh; Che-Wei Hung; Cheng-Hsing Kao; Chien-Ming Chao

    2014-01-01

    Objective:To determine if theBryan cervical disc prosthesis could relieve objective neurological symptoms, signs, and restore mobility in patients with severe cervical disc narrowing. Methods:Clinical data of thirty-two patients underwentBryan cervical disc replacement has been collected fromApril2006 toFebruary2010.Severe cervical disc narrowing with gradeV disc degeneration were included in this study.Bryan cervical disc prostheses have been implanted through anterior approach.JapaneseOrthopedicsAssociation(JOA) score, visual analog scale, Odom’s scale, and flexion-extension radiological follow-ups were applied for evaluations. Results:A total of41Bryan disc prostheses from32 patients with an average follow-up duration of33.5 months(range23 to44 months) were evaluated.Clinical functions of patients were significantly improved.Preoperative averaged visual analog scale score of6.3±2.2 was decreased to1.3±1.2(at36 months,P<0.001), while preoperative averagedJOA score of14.4±1.2 was increased to16.3±0.9(at36 months,P<0.001).Thirty of32 patients received excellent to good outcomes inOdom’s scale.Averaged mobility was restored to(9.9±3.2)°at the last follow-up evaluation of36 months.No subsidence or migration of implant was identified. Conclusions:Acceptable clinical outcome for treatment of severe cervical disc narrowing with cervical disc replacement technique has been performed in current study.Most patients maintained good postoperative mobility and no significant adjacent level degeneration were found.Cervical disc replacement may be applicable in treatment of severe cervical disc narrowing; however, longer follow-ups are required for ensuring the long-term efficacy of cervical disc replacement.

  15. 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.

  16. Genetic association studies in lumbar disc degeneration

    DEFF Research Database (Denmark)

    Eskola, Pasi J; Lemmelä, Susanna; Kjaer, 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....

  17. 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

  18. Magnetic resonance imaging of intervertebral disc degeneration

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    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.).

  19. Biomechanical study of intervertebral disc degeneration

    OpenAIRE

    González Guitiérrez, Ramiro Arturo

    2012-01-01

    Degeneration and age affect the biomechanics of the intervertebral disc, by reducing its stiffness, flexibility and shock absorption capacities against daily movement and spinal load. The biomechanical characterization of intervertebral discs is achieved by conducting mechanical testing to vertebra-disc-vertebra segments and applying axial, shear, bend and torsion loads, statically or dynamically, with load magnitudes corresponding to the physiological range. However, traditional testing does...

  20. 颈椎人工椎间盘置换后对相邻节段退变的影响%Effect of cervical disc arthroplasty on adjacent segment degeneration

    Institute of Scientific and Technical Information of China (English)

    孙宇; 赵衍斌; 周非非; 张凤山; 潘胜发; 周方; 刘忠军

    2011-01-01

    Objective:To investigate the adjacent segment degeneration after single level cervical disc arthroplasty. Method : Patients received single level cervical arthroplasty in our institute were reviewed retrospectively. Up to October 2010,a total of 80 patients gained at least 20 months' follow-up.There were 8 cases of C3/4,15 C4/5,49 C5/6 and 8 C6/7.41 patents received Bryan Disc cervical prosthesis and 39 received ProDisc-C prosthesis. Adjacent segment degeneration was evaluated on X-ray and magnetic resonance imaging (MRI) at preoperative and final follow-up.X-ray based adjacent segment degeneration included the presence of aoy of the following parameters:narrowing of disc space>10%,new anterior or/and extended osteophyte formation,calcification of anterior longitudinal ligament. Cervical disc degeneration was evaluated according to Miyazaki's grading system based on T2-weighted MRI.Result:The mean follow-up period was 38 months (range,20-64 months).Of 160 segments at final follow-up,8 distal adjacent segments were excluded due to unavailability of X-ray,adjacent segment degeneration was observed in 21 of 152 segments(13.8%) based on X-ray findings.The rate of adjacent segment degeneration for Bryan disc group was 10.0%,which was lower than that of ProDisc-C group (18.1%).47 patients gained MRI follow-up,and adjacent segment degeneration was observed in 14 of 94 segments (14.9%).The rate of MRI-based adjacent segment degeneration for Bryan Disc group was 12.5%,which was also lower than that of ProDisc-C group (22.7%).No adjacent segment disease developed at final follow-up. Conclusion:Less than 15% cases develop adjacent segment degeneration 38 months after cervical disc arthroplasty,and the effect may vary between different prosthesis.%目的:观察单节段颈椎人工椎间盘置换术后相邻节段退变情况.方法:截止到2010年10月在我院行单节段颈椎人工椎间盘置换术后随访20个月以上且资料完整、既

  1. 艾灸对兔退变颈椎间盘蛋白多糖含量的影响%Effect of Moxibustion on the Contents of Proteoglycan of Rabbits with Degeneration of Cervical Intervertebral Disc

    Institute of Scientific and Technical Information of China (English)

    蔡洁; 彭锐; 熊勇

    2011-01-01

    Objective:To observe the effect of moxibustion on the contents of proteoglycan of rabbits with degeneration of cervical in-tervertebral disc, and to explore its potential mechanism. Methods: Twenty-four Japanese white rabbits were divided into three groups at random: moxibustion group, model group and normal group, 8 in each group. Model of degeneration of cervical interver-tebral disc was established with modified fixation in sixty-degree flexion, and intervention was used at the beginning of model preparation. Animals in the moxibustion group were treated with moxibustion applied on cervical paravertebral point (EX-B 2) (each acupoint for 15minutes, once a day); animals in the nomal group with nothing. The intervertebral disc tissues were harvested three months after model preparation, and the proteoglycan contents were measured. Results:The contents of proteoglycan in the model group were significantly decreased (P0. 05). Conclusion: Moxibustion can prevent depression of the contents of proteoglycan, which may contribute to the therapeutic effect of moxibustion on degeneration of cervical intervertebral disc.%目的:观察艾灸对兔退变颈椎间盘蛋白多糖的影响,探讨艾灸防治颈椎间盘退变的作用及可能机制.方法:24只日本大耳白兔随机分为艾灸组、模型组和正常组,每组8只,采用颈椎曲位固定法制备兔颈椎间盘退变模型,造模后立即干预.艾灸组温和灸颈部夹脊穴,每穴15min,1次/d.造模3月后,各组取出退变椎间盘组织,测量其蛋白多糖含量.结果:模型组椎间盘蛋白多糖含量明显减少(P0.05).结论:艾灸可防止兔颈椎间盘蛋白多糖含童过度减少,对兔颈椎间盘退变有一定延缓作用.

  2. 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

  3. 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.

  4. 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

  5. 大鼠颈椎间盘退行性变后软骨细胞凋亡及形态学改变%Chondrocyte apoptosis and morphological changes of degenerated cervical intervertebral disc in rats

    Institute of Scientific and Technical Information of China (English)

    王拥军; 施杞; 李家顺; 贾连顺; 周重建; 刘梅; 周泉

    2004-01-01

    intervertebral disc after imbalance of dynamic and static force was established in the cervix of rats.DESIGN: A completely randomized controlled study.SETTING and PARTICIPANTS: The study was conducted in the Research Institute of Spine, Shanghai University of Traditional Chinese Medical. Subjects were sixty 8-month-old SD rats with 30 rats in each gender (clean grade).INTERVENTIONS: Male and female rats were randomly allocated into 3-,5- and 7-month control groups and 3-, 5- and 7-month model groups with 10rats each(5 in each gender) by means of random number table. Skin was cut in the medium of the cervical back in rats. Each layer of muscle was separately adequately. The deep cervical splenius muscle and the longest muscles of head, cervix and neck were cut crossly. Iliocostalis cervicis and semispinalis capitis muscles were completely cut. The supraspinal and interspinal ligaments were cut off from C2 to C7 in turn. After the procedures,the rat model of degeneration in cervical intervertebral disc caused by imbalance between the dynamic and static force was set up.MAIN OUTCOME MEASURES: The degree of chondrocyte apoptosis in intervertebral disc at 3, 5 and 7 months respectively.RESULTS: There was typical chondrocyte apoptosis in degenerated cervical intervertebral disc. The index of apoptosis was significantly higher in the disc of each model groups compared with each control groups respectively (P<0.01) . The apoptotic indices were significant higher in 5- and 7-month model groups[ (36.59±5.93) and (36.36±5.13) respectively]compared with that of 3-month model group(27.73±4.12,P<0.01) by TUNEL method, and the apoptotic indices were significantly higher in 5-month and 7-month model groups[ (37.56±3.82) and (28.02 + 3.48)respectively] compared with that of 3-month model group(21.45 + 2.23, P <0.01) analyzed by flow cytometry.CONCLUSION: There are much more apoptotic cells in cartilage endplate of degenerated cervical intervertebral discs, which may be one of the

  6. 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.

  7. ADJACENT SEGMENT DEGENERATION AFTER CERVICAL ARTIFICIAL DISC REPLACEMENT AT EARLY MID-TERM FOLLOW-UP%人工颈椎间盘置换术后邻近节段退变情况的早中期随访

    Institute of Scientific and Technical Information of China (English)

    刘雅普; 夏虹; 艾福志; 石林; 隋文渊

    2012-01-01

    Objective To study the effectiveness of artificial disc replacement for cervical diseases and the adjacent segment degeneration. Methods Between January 2008 and October 2010, 39 cases of cervical spondylosis underwent cervical disc replacement. Of them, there were 20 males and 19 females with an average age of 45.7 years (range, 32-60 years) and an average disease duration of 30 months (range, 1 month to 10 years), including 26 cases of cervical myelopathy, 11 cases of nerve root cervical spondylosis, and 2 cases of mixed cervical spondylosis. Single level disc lesion was observed in 27 cases while bi-level lesion in 12 cases. Prestige disc prosthesis was used in 9 patients, Prodisc-C prosthesis in 4 patients, and Discover disc prosthesis in 26 patients. The neurological functional recovery was assessed after operation by Japanese Orthopaedic Association (JOA) score. The range of motion of replaced segment and adjacent segments was measured (Cobb angle), and Kellgren's X-ray assessment was used to evaluate the degree of adjacent segment degeneration. Results The operation was successfully performed in all cases, with primary healing of all the incisions. All patients were followed up from 12 to 36 months with an average of 23.1 months. JOA score was significantly improved at last follow-up when compared with preoperative score (P 0.05). According to the Kellgren's X-ray assessment, degeneration of the adjacent segments occurred in 5 cases at last follow-up, including 3 cases of degeneration from grade 0 to grade 1 or 2, 1 from grade 1 to grade 2, and 1 from grade 2 to grade 3, with a degeneration rate of 12.8%, but no significant difference was found in degeneration degree when compared with preoperative value (X2=1.793, P=0.406). No degeneration of adjacent segments occurred in 32 patients at 15 months after operation. Conclusion Artificial disc replacement has a good effectiveness in treating cervical spondylosis, which can maintain the range of motion of the

  8. 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.

  9. Tourette's syndrome with cervical disc herniation.

    Science.gov (United States)

    Lin, Jainn-Jim; Wang, Huei-Shyong; Wong, Mun-Ching; Wu, Chieh-Tsai; Lin, Kuang-Lin

    2007-03-01

    Tourette's syndrome is manifested in a broad spectrum of motor, vocal, and behavioral disturbances. Movement disorders, such as tics, may contribute to the development of cervical myelopathy owing to the effects of involuntary movements on the neck. However, the association of cervical myelopathy with motor tics of the head and neck is rare. We report here a case of a violent, repetitive neck extension due to Tourette's syndrome that developed cervical myelopathy caused by cervical disc herniation.

  10. Finite element analysis of the effects of disc degeneration on the biomechanical behavior of the cervical spine%颈椎间盘退变对颈椎生物力学影响的有限元研究

    Institute of Scientific and Technical Information of China (English)

    王诗成; 潘磊; 黄必留; 孔抗美; 王新家

    2015-01-01

    Objective To investigate the effects of disc degeneration on the biomechanical behavior of the cervical spinal motion segment,an anatomic detailed finite element model of the lower cervical spine (C4-C5-C6) and three finite element models of lower cervical spine (C4-C5-C6) with three different grades of progressive disc degeneration (lightly,moderately,severely) at the (C5-6) level were developed. Methods Three finite element models with progressive grades of disc degeneration(lightly,moderately,severely) at the (C5-6) level were established by modify-ing the material properties and height of the disc according to normal finite element model. The biomechanical parameters such as the displacement of disc,Von Mises stresses in the annulus fi-brosus,intradiscal-pressure in the nucleus pulposus and the forces in the facet joints were mea-sured under 45 N axial compressive loading. Results Three finite element models of lower cer-vical spine(C4-C5-C6)with three different grades of progressive disc degeneration at (C5-6) level have been developed. According to the models,both disc axial displacement and disc bulge ob-viously decreased in MD and SD under axial pressure (45 N),but increased in LD. It was showed that compressive pressure on outer annular fibrosus were increasing but the pressure on nucleus pulposus was decreasing. The compressive stress and von mises stress of facets in-creased in LD under axial pressure,but decreased in MD and SD. Conclusion The stability of spine was decreased on spinal motion segment with slight disc degeneration. The conditions were opposite with moderate and severe disc degeneration. This is likely a compensatory mechanism to maintain the stability of spine.%目的:建立人体颈椎C4-C5-C6节段颈椎间盘退变三维有限元模型,分析椎间盘退变对颈椎运动节段生物力学的影响。方法通过改变椎间盘材料特性和高度等参数,建立椎间盘轻度退变模型(LD)、中度退变模型(MD)

  11. 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.

  12. Gene expression profile analysis of human intervertebral disc degeneration

    OpenAIRE

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

    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 signi...

  13. 颈椎间盘置换及前路椎间融合治疗单节段颈椎间盘突出症:谁更多影响邻近节段发生退变?%Anterior cervical disc replacement and anterior cervical decompression and fusion for treating single segment cervical disc herniation:which has greater effects on adjacent segment degeneration?

    Institute of Scientific and Technical Information of China (English)

    刘威; 盛伟斌; 张健; 邓强; 郭海龙

    2016-01-01

    背景:有研究表明,颈椎间盘置换及前路固定融合治疗颈椎病可以取得较好的临床效果,但是哪种术式在避免邻近节段退变方面更具优势尚无定论。目的:比较颈椎间盘置换与前路固定融合治疗单节段颈椎间盘突出症对邻近节段的近期影响。方法:收集2009年1月至2012年12月以“颈椎间盘突出症”为诊断收入院并行单节段颈椎间盘置换或颈前路椎间盘切除融合患者178例的临床资料,进行回顾性分析,其中前路固定融合组116例,颈椎间盘置换组62例。结果与结论:①评价:两组患者末次随访时目测类比评分、日本骨科协会评估治疗评分、颈椎功能障碍指数均较治疗前明显改善(P 0.05)。前路固定融合组术后3个月时手术节段基本融合,活动度丧失,末次随访时邻近上位节段活动度与邻近下位节段活动度明显增加,且上位节段活动度增加的度数较下位节段大(P 0.05). At 3 months after surgery, in the anterior cervical decompression and fusion group, surgical segment was confluent, and range of motion lost. During final fol ow-up, range of motion of adjacent upper segment and adjacent lower segment was significantly increased, and the increased range of motion in the upper segment was bigger than that of the lower segment (P < 0.05). (3) During final fol ow-up, X-ray films and MRI images revealed the number of degenerated adjacent segment was more in the anterior cervical decompression and fusion group than in the anterior cervical disc replacement group (P <0.05). The number of degenerated middle and upper segments was more than that of the lower segment in both groups (P < 0.05). (4) The findings confirmed that anterior cervical disc replacement or anterior cervical decompression and fusion for treating cervical disc herniation could effectively relieve nerve symptoms of patients. However, compared with the anterior cervical disc

  14. 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

  15. 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

  16. Aging and degeneration of the intervertebral disc: review of basic science

    Directory of Open Access Journals (Sweden)

    Josemberg da Silva Baptista

    2015-06-01

    Full Text Available Currently there is a growing interest in the study of intervertebral discs due to loss of manpower brought to society by low back and neck pains. These papers seek to delineate the difference between normal aging and disc degeneration, trying to understand what factor would be determining for the second condition. Thus, the morphology field was expanded and knowledge on the structure of intervertebral discs currently uses the research field of cell and molecular biology, and genetics. The results indicate that regardless of age or condition, the intervertebral disc undergoes long and extensive remodeling of its constituents, which are influenced by several factors: environmental, soluble, cell growth and extracellular matrix. In this literature review we describe the biological characteristics of the cervical and lumbar intervertebral disc with a focus on basic science of aging and degeneration, selecting the latest findings and discussions of the area, which influence future research and clinical thoughts.

  17. Delivery systems for the treatment of degenerated intervertebral discs

    NARCIS (Netherlands)

    Blanquer, S.B.G.; Grijpma, D.W.; Poot, A.A.

    2015-01-01

    The intervertebral disc (IVD) is the most avascular and acellular tissue in the body and therefore prone to degeneration. During IVD degeneration, the balance between anabolic and catabolic processes in the disc is deregulated, amongst others leading to alteration of extracellular matrix production,

  18. Delivery systems for the treatment of degenerated intervertebral discs

    NARCIS (Netherlands)

    Blanquer, S. B. G.; Grijpma, D. W.; Poot, A. A.

    2015-01-01

    The intervertebral disc (ND) is the most avascular and acellular tissue in the body and therefore prone to degeneration. During IVD degeneration, the balance between anabolic and catabolic processes in the disc is deregulated, amongst others leading to alteration of extracellular matrix production,

  19. 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.

  20. Magnetic resonance imaging of the cervical spine: Frequency of degenerative changes in the intervertebral disc with relation to age

    Energy Technology Data Exchange (ETDEWEB)

    Abdulkarim, J.A.; Dhingsa, R.; Finlay, D.B.L

    2003-12-01

    AIM: To ascertain the level at which intervertebral disc degeneration of the cervical spine most commonly occurs in each decade from 20-79 years. MATERIALS AND METHODS: Using computer analysis, we retrospectively assessed the mean signal intensity from each cervical disc from T2-weighted spin-echo images in 60 symptomatic patients (10 per decade from the third to eighth inclusive). RESULTS: Age, disc level and interaction between age and level were highly significant predictors for the magnetic resonance imaging (MRI) mean signal intensity from intervertebral discs (p<0.0001 for all three terms). The MRI signals were generally lower as age increased and also for the higher discs (C2-C3, etc). CONCLUSION: In our study we have shown that in younger patients the higher discs are more frequently affected by degeneration than the lower ones. As age increases, the process of degeneration becomes more generalized with less variability between discs.

  1. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation.

    Science.gov (United States)

    Li, Jian; Yan, Deng-lu; Zhang, Zai-Heng

    2008-12-01

    Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors' clinic and treated by PCN. The patients' gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 +/- 10.2 years). The levels of involvement were 21 cases at C3-4, 30 cases at C4-5, 40 cases at C5-6, and 35 cases at C6-7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) > or =11 degrees or horizontal displacement (HD) > or =3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P PCN procedure. There was no significant difference in stability either preoperatively or

  2. Diaphragm paralysis from cervical disc lesions.

    Science.gov (United States)

    Cloward, R B

    1988-01-01

    An opera singer, who "made her living with her diaphragm", developed a post-traumatic unilateral radiculopathy due to cervical disc lesions, C3 to C6. During one year of severe neck and left arm pain she gradually lost the ability to sing difficult operatic passages which brought an end to her music career. Following a three level anterior cervical decompression and fusion, the neck and arm pain was immediately relieved. One week later her voice and singing ability returned to its full strength and power permitting her to resume her activities as a vocalist. The diagnosis of paresis of the left hemi-diaphragm as part of the cervical disc syndrome was implied by postoperative retrospective inference.

  3. Notochord Cells in Intervertebral Disc Development and Degeneration

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    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.

  4. Hybrid Surgery Versus Anterior Cervical Discectomy and Fusion in Multilevel Cervical Disc Diseases: A Meta-Analysis.

    Science.gov (United States)

    Zhang, Jianfeng; Meng, Fanxin; Ding, Yan; Li, Jie; Han, Jian; Zhang, Xintao; Dong, Wei

    2016-05-01

    To investigate the outcomes and reliability of hybrid surgery (HS) versus anterior cervical discectomy and fusion (ACDF) for the treatment of multilevel cervical spondylosis and disc diseases.Hybrid surgery, combining cervical disc arthroplasty (CDA) with fusion, is a novel treatment to multilevel cervical degenerated disc disease in recent years. However, the effect and reliability of HS are still unclear compared with ACDF.To investigate the studies of HS versus ACDF in patients with multilevel cervical disease, electronic databases (Medline, Embase, Pubmed, Cochrane library, and Cochrane Central Register of Controlled Trials) were searched. Studies were included when they compared HS with ACDF and reported at least one of the following outcomes: functionality, neck pain, arm pain, cervical range of motion (ROM), quality of life, and incidence of complications. No language restrictions were used. Two authors independently assessed the methodological quality of included studies and extracted the relevant data.Seven clinical controlled trials were included in this study. Two trials were prospective and the other 5 were retrospective. The results of the meta-analysis indicated that HS achieved better recovery of NDI score (P = 0.038) and similar recovery of VAS score (P = 0.058) compared with ACDF at 2 years follow-up. Moreover, the total cervical ROM (C2-C7) after HS was preserved significantly more than the cervical ROM after ACDF (P = 0.000) at 2 years follow-up. Notably, the compensatory increase of the ROM of superior and inferior adjacent segments was significant in ACDF groups at 2-year follow-up (P multilevel cervical spondylosis to preserve cervical ROM and reduce the risk of adjacent disc degeneration. Nonetheless, more well-designed studies with large groups of patients are required to provide further evidence for the benefit and reliability of HS for the treatment of cervical disk diseases.

  5. Classification of the lumbar disc degeneration using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Hirotoshi; Shinomiya, Kenichi; Okamoto, Akihiko; Muto, Naoko; Furuya, Kotaro (Tokyo Medical and Dental Univ. (Japan). School of Medicine)

    1992-11-01

    Magnetic resonance (MR) imaging has been performed in consecutive 114 patients with a chief complaint of lumbar pain. A retrospective review of MR images of a total of 570 lumbar vertebrae from these patients were done to examine lumbar disc degeneration. According to the MR intensity of nucleus pulposus on T2-wighted sagittal images, lumbar disc degeneration was graded on a scale of 0-4: 0=uniform hyperintensity; 1=slight hypointensity; 2=centrally band-like hypointensity with marginal hyperintensity; 3=irregular hypointensity in both the central and marginal sites; 4=uniform hypointensity. Lumbar disc degeneration was observed in 76%; and it was rapidly increased in frequency in the 30 or older age groups. Of 570 vertebrae, 51 (8.9%) had narrowing of intervertebral cavity. For these vertebrae, a mean score of lumbar disc degeneration was 3.1. Lumbar disc herniation was seen in 93 vertebrae, with a mean score of lumbar disc degeneration being 3.07. Changes in vertebral body marrow were seen in 14 vertebrae (2.5%), in which a mean score of intervertebral disc degeneration was 3.71. (N.K.).

  6. Potential regenerative treatment strategies for intervertebral disc degeneration in dogs

    NARCIS (Netherlands)

    Bach, Frances C; Willems, Nicole; Penning, Louis C; Ito, Keita; Meij, Björn P; Tryfonidou, Marianna A

    2014-01-01

    Pain due to spontaneous intervertebral disc (IVD) disease is common in dogs. In chondrodystrophic (CD) dogs, IVD disease typically develops in the cervical or thoracolumbar spine at about 3-7 years of age, whereas in non-chondrodystrophic (NCD) dogs, it usually develops in the caudal cervical or lum

  7. New treatment strategies for canine intervertebral disc degeneration

    NARCIS (Netherlands)

    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. How

  8. 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

  9. 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.

  10. 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

    Directory of Open Access Journals (Sweden)

    van den Akker Elske

    2010-06-01

    Full Text Available Abstract Background 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 a known entity on the long term. Recently, cervical disc prostheses are developed to maintain motion and possibly reduce the incidence of adjacent disc degeneration. A comparative cost-effectiveness study focused on adjacent segment degeneration and functional outcome has not been performed yet. We present the design of the NECK trial, a randomised study on cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in patients with cervical disc herniation. Methods/Design Patients (age 18-65 years presenting with radicular signs due to single level cervical disc herniation lasting more than 8 weeks are included. Patients will be randomised into 3 groups: anterior discectomy only, anterior discectomy with interbody fusion, and anterior discectomy with disc prosthesis. The primary outcome measure is symptomatic adjacent disc degeneration at 2 and 5 years after surgery. Other outcome parameters will be the Neck Disability Index, perceived recovery, arm and neck pain, complications, re-operations, quality of life, job satisfaction, anxiety and depression assessment, medical consumption, absenteeism, and costs. The study is a randomised prospective multicenter trial, in which 3 surgical techniques are compared in a parallel group design. Patients and research nurses will be kept blinded of the allocated treatment for 2 years. The follow-up period is 5 years. Discussion Currently, anterior cervical discectomy with fusion is the golden standard in the surgical treatment of cervical disc herniation. Whether additional interbody fusion or disc prothesis is necessary and cost-effective will be determined by this trial

  11. 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.

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

    Science.gov (United States)

    Capossela, S; Schläfli, P; Bertolo, A; Janner, T; Stadler, B M; Pötzel, T; Baur, M; Stoyanov, J V

    2014-04-04

    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.

  13. 颈椎前路融合致邻近节段椎间盘退变的原因探讨%Causes of adjacent segments disc degeneration caused by anterior cervical fusion

    Institute of Scientific and Technical Information of China (English)

    张克非; 刘伟; 于长水; 袁绍辉; 潘琦

    2011-01-01

    目的 探讨颈椎前路融合后邻近节段椎间盘退变的原因及其防治办法.方法 对实施颈椎前路融合术的126例颈椎间盘突出症患者进行回顾性分析,归纳可能导致颈椎前路融合术后临近椎间盘退变突出的原因.结果 随访时间最短10个月,最长10年,平均7.8年.37例颈椎间盘突出症患者发生临近节段椎间盘退变加重,其中7例患者再次手术.结论 颈椎前路融合后邻近节段椎间盘退变的原因可能为临近节段原有退变加重,椎间融合后生物力学改变,临近节段应力集中.%To investigate the causes of the adjacent intervertebral disc degeneration after anterior decompression and interbody fusion of C-spine and search for the way of prevention.Methods A retrospective study was given to 126 patients who underwent an anterior decompression and interbody fusion of C-spine, the causes of the adjacent intervertebral disc degeneration after anterior decompression and interbody fusion of C-spine were analyzed. Results The follow-up time was from 10 months to 10 years, average 7.8 years. Thirty-seven patients occurred the aggravation of adjacent intervertebral discs degeneration, in which 7 patients underwent reoperation. Conclusion The possible causes of the adjacent intervertebral disc degeneration after anterior decompression and interbody fusion of C-spine is that the aggravation of original degeneration of adjacent intervertebral disc, the alteration of biomechanics after anterior decompression and interbody fusion of C-spine induces the stress concentration of the adjacent intervertebral disc.

  14. 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.

  15. 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.

  16. 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)....

  17. Cervical intradural disc herniation and cerebrospinal fluid leak

    Directory of Open Access Journals (Sweden)

    Ritesh Kansal

    2011-01-01

    Full Text Available Cervical intradural disc herniation (IDH is a rare condition and only 25 cases of cervical have been reported. We report a 45-year-old male who presented with sudden onset right lower limb weakness after lifting heavy weight. Magnetic resonance imaging of the cervical spine showed C5/6 disc prolapse with intradural extension. The patient underwent C5/6 discectomy through anterior cervical approach. Postoperatively, the patient improved in stiffness but developed cerebrospinal fluid leak and the leak resolved with multiple lumbar punctures.

  18. Discover cervical disc arthroplasty versus anterior cervical discectomy and fusion in symptomatic cervical disc diseases: A meta-analysis

    Science.gov (United States)

    Shangguan, Lei; Ning, Guang-Zhi; Tang, Yu; Wang, Zhe; Luo, Zhuo-Jing; Zhou, Yue

    2017-01-01

    Objective Symptomatic cervical disc disease (SCDD) is a common degenerative disease, and Discover artificial cervical disc, a new-generation nonconstrained artificial disk, has been developed and performed gradually to treat it. We performed this meta-analysis to compare the efficacy and safety between Discover cervical disc arthroplasty (DCDA) and anterior cervical discectomy and fusion (ACDF) for SCDD. Methods An exhaustive literature search of PubMed, EMBASE, and the Cochrane Library was conducted to identify randomized controlled trials that compared DCDA with ACDF for patients suffering SCDD. A random-effect model was used. Results were reported as standardized mean difference or risk ratio with 95% confidence interval. Results Of 33 articles identified, six studies were included. Compared with ACDF, DCDA demonstrated shorter operation time (P 0.05). Subgroup analyses did not demonstrated significant differences. Conclusion In conclusion, DCDA presented shorter operation time, and better ROM at the operative level. However, no significant differences were observed in blood loss, NDI scores, neck and arm pain scores, JOA scores, secondary surgery procedures and adverse events between the two groups. Additionally, more studies of high quality with mid- to long-term follow-up are required in future. PMID:28358860

  19. Height of lumbar discs measured from radiographs compared with degeneration and height classified from MR images

    Energy Technology Data Exchange (ETDEWEB)

    Frobin, W.; Brinckmann, P. [Muenster Univ. (Germany). Inst. fuer Experimentelle Biomechanik; Kramer, M.; Hartwig, E. [Ulm Univ. (Germany). Sektion fuer Unfallchirurgische Forschung und Biomechanik

    2001-02-01

    The relation between height of lumbar discs (measured from lateral radiographic views) and disc degeneration (classified from MR images) deserves attention in view of the wide, often parallel or interchanged use of both methods. The time sequence of degenerative signs and decrease of disc height is controversial. To clarify the issue, this cross-sectional study documents the relation between disc degeneration and disc height in a selected cohort. Forty-three subjects were selected at random from a cohort examined for potential disc-related disease caused by long-term lifting and carrying. From each subject a lateral radiographic view of the lumbar spine as well as findings from an MR investigation of (in most cases) levels T12/L1 to L5/S1 were available; thus, n = 237 lumbar discs were available for measurement and classification. Disc height was measured from the radiographic views with a new protocol compensating for image distortion and permitting comparison with normal, age- and gender-appropriate disc height. Degeneration as well as disc height were classified twice from MR images by independent observers in a blinded fashion. Disc degeneration classified from MR images is not related to a measurable disc height loss in the first stage of degeneration, whereas progressive degeneration goes along with progressive loss of disc height, though with considerable interindividual variation. Loss of disc height classified from MR images is on average compatible with loss of disc height measured from radiographs. In individual discs, however, classification of height loss from MR images is imprecise. The first sign of disc degeneration (a moderate loss of nucleus signal) precedes disc height decrease. As degeneration progresses, disc height decreases. Disc height decrease and progress of degeneration, however, appear to be only loosely correlated. (orig.)

  20. 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.)

  1. 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

  2. Genetic susceptibility of intervertebral disc degeneration among young Finnish adults

    OpenAIRE

    2011-01-01

    Abstract Background Disc degeneration (DD) is a common condition that progresses with aging. Although the events leading to DD are not well understood, a significant genetic influence has been found. This study was undertaken to assess the association between relevant candidate gene polymorphisms and moderate DD in a well-defined and characterized cohort of young adults. Focusing on young age can be valuable in determining genetic predisposition to DD. Methods We investigated the associations...

  3. 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

  4. 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

  5. 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.)

  6. 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.

  7. Structural and Ultrastructural Analysis of the Cervical Discs of Young and Elderly Humans.

    Directory of Open Access Journals (Sweden)

    Ricardo Braganca de Vasconcellos Fontes

    Full Text Available Several studies describing the ultrastructure and extracellular matrix (ECM of intervertebral discs (IVDs involve animal models and specimens obtained from symptomatic individuals during surgery for degenerative disease or scoliosis, which may not necessarily correlate to changes secondary to normal aging in humans. These changes may also be segment-specific based on different load patterns throughout life. Our objective was to describe the ECM and collagen profile of cervical IVDs in young (G1 - 65 years presumably-asymptomatic individuals. Thirty cervical discs per group were obtained during autopsies of presumably-asymptomatic individuals. IVDs were analyzed with MRI, a morphological grading scale, light microscopy, scanning electron microscopy (SEM and immunohistochemistry (IHC for collagen types I, II, III, IV, V, VI, IX and X. Macroscopic degenerative features such as loss of annulus-nucleus distinction and fissures were found in both groups and significantly more severe in G2 as expected. MRI could not detect all morphological changes when compared even with simple morphological inspection. The loose fibrocartilaginous G1 matrix was replaced by a denser ECM in G2 with predominantly cartilaginous characteristics, chondrocyte clusters and absent elastic fibers. SEM demonstrated persistence of an identifiable nucleus and Sharpey-type insertion of cervical annulus fibers even in highly-degenerated G2 specimens. All collagen types were detected in every disc sector except for collagen X, with the largest area stained by collagens II and IV. Collagen detection was significantly decreased in G2: although significant intradiscal differences were rare, changes may occur faster or earlier in the posterior annulus. These results demonstrate an extensive modification of the ECM with maintenance of basic ultrastructural features despite severe macroscopic degeneration. Collagen analysis supports there is not a "pathologic" collagen type and changes

  8. 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.

  9. 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.

  10. 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.

  11. Clinical Impact of Sagittal Spinopelvic Parameters on Disc Degeneration in Young Adults.

    Science.gov (United States)

    Oh, Young-Min; Eun, Jong-Pil

    2015-10-01

    The sagittal balance plays an important role in the determination of shear and compressive forces applied on the anterior (vertebral bodies and intervertebral discs) and posterior (facet joints) elements of the lumbar vertebral column. Many studies have also examined the effect of structural changes in the disc on the biomechanical characteristics of the spinal segment. Nevertheless, the relationship between sagittal balance and the degree of disc degeneration has not been extensively explored. Thus, here we investigated the relationships between various sagittal spinopelvic parameters and the degree of disc degeneration in young adults.A total of 278 young adult male patients were included in this study (age range: 18-24 years old). Multiple sagittal spinopelvic parameters, including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), sacral inclination (SI), lumbosacral angle (LSA), and sacral table angle (STA), were measured from standing lateral lumbosacral radiographs. The degree of intervertebral disc degeneration was classified using a modified Pfirrmann scale. To assess the pain intensity of each patient, the visual analogue scale (VAS) score for low back pain (LBP) was obtained from all the patients. Finally, the relationships between these spinopelvic parameters and the degree of disc degeneration in young adults were analyzed. Also, we performed multiple logistic regression study.Out of all the spinopelvic parameters measured in this study, a low STA and a low SI were the only significant risk factors that were associated with disc degeneration in young adults. It means that patients with disc degeneration tend to have more severe sacral kyphosis and vertical sacrum.We found that patients with disc degeneration showed a lower SI and lower STA compared with patients without disc degeneration in young adults. Therefore, we suggest that the patients with disc degeneration tend to have more vertical sacrum, more sacral kyphosis

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

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    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.

  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. In-Depth Analysis on Influencing Factors of Adjacent Segment Degeneration After Cervical Fusion

    Science.gov (United States)

    Yu, Chaojie; Mu, Xiaoping; Wei, Jianxun; Chu, Ye; Liang, Bin

    2016-01-01

    Background To explore the related influencing factors of adjacent segment degeneration (ASD) after cervical discectomy and fusion (ACDF). Material/Methods A retrospective analysis of 263 patients who underwent ACDF was carried out. Cervical x-ray and magnetic resonance imaging (MRI) were required before operation, after operation, and at the last follow-up. General information and some radiographic parameters of all patients were measured and recorded. According to the imaging data, patients were put into one of two groups: non-ASD group and ASD group. The differences between the two groups were compared by t-test and χ2-test, and the related influencing factors of ASD were analyzed by logistic regression. Results In all, 138 patients had imaging ASD. Comparing the age, the postoperative cervical arc chord distance (po-CACD), and the plate to disc distance (PDD) of the two groups, differences were statistically significant (pspinal canal ratio, and the upper and lower disc height (DH) showed no statistical difference between the two groups (p>0.05). The results of logistic regression analysis showed that there were significant correlations in the following characteristics: age, postoperative po-CACD, and the PDD (pcurvature of cervical spine, and a PDD < 5 mm was more likely to lead to ASD. PMID:27965512

  15. 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.

  16. Increased MMP-2 activity during intervertebral disc degeneration is correlated to MMP-14 levels

    NARCIS (Netherlands)

    Rutges, J. P. H. J.; Kummer, J. A.; Oner, F. C.; Verbout, A. J.; Roestenburg, H. J. A.; Dhert, W. J. A.; Creemers, L. B.

    2008-01-01

    Intervertebral disc (IVD) degeneration is associated with the increased expression of several matrix metalloproteinases (MMPs), in particular MMP-2. However, little is known about the actual activity of MMP-2 in healthy and degenerated discs, or what mechanisms are involved in its activation. A majo

  17. Surgery in cervical disc herniation: anterior cervical discectomy without fusion or with fusion

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    Iencean Andrei Stefan

    2017-03-01

    Full Text Available The study included a group of anterior cervical microdiscectomy without fusion performed at one level (either C5-C6 level or at the C6-C7 level and a second group of patients with same single-level of anterior cervical discectomy with fusion. The kinematic analysis included the range of motion, anteroposterior translation and disc height assessed for the cervical functional spinal units at the operated level and adjacent levels. At the operated level the range of motion and the translation were minimal in the anterior cervical discectomy without fusion group, both for the C5-C6 and C6-C7 levels, and absent in the cervical discectomy with fusion group. The superior adjacent levels translations were greater in the ACDF group compared with the ACD group. The clinical results of both types of cervical discectomy were comparable. In cervical microdiscectomy without fusion the elastic fibrous intradiscal scar at the operated level allows a small degree of mobility and the adjacent cervical levels are not overstressed. No need for anterior cervical discectomy with fusion to trait a single level cervical disc herniation than in selected cases.

  18. Experimental study on the effect of manipulation on IL-6 and TNF-α of degenerated cervical intervertebral discs in rabbits%手法对颈椎病模型兔颈椎间盘炎性因子的影响

    Institute of Scientific and Technical Information of China (English)

    赵凯; 盛杰; 夏亮

    2012-01-01

    Objective To explore the anti - inflammation effect of manipulation on cervical spondylosis in the cervical intervertebral disc of degenerated cervical vertebral of rabbits. Methods 34 six - month - old New Zealand rabbits, weight 2. 0 - 3. Okg each, male or female informality, were randomly divided into two groups: model group and sham group. The animal model was established by surgical intervention induced static force imblance combination of fixed at a specially - made sitting or flexion scaffold. All of the rabbits were examined with lateral cervical spine X - ray and at 4 and 8 weeks after modeling. The pathological examination was performed for the cervical intervertebral disc 8 weeks later. The animal model was verified successfully according to X - ray pathology result, and the model rabbits were divided into 2 groups randomly: treatment group and model control group. The rabbits were fed freely in model control group and sham group, not fixed sitting or flexion. The treatment group was administered with manipulation for once a day. The rabbits were killed to collect experimental samples after 8 weeks treatment, and then the cerival intervertebral disc specimens were homogenated to test the contents of IL - 6 and TNF - αby radioimmunoassay. Results The contens of IL - 6 and TNF -α in discs of degenerated cervical vertebral rabbits model were significantly higher than those of sham group( P < 0.01 ). The contents of IL - 6 and TNF - α in disc of treatment group were lower than those of model control group ( P <0.01 ). Conclusion The manipulation can inhibit the inflammatory reaction and attain its effect in the prevention and treatment of cervical spondylosis.%目的 观察手法干预对实验性家兔退变颈椎间盘组织IL-6、TNF-α活性的影响,以探讨手法治疗颈椎病的抗炎作用机制.方法 34只6月龄新西兰大白兔,体质量2.0~3.0 kg,雌雄不分.随机分为模型组(n=22)、假手术对照组(n=12).模型组采用静力

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

    OpenAIRE

    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...

  20. The effect of disc degeneration on anterior shear translation in the lumbar spine.

    Science.gov (United States)

    Melnyk, Angela D; Kelly, Adrienne; Chak, Jason D; Wen, Tian Lin; Cripton, Peter A; Dvorak, Marcel F; Oxland, Thomas R

    2015-04-01

    Many pathologies involving disc degeneration are treated with surgery and spinal implants. It is important to understand how the spine behaves mechanically as a function of disc degeneration. Shear loading is especially relevant in the natural and surgically stabilized lumbar spine. The objective of our study was to determine the effect of disc degeneration on anterior translation of the lumbar spine under shear loading. We tested 30 human cadaveric functional spinal units (L3-4 and L4-5) in anterior shear loading. First, the specimens were imaged in a 1.5 T magnetic resonance scanner. The discs were graded according to the Pfirrmann classification. The specimens were then loaded up to 250 N in anterior shear with an axial compression force of 300 N. Motion of the vertebrae was captured with an optoelectronic camera system. Inter- and intra-observer reliability for disc grading was determined (Cohen's and Fleiss' Kappa), and a non-parametric test was performed on the translation data to characterize the effect of disc degeneration on this parameter. We found fair to moderate agreement between and within observers for the disc grading. We found no significant effect of disc degeneration on anterior shear translation (Kruskal-Wallis ANOVA). Our results indicate that disc degeneration, as classified with the Pfirrmann scale, does not predict lumbar spinal motion in shear.

  1. Herb formula "Fufangqishe-Pill" prevents upright posture-induced intervertebral disc degeneration at the lumbar in rats.

    Science.gov (United States)

    Liang, Qian-Qian; Xi, Zhi-Jie; Bian, Qin; Cui, Xue-Jun; Li, Chen-Guang; Hou, Wei; Shi, Qi; Wang, Yong-Jun

    2010-01-01

    Degeneration of the lumbar spine plays an important role in most chronic low back pain. Prevention of lumbar intervertebral disc (IVD) degeneration is therefore a high research priority. Both our previous multicenter clinical trials and pharmacological research showed that Fufangqishe-Pill (FFQSP), a newly patented traditional Chinese medicine, could effectively relieve the symptoms of neck pain and prevent cervical degeneration. To clarify the effect of FFQSP on lumbar IVD degeneration, we applied a lumbar IVD degeneration rat model induced by prolonged upright posture. Pretreatment of FFQSP for one month prevented the histological changes indicating IVD disorganization; increased type II-collagen level, decreased type X-collagen protein level, and increased Col2alpha1 mRNA expression at all time points; and decreased Col10alpha1, matrix metalloproteinase (MMP)-3, MMP13, and Interleukin (IL)-1beta mRNA expression induced by upright posture for 7 and 9 months. These results suggest that FFQSP prevents lumbar IVD degeneration induced by upright posture. FFQSP is a promising medicine for lumbar IVD degeneration disease.

  2. [Traumatic cervical disc prolapse with severe neurological impact].

    Science.gov (United States)

    Knudsen, Roland; Gundtoft, Per

    2014-12-15

    A 51-year-old male drove into a ditch on his scooter. Immediately after the trauma the patient complained of neck pain and decreased ability to feel and move his extremities. An initial trauma computed tomography (CT) of the columna showed normal conditions. Because the patient had neurological deficiencies, magnetic resonance imaging of the columna was performed 12 days later, and a disc prolapse at the C3/C4 level with spinal cord compression was visible. Despite decompression the patient did not recover. Traumatic cervical disc prolapse is a rare and positionally dangerous condition, which can be present despite a CT showing normal conditions.

  3. Two-level cervical disc replacement: perspectives and patient selection

    Directory of Open Access Journals (Sweden)

    Narain AS

    2017-02-01

    Full Text Available Ankur S Narain, Fady Y Hijji, Daniel D Bohl, Kelly H Yom, Krishna T Kudaravalli, Kern Singh Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA Introduction: Cervical disc replacement (CDR is an emerging treatment option for cervical degenerative disease. Postulated benefits of cervical disc replacement compared to anterior cervical discectomy and fusion include preserved motion at the operative segments and decreased motion at adjacent levels. Multiple studies have been performed investigating the outcomes of CDR in single-level pathology. The investigation of the use of CDR in two-level pathology is an emerging topic within the literature.Purpose: To critically evaluate the literature regarding two-level CDR in order to determine its utility compared to two-level cervical arthrodesis. Patient selection factors including indications and contraindications will also be explored.Methods: The PubMed database was searched for all articles published on the subject of two-level CDR up until October 2016. Studies were classified by publication year, study design, sample size, follow-up interval, and conflict of interest. Outcomes were recorded from each study, and included data on patient-reported outcomes, radiographic measurements, range of motion, peri- and postoperative complications, heterotopic ossification, adjacent segment disease, reoperation rate, and total intervention cost. Results: Fourteen studies were included in this review. All studies demonstrated at least noninferiority of two-level CDR compared to both two-level arthrodesis and single-level CDR. Patient selection in two-level CDR is driven by the inclusion and exclusion criteria presented in prospective, randomized controlled trials. The most common indication is subaxial degenerative disc disease over two contiguous levels presenting with radiculopathy or myelopathy. Furthermore, costs analyses trended toward at least noninferiority of two

  4. 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.)

  5. Genetic susceptibility of intervertebral disc degeneration among young Finnish adults

    Directory of Open Access Journals (Sweden)

    Kelempisioti Anthi

    2011-11-01

    Full Text Available Abstract Background Disc degeneration (DD is a common condition that progresses with aging. Although the events leading to DD are not well understood, a significant genetic influence has been found. This study was undertaken to assess the association between relevant candidate gene polymorphisms and moderate DD in a well-defined and characterized cohort of young adults. Focusing on young age can be valuable in determining genetic predisposition to DD. Methods We investigated the associations of existing candidate genes for DD among 538 young adults with a mean age of 19 belonging to the 1986 Northern Finland Birth Cohort. Nineteen single nucleotide polymorphisms (SNP in 16 genes were genotyped. We evaluated lumbar DD using the modified Pfirrmann classification and a 1.5-T magnetic resonance scanner for imaging. Results Of the 538 individuals studied, 46% had no degeneration, while 54% had DD and 51% of these had moderate DD. The risk of DD was significantly higher in subjects with an allele G of IL6 SNPs rs1800795 (OR 1.45, 95% CI 1.07-1.96 and rs1800797 (OR 1.37, 95% CI 1.02-1.85 in the additive inheritance model. The role of IL6 was further supported by the haplotype analysis, which resulted in an association between the GGG haplotype (SNPs rs1800797, rs1800796 and rs1800795 and DD with an OR of 1.51 (95% CI 1.11-2.04. In addition, we observed an association between DD and two other polymorphisms, SKT rs16924573 (OR 0.27 95% CI 0.07-0.96 and CILP rs2073711 in women (OR 2.04, 95% CI 1.07-3.89. Conclusion Our results indicate that IL6, SKT and CILP are involved in the etiology of DD among young adults.

  6. Glucosamine Supplementation Demonstrates a Negative Effect On Intervertebral Disc Matrix in an Animal Model of Disc Degeneration

    Science.gov (United States)

    Jacobs, Lloydine; Vo, Nam; Coehlo, J. Paulo; Dong, Qing; Bechara, Bernard; Woods, Barrett; Hempen, Eric; Hartman, Robert; Preuss, Harry; Balk, Judith; Kang, James; Sowa, Gwendolyn

    2013-01-01

    Study Design Laboratory based controlled in vivo study Objective To determine the in vivo effects of oral glucosamine sulfate on intervertebral disc degeneration Summary of Background Data Although glucosamine has demonstrated beneficial effect in articular cartilage, clinical benefit is uncertain. A CDC report from 2009 reported that many patients are using glucosamine supplementation for low back pain (LBP), without significant evidence to support its use. Because disc degeneration is a major contributor of LBP, we explored the effects of glucosamine on disc matrix homeostasis in an animal model of disc degeneration. Methods Eighteen skeletally mature New Zealand White rabbits were divided into four groups: control, annular puncture, glucosamine, and annular puncture+glucosamine. Glucosamine treated rabbits received daily oral supplementation with 107mg/day (weight based equivalent to human 1500mg/day). Annular puncture surgery involved puncturing the annulus fibrosus (AF) of 3 lumbar discs with a 16G needle to induce degeneration. Serial MRIs were obtained at 0, 4, 8, 12, and 20 weeks. Discs were harvested at 20 weeks for determination of glycosaminoglycan(GAG) content, relative gene expression measured by RT-PCR, and histological analyses. Results The MRI index and NP area of injured discs of glucosamine treated animals with annular puncture was found to be lower than that of degenerated discs from rabbits not supplemented with glucosamine. Consistent with this, decreased glycosaminoglycan was demonstrated in glucosamine fed animals, as determined by both histological and GAG content. Gene expression was consistent with a detrimental effect on matrix. Conclusions These data demonstrate that the net effect on matrix in an animal model in vivo, as measured by gene expression, MRI, histology, and total proteoglycan is anti-anabolic. This raises concern over this commonly used supplement, and future research is needed to establish the clinical relevance of these

  7. 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.

  8. 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.

  9. Human cells derived from degenerate intervertebral discs respond differently to those derived from non-degenerate intervertebral discs following application of dynamic hydrostatic pressure.

    Science.gov (United States)

    Le Maitre, Christine Lyn; Frain, Jennie; Fotheringham, Andrew P; Freemont, Anthony J; Hoyland, Judith Alison

    2008-01-01

    The intervertebral disc (IVD) is one of the body's most important load-bearing structures with the major mechanical force experienced in the nucleus pulposus (NP) being hydrostatic pressure (HP). Physiological levels of HP have an anabolic effect on IVD matrix metabolism in cells derived from non-degenerate animal and herniated IVD while excessive HP has a catabolic effect. However, no studies have investigated the response of non-degenerate and degenerate human disc cells derived from non-herniated discs to HP. Here we investigate the effect of physiological HP on such cells using a novel loading rig. Human IVD cells (both NP and AF) cultured in alginate were subjected to dynamic HP (0.8-1.7 MPa 0.5 Hz) for 2 h. Cell viability was assessed, RNA extracted and qRT-PCR for 18 s, c-fos, Sox-9, collagen type II, aggrecan and MMP-3 performed. Cell viability was unaffected by the loading regime. In non-degenerate NP cells, HP increased c-fos, aggrecan, Sox-9 and collagen type II (significantly so in the case of c-fos and aggrecan), but not MMP-3 gene expression. In contrast, application of HP to AF or degenerate NP cells had no effect on target gene expression. Our data shows that cells obtained from the healthy NP respond to dynamic HP by up-regulating genes indicative of healthy matrix homeostasis. However, responses differed in degenerate NP cells suggesting that an altered mechanotransduction pathway may be operational.

  10. Protective effects of cannabidiol on lesion-induced intervertebral disc degeneration.

    Directory of Open Access Journals (Sweden)

    João W Silveira

    Full Text Available Disc degeneration is a multifactorial process that involves hypoxia, inflammation, neoinnervation, accelerated catabolism, and reduction in water and glycosaminoglycan content. Cannabidiol is the main non-psychotropic component of the Cannabis sativa with protective and anti-inflammatory properties. However, possible therapeutic effects of cannabidiol on intervertebral disc degeneration have not been investigated yet. The present study investigated the effects of cannabidiol intradiscal injection in the coccygeal intervertebral disc degeneration induced by the needle puncture model using magnetic resonance imaging (MRI and histological analyses. Disc injury was induced in the tail of male Wistar rats via a single needle puncture. The discs selected for injury were punctured percutaneously using a 21-gauge needle. MRI and histological evaluation were employed to assess the results. The effects of intradiscal injection of cannabidiol (30, 60 or 120 nmol injected immediately after lesion were analyzed acutely (2 days by MRI. The experimental group that received cannabidiol 120 nmol was resubmitted to MRI examination and then to histological analyses 15 days after lesion/cannabidiol injection. The needle puncture produced a significant disc injury detected both by MRI and histological analyses. Cannabidiol significantly attenuated the effects of disc injury induced by the needle puncture. Considering that cannabidiol presents an extremely safe profile and is currently being used clinically, these results suggest that this compound could be useful in the treatment of intervertebral disc degeneration.

  11. Protective effects of cannabidiol on lesion-induced intervertebral disc degeneration.

    Science.gov (United States)

    Silveira, João W; Issy, Ana Carolina; Castania, Vitor A; Salmon, Carlos E G; Nogueira-Barbosa, Marcello H; Guimarães, Francisco S; Defino, Helton L A; Del Bel, Elaine

    2014-01-01

    Disc degeneration is a multifactorial process that involves hypoxia, inflammation, neoinnervation, accelerated catabolism, and reduction in water and glycosaminoglycan content. Cannabidiol is the main non-psychotropic component of the Cannabis sativa with protective and anti-inflammatory properties. However, possible therapeutic effects of cannabidiol on intervertebral disc degeneration have not been investigated yet. The present study investigated the effects of cannabidiol intradiscal injection in the coccygeal intervertebral disc degeneration induced by the needle puncture model using magnetic resonance imaging (MRI) and histological analyses. Disc injury was induced in the tail of male Wistar rats via a single needle puncture. The discs selected for injury were punctured percutaneously using a 21-gauge needle. MRI and histological evaluation were employed to assess the results. The effects of intradiscal injection of cannabidiol (30, 60 or 120 nmol) injected immediately after lesion were analyzed acutely (2 days) by MRI. The experimental group that received cannabidiol 120 nmol was resubmitted to MRI examination and then to histological analyses 15 days after lesion/cannabidiol injection. The needle puncture produced a significant disc injury detected both by MRI and histological analyses. Cannabidiol significantly attenuated the effects of disc injury induced by the needle puncture. Considering that cannabidiol presents an extremely safe profile and is currently being used clinically, these results suggest that this compound could be useful in the treatment of intervertebral disc degeneration.

  12. 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

  13. Durability of cervical disc arthroplasties and its influence factors

    Science.gov (United States)

    Chen, Chao; Zhang, Xiaolin; Ma, Xinlong

    2017-01-01

    Abstract Background: The durability of cervical disc arthroplasties (CDA) may vary significantly because of different designs and implanting techniques of the devices. Nevertheless, the comparative durability remains unknown. Objectives: We aimed to assess the durability of CDAs in at least 2-year follow-up. We analyzed the classifications and causes of secondary surgical procedures, as well as the structural designs of the devices that might influence the durability. Methods: PubMed, Medline, Embase, and Cochrane Central Register of Controlled Trials were searched from the inception of each database to September 2015 using the following Keywords: “cervical disc replacement” OR “cervical disc arthroplasty” AND “randomized controlled trial (RCT).” Publication language was restricted to English. The primary outcome was the rate of secondary surgical procedures following CDA or anterior cervical decompression and fusion (ACDF). Pairwise meta-analysis and a Bayesian network meta-analysis were carried out using Review Manager v5.3.5 and WinBUGS version 1.4.3, respectively. Quality of evidence was appraised by Grading of Recommendations Assessment, Development and Evaluation methodology. Results: Twelve RCTs that met the eligibility criteria were included. Follow-up ranged from 2 years to 7 years. A total of 103 secondary surgical procedures were performed. The most frequent classification of secondary surgical procedures was reoperation (48/103) and removal (47/103). Revision (3/103) and supplementary fixation (2/103) were rare. Adjacent-level diseases were the most common cause of reoperations. The rates of secondary surgical procedures were significantly lower in Mobi-C, Prestige, Prodisc-C, Secure-C group than in ACDF group. No significant difference was detected between Bryan, PCM, Kineflex-C, Discover, and ACDF. Mobi-C, Secure-C, and Prodisc-C ranked the best, the second best, the third best, respectively. Conclusions: We concluded that Mobi-C, Secure

  14. Cervical and lumbar pain and radiological degeneration among fighter pilots: a systematic review and meta-analysis.

    Science.gov (United States)

    Shiri, Rahman; Frilander, Heikki; Sainio, Markku; Karvala, Kirsi; Sovelius, Roope; Vehmas, Tapio; Viikari-Juntura, Eira

    2015-02-01

    To assess the associations of acceleration force indicators (aircraft type and flight hours) with cervical and lumbar pain and radiological degeneration among fighter pilots. The PubMed, Embase, Scopus and Web of Science databases were searched until October 2013. Twenty-seven studies were included in the review and 20 in the meta-analysis. There were no differences in the prevalence of neck pain (pooled OR=1.07, 95% CI 0.87 to 1.33), cervical disc degeneration (OR=1.26, CI 0.81 to 1.96), low back pain (OR=0.80, CI 0.47 to 1.38) or lumbar disc degeneration (OR=0.87, CI 0.67 to 1.13) between fighter pilots and helicopter or transport/cargo pilots. Moreover, the prevalence of cervical (OR=1.14, CI 0.61 to 2.16) or lumbar (OR=1.05, CI 0.49 to 2.26) disc degeneration did not differ between fighter pilots and non-flying personnel. Most studies did not control their estimates for age and other potential confounders. Among high-performance aircraft pilots, exposure to the highest G-forces was associated with a higher prevalence of neck pain compared with exposure to lower G-forces (pooled OR=3.12, CI 2.08 to 4.67). The studies on the association between flight hours and neck pain reported inconsistent findings. Moreover, looking back over the shoulder (check six) was the most common posture associated with neck pain. Fighter pilots exposed to high G-forces may be at a greater risk for neck pain than those exposed to low G-forces. This finding should be confirmed with better control for confounding. Awkward neck posture may be an important factor in neck pain among fighter pilots.

  15. Temporomandibular joint disc; a proposed histopathological degeneration grading score system

    OpenAIRE

    2010-01-01

    Summary. Aims: The purpose of this study was to draw up a TMJ disc histopathological score that is a semiquantitative transcription of the entire spectrum of TMJ disc degenerative diseases related to changes in disc tissue, and then validate the proposed grading, in order to contribute to a standardized histopathological diagnosis. Methods: Sections from sixty two temporomandibular joint disc specimens affected by tissue degenerative changes and stained with Hematox...

  16. 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

  17. Disckectomy, Partial Adjacent Centrum Resection, Bone Graft with Titanium Mesh and Titanium Plate Fixation for the Treatment of Single Segment Cervical Disc Degeneration with Adjacent Vertebral Posterior Osteophyte%椎间盘及部分椎体切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘突出伴椎体后缘骨赘

    Institute of Scientific and Technical Information of China (English)

    孙继飞; 何强; 刘振利; 陈庆胜

    2012-01-01

    目的 评价颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘退变突出伴相邻椎体后缘骨赘的疗效. 方法 应用颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘退变突出伴相邻椎体后缘骨赘22例.取颈椎前路手术切口,术中仅切除突出的椎间盘及相邻椎体的1/3~ 1/2,使脊髓得到彻底的减压.再用填满碎骨的钛网植于骨缺损处加用钛板螺丝钉内固定,固定范围仅限于相邻椎体.术前和术后通过神经功能JOA评分、颈部轴性症状、颈椎动态侧位片和颈椎MRI比较临床疗效. 结果 均获随访,平均15(6 ~24)个月,术后JOA评分优良率86.4%,颈部轴性症状减轻,脊髓功能明显得到恢复.颈椎活动度良好.X线检查见钛网植骨及钛板内固定良好,未见不稳现象.MRI示颈髓压迫解除. 结论 颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘突出伴相邻椎体骨赘效果显著,可最大限度地保留颈椎节段的活动度.%Objective To evaluate the clinical effects of disckectomy, partial adjacent centrum resection , bone graft with titanium mesh and titanium plate fixation for the treatment of single segment cervical disc degeneration with adjacent vertebral posterior osteophyte. Methods There were 22 cases received this kind of surgical procedure. By anterior cervical incision, the herniated disc and only 1/3 to 1/2 of the adjacent vertebral body were removed for the decompression of the spinal cord. Then the titanium mesh filled with the small bones was implanted in the bone defect followed by titanium screw fixation. The fixation was limited to the adjacent vertebral bodies. Preoperative and postoperative neurological functions of the JOA score, the cervical axial symptoms, the cervical dynamic radiographs and cervical spine MRI were used to compare the clinical

  18. MRI quantification of human spine cartilage endplate geometry: Comparison with age, degeneration, level, and disc geometry.

    Science.gov (United States)

    DeLucca, John F; Peloquin, John M; Smith, Lachlan J; Wright, Alexander C; Vresilovic, Edward J; Elliott, Dawn M

    2016-08-01

    Geometry is an important indicator of disc mechanical function and degeneration. While the geometry and associated degenerative changes in the nucleus pulposus and the annulus fibrosus are well-defined, the geometry of the cartilage endplate (CEP) and its relationship to disc degeneration are unknown. The objectives of this study were to quantify CEP geometry in three dimensions using an MRI FLASH imaging sequence and evaluate relationships between CEP geometry and age, degeneration, spinal level, and overall disc geometry. To do so, we assessed the MRI-based measurements for accuracy and repeatability. Next, we measured CEP geometry across a larger sample set and correlated CEP geometric parameters to age, disc degeneration, level, and disc geometry. The MRI-based measures resulted in thicknesses (0.3-1 mm) that are comparable to prior measurements of CEP thickness. CEP thickness was greatest at the anterior/posterior (A/P) margins and smallest in the center. The CEP A/P thickness, axial area, and lateral width decreased with age but were not related to disc degeneration. Age-related, but not degeneration-related, changes in geometry suggest that the CEP may not follow the progression of disc degeneration. Ultimately, if the CEP undergoes significant geometric changes with aging and if these can be related to low back pain, a clinically feasible translation of the FLASH MRI-based measurement of CEP geometry presented in this study may prove a useful diagnostic tool. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1410-1417, 2016.

  19. A Novel Catechol-O-Methyltransferase Variant Associated with Human Disc Degeneration

    Science.gov (United States)

    Gruber, Helen E.; Sha, Wei; Brouwer, Cory R.; Steuerwald, Nury; Hoelscher, Gretchen L.; Hanley, Edward N. Jr.

    2014-01-01

    Background: Disc degeneration and its associated low back pain are a major health care concern causing disability with a prominent role in this country's medical, social and economic structure. Low back pain is devastating and influences the quality of life for millions. Low back pain lifetime prevalence approximates 80% with an estimated direct cost burden of $86 billion per year. Back pain patients incur higher costs, greater health care utilization, and greater work loss than patients without back pain. Methods: Research was performed following approval of our Institutional Review Board. DNA was isolated, processed and amplified using routine techniques. Amplified DNA was hybridized to Affymetrix Genome-Wide Human SNP Arrays. Quality control and genotyping analysis were performed using Affymetrix Genotyping Console. The Birdseed v2 algorithm was used for genotyping analysis. 2589 SNPs were selected a priori to enter statistical analysis using lotistic regression in SAS. Results: Our objective was to search for novel single nucleotide polymorphisms (SNPs) associated with disc degeneration. Four SNPs were found to have a significant relationship to disc degeneration; three are novel. Rs165656, a new SNP found to be associated with disc degeneration, was in catechol-O-methyltransferase (COMT), a gene with well-recognized pain involvement, especially in female subjects (p=0.01). Analysis confirmed the previously association between COMT SNP rs4633 and disc degeneration. We also report two novel disc degeneration-related SNPs (rs2095019 and rs470859) located in intergenic regions upstream to thrombospondin 2. Conclusions: Findings contribute to the challenging field of disc degeneration and pain, and are important in light of the high clinical relevance of low back pain and the need for improved understanding of its fundamental basis. PMID:24904231

  20. Parameters that effect spine biomechanics following cervical disc replacement.

    Science.gov (United States)

    Goel, Vijay K; Faizan, Ahmad; Palepu, Vivek; Bhattacharya, Sanghita

    2012-06-01

    Total disc replacement (TDR) is expected to provide a more physiologic alternative to fusion. However, long-term clinical data proving the efficacy of the implants is lacking. Limited clinical data suggest somewhat of a disagreement between the in vitro biomechanical studies and in vivo assessments. This conceptual paper presents the potential biomechanical challenges affecting the TDR that should be addressed with a hope to improve the clinical outcomes and our understanding of the devices. Appropriate literature and our own research findings comparing the biomechanics of different disc designs are presented to highlight the need for additional investigations. The biomechanical effects of various surgical procedures are analyzed, reiterating the importance of parameters like preserving uncinate processes, disc placement and its orientation within the cervical spine. Moreover, the need for a 360° dynamic system for disc recipients who may experience whiplash injuries is explored. Probabilistic studies as performed already in the lumbar spine may explore high risk combinations of different parameters and explain the differences between "standard" biomechanical investigations and clinical studies. Development of a patient specific optimized finite element model that takes muscle forces into consideration may help resolve the discrepancies between biomechanics of TDR and the clinical studies. Factors affecting long-term performance such as bone remodeling, subsidence, and wear are elaborated. In vivo assessment of segmental spine motion has been, and continues to be, a challenge. In general, clinical studies while reporting the data have placed lesser emphasis on kinematics following intervertebral disc replacements. Evaluation of in vivo kinematics following TDR to analyze the quality and quantity of motion using stereoradiogrammetric technique may be needed.

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

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N

    2011-01-01

    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.

  2. 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.

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

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N.

    2011-01-01

    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. PMID:23259105

  4. Quantitative analysis of disc degeneration using axial T2 mapping in a percutaneous annular puncture model in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Chai, Jee Won; Kim, Su Jin [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Kang, Heung Sik; Lee, Joon Woo [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Hong, Sung Hwan [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-02-15

    To evaluate T2 relaxation time change using axial T2 mapping in a rabbit degenerated disc model and determine the most correlated variable with histologic score among T2 relaxation time, disc height index, and Pfirrmann grade. Degenerated disc model was made in 4 lumbar discs of 11 rabbits (n = 44) by percutaneous annular puncture with various severities of an injury. Lumbar spine lateral radiograph, MR T2 sagittal scan and MR axial T2 mapping were obtained at baseline and 2 weeks and 4 weeks after the injury in 7 rabbits and at baseline and 2 weeks, 4 weeks, and 6 weeks after the injury in 4 rabbits. Generalized estimating equations were used for a longitudinal analysis of changes in T2 relaxation time in degenerated disc model. T2 relaxation time, disc height index and Pfirrmann grade were correlated with the histologic scoring of disc degeneration using Spearman's rho test. There was a significant difference in T2 relaxation time between uninjured and injured discs after annular puncture. Progressive decrease in T2 relaxation time was observed in injured discs throughout the study period. Lower T2 relaxation time was observed in the more severely injured discs. T2 relaxation time showed the strongest inverse correlation with the histologic score among the variables investigated (r = -0.811, p < 0.001). T2 relaxation time measured with axial T2 mapping in degenerated discs is a potential method to assess disc degeneration.

  5. Cervical brucellar spondylodiscitis mimicking a cervical disc herniation with epidural abscess: a case report

    Directory of Open Access Journals (Sweden)

    Ahmet Aslan

    2014-05-01

    Full Text Available Brucellosis can show many clinical manifestations according to the affected sites of the body, and is usually diagnosed with osteoarticular symptoms. We present a patient with cervical brucellar spondylodiscitis and epidural abscess who presented with severe neck and left upper extremity pain and was referred to our hospital for surgery because of cervical disc herniation. The patient didn’t undergo surgery and was cured with 6 months of medical therapy. Duration of the medical therapy was assessed by magnetic resonans imaging (MRI studies. In endemic regions, brucellar spondylodiscitis should be included in differential diagnoses for patients who have cervical pain with or without neurological deficits. Patients should be attentively questioned concerning occupation, settlement place, subfebril fever, consumption of raw milk or dairy products, travel to endemic regions or past brucellosis history in the family. MRI is an important imaging modality in the diagnosis and response to medical treatment in brucellar spondylodiscitis.

  6. Cervical disc prosthesis: 2-year follow-up

    Directory of Open Access Journals (Sweden)

    Romero Pinto de Oliveira Bilhar

    2015-06-01

    Full Text Available OBJECTIVE: To review the medical records of patients who underwent surgery for placement of cervical disc prosthesis after two years of postoperative follow-up, showing the basic epidemiological data, the technical aspects and the incidence of complications.METHODS: Medical records of seven patients who underwent surgery for placement of cervical disc prosthesis were reviewed after two years of follow-up, at the Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo.RESULTS: The average age of patients participating in this study was 43.86 years. Six patients (85.7% had one level approached while one patient (14.3% had two levels addressed. The level C5-C6 has been approached in one patient (14.3% while the C6-C7 level was addressed in five patients (71.4%. One patient (14.3% had these two levels being addressed, C5-C6 and C6-C7. The mean operative time was 164.29±40 minutes. Three patients were hospitalized for 2 days and four for 3 days making an average of 2.57±0.535 days. Two patients (28.6% underwent a new surgical intervention due to loosening of the prosthesis. The mean follow-up was 28.14±5.178 months (23-35 months.CONCLUSIONS: Although cervical arthroplasty appears to be a safe procedure and present promising results in our study as well as in many other studies, it requires long-term studies.

  7. Footprint Mismatch of Cervical Disc Prostheses with Chinese Cervical Anatomic Dimensions

    Institute of Scientific and Technical Information of China (English)

    Liang Dong; Ming-Sheng Tan; Qin-Hua Yan; Ping Yi; Feng Yang; Xiang-Sheng Tang; Qing-Ying Hao

    2015-01-01

    Background:The footprint of most prostheses is designed according to Caucasian data.Total disc replacement (TDR) has been performed widely for cervical degenerative diseases in China.It is essential to analyze the match sizes of prostheses footprints and Chinese cervical anatomic dimensions in our study.Methods:The anatomic dimensions of the C4-C7 segments of 138 patients (age range 16-77 years) in a Chinese population were measured by computed tomography scans.We compared the footprints of the most commonly used cervical disc prostheses (Bryan:Medtronic,Minneapolis,MN,USA; Prestige LP:Medtronic,Fridley,Minnesota,USA; Discover:DePuy,Raynham,MA,USA; Prodisc-C:Synthes,West Chester,PA,USA) in China with Chinese cervical anatomic dimensions and assessed the match of their size.Results:The mismatch of available dimensions of prostheses and anatomic data of cervical endplates ranged from 17.03% (C4/C5,Prestige LP,Prodisc-C) to 57.61% (C6/C7,Discover) in the anterior-posterior (AP) diameter,and 35.51% (C4/C5,Prodisc-C,Prestige LP) to 94.93% (C6/C7,Bryan) in the center mediolateral (CML) diameter.About 21.01% of endplates were larger than the largest prostheses in the AP diameter and 57.25% in the CML diameter.All available footprints of prostheses expect the Bryan with an unfixed height,can accommodate the disc height (DH),however,36.23% of the middle DH was less than the smallest height of the prostheses.The average disc sagittal angles (DSAs) of C4-C7 junctions were 5.04°,5.15°,and 4.13° respectively.Only the Discover brand had a built-in 7° lordotic angle,roughly matching with the DSA.Conclusions:There is a large discrepancy between footprints of prostheses and Chinese cervical anatomic data.In recent years,possible complications of TDR related with mismatch sizes are increasing,such as subsidence,displacement,and heterotopic ossification.Manufacturers of prostheses should introduce or produce additional footprints of prostheses for Chinese TDR.

  8. Cervical intervertebral disc herniation treatment via radiofrequency combined with low-dose collagenase injection into the disc interior using an anterior cervical approach.

    Science.gov (United States)

    Wang, Zhi-Jian; Zhu, Meng-Ye; Liu, Xiao-Jian; Zhang, Xue-Xue; Zhang, Da-Ying; Wei, Jian-Mei

    2016-06-01

    This study aimed to determine the therapeutic effect of radiofrequency combined with low-dose collagenase injected into the disc interior via an anterior cervical approach for cervical intervertebral disc herniation.Forty-three patients (26-62-year old; male/female ratio: 31/12) with cervical intervertebral disc herniation received radiofrequency combined with 60 to 100 U of collagenase, injected via an anterior cervical approach. The degree of nerve function was assessed using the current Japanese Orthopaedic Association (JOA) scoring system at 3 and 12 months postoperation. A visual analogue scale (VAS) was used to evaluate the degree of pain preoperation and 7 days postoperation. The preoperative and 3 month postoperative protrusion areas were measured and compared via magnetic resonance imaging (MRI) and picture archiving and communication systems (PACS).Compared with the preoperative pain scores, the 7-day postoperative pain was significantly reduced (P <0.01). The excellent and good rates of nerve function amelioration were 93.0% and 90.7% at 3 and 12 months postoperation, respectively, which was not significantly different. Twenty-seven cases exhibited a significantly reduced protrusion area (P <0.01) at 3 months postoperation. No serious side effects were noted.To our knowledge, this is the first study to demonstrate that the use of radiofrequency combined with low-dose collagenase injection into the disc interior via an anterior cervical approach is effective and safe for the treatment of cervical intervertebral disc herniation.

  9. The relationship between disc degeneration and flexibility of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Nobuhiro; Fujimoto, Yoshinori; Ochi, Mitsuo [Hiroshima Univ. (Japan). Graduate School of Biomedical Sciences; An, H.S.; Lim, T.H.; Fujiwara, Atsushi [Rush-Presbyterian-St. Luke' s Medical Center, Chicago, IL (United States)

    2003-04-01

    The purpose of this study was to investigate the relationship between grade of degeneration of intervertebral discs and 3-dimensional biomechanical characteristics of the motion segment under multidirectional loading conditions. The material used in this study consisted of 114 lumbar motion segments from T12-L1 to L5-S1 retrieved from 47 fresh cadaver spines (average age at death, 68 years; range, 39 to 87 years). The severity of degeneration (grades I to V according to Thomson's system) was determined by examining magnetic resonance (MR) images and cryomicrotome sections. Pure unconstrained moments with dead weights were applied to the motion segments in 6 load steps. The directions of loading included flexion, extension, right and left axial rotation, and right and left lateral bending. Segments from the upper lumbar levels (T12-L1 to L3-4) tended to have greater rotational movement in flexion, extension, and axial rotation with disc degeneration up to grade IV, but the motion decreased when the disc degeneration reached grade V. In the lower lumbar spine, motion in axial rotation and lateral bending at L4-5 and L5-S1 was increased in grade III. These results suggest that kinematic properties of the lumbar spine are related to disc degeneration. Disc degeneration, particularly in grades III and IV, in which radial tears of the anulus fibrosus are found, was generally associated with greater motion. Disc space collapse and osteophyte formation, as found in grade V, resulted in stabilization of the motion segments. (author)

  10. Effects of Tobacco Smoking on the Degeneration of the Intervertebral Disc: A Finite Element Study.

    Science.gov (United States)

    Elmasry, Shady; Asfour, Shihab; de Rivero Vaccari, Juan Pablo; Travascio, Francesco

    2015-01-01

    Tobacco smoking is associated with numerous pathological conditions. Compelling experimental evidence associates smoking to the degeneration of the intervertebral disc (IVD). In particular, it has been shown that nicotine down-regulates both the proliferation rate and glycosaminoglycan (GAG) biosynthesis of disc cells. Moreover, tobacco smoking causes the constriction of the vascular network surrounding the IVD, thus reducing the exchange of nutrients and anabolic agents from the blood vessels to the disc. It has been hypothesized that both nicotine presence in the IVD and the reduced solute exchange are responsible for the degeneration of the disc due to tobacco smoking, but their effects on tissue homeostasis have never been quantified. In this study, a previously presented computational model describing the homeostasis of the IVD was deployed to investigate the effects of impaired solute supply and nicotine-mediated down-regulation of cell proliferation and biosynthetic activity on the health of the disc. We found that the nicotine-mediated down-regulation of cell anabolism mostly affected the GAG concentration at the cartilage endplate, reducing it up to 65% of the value attained in normal physiological conditions. In contrast, the reduction of solutes exchange between blood vessels and disc tissue mostly affected the nucleus pulposus, whose cell density and GAG levels were reduced up to 50% of their normal physiological levels. The effectiveness of quitting smoking on the regeneration of a degenerated IVD was also investigated, and showed to have limited benefit on the health of the disc. A cell-based therapy in conjunction with smoke cessation provided significant improvements in disc health, suggesting that, besides quitting smoking, additional treatments should be implemented in the attempt to recover the health of an IVD degenerated by tobacco smoking.

  11. The Comparison between Cervical Artificial Disc Arthroplasty and Anterior Cervical Decompression and Fusion on the Influence of the Adjacent Segments Degeneration%颈椎间盘置换术与颈椎前路减压融合术对邻近节段退变情况影响的比较

    Institute of Scientific and Technical Information of China (English)

    王鲲鹏; 邱玉金; 王玉凤; 刘守勇; 吴磊磊

    2013-01-01

    Objective To compare CADR with ACDF on the influence of the adjacent segments degenera-tion.Methods From February 2008 to October 2010,a total of 62 cases of cervical spondylosis was retrospectively re-viewed.All the patients were divided into CADR group and ACDF group ,depending on different surgical methods .The symptoms and neurological function were evaluated by the cervical Japanese Orthopaedic Association ( JOA) Scores and neck disability index ( NDI ) .The Cobb angle of C 2~7 and the mobility of adjacent segments were valuated the cervical range of mobility and degeneration .Results Compared with the preoperation , the last follow-up neurological function significantly improved ,the difference was statistically significant ( P0 .05 ) .At last follow-up Cobb angle of C 2~7 and the mobility of adjacent upper and lower segments in CADR group were similar to the preoperative ,there was no significant difference statistically (P>0.05).And there was significant difference statistically in ACDF group and between the groups ( P<0.05) .Conclusion CADR is less influ-ential on the adjacent segments degeneration postoperative .%目的:比较分析颈椎间盘置换术( CADR )与颈椎前路减压融合术( ACDF )对邻近节段退变情况的影响。方法回顾性分析2008年2月~2011年10月手术治疗的62名患者,根据术式不同,分为CADR组与ACDF组。采用颈椎JOA、NDI评分评价症状及神经功能,C2~7 Cobb角和手术相邻节段活动度评价颈椎活动范围及退变情况。结果与术前比较,末次随访时两组患者神经功能明显改善,组内差异有显著性(P<0.05),但组间比较差异无显著性(P>0.05)。与术前相比,末次随访时CADR组C2~7 Cobb角和手术相邻上、下节段活动度相近,差异无显著性(P>0.05);ACDF组内比较与两组间末次随访时比较C2~7 Cobb角和手术相邻上、下节段活动度,差异有显著性( P<0.05

  12. Pathology and possible mechanisms of nervous system response to disc degeneration.

    Science.gov (United States)

    Brisby, Helena

    2006-04-01

    Degeneration of the intervertebral disc is clinically considered to be an important source of pain in patients with low-back pain. Disc deterioration and/or degeneration may influence the nervous system by stimulation of nociceptors in the anulus fibrosus, causing nociceptive pain that is often referred to as discogenic pain. The stimulation of the nociceptors may be of mechanical or inflammatory origin. Deterioration of a disc with loss of normal structure and weight-bearing properties may lead to abnormal motions that cause mechanical stimulation. This theory is supported by the fact that patients commonly experience an increase in pain with weight-bearing and certain movements. In addition, an ingrowth of vessels and nerve fibers into deeper layers of the anulus fibrosus has been observed in degenerated discs. A large number of inflammatory and signaling substances, such as tumor necrosis factor and interleukins (interleukin-1beta, interleukin-6, and interleukin-8), may also play a role in the development of back pain. Independent of stimulus of the nociceptors, the pain impulses are conducted through myelinated A delta fibers and unmyelinated C fibers to the dorsal root ganglion and continue by way of the spinothalamic tract to the thalamus and the somatosensory cortex. In response to stimulation of the nociceptors in the disc, the somatosensory system may increase its sensitivity, resulting in a nonfunctional response; that is, normally innocuous stimuli may generate an amplified response (peripheral sensitization). When disc degeneration leads to a disc herniation, the adjacent nervous system structures, such as the nerve roots or the dorsal root ganglion, can be affected, causing neuropathic pain of mechanical or biochemical origin. Disc deterioration also influences other spinal structures, such as facet joints, ligaments, and muscles, which can also become pain generators. Thus, disc degeneration may be responsible for the development of chronic low

  13. 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

  14. Do design variations in the artificial disc influence cervical spine biomechanics? A finite element investigation

    OpenAIRE

    Faizan, Ahmad; Goel, Vijay K.; Garfin, Steven R.; Serhan, Hassan; Biyani, Ashok; Elgafy, Hossein; Krishna, Manoj; Friesem, Tai; Bono, Christopher M

    2009-01-01

    Various ball and socket-type designs of cervical artificial discs are in use or under investigation. Many artificial disc designs claim to restore the normal kinematics of the cervical spine. What differentiates one type of design from another design is currently not well understood. In this study, authors examined various clinically relevant parameters using a finite element model of C3–C7 cervical spine to study the effects of variations of ball and socket disc designs. Four variations of b...

  15. 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.

  16. Class 3 semaphorins expression and association with innervation and angiogenesis within the degenerate human intervertebral disc

    NARCIS (Netherlands)

    Binch, Abbie L A; Cole, Ashley A; Breakwell, Lee M; Michael, Anthony L R; Chiverton, Neil; Creemers, Laura B; Cross, Alison K; Le Maitre, Christine L

    2015-01-01

    Nerve and blood vessel ingrowth during intervertebral disc degeneration, is thought to be a major cause of low back pain, however the regulation of this process is poorly understood. Here, we investigated the expression and regulation of a subclass of axonal guidance molecules known as the class 3 s

  17. Does elite swimming accelerate lumbar intervertebral disc degeneration and increase low back pain?

    DEFF Research Database (Denmark)

    Folkvardsen, Steffen; Magnussen, Erland; Karppinen, Jaro

    2016-01-01

    PURPOSE: The aim was to elucidate elite swimming's possible influence on lumbar disc degeneration (DD) and low back pain (LBP). METHODS: Lumbar spine MRI was performed on a group of elite swimmers and compared to a matched Finnish population-based no-sport group. RESULTS: One hundred elite swimmers...

  18. Novel genetic variants associated with lumbar disc degeneration in northern Europeans: A meta-analysis of 4600 subjects

    NARCIS (Netherlands)

    F.M.K. Williams (Frances); A.T. Bansal (Aruna); J.B.J. van Meurs (Joyce); J.T. Bell (Jordana); I. Meulenbelt (Ingrid); P. Suri (Pradeep); F. Rivadeneira Ramirez (Fernando); P.N. Sambrook (Philip); A. Hofman (Albert); S.M. Bierma-Zeinstra (Sita); C. Menni (Cristina); M. Kloppenburg (Margreet); P.E. Slagboom (Eline); D. Hunter (David); A.J. MacGregor (Alex ); A.G. Uitterlinden (André); T.D. Spector (Timothy)

    2013-01-01

    textabstractObjective: Lumbar disc degeneration (LDD) is an important cause of low back pain, which is a common and costly problem. LDD is characterised by disc space narrowing and osteophyte growth at the circumference of the disc. To date, the agnostic search of the genome by genome-wide associati

  19. Protective effect of calcitonin on lumbar fusion-induced adjacent-segment disc degeneration in ovariectomized rat

    OpenAIRE

    Liu, Chang-Cheng; Tian, Fa-Ming; Zhou, Zhuang; Wang, Peng; Gou, Yu; Zhang, Heng; Wang, Wen-Ya; Shen, Yong; Zhang, Ying-Ze; Zhang, Liu

    2015-01-01

    Background Intervertebral disc (IVD) degeneration and pathological changes in the spinal cord are major causes of back pain. In addition to its well-established anti-resorptive effect on bone, calcitonin (CT) potentially exerts protective effects on IVD degeneration in ovariectomized rats. However, possible therapeutic effects of CT on lumbar fusion-induced adjacent-segment disc degeneration (ASDD) have not been investigated yet. In this study, we examined the effects of CT on IVD degeneratio...

  20. 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.

    Directory of Open Access Journals (Sweden)

    Sheng Shi

    Full Text Available 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.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.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.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.

  1. MRI assessment of lumbar intervertebral disc degeneration with lumbar degenerative disease using the Pfirrmann grading systems.

    Directory of Open Access Journals (Sweden)

    Li-Peng Yu

    Full Text Available BACKGROUND: To evaluate by MRI intervertebral disc degeneration in patients with lumbar degenerative disease using the Pfirrmann grading system and to determine whether Modic changes correlated with the Pfirrmann grades and modified Pfirrmann grades of disc degeneration. METHODS: The clinical data of 108 surgical patients with lumbar degenerative disease were reviewed and their preoperative MR images were analyzed. Disc degeneration was evaluated using the Pfirrmann grading system. Patients were followed up and low back pain was evaluated using the visual analog scale (VAS and the effect of back pain on the daily quality of life was assessed using Oswestry disability index (ODI. RESULTS: Forty-four cases had normal anatomical appearance (Modic type 0 and their Pfirrmann grades were 3.77±0.480 and their modified Pfirrmann grades were of 5.81±1.006. Twenty-seven cases had Modic type I changes and their Pfirrmann grades were 4.79±0.557 and their modified Pfirrmann grades were 7.00±0.832. Thirty-six cases exhibited Modic type II changes and their Pfirrmann grades and modified Pfirrmann grades were 4.11±0.398 and 6.64±0.867, respectively. One case had Modic type III changes. Kruskal-Wallis test revealed significant difference in modified Pfirrmann grade among Modic type 0, I and II changes (P0.05. Binary regression analysis showed that Modic changes correlated most strongly with disc degeneration. Follow up studies indicated that the VAS and ODI scores were markedly improved postoperatively. However, no difference was noted in VAS and ODI scores among patients with different Modic types. CONCLUSION: Modic changes correlate with the Pfirrmann and modified Pfirrmann grades of disc degeneration in lumbar degenerative disease. There is no significant correlation between Modic types and surgical outcomes.

  2. Long term preservation of motion with artificial cervical disc implants: A comparison between cervical disc replacement and rigid fusion with cage

    Science.gov (United States)

    Cincu, Rafael; Lorente, Francisco de Asis; Gomez, Joaquin; Eiras, Jose; Agrawal, Amit

    2014-01-01

    Background: With the advancement of technologies there is more interest in the maintenance of the spine's biomechanical properties focusing on the preservation of the functional motion segment. In present article we describe our experience with 25 cases managed with artificial cervical discs with 28 Solis cage following cervical discectomy with a mean follow-up period of 7.5 year. Materials and Methods: All surgeries were performed by single surgeon from March 2004 to June 2005 with a follow-up till date. Patients with symptomatic single or multiple level diseases that had no prior cervical surgery were candidates for the study. Cohort demographics were comparable. Standardized clinical outcome measures and radiographic examinations were used at prescribed post-operative intervals to compare the treatment groups. Relief in radicular pain, cervical spine motion, and degenerative changes at follow-up were noted. Results: In a total 53 cases, the mean age in prosthesis group was 47 years (age range: 30-63 years) and mean age in cage group was 44 years (32-62 years). Mean hospital stay was 2.7 days in both the groups. At 4 weeks complete cervical movements could be achieved in 19 cases in artificial disc group. Maintenance of movement after 7.5 years was in 76% of these patients. Lordosis was maintained in all cases till date. There was no mortality or wound infection in our series. Conclusions: We conclude that artificial cervical disc could be an alternative to fixed spinal fusion as it represents the most physiological substitute of disc. However, there is need for further studies to support the use of artificial cervical disc prosthesis. PMID:25685218

  3. Regenerative and immunogenic characteristics of cultured nucleus pulposus cells from human cervical intervertebral discs.

    Directory of Open Access Journals (Sweden)

    Stefan Stich

    Full Text Available Cell-based regenerative approaches have been suggested as primary or adjuvant procedures for the treatment of degenerated intervertebral disc (IVD diseases. Our aim was to evaluate the regenerative and immunogenic properties of mildly and severely degenerated cervical nucleus pulposus (NP cells with regard to cell isolation, proliferation and differentiation, as well as to cell surface markers and co-cultures with autologous or allogeneic peripheral blood mononuclear cells (PBMC including changes in their immunogenic properties after 3-dimensional (3D-culture. Tissue from the NP compartment of 10 patients with mild or severe grades of IVD degeneration was collected. Cells were isolated, expanded with and without basic fibroblast growth factor and cultured in 3D fibrin/poly (lactic-co-glycolic acid transplants for 21 days. Real-time reverse-transcription polymerase chain reaction (RT-PCR showed the expression of characteristic NP markers ACAN, COL1A1 and COL2A1 in 2D- and 3D-culture with degeneration- and culture-dependent differences. In a 5,6-carboxyfluorescein diacetate N-succinimidyl ester-based proliferation assay, NP cells in monolayer, regardless of their grade of degeneration, did not provoke a significant proliferation response in T cells, natural killer (NK cells or B cells, not only with donor PBMC, but also with allogeneic PBMC. In conjunction with low inflammatory cytokine expression, analyzed by Cytometric Bead Array and fluorescence-activated cell sorting (FACS, a low immunogenicity can be assumed, facilitating possible therapeutic approaches. In 3D-culture, however, we found elevated immune cell proliferation levels, and there was a general trend to higher responses for NP cells from severely degenerated IVD tissue. This emphasizes the importance of considering the specific immunological alterations when including biomaterials in a therapeutic concept. The overall expression of Fas receptor, found on cultured NP cells, could have

  4. Lack of association between lumbar disc degeneration and osteophyte formation in elderly japanese women with back pain.

    Science.gov (United States)

    Oishi, Y; Shimizu, K; Katoh, T; Nakao, H; Yamaura, M; Furuko, T; Narusawa, K; Nakamura, T

    2003-04-01

    Our study was designed to assess the contributions of the physical and constitutional factors to osteophyte formation, disc degeneration, and bone mineral density (BMD) in lumbar vertebrae of elderly postmenopausal women. A total of 126 Japanese women with back pain, aged over 60 years, were invited to participate in the study. Then 80 subjects with a full set of data for physical examinations, radiographs, MRI, and DXA were examined. TaqI polymorphism of vitamin D receptor (VDR) gene was examined in 60 subjects. Prevalence rates of osteophytes (on radiographs) and disc degeneration (on MRI) were 61 and 68%, respectively. Body weight and BMI correlated significantly with anteroposterior (AP) and lateral (LAT) BMD (r = 0.354 for weight, r = 0.347 for BMI) and mean osteophyte area (r = 0.557 for weight, r = 0.486 for BMI), and body weight also correlated with number of discs with osteophytes. However, these did not correlate with the disc area or the number of degenerated discs. Stepwise regression analysis revealed that body weight and LAT-BMD values independently related to the osteophyte area. Disc area (r = 0.386 for AP view) and osteophyte area (r = 0.384 for AP view) significantly correlated with BMD. However, disc area and osteophyte area did not correlate with each other (r = 0.056). The proportion of degenerated discs was higher in the lower lumbar discs, but not the proportion of discs with osteophytes. Frequencies of T and t alleles of VDR did not correlate with disc degeneration, osteophyte formation, or osteoporosis. Our data showed that increases in osteophyte formation and BMD in the lumbar vertebrae are influenced by body weight and BMI, but did not correlate with disc area, which correlated inversely with BMD. Disc degeneration and osteophyte formation seem to represent two different factors that affect lumbar spine in elderly women.

  5. The Effects of Platelet-Rich Plasma on Halting the Progression in Porcine Intervertebral Disc Degeneration.

    Science.gov (United States)

    Cho, Hongsik; Holt, David C; Smith, Richard; Kim, Song-Ja; Gardocki, Raymond J; Hasty, Karen A

    2016-02-01

    Disc degeneration and the subsequent herniation and/or rupture of the intervertebral disc (IVD) are due to a failure of the extracellular matrix of the annulus to contain the contents of the nucleus. This results from inadequate maintenance of the matrix components as well as the proteolytic activity of matrix metalloproteinases (MMPs) that degrade matrix molecules. Arresting progression of disc degeneration in the annulus holds greater clinical potential at this point than prevention of its onset in the nucleus. Therefore, in this study, we have therapeutic aims that would decrease levels of the cytokines and growth factors that indirectly lead to disc degeneration via stimulating MMP and increase levels of several beneficial growth factors, such as transforming growth factor-β, with the addition of platelet-rich plasma (PRP) that would stimulate cell growth and matrix synthesis. For this study, we attempted to address these imbalances of metabolism by using tumor necrosis factor-α treated annulus fibrosus cells isolated from porcine IVD tissue and incubating the cells in a growth factor rich environment with PRP. These results indicate that the PRP in vitro increased the production of the major matrix components (type II collagen and aggrecan) and decreased the inhibitory collagenase MMP-1. This application will address a therapeutic approach for intervening early in the degenerative process.

  6. 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.

  7. Class 3 semaphorins expression and association with innervation and angiogenesis within the degenerate human intervertebral disc.

    Science.gov (United States)

    Binch, Abbie L A; Cole, Ashley A; Breakwell, Lee M; Michael, Anthony L R; Chiverton, Neil; Creemers, Laura B; Cross, Alison K; Le Maitre, Christine L

    2015-07-30

    Nerve and blood vessel ingrowth during intervertebral disc degeneration, is thought to be a major cause of low back pain, however the regulation of this process is poorly understood. Here, we investigated the expression and regulation of a subclass of axonal guidance molecules known as the class 3 semaphorins, and their receptors; plexins and neuropilins within human NP tissue and their regulation by pro-inflammatory cytokines. Importantly this determined whether semaphorin expression was associated with the presence of nerves and blood vessels in tissues from human intervertebral discs. The study demonstrated that semaphorin3A, 3C, 3D, 3E and 3F and their receptors were expressed by native NP cells and further demonstrated their expression was regulated by IL-1β but to a lesser extent by IL-6 and TNFα. This is the first study to identify sema3C, sema3D and their receptors within the nucleus pulposus of intervertebral discs. Immunopositivity shows significant increases in semaphorin3C, 3D and their receptor neuropilin-2 in degenerate samples which were shown to contain nerves and blood vessels, compared to non-degenerate samples without nerves and blood vessels. Therefore data presented here suggests that semaphorin3C may have a role in promoting innervation and vascularisation during degeneration, which may go on to cause low back pain.

  8. Calcium pentosan polysulfate and sodium pentosan polysulfate may be used to treat intervertebral disc degeneration.

    Science.gov (United States)

    Zhao, Jia-Guo; Wang, Jia; Xin, Qi; Zhang, Peng; Zhang, Sheng-Fei; Qi, Feng; Mao, Dong; Zhang, Zhi-Cheng

    2011-04-01

    Intervertebral disc degeneration (IDD) is a major health problem world-wide, and several spinal disorders are closely associated with it. Although people have invested a great deal of time and effort, how to prevent and reverse the IDD for the researchers is still a difficult and hot issue. Intervertebral disc belongs to cartilage tissue, and IDD also is the cartilage degeneration disease. A large quantity of studies have shown that Calcium pentosan polysulfate (CaPPS) and sodium pentosan polysulfate (NaPPS) possess chondroprotective activities and play an important role in maintaining cartilage integrity. We reasonably hypothesize that NaPPS and CaPPS may be used to treat IDD. The possible mechanism may include that: (1) the significant effects of NaPPS and CaPPS in improving capillary blood flow could maintain nutritional supply to intervertebral disc, and preserve intervertebral disc tissue against degeneration; (2) CaPPS and NaPPS preserve cartilage integrity, proteoglycan synthesis, and improve cartilage biomechanical properties; (3) as the multifaceted exosite inhibitors of proteinases NaPPS and CaPPS strongly impede the activity and production of proteinases; (4) promotion of the balance between proteinases and TIMPs also may be involved in treating IDD; (5) NaPPS and CaPPS exhibit potent anti-inflammatory effects, and then reduce inflammation-induced IDD. If the hypothesis were conformed, the symptoms caused by IDD and its related diseases would be a corresponding alleviation or even disappearance, which could greatly alleviate the suffering of patients from disc degeneration diseases. Certainly, many roles of CaPPS and NaPPS, such as effectiveness, safety and side effects, need to be tested, and further works such as animal model and clinical trial, need to be done to prove this hypothesis.

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

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    Purmessur, D.; Walter, B.A. [Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States); Roughley, P.J. [Shriners Hospital for Children, Montreal, QC (Canada); Laudier, D.M.; Hecht, A.C. [Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States); Iatridis, James, E-mail: james.iatridis@mssm.edu [Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States)

    2013-03-29

    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

  10. Reconstitution of degenerated ovine lumbar discs by STRO-3-positive allogeneic mesenchymal precursor cells combined with pentosan polysulfate.

    Science.gov (United States)

    Oehme, David; Ghosh, Peter; Goldschlager, Tony; Itescu, Silviu; Shimon, Susan; Wu, Jiehua; McDonald, Courtney; Troupis, John M; Rosenfeld, Jeffrey V; Jenkin, Graham

    2016-05-01

    OBJECTIVE Disc degeneration and associated low-back pain are major causes of suffering and disability. The authors examined the potential of mesenchymal precursor cells (MPCs), when formulated with pentosan polysulfate (PPS), to ameliorate disc degeneration in an ovine model. METHODS Twenty-four sheep had annular incisions made at L2-3, L3-4, and L4-5 to induce degeneration. Twelve weeks after injury, the nucleus pulposus of a degenerated disc in each animal was injected with ProFreeze and PPS formulated with either a low dose (0.1 million MPCs) or a high dose (0.5 million MPCs) of cells. The 2 adjacent injured discs in each spine were either injected with PPS and ProFreeze (PPS control) or not injected (nil-injected control). The adjacent noninjured L1-2 and L5-6 discs served as noninjured control discs. Disc height indices (DHIs) were obtained at baseline, before injection, and at planned death. After necropsy, 24 weeks after injection, the spines were subjected to MRI and morphological, histological, and biochemical analyses. RESULTS Twelve weeks after the annular injury, all the injured discs exhibited a significant reduction in mean DHI (low-dose group 17.19%; high-dose group 18.01% [p PPS formulation recovered disc height, and their mean DHI was significantly greater than the DHI of PPS- and nil-injected discs (p PPS-injected discs was lower than that for the nil- and PPS-injected discs, the differences were not significant. The disc morphology scores for the nil- and PPS-injected discs were significantly higher than the normal control disc scores (p PPS-injected disc scores were not significantly different from those of the normal controls. The mean glycosaminoglycan content of the nuclei pulposus of the low-dose MPC+PPS-injected discs was significantly higher than that of the PPS-injected controls (p PPS-injected discs were lower than those for the PPS- and Nil-injected discs. The corresponding high-dose MPC+PPS-injected discs failed to show significant

  11. Association between intervertebral disc degeneration and disturbances of blood supply to the vertebrae

    Institute of Scientific and Technical Information of China (English)

    TIAN Wei; QI Hui

    2010-01-01

    @@ Low back pain is a common public health problem in western industrialized societies and the world as well. Studies indicate that the prevalence rate ranges from 12% to 35%, with around 10% of patients becoming chronically disabled. It also places an enormous economic burden on society. Although the exact cause of low back pain has yet to be defined, intervertebral disc degeneration is considered a major source of it. Since patients with degenerative discs are often asymptomatic, the mechanisms of it are still unclear.

  12. 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.)

  13. Effects of imbalance of dynamic and static forces on the disc degeneration of cervical spine at different levels in rats: a micro-CT morphology and histology study%动静力失衡对大鼠颈椎不同节段椎间盘退变影响的显微CT形态学和组织学研究

    Institute of Scientific and Technical Information of China (English)

    丁寅; 姜杰; 周剑; 吴秀华; 黄志平; 陈建庭; 朱青安

    2013-01-01

    椎间盘退变程度也较严重,是该模型椎间盘退变的主要节段.软骨终板的形态学改变与椎间高度的降低和椎间盘退变程度有明显的相关性.%Objectives:To evaluate the effects of imbalance of dynamic and static forces on the cartilage endplate lesion,intervertebral disc height(IDH) and histological score from C4-C7 in a rat model of cervical spine degeneration,and the correlation between the cartilage endplate lesion and IDH.Methods:24 SpragueDawley female rats with the age of 3 months were assigned randomly into model group and control group(n=14 and 10).The control group was treated with skin incision only; the back of the neck muscles and ligaments of model group were transverse cutting.The C4-C7 segments were harvested at 12,18 and 24 weeks after surgery.Specimens were scanned using micro CT,and stained with Safranine O/fast green.Lesions of the cartilage endplate were identified on axial CT images,and the ratio of lesion area to the whole endplate area was calculated.IDH was measured and disc dcgcncration (DD) was graded for each sample.Results:The cartilage endplate lesion was presented on the ventral side of cartilage endplates with the greater lesion for lower levels at 12 weeks after surgery in the model group.The more severe lesion in C5/6 and C6/7 was seen in the model group compared with the control group at 18 and 24 weeks (P<0.05) respectively.The lesion varied with levels and the C6/7 lesion was more severe than C4/5 (P<0.05).The histological results showed the lesion shrunk and calcified in situ at 18 and 24 weeks.Compared with the control group,the IDH was lower of the C5/6 and C6/7 in the model group at 12 weeks.The DD score of the model group was 11.5±1.0,11.8±1.0 and 12.8±0.8 at the C4/5,C5/6 and C6/7 level respectively,which changed significantly among levels.The C6/7 DD score was larger than which of the other levels(P<0.05).The lesion was correlated with DD score at 12,18 and 24 weeks(P<0.05) and

  14. Lumbar disc degeneration below a long arthrodesis (performed for scoliosis in adults) to L4 or L5.

    Science.gov (United States)

    Harding, Ian J; Charosky, Sebastian; Vialle, Raphael; Chopin, Daniel H

    2008-02-01

    A retrospective analysis of adults treated with long instrumented fusion for scoliosis from the thoracic spine proximally to L4 or L5. To evaluate the long-term clinical outcomes as well as radiological changes in distal unfused mobile segments and to evaluate factors that may predispose to distal disc degeneration and/or poor outcome. A total of 151 mobile segments in 85 patients (65 female), mean age 43.2 (range 21-68), were studied. Curve type, number of fused levels and pelvic incidence were recorded. Clinical outcome was measured using the Whitecloud function scale and disc degeneration using the UCLA disc degeneration score. Spinal balance, local segmental angulations and lumbar lordosis were measured pre- and post-operatively as well as at the most recent follow up--mean 9.3 years (range 7-19). A total of 62% of patients had a good or excellent outcome. Eleven had a poor outcome of which ten underwent extension of fusion--five for pain alone, three for pain with stenosis and two for pseudarthroses. Pre-operative disc degeneration was often asymmetric and was slightly greater in older patients. Overall, there was a significant deterioration in disc degeneration (P < 0.0001) that did not correlate with clinical outcome. Disc degeneration correlated with the recent sagittal balance (Anova F = 14.285, P < 0.001) and the most recent lordosis (Anova F = 4.057, P = 0.048). The post-operative sagittal balance and local L5-S1 sagittal angulation correlated to L4 and L5 degeneration, respectively. There was no correlation between degeneration and age, pre-operative degenerative score, pelvic incidence, sacral slope, number of fused levels or distal level of fusion. Disc degeneration does occur below an arthrodesis for scoliosis in adults which does not correlate with clinical outcome. The correlation of loss of sagittal balance with disc degeneration may be as a result of degeneration causing the loss of balance or vice versa, i.e. sagittal imbalance causing

  15. Do design variations in the artificial disc influence cervical spine biomechanics? A finite element investigation.

    Science.gov (United States)

    Faizan, Ahmad; Goel, Vijay K; Garfin, Steven R; Bono, Christopher M; Serhan, Hassan; Biyani, Ashok; Elgafy, Hossein; Krishna, Manoj; Friesem, Tai

    2012-06-01

    Various ball and socket-type designs of cervical artificial discs are in use or under investigation. Many artificial disc designs claim to restore the normal kinematics of the cervical spine. What differentiates one type of design from another design is currently not well understood. In this study, authors examined various clinically relevant parameters using a finite element model of C3-C7 cervical spine to study the effects of variations of ball and socket disc designs. Four variations of ball and socket-type artificial disc were placed at the C5-C6 level in an experimentally validated finite element model. Biomechanical effects of the shape (oval vs. spherical ball) and location (inferior vs. superior ball) were studied in detail. Range of motion, facet loading, implant stresses and capsule ligament strains were computed to investigate the influence of disc designs on resulting biomechanics. Motions at the implant level tended to increase following disc replacement. No major kinematic differences were observed among the disc designs tested. However, implant stresses were substantially higher in the spherical designs when compared to the oval designs. For both spherical and oval designs, the facet loads were lower for the designs with an inferior ball component. The capsule ligament strains were lower for the oval design with an inferior ball component. Overall, the oval design with an inferior ball component, produced motion, facet loads, implant stresses and capsule ligament strains closest to the intact spine, which may be key to long-term implant survival.

  16. 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.

  17. A review on the clinical advances of artiifcial cervical disc replacement%人工颈椎间盘置换术的临床疗效研究进展

    Institute of Scientific and Technical Information of China (English)

    陈佳海; 阮狄克; 王德利; 胡学昱; 叶斌; 伍耀宏

    2016-01-01

    Anterior cervical discectomy and fusion ( ACDF ) is one of the commonest operative methods in the treatment of cervical intervertebral disc diseases. It needs to remove the degenerated disc and ifx the upper and lower vertebral bodies together, but in this way, the disc loses the motion and the stress of the adjacent segments might increase. Therefore, non-fusion method begins to attract extensive attention in clinical practice. Artiifcial cervical disc replacement is a new operation, which has become popular gradually in recent years and its short term clinical outcomes are reported to be satisfactory. However, whether it can really sustain the range of motion persistently and decrease the degeneration of the adjacent segments is unknown. It is still controversial whether its clinical outcomes are better than ACDF. All of these problems need to be proved by mid-long term clinical efifcacy. In this paper, we summarize the clinical efifcacy and application prospect of artiifcial cervical disc replacement based on the latest literature.

  18. Spontaneous disc degeneration in the baboon model: magnetic resonance imaging and histopathologic correlation.

    Science.gov (United States)

    Platenberg, R C; Hubbard, G B; Ehler, W J; Hixson, C J

    2001-10-01

    Degenerative disc disease is a major source of disability in humans. The baboon model is an excellent natural disease model to study comparable human disease, because baboons are relatively large (adult males 20-26 kg, adult females 12-17 kg), long-lived (30-45 years), well defined, easy to use, and closely related to humans. Published investigations with plain radiographs of disc degeneration in baboons indicated vertebral anatomy and changes that were remarkably similar to those seen in humans, and it would be valuable to determine if magnetic resonance imaging (MRI) and histopathologic evaluation would be useful methods for studying the model, as MRI allows multi-planar visualization of tissues without the use of intravenous contrast and it is superior for evaluating disc hydration, annulus tears, and herniations. The thoracolumbar junctions from 47 randomly selected baboons, ranging in age from 2 weeks to 34 years, were evaluated with MRI and histopathology. Excellent correlation with MRI was observed for changes in disc desiccation, height, and age (P discs seen by MRI were in baboons 14 years of age or older.

  19. 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.

  20. The early stage adjacent disc degeneration after percutaneous vertebroplasty and kyphoplasty in the treatment of osteoporotic VCFs.

    Directory of Open Access Journals (Sweden)

    Jun Qian

    Full Text Available BACKGROUND: The purpose of this paper is to determine the early incidence of disc de- generation adjacent to the vertebral body of osteoporotic fracture treated with percutaneous vertebroplasty or balloon kyphoplasty and whether adjacent disc degeneration is accelerated by this two procedures. METHODS: 182 patients with painful vertebral compression fractures were treated. A total of 97 patients were enrolled in this prospective study. 97 patients with a mean age of 65.3 years were classified into control group and surgical treatment group of non-random. 35 patients were in control group and 62 patients who were performed percutaneous vertebroplasty or balloon kyphoplasty in treatment group. X-ray and Magnetic resonance imaging were done at the first and final visit. The grade of disc degeneration above the fractured vertebral was confirmed by evaluation of bony oedema in the fat suppressed sequences and T2-weighted image of magnetic resonance imaging. The height of degenerative disc was measured on X-ray film. RESULTS: All patients were followed up two years after the first visit and the follow-up rate was 90.7% (88/97. The incidence of degeneration of adjacent disc above the fractured vertebral was 29.0% (9/31 in control group and 52.6% (30/57 in treatment group. It presented a statistically significant difference between two groups about the incidence of adjacent disc degeneration (P=0.033. The percentage of adjacent disc height reduction in control group was 13.5% and 17.6% in treatment group. Statistically significant difference of VAS score and ODI was not found between the first evaluation postoperatively and the final follow-up in treatment group (P>0.05. CONCLUSIONS: Disc degeneration adjacent to the fractured vertebral is accelerated by VP and BK procedures in the early stage, but clinical outcomes has not been weakened even in the presence of accelerated disc degeneration.

  1. 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.

  2. 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.)

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

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    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

  4. Stem-cell treatment in disc degeneration: What is the evidence?

    Directory of Open Access Journals (Sweden)

    Manuela Peletti-Figueiró

    2013-01-01

    Full Text Available To review the potential role of stem cells in treating degenerative disc disease of the intervertebral disc (IVD. A review was performed of articles from the Medline database concerning stem cells and degenerative disc disease (DDD. To discuss the data, the papers were classified as: review, in vitro, experimental, and clinical. The currently available treatments were basically for symptom reduction, not to revert the IVD degenerative process. The use of mesenchymal stem cells (MSC is being proposed as an option of treatment for DDD. In vitro studies have shown that the MSC are able to differentiate into NP cells and that the MSC also reduce the inflammatory levels of the degenerated IVD. Besides, experimental studies demonstrated that the MSC remained viable when injected into the IVD, and that they were able to regenerate partially from the degenerated IVD and its structure. The few clinical studies found in the literature presented diverging results. The use of MSC is being widely studied and shows promising results for the treatment of DDD. Although many advances are being achieved in studies in vitro and experimental, there is a lack of clinical studies to prove the role of MSC in DDD management.

  5. 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.

  6. 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.

  7. Acid-sensing ion channel 1a regulates the survival of nucleus pulposus cells in the acidic environment of degenerated intervertebral discs

    Directory of Open Access Journals (Sweden)

    Feng Cai

    2016-08-01

    Conclusion: The present findings suggest that further understanding of ASIC1a functionality may provide not only a novel insight into intervertebral disc biology but also a novel therapeutic target for intervertebral disc degeneration.

  8. Cell and molecular biology of intervertebral disc degeneration: current understanding and implications for potential therapeutic strategies.

    Science.gov (United States)

    Wang, S Z; Rui, Y F; Lu, J; Wang, C

    2014-10-01

    Intervertebral disc degeneration (IDD) is a chronic, complex process associated with low back pain; mechanisms of its occurrence have not yet been fully elucidated. Its process is not only accompanied by morphological changes, but also by systematic changes in its histological and biochemical properties. Many cellular and molecular mechanisms have been reported to be related with IDD and to reverse degenerative trends, abnormal conditions of the living cells and altered cell phenotypes would need to be restored. Promising biological therapeutic strategies still rely on injection of active substances, gene therapy and cell transplantation. With advanced study of tissue engineering protocols based on cell therapy, combined use of seeding cells, bio-active substances and bio-compatible materials, are promising for IDD regeneration. Recently reported progenitor cells within discs themselves also hold prospects for future IDD studies. This article describes the background of IDD, current understanding and implications of potential therapeutic strategies.

  9. Ranges of Cervical Intervertebral Disc Deformation during an In-Vivo Dynamic Flexion-Extension of the Neck.

    Science.gov (United States)

    Yu, Yan; Mao, Haiqing; Li, Jing-Sheng; Tsai, Tsung-Yuan; Cheng, Liming; Wood, Kirkham B; Li, Guoan; Cha, Thomas D

    2017-03-23

    While abnormal loading is widely believed to cause cervical spine disc diseases, in-vivo cervical disc deformation during dynamic neck motion has not been well delineated. This study investigated the range of cervical disc deformation during an in-vivo functional flexion-extension of the neck. Ten asymptomatic human subjects were tested using a combined dual fluoroscopic imaging system and MRI based 3D modeling technique. Overall disc deformation was determined using the changes of the space geometry between upper and lower endplates of each intervertebral segment (C3/4, C4/5, C5/6 and C6/7). Five points (anterior, center, posterior, left and right) of each disc were analyzed to examine the disc deformation distributions. The data indicated that between the functional maximum flexion and extension of the neck, the anterior points of the discs experienced large changes of distraction/compression deformation and shear deformation. The higher level discs experienced higher ranges of disc deformation. No significant difference was found in deformation ranges at posterior points of all discs. The data indicated that the range of disc deformation is disc level dependent and the anterior region experienced larger changes of deformation than the center and posterior regions, except for the C6/7 disc. The data obtained from this study could serve as baseline knowledge for the understanding of the cervical spine disc biomechanics and for investigation of the biomechanical etiology of disc diseases. These data could also provide insights for development of motion preservation surgeries for cervical spine.

  10. 探讨 ProDisc-C 人工颈椎间盘置换术与颈前路椎间盘切除融合治疗颈椎病的临床疗效%To evaluate clinical outcomes of ProDisc-C cervical disc replacement versus fusion for cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    郭卫春; 黄文俊; 汪光晔

    2015-01-01

    myelopathy or radiculopathy were enrolled in this study .They were randomly assigned to ProDisc-C artificial cervical disc replacement group ( arthroplasty group:24 patients) and anterior cervical discectomy and fusion group (fusion group:22 patients).Operation time,blood loss were compared between the 2 groups.Visual analogue scale(VAS),Japanese Orthopedics Association( JOA) score,Range-of-motion of cervical overall and adjacent intervertebral area near the intervertebral space were evaluated preoperatively and 3,12,months postoperatively.Results A total of 46 patients(100%) were followed up for an aver-age 12 months(range,6~24).No difference was found in the operation time,intraoperative blood loss between 2 groups(P>0.05). VAS and JOA scores were apparently improved after surgery compared with before surgery in each group(P0.05).In ProDisc-C group,pre-and postoperative motion of cervical overall and adjacent intervertebral area near the intervertebral space are remained unchanged at any of the follow-up time (P>0.05).In ACDF group,motion of cervical overall decreased in 3 months after operation but gradually recovered to preoperative level in12 months after operation.Motion of adjacent intervertebral area increased in 12 months (P<0.05).There are 3 cases with dysphagia after operation in ACDF group.Conclusion ProDisc-C artificial cervical disc replacement can achieve similar clinical improvement compared with traditional ACDF for treatment of single segment disc degeneration in Mid term follow up.Artificial cervical disc replacement can effectively retain the cervical range of motion,reduce the degeneration of adjacent segments and the inci-dence of postoperative dysphagia.

  11. 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.

  12. 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.

  13. A rat tail temporary static compression model reproduces different stages of intervertebral disc degeneration with decreased notochordal cell phenotype.

    Science.gov (United States)

    Hirata, Hiroaki; Yurube, Takashi; Kakutani, Kenichiro; Maeno, Koichiro; Takada, Toru; Yamamoto, Junya; Kurakawa, Takuto; Akisue, Toshihiro; Kuroda, Ryosuke; Kurosaka, Masahiro; Nishida, Kotaro

    2014-03-01

    The intervertebral disc nucleus pulposus (NP) has two phenotypically distinct cell types-notochordal cells (NCs) and non-notochordal chondrocyte-like cells. In human discs, NCs are lost during adolescence, which is also when discs begin to show degenerative signs. However, little evidence exists regarding the link between NC disappearance and the pathogenesis of disc degeneration. To clarify this, a rat tail disc degeneration model induced by static compression at 1.3 MPa for 0, 1, or 7 days was designed and assessed for up to 56 postoperative days. Radiography, MRI, and histomorphology showed degenerative disc findings in response to the compression period. Immunofluorescence displayed that the number of DAPI-positive NP cells decreased with compression; particularly, the decrease was notable in larger, vacuolated, cytokeratin-8- and galectin-3-co-positive cells, identified as NCs. The proportion of TUNEL-positive cells, which predominantly comprised non-NCs, increased with compression. Quantitative PCR demonstrated isolated mRNA up-regulation of ADAMTS-5 in the 1-day loaded group and MMP-3 in the 7-day loaded group. Aggrecan-1 and collagen type 2α-1 mRNA levels were down-regulated in both groups. This rat tail temporary static compression model, which exhibits decreased NC phenotype, increased apoptotic cell death, and imbalanced catabolic and anabolic gene expression, reproduces different stages of intervertebral disc degeneration.

  14. Bryan人工颈椎间盘置换术治疗颈椎病的中期疗效观察%Midterm results of cervical disc replacement with the Bryan cervical disc prosthesis for cervical disc disorders

    Institute of Scientific and Technical Information of China (English)

    姜宇; 田野; 王以朋; 邱贵兴; 翁习生; 冯宾

    2011-01-01

    目的 观察Bryan人工颈椎间盘置换术治疗颈椎病的中期疗效.方法 2005年11月至2010年5月对16例颈椎病患者行Bryan人工颈椎间盘置换术.统计并分析患者术前、术后及末次随访时的JOA评分、置换节段活动度,观察术后及末次随访时假体松动、移位、异位骨化等并发症.结果 16例患者均获得随访,随访时间为12~53个月,平均24.1个月,JOA评分由术前平均(10.4±1.9)分增至术后平均(14.4±1.9)分以及末次随访平均(16.1±0.7)分,术前与术后(t=-12.215,P=0.000)、术后与末次随访(t=-4.273,P=0.001)均有显著性差异.12例患者随访时行颈椎屈伸位X线片检查,随访时间13~53月,平均24.2月,测量屈伸位X线片计算置换节段颈椎屈伸活动度(range of motion,ROM),术前平均7.1°±2.6°、术后平均6.9°±1.9°、末次随访平均6.5°±1.8°,术前与术后(t=0.700,P=0.395)、术后与末次随访(t=2.132,P=0.054)均无统计学差异.无一例发生异位骨化;1例随访时出现假体周围骨吸收.结论 Bryan人工颈椎间盘置换术治疗颈椎病的中期疗效满意,但仍需长时间随访以评估其远期疗效.%Objective To investigate the midterm outcomes of cervical disc replacement with Bryan cervical disc prosthesis for cervical disc disorders. Methods Sixteen patients with cervical disc disorders were performed cervical disc replacement with 16 Bryan discs from November 2005 to May 2010. The JOA score and range of motion ( ROM) of the implanted disc level were measured pre-operatively, post-operatively and at final follow-up. Complications of prosthesis dislodgement, heterotopic ossification and so on were also analyzed. Results All cases obtained the follow-up with an average of 24. 1 months (ranged 12 to 53 months). The average JOA score was 10.4 ± 1.9 pre-operatively, 14.4 ± 1. 9 post-operatively and 16. 1 ± 0.7 at final follow-up. There were significantly statistical difference between per-operativelyand post

  15. 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.

  16. The clinical study of percutaneous disc decompression of treating herniation of cervical disc with Nd:YAG laser

    Science.gov (United States)

    Zhang, Dianxue; Cheng, Hefu; Wang, Jindong

    2005-07-01

    Objective: The possibility of PLDD (percutaneous laser disc decompression) and an ideal non-operative method which is long everlasting effect for PLDD was investigated. Methods: 159 patients of Cervical Disc Herniation with PLDD were studied. All the herniated discs were irradiated with 10­15J/S Nd:YAG laser quantum through optical-fiber under the supervision of C-arm X-ray. Results: All the patients were followed and reexamined CT or MRI after one to six months of PLDD. The result of cured (67.92%), excellent (24.53%), moderation (5.66%), non-effect (1.88%) was got. The excellent rate was 88.24%. The effective rate was 97.65%. Non-effective rate was 2.35%. Conclusion: When irradiated with Nd:YAG laser, the nucleus pulposus was vapouring, charring and coagulating. The volume and inner-pressure of the disc decreased. So the symptoms and signs improved. The main value of this methods were micro-damage, non-operation, no bleeding, no bone injury, good therapy effect, quick recovery, lesser pain, safety and excellent long everlasting effect. It is an ideal non-operative method of treating PLDD.

  17. Heterotopic ossification associated with myelopathy following cervical disc prosthesis implantation.

    Science.gov (United States)

    Wenger, Markus; Markwalder, Thomas-Marc

    2016-04-01

    This case report presents a 37-year-old man with clinical signs of myelopathy almost 9 years after implantation of a Bryan disc prosthesis (Medtronic Sofamor Danek, Memphis, TN, USA) for C5/C6 soft disc herniation. As demonstrated on MRI and CT scan, spinal cord compression was caused by bony spurs due to heterotopic ossification posterior to the still moving prosthesis. The device, as well as the ectopic bone deposits, had to be removed because of myelopathy and its imminent aggravation. Conversion to anterior spondylodesis was performed.

  18. Research Advances in Intervertebal Disc Degeneration Models%椎间盘退变模型的研究进展

    Institute of Scientific and Technical Information of China (English)

    王凯

    2013-01-01

    目前国内外关于椎间盘退变的病因和发病机制尚无定论,构建能模拟人退变椎间盘的动物模型是研究的关键.常用于研究椎间盘退行性疾病的模型可分为体内、体外模型.目前已成功建立的椎间盘动物模型均具有一定的局限性,尚无公认的能够完全模拟人类椎间盘退变的标准模型.随着大型动物与灵长类动物模型的建立,动物椎间盘退变模型与人类椎间盘退变之间的相关性和可比性逐渐明确,其在椎间盘退变疾病的研究中具有广阔的前景.%The etiology and pathogenesis of intervertebal disc degeneration is still not clear at home and abroad, and an animal model which can simulate the human intervertebral disc degeneration is the key to the study. Presently,the intervertebral disc degeneration model can be divided into two kinds:in vivo and ex vivo models. The established intervertebral disc animal models have certain limitations, and there is no acknowledged standard model which can completely simulate human intervertebral disc degeneration. With the large animal and primate animal models established,the relativity and comparability between animal and human intervertebal disc degeneration are gradually clear, and the animal models have broad prospects in the research.

  19. 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

  20. lncRNAs: novel players in intervertebral disc degeneration and osteoarthritis.

    Science.gov (United States)

    Chen, Wen-Kang; Yu, Xiao-Hua; Yang, Wei; Wang, Cheng; He, Wen-Si; Yan, Yi-Guo; Zhang, Jian; Wang, Wen-Jun

    2017-02-01

    The term long non-coding RNA (lncRNA) refers to a group of RNAs with length more than 200 nucleotides, limited protein-coding potential, and having widespread biological functions, including regulation of transcriptional patterns and protein activity, formation of endogenous small interfering RNAs (siRNAs) and natural microRNA (miRNA) sponges. Intervertebral disc degeneration (IDD) and osteoarthritis (OA) are the most common chronic, prevalent and age-related degenerative musculoskeletal disorders. Numbers of lncRNAs are differentially expressed in human degenerative nucleus pulposus tissue and OA cartilage. Moreover, some lncRNAs have been shown to be involved in multiple pathological processes during OA, including extracellular matrix (ECM) degradation, inflammatory responses, apoptosis and angiogenesis. In this review, we summarize current knowledge concerning lncRNAs, from their biogenesis, classification and biological functions to molecular mechanisms and therapeutic potential in IDD and OA.

  1. Magnetic resonance imaging on disc degeneration changes after implantation of an interspinous spacer and fusion of the adjacent segment.

    Science.gov (United States)

    Liu, Xiaokang; Liu, Yingjie; Lian, Xiaofeng; Xu, Jianguang

    2015-01-01

    The aim of the study was to investigate the changes of the lumbar intervertebral disc degeneration by magnetic resonance imaging (MRI) after the implantation of interspinous device and the fusion of the adjacent segment. A total of 62 consecutive patients suffering L5/S1 lumbar disc herniation (LDH) with concomitant disc space narrowing or low-grade instability up to 5 mm translational slip in L5/S1 level were treated with lumbar interbody fusion (LIF) via posterior approach. Thirty-four of these patients (Coflex group) received an additional implantation of the interspinous spacer device (Coflex™) in the level L4/L5, while the rest of 28 patients (fusion group) underwent the fusion surgery alone. Clinical and radiographic examinations were performed at pre- and postoperative visits to compare the clinical outcomes and the changes of the L4/L5 vertebral disc degeneration on MRI in both Coflex and fusion group. Although both Coflex and fusion group showed improvements of the clinical outcomes assessed by the Oswestry Disability Index (ODI) after surgery, patients in Coflex group had more significant amelioration (P degeneration changes in Coflex group assessed by the relative signal intensity (RSI) differed from those in fusion group (P degeneration of the adjacent segment.

  2. Posteriorly directed shear loads and disc degeneration affect the torsional stiffness of spinal motion segments; a biomechanical modeling study

    NARCIS (Netherlands)

    Homminga, J.J.; Lehr, A.M.; Meijer, G.J.M.; Janssen, M.M.A.; Schlösser, T.P.C.; Verkerke, G.J.; Castelein, R.M.

    2013-01-01

    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 and elderly patients. Our concept o

  3. 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

  4. Organ culture bioreactors--platforms to study human intervertebral disc degeneration and regenerative therapy.

    Science.gov (United States)

    Gantenbein, Benjamin; Illien-Jünger, Svenja; Chan, Samantha C W; 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 spine and IVD research, these organ culture models offer appealing alternatives, as large bipedal animal models with naturally occurring IVD degeneration and a genetic background similar to the human condition do not exist. Latest research has demonstrated important concepts including the potential of homing of mesenchymal stem cells to nutritionally or mechanically stressed IVDs, and the regenerative potential of "smart" biomaterials for nucleus pulposus or annulus fibrosus repair. In this review, we summarize the current knowledge about cell therapy, injection of cytokines and short peptides to rescue the degenerating IVD. We further stress that most bioreactor systems simplify the real in vivo conditions providing a useful proof of concept. Limitations are that certain aspects of the immune host response and pain assessments cannot be addressed with ex vivo systems. Coccygeal animal disc models are commonly used because of their availability and similarity to human IVDs. Although in vitro loading environments are not identical to the human in vivo situation, 3D ex vivo organ culture models of large animal coccygeal and human lumbar IVDs should be seen as valid alternatives for screening and feasibility testing to augment existing small animal, large animal, and human clinical trial experiments.

  5. 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.

  6. 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.

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

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    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.

  8. Development of Ultrasound to Measure In-vivo Dynamic Cervical Spine Intervertebral Disc Mechanics

    Science.gov (United States)

    2015-01-01

    Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Neck pain is pervasive problems in military population...especially in those working in vibrating environments. Previous studies show neck pain is strongly associated with degeneration of Intervertebral Disc (IVD...The capability of dual US to measure C-spine properties in-vivo in simulation environment is currently being tested. Biomechanics finite element(FE

  9. Effects of Ge Gen Decoction on PGE2 Content and COX Activity in the Degenarated Cervical Intervertebral Discs of Rats

    Institute of Scientific and Technical Information of China (English)

    Zhou Jun; Fang Suping; Huo Hairu; Qi Yun; Guo Shuying; Jiang Tingliang; Shi Qi; Wang Youjing

    2005-01-01

    After the rat model of cervical spondylosis was developed for 6 months, the PGE2 content and COX activity in the cervical intervertebral discs were determined respectively by radioimmunoassay and catalytic activity assay.The results indicated that the PGF2 content and COX activity in the model rat increased significantly, and that Ge Gen Decoction could down-regulate the PGE2 content and inhibit COX activity. This is possibly one of the mechanisms of Ge Gen Decoction for treating cervical spondylosis.

  10. 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).

  11. Kinematic MR imaging in surgical management of cervical disc disease, spondylosis and spondylotic myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Muhle, C.; Metzner, J.; Brinkmann, G.; Heller, M. [Christian-Albrechts-Universitaet, Kiel (Germany). Dept. of Diagnostic Radiology; Weinert, D.; Schoen, R.; Rautenberg, E.; Mehdorn, H.M. [Christian-Albrechts-Universitaet, Kiel (Germany). Dept. of Neurosurgery; Falliner, A. [Christian-Albrechts-Universitaet, Kiel (Germany). Dept. of Orthopedics; Resnick, D. [Veterans Affairs Medical Center, San Diego, CA (United States). Dept. of Radiology

    1999-03-01

    Purpose: To estimate the clinical value and influence of kinematic MR imaging in patients with degenerative diseases of the cervical spine. Material and methods: Eighty-one patients were examined with a 1.5 T whole body magnet using a positioning device. Cervical disc disease was classified according to clinical and radiographic findings into 4 stages: stage I=cervical disc disease (n=13); stage II=spondylosis (n=42); stage III=spondylosis with restricted motion (n=11); and stage IV-cervical spondylotic myelopathy (n=15). Findings on kinematic MR images were compared to those on flexion and extension radiographs, myelography, CT-myelography and static MR imaging. Furthermore, the influence of kinematic MR imaging on surgical management and intra-operative patient positioning was determined. Results: Additional information obtained by kinematic MR imaging changed the therapeutic management in 7 of 11 (64%) patients with stage III disease, and in 13 of 15 (87%) patients with stage IV disease. Instead of an anterior approach, a posterior surgical approach was chosen in 3 of 11 patients (27%) with stage III disease and in 6 of 15 patients (40%) with stage IV disease. Hyperextension of the neck was avoided intra-operatively in 4 patients (27%) with cervical spondylotic myelopathy, and in 1 patient with stage II (2%) and in 1 patient with stage III (9%) disease. Kinematic MR imaging provided additional information in all patients with stages III and IV disease except in 1 patient with stage III disease, when compared to flexion and extension radiographs, myelography, CT-myelography and static MR examination. Conclusion: Kinematic MR imaging adds additional information when compared to conventional imaging methods in patients with advanced stages of degenerative disease of the cervical spine. (orig.)

  12. 颈椎间盘置换术治疗颈椎病的短期疗效观察%Short-term curative effects of cervical disc replacement for cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    戚小忠; 徐宏光; 孙良吕; 王弘; 刘平; 俞宏星

    2013-01-01

    Objective ;To observe the curative effects of artificial disc for cervical disc replacement in treatment of cervical spondylosis. Methods: The curative effects were reviewed in 20 patients undergone artificial in-tervertebral disc replacement between March 2010 and January 2011 ,with regard to the JOA scoring, intervertebral height, motion range of the cervical vertebra and functional spinal unit range of motion before surgery and three month after the procedure as well as the final follow-up. Results :T\\ie follow-up lasted for ( 18.9 ±7.23 ) months on average, and it suggested that all patients achieved significant clinical remission. JOA scoring, the intervertebral disc height observed pre-and post-operatively and at final follow-up were statistically different( P 0.05 ). Conclusion:In the event of the indications and contraindications being stringently controlled, artificial disc replacement for cervical spondylosis may lead to better curative outcomes and simultaneously reducing degeneration of adjacent segments of the cervical spine, and is worthy of wider clinical application.%目的:探讨颈椎间盘置换术治疗颈椎病的临床疗效.方法:观察2010年3月~2011年1月期间皖南医学院附属弋矶山医院脊柱外科采用颈椎间盘置换术治疗颈椎病患者20例;记录并比较术前、术后3个月及末次随访患者的颈椎JOA评分、椎间高度、颈椎活动度和脊柱功能单位活动度.结果:平均随访(18.9±7.23)个月.患者临床症状明显缓解.JOA评分、椎间高度术前与术后、末次随访差异有统计学意义(P0.05).结论:在严格把握手术适应证和禁忌症的情况下,颈椎间盘置换术可取得满意的临床疗效,同时可预防和减少邻近节段退变的发生,值得临床推广应用.

  13. ProDisc-C人工椎间盘双节段置换治疗重症颈椎病%ProDisc-C cervical disc two-segment replacement from severe cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    曾云; 熊敏; 余化龙; 何宁; 王志勇; 刘志刚; 韩珩; 陈森; 郭乐运

    2013-01-01

    Objective To investigate the clinical effect of ProDisc-C cervical disc replacement for two-segment severe cervical spondylosis.Methods Seventeen cases of two-segment severe cervical spondylosis aged from 36-59 years old were treated with artificial cervical disc replacement.The patients were followed up for 24 to 55 months after operation.The visual analogue scale (VAS),Japanese Orthopedic Association (JOA) scores,cervical curvature overall and the range of motion of the replacement segment were evaluated pre-and 3,12 and 24 months post-operation.Results The VAS scores at 3,12 and 24 months post-operation were 3.8 ± 1.9,1.9 ± 0.8 and 1.1 ± 0.4 respectively,which were significantly reduced as compared with pre-operation (6.3 ± 2.7,P < 0.05).The JOA scores at 3,12 and 24 months postoperation were 13.4 ± 1.5,15.2 ± 1.1 and 15.9 ± 1.4 respectively,which were significantly increased as compared with pre-operation (8.7 ± 2.1,P < 0.05).There was no statistically significant difference in the cervical curvature overall before and 24 months after operation (P > 0.05).There was significant difference in the range of motion of the replacement segmentl before and 24 months after operation (P < 0.05).Conclusion The clinical effect of ProDisc-C cervical disc replacement for two-segment severe cervical spondylosis is satisfactory and it can maintain good cervical activity after operation.%目的 观察ProDisc-C人工椎间盘置换治疗双节段重症颈椎病的疗效.方法 对17例双节段重症颈椎病患者进行人工椎间盘置换术,年龄36~59岁,术后随访时间24 ~55个月,手术前后观察视觉模拟评分(VAS)、JOA评分、颈椎整体曲度、置换节段活动度.结果 术后第3、12、24个月VAS评分分别为(3.8±1.9)、(1.9±0.8)、(1.1±0.4)分,与术前(6.3±2.7)分比较差异有统计学意义(P<0.05);术后第3、12、24个月JOA评分分别为(13.4±1.5)、(15.2±1.1)、(15.9±1.4)分,与术前(8.7±2.1)分比

  14. 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.)

  15. 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。

  16. Human MMP28 expression is unresponsive to inflammatory stimuli and does not correlate to the grade of intervertebral disc degeneration

    Directory of Open Access Journals (Sweden)

    Klawitter Marina

    2011-07-01

    Full Text Available Abstract Background MMP28 (epilysin is a recently discovered member of the MMP (matrix metalloproteinase family that is, amongst others, expressed in osteoarthritic cartilage and intervertebral disc (IVD tissue. In this study the hypothesis that increased expression of MMP28 correlates with higher grades of degeneration and is stimulated by the presence of proinflammatory molecules was tested. Gene expression levels of MMP28 were investigated in traumatic and degenerative human IVD tissue and correlated to the type of disease and the degree of degeneration (Thompson grade. Quantification of MMP28 gene expression in human IVD tissue or in isolated cells after stimulation with the inflammatory mediators lipopolysaccharide (LPS, interleukin (IL-1β, tumor necrosis factor (TNF-α or the histondeacetylase inhibitor trichostatin A was performed by real-time RT PCR. Results While MMP28 expression was increased in individual cases with trauma or disc degeneration, there was no significant correlation between the grade of disease and MMP28 expression. Stimulation with LPS, IL-1β, TNF-α or trichostatin A did not alter MMP28 gene expression at any investigated time point or any concentration. Conclusions Our results demonstrate that gene expression of MMP28 in the IVD is not regulated by inflammatory mechanisms, is donor-dependent and cannot be positively or negatively linked to the grade of degeneration and only weakly to the occurrence of trauma. New hypotheses and future studies are needed to find the role of MMP28 in the intervertebral disc.

  17. 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

  18. Effect of Degeneration on Fluid-Solid Interaction within Intervertebral Disc under Cyclic Loading – A Meta-Model Analysis of Finite Element Simulations

    Directory of Open Access Journals (Sweden)

    Mohammad eNikkhoo

    2015-01-01

    Full Text Available The risk of low back pain resulted from cyclic loadings is greater than that resulted from prolonged static postures. Disc degeneration results in degradation of disc solid structures and decrease of water contents, which is caused by activation of matrix digestive enzymes. The mechanical responses resulted from internal solid-fluid interactions of degenerative discs to cyclic loadings are not well studied yet. The fluid-solid interactions in discs can be evaluated by mathematical models, especially the poroelastic finite element models. We developed a robust disc poroelastic FE model to analyze the effect of degeneration on solid-fluid interactions within disc subjected to cyclic loadings at different loading frequencies. A backward analysis combined with in-vitro experiments were used to find the elastic modulus and hydraulic permeability of intact and enzyme-induced degenerated porcine discs. The results showed that the averaged peak-to-peak disc deformations during the in-vitro cyclic tests were well fitted with limited FE simulations and a quadratic response surface regression for both disc groups. The results showed that higher loading frequency increased the intradiscal pressure, decreased the total fluid loss, and slightly increased the maximum axial stress within solid matrix. Enzyme-induced degeneration decreased the intradiscal pressure and total fluid loss, and barely changed the maximum axial stress within solid matrix. The increase of intradiscal pressure and total fluid loss with loading frequency was less sensitive after the frequency elevated to 0.1 Hz for the enzyme-induced degenerated disc. Based on this study, it is found that enzyme-induced degeneration decreases energy attenuation capability of disc, but less change the strength of disc.

  19. 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.

  20. 人工颈椎间盘的假体结构及应用特点%Prosthesis structure and application features of artificial cervical disc

    Institute of Scientific and Technical Information of China (English)

    颜端国

    2014-01-01

    herniation, the surgical therapy. 200 literatures and 56 literatures were respectively searched in CNKI and the PubMed. Titles and abstracts were read. A total of 40 literatures were in accordance with inclusion criteria and included. RESULTS AND CONCLUSION:Artificial cervical disc prosthesis was consistent with physiological functions of intervertebral disk. The material is characterized by abrasion, fatigue resistance and corrosion resistance, is similar to physiological and biomechanical function of human disc, maintains the stability of the spine and motor function, and avoids the accelerated degeneration of adjacent segments. Articles mainly introduced the structure of Bryan, Mobi-C, PCM, Prodisc-C, Prestige and CerviCore artificial cervical disc. Short-period therapeutic effects of artificial cervical disc replacement have obtained approval. However, it cannot completely replace anterior cervical fusion, but is another manner to treat cervical degenerative disc disease.

  1. Interleukin 1 Polymorphisms Contribute to Intervertebral Disc Degeneration Risk: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Zheng Wang

    Full Text Available We performed a meta-analysis to assess association between interleukin 1 (IL-1 polymorphisms and the risk of Intervertebral Disc Degeneration (IDD.A series of studies have investigated the association between common single nucleotide polymorphisms in IL-1 and IDD risk; however, the overall results are inconclusive.Two independent investigators conducted a systematic search for relevant available studies. Allele frequencies were extracted from each study. The association between the IL-1α (+889C/T or IL-1β (+3954C/T polymorphism and IDD risk was measured by odds ratios (OR with 95% confidence intervals (95% CI.Five and six studies, respectively, were ultimately included in the meta-analysis for the IL-1α (+889C/T and IL-1β (+3954C/T polymorphism. The combined results showed that the IL-1α (+889C/T polymorphism was significantly associated with increased susceptibility to IDD, particularly in Caucasians (TT versus CC: OR = 2.95, 95% CI: 1.45, 6.04; Pheterogeneity = 0.82; TT versusOR = 2.29, 95% CI: 1.18, 4.47; Pheterogeneity = 0.20. In contrast, the IL-1β (+3954C/T polymorphism showed a trend towards increased risk in Caucasians but no association in Asians.This meta-analysis suggested that the IL-1α (+889C/T polymorphism is significantly associated with risk of IDD, especially in Caucasian populations.

  2. Hydrogen sulfide protects against endoplasmic reticulum stress and mitochondrial injury in nucleus pulposus cells and ameliorates intervertebral disc degeneration.

    Science.gov (United States)

    Xu, Daoliang; Jin, Haiming; Wen, Jianxia; Chen, Jiaoxiang; Chen, Deheng; Cai, Ningyu; Wang, Yongli; Wang, Jianle; Chen, Yu; Zhang, Xiaolei; Wang, Xiangyang

    2017-03-01

    It has been suggested that excessive apoptosis in intervertebral disc cells induced by inflammatory cytokines, such as interleukin (IL)-1β, is related to the process of intervertebral disc degeneration (IVDD). Hydrogen sulfide (H2S), a gaseous signaling molecule, has drawn attention for its anti-apoptosis role in various pathophysiological processes in degenerative diseases. To date, there has been no investigation of the correlation of H2S production and IVDD or of the effects of H2S on IL-1β-induced apoptosis in nucleus pulposus (NP) cells. Here, we found that the expression levels of cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE), two key enzymes in the generation of H2S, were significantly decreased in human degenerate NP tissues as well as in IL-1β-treated NP cells. NaHS (H2S donor) administration showed a protective effect by inhibiting the endoplasmic reticulum (ER) stress response and mitochondrial dysfunction induced by IL-1β stimulation in vitro, the effect was related to activation of the PI3K/Akt and ERK1/2 signaling pathways. Suppression of these pathways by specific inhibitors, LY294002 and PD98059, partially reduced the protective effect of NaHS. Moreover, in the percutaneous needle puncture disc degeneration rat tail model, disc degeneration was partially reversed by NaHS administration. Taken together, our results suggest that H2S plays a protective role in IVDD and the underlying mechanism involves PI3K/Akt and ERK1/2 signaling pathways-mediated suppression of ER stress and mitochondrial dysfunction in IL-1β-induced NP cells.

  3. 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.

  4. Scalene myofascial pain syndrome mimicking cervical disc prolapse: a report of two cases.

    Science.gov (United States)

    Abd Jalil, Nizar; Awang, Mohammad Saufi; Omar, Mahamarowi

    2010-01-01

    Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain syndrome mimics cervical radiculopathy, this condition often leads to mismanagement, which can, in turn, result in persistent pain and suffering. In the worst-case scenarios, patients may be subjected to unjustifiable surgical intervention. Because the clinical findings in scalene myofascial pain syndrome are "pathognomonic", clinicians should be aware of ways to recognize this disorder and be able to differentiate it from other conditions that present with neck pain and rediculopathy. We present two cases of unilateral scalene myofascial pain syndrome that significantly impaired the patients' functioning and quality of life. This case report serves to create awareness about the existence of the syndrome and to highlight the potential morbidity due to clinical misdiagnosis.

  5. Characteristics of Modic changes in the cervical spine and its relationship with cervical degeneration%颈椎终板Modic改变分布特点与退变的关系

    Institute of Scientific and Technical Information of China (English)

    李继刚; 杨惠林; 朱若夫; 张磊

    2011-01-01

    BACKGROUND: The distribution and characteristics of Modic changes in lumbar spine have been described, but there are few studies focusing on Modic changes in the cervical spineOBJECTIVE: To report on the prevalence, types, distribution of Modic changes and its relationship with cervical degeneration found in the cervical spine.METHODS: From 1187 cases in the year 2009, 200 patients aged 20-83 years, randomly selected cervical spine MRI and X-ray were viewed. Data were recorded for patient age, patient sex, and the presence or absence of Modic changes, then the specific Modic type and the precise vertebral levels and location of these changes were recorded. The prevalence of Modic changes on sex, age, segment, grade of intervertebral disc degeneration, disc height and cervical curve was analyzed retrospectively.RESULTS AND CONCLUSION : Among 1200 intervertebral discs of 200 patients, 23 (11.5%) patients with 29 (2.4%)intervertebral discs were involved with Modic changes. Eight (4%) cases with 10 (0.8%) discs were diagnosed as type Ⅰ ; 13(6.5%) cases with 16 (1.3%) discs were type Ⅱ ; 2 (1%) cases with 3 (0.25%) discs were type Ⅲ. According to the segment, the lesions involved C2/3 for 0 (0%), C3/4 for 4 (0.33%), C4/5 for 6 (0.5%), C5/6 for 12 (1%), C6/7 for 7 (0.58%), C7/T1 for 0 (0%). These findings demonstrated that Modic changes are observed in the cervical spine, with the C5/6 level being the most commonly involved. Like in the lumbar spine in which Modic type Ⅱ changes predominate, type Ⅱ is the most, type Ⅲ is the least. They are far more common in the posterior area of the endplate. Modic changes are distributed mainly over the age of 50, which are correlated with ages, grade of disc degeneration, disc level, disc height and cervical curve.%背景:关于Modic改变在腰椎中分布及特点的相关性研究比较多,而在颈椎中的相关研究则较少.目的:分析颈椎终板Modic改变的临床分布特点,并

  6. Vitamin D Receptor Gene, Matrix Metalloproteinase 3 Polymorphisms and the Risk of Intervertebral Disc Degeneration Susceptibility: Meta-Analysis

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    Huang, Yongjing; Zhao, Shujie; Xu, Nanwei

    2016-01-01

    Several studies have evaluated the association between vitamin D receptor, matrix metalloproteinase 3 (MMP-3) polymorphisms and the risk of intervertebral disc degeneration susceptibility. The findings were inconsistent. This meta-analysis aimed to systematically assess the association between vitamin D receptor, MMP-3 polymorphisms and the risk of intervertebral disc degeneration susceptibility. A search of various databases was done covering all papers published until December 31th, 2014. Eight, 4, 3 studies were finally included that addressed the risk of intervertebral disc degeneration susceptibility and vitamin D receptor FokI (rs2228570), ApaI (rs7975232), and MMP-3 (rs731236) polymorphisms, respectively. FokI (f vs. F: summary odds ratio [OR], 1.13; 95% confidence interval [CI], 0.76–1.69; ff vs. FF: OR, 1.02; 95% CI, 0.59–1.77; ff vs. Ff/FF: OR, 1.05; 95% CI, 0.70–1.58), ApaI (a vs. A: OR, 0.73; 95% CI, 0.45–1.19; aa vs. AA: OR, 0.53; 95% CI, 0.22–1.25 p=0.14; aa vs. AA/Aa: OR, 0.69; 95% CI, 0.53–0.89) in the vitamin D receptor gene and MMP3 polymorphisms (5A vs. 6A: OR, 1.92; 95% CI, 0.77–4.80; 5A5A vs. 6A6A: OR, 2.17; 95% CI, 0.75–6.24; 5A5A vs. 5A6A/6A6A: OR, 1.58; 95% CI, 0.72–3.44) were not obviously associated with risk of intervertebral disc degeneration susceptibility. FokI, ApaI polymorphisms in the vitamin D receptor gene and MMP-3 polymorphism are not obvious risk factors for intervertebral disc degeneration susceptibility.

  7. Study of the influence of degenerative intervertebral disc changes on the deformation behavior of the cervical spine segment in flexion

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    Kolmakova, Tatyana V.

    2016-11-01

    The paper describes the model of the cervical spine segment (C3-C4) and the calculation results of the deformation behavior of the segment under degenerative changes of the intervertebral disc. The segment model was built based on the experimental literature data taking into account the presence of the cortical and cancellous bone tissue of vertebral bodies. The calculation results show that degenerative changes of the intervertebral disc cause the immobility of the C3 vertebra at flexion.

  8. 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

  9. Are the determinants of vertebral endplate changes and severe disc degeneration in the lumbar spine the same? A magnetic resonance imaging study in middle-aged male workers

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    Korpelainen Raija

    2008-04-01

    Full Text Available Abstract Background Modic changes are bone marrow lesions visible in magnetic resonance imaging (MRI, and they are assumed to be associated with symptomatic intervertebral disc disease, especially changes located at L5-S1. Only limited information exists about the determinants of Modic changes. The objective of this study was to evaluate the determinants of vertebral endplate (Modic changes, and whether they are similar for Modic changes and severe disc degeneration focusing on L5-S1 level. Methods 228 middle-aged male workers (159 train engineers and 69 sedentary factory workers from northern Finland underwent sagittal T1- and T2-weighted MRI. Modic changes and disc degeneration were analyzed from the scans. The participants responded to a questionnaire including items of occupational history and lifestyle factors. Logistic regression analysis was used to evaluate the associations between selected determinants (age, lifetime exercise, weight-related factors, fat percentage, smoking, alcohol use, lifetime whole-body vibration and Modic type I and II changes, and severe disc degeneration (= grade V on Pfirrmann's classification. Results The prevalences of the Modic changes and severe disc degeneration were similar in the occupational groups. Age was significantly associated with all degenerative changes. In the age-adjusted analyses, only weight-related determinants (BMI, waist circumference were associated with type II changes. Exposure to whole-body vibration, besides age, was the only significant determinant for severe disc degeneration. In the multivariate model, BMI was associated with type II changes at L5-S1 (OR 2.75 per one SD = 3 unit increment in BMI, and vibration exposure with severe disc degeneration at L5-S1 (OR 1.08 per one SD = 11-year increment in vibration exposure. Conclusion Besides age, weight-related factors seem important in the pathogenesis of Modic changes, whereas whole-body vibration was the only significant determinant

  10. 人工椎间盘置换术治疗跳跃型多节段颈椎病的中期疗效%Comparison of the mid-term follow-up results between treatment of Bryan cervical artificial disc replacement and ante-rior cervical decompression and fusion for"skip"cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    尚子琨; 张英泽; 张迪; 丁文元; 张为; 孟宪中; 王林峰; 申勇

    2014-01-01

    Objective To retrospectively analysis and compareabout Bryan artificial cervical disc arthroplasty with ante-rior cervical decompression and fusion (ACDF) on the clinical efficacy for“Skip”cervical spondylosis. Methods From February 2002 to May 2012, 49 cases were treated with Bryan artificial cervical disc arthroplasty (artificial cervical disc replacement surgery group, 18 cases) or anterior cervical decompression and fusion (ACDF group, 31 cases), 29 males and 20 females. Each case was evaluated at the moment of preoperatively, 3 months, 6 and 12 months and last follow-up after surgery by the Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), Visual Analog Scale (VAS), Cervical sagittal curvature, the total cervical spine range of motion(ROM),middle segments of motion. MRI was also used to assess to adjacent segment disc degeneration, spinal cord compression and signal change situation. Results All patients were followed up for more than 24 months. The score of the JOA, NDI, VAS in the two groups of patients improved significantly after surgery than before surgery. In addition, the VAS score in last follow-up were significantly different between the two groups, but other index each time in the two groups showed no significant difference. In last follow-up, the result of artificial cervical disc arthroplasty group were better than ACDF group on the incidence of axial symptoms, the total cervical spine range of motion (ROM) and middle segments of motion. The incidence of axial symptoms in artificial cervical disc arthroplasty group were 11.1%,ACDF group were 45.2%. ROM in arti-ficial cervical disc arthroplasty group were 35.5°±5.9°,ACDF group were 24.5°±6.2°. Middle segments of motion in artificial cer-vical disc arthroplasty group were 7.3°±1.4°,ACDF group were 10.1°±1.6°. The above comparison of the datas were statistically different. There are two cases of adjacent segment degeneration in ACDF group without need to surgery

  11. Fluoroscopic cervical epidural injections in chronic axial or disc-related neck pain without disc herniation, facet joint pain, or radiculitis

    Directory of Open Access Journals (Sweden)

    Manchikanti L

    2012-07-01

    Full Text Available Laxmaiah Manchikanti, Kimberly A Cash, Vidyasagar Pampati, Yogesh MallaPain Management Center of Paducah, Paducah, KY, USABackground: While chronic neck pain is a common problem in the adult population, with a typical 12-month prevalence of 30%–50%, there is a lack of consensus regarding its causes and treatment. Despite limited evidence, cervical epidural injections are one of the commonly performed nonsurgical interventions in the management of chronic neck pain.Methods: A randomized, double-blind, active, controlled trial was conducted to evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of chronic neck pain with or without upper extremity pain in patients without disc herniation, radiculitis, or facet joint pain.Results: One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of two treatment groups, ie, injection of local anesthetic only (group 1 or local anesthetic mixed with nonparticulate betamethasone (group 2. The primary outcome of significant pain relief and improvement in functional status (≥50% was demonstrated in 72% of group 1 and 68% of group 2. The overall average number of procedures per year was 3.6 in both groups with an average total relief per year of 37–39 weeks in the successful group over a period of 52 weeks.Conclusion: Cervical interlaminar epidural injections of local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic or axial pain.Keywords: chronic neck pain, cervical disc herniation, cervical discogenic pain, cervical epidural injections, epidural steroids, local anesthetics

  12. 颈椎前路减压人工颈椎间盘置换术与融合术治疗单节段颈椎间盘突出症的短期疗效比较%Clinical outcome of Discover artificial cervical disc replacement versus anterior cervical decompression and fusion for single segment cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    卡哈尔·艾肯木; 楚戈; 王振斌; 陈继征; 顾文飞; 胡雅斌; 涂来勇; 赵疆; 项泽文

    2014-01-01

    Background: The curative effect of anterior cervical discectomy and fusion (ACDF) is satisfactory for the patients with symptomatic cervical disc herniation. However, it can result in stress increase in adjacent segments and speed up the degen-eration of adjacent segments. Artificial cervical disc replacement (ACDR), a typical non-fusion surgical treatment, may be an alternative to ACDF for cervical disc herniation. Objective:To compare the clinical outcomes between ACDR and ACDF for single segmental cervical disc herniation. Methods:From January 2009 to February 2012, 61 patients with single segmental cervical disc herniation were treated in our hospital. Of them, 26 received Discover ACDF (arthroplasty group) and 35 underwent single-level ACDF (fusion group). Visual analogue scale (VAS) neck/arm pain score, Japanese Orthopedics Association (JOA) score and flexion-exten-sion range of motion of operative and adjacent segments were evaluated preoperatively and 1 week and 3, 6, 12, and 24 months postoperatively. Complications and secondary treatment were recorded. Results:A total of 52 patients (29 in arthroplasty group and 23 in fusion group) were followed up. The average follow-up pe-riod was 15.3 months (range, 12-24 months). The VAS scores of neck pain and upper limb pain and JOA score were signifi-cantly improved during follow up as compared with preoperative ones in all patients (P0.05). In arthroplasty group, there was no significant difference in range of motion of opera-tive and adjacent segments before and after treatment (P>0.05). The rate of fusion achievement was 90.5%. In arthroplasy group, prosthesis antedisplacement (<3 mm) in 2 patients at 6 months after surgery, and cerebrospinal fluid leakage oc-curred 1 patient. In fusion group, adjacent segment disease occurred in one patient who underwent secondary operation. Conclusions:Discover cervical disc replacement is a feasible alternative to ACDF for patients with persistent symptomatic cervical disc

  13. Development and Kinematic Verification of a Finite Element Model for the Lumbar Spine: Application to Disc Degeneration

    Directory of Open Access Journals (Sweden)

    Elena Ibarz

    2013-01-01

    Full Text Available The knowledge of the lumbar spine biomechanics is essential for clinical applications. Due to the difficulties to experiment on living people and the irregular results published, simulation based on finite elements (FE has been developed, making it possible to adequately reproduce the biomechanics of the lumbar spine. A 3D FE model of the complete lumbar spine (vertebrae, discs, and ligaments has been developed. To verify the model, radiological images (X-rays were taken over a group of 25 healthy, male individuals with average age of 27.4 and average weight of 78.6 kg with the corresponding informed consent. A maximum angle of 34.40° is achieved in flexion and of 35.58° in extension with a flexion-extension angle of 69.98°. The radiological measurements were 33.94 ± 4.91°, 38.73 ± 4.29°, and 72.67°, respectively. In lateral bending, the maximum angles were 19.33° and 23.40 ± 2.39, respectively. In rotation a maximum angle of 9.96° was obtained. The model incorporates a precise geometrical characterization of several elements (vertebrae, discs, and ligaments, respecting anatomical features and being capable of reproducing a wide range of physiological movements. Application to disc degeneration (L5-S1 allows predicting the affection in the mobility of the different lumbar segments, by means of parametric studies for different ranges of degeneration.

  14. EVALUATION OF TERMINAL VERTEBRAL PLATE ON CERVICAL SPINE AT DIFFERENT AGE GROUPS AND ITS CORRELATION WITH INTERVERTEBRAL DISC THICKNESS

    Science.gov (United States)

    Luiz Vieira, Juliano Silveira; da Silva Herrero, Carlos Fernando Pereira; Porto, Maximiliano Aguiar; Nogueira Barbosa, Marcello Henrique; Garcia, Sérgio Britto; Zambelli Ramalho, Leandra Náira; Aparecido Defino, Helton Luiz

    2015-01-01

    To evaluate, by means of histomorphometry, terminal vertebral plate thickness, intervertebral disc thickness and its correlation on different age groups, seeking to identify its correlation. Methods: C4-C5 and C5-C6 cervical segments removed from human cadavers of both genders were assessed and divided into five groups of 10-year age intervals, from 21 years old. TVP and intervertebral disc thickness evaluation was made by means of histomorphometry of histological slides stained with hematoxylin and eosyn. Lower C4 TVP, upper C5 TVP, and upper C6 TVP de were compared between each other and to the interposed intervertebral disc thickness between relevant TVP. Results: The thickness of terminal vertebral plates adjacent to the same ID did not show statistic differences. However, the comparison of upper and lower vertebral plates thickness on the same cervical vertebra (C5), showed statistical difference on all age groups studied. We found a statistical correlation coefficient above 80% between terminal vertebral plate and adjacent intervertebral disc, with a proportional thickness reduction of both structures on the different cervical levels studied, and also on the different age groups assessed. Conclusion: Terminal vertebral plate shows a morphologic correlation with the intervertebral disc next to it, and does not show correlation with the terminal vertebral plate on the same vertebra. PMID:26998448

  15. 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.

  16. Degeneration and regeneration in the superior cervical sympathetic ganglion after Latrodectus venom.

    Science.gov (United States)

    Daniel, S E

    1989-06-01

    The effects of the venom of the spider Latrodectus mactans hasselti on the superior cervical ganglion were studied in the guinea pig. Under anaesthesia the ganglion was bathed in venom solution for 15 min. Shortly afterwards animals salivated profusely and later developed unilateral ptosis and enophthalmos. Postoperative survival times ranged from 15 min to 10 weeks. Electron microscopy showed acute swelling of preganglionic cholinergic nerve terminals, followed by degeneration with separation of synapses. Other ganglionic elements appeared to be undamaged, although after detachment of synapses the dendritic postsynaptic specializations were reduced in number. Recovery was very rapid; axon growth cones were identifiable at 18 h and synapse reformation was well established by 2 weeks. With longer survival times there was progressive restoration of normal morphology such that by 8 weeks regeneration appeared complete. These experiments indicate that the preganglionic cholinergic nerve terminals are selectively affected by Latrodectus venom and have a considerable capacity for appropriate regeneration.

  17. 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.

  18. Biomechanics of a posture-controlling cervical artificial disc: mechanical, in vitro, and finite-element analysis.

    Science.gov (United States)

    Crawford, Neil R; Arnett, Jeffery D; Butters, Joshua A; Ferrara, Lisa A; Kulkarni, Nikhil; Goel, Vijay K; Duggal, Neil

    2010-06-01

    Different methods have been described by numerous investigators for experimentally assessing the kinematics of cervical artificial discs. However, in addition to understanding how artificial discs affect range of motion, it is also clinically relevant to understand how artificial discs affect segmental posture. The purpose of this paper is to describe novel considerations and methods for experimentally assessing cervical spine postural control in the laboratory. These methods, which include mechanical testing, cadaveric testing, and computer modeling studies, are applied in comparing postural biomechanics of a novel postural control arthroplasty (PCA) device versus standard ball-and-socket (BS) and ball-in-trough (BT) arthroplasty devices. The overall body of evidence from this group of tests supports the conclusion that the PCA device does control posture to a particular lordotic position, whereas BS and BT devices move freely through their ranges of motion.

  19. Voxel-based analysis of grey and white matter degeneration in cervical spondylotic myelopathy.

    Science.gov (United States)

    Grabher, Patrick; Mohammadi, Siawoosh; Trachsler, Aaron; Friedl, Susanne; David, Gergely; Sutter, Reto; Weiskopf, Nikolaus; Thompson, Alan J; Curt, Armin; Freund, Patrick

    2016-04-20

    In this prospective study, we made an unbiased voxel-based analysis to investigate above-stenosis spinal degeneration and its relation to impairment in patients with cervical spondylotic myelopathy (CSM). Twenty patients and 18 controls were assessed with high-resolution MRI protocols above the level of stenosis. Cross-sectional areas of grey matter (GM), white matter (WM), and posterior columns (PC) were measured to determine atrophy. Diffusion indices assessed tract-specific integrity of PC and lateral corticospinal tracts (CST). Regression analysis was used to reveal relationships between MRI measures and clinical impairment. Patients showed mainly sensory impairment. Atrophy was prominent within the cervical WM (13.9%, p = 0.004), GM (7.2%, p = 0.043), and PC (16.1%, p = 0.005). Fractional anisotropy (FA) was reduced in the PC (-11.98%, p = 0.006) and lateral CST (-12.96%, p = 0.014). In addition, radial (+28.47%, p = 0.014), axial (+14.72%, p = 0.005), and mean (+16.50%, p = 0.001) diffusivities were increased in the PC. Light-touch score was associated with atrophy (R(2) = 0.3559, p = 0.020) and FA (z score 3.74, p = 0.003) in the PC, as was functional independence and FA in the lateral CST (z score 3.68, p = 0.020). This study demonstrates voxel-based degeneration far above the stenosis at a level not directly affected by the compression and provides unbiased readouts of tract-specific changes that relate to impairment.

  20. Hemifacial hyperhidrosis associated with ipsilateral/contralateral cervical disc herniation myelopathy. Functional considerations on how compression pattern determines the laterality.

    Science.gov (United States)

    Iwase, Satoshi; Inukai, Yoko; Nishimura, Naoki; Sato, Maki; Sugenoya, Junichi

    2014-01-01

    Sweating is an important mechanism for ensuring constant thermoregulation, but hyperhidrosis may be disturbing. We present five cases of hemifacial hyperhidrosis as a compensatory response to an/hypohidrosis caused by cervical disc herniation. All the patients complained of hemifacial hyperhidrosis, without anisocoria or blepharoptosis. Sweat function testing and thermography confirmed hyperhidrosis of hemifacial and adjacent areas. Neck MRI showed cervical disc herniation. Three of the patients had lateral compression with welldemarcated hypohidrosis below the hyperhidrosis on the same side as the cervical lesion. The rest had paramedian compression with poorly demarcated hyperhidrosis and hypohidrosis on the contralateral side. Although MRI showed no intraspinal pathological signal intensity, lateral dural compression might influence the circulation to the sudomotor pathway, and paramedian compression might influence the ipsilateral sulcal artery, which perfuses the sympathetic descending pathway and the intermediolateral nucleus. Sweat function testing and thermography should be performed to determine the focus of the hemifacial hyperhidrosis, and the myelopathy should be investigated on both sides.

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

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    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

  2. Current research status of the prosthesis-related complication after cervical disc arthroplasty%颈椎间盘置换术后假体相关并发症的研究现状

    Institute of Scientific and Technical Information of China (English)

    赵郭盛; 张圆; 权正学

    2016-01-01

    近年来,为避免颈椎融合术治疗颈椎退行性疾病所带来的假关节形成及邻近节段退变加速等问题,颈椎间盘置换术作为一种非融合技术广泛应用于临床,其疗效确切,已逐渐成为治疗颈椎退行性疾病的常规手术方式。但随着该技术应用的深入,随访年限的增加,颈椎间盘置换术后与假体相关的一系列特殊并发症逐渐被学者报道。本文就颈椎间盘置换术后假体相关并发症的研究现状作一综述。%Recently,to avoid the adverse effect such as pseudoarthrosis and accelerated degeneration of ad-jacent segments resulting from cervical fusion, cervical disc arthroplasty ( CDA) has been widely used in clinical practice as a procedure in the treatment of cervical degeneration disease.With satisfactory outcomes,CDA has been gradually accepted as a conventional procedure in treating cervical spondylosis.However,with the increased number of the total operations and the accumulation of follow-up information,some complications due to the prosthesis were revealed.Thus,we collect the related references and conduct this study to review the current status of prosthesis-re-lated complications after cervical disc arthoplasty.

  3. Medium term efficacy analysis of bi-level BRYAN artificial cervical disc replacement for the treatment of cervical spondylosis%双节段BRYAN人工颈间盘置换的中期疗效分析

    Institute of Scientific and Technical Information of China (English)

    种涛; 俞兴; 贾育松; 李春根; 柳根哲; 毕连涌; 徐林

    2013-01-01

    [ Objective]To observe the clinical effect and imaging results of the treatment of adjacent segment cervical spon-dylosis in the adjacent bi - level BRYAN cervical disc replacement. [ Method] A retrospective studying was performed on 19 cases of cervical spondylosis receiving adjacent bi - level BRYAN artificial cervical disc replacement and were followed up from January 2006 to February 2009 in our hospital. Clinical outcome of surgery was evaluated by Japanese Orthopaedic Association score (JOA) , neck disability index(NDI) and visual analogue pain scale (VAS)for neck pain before surgery and at 1 week,3, 6,12,24,36 months after surgery respectively. The range of motion (ROM) of the surgical segments, the upper and lower adjacent segments, and C2-7 was assessed by cervical dynamic X - ray film before operation and 3 ,6,12,24,36 months after sugery. Operative adjacent segment degeneration was assessed by X - ray disc degeneration scoring system 12,24 and 36 months after surgery. [Result]The neurological symptoms of each patients were significantly improved. The postoperative JOA score , NDI scores, neck pain VAS scores were improved significantly at each follow - up time point compared with those of preoperation, difference was statistically significant (P 0. 05). ROM of the two operative segment increased significantly compared with the preoperative each time point after 3 - month follow - up (P 0. 05). To the last follow - up, the surgery had not led to adjacent segment disc degeneration exacerbated and no serious complications occurred. [ Conclusion ] The clinical result of BRYAN artificial cervical disc replacement in the treatment of adjacent bi - level cervical degenerative disc disease is good, not only reserving the kinematic characteristics of operative segment, adjacent segments , C2-7 segment but preventing of adjacent segment degeneration. No serious complication occurs during mediterm follow - up.%[目的]观察相邻双节段BRYAN人工颈椎间盘

  4. Reproducible long-term disc degeneration in a large animal model

    NARCIS (Netherlands)

    Hoogendoorn, R.J.W.; Helder, M.N.; Kroeze, R.J.; Bank, R.A.; Smit, T.H.; Wuisman, P.I.J.M.

    2008-01-01

    STUDY DESIGN. Twelve goats were chemically degenerated and the development of the degenerative signs was followed for 26 weeks to evaluate the progression of the induced degeneration. The results were also compared with a previous study to determine the reproducibility. OBJECTIVES. The purpose of th

  5. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar surgery for adjacent segment degeneration and recurrent disc herniation.

    Science.gov (United States)

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

    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 herniation at L3-4, L4-5, or L5-S1 level, were assigned to different groups according to the surgical approaches. Clinical data were assessed and compared. Results. Mean blood loss was significantly less in the PELD group as compared to the open lumbar surgery group (P < 0.0001). Hospital stay and mean operating time were shorter significantly in the PELD group as compared to the open lumbar surgery group (P < 0.0001). Immediate postoperative pain improvement in VAS was 3.5 in the PELD group and -0.56 in the open lumbar surgery group (P < 0.0001). Conclusion. For ASD and recurrent lumbar disc herniation, PELD had more advantages over open lumbar surgery in terms of reduced blood loss, shorter hospital stay, operating time, fewer complications, and less postoperative discomfort.

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

    Directory of Open Access Journals (Sweden)

    Huan-Chieh Chen

    2015-01-01

    Full Text Available 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 herniation at L3-4, L4-5, or L5-S1 level, were assigned to different groups according to the surgical approaches. Clinical data were assessed and compared. Results. Mean blood loss was significantly less in the PELD group as compared to the open lumbar surgery group P<0.0001. Hospital stay and mean operating time were shorter significantly in the PELD group as compared to the open lumbar surgery group P<0.0001. Immediate postoperative pain improvement in VAS was 3.5 in the PELD group and −0.56 in the open lumbar surgery group P<0.0001. Conclusion. For ASD and recurrent lumbar disc herniation, PELD had more advantages over open lumbar surgery in terms of reduced blood loss, shorter hospital stay, operating time, fewer complications, and less postoperative discomfort.

  7. 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.

  8. Matrix stiffness promotes cartilage endplate chondrocyte calcification in disc degeneration via miR-20a targeting ANKH expression.

    Science.gov (United States)

    Liu, Ming-Han; Sun, Chao; Yao, Yuan; Fan, Xin; Liu, Huan; Cui, You-Hong; Bian, Xiu-Wu; Huang, Bo; Zhou, Yue

    2016-05-04

    The mechanical environment is crucial for intervertebral disc degeneration (IDD). However, the mechanisms underlying the regulation of cartilage endplate (CEP) calcification by altered matrix stiffness remain unclear. In this study, we found that matrix stiffness of CEP was positively correlated with the degree of IDD, and stiff matrix, which mimicked the severe degeneration of CEP, promoted inorganic phosphate-induced calcification in CEP chondrocytes. Co-expression analysis of the miRNA and mRNA profiles showed that increasing stiffness resulted in up-regulation of miR-20a and down-regulation of decreased ankylosis protein homolog (ANKH) during inorganic phosphate-induced calcification in CEP chondrocytes. Through a dual luciferase reporter assay, we confirmed that miR-20a directly targets 3'-untranslated regions of ANKH. The inhibition of miR-20a attenuated the calcium deposition and calcification-related gene expression, whereas the overexpression of miR-20a enhanced calcification in CEP chondrocytes on stiff matrix. The rescue of ANKH expression restored the decreased pyrophosphate efflux and inhibited calcification. In clinical samples, the levels of ANKH expression were inversely associated with the degeneration degree of CEP. Thus, our findings demonstrate that the miR-20a/ANKH axis mediates the stiff matrix- promoted CEP calcification, suggesting that miR-20a and ANKH are potential targets in restraining the progression of IDD.

  9. Clinical Effect of Anterior Disc Excision with Bone Graft Fusion and Bryan Artificial Cervical Disc Replacement%颈前路减压植骨融合与Bryan人工颈椎间盘置换疗效比较

    Institute of Scientific and Technical Information of China (English)

    陈昆; 蔡惠民; 陈荣滋

    2014-01-01

    目的:探讨颈椎前路减压植骨融合术( anterior cervical decompression and fusion,ACDF)与Bryan人工颈椎椎间盘置换术( artificial cervical disc replacement,ACDR)两种手术方式用于治疗脊髓型颈椎病及神经根型颈椎病的近期和远期疗效。方法系统分析我院2010年11月至2012年11月70例(70个节段)脊髓型或神经根型颈椎病患者病例资料,将70例(70个节段)脊髓型或神经根型颈椎病患者,通过随机数字表法随机分为ACDF组(35例)及Bryan组(35例)。通过分析术前及术后随访12个月的Odom′s标准评分、活动度( range of motion,ROM)、日本骨科协会( Japa-nese orthopaedic association,JOA)、健康调查简表( the MOS item short from health survey,SF-36)及颈椎残障功能指数( neck disability index,NDI)观察指标的差异,同时对随访12个月的上述各项指标进行两组间比较,比较两者疗效,分析两种术式的优点及他们产生的问题。结果两种手术方式都能取得明确疗效,治疗后患者症状明显缓解( P0.05);JOA评分及SF-36评分两者差异性不显著( P>0.05);而在12个月随访ROM评估及NDI比较有差异,Bryan组数据优于 ACDF组,差异具有统计学意义( P0. 05). JOA score and SF-36 scale had no significant differences(P>0. 05). There was difference between ROM and NDI in the evaluation of 12 month follow-up. Data of Bryan group were better than ACDF group(P<0. 05). Conclusion Bryan artificial cervical disc re-placement(ACDR)is superior to the anterior cervical decompression and fusion(ACDF)in reducing the adjacent segment degeneration of cervical vertebra. Its short-term and mid-term curative effect is superior to the ACDF. But Bryan artificial cervi-cal disc replacement( ACDR)coexist the complications such as incomplete decompression and heterotopic ossification,the long-term curative effect is inferior than ACDF.

  10. 人工颈椎间盘置换与前路颈椎间盘切除融合后邻近节段椎间盘应力分布的有限元对比%Comparison of stress distribution of adjacent segments after artificial cervical disc replacement versus anterior cervical discectomy and fusion:a finite element analysis

    Institute of Scientific and Technical Information of China (English)

    刘雅普; 侯秀伟; 吴广良; 夏虹

    2016-01-01

    背景:通过前期的临床随访研究发现,前路颈椎融合后邻近节段椎间盘退变速度要快于人工颈椎间盘置换,人工颈椎间盘置换相较于前路颈椎融合可以保持良好的置换节段活动度,是否置换后邻近椎间盘的应力情况与融合之间存在着差异需要进一步研究。目的:对比人工颈椎间盘置换与前路颈椎间盘切除融合后邻近节段椎间盘的应力分布情况。方法:选择1名30岁健康男性志愿者,人工颈椎间盘和颈椎前路钢板实物进行薄层CT扫描,通过Mimics 10.01及Geomagic Studio.v11软件重建出三维图像,将以上三维数据导入Abaqus 6.9有限元分析软件中进行网格划分、赋值、应力分析。利用有限元方法分析模拟人工颈椎间盘置换及前路颈椎间盘切除融合后邻近节段椎间盘的应力变化。结果与结论:①在相同的预载荷条件下,前屈、后伸、侧屈等运动状态时前路颈椎间盘切除融合后邻近节段椎间盘的应力明显大于正常人相应节段椎间盘应力;而人工椎间盘植入后与正常人相比,在前屈、后伸、侧屈等运动状态时邻近节段椎间盘的应力差异无显著性意义;②前路颈椎间盘切除融合组与人工颈椎间盘置换组相比较,融合组术后邻近节段椎间盘的应力较置换组增大10.3%-51.6%;③有限元分析方法发现,前路颈椎间盘切除融合后邻近节段椎间盘应力大于人工颈椎间盘置换组,随着随访时间的延长,相较于传统前路减压融合,人工颈椎间盘置换可能将更好地发挥其对邻近节段椎间盘的保护作用。%BACKGROUND:Previous clinical fol ow-up study showed that disc degeneration of adjacent segment after anterior cervical discectomy and fusion was faster than that of artificial cervical disc replacement. Compared with the anterior cervical discectomy and fusion, artificial cervical disc replacement can maintain a

  11. Is the transport of a gadolinium-based contrast agent decreased in a degenerated or aged disc? A post contrast MRI study.

    Directory of Open Access Journals (Sweden)

    Marta Tibiletti

    Full Text Available A post contrast magnetic resonance imaging study has been performed in a wide population of low back pain patients to investigate which radiological and phenotypic characteristics influence the penetration of the contrast agent in lumbar discs in vivo. 37 patients affected by different pathologies (disc herniation, spondylolisthesis, foraminal stenosis, central canal stenosis were enrolled in the study. The selected population included 26 male and 11 female subjects, with a mean age of 42.4 ± 9.3 years (range 18-60. Magnetic resonance images of the lumbar spine were obtained with a 1.5 T scanner (Avanto, Siemens, Erlangen, Germany with a phased-array back coil. A paramagnetic non-ionic contrast agent was injected with a dose of 0.4 ml/kg. T1-weighted magnetic resonance images were subsequently acquired at 5 time points, 5 and 10 minutes, 2, 4 and 6 hours after injection. Endplates presented clear enhancement already 5 minutes after injection, and showed an increase in the next 2 hours followed by a decrease. At 5 and 10 minutes, virtually no contrast medium was present inside the intervertebral disc; afterwards, enhancement significantly increased. Highly degenerated discs showed higher enhancement in comparison with low and medium degenerated discs. Discs classified as Pfirrmann 5 showed a statistically significant higher enhancement than Pfirrmann 1, 2 and 3 at all time points but the first one, possibly due to vascularization. Disc height collapse and Modic changes significantly increased enhancement. Presence of endplate defects did not show any significant influence on post contrast enhancement, but the lack of a clear classification of endplate defects as seen on magnetic resonance scans may be shadowing some effects. In conclusion, disc height, high level of degeneration and presence of Modic changes are factors which increase post contrast enhancement in the intervertebral disc. The effect of age could not be demonstrated.

  12. 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.

  13. 单节段人工椎间盘置换治疗颈椎病的中长期疗效%Medium and long term result of the single level cervical disc arthroplasty for cervical spondylosis meylopathy

    Institute of Scientific and Technical Information of China (English)

    张雪松; 王岩; 张永刚; 肖嵩华; 王征; 陆宁; 毛克亚; 崔庚; 徐辉; 齐登彬

    2012-01-01

    ACDF手术治疗单节段颈椎病的中长期临床疗效间无显著性差异,颈椎人工椎间盘置换节段术后中长期可以保持一定活动度,相邻节段椎间盘退变情况好于ACDF组,可以作为单节段颈椎病的手术选择方式.%Objectives: To investigate the medium and long term clinical outcome of the single level cervical disc arthroplasty(CDA) vs anterior cervical decompression and fusion(ACDF) in a randomized controlled study. Methods: The medium and long term clinical outcome of the single level Bryan prosthesis CDA(experimental group) and conventional ACDF(controlled group) was reviewed retrospectively. All the patients participated in a randomized controlled prospective study from 2003 to 2005, the inclusive criteria for cervical disc arthroplasty was used in 80 cases, and 32 patients was in CDA group and 35 patients in ACDF group finished the clinical and imaging follow-up(range, 7-9 years). The range of movement(ROM) in operation segement was determined by dynamic X-ray. The heterotopic ossification around the prosthesis was determined according to McAfee classification, the adjacent segment degeneration was verified according to Miyazaki classification on MRI T2 weighted images, and the symptom improvement was determined by NDI and VAS score. Results: The postoperative follow-up averaged 8.8 years, ranging from 7.2 to 9.6 years. No prosthesis displacement occurred in CDA group. Range of motion in CDA group averaged 6.35°±1.45°, ranging from 1.20° to 8.20°. The heterotopic ossification around the prosthesis was noted in 8 of 32(25%) segments, which induced loss of motion in 2 cases. 3 patients underwent the revision surgery due to 1 cranial adjacent segment degeneration and canal stenosis caused by ossification next to adjacent segment in 2 cases. The adjacent disc degeneration was noted as deterioration of 1 grade in 22 and 2 grade in 8 of the rest 63 segments, but remained asymptomatic. 3 patients underwent revision surgery in

  14. Clinical and magnetic resonance imaging features of compressive cervical myelopathy with traumatic intervertebral disc herniation in cynomolgus macaque (Macaca fascicularis)

    Science.gov (United States)

    Choi, Yun-Jung; Park, Hye-Jin; Sohn, Chul-Ho; Jung, Kyeong Cheon; Park, Seong Hoe

    2016-01-01

    Intervertebral disc herniation (IVDH) with nucleus pulposus extrusion, traumatic or not, is a devastating clinical condition accompanied by neurological problems. Here we report a cynomolgus macaque suffering from acute and progressive neurological dysfunction by a blunt trauma due to neck collar, an animal handling device. Tetraplegia, urinary incontinence, decreased proprioception, and imperception of pain were shown on physical and neurological examinations. MRI sagittal T2 weighted sequences revealed an extensive protrusion of disc material between C2 and C3 cervical vertebra, and this protrusion resulted in central stenosis of the spinal cord. Histopathologic findings showed a large number of inflammatory cells infiltrated at sites of spinal cord injury (SCI). This case is the first report of compressive cervical SCI caused by IVDH associated with blunt trauma. PMID:28053621

  15. Lumbar intervertebral disc degeneration associated with axial and radiating low back pain in ageing SPARC-null mice.

    Science.gov (United States)

    Millecamps, Magali; Tajerian, Maral; Naso, Lina; Sage, E Helene; Stone, Laura S

    2012-06-01

    Chronic low back pain (LBP) is a complex, multifactorial disorder with unclear underlying mechanisms. In humans and rodents, decreased expression of secreted protein acidic rich in cysteine (SPARC) is associated with intervertebral disc (IVD) degeneration and signs of LBP. The current study investigates the hypothesis that IVD degeneration is a risk factor for chronic LBP. SPARC-null and age-matched control mice ranging from 6 to 78 weeks of age were evaluated in this study. X-ray and histologic analysis revealed reduced IVD height, increased wedging, and signs of degeneration (bulging and herniation). Cutaneous sensitivity to cold, heat, and mechanical stimuli were used as measures of referred (low back and tail) and radiating pain (hind paw). Region specificity was assessed by measuring icilin- and capsaicin-evoked behaviour after subcutaneous injection into the hind paw or upper lip. Axial discomfort was measured by the tail suspension and grip force assays. Motor impairment was determined by the accelerating rotarod. Physical function was evaluated by voluntary activity after axial strain or during ambulation with forced lateral flexion. SPARC-null mice developed (1) region-specific, age-dependent hypersensitivity to cold, icilin, and capsaicin (hind paw only), (2) axial discomfort, (3) motor impairment, and (4) reduced physical function. Morphine (6 mg/kg, i.p.) reduced cutaneous sensitivity and alleviated axial discomfort in SPARC-null mice. Ageing SPARC-null mice mirror many aspects of the complex and challenging nature of LBP in humans and incorporate both anatomic and functional components of the disease. The current study supports the hypothesis that IVD degeneration is a risk factor for chronic LBP.

  16. 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.

  17. 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。

  18. The effects of cervical intervertebral disc replacemen on the range of movement and pressure change of intervertebral discs at adjacent segments%人工椎间盘置换对颈椎临近节段活动度及椎间盘内压力的影响

    Institute of Scientific and Technical Information of China (English)

    张维成; 麦伟; 廖兴华; 黄晓魏; 方文焕; 李智

    2009-01-01

    Objective To study the efects of cervical intervertebral disc replacemen on the range of movement and pressure change of intervertebral discs at adjacent segments.Methods 20 patients with cervical spondylosis were treated with cervical intervertebral disc replacement.The pressure change of intervertebral discs at adjacent segments were measured in the operation,and dynamical X-rays examination were carried out preoperatively and 3 month and 6 month postoperatively.The range of movement at the adjacent segments were studied.Results There were no significant diferences between pre-operative and post-operative on the range of movement and pressure change of intervertebral discs at adjacent segments(P>0.05).Conclusion The normal range of movement and pressure of intervertebral discs at the adjacent segments can be saved in the application of cervical intervertebral disc replacement,and then adjacent degeneration can be prevented.%目的 观察人工椎间盘置换对颈椎临近节段活动度及椎间盘内压力的影响.方法 应用人工椎间盘置换术治疗颈椎病患者20例,于术中椎间盘置换前后分别测量临近节段椎间盘内压力,并于术前及术后3个月、半年分别摄颈椎动力位x线片,观察上下临近节段的活动度.结果 人工椎间盘置换术后颈椎临近节段椎间盘内压力较术前无明显变化(P>0.05),上下临近关节活动度未显著增加(P>0.05).结论 人工椎间盘置换在治疗颈椎病的同时保留正常的椎间运动而不影响邻近节段,从而防止邻近节段继发性退变.

  19. 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

  20. Analysis of the Clinical Value of X-ray Diagnosis of Cervical Vertebra Degeneration%X线对青年颈椎退行性变的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李征军; 肖本模

    2015-01-01

    目的:探讨青年颈椎退变的主要影像特征,并对其检查方法、临床特点、发病原因等进行分析。方法本文收集60例30岁以下颈椎退行性变患者资料,分析其X线影像特征及发病原因、临床特点等,并对相关分析进行总结。结果青年颈椎退变的临床特点主要有颈项强直、活动受限,肩痛不适,部分伴有头晕及上肢麻木等。其主要X线特征为颈椎生理曲度改变、颈椎椎体增生及椎间隙变窄等,发病因素与不良的工作、生活习惯及锻炼不足密切相关。结论 X线多体位摄片应作为青年颈椎退行性变的首选及常规检查方法,其影像特征对临床诊断及防治意义重大。%Objective To explore the main image characteristics of youth cervical vertebra degeneration, and the inspection method, clinical characteristics and causes were analyzed. Methods This paper col ected 60 cases under the age of 30 patients with cervical vertebrae degeneration data, analysis the X-ray features and etiology, clinical characteristics, etc., and to summarize cor elation analysis. Results The clinical characteristics of youth cervical vertebra degeneration is mainly has a neck stif ness, limited activity, shoulder pain, accompanied by dizziness and upper limb numbness, etc. The main X-ray features for cervical physiological curvature change narrow, hyperplasia of cervical vertebral body and intervertebral disc, etc., risk factors and bad work, life habits and lack of exercise are closely related. Conclusion X-ray radiography more position should be as a youth cervical vertebra degeneration of choice and routine inspection method, the image features is of great significance to clinical diagnosis and treatment.

  1. Preoperative and postoperative evaluation of somatosensorial evoked potentials of upper extremities in cervical intervertebral disc herniation.

    Science.gov (United States)

    Umur, Ahmet Sukru; Selcuki, Mehmet; Selcuki, Deniz; Temiz, Cuneyt; Akbasak, Aytac

    2013-01-01

    This study aims to determine the dysfunction caused by existing pathological condition in structures involved in the transfer of sensory functions of the neural system in cervical disc herniation, and to establish whether or not the level and degree of this anatomical damage can be anticipated by SEP (Somatosensorial Evoked Potentials). We compared the obtained SEP values for statistical significance using the Friedman Variation Analysis. In parameters with statistical significance, the Wilcoxon Signed Rank test was used to identify when significant improvements occurred. The study found that the statistical data of the latency of the N14 wave originating from the dorsal column nuclei of the medulla spinalis and dorsal column gray matter improved (p < 0.05) in the postoperative period compared with the preoperative values. Using the Wilcoxon Signed Rank test, we studied postoperative months separately in regard to the difference in the latency of the N14 wave, and found the statistically significant improvement to be marked particularly in months 3 and 6 postoperatively (p < 0.05). In conclusion, we suggest that SEP is a useful tool to check the functional condition of the dorsal spinal column. The benefit of the SEP utilization is the ability to determine the severity of the pathological condition preoperatively and follow the patient's functional postoperative improvement.

  2. Enhancement of Lumbar Fusion and Alleviation of Adjacent Segment Disc Degeneration by Intermittent PTH(1-34) in Ovariectomized Rats.

    Science.gov (United States)

    Zhou, Zhuang; Tian, Fa-Ming; Gou, Yu; Wang, Peng; Zhang, Heng; Song, Hui-Ping; Shen, Yong; Zhang, Ying-Ze; Zhang, Liu

    2016-04-01

    Osteoporosis, which is prevalent in postmenopausal or aged populations, is thought to be a contributing factor to adjacent segment disc degeneration (ASDD), and the incidence and extent of ASDD may be augmented by osteopenia. Parathyroid hormone (PTH) (1-34) has already been shown to be beneficial in osteoporosis, lumbar fusion and matrix homeostasis of intervertebral discs. However, whether PTH(1-34) has a reversing or retarding effect on ASDD in osteopenia has not been confirmed. In the present study, we evaluated the effects of intermittent PTH(1-34) on ASDD in an ovariectomized (OVX) rat model. One hundred 3-month-old female Sprague-Dawley rats underwent L4 -L5 posterolateral lumbar fusion (PLF) with spinous-process wire fixation 4 weeks after OVX surgery. Control groups were established accordingly. PTH(1-34) was intermittently administered immediately after PLF surgery and lasted for 8 weeks using the following groups (n = 20) (V = vehicle): Sham+V, OVX+V, Sham+PLF+V, OVX+PLF+V, OVX+PLF+PTH. The fused segments showed clear evidence of eliminated motion on the fusion-segment based on manual palpation. Greater new bone formation in histology was observed in PTH-treated animals compared to the control group. The extent of ASDD was significantly increased by ovariotomy. Intermittent PTH(1-34) significantly alleviated ASDD by preserving disc height, microvessel density, relative area of vascular buds, endplate thickness and the relative area of endplate calcification. Moreover, protein expression results showed that PTH(1-34) not only inhibited matrix degradation by decreasing MMP-13, ADAMTS-4 and Col-I, but also promote matrix synthesis by increasing Col-II and Aggrecan. In conclusion, PTH(1-34), which effectively improves lumbar fusion and alleviates ASDD in ovariectomized rats, may be a potential candidate to ameliorate the prognosis of lumbar fusion in osteopenia.

  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. The Correlation between Relation of Anterior Cervical Plate Position and Adjacent Level Degeneration%颈前路钢板固定位置与相邻节段退变之间关系的研究

    Institute of Scientific and Technical Information of China (English)

    冯虎; 马志兵; 齐祥如; 袁峰; 郭开今

    2011-01-01

    Objective To study adjacent level degeneration after anterior cervical spine fusion with a plate and its relation to the plate position.Methods Totally 165 patients were received anterior cervical spine fusion with plates months, who had a bony fusion wholly.The cephalad and caudal plate to disc distance(PDD) was measured on thepostoperative lateral radiograph and was used to divide the patients into two groups. In group A the PDD was<5mm, and in group B it was>5mm. The severity of the ossification at the two adjacent disc space was classified on a scale ranging from grade 0(no ossification ) to grade 2(complete bridging ). Preoperative, immediate postoperative and 6 to 46 months follow-up radiographs were taken, measured the height of cephalad and caudal adjacent intervertebral and adjacent vertebral body, and then calculated the ratio of intervertebral height to vertebral body height (R), besides, calculated the angle(α)of upper and down endplate gradient of two adjacent disc. Results In cephalad adjacent disc, group A had 53.7% levels developed ossification and 29.8% in group B; compared to caudal adjacent disc, group A and B was 38.5% and 19.7%, respectively. The rate of ossification was higher in group A than in group B, both at two adjacent disc (P<0.05). There was no significant difference between preoperative and postoperative both R ratio and angle α in group A of cephalad adjacent disc (P>0.05), but it was significant decreased when followed up comparing to preoperative and postoperative (P<0.05). The result of R ratio of caudal adjacent disc was similar with cephalad adjacent disc in group A, but angle α was not. There was no significant difference among preoperative, postoperative and following up time both R ratio and angle α in group B of cephalad and caudal adjacent disc (P>0.05).Conclusion Adjacent segments degeneration was one of the common complications after anterior cervical spine fusion. The incidence could be affected

  5. 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.

  6. Cervical spondylosis anatomy: pathophysiology and biomechanics.

    Science.gov (United States)

    Shedid, Daniel; Benzel, Edward C

    2007-01-01

    Cervical spondylosis is the most common progressive disorder in the aging cervical spine. It results from the process of degeneration of the intervertebral discs and facet joints of the cervical spine. Biomechanically, the disc and the facets are the connecting structures between the vertebrae for the transmission of external forces. They also facilitate cervical spine mobility. Symptoms related to myelopathy and radiculopathy are caused by the formation of osteophytes, which compromise the diameter of the spinal canal. This compromise may also be partially developmental. The developmental process, together with the degenerative process, may cause mechanical pressure on the spinal cord at one or multiple levels. This pressure may produce direct neurological damage or ischemic changes and, thus, lead to spinal cord disturbances. A thorough understanding of the biomechanics, the pathology, the clinical presentation, the radiological evaluation, as well as the surgical indications of cervical spondylosis, is essential for the management of patients with cervical spondylosis.

  7. Análise radiológica da degeneração discal experimental em coelhos Radiological analysis of experimental disc degeneration in rabbits

    Directory of Open Access Journals (Sweden)

    Emiliano Vialle

    2009-01-01

    Full Text Available OBJETIVO: Validar a avaliação radiográfica da degeneração discal experimental em coelhos. MÉTODOS: Os discos intervertebrais lombares de coelhos New Zealand foram puncionados três vezes com uma agulha 18G com profundidade limitada de 5mm, através de abordagem lateral. Foram realizadas radiografias seriadas pré e pós-operatórias imediatas, e depois de quatro, oito e 12 semanas do procedimento, com posterior análise da altura discal, formação de osteófito, esclerose da placa vertebral e presença de degeneração discal. A análise estatística dos dados foi validada pelo coeficiente de concordância Kappa, com intervalo de confiança (IC de 95%. RESULTADOS: Observou-se diminuição significativa do espaço discal nas radiografias em AP após 12 semanas de pós-operatório, com Kappa = 0,489 para IC 95% (0,25-0,72 com p OBJECTIVE: To validate radiographic evaluation of a rabbit model for disc degeneration. METHODS: Lumbar intervertebral discs of New Zealand rabbits were stabbed three times with a 18G needle at a limited depth of 5mm, through lateral approach. Serial radiographic images were taken on the early pre-and postoperative periods, and after four, eight and 12 weeks of the procedure, with subsequent analysis of disc height, osteophyte formation, endplate sclerosis, and presence of disc degeneration. The statistical analysis of data was validated by the Kappa coefficient, with a confidence interval (CI of 95%. RESULTS: A significant reduction of disc space was found on AP X-ray images after 12 postoperative weeks, with Kappa = 0.489 for CI 95% (0.25-0.72 with p < 0.001. X-ray signs of disc degeneration also presented Kappa = 0.63 for CI 95% (0.39-0.86 with p < 0.001. The remaining assessed criteria showed positive results, but with a lower Kappa value. CONCLUSION: The disc degeneration model using rabbits as proposed in this study was shown to be feasible, with positive X-ray correlation between pre- and postoperative images

  8. 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.

  9. Biomechanical Analysis of a Novel Prosthesis Based on the Physiological Curvature of Endplate for Cervical Disc Replacement.

    Directory of Open Access Journals (Sweden)

    Cheng-Cheng Yu

    Full Text Available Biomechanical analysis of a novel prosthesis based on the physiological curvature of endplate was performed.To compare the biomechanical differences between a novel prosthesis based on the physiological curvature of the endplate and the Prestige LP prosthesis after cervical disc replacement (CDR.Artificial disc prostheses have been widely used to preserve the physiological function of treated and adjacent motion segments in CDR, while most of those present a flat surface instead of an arcuate surface which approximately similar to anatomic structures in vivo. We first reported a well-designed artificial disc prosthesis based on the physiological curvature of the endplate.Three motion segments of 24 ovine cervical spines (C2-5 were evaluated in a robotic spine system with axial compressive loads of 50N. Testing conditions were as follows: 1 intact, 2 C3-4 CDR with artificial disc prosthesis based on the physiological curvature of the endplate, and 3 C3-4 CDR with the Prestige LP prosthesis. The range of motion (ROM and the pressures on the inferior surface of the two prostheses were recorded and analyzed.As compared to the intact state, the ROM of all three segments had no significant difference in the replacement group. Additionally, there was no significant difference in ROM between the two prostheses. The mean pressure on the novel prosthesis was significantly less than the Prestige LP prosthesis.ROM in 3 groups (intact group, CDR group with novel prosthesis and CDR group with Prestige LP showed no significant difference. The mean pressure on the inferior surface of the novel prosthesis was significantly lower than the Prestige LP prosthesis. Therefore, the novel artificial disc prosthesis is feasible and effective, and can reduce the implant-bone interface pressure on the endplate, which may be one possible reason of prosthesis subsidence.

  10. Is there a role for endothelial dysfunction in the pathogenesis of lumbar disc degeneration? A hypothesis that needs to be tested.

    Science.gov (United States)

    Papalia, Rocco; Albo, Erika; Vadalà, Gianluca; D'Adamio, Stefano; Lanotte, Angela; Di Martino, Alberto; Denaro, Vincenzo

    2015-03-01

    Low back pain is a painful condition affecting most people at least once in their life. It can be the expression of lumbar disc degeneration, a condition whose progression is influenced by environmental, individual and genetic factors. The pathogenesis of this condition implies the reduction of sustenance for the tissues within the intervertebral disc (ID) due to a decreased blood flow in the local microcirculation. In fact, it is known that the ID is an avascular structure that receives nutritive molecules and exchanges waste products through a process of osmotic diffusion from the capillaries located at the ID-vertebral body interface. The maintenance of a correct oxygen supply is essential for the health of disc cells also because ID is subjected to continuous compression stress due to its bearing function between vertebral bodies. This vital condition is guaranteed by proper dilation of blood vessels in response to mechanical stress, thanks to a finely balanced homeostasis between vasodilatory factors, such as nitric oxide, and vasoconstrictive substances produced by the endothelium. Endothelial dysfunction may disrupt this delicate equilibrium, causing a reduced oxygen supply eventually resulting in ID degeneration. Our hypothesis is that endothelial dysfunction, a systemic condition of reduced vessel dilation in response to mechanical stress, should be considered as an important pathological factor implicated intervertebral disc degeneration. This relationship may pave the way for a change in therapeutic approach to low back pain, especially in the early stages.

  11. The role of TGF-β1/Smad2/3 pathway in platelet-rich plasma in retarding intervertebral disc degeneration.

    Science.gov (United States)

    Yang, Huilin; Yuan, Chenxi; Wu, Chunshen; Qian, Jiale; Shi, Qing; Li, Xuefeng; Zhu, Xuesong; Zou, Jun

    2016-08-01

    Recent studies have suggested that platelet-rich plasma (PRP) injections are an effective way to retard intervertebral disc degeneration, but the mechanism of action is unclear. Activated platelets release some growth factors, such as transforming growth factor-β1 (TGF-β1), which positively modulate the extracellular matrix of nucleus pulposus cells. The purpose of this study was to explore the mechanism underlying the PRP-mediated inhibition of intervertebral disc degeneration. In an in vitro study, we found that the proliferation of nucleus pulposus cells was greatly enhanced with 2.5% PRP treatment. The TGF-β1 concentration was much higher after PRP treatment. PRP administration effectively increased the collagen II, aggrecan and sox-9 mRNA levels and decreased collagen X levels. However, Western blotting demonstrated that specifically inhibiting TGF-β1 signalling could significantly prevent nucleus pulpous cellular expression of Smad2/3 and matrix protein. In a rabbit study, magnetic resonance imaging revealed significant recovery signal intensity in the intervertebral discs of the PRP injection group compared with the very low signal intensity in the control groups. Histologically, the PRP plus inhibitor injection group had significantly lower expression levels of Smad2/3 and collagen II than the PRP group. These results demonstrated that a high TGF-β1 content in the platelets retarded disc degeneration in vitro and in vivo. Inhibiting the TGF-β1/Smad2/3 pathway could prevent this recovery by inactivating Smad2/3 and down-regulating the extracellular matrix. Therefore, the TGF-β1/Smad2/3 pathway might play a critical role in the ability of PRP to retard intervertebral disc degeneration.

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

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    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.

  13. The Relation Between Sacral Angle and Vertical Angle of Sacral Curvature and Lumbar Disc Degeneration: A Case-Control Study.

    Science.gov (United States)

    Ghasemi, Ahmad; Haddadi, Kaveh; Khoshakhlagh, Mohammad; Ganjeh, Hamid Reza

    2016-02-01

    The purpose of this study is to determine the reliability and validity of a goniometric measurement of the vertical angle of the sacrum and sacral angle (SA), and their relationships to lumbar degeneration.A herniated lumbar disc is one of the most frequent medical issues. Investigators in a number of studies have reported associated risk factors for prevalent disc degeneration. Atypical lumbosacral angles and curvature are thought to contribute to the degradation of the spine by many researchers. This study analyzed 360 patients referred to our clinic from 2013 to 2015 due to low back pain. A cross-sectional case-control study was designed in order to compare the sagittal alignment of the lumbosacral area in 3 groups of patients suffering from LBP. A total 120 patients were in a control group with a normal lumbar magnetic resonance imaging (MRI), 120 patients had lumbar disk herniation (LDH), and 120 patients had spinal stenosis. From the sagittal plan of lumbar MRI, SA and vertical angle of sacral curvature (VASC) were determined and then analyzed.The means of VASC in these groups were: 38.98 (SD: 6.36 ± 0.58), 40.89 (SD: 7.69 ± 0.69), and 40.54 (SD: 7.13 ± 0.92), respectively (P = 0.089). Moreover, studies of SA in 3 groups showed that the means of SA were: 39.30 (SD: 6.69 ± 0.63), 40.52 (SD: 7.47 ± 0.65), and 35.63 (SD: 6.07 ± 0.79), respectively. Relation between SA and spinal stenosis was just statistically significant (P ≤ 0.05).One significant limitation of our study is the lack of standing MRI for increased accuracy of measurement. However, we were reluctant to give patients needless exposure to radiation from conventional X-ray, and instead used MRI scans. We did not find any significant correlation between the VASC and LDH in lumbar MRI. Also, SA is not an independent risk factor for LDH in men and women. We suggested that there are several biomechanical factors involved in LDH.

  14. 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.

  15. Kaempferol slows intervertebral disc degeneration by modifying LPS-induced osteogenesis/adipogenesis imbalance and inflammation response in BMSCs.

    Science.gov (United States)

    Zhu, Jun; Tang, Haoyu; Zhang, Zhenhua; Zhang, Yong; Qiu, Chengfeng; Zhang, Ling; Huang, Pinge; Li, Feng

    2017-02-01

    Intervertebral disc (IVD) degeneration is a common disease that represents a significant cause of socio-economic problems. Bone marrow-derived mesenchymal stem cells (BMSCs) are a potential autologous stem cell source for the nucleus pulposus regeneration. Kaempferol has been reported to exert protective effects against both osteoporosis and obesity. This study explored the effect of kaempferol on BMSCs differentiation and inflammation. The results demonstrated that kaempferol did not show any cytotoxicity at concentrations of 20, 60 and 100μM. Kaempferol enhanced cell viability by counteracting the lipopolysaccharide (LPS)-induced cell apoptosis and increasing cell proliferation. Western blot analysis of mitosis-associated nuclear antigen (Ki67) and proliferation cell nuclear antigen (PCNA) further confirmed the increased effect of kaempferol on LPS-induced decreased viability of BMSCs. Besides, kaempferol elevated LPS-induced reduced level of chondrogenic markers (SOX-9, Collagen II and Aggrecan), decreased the level of matrix-degrading enzymes, i.e., matrix metalloprotease (MMP)-3 and MMP-13, suggesting the osteogenesis of BMSC under kaempferol treatment. On the other hand, kaempferol enhanced LPS-induced decreased expression of lipid catabolism-related genes, i.e., carnitine palmitoyl transferase-1 (CPT-1). Kaempferol also suppressed the expression of lipid anabolism-related genes, i.e., peroxisome proliferators-activated receptor-γ (PPAR-γ). The Oil red O staining further convinced the inhibition effect of kaempferol on BMSCs adipogenesis. In addition, kaempferol alleviated inflammatory by reducing the level of pro-inflammatory cytokines (i.e., interleukin (IL)-6) and increasing anti-inflammatory cytokine (IL-10) via inhibiting the nucleus translocation of nuclear transcription factor (NF)-κB p65. Taken together, our research indicated that kaempferol may serve as a novel target for treatment of IVD degeneration.

  16. Short-term follow-up for artificial cervical disc replacement: Changes of stability and range of motion in cervical vertebra%人工颈椎间盘假体置换短期随访:颈椎稳定性及其运动范围变化

    Institute of Scientific and Technical Information of China (English)

    汤雪明; 徐南伟; 周栋; 蒋巍; 李海波

    2012-01-01

    背景:椎间盘摘除减压后的节段融合会限制节段的生理运动,造成邻近节段应力加大而导致其退变加速.目的:观察人工颈椎间盘植入假体治疗颈椎病短期随访中的稳定性及置换节段和颈椎整个节段的运动范围变化.方法:于2010-06/2011-08在常州市第二人民医院骨科共施行PCM钴铬合金颈椎间盘假体置换11例12个节段,男7例,女4例;脊髓型颈椎病8例,外伤性颈椎间盘突出3例.结果与结论:患者随访时间为3~12个月.置换后1,3,6个月以及末次随访时置换节段过屈过伸活动度、左右侧屈活动度与术前接近.置换后1个月、末次随访时患者日本矫形外科协会评分明显升高,而Oswestry颈椎功能障碍指数明显降低(P 0.05),同时X射线未发现假体松动、下沉或异位骨化等不良反应.提示PCM人工颈椎间盘置换后短期颈椎稳定功能活动效果较好.%BACKGROUND: Segment fusion after the discectomy decompression of cervical disc limits the physical exercise of the segment,which causes the accelerated degeneration due to increased stress of adjacent segment.OBJECTIVE: To observe stability and range of motion (ROM) in the replacement segment and cervical segment duringshort-term follow-up using artificial cervical disc replacement for the treatment of cervical disc disease.METHODS: Totally 11 cases (12 segments) who treated with cobalt-chromium alloy PCM cervical disc replacement fromDepartment of Orthopedics, the Second People's Hospital of Changzhou from June 2010 to August 2011 PCM were selectedincluding seven males and four females. Among these cases, there were eight cases with cervical myelopathy, and three caseswith traumatic cervical disc herniation.RESULTS AND CONCLUSION: All cases were followed-up for 3 to 12 months. ROM over flexion and extension, and flexionROM on lateral left and right were similar to preoperation at 1, 3, 6 months and final follow-up after replacement. Japaneseorthopaedic

  17. Genetic polymorphisms of interleukin-1 alpha and the vitamin d receptor in mexican mestizo patients with intervertebral disc degeneration.

    Science.gov (United States)

    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) 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.

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

    Science.gov (United States)

    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) 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. PMID:25506053

  19. 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.

  20. Clinical Effectiveness and Influence on Adjacent Segments Degeneration after Single-level Anterior Cervical Fusion%单节段颈椎前路减压融合术对邻近节段退变的影响及疗效观察

    Institute of Scientific and Technical Information of China (English)

    郑兆君; 邱玉金; 刘文华; 李军磊; 曹亮波

    2013-01-01

    Objective To evaluate the clinical effectiveness and influence on adjacent segments degenera-tion after single-level anterior cervical fusion.Methods A retrospective study was given to 40 patients who underwent single-level anterior cervical fusion from Aug.2007 to Dec.2010 and 40 patients with cervical spondylosis of the same age for the same period(imaging showed only a single segment lesions ) underwent conservative therapypatient .The disc degeneration were evaluated using intervertebral disc height and disc Pfirrmann MRI degeneration score .The clinical ef-fectiveness were evaluated using cervical JOA score ,the neck disability index(NDI) .Results The surgical group and conservative group had a statistically significant difference (P0.05) in cervi-cal JOA score and NDI than 1 week after that.Conclusion Anterior cervical discectomy and fusion can lead to degener-ation at the adjacent segment,but the clinical effectiveness are worthy of recognition .%  目的探讨单节段颈椎前路减压融合术对邻近节段退变的影响及手术疗效.方法回顾性分析2007年8月~2010年12月我科收治的40例行单节段颈椎前路减压融合术患者及同期同年龄段颈椎病(影像学显示仅单节段病变)且行保守治疗的患者资料.采用椎间隙高度及椎间盘Pfirrmann MRI退变评分作为评价椎间盘退变指标;采用颈椎JOA评分、颈椎功能障碍指数(NDI)作为手术疗效评价指标.结果术后24个月时,与对照组相比,手术组邻近节段椎间隙高度明显降低,差异有统计学意义(P0.05).结论颈椎前路减压融合术后邻近节段易发生退变,但疗效值得肯定.

  1. Dysphagia, short-term outcomes, and cost of care after anterior cervical disc surgery.

    Science.gov (United States)

    Starmer, Heather M; Riley, Lee H; Hillel, Alexander T; Akst, Lee M; Best, Simon R A; Gourin, Christine G

    2014-02-01

    Dysphonia and dysphagia are common complications of anterior cervical discectomy (ACD). We sought to determine the relationship between dysphagia and in-hospital mortality, complications, speech therapy/dysphagia training, length of hospitalization, and costs associated with ACD. Discharge data from the Nationwide Inpatient Sample for 1,649,871 patients who underwent ACD of fewer than four vertebrae for benign acquired disease between 2001 and 2010 were analyzed using cross-tabulations and multivariate regression modeling. Dysphagia was reported in 32,922 cases (2.0 %). Speech therapy/dysphagia training was reported in less than 0.1 % of all cases and in only 0.2 % of patients with dysphagia. Dysphagia was significantly associated with age ≥65 years (OR = 1.5 [95 % CI 1.4-1.7], P < 0.001), advanced comorbidity (OR = 2.3 [2.0-2.6], P < 0.001), revision surgery (OR = 2.7 [2.3-3.1], P < 0.001), disc prosthesis placement (OR = 1.5 [1.0-2.0], P = 0.029), and vocal cord paralysis (OR = 11.6 [8.3-16.1], P < 0.001). Dysphagia was a significant predictor of aspiration pneumonia (OR = 8.6 [6.7-10.9], P < 0.001), tracheostomy (OR = 2.3 [1.6-3.3], P < 0.001), gastrostomy (OR = 30.9 [25.3-37.8], P < 0.001), and speech therapy/dysphagia training (OR = 32.0 [15.4-66.4], P < 0.001). Aspiration pneumonia was significantly associated with in-hospital mortality (OR = 15.9 [11.0-23.1], P < 0.001). Dysphagia, vocal cord paralysis, and aspiration pneumonia were significant predictors of increased length of hospitalization and hospital-related costs, with aspiration pneumonia having the single largest impact on length of hospitalization and costs. Dysphagia is significantly associated with increased morbidity, length of hospitalization, and hospital-related costs in ACD patients. Despite the known risk of dysphagia in ACD patients and an established role for the speech-language pathologist in dysphagia management, speech-language pathology

  2. Comparison of the mid-term follow-up results between Bryan cervical artificial disc replacement and anterior cervical decompression and fusion for cervical degenerative disc disease%Bryan人工间盘置换与前路减压融合治疗颈椎退行性疾病的中期随访研究

    Institute of Scientific and Technical Information of China (English)

    田伟; 阎凯; 韩骁; 于杰; 靳培浩; 韩晓光

    2013-01-01

    Objective To evaluate the mid-term tollow-up results of cervical artificial disc replacement (CADR) for cervical degenerative disc disease,and to explore whether it can reduce the occurrence of adjacent segment degeneration (ASD).Methods A prospective comparative study of 93 patients who underwent CADR or anterior cervical decompression and fusion (ACDF) for cervical degenerative disc disease were conducted.All patients were followed up for more than 6 years.The Japanese Orthopaedic Association (JOA) score,neck disability index (NDI),Odom's scale,X-rays and magnetic resonance imaging (MRI) were used to evaluate the clinical and radiologic results.Results Twenty eight patients who underwent CADR and 35 patients who underwent ACDF had complete follow-up data.At final follow-up,the JOA score and NDI improved significantly in both groups.Between the two groups,there was no significant difference in terms of JOA score,NDI and Odom's scale.The sagittal alignment was well maintained in both groups.The total cervical spine range of motion (ROM) had no significant change for the CADR group,whereas,it significantly decreased for the ACDF group.The ROM at the replacement level of CADR patients decreased from 9.5° ± 3.7° before operation to 7.0° ± 3.0° 3 months after operation,and it was maintained to 6.6° ± 4.1° at final follow-up without significant decrease.Lateral radiographs and T2-weighted MRI showed the incidence of ASD in CADR group was significantly lower than that in ACDF group.Conclusion The six-year follow-up results of CADR are basically satisfactory.Compared with ACDF,it could better preserve physiological motion and biomechanics of cervical spine,and reduce the incidence of ASD.%目的 评价人工椎间盘置换术治疗颈椎退行性疾病的中期疗效,并探讨其是否可以减少邻近节段退变的发生.方法 前瞻性对比分析接受颈椎人工间盘置换术(置换组,45例)与颈椎前路减压融合术(融合组,48例)治疗的颈椎

  3. 椎间盘退变生物治疗进展%The recent advances in biological therapy for intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    石志远; 张超; 阮狄克

    2012-01-01

    @@ 临床上椎间盘退行性疾病在保守治疗基础上,大多数需要通过外科干预达到长期缓解局部疼痛的目的.但由于椎间盘生物力学上的特殊地位,使得如何在保持椎间盘完整性的基础上,促进椎间盘细胞外基质再生的生物治疗方法成为椎间盘退变预防和治疗的研究热点.椎间盘髓核基质数量和成分的改变被认为是椎间盘退变的一个重要原因,目前许多学者试图通过引入各种外源性生长因子、种子细胞、基因以及基因转染的细胞,以期增加髓核细胞外基质含量,恢复II型胶原和蛋白多糖比例,逆转或延缓椎间盘退变的发展进程.%With the continuous exploration of basic research for the pathogeny of intervertebral disc degenerative disease, the causes of intervertebral disc degeneration (the anabolic imbalance initiated by cells, extracellular matrix, growth factors and inflammatory factors) have gradually become explicit. Combining with the ceaseless extending of tissue engineering in the field of orthopedics, more and more clinical and basic researchers attempt to treat the discogenic disease through the exogenous interference in the process of intervertebral disc degeneration, including molecular therapy, cell therapy and gene therapy. In molecular therapy, stimulating endogenous cell activity and delaying the process of intervertebral disc degeneration, researchers attempt to increase the anabolic growth factors through reducing the inflammatory factors such as TNF-a, IL-8 and so on. Exogenous growth factors BMP7, BMP2 and BM14 (GDF5) have also been proved to have the effects of restraining intervertebral disc degeneration. In cell therapy, the researches are mainly on the introduction of exogenous cells and the expansion and replantation of autologous nucleus pulposus cells in vitro. A randomized controlled trial in clinic preliminarily confirms that the transplantation of autologous nucleus pulposus cells plays a role

  4. JNK phosphorylation promotes degeneration of cervical endplate chondrocytes through down-regulation of the expression of ANK in humans

    Institute of Scientific and Technical Information of China (English)

    XU Hong-guang; SONG Jun-xing; CHENG Jia-feng; ZHANG Ping-Zhi; WANG Hong; LIU Ping; L(U) Kun

    2013-01-01

    Background C-Jun N-terminal kinase (JNK) signaling pathway and ankylosis gene (ANK) play a critical role in endplate chondrocytes degeneration.The purpose of this study was to investigate whether the expression levels of ANK was associated with the activation of JNK.Methods Cartilage endplates of 49 patients were divided into the control group (n=19) and the experimental group (n=30).The patients in the control group were graded 0 and those in the experimental group were graded Ⅰ-Ⅲ according to Miller's classification.Endplate chondrocytes were isolated by enzyme digestion and cultured in vitro.The inverted phase contrast microscope,teluidine blue staining,HE staining,real time RT-PCR,and MTT were used to observe morphological appearances,biological characteristics,and growth curve of endplate chondrocytes from the cartilage endplate of the two groups.Real time RT-PCR and Western blotting were used to analyze the mRNA and protein expression levels of associated factors in the degeneration process in the cultured endplate chondrocytes with or without subjected SP600125.Results The expression levels of type Ⅱ collagen,aggrecan,and ANK in endplate chondrocytes of experimental group were lower than that of control group and phosphorylation level of JNK in the experimental group which was higher than that in the control group.Application of JNK phosphorylation inhibitor to degeneration chondrocytes resulted in a marked decrease in the phosphorylation level of JNK and a significant increase in the expression levels of type Ⅱ collagen,aggrecan,and ANK.Conclusion The degeneration of the human cervical endplate chondrocytes might be promoted by JNK phosphorylation by down-regulating the expression of ANK

  5. Relative contributions of strain-dependent permeability and fixed charged density of proteoglycans in predicting cervical disc biomechanics: a poroelastic C5-C6 finite element model study.

    Science.gov (United States)

    Hussain, Mozammil; Natarajan, Raghu N; Chaudhary, Gulafsha; An, Howard S; Andersson, Gunnar B J

    2011-05-01

    Disc swelling pressure (P(swell)) facilitated by fixed charged density (FCD) of proteoglycans (P(fcd)) and strain-dependent permeability (P(strain)) are of critical significance in the physiological functioning of discs. FCD of proteoglycans prevents any excessive matrix deformation by tissue stiffening, whereas strain-dependent permeability limits the rate of stress transfer from fluid to solid skeleton. To date, studies involving the modeling of FCD of proteoglycans and strain-dependent permeability have not been reported for the cervical discs. The current study objective is to compare the relative contributions of strain-dependent permeability and FCD of proteoglycans in predicting cervical disc biomechanics. Three-dimensional finite element models of a C5-C6 segment with three different disc compositions were analyzed: an SPFP model (strain-dependent permeability and FCD of proteoglycans), an SP model (strain-dependent permeability alone), and an FP model (FCD of proteoglycans alone). The outcomes of the current study suggest that the relative contributions of strain-dependent permeability and FCD of proteoglycans were almost comparable in predicting the physiological behavior of the cervical discs under moment loads. However, under compression, strain-dependent permeability better predicted the in vivo disc response than that of the FCD of proteoglycans. Unlike the FP model (least stiff) in compression, motion behavior of the three models did not vary much from each other and agreed well within the standard deviations of the corresponding in vivo published data. Flexion was recorded with maximum P(fcd) and P(strain), whereas minimum values were found in extension. The study data enhance the understanding of the roles played by the FCD of proteoglycans and strain-dependent permeability and porosity in determining disc tissue swelling behavior. Degenerative changes involving strain-dependent permeability and/or loss of FCD of proteoglycans can further be

  6. 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.

  7. Innervation of ''painful'' lumbar discs

    NARCIS (Netherlands)

    Coppes, MH; Marani, E; Thomeer, RTWM; Groen, GJ

    1997-01-01

    Study Design. The authors investigated the innervation of discographically confirmed degenerated and ''painful'' human intervertebral discs. Objective. To determine the type and distribution patterns of nerve fibers present in degenerated human intervertebral discs. Summary of Background Data. The i

  8. Quality of systematic reviews: an example of studies comparing artificial disc replacement with fusion in the cervical spine.

    Science.gov (United States)

    Tashani, Osama A; El-Tumi, Hanan; Aneiba, Khaled

    2015-01-01

    Cervical artificial disc replacement (C-ADR) is now an alternative to anterior cervical discectomy and fusion (ACDF). Many studies have evaluated the efficacy of C-ADR compared with ACDF. This led to a series of systematic reviews and meta-analyses to evaluate the evidence of the superiority of one intervention against the other. The aim of the study presented here was to evaluate the quality of these reviews and meta-analyses. Medline via Ovid, Embase, and Cochrane Library were searched using the keywords: (total disk replacement, prosthesis, implantation, discectomy, and arthroplasty) AND (cervical vertebrae, cervical spine, and spine) AND (systematic reviews, reviews, and meta-analysis). Screening and data extraction were conducted by two reviewers independently. Two reviewers then assessed the quality of the selected reviews and meta-analysis using 11-item AMSTAR score which is a validated measurement tool to assess the methodological quality of systematic reviews. Screening of full reports of 46 relevant abstracts resulted in the selection of 15 systematic reviews and/or meta-analyses as eligible for this study. The two reviewers' inter-rater agreement level was high as indicated by kappa of >0.72. The AMSTAR score of the reviews ranged from 3 to 11. Only one study (a Cochrane review) scored 100% (AMSTAR 11). Five studies scored below (AMSTAR 5) indicating low-quality reviews. The most significant drawbacks of reviews of a score below 5 were not using an extensive search strategy, failure to use the scientific quality of the included studies appropriately in formulating a conclusion, not assessing publication bias, and not reporting the excluded studies. With a significant exception of a Cochrane review, the methodological quality of systematic reviews evaluating the evidence of C-ADR versus ACDF has to be improved.

  9. Adjacent Segment Pathology after Anterior Cervical Fusion.

    Science.gov (United States)

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon; Kim, Sung Kyu

    2016-06-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion.

  10. 颈椎间盘置换治疗脊髓型颈椎病的疗效观察%EFFECTIVENESS OF CERVICAL DISC REPLACEMENT FOR CERVICAL MYELOPATHY

    Institute of Scientific and Technical Information of China (English)

    严冬雪; 肖增明; 沈翀; 黄永吉

    2012-01-01

    目的 探讨颈椎间盘置换治疗脊髓型颈椎病的疗效. 方法 2006年10月- 2008年10月,采用椎间盘置换治疗20例(26个节段)脊髓型颈椎病患者.男8例,女12例;年龄26~65岁,平均46岁.病程2~18个月,平均7个月.单节段置换14例,双节段置换6例.术后以Odom等标准评价疗效,以疼痛视觉模拟评分(VAS)评价颈、肩部及上肢疼痛情况.X线片测量假体椎间盘间隙角及颈椎过屈、过伸位活动度,观察异位骨化、骨赘形成及假体松动等情况. 结果 术后切口均Ⅰ期愈合,无严重并发症发生.20例均获随访,随访时间30~48个月,平均34个月.术后28个月按Odom等标准获优17例、良3例,颈、肩部及上肢VAS评分均较术前显著改善(P<0.05).术后30个月,20个置换节段未融合,假体活动度为(10.6±4.5)°,与上位相邻节段的(10.8±3.7)°和下位相邻节段的(7.5±4.2)°比较差异均无统计学意义(P>0.05).术后10例13个节段发生异位骨化,1例假体后方移位;其他假体无移位、下沉、松动等并发症发生. 结论 颈椎间盘置换治疗脊髓型颈椎病能维持颈椎正常活动范围和生理弯曲,但其功能和对邻近节段的影响需进一步随访.%Objective To evaluate the effectiveness of cervical disc replacement for cervical myelopathy. Methods Between October 2006 and October 2008, 20 patients (26 segments) with cervical myelopathy underwent single-level (14 segments) or bi-level (6 segments) cervical disc replacement. There were 8 males and 12 females with an average age of 46 years (range, 26-65 years). The disease duration ranged 2-18 months (mean, 7 months). The effectiveness was evaluated using visual analogue scale (VAS) score, cervical range of motion (ROM), and the Odom etal criteria. Heterotopic ossification (HO), osteophyte formation, and prosthesis loosening were observed. Results All incisions healed by first intention, with no severe complication. Twenty patients were followed

  11. 人工颈椎间盘置换联合颈前路融合术治疗多节段脊髓型颈椎病%Treatment on multilevel cervical spondylotic myelopathy by artificial cervical disc replace-ment combined with anterior cervical discectomy and fusion

    Institute of Scientific and Technical Information of China (English)

    游新茂; 叶秀益; 宋滇文; 贾连顺

    2014-01-01

    Objective To explore the clinical effects of artificial cervical disc replacement( ACDR) combined with anterior cervical discectomy fusion ( ACDF ) for the treatment of multi-segmental cervical spondylotic myelopathy ( CSM) . Methods 18 cases with multi-segmental CSM which were treated by ACDR combined with ACDF were re-viewed. The stability of artificial disc, internal fixation and bone fusion were evaluated by X-ray films before opera-tive, immediate postoperative and follow-up. The JOA scores was evaluated also at the same time. Results 18 pa-tients were followed up from 24 to 60 months ( averaged 36 ± 9. 6 months) . The range of motion of the replacement segment were 13. 8° ± 6. 5° at preoperative and 12. 5° ± 5. 3° at the final follow-up, and there was no significant difference between them(P>0. 05). The preoperative JOA scores was 9. 5 ± 1. 5, which was improved to 14. 2 ± 2. 2 in 4 months after operation; Preoperative neurological symptoms were obviously alleviated in most patients, and the improvement ratio of JOA was 62. 7% ± 11. 2%. The results were excellent in 9 patients, good in 5, fair in 2 and poor in 2. There were no patient with false of internal fixation, and the position of artificial disc was good. Conclu-sions ACDR combined with ACDF is a good procedure for multi-segmental cervical spondylotic myelopathy, it not only maintain the cervical spine alignment with saving more movement segments,but also reduce the incidence of ad-jacent segment degeneration.%目的:评价人工颈椎间盘置换联合颈前路融合术治疗多节段脊髓型颈椎病的临床效果。方法采用人工颈椎间盘置换联合颈前路融合治疗18例多节段脊髓型颈椎病患者。根据术前、术后、随访时的颈椎X线片观察人工椎间盘、内固定、植骨融合以及JOA评分改善情况。结果18例均获随访,时间24~60(36±9.6)个月。置换间隙平均活动度术前为13.8°±6.5°,末次随访时为12.5°±5.3

  12. Biomaterials for intervertebral disc regeneration : Past performance and possible future strategies

    NARCIS (Netherlands)

    Schutgens, E. M.; Tryfonidou, M. A.; Smit, T. H.; Cumhur Öner, F.; Krouwels, A.; Ito, K.; Creemers, L. B.

    2015-01-01

    Intervertebral disc (IVD) degeneration is associated with most cases of cervical and lumbar spine pathologies, amongst which chronic low back pain has become the number one cause of loss of quality-adjusted life years. In search of alternatives to the current less than optimal and usually highly inv

  13. 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

  14. 腰椎间盘退变的分子病理学变化及发病机制%Molecular pathological changes and pathogenesis of lumbar disc degeneration

    Institute of Scientific and Technical Information of China (English)

    徐宝山; 杨强; 夏群

    2011-01-01

    BACKGROUND: The lumbar disc degeneration is a common reason of low back pain. Pathological changes and pathogenesis of lumbar disc degeneration, but has not yet entirely clear.OBJECTIVE: To introduce the research progress on molecular pathological changes and pathogenesis of lumbar disc degeneration.METHODS: Taking "disc histology, disc degenerative disease, disc gene" as search terms, PubMed database was retrieved from 2005 to 2010. Literature about the histological changes and pathogenesis of lumbar disc degeneration was screened. Research progress and results of lumbar disc degeneration were summarized and generalized.RESULTS AND CONCLUSION: A total of 118 literatures related to lumbar disc degeneration were retrieved and 30 of them were included. The results showed that the lumbar disc degeneration is influenced by many factors, including gene hereditary factors,natural aging, accumulative injuries, etc. Gene polymorphism is an important prepositive factor of induced degeneration.Intervertebral disc degeneration can induce degenerative disc disease (DDD) by immunological reaction, mechanical compression or instability, blood circulation disorders, inflammatory mediators and other factors. It is difficult to differentiate aging and degeneration on imageology and pathology, so the reasonable treatment should be adopted according to specific circumstances of DDD. Biological therapy provides a new treatment idea, but research is still in experimental stage.%背景:腰椎间盘退变是引起腰腿痛的常见原因,椎间盘退变的病理改变及发病机制至今仍未完全明确.目的:介绍腰椎间盘退变的分子病理改变及其发病机制的研究进展.方法:以"disc histology,disc degenerative disease,disc gene"等主题词检索PubMed 数据库,检索时间为2005/2010年,筛选与腰椎间盘组织学变化和发病机制相关的文献,总结归纳腰椎间盘退变的研究进展和研究结果.结果与结论:共检索到与腰

  15. Short-and medium-term efficacy of artificial cervical disc replacement versus fusion for cervical spondylosis%人工颈椎间盘置换与融合治疗颈椎病:中短期疗效的比较

    Institute of Scientific and Technical Information of China (English)

    高明勇; 陶海鹰; 卫爱林; 贺斌

    2014-01-01

    BACKGROUND:Recently, non-fusion technology representing as artificial cervical disc replacement continues to improve. On the basis of reconstruction of disc structure and function of involved segments, cervical spine structure of surgery area segment is significantly close to dynamic and static load stress distribution required by natural physiological systems. It effects are apparent in protecting intervertebral facet joints of degenerated segment and structure and function of the cervical spine of adjacent segments and in maintaining cervical dynamic stability, which presented obvious methodological strengths compared with segmental fusion technology. OBJECTIVE:To evaluate the clinical outcomes of anterior cervical discectomy and fusion and Bryan artificial cervical disc replacement in the treatment of single-level cervical spondylotic myelopathy or radiculopathy. METHODS:A total of 43 middle and old age patients with single-level cervical spondylotic myelopathy or radiculopathy, who were treated from March 2010 to March 2012, were enrol ed in this study. They were randomly assigned to anterior cervical discectomy and fusion group (fusion group) and Bryan artificial cervical disc replacement group. Range-of-motion of cervical overal and adjacent intervertebral area near the intervertebral space was observed with radiography. During fol ow-up, postoperative recovery of neurological function was evaluated using Japanese Orthopaedic Association scale, visual analog scale and neck disability index. RESULTS AND CONCLUSION:None patients experienced complications of neurovascular injury during and after the surgery. Range-of-motion of postoperative overal cervical vertebra and adjacent joint was improved in the Bryan artificial cervical disc replacement group compared with the fusion group. Neurological function was apparently improved after surgery in each group. At 3 months after surgery, scores of Japanese Orthopaedic Association, visual analog scale and neck

  16. 经前路颈椎椎体次全切除钛网置入融合后相邻节段的退变%Adjacent segment degeneration after anterior cervical corpectomy and fusion

    Institute of Scientific and Technical Information of China (English)

    翟鹏飞; 刘伟; 孙志明; 张学利

    2016-01-01

    BACKGROUND:In recent years, the researchers have studied the adjacent segment degeneration after cervical fusion. Several studies concerned the adjacent segment degeneration after anterior cervical corpectomy and fusion. OBJECTIVE:To evaluate the correlative factors of adjacent segment degeneration after anterior cervical corpectomy and fusion. METHODS:122 patients were included in the study from 126 patients who underwent anterior cervical corpectomy and fusion that operated by the same treatment team and involved a single vertebral body and the two plates between February 2009 and February 2012. The final fol ow-up period was 3 years. According to the degeneration progress of adjacent segment degeneration, these patients were divided into non-progression group and progression group. The gender, age, preoperative adjacent segment degeneration, cervical range of motion, upper and lower vertebral range of motion, surgical segment, titanium mesh subsidence, plate-to-disc distance, and cervical curvature index were compared between two groups. Logistic regression analysis was applied to analyze the correlative factors of adjacent segment degeneration. RESULTS AND CONCLUSION:(1) There were significant differences in preoperative adjacent segment degeneration, postoperative cervical range of motion, postoperative upper and lower vertebral range of motion, and postoperative cervical curvature index (P  目的:探讨经前路椎体次全切除钛网椎间置入融合后相邻节段退变的相关因素。  方法:纳入2009年2月至2012年2月行经前路椎体次全切除钛网椎间置入融合的患者共126例,其中资料完整的122例纳入研究。均由同一治疗组完成,且手术均涉及单个椎体及2个间盘。终末随访期为3年。根据术前及术后相邻节段退变程度,分为非相邻节段退变进展组和相邻节段退变进展组,比较2组患者的性别、年龄、术前相邻节段退变、颈椎活动度、术椎

  17. Radiological Parameters of Undegenerated Cervical Vertebral Segments in a Korean Population

    Science.gov (United States)

    Choi, Sung Hoon; Lee, HeeSang; Cho, Jae Hwan; Jung, Jin Il

    2017-01-01

    Background Several scoring systems for cervical disc and facet joint degeneration, using radiography or computed tomography, have been developed and tested for reliability. However, definitions of disc height and facet joint space narrowing vary. To our knowledge, no study has reported quantitative data for normal radiologic values of the cervical spine in the Korean population. The purpose of this study is to determine normal cervical disc height, disc height ratio, and facet joint space values, and investigate the correlation between demographic data and these values. Methods We performed a retrospective study of patients who underwent artificial disc replacement of the cervical spine. Disc heights and facet joint spaces were measured using cervical neutral lateral radiographs and computed tomography. The means, standard deviations, and 95% confidence intervals of the values were determined. Results We measured 148 intervertebral discs and 352 posterior facet joints. The mean disc height measured by plain radiography and computed tomography was 5.57 ± 0.81 mm and 4.94 ± 0.94 mm, respectively. The mean facet joint space values measured by plain radiography and computed tomography were 1.94 ± 0.45 mm and 1.43 ± 0.39 mm, respectively. The disc heights and facet joint space values measured by plain radiography were greater than those measured by computed tomography. The lower limit of the 95% confidence interval of the disc height ratio calculated by plain radiography and computed tomography was greater than 0.94 at all levels except for C5–6. Patient height and disc height showed a tendency of positive correlation. Conclusions In a Korean population, the normal cervical disc height was about 5.0 mm and the normal facet joint space was 1.4 mm. Disc height ratio can reliably identify normal cervical disc height in patients with mild degeneration. Patient height was positively correlated with disc height and facet joint space. Thus, when selecting a cervical

  18. The presence of local mesenchymal progenitor cells in human degenerated intervertebral discs and possibilities to influence these in vitro: a descriptive study in humans.

    Science.gov (United States)

    Brisby, Helena; Papadimitriou, Nikolaos; Brantsing, Camilla; Bergh, Peter; Lindahl, Anders; Barreto Henriksson, Helena

    2013-03-01

    Low back pain is common and degenerated discs (DDs) are believed to be a major cause. In non-degenerated intervertebral discs (IVDs) presence of stem/progenitor cells was recently reported in different mammals (rabbit, rat, pig). Understanding processes of disc degeneration and regenerative mechanisms within DDs is important. The aim of the study was to examine the presence of local stem/progenitor cells in human DDs and if these cell populations could respond to paracrine stimulation in vitro. Tissue biopsies from the IVD region (L3-S1) were collected from 15 patients, age 34-69 years, undergoing surgery (spinal fusion) and mesenchymal stem cells (MSCs) (iliac crest) from 2 donors. Non-DD cells were collected from 1 donor (scoliosis) and chordoma tissue was obtained from (positive control, stem cell markers) 2 donors. The IVD biopsies were investigated for gene and protein expression of: OCT3/4, CD105, CD90, STRO-1, and NOTCH1. DD cell cultures (pellet mass) were performed with conditioned media from MSCs and non-degenerated IVD cells. Pellets were investigated after 7, 14, 28 days for the same stem cell markers as above. Gene expression of OCT3/4 and STRO-1 was detected in 13/15 patient samples, CD105 in 14/15 samples, and CD90 and NOTCH1 were detected 15/15 samples. Immunohistochemistry analysis supported findings on the protein level, in cells sparsely distributed in DDs tissues. DDs cell cultures displayed more undifferentiated appearance with increased expression of CD105, CD90, STRO-1, OCT3/4, NOTCH1, and JAGGED1, which was observed when cultured in conditioned cell culture media from MSCs compared to cell cultures cultured with conditioned media from non-DD cells. Expression of OCT3/4 (multipotency marker) and NOTCH1 (regulator of cell fate), MSC-markers, CD105, CD90, and STRO-1, indicate that primitive cell populations are present within DDs. Furthermore, the possibility to influence cells from DDs by paracrine signaling /soluble factors from MSCs and from

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-08-01

    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.

  20. Development of Ultrasound to Measure In-Vivo Dynamic Cervical Spine Intervertebral Disc Mechanics

    Science.gov (United States)

    2016-01-01

    during jumping. Para-cervical muscles ( SCM , upper trapezius) activation were measured by non- invasive surface EMG. 3.2 In-vivo Dual US Test in...exceeded a set threshold (0.1V/1k amp & 1V/10k amp for upper Trapezius and SCM respectively) were used to evaluate the intensity of EMG activation...Model A showed good correlation to the experimental data. Model B with separations in its two components (i.e. the annulus and the nucleus

  1. Cervical spine degeneration in fighter pilots and controls: a 5-yr follow-up study.

    Science.gov (United States)

    Petrén-Mallmin, M; Linder, J

    2001-05-01

    At 5 yr after MRI of the cervical spine, for evaluation concerning degenerative lesions, follow-up MRI was performed on asymptomatic experienced military high performance aircraft pilots (mean age 47 yr; mean accumulated flying time 3,100 h) and on age-matched controls without military flying experience. Young military high performance aircraft pilots (mean age 28 yr, mean accumulated flying time 915 h) were also re-examined. Compared with baseline MRI 5 yr earlier, there was significant increase in disk protrusions in all groups, in osteophytes in controls, and in foraminal stenoses in experienced pilots, and a significant reduction in disk signal intensity in young pilots. The difference between experienced pilots and controls was markedly reduced compared with that at baseline MRI. Thus, military high performance aircraft pilots seem to be at increased risk of premature development of degenerative lesions of the same type as are seen in an aging population. With increasing age the difference between pilots and controls diminishes.

  2. Evaluation of intervertebral disc herniation and hypermobile intersegmental instability in symptomatic adult patients undergoing recumbent and upright MRI of the cervical or lumbosacral spines

    Energy Technology Data Exchange (ETDEWEB)

    Ferreiro Perez, Antonio [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain)]. E-mail: antoine69@terra.es; Garcia Isidro, Millan [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain); Ayerbe, Elena [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain); Castedo, Julio [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain); Jinkins, J.R. [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain)

    2007-06-15

    Purpose: The purpose of the study was to determine the difference in findings between recumbent and upright-sitting MRI of the cervical and lumbosacral spine in patients with related sign and symptoms. Materials and methods: A total of 89 patients were studied (lumbosacral spine: 45 patients; cervical: 44 patients). T1-weighted (TR: 350, TE: 20) fast spin echo and T2-weighted (TR: 2500, TE: 160) fast spin echo images were acquired in the sagittal and axial planes in both the recumbent and sitting-neutral positions. The images were acquired on the Upright{sup TM} MRI unit (Fonar Corporation, Melville, NY). Differences were sought between the recumbent and upright-sitting positions at all levels imaged, in both planes. Results: The total number of cases of pathology was 68, including instances of posterior disc herniation and anterior and posterior spondylolisthesis. Focal posterior disc herniations were noted in 55 patients (cervical: 31, lumbosacral: 24) [62% of patients]. Six of these herniations (cervical: 4, lumbosacral: 2) [11%] were seen only on the upright-sitting study. Focal posterior disc herniations were seen to comparatively enlarge in size in 35 patients on the upright-seated examination (cervical: 21, lumbosacral: 14) [72%], and reduce in size in 9 patients (cervical: 5, lumbosacral: 4) [18%]. Degenerative anterior (n: 11) and posterior (n: 2) spondylolisthesis was seen in 13 patients (cervical: 0, lumbosacral: 13) [15% of patient total]. Anterior spondylolisthesis was only seen on the upright-seated examination in 4 patients (cervical: 0, lumbosacral: 4) [31%]. Anterior spondylolisthesis was comparatively greater in degree on the upright-seated study in 7 patients (cervical: 0, lumbosacral: 7) [54%]. Posterior spondylolisthesis was comparatively greater in degree on the recumbent examination in 2 patients (cervical: 0, lumbosacral: 2) [15%]. The overall combined recumbent miss rate in cases of pathology was 15% (10/68). The overall combined recumbent

  3. 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.

  4. Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?

    Directory of Open Access Journals (Sweden)

    Gülcan Öztürk

    2016-04-01

    Full Text Available Objective: The aim of this study was to investigate the coexistence of myofascial trigger points (MTrPs and cervical disc herniations (CDH in patients with neck and upper back pain. Materials and Methods: In this retrospective study, patients having only MTrPs were defined as group-1, patients having only CDH were defined as group-2, patients having both MTrPs and CDH were defined as Group-3. Two hundred twenty three patients (151 females/72 males; mean age 38.2±10.1 years were enrolled in this study. There were 30 patients in group 1, 46 patients in group 2, 147 patients in group 3. Results: Thirty eight patients had radiculopathy, 27 of them had MTrP(s. There was no significant difference in terms of CDH level (p=0.275 and degree of herniation (p=0.188 between groups 2 and 3. There was no significant difference in terms of MTrP localisation (p=0.684 between groups 1 and 3. There was no significant difference in terms of MTrP localisations according to CDH level and nerve root compression level in groups 3. Conclusion: MTrP and CDH coexistence is frequent. Management of the pain in the upper back region should be based on whether if the pain originates from MTrP, CDH or both

  5. MRI Analysis of the Structural Morphology of Cervical Intervertebral Disc Herniation%颈椎间盘突出症牵引下MRI影象学的形态结构分析

    Institute of Scientific and Technical Information of China (English)

    宋洪臣; 赵国库; 刘世文; 安晓芳

    2001-01-01

    目的对18例患者总计突出颈椎间盘28个,比较不同牵引方向对颈椎间盘突出症(HCD)的颈椎功能变化规律。方法借助MRI影象扫描研究不同牵引方向对颈椎突出间盘的运动、脊髓受压指数、椎间隙的变化及伴有变性病例的作用。结果不同的牵引方向对间盘突出的作用是有差异的,屈曲牵引使间盘部分还纳最为明显。脊髓受压指数在屈曲方向牵引最低。伸展牵引时椎间盘突出缩小组的后缘椎间隙减小明显。屈曲牵引时椎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 HCD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。牵引对伴有变性者意义可能不大。%Objective To compare the fuctional and morphological changes of the cervical spine of 18 patients (28 disci herniations) under different directions in herniation of cervical disc (HCD).Methods To study the effect of different directions of traction on the movement of herniated disc,compression index of spinal cord,changes of intervertebral space and the influence on cases with degeneration by MRI.Results There were differences among the effects of traction in different directions.Most significant partial retraction of the herniated disc was experienced in flexion traction.Both flexion and extension traction caused marked reduction of index of compression of spinal cord.Extension traction resulted in marked narrowing of the posterior edge of intervertebral space in the group with disc size reduction,but there was not much difference between the groups with and without disc size reduction under flexion traction.There was no marked effect on the morphological changes in cases with degeneration in any direction of

  6. 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

  7. The effect of preoperative factors on the function of the cervical spine after cervical artificial disc replacement:a minimal 3 years follow-up%术前因素对人工颈椎间盘置换术中期疗效的影响

    Institute of Scientific and Technical Information of China (English)

    田伟; 韩骁; 刘波; 李勤; 胡临; 李志宇; 袁强; 何达

    2010-01-01

    for more than 3 years, would have worse JOA recovery rate through the surgery compared with the patients who got neural syndrome less than 3 month. As for radiographic results, the preoperative range of movement (ROM) at the implanted disc spaces was 10. 4° ± 5.0° which had significant correlation with the most recent follow-up ROM which was 8. 6°± 4. 8° ( r = 0. 325, P < 0. 05 ) . The group which height ratio of the operative disc and the adjacent discs was less than 0. 87 would have worse JOA recovery rate and range of motion at operated level at the most recent follow-up than the group more than 0. 87 with statistical significance. Conclusions For the patients with cervical spendylosis or cervical disc herniation who get nervous syndrome for more than 3 years, will have worse JOA recovery rate through the surgery, so the patient should get the operation in time to achieve better improvement. When the operated level is severe degenerated, the motion of the replaced disc and the clinical results is dissatisfied at the time of final follow-up, so it is the relative contraindications for the cervical disc replacement.

  8. Course of atlanto-axial involvement and disc narrowing of the cervical spine in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    de Carvalho, A.; Graudal, H.

    1981-07-01

    In 188 patients with rheumatoid arthritis 585 radiological examinations of the cervical spine were performed. Subluxation of C1-2 was found more often than expected; it was often the only radiological change in that segment, and its degree was not related to the duration of the disease. Lateral radiographs taken in full flexion were important for the diagnosis. Age over 40 years at the onset of RA, increased ESR at least on one occasion and seropositivity were related to more severe degrees of involvement. The presence of subcutaneous nodules, high titres of the Rose-Waaler reaction and the presence of antinuclear antibodies had no definite relation to the degree of involvement.

  9. Two-level total disc replacement with Mobi-C(r over 3-years

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    Reginald Davis

    2014-01-01

    Full Text Available Objective: To evaluate the safety and effectiveness of two-level total disc replacement (TDR using a Mobi-C(r Cervical Artificial Disc at the 36 month follow-up. Methods: a Prospective, randomized, controlled, multicenter clinical trial of an artificial cervical disc (Mobi-C(r Cervical Artificial Disc was conducted under the Investigational Device Exemptions (IDE and the U.S. Food & Drug Administration (FDA regulations. A total of 339 patients with degenerative disc disease were enrolled to receive either two-level treatment with TDR, or a two-level anterior cervical discectomy and fusion (ACDF as control. The 234 TDR patients and 105 ACDF patients were followed up at regular time points for three years after surgery. Results: At 36 months, both groups demonstrated an improvement in clinical outcome measures and a comparable safety profile. NDI scores, SF-12 PCS scores, patient satisfaction, and overall success indicated greater statistically significant improvement from baseline for the TDR group, in comparison to the ACDF group. The TDR patients experienced lower subsequent surgery rates and a lower rate of adjacent segment degeneration. On average, the TDR patients maintained segmental range of motion through 36 months with no device failure. Conclusion: Results at three-years support TDR as a safe, effective and statistically superior alternative to ACDF for the treatment of degenerative disc disease at two contiguous cervical levels.

  10. Mobi-C人工颈椎间盘在颈前路手术的临床应用%Clinical study of Mobi-C cervical prosthetic disc in cervical anterior route operation

    Institute of Scientific and Technical Information of China (English)

    严力生; 罗旭耀; 钱海平; 梁伟; 鲍宏伟; 宫峰

    2011-01-01

    目的 探讨观察Mobi-C人工颈椎间盘置换技术治疗颈椎病、颈椎间盘脱出症的临床疗效.方法 自2008-10-2010-03,应用Mobi-C人工颈椎间盘置换术治疗颈椎病8例13个椎间隙、颈椎间盘脱出症5例6个间隙,对手术操作、术中出血、术后影像学检查及临床疗效等进行了分析.结果 患者手术后1周均感到上胸部紧缩感及手指麻木等神经症状明显好转,手指持物及下肢肌力增加.术后1周X线片检查显示:椎间隙高度、位置良好.随访6~23个月,根据JOA评分:从手术前的平均9.5分增加到随访时16.5分,术后改善率93.4%.X线摄片示无椎间隙的高度丢失、椎体后缘自发骨化及后凸畸形,动力性摄片未见不稳、假体移位、松动征象.术后未出现喉头水肿、伤口血肿、切口感染、声音嘶哑等并发症.结论 Mobi-C人工颈椎间盘置换术治疗颈椎病、颈椎间盘突出症能获得优良的近期疗效.%objective To observe the clinic effecl of Mobi-C artifitial cervical disc prosthesis on treating cervical spondylotic myelopathy and cervical disc protrusion. Methods From October 2(X)8 to March 2010,8 cases(13 spacs )of cervical spondylotic myelepathy anrl 5 cases(6spacs)of cervical disc protrusion were treated surgically by cervical arthroplasty using Mobi-C disc prosthesis. The material include the surgery procedures, operative time,blood loss,radiological examinations,clinical effect and complications were analyzed. Results The neurologic symptoms were relieved obviously within one week postoperative in all patients. Low limb muscle strength increased, upper limb abnormal sensation disappeared and limb moved more agile. Cervical X-ray film showed cervical curve anil position of Mobi-C prosthesis resumed normal. The intervertebral space height were maintaining original height in all cases. Followed up average 15 months (6~23 months). The average JOA score increased from 9.5 preoperative to 16.5 at followed up

  11. 椎间盘退变患者血清及髓核组织中基质金属蛋白酶1及抑制剂1的表达%Serum and tissue levels of matrix metalloproteinase-1 and its tissue inhibitor in patients with intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    邓斌; 王叶新; 孟纯阳

    2016-01-01

    BACKGROUND:Matrix metaloproteinases are now generaly considered to be able to degrade al extracelular matrices. Hypersecretion of matrix metaloproteinases or reduction in tissue inhibitors of matrix metaloproteinases leads to destruction of the dynamic balance of extracelular matrix. OBJECTIVE: To elucidate the role of matrix metaloproteinase-1 and tissue inhibitor of matrix metaloproteinase-1 in the pathogenesis and progression of intervertebral disc degeneration. METHODS:A total of 60 patients with intervertebral disc degeneration were included. Mild, moderate, and severe degeneration signals appeared on MRI imaging of the patients. Meanwhile, 20 patients with vertebral fracture, mainly cervical spine fracture, were selected as the control group. Venous blood samples were colected before the surgery; the intervertebral disc specimens were sequentialy colected. RESULTS AND CONCLUSION: Serum and tissue levels of matrix metaloproteinase-1 in patients with intervertebral disc degeneration were significantly increased compared with the control group (P 0.05). These results indicate that hypersecretion of matrix metaloproteinase-1 occurs in patients with intervertebral disc degeneration; however, the expression of tissue inhibitor of matrix metaloproteinase-1 is not correlated with intervertebral disc degeneration.%背景:基质金属蛋白酶现被公认为能降解所有的细胞外基质,基质金属蛋白酶分泌过多或金属蛋白酶抑制剂的分泌减少能破坏细胞外基质的动态平衡。目的:试图阐明基质金属蛋白酶1和金属蛋白酶抑制剂1在椎间盘退变的发病机制。方法:选择60例椎间盘退变患者,根据磁共振(MRI)检查结果分为椎间盘有轻度的退变信号、椎间盘中度抑制信号及椎间盘严重的退变信号3个亚组;对照组20例椎体骨折(颈椎为主)但椎间盘正常的患者。在术前收集静脉血液样品,随后收集病变的椎间盘组织。结果与结论:①椎

  12. Cervical disc replacement and anterior interbody fusion in the repair of middle-aged patients with cervical spondylosis:cervical function and range of motion%颈椎间盘置换与前路椎间植骨融合修复中年颈椎病:颈椎功能及活动度比较

    Institute of Scientific and Technical Information of China (English)

    蒋新祥; 徐海栋; 路晓

    2015-01-01

    BACKGROUND:The development of spinal non-fusion technology promoted movement function protection of adjacent segment and operating segment. In the treatment of cervical spondylosis surgery, non-fusion technology has been widely carried out. For middle-aged patients with cervical spondylosis, the demand for spinal joint movement function is high. Non-fusion technology can improve the postoperative quality of life and slow down the risk of adjacent segment degeneration. OBJECTIVE:To evaluate the clinical efficacy of anterior cervical different implant materials (fusion or non-fusion) in the treatment of single segment of the intervertebral disc degeneration of cervical spondylosis in middle-aged patients. METHODS:This study enrol ed 10 cases of single segmental radiculopathy and cervical myelopathy after cervical intervertebral disc replacement from June 2011 to June 2013. Simultaneously, 10 cases were randomly selected from patients with anterior interbody fusion as the control group. Before treatment, at 1 and 3 months, and 1 year after treatment, changes in range of motion of cervical vertebra were observed using imaging results. Therapeutic effects were assessed using Japanese Orthopaedic Association Scores, Visual Analog Scale and The Neek Disability Index in both groups. RESULTS AND CONCLUSION:Al patients did not suffer from incision fat liquefaction, infection and delayed healing, and had finished fol ow-up for more than 1 year. Results revealed that Japanese Orthopaedic Association Scores and Visual Analog Scale scores were improved at 1 and 3 months, and 1 year after treatment (P0.05). In the analysis of range of motion of cervical vertebra and The Neek Disability Index, there were significant advantages in non-fusion treatment group (P  目的:评价在中年颈椎病患者人群中,采用颈椎前路不同植入材料(融合与非融合)治疗单节段椎间盘退变性颈椎病的临床效果。  方法:纳入2011年6月至2013年6月收

  13. Observation on early therapeutic effect of DISCOVER artificial cervical disc replacement for cervical spondylotic myelopathy%DISCOVER人工颈椎间盘置换术治疗脊髓型颈椎病的早期疗效观察

    Institute of Scientific and Technical Information of China (English)

    钱俊; 辛兵; 何玉泽; 郭开今

    2013-01-01

    目的 探讨应用DISCOVER人工颈椎间盘置换术治疗脊髓型颈椎病的早期临床疗效.方法 回顾性分析行DISCOVER人工颈椎间盘置换术的12例脊髓型颈椎病患者的临床资料,统计并分析患者术前和术后神经功能状态JOA评分和颈椎总活动度(ROM),进行早期疗效评估.结果 所有患者随访6个月,术后临床症状和体征明显改善或消失,JOA评分由术前的(6.79±3.62)分提高到末次随访的(15.84 ±0.89)分(P<0.05);ROM术前为(51.3 ±14.2)°,术后末次随访为(49.9±13.8)°,差异无统计学意义(P>0.05).按照Odom评定标准,末次随访时,优9例,良2例,可1例,优良率91.7%.结论 应用DISCOVER人工颈椎间盘置换术治疗脊髓型颈椎病早期疗效良好,远期效果有待进一步观察.%Objective To evaluate the early clinical efficacy of DISCOVER artificial cervical disc replacement sur gery for cervical spondylotic myelopathy. Methods The clinical data of 12 patients with cervical spondylotic myelopathy undergoing DISCOVER artificial cervical disc replacement was analyzed retrospectively. Preoperative and postoperative neurological status JOA scores and cervical range of motion (ROM) were compared and early therapeutic efficacy was e-valuated. Results All patients were followed - up for 6 months. The neurological symptoms and signs were alleviated or disappeared in all cases. The JOA score was significantly improved from 6. 79 ±3. 62 preoperatively to 15. 84 ±0. 89 at the last postoperative follow - up (P 0. 05 ). According to Odom criteria, 9 cases got excellent results, 3 cases got good results, 1 case got fair results. The rate of excellent and good results was 91.7%. Conclusion Our findings suggest that the DISCOVER cervical disc replacement for cervical spondylotic myelopathy may yield good short - term functional results. Further follow - up is necessary to evaluate mid and long - term outcome.

  14. 终板蛋白多糖的变化对颈椎间盘力学性能的影响%Effect of proteoglycan changes in cartilage endplate on biomechanical behavior of cervical intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    应航; 陈立; 詹红生; 熊爱民; 吕荣坤

    2004-01-01

    BACKGROUND: Proteoglycan is the main component of cartilage endplate,which is the biochemical basis in maintaining the biomechanical behavior of cervical intervertebral disc.OBJECTIVE: To discuss the molecular mechanism for abnormal biomechanics behavior in the cervical intervertebral disc with retrogressive changes by assaying the compressive capability of cervical intervertebral disc with retrogressive changes and observing the changes of proteoglycan in cartilage endplate.DESIGN: A randomized controlled study was conducted.SETTING and PARTICIPANTS: The study was completed in the Department of Biomechanics, Zhejiang College of Traditional Chinese Medicine. The subjects were 24 Japanese clean white rabbits obtained from Center for Experimental Animals, Zhejiang College of Traditional Chinese Medicine.INTERVENTIONS: Twenty-four Japanese white rabbits were randomly divided into control and model group. The model rabbits were kept at 45°flexion for 5 hours once daily. At 1, 2, and 3 months after model establishment, the mechanics index and GAG content were measured to analyze the systemic changes of stromal components of cervical intervertebral disc with retrogressive changes and the effect on the biomechanics capacities of cervical intervertebral disc.MAIN OUTCOME MEASURES: C5-6 disc was chosen to determine the biomechanical characters, the GAG content, ratio of chondroitin sulphate (CS) to keratin sulphate(KS) and hyaluronic acid(HA) content.RESULTS: There were significant decreases of antipress intension and largest shape change, GAG content, CS/KS ratio, and HA content in model group compared with that of control group( t = 1.78-6.23, P < 0.05),which decreased over time.CONCLUSION: The specific mechanic changes of intervertebral disc can be induced by long time abnormal stress. The changes of proteoglycan content may be the major reason of intervertebral disc degeneration.%背景:蛋白多糖是软骨终板的主要组成部分,是维持椎间盘力学性能

  15. 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

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

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    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.

  17. Observation of curative effect after treatment of cervical spondylopathy with the artifitial cervical disc prosthesis%人工颈椎间盘置换术治疗颈椎病疗效观察

    Institute of Scientific and Technical Information of China (English)

    文益民; 葛宝丰; 蓝旭; 张军华; 王世勇; 张巧娥; 李慎松

    2009-01-01

    [目的]探讨人工颈椎间盘置换术治疗颈椎病所致神经或脊髓受损的临床症状及体征的缓解情况,置换节段的稳定性,活动度的维持.[方法]对6例颈椎病患者6个椎间盘实施了颈椎前路人工颈椎间盘置换术,其中神经根型颈椎病3例,脊髓型颈椎病3例.随访时间8~39个月,平均28个月.[结果]6例患者神经、脊髓受损临床症状及体征均得到了明显的恢复和缓解.JOA评分从平均8.2增加到16.3.假体无明显下沉和偏移,置换节段稳定,颈椎活动范围得到了明显恢复.前屈和后伸活动范围平均恢复4.86°(3.3°~6.28°);左右侧屈的活动范围平均恢复3.26°(2.6°~5.1°),3.52°(2.6°~4.8°),颈椎生理弧度无明显丢失,假体节段周围无骨化.无神经及血管损伤等并发症.[结论]6例人工颈椎间盘置换术均取得了满意的近期临床疗效.与当今标准颈前路椎间盘摘除,椎体间植骨融合,钢板螺钉内固定术比较,其最大的优点是病人恢复快,颈椎活动度无明显受损.%[Objective] To investigate the treatment of nerve and spinal cord injury caused by cervical spondylopathy with the artifitial cervical disc prosthesis, relief from objective symptoms and signs, maintain stability and segmental motion. [ Methods ] Six cases of cervical spondylopathy were treated through anterior approach excision and repaired by 6 discs of artifical cervical disc replacement Among them, there were 3 cases of cervical spondylotic myelopathy and 3 of nerve root cervical syndrome. The follow - up time ranged from 8 to 39 months, averaged 28 months. [ Results] The neurologic symptom and sign in all cases had significant improvement. JOA score increased from averaged 8.2 to 16.3. There were no prosthesis subsidence or deviation. Replaced segment achived stability and restored partial of normal ROM, 4.68°(3.3°~6.28°) in flextion and extension position and 3.26°(2.6°~5.1°) ,3.52°(2.6°~4.8°) in left

  18. Lições sobre a substituição total de disco cervical após sete anos de acompanhamento Lecciones sobre el reemplazo total de disco cervical después de siete años de seguimiento Lessons learned on cervical total disc replacement after 7-year follow-up

    Directory of Open Access Journals (Sweden)

    Thiago Coutinho

    2012-06-01

    fueron operados en un solo nivel, 67 pacientes en dos, 17 en tres niveles, siendo 4 niveles en seis. Los resultados clínicos y radiológicos fueron recolectados antes de la operación, 1 semana, y 1, 3 y 6 meses y anualmente. Cuestionarios de NDI/VAS se utilizaron para evaluar el dolor y los resultados funcionales. Para el análisis de la degeneración de las facetas, se utilizó una escala de cuatro grados basada ​​en la tomografía computarizada. RESULTADOS: Los resultados clínicos han mejorado significativamente en todas las visitas posoperatorias. La mayoría de los pacientes progresó hasta los grados I y II de degeneración facetária, y en estos casos no hubo deterioro clínico, a diferencia de los casos con grados III y IV. Entre los niveles estudiados, 25 (8,93% mostraron algún grado de HO: 14 fueron de grado I (56%, 7 de grado II (28%, tres con grado III (12% y solo uno de grado IV (4%. En 92% de los pacientes, que desarrollaron HO, había incipiente presencia de osteofitos. La enfermedad de niveles adyacentes se produjo en el 5,7% de los pacientes. CONCLUSIÓN: Los buenos resultados clínicos también corroboran la superioridad de CTDR en comparación con los resultados del ACDF descritos en la literatura.OBJECTIVE: To present the clinical and radiological experience of cervical arthroplasty in the treatment of intervertebral disc degeneration, maintaining movement and reducing adjacent segments stress and degeneration. METHODS: We studied the radiographs of 280 levels in 161 patients (mean age 45.4 years treated between cervical levels C3-4 and C7-T1. Seventy-one patients were operated at one disc level, 67 at two, 17 at three, and 6 at four levels. Radiological and clinical outcomes were collected preoperatively, 1 week and 1, 3 and 6 months and annually. NDI/VAS questionnaires were used to assess pain and functional outcomes. For facet degeneration analysis, we used a four-grade scale based on CT scans. RESULTS: The clinical outcomes significantly

  19. Bryan人工椎间盘单节段置换治疗颈椎间盘退变性疾病的临床疗效%Clinic Therapeutic Effect of Bryan Artificial Disc Single Level Replacement on Cervical Disc Degenerative Diseases

    Institute of Scientific and Technical Information of China (English)

    石锐; 刘浩; 丁琛; 胡韬; 李涛; 龚全; 宋跃明; 洪瑛

    2011-01-01

    目的 评价Bryan人工椎间盘单节段置换治疗颈椎间盘退变性疾病的临床疗效.方法 2004年11月-2008年4月,21例颈椎间盘退变突出并经保守治疗无效的患者接受Bryan人工颈椎间盘单节段置换术.患者术前、术后1、6、12、18、24个月时使用颈椎功能障碍指数(neck disable index,NDI)、症状程度主观评价、疼痛视觉模拟疼痛量表(visual analogue scale,VAS)进行疗效评估,手术效果使用Odom法评价.影像学检查包括颈椎功能位X线片、颈椎CT及MRI检查.结果 21例患者均顺利完成椎间盘置换手术,术后随访2年.患者对症状的主观评分,颈痛VAS评分、手臂疼痛VAS评分,NDI分别由术前的(2.80士0.42)、(4.62±1.84)、(5.01士1.79)、(22.60±4.88)分下降到随访终止时的(0.20士0.42)、(1.01士0.56)、(0.82±0.24)、(4.30±1.25)分.所有患者对手术效果Odom评级优良,8例(38.1%)自觉症状完全缓解.手术过程平均时间为(110.5±42.6)min,术中出血量平均为(166.0±108.8)mL.影像学评价见植入的人工椎间盘运动功能良好,未见颈椎不稳的表现.2例假体在术后早期轻度前移.结论 Bryan人工椎间盘单节段置换是治疗颈椎间盘退变性疾病的一种安全有效的方法,术后随访2年临床疗效满意.%Objective To evaluate the clinical therapeutic effect of single segment Bryan disc replacement on cervical disc degenerative diseases. Methods From November 2004 to April 2008, 21 patients who had a poor response after conservative treatment for their cervical disc degeneration underwent the single level Bryan disc replacement. Before the operation and 1, 6, 12, 18, and 24 months after the operation, all patients were evaluated by neck disable index (NDI), subjective symptom scale, visual analogue scale (VAS) and ()dom score. The radiological examinations included X-ray, CT scan and MRL Results Operations were successfully executed in 21 patients. All patients had obeyed the follow

  20. Fusion of Adjacent Segment Degeneration after Anterior Portion Cervical Decompression%颈前路融合术后相邻节段退变120例

    Institute of Scientific and Technical Information of China (English)

    占蓓蕾; 叶舟

    2014-01-01

    目的:探讨颈椎前路减压融合术后相邻节段退变的因果关系。方法:对237例患者行前路椎间节段减压植骨融合术(87例),椎体次全切除减压植骨融合术(109例),椎间节段减压、椎体次全切除减压植骨融合术(41例)。通过影像学检查,观察不同手术方法术后相邻节段退变发生情况。结果:术后随访时间2.6~13年,平均6.8年;发生相邻节段明显退变的120例(50.6%),头侧相邻节段退变发生率明显高于尾侧邻近节段(P<0.05),其中27例(22.2%)需2次翻修手术。结论:颈椎前路融合术后可导致颈椎相邻节段的退变。%Objective To investigate the result of anterior cervical decompression and fusion of adjacent segment degeneration after causality. Methods among 237 patients(87 cases) weretreated with anterior decom-pression and interbody fusion intervertebral segments, 109cases with subtotal excision of the vertebral body with decompression and interbody fusion,and 41 cases with intervertebral segmental decompression, vertebral body subtotal resection decompression and interbody fusion.By imaging examination, different surgical methods and postoperative adjacent segment degeneration were observed. Results Postoperative follow-up at time of 2.6~13 years, averaging 6.8 years; showed significantly degeneration of adjacent segments in 120 cases (50.6%), the cranial adjacent segment degeneration rate significantly higher than that of the caudal adjacent segment (P<0.05), among them,27 cases (22.2%)needed 2 times of revision surgery. Conclusion The anterior cervical fu-sion surgery can lead to cervical vertebral adjacent segment degeneration.

  1. Internal carotid artery dissection after anterior cervical disc replacement: first case report and literature review of vascular complications of the approach.

    Science.gov (United States)

    Loret, Jean-Edouard; Francois, Patrick; Papagiannaki, Chrysanthi; Cottier, Jean-Philippe; Terrier, Louis-Marie; Zemmoura, Ilyess

    2013-07-01

    We report the case of a 41-year-old woman who underwent cervical total disc replacement at C4C5 and C5C6 levels and fusion at C6C7 level through an anterior right-side approach. After anesthesia recovery, the patient presented left hemiparesia and facial palsy due to large right hemispheric stroke. Diffusion-weighted magnetic resonance imaging was performed as soon as the patient developed neurologic symptoms of stroke and revealed a right internal carotid artery dissection. Digital substraction angiography, endovascular stenting, angioplasty and thrombectomy were performed. Six months after treatment, clinical examination showed mild left-arm spasticity. To the best of our knowledge, only two cases of internal carotid artery stroke without dissection or thrombosis are reported. In conclusion, although vascular complications are rare after anterior cervical spine procedure, internal carotid artery dissection can occur. Suspected risk factors are prolonged retraction of the carotid artery and neck extension.

  2. Cervicitis

    Science.gov (United States)

    ... much growth of normal bacteria in the vagina (bacterial vaginosis) can also cause cervicitis. ... under a microscope (may show candidiasis , trichomoniasis , or bacterial vaginosis) Pap test Tests for gonorrhea or chlamydia Rarely, ...

  3. 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

  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. A Meta-analysis of Cervical Disc Arthroplasty Compared to Anterior Cervical Discectomy and Fu-sion for Degenerative Cervical Disc Disease%颈椎间盘置换与融合治疗退变性颈椎间盘疾病的 Meta 分析

    Institute of Scientific and Technical Information of China (English)

    石青鹏; 朱永林

    2016-01-01

    Objective To systematically compare the outcomes of cervical disc arthroplasty with anterior cervical discecto-my and fusion in the treatment of single-level degenerative cervical disc disease. Methods The references concerning cervical disc arthroplasty and anterior cervical discectomy and fusion for the singel-level degenerative cervical disc disease were re-trieved through PubMed,Cochrane Library,Ovid,SpringerLink,the China Biological Medicine Database,Wafang Database and Weipu Database,as well as by manually searching the related journals and literature. The eligible trials were extracted accord-ing to the inclusion and exclusion criteria. The methodological quality of the included trials were evaluated. RevMan5. 1 soft-ware was used for data analysis. Results Eight randomized controlled trials were included in the final Meta-analysis. The re-sults of Meta-analysis showed that statistically difference between these procedures in the SF-36(MD = 0. 98,95% CI:- 0. 33~ - 2. 29,Z = 1. 46,P = 0. 14),complications(OR = 0. 60,95% CI:0. 34 ~ 1. 04,P = 0. 07),reoperation rate(OR = 0. 52, 95% CI:0. 26 ~ 1. 05,Z = 1. 83,P = 0. 07). There were no statistically difference in the neck disability index(MD = - 2. 74, 95% CI:- 4. 57 ~ - 0. 91,Z = 2. 93,P = 0. 003),neck VAS(MD = - 2. 84,95% CI:- 4. 85 ~ - 0. 84,Z = 2. 78,P = 0. 005) and arm pain VAS(MD = - 1. 84,95% CI:- 3. 07 ~ - 0. 61,Z = 2. 92,P = 0. 003). Conclusion In treatment of single-level degenerative cervical disc disease,cervical disc arthroplasty has better outcomes in the improvement of pain symptom and neck function,but no superiority in complications,reoperation rate and SF-36 scores.%目的:系统性评价颈椎间盘置换与颈椎间盘摘除和融合治疗单节段退变性颈椎间盘疾病的效果。方法计算机检索 PubMed、Cochrane Library、Ovid、SpringerLink、中国生物医学文献数据库、万方、维普等数据库,手工检索相关杂志及纳入研究的参考文献,制

  6. 白细胞介素-17与椎间盘退变相关性的研究进展%Progress of correlation between interleukin-17 and intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    罗元一; 殷明; 何丁文; 魏强强

    2013-01-01

    The mechanism of intervertebral disc degeneration is very complex and related to many factors.In recent years,studies have indicated that intervertebral disc degeneration is closely related to immune inflammation,in which immune cells and many kinds of inflammatory cytokines are involved.As proinflammatory cytokine,interleukin-17 plays a very important role in autoimmune disease and chronic inflammation,which is associated with inflammatory cytokines and cells apoptosis.These secreted inflammation cytokines and increased intervertebral disc cells apoptosis will promote the intervertebral disc degeneration.In the disc cells,IL-17 will promote synthesis of inflammation mediator,thereby induce extracellular matrix metabolic imbalances and accelerate apoptosis.These factors further interacted with each other and promote the intervertebral disc degeneration.This article reviews the biological characteristics of interleukin-17 and its role in the intervertebral disc degeneration.%椎间盘退变机制非常复杂与多种因素相关,近年来研究认为椎间盘退变与免疫炎症密切相关,椎间盘退变机制中有免疫细胞和多种炎症介质的参与,炎症细胞因子在椎间盘的退变中扮演者重要角色,而白细胞介素-17(interleukin-17,IL-17)在自身免疫性疾病和慢性炎症中发挥着重要作用,是非常重要的促炎细胞因子,与许多炎症介质有关,也与细胞凋亡等有很大关系.在椎间盘细胞中,IL-17将促进椎间盘细胞合成炎症介质、椎间盘细胞外基质代谢失衡和椎间盘细胞的过快凋亡.这些因素相互作用从而加速了椎间盘的退变 本文主要对IL-17的生物学特性及在椎间盘退变中的作用进行综述.

  7. 单节段颈椎人工椎间盘置换与前路椎间融合内固定:维持颈椎活动度和稳定性的比较%Single level artificial disc replacement versus anterior cervical fusion:range of motion and stability of cervical vertebra

    Institute of Scientific and Technical Information of China (English)

    王威; 王利民; 王卫东; 谭洪宇; 刘屹林; 张书豪

    2014-01-01

    BACKGROUND:Fusion treatment for single segment cervical spondylosis can induce complications such as abnormal enlargement of range of motion in adjacent segments and degenerative manifestations. Recently, scholars began to explore and to use non-fusion technique to replace traditional fusion therapy. Cervical artificial disc replacement as a new anterior non-fusion program has been greatly used in the clinic, not only obtained good clinical therapeutic effects, but also made cervical vertebrae near physiological stability, delayed adjacent segment degeneration and reduced complications. OBJECTIVE:To compare the clinical effects of the single level artificial disc replacement and the anterior cervical decompression and fusion for cervical spondylosis. METHODS:A total of 59 patients with single segment cervical spondylosis, whose clinical signs and symptoms were accorded, were enrol ed from the First Affiliated Hospital of Zhengzhou University, China from May 2011 to May 2013. Imaging revealed that single segment of cervical disc degeneration compressed spinal cord or nerve root. Owing to different surgeries, these patients were divided into artificial disc replacement group (replacement group;n=32) and anterior cervical decompression and fusion group (fusion group;n=27). They were fol owed up at 5 days, 3, 6 and 12 months after treatment. Japanese Orthopaedic Association scores, neck pain, upper extremity pain visual analog scale scores were measured. The range of motion of the replacement segment and its effects on adjacent segments were observed. RESULTS AND CONCLUSION:The postoperative Japanese Orthopaedic Association Scores were improved compared with preoperative scores (P0.05). Range of motion of the replacement segment after treatment was (11.6±3.0)° in the replacement group, showing no significant differences as compared with before surgery (8.8±2.7)° (P>0.05). No significant activity was found at 3 months after treatment in the fusion group. During fol

  8. 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.

  9. 中青年颈椎间盘突出症的CT对照分析%CT Analysis of Young and Middle-aged Cervical Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    宋樟伟; 葛文; 许崇永; 陈雪鹏; 吴爱琴; 高凌云

    2011-01-01

    目的 探讨无症状组及有症状组中青年颈椎间盘突出症在CT上的区别.方法 搜集无症状及有症状中青年受检者300例及125例,对两组颈椎间盘突出的临床及CT 表现特点进行对照分析.结果 有症状组椎间盘突出检出率为81.2%(102/125),突出椎间盘198节,突出程度3.63±0.20mm,椎管狭窄8.6%(17/198),黄韧带肥厚19.2%(38/198),椎体及椎小关节增生40.9%(81/198),无症状组椎间盘突出检出率为42.3%(127/300),突出椎间盘159节,突出程度2.13±0.11mm,椎管狭窄1.3%(2/159),黄韧带肥厚8.2%(13/159),椎体及椎小关节增生35.2%(56/159).两组除椎体及椎小关节增生外均有明显统计学差异(P<0.05).结论 有症状组在椎间盘突出检出率、突出程度、椎管狭窄、黄韧带肥厚等方面均较无症状组明显,颈椎间盘突出达3.6mm以上或合并椎管狭窄、黄韧带肥厚者发展为颈椎病的可能性较大,应予以早期治疗.CT可以早期发现颈椎间盘突出、突出程度等信息,是颈椎间盘突出症重要检查方法.%Objective To investigate the difference of cervical disc hemiation between asymptomatic and symptomatic young and middle - aged patients in CT ( computed tomography) .Methods Three hundrend asymptomatic and 125 symptomatic young and middle - aged examinees were collected, and the clinical and CT performances of the two cervical disc hemiation groups were analyzed.Results The reBults of symptomatic group were as follows : the relevance ratio of protrusion of intervertebral disc was 81 .2% ( 102/125 ) , protruded discs were 198 joints with the degree of protrusion of 3.63 ± 0.20mm , vertebral canal stenosis was 8.6% ( 17/198) , hypertrophy of ligament falvum was 19.2% ( 38/198 ) , centrum and intervertebral facet joints hyperplasia was 40.9% ( 81/198) .And the results of asymptomatic group were as follows : the relevance ratio of prolrusion of intervertehral disc was 42.3% ( 127/300) , protruded discs was

  10. Clinical and radiological outcome of anterior–posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients

    Science.gov (United States)

    Schwender, James D.; Safriel, Yair; Gilbert, Thomas J.; Mehbod, Amir A.; Denis, Francis; Transfeldt, Ensor E.; Wroblewski, Jill M.

    2009-01-01

    Abundant data are available for direct anterior/posterior spine fusion (APF) and some for transforaminal lumbar interbody fusion (TLIF), but only few studies from one institution compares the two techniques. One-hundred and thirty-three patients were retrospectively analyzed, 68 having APF and 65 having TLIF. All patients had symptomatic disc degeneration of the lumbar spine. Only those with one or two-level surgeries were included. Clinical chart and radiologic reviews were done, fusion solidity assessed, and functional outcomes determined by pre- and postoperative SF-36 and postoperative Oswestry Disability Index (ODI), and a satisfaction questionnaire. The minimum follow-up was 24 months. The mean operating room time and hospital length of stay were less in the TLIF group. The blood loss was slightly less in the TLIF group (409 vs. 480 cc.). Intra-operative complications were higher in the APF group, mostly due to vein lacerations in the anterior retroperitoneal approach. Postoperative complications were higher in the TLIF group due to graft material extruding against the nerve root or wound drainage. The pseudarthrosis rate was statistically equal (APF 17.6% and TLIF 23.1%) and was higher than most published reports. Significant improvements were noted in both groups for the SF-36 questionnaires. The mean ODI scores at follow-up were 33.5 for the APF and 39.5 for the TLIF group. The patient satisfaction rate was equal for the two groups. PMID:19125304

  11. 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

    2016-07-19

    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

  12. 人工颈椎间盘置换术治疗脊髓型颈椎病10例临床分析%Artificial cervical disc replacement in the treatment of cervical spondylotic myelopathy clinical analysis of 10 cases

    Institute of Scientific and Technical Information of China (English)

    杨磊; 崔宏勋; 赵庆安; 饶耀剑

    2013-01-01

      目的探讨人工颈椎间盘置换术用于治疗脊髓型颈椎病的临床疗效.方法2010年6月—2012年9月,对10例保守治疗无效患者的11个节段进行了人工颈椎间盘置换术,男6例,女4例;年龄41~61岁,平均(48±0.8)岁.单节段9例,双节段1例,术后随访3~12个月.结果所有患者伤口均I期临床愈合,术中及术后没有神经和血管损伤的并发症,结合术前术后颈椎活动范围检查、神经系统症状、Odom评级、JOA评分及影像学检查,患者神经系统症状均获得满意改善,JOA评分较术前明显升高.颈椎曲度、置换节段功能活动度、置换节段上下位椎体椎间隙高度得到保持.假体未见下沉或偏移,未见异位骨化.结论颈椎人工椎间盘置换术在维持节段运动功能的同时,可取得良好的神经减压效果,人工椎间盘置换术的短中期疗效是令人满意的.%Objective To investigate the artificial cervical disc replacement for the treatment of cervical spondylotic myelopathy. Methods In 2010 June to 2012 September,10 cases of invalid conservative treatment of patients with 11 segments for the artificial cervical disc replacement,6 cases were male,4 female;age 41-61 years,mean 48±0.8 years old. 9 cases of single segment,1 cases of double segments,followed up for 3 months to 12 months. Results All patients were healed wound phase I clinical,intraoperative and postoperative no nerve and blood vessel injury,combined examination of cervical range check, neurological symptoms,Odom rating,JOA score and imaging before and after surgery,patients with nervous system symptoms were satisfactory improvement,JOA score was significantly higher than that before operation. Cervical curvature,replacement of segmental function activity,replacement segment inferior vertebral height is maintained. Prosthesis no sinking or offset, no heterotopic ossification. Conclusion Cervical artificial disc replacement in the maintenance of segmental motion

  13. 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 ...

  14. 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.

  15. 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

  16. Adjacent-level arthroplasty following cervical fusion.

    Science.gov (United States)

    Rajakumar, Deshpande V; Hari, Akshay; Krishna, Murali; Konar, Subhas; Sharma, Ankit

    2017-02-01

    OBJECTIVE Adjacent-level disc degeneration following cervical fusion has been well reported. This condition poses a major treatment dilemma when it becomes symptomatic. The potential application of cervical arthroplasty to preserve motion in the affected segment is not well documented, with few studies in the literature. The authors present their initial experience of analyzing clinical and radiological results in such patients who were treated with arthroplasty for new or persistent arm and/or neck symptoms related to neural compression due to adjacent-segment disease after anterior cervical discectomy and fusion (ACDF). METHODS During a 5-year period, 11 patients who had undergone ACDF anterior cervical discectomy and fusion (ACDF) and subsequently developed recurrent neck or arm pain related to adjacent-level cervical disc disease were treated with cervical arthroplasty at the authors' institution. A total of 15 devices were implanted (range of treated levels per patient: 1-3). Clinical evaluation was performed both before and after surgery, using a visual analog scale (VAS) for pain and the Neck Disability Index (NDI). Radiological outcomes were analyzed using pre- and postoperative flexion/extension lateral radiographs measuring Cobb angle (overall C2-7 sagittal alignment), functional spinal unit (FSU) angle, and range of motion (ROM). RESULTS There were no major perioperative complications or device-related failures. Statistically significant results, obtained in all cases, were reflected by an improvement in VAS scores for neck/arm pain and NDI scores for neck pain. Radiologically, statistically significant increases in the overall lordosis (as measured by Cobb angle) and ROM at the treated disc level were observed. Three patients were lost to follow-up within the first year after arthroplasty. In the remaining 8 cases, the duration of follow-up ranged from 1 to 3 years. None of these 8 patients required surgery for the same vertebral level during the follow

  17. 颈椎间盘置换治疗颈椎病的疗效观察%Efficacy evaluation of treating cervical spondylopathy with the Discover artificial cervical disc prosthesis

    Institute of Scientific and Technical Information of China (English)

    方礼明; 张亚军; 张军; 李勤

    2013-01-01

    Objective To explore the clinical and radiological outcomes of Discover artificial cervical disc arthroplasty and the range of motion status on adjacent segments for cervical spondylosis causing radiculopathy or myelopathy.Methods A total of 18 consecutive patients underwent cervical arthroplasty with the Discover artificial cervical disc at our hospital.Clinical and radiological follow-ups were conducted.Their radiographic parameters of treatment and adjacent segments were evaluated at Month 1,3,6,12,18 post-operation.And the Japanese Orthopedic Association (JOA) score,visual analog scale (VAS) pain score and Odom's scale were recorded and analyzed.Results During follow-ups over an average of 15 months,there was no occurrence of vascular injury,severe complications or prosthesis displacement and loosening.The score of JOA was 7.2 ± 1.8 at preoperation and 16.7 ± 4.5 at postoperation.And the score of VAS was 8.15 ± 1.65 at preoperation and 2.03 ± 1.12 at postoperation.Conclusion Discover artificial cervical disc arthroplasty is efficacious and the patients recover quickly.Targeted cervical segments may be stabilized and their physiological ranges of motion preserved.%目的 探讨颈椎人工间盘治疗脊髓型和神经根型颈椎病术后的临床效果.方法 2008年6月至2010年6月,武警北京市总队第二医院骨科18例保守治疗无效的颈椎病患者行DiscoverTM人工颈椎间盘置换术,术后按计划随访术后1、3、6、12、18个月,记录术前和术后每个时间点JOA评分,Odom分级及VAS评分.术前、术后3、6、12、18个月登记颈椎正侧及动力位X线片,分析评价椎间盘的位置.结果 18例患者均获得随访,平均随访15个月,术后未出现血管神经损伤,无严重并发症发生.术后患者未发现假体松动和移位.JOA评分从术前(7.2±1.8)分到术后(16.7±4.5)分,VAS评分从术前(8.4±1.4)分到术后(2.0±1.1)分,术后手术效果按照Odom分级都是优良结果,优16例,良2

  18. 单节段颈椎人工椎间盘置换术临床疗效探讨%Clinical study of single-level artificial cervical disc replacement for cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    戚正; 王利民; 谭洪宇; 王卫东

    2011-01-01

    Objective To investigate the curative effect of single-level artifical cervical disc arthroplasty. Methods Thirty-two patients with cervical spondylosis were treated with single-level artifical cervical disc replacement, At 6 weeks, 3, 6, 12 and 18 months after operation, the patients were followed up. The radiography of forward flexion, backward extension, and left and right lateral flexion were obtained atevery follow-up time. The stability of prosthesis, the range of motion status atoperated levelin Active C group were observed. Meanwhile, investigate all patients with complications by follow-up score. Results The incidence rates of early postoperative dysphagia,cervicodynia,brachialgia in the operation group decreased obviously(P<0.05).There was no significant difference in the motion range of adjancent segments before and after Active C replacement(P>0.05). Conclusions Single segment cervial artificial disc replacement can reduce complications in early stage. The adjacent segments postoperative is avoided in mid-term.%目的 探讨单节段颈椎人工椎间盘置换术临床疗效.方法 对我院32例患者经单节段颈椎人工椎间盘(ActivC型)置换术.术后6周、3个月、6个月、12个月、18个月复查拍摄颈椎前屈后伸动力位X线片,观察置换组假体稳定性.同时进行术后系列调查评分,对治疗结果进行回顾性分析.结果 手术组术后早期吞咽困难、颈痛、上肢疼痛等发生率明显降低(P<0.05).人工颈椎间盘置换组置换前后邻近节段活动范围差异无统计学意义(P>0.05).结论 单节段颈椎人工椎间盘置换术后早期并发症减少,中期能保护相邻节段退变.

  19. Research progress of mesenchymal stem cell therapy for regeneration of degenerated intervertebral discs%间充质干细胞治疗椎间盘退变的研究进展

    Institute of Scientific and Technical Information of China (English)

    毕松超; 杨建东; 冯新民; 陈涛; 黄泽楠; 张亮

    2016-01-01

    Intervertebral disc degeneration (IVD) represents the main cause of the low-back pain that affects the majority of the adult population, and causes major social and economic costs. Physical therapy and spinal fusion as the major treatment for IVD degeneration only can relieve symptoms, but can not reverse IVD degeneration. People had begun to pay attention to the number and functional recovery of intervertebral disc cells, to achieve the goal of reversing the degeneration of intervertebral disc. Adult mesenchymal stem cells (MSC) can be differentiated into nucleus pulposus like cells, which provide seed cells for the treatment of IVD. MSC and intervertebral disc cells co-culture technology also provides a feasible method. At present, the use of MSC for IVD degeneration is limited to pre-clinical research, and many problems need to be solved. For example, how to determine the phenotype of nucleus pulposus cells, how to avoid the leakage of stem cells and tumor formation.%下腰痛已严重影响了人们的工作和生活,带来了严重的经济负担和社会负担。下腰痛主要是由椎间盘退变性疾病引起,保守治疗和手术治疗是目前临床上治疗椎间盘退变的常用方法,但这些方法仅限于缓解症状,而无法从根本上扭转椎间盘退变。人们已经开始关注通过恢复椎间盘细胞的数量和功能,从而实现生物学修复椎间盘退变的目的。间充质干细胞可分化为髓核样细胞,这为利用干细胞治疗椎间盘退变提供了种子细胞。间充质干细胞与椎间盘细胞的共培养技术也为此提供了可行的方法。目前这种方法也仅限于临床前研究,还有许多问题需要解决,例如:如何确定髓核细胞表型、如何避免干细胞的渗漏和肿瘤形成等。

  20. Wear studies on ZrO2-filled PEEK as coating bearing materials for artificial cervical discs of Ti6Al4V.

    Science.gov (United States)

    Song, Jian; Liu, Yuhong; Liao, Zhenhua; Wang, Song; Tyagi, Rajnesh; Liu, Weiqiang

    2016-12-01

    Polyetheretherketone (PEEK) and its composite coatings are believed to be the potential candidates' bio-implant materials. However, these coatings have not yet been used on the surface of titanium-based orthopedics and joint products and very few investigations on the tribological characteristics could be found in the published literature till date. In this study, the wettabilities, composition and micro-hardness were characterized using contact angle measurement, scanning electron microscopy (SEM) and hardness tester. The tribological tests were conducted using a ball-on-disc contact pair under 25% newborn calf serum (NCS) lubricated condition. For comparison, bare Ti6Al4V was studied. The obtained results revealed that those PEEK/ZrO2 composite coatings could improve the tribological properties of Ti6Al4V significantly. Adhesive wear and mild abrasive wear might be the dominant wear and failure mechanisms for PEEK/ZrO2 composite coatings in NCS lubricated condition. After comprehensive evaluation in the present study, 5wt.% ZrO2 nanoparticles filled PEEK coating displayed the optimum tribological characteristics and could be taken as a potential candidate for the bearing material of artificial cervical disc.

  1. RESEARCH PROGRESS OF CELLULAR SENESCENCE AND SENESCENT SECRETARY PHENOTYPE IN INTERVERTEBRAL DISC DEGENERATION%细胞老化及老化表型改变在椎间盘退行性变中的研究进展

    Institute of Scientific and Technical Information of China (English)

    王锋; 郑陈静美; 吴小涛

    2012-01-01

    Objective To summarize the role of cellular senescence and senescent secretary phenotype in the intervertebral disc (IVD) degeneration. Methods Relevant articles that discussed the roles of cellular senescence in the IVD degeneration were extensively reviewed, and retrospective and comprehensive analysis was performed. The senescent phenomenon during IVD degeneration, senescent secretary phenotype of the disc cells, senescent pathways within the IVD microenvironment, as well as the anti-senescent approaches for IVD regeneration were systematically reviewed. Results During aging and degeneration, IVD cells gradually and/or prematurely undergo senescence by activating p53-p21-retinoblastoma (RB) or pl6INK4A-RB senescent pathways. The accumulation of senescent cells not only decreases the self-renewal ability of IVD, but also deteriorates the disc microenvironment by producing more inflammatory cytokines and matrix degrading enzymes. More specific senescent biomarkers are required to fully understand the phenotype change of senescent disc cells during IVD degeneration. Molecular analysis of the senescent disc cells and their intracellular signaling pathways are needed to get a safer and more efficient anti-senescence strategy for IVD regeneration. Conclusion Cellular senescence is an important mechanism by which IVD cells decrease viabil ity and degenerate biological behaviors, which provide a new thinking to understand the pathogenesis of IVD degeneration.%目的 综述细胞老化及老化表型改变在椎间盘退行性变中的研究进展. 方法 查阅椎间盘退行性变领域细胞老化相关的国内外文献并回顾分析,综述椎间盘细胞的老化现象、老化表型改变、老化信号激活与椎间盘退行性变的相互关系,评价抗老化治疗对椎间盘退行性变的修复作用. 结果 随着机体衰老与椎间盘退行性变,椎间盘细胞通过选择性地激活p53-p21-视网膜母细胞瘤(retinoblastoma,RB)或p16INK4A-RB信号

  2. 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

  3. Study of correlation between Schmorl’s node and degeneration of lumbar disc%许莫结节与腰椎间盘退变的相关性研究

    Institute of Scientific and Technical Information of China (English)

    刘璞

    2015-01-01

    Objective:To study the correlation between Schmorl’s node and degeneration of lumbar disc and evaluate the distribution of Schmorl’s node in patients with low back pain .Method:1115 patients with low back pain were divided into the Schmorl’s node group (284 cases) and the control group (731cases) .Demographic char‐acteristics and level of lumbar intervertebral disc degeneration of the two groups were compared .Results:Schmorl’ s node located in L1‐2 、L2‐3 、L3‐4 、L4‐5 、L5‐S1 according to the incidence rate;age of the Schmorl’s node group was sta‐tistically higher than that of the control group (P<0 .05) ,multivariate analysis showed that age was an independent risk factor for the occurrence of Schmorl’s node (P<0 .05);level of lumbar intervertebral disc degeneration of the Schmorl’s node group was statistically worse than that of the control group (P<0 .05);level of lumbar interverte‐bral disc degeneration in non‐acute phase intervertebral discs was statistically worse than those in non‐acute phase (P<0 .05) .Conclusion:There’s some relationship between Schmorl’s node and degeneration of lumbar disc ,but dee‐per relationship need more in‐depth case studies and long‐term follow‐up .%目的:探讨许莫结节与腰椎间盘退变的相关性及其在腰腿痛患者中的分布情况。方法:将1115例腰腿痛患者分为许莫结节组(284例)与对照组(731例)。比较两组的人口学特征及腰椎间盘的退变情况。结果:许莫结节发生率从高到低分布在L1‐2、L2‐3、L3‐4、L4‐5、L5‐S1;许莫结节组患者的平均年龄要显著高于对照组(P <0.05),进一步的多因素分析显示:年龄是许莫结节发生的独立危险因素(P <0.05);许莫结节组椎间盘的退变程度要显著高于对照组(P <0.05);许莫结节组非急性期椎间盘的退变程度要明显重于急性炎症水肿期( P<0.05)。结论:

  4. 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.

  5. 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.

  6. 人工颈椎间盘结构、材料及体外生物力学的研究进展*★%Research progresses of artificial cervical disc structure, material and in vitro biomechanics

    Institute of Scientific and Technical Information of China (English)

    蒲婷; 原芳; 廖振华; 刘伟强

    2013-01-01

      背景:人工颈椎间盘置换作为颈椎疾病治疗的全新方法,正逐渐得到临床广泛认可,其使用的植入器械——人工颈椎间盘还需更深入研发及验证。目的:综述了现有人工颈椎间盘产品的结构、材料及体外生物力学研究,并对未来发展状态进行展望。方法:以“artificial cervical disc,prothesis,structure,material,biomechanical study”为英文检索词检索Pubmed数据库,以“人工颈椎间盘,假体,结构,材料,生物力学”为检索词检索CNKI数据库,纳入人工颈椎间盘结构设计、材料设计及体外生物力学评估相关工作,主要整理近5年来有关研究,排除重复性工作,重点对36篇文献进行分析讨论。结果与结论:现有人工颈椎间盘产品主要采用金属-聚合物(MOP)结构,以半限制型和非限制型居多,尺寸系列已较完善,且全为进口产品。通过对现有产品进行分析与总结,提出人工颈椎间盘在新结构设计、面向种群设计和材料改进3个方向有重大发展空间,材料改进可以从终板材料、髓核材料、表面喷涂材料几方面考虑。%  BACKGROUND: Artificial cervical disc replacement has been widely used in clinical cervical surgery. Further research of biomechanics of the artificial cervical disc used in the surgery is needed. OBJECTIVE: To review the structure, material types and in vitro biomechanical study of the existed artificial cervical disc, and to prospect the development in the future. METHODS: The PubMed databases and CNKI database were searched with key words of “artificial cervical disc, prosthesis, structure, material, biomechanical study” in English and Chinese respectively. The articles related to artificial cervical disc structure, material, and in vitro biomechanics were included. The researches in the recent 5 years were col ected, and the repetitive studies were excluded. A total of 36

  7. The short-term efficacy of Prestige LP artificial disc single-level replacement for cervical spondylosis%Prestige LP人工椎间盘置换治疗单节段颈椎病的近期疗效

    Institute of Scientific and Technical Information of China (English)

    黄波; 卢一生; 施建东; 徐静芳; 刘振刚

    2014-01-01

    Objective To evaluate the short-term radiological and functional outcome of artifi-cial disc single-level replacement for cervical disc degenerative diseases. Methods 15 patients with cervical disc degenerative diseases underwent Prestige LP artificial disc replacement were se-lected in this study. There were 8 cases of cervical spondylotic myelopathy and 7 cases of nerve root cervical syndrome. The range of motion(ROM) of the cervical spine,ROM of treated segment and lordosis of cervical spine were reviewed respectively at preoperation and 1 month,3 months and 12 months postoperation,and the NDI scores,VAS for neck and arm pain were also reviewed respectively preoperation and the last follow-up. Results At an average of 16.3 months(range 6-24 months) follow-up,the neurologic symptom and sign in all cases had significant improvement. The NDI was significantly improved from(47.80±11.52)% to(16.20±9.34)%(P<0.05),the VAS for neck and arm pain were all significantly improved from(5.13±1.44) and (6.30±1.51) to (1.46±0. 81) and (1.14 ±0.57) respectively (P<0.05). The lordosis of cervical spine was significantly in-creased at follow up (P<0.05). The ROM of the cervical spine and ROM of treated segment re-covered to the preoperative level. There was no neurological complication during operation,and no ossification in the replaced level and no prosthesis displacement and loosening . Conclusion Our findings suggest that the Prestige LP cervical disc replacement in the treatment of cervical disc degenerative diseases has good functional short-term results, further follow-up is necessary to e-valuate mid- and long-term outcome.%目的:探讨应用Prestige LP人工椎间盘置换治疗单节段颈椎病的近期临床疗效。方法治疗单节段颈椎病患者15例,统计并分析患者术前和术后1、3、12个月随访时JOA评分、NDI脊髓功能评分、颈部及上肢疼痛VAS评分、置换节段活动度、颈椎运动范围、颈椎生理曲度等指标

  8. 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

  9. 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

  10. 颈椎动态稳定器治疗颈椎间盘突出症的早期临床疗效%Early clinical effects of dynamic cervical implant in treatment of cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    高延征; 司文腾; 余正红; 高坤; 陈书连; 张广泉

    2012-01-01

    目的 探讨应用颈椎动态稳定器(dynamic cervical implant,DCI)治疗颈椎间盘突出症的安全性及早期临床疗效.方法 2009年9月至2010年12月,应用颈前路DCI治疗31例颈椎间盘突出症患者,记录并统计分析手术时间和出血量;采用颈椎残障功能指数(neck disability index,NDI)、日本矫形外科协会(Japanese Orthopaedic Association,JOA)评分评价神经功能改善情况,评估患者手术前后的疼痛视觉模拟评分(visual analogue scale,VAS).在X线片上测量术前和末次随访时植入节段的运动范围、手术节段脊柱功能单位(functional spine unit,FSU)高度与上位椎体高度比值(H/h)等的差异.结果 31例患者的手术时间为(45±15) min,出血量为(100±30) ml.术后随访6~20个月,平均14个月.术前与末次随访时植入节段的运动范围(9.6°±4.2°vs.6.9°±5.3°,P>0.05)、H/h(2.6±0.1 vs.2.5±0.1,P>0.05)和FSU的角度(2.6°±5.2°vs.1.7°±2.9°,P>0.05)差异无统计学意义;而术前与末次随访时NDI(50.5±16.2vs.19.6±4.3,P< 0.05)、JOA评分(12.3±1.6 vs.13.9±1.8,P< 0.05)及颈痛VAS(6.3±2.6 vs.3.1±2.2,P<0.05)差异有统计学意义.结论 应用DCI非融合技术治疗颈椎间盘突出症,手术时间短,出血少,可以早期保留手术节段的运动功能,维持了椎间高度,早期临床效果满意.%Objective To investigate the safety and early clinical efficiency of dynamic cervical implant (DCI) internal fixation to treat cervical disc herniation.Methods From September 2009 to December 2010,31 patients with herniation of cervical disc underwent DCI implantation.The operation time and blood loss were recorded and analyzed.Neck disability index (NDI),Japanese Orthopaedic Association (JOA) score,and visual analogue scale (VAS) score were used to evaluate neurofunctional recovery pre- and post-operation.Routinely,the patients accepted X-ray examination preoperatively and postoperatively.We used White's measurement to

  11. PRELIMINARY CLINICAL STUDY ON ARTIFICIAL CERVICAL DISC REPLACEMENT BY Mobi-C PROSTHESIS%Mobi-C人工颈椎间盘临床应用初步报告

    Institute of Scientific and Technical Information of China (English)

    鲍达; 马远征; 陈兴; 李宏伟; 胡明; 高天君

    2011-01-01

    Objective To study the clinical application of Mobi-C prosthesis in treatment of anterior cervical discectomy and artificial disc replacement (ADR). Methods Between January 2009 and June 2009, 20 cases of degenerative cervical disease were treated with anterior discectomy and ADR by Mobi-C prosthesis, including 13 cases of cervical disc herniation and 7 cases of cervical spondylotic radiculopathy, and 25 Mobi-C prosthesis were implanted. There were 8 males and 12 females, aged 29-54 years (mean, 45.2 years). The disease duration was from 4 days to 5 years (mean, 1.2 years). Affected segments of process included C3, 4 in 1 case, C4, 5 in 2 cases, C5, 6 in 7 cases, C6,7 in 5 cases, C4, 5 and C5, 6 in 2 cases, and C5, 6 and C6, 7 in 3 cases. Radiographs were taken regularly, and cervical range of motion (ROM) on segments of disc replacements were measured. The functions of cervical spinal cord were evaluated by "40 score" system (COA) preoperatively, immediately postoperatively, and at follow-up. The quality of life was evaluated by neck disability index (NDI) and visual analogue scale (VAS) score. Results All incisions healed by first intention. No perioperative complication was found. All cases were followed up 16.5 months on average (range, 14-18 months). There was no significant difference in cervical ROM of operatied segment between preoperation and follow-up duration (t=0.808, P=0.440). No heterotopic ossification was found at follow-up. COA score at last follow-up (38.20 ± 1.14) was significantly higher than preoperative one (32.10 ± 2.96), (t=9.278, P=0.000), and the improvement rate at last follow-up was 77.2% ± 5.4%. VAS score at last follow-up (3.20 ± 1.23) had significant difference when compared with preoperative one (5.10 ± 1.29), (t=10.585, P=0.000). NDI score at last follow-up (29.40 ± 4.55) had significant difference when compared with preoperative one (39.20 ± 3.80), (t=16.039, P=0.000). Conclusion A satisfactory short-term curative effect

  12. The species-specific regenerative effects of notochordal cell-conditioned medium on chondrocyte-like cells derived from degenerated human intervertebral discs

    NARCIS (Netherlands)

    Bach, F C; de Vries, S A; Krouwels, A; Creemers, L B; Ito, K; Meij, B P; Tryfonidou, M A

    2015-01-01

    During intervertebral disc (IVD) maturation, the main cell type shifts from notochordal cells (NCs) to chondrocyte-like cells (CLCs). NCs secrete factors with regenerative potential, making them an interesting focus for regenerative treatments. During initial development, these strategies preferably

  13. The species-specific regenerative effects of notochordal cell-conditioned medium on chondrocyte-like cells derived from degenerated human intervertebral discs.

    NARCIS (Netherlands)

    Bach, FC; de Vries, S A H; Krouwels, A; Creemers, L B; Ito, K; Meij, B P; Tryfonidou, M A

    2015-01-01

    During intervertebral disc (IVD) maturation, the main cell type shifts from notochordal cells (NCs) to chondrocyte-like cells (CLCs). NCs secrete factors with regenerative potential, making them an interesting focus for regenerative treatments. During initial development, these strategies preferably

  14. 人工颈椎间盘置换术治疗脊髓型颈椎病的近期疗效%Short-term efficacy of Bryan cervical disc arthroplasty in patients with cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    梁英杰; 钟润泉; 郭东明; 温世锋

    2014-01-01

    目的:探讨Bryan人工颈椎间盘置换术治疗脊髓型颈椎病的近期疗效。方法应用Bryan人工颈椎间盘置换术治疗26例脊髓型颈椎病患者,在术前及末次随访时的颈椎X线片上测量置换节段矢状位、冠状位活动度。应用JOA评分评价术后神经功能。结果术后患者症状均明显缓解。26例均获随访,时间29~48个月。末次随访JOA评分由术前平均8.3分±4.6分增加到16.1分±5.3分,置换节段矢状位活动范围4.3°~7.2°(5.6°±2.4°);冠状位左右侧屈活动范围分别为3.1°~4.3°(3.8°±1.1°)和3.1°~4.6°(3.9°±0.9°)。随访期间假体无偏移松动或下沉,无置换节段假体周围异位骨化。结论 Bryan人工颈椎间盘置换术治疗脊髓型颈椎病近期临床效果较好,维持颈椎正常的活动范围、生理曲度和较好的生物力学稳定性。%Objective To discuss the short-term clinical and radiographic outcome of Bryan cervical disc arthroplas-ty.Methods Radiographic and clinical outcomes in 26 patients who received the Bryan cervical disc prosthesis were retrospectively reviewed.Static and dynamic X-ray was taken for measuring the range of motion.Clinical outcomes were assessed using Japanese Orthopedics Academy (JOA)scale.Results The average follow-up time was 29~48 months,and all patients were satisfied with the relief of symptoms.In the last follow-up,the average JOA scale was 16.1 ±5.3 ,while it was 8.3 ±4.6 pre-operation.The sagittal range of motion was 4.3°~7.2°(5.6°±2.4°),and the coronal range of motion was 3.1°~4.3°(3.8°±1.1°)and 3.1°~4.6°(3.9°±0.9°).No heterotopic ossifica-tion,prosthesis loosening,prosthesis migration or other complications occured.Conclusions Arthroplasty using the Bryan disc for cervical spondylotic myelopathy patients seems to be safe and provids encouraging clinical and radiolog-ic outcome in our short-term study.

  15. Meta - analysis of clinical trails for postoperative effect of cervical disc replacement versus anterior cervical discectomy and fusion%系统综述颈椎间盘置换与椎间融合的临床疗效

    Institute of Scientific and Technical Information of China (English)

    郑章; 贾长青; 梁峰; 付勤; 于云祥

    2011-01-01

    [Objective] To make an assessment of postoperative effects in patients who received cervical disc replacement compared with those who received anterior cervical discectomy and fusion (ACDF) . [ Methods ] We searched in Pubmed, Medline, EBSCO, Springer, Ovid, CNKI, Cochrane Library, foreign journals integrations system. We collected the randomized controlled trials (RCTs) from 1995 -2010 about cervical disc replacement versus anterior cervical discectomy and fusion (ACDF) . The methodological quality of the included RCTs were assessed, and the data were extracted by two reviewers independently according to the Cochrand Hand book. The homogeneous RCTs were pooled using RevMan software, and the non -homogeneous studies were evaluted using descriptive qualitative analysis. The evaluation of the postoperative effect included neck disability index ( NDI) , visual analog seal (VAS) , range of motion ( ROM) of the related leveL [ Results] Eight RCTs involving 1 734 patients met the inclusion criteria. The results of meta - analyses showed that the combined Weighted Mean Difference (WMD) ofNDIwas -7.82 (95% CI, -8.73- -6. 91) 2 years after operation, (P<0.05) . The combined WMD of NDI was - 5. 92 (95% CI, - 9. 89 ~ - 1. 94) 4 years after operation, (P < 0.05) .The combined WMD of ROM was 4. 93 (95% CI, 2. 08 -6. 71) 1 years after operation, (P <0. 05) .The combined WMD of ROM was 7. 26 (95% CI, 6. 82 ~ 7. 69) 2 years after operation, (P < 0. 05) .The combined WMD of the neck VAS was - 7. 56 (95% CI, - 14. 20 ~ - 0.92) 2 years after operation, (P <0. 05) . The combined WMD of the arm VAS was -5. 26 (95% CI, - 10. 01 - -0. 51) 2 yearsafter operation, ( P < 0. 05 ) . [ Conclusion ] Our results indicate that cervical disc replacement is superior than ACDF in maintaining the clinical effect (NDI) within 2 years and 4 years, the ROM within 1 year and 2 years, the pain relief of neek and arm (VAS) within 2 years after operation.%[目的]系统评价多节段颈椎间盘置换术

  16. Propionibacterium acnes, Coagulase-Negative Staphylococcus, and the “Biofilm-like” Intervertebral Disc

    Science.gov (United States)

    Coscia, Michael F.; Denys, Gerald A.; Wack, Matthew F.

    2016-01-01

    Study Design. Patients scheduled for spinal surgery were screened prospectively for a microbial presence associated with intervertebral disc specimens. Inclusion was limited to patients requiring surgery for any of five conditions: study patients with cervical spine intervertebral herniation (IVH), lumbar spine IVH, lumbar spine discogenic pain, and control patients with idiopathic scoliosis/Scheurermann's kyphosis or trauma/neuromuscular deformity. Exclusion criteria included ongoing systemic infection, abnormal pre-operative white cell counts, documented or suspected spinal infection, or previous surgery to the involved disc. Objective. The aim of this study was to test for an association between the presence of a bacterial entity in operated discs and a diagnosis of pathologic disc disease. Summary of Background Data. An association has been described between microbial colonization and progressive intervertebral disc degeneration in 36 herniation patients undergoing microdiscectomies. A total of 19 patients had positive cultures on long-term incubation, with Propionibacterium acnes present in 84% of discs. Materials and Methods. Discs were harvested during surgery, using strict sterile technique. Each disc was divided, with half the sample sealed in a sterile, commercially prepared anaerobic culture transport container, and half fixed in formalin. Live specimens were cultured for bacteria at a university-affiliated laboratory in a blinded fashion. Fixed pathologic specimens were gram-stained and read by a board-certified pathologist. Results. A total of 169 intervertebral discs from 87 patients were evaluated (46 males, 41 females). Positive cultures were noted in 76 of 169 discs (45%), with 34 discs positive for P. acnes and 30 discs positive for Staphylococcus. No pathologic evidence was seen of microorganisms, acute or chronic inflammation, or infection. Pooling the IVH and discogenic pain patients and contrasting them with control patients showed a

  17. Correlation of lumbar disc degeneration and spinal-pelvic sagittal balance%腰椎间盘退变与脊柱-骨盆矢状面平衡的相关性

    Institute of Scientific and Technical Information of China (English)

    刘辉; 希腊本大; 郑召民; 王建儒; 杨豪; 李泽民; 王太平; 王华; 乌扎布

    2013-01-01

    椎间盘退变程度有重要影响;L5/S1椎间盘退变程度对骨盆姿势性参数(PT、SS)有显著影响,L5/S1的退变是引起骨盆后旋机制参与代偿过程的重要因素;L5/Sl椎间盘退变对脊柱-骨盆整体参数(SVA、SPA、C7T)有重要影响,L5/S1的退变是引起躯干失衡的重要因素.%Objective To elucidate the relationship between spino-pelvic sagittal balance parameters and lumbar intervertebral disc degeneration of each segment through retrospective analysis in lumbar degeneration patients.Methods Retrospective analysis was conducted for the follow-up data in 126 patients with lumbar degenerative disease from July 2009 to June 2012.There were 38 cases with whole spine plates and 88 cases with lumbar plates.All of them received magnetic resonance imaging (MRI)scans.Through software Image J,the following spino-pelvic sagittal balance parameters were measured:sagittal vertical axis (SVA,distance between C7 plumb line and posterior upper corner of S1 endplate),thoracic kyphosis (TK,T5-T12 Cobb angle),thoracolumbar kyphosis (TLK,T10-L2 Cobb angle),lumbar lordosis (LL,L1-L5 Cobb angle),pelvic incidence (PI),pelvic tilt (PT),sacral slope (SS),T1 spinopelvic inclination (T1-SPI),T9 spino-pelvic inclination (T9-SPI),spino-sacral angle (SSA),spino-pelvic angle (SPA) and C7 tilt (C7T).Based on the grading system of Pfirrmann et al,the intervertebral disc degeneration grades were acquired for each lumbar segment.According to the normal range of previous studies,each spino-pelvic sagittal balance parameter was classified into 3 groups,i.e.Group A (less than normal),Group B (normal) and Group C (more than normal).All statistical analyses were performed to compare the differences of each lumbar segment/intervertebral disc degeneration among groups by one-way ANOVA test via SPSS 18.0.And P-value < 0.05 was deemed significant.Results PI had a significant impact on the L5/S1 disc degeneration.And L5/S1 disc degeneration had a significant

  18. Finite element analysis of cervical spine following artificial intervertebral disc replacement%颈椎人工椎间盘置换有限元分析

    Institute of Scientific and Technical Information of China (English)

    徐波; 金大地; 张美超

    2013-01-01

    Objective To establish a three-dimensional finite element model of cervical spine C4~5segment following PrestigeTM-LP artificial intervertebral disc replacement and analyze segmental motions.Methods The geometry of C4~5 vertebrae was reconstructed from computer tomography (CT) scan images of an adult male human fresh cervical spinal specimen.A FEM of C4~5 vertebrae and PrestigeTM-LP prosthesis was established and simulated clinical operation by using ANSYS10.0 system.Motions of flexion,extension,lateral bending and axial rotation were determined in physiological loading.Results Detailed geometries of vertebral bodies were modeled including ligaments,facet joints,and uncovertebral joints.Motions of flexion,extension,lateral bending,axial rotation are 5.7°,3.5°,5.0°,11.3°,respectively and conform with what have been reported in the literature.Conclusions The FEM possesses a high precision of geometries of vertebral bodies and biomechanical character.PrestigeTM-LP artificial disc prosthesis well preserves intervertebral segmental motion for cervical spine.%目的 建立C4~5节段PrestigeTM-LP颈椎人工椎间盘植入后的三维有限元模型,进行手术节段的运动分析.方法 采用对成年男性的新鲜尸体的颈椎标本进行CT三维扫描方法建立C4~5节段和PrestigeTM-LP人工间盘有限元,模拟完成C4~5人工椎间盘置换手术.测量生理加载下手术节段前屈/后伸、侧弯及轴向旋转运动角度.结果 有限元模型对颈椎的结构,包括椎体间韧带、颈椎关节突关节、钩椎关节等均进行了精确的重建,并较好地模拟手术操作进行PrestigeTM-LP人工间盘植入.运动加载后运动角度,前屈5.7°,后伸3.5°,侧弯5.0°,旋转11.3°,与文献报道结果较为接近.结论 有限元模型具有精确度高,手术模拟真实的特点,可作为颈椎人工椎间盘生物力学研究的一种较好途径.PrestigeTM-LP颈椎人工椎间盘置换可较好地保留手术节段的运动功能.

  19. 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

  20. 烟酰胺对压力诱发免腰椎间盘退变的保护作用%Protective effects of Niacinamide against axial loading induced degeneration of rabbit lumbar disc

    Institute of Scientific and Technical Information of China (English)

    周建国; 杨述华; 杨操; 邵增务; 徐蔚蔚; 郭兵; 俞旭东; 熊蠡茗

    2009-01-01

    的椎间盘恢复.%BACKGROUND:Recent studies have demonstrated that Niacinamide is capable of promoting the proliferation of intervertebral cells and improving intervertebral disc degeneration.Overloading is thought to the main cause of intervertebral disc degeneration.However,the protective effects of Niacinamide in loading induced intervertebral disc degeneration remains uncertain,OBJECTIVE:To investigate the protective effects of Niacinamide against axial loading induced degeneration of rabbit lumbar disc.DESIGN,TIME AND SETTING:A randomized controlled experiment was carded out in the Central Laboratory and the Laboratory of Department of Orthopaedics,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from November 2008 to April 2009.MATERIALS:Twenty-four Japanese white rabbits (4 months old,weighing 2.0 kg).Niacinamide was supplied by Tianjin Damao Chemical Reagent Factory.METHODS:Twenty-four Japanese white rabbits were randomly divided into 6 groups.The controllable axial loading induced rabbit lumbar disc degeneration model was adopted to impose 98N pressure on the rabbit discs to induce degeneration.Various doses of Niacinamide were given intragastrically to the rabbits in different groups:2 rabbits in group 1,the loading device was installed without pressing,and no Niacinamide was given;2 rabbits in group 2,given 50 mg/kg Niacinamide for 1 week;5 rabbits in group 3,loaded with 98N for 1 week;5 rabbits in group 4,loaded with 98N for 1 week,then the pressure was released for another week's recovery;5 rabbits in group 5,loaded with 98N and given 50 mg/kg Niacinamide for 1 week;5 rabbits in group 6,loaded with 98N for 1 week and then the pressure was released for another week's recovery,50 mg/kg Niacinamide was continually given during the 2 weeks.MAIN OUTCOME MEASURES:Magnetic resonance image and Thompson's grading system were used to assess degeneration degree of the discs;hematoxylin and eosin staining,immunohistochemical staining for type Ⅱ collagen

  1. Comparative study of artificial cervical disc replacement verus anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy%人工颈椎间盘置换与颈前路减压融合术治疗脊髓型颈椎病的对照研究

    Institute of Scientific and Technical Information of China (English)

    马晓勇; 陈涛平; 郭志学

    2012-01-01

    目的 比较人工颈椎间盘置换术与颈前路减压融合术治疗脊髓型颈椎病的疗效,评价其优缺点.方法 65例脊髓型颈椎病患者按照手术方式分为人工颈椎间盘置换术组(33例,行Bryan假体置换术)和颈前路减压融合术组(32例,行颈前路减压融合术).观察两组患者住院时间、术后颈部外固定时间以及术后恢复工作时间;两组患者于术前、术后3、6、12个月行日本矫形外科协会(JOA)评分,并行X线检测颈椎活动度(ROM);评价临床疗效及术后并发症.结果 人工颈椎间盘置换术组患者住院时间、术后颈部外固定时间以及术后恢复工作时间均显著短于颈前路减压融合术组(P < 0.01).两组术后12个月JOA评分均较术前明显提高(P < 0.05),两组差异无统计学意义(P > 0.05).人工颈椎间盘置换术组术后12个月单节段及双节段置换ROM较术前无显著改变(P > 0.05),颈前路减压融合术组术后12个月ROM较术前减小(P < 0.05或P < 0.01),且显著小于人工颈椎间盘置换术组(P < 0.05或P < 0.01).两组患者满意率无差异(P > 0.05).两组术后均无严重并发症发生.结论 人工颈椎间盘置换术治疗脊髓型颈椎病患者术后恢复快,住院时间短,颈部外固定时间短,使患者保持正常的颈椎活动度,临床疗效好,值得临床推广使用.%Objective To compare the efficacy of artificial cervical disc replacement verus anterior cervical discectomy and fusion (ACDF) in the treatment of cervical spondylotic myelopathy (CSM), and evaluate their advantages and disadvantages. Methods A total of 65 patients with CSM were divided into artificial cervical disc replacement group (33 patients) and ACDF group (32 patients). The hospital stay, postoperative cervical fixation time and postoperative time returning to work of the two groups were observed; the Japanese Orthopaedic Association (JOA) score and range of motion by X-ray before surgery, 3

  2. Histologic observation of intervertebral disc degeneration in lack-leptin mice%瘦素缺乏小鼠椎间盘退变的组织学观察

    Institute of Scientific and Technical Information of China (English)

    郭震; 李新锋; 戴力扬

    2012-01-01

    目的 探讨瘦素在椎间盘退变中的可能作用.方法 采用HE染色观察6月龄雄性ob/ob小鼠(瘦素缺乏小鼠)和野生型小鼠(C57BL小鼠)椎间盘的形态学;免疫组织化学检测Ⅱ型胶原、蛋白聚糖的表达;Real-time PCR检测Ⅱ型胶原、Ⅹ型胶原及蛋白聚糖的基因表达.结果 与野生型小鼠相比,ob/ob小鼠椎间盘HE染色表现为椎间盘组织的胶原结构紊乱、髓核碎裂、椎间盘高度降低,免疫组化检测显示Ⅱ型胶原、蛋白聚糖表达减少,Real-time PCR检测显示Ⅱ型胶原、蛋白聚糖基因表达下调而Ⅹ型胶原基因表达上调,差异有统计学意义(P<0.05).结论活体内瘦素缺乏可能加速小鼠椎间盘退变.%Objective To explore the possible role of leptin in intervertebral disc degeneration. Methods The interver-tebral discs of 6-month-old male ob/ob mice ( lack-leptin mice ) and wild type mice ( C57BL mice ) were histologically observed by HE staining. The expression of collagen II and aggrecan were detected by immunohistochemistry. And the gene expression of collagen II , collagen X and aggrecan were measured by Real-time PCR. Results HE staining results showed collagen disorders, fragmentation of nucleus pulposus, and decreased height of intervertebral disc in ob/ob mice. Compare with the wild type mice, there were decreased protein level of collagen II and aggrecan, downregulated mRNA expression of collagen II and aggrecan, and upregulated mRNA expression of collagen X in ob/ob mice. There was significant difference of the changes between wild type mice and ob/ob mice ( P<0.05 ). Conclusion In vivo, lack of leptin may accelerate intervertebral disc degeneration in mice.

  3. 腰椎间盘退变与COL9A2基因单核苷酸多态性的相关性%Correlation between lumbar disc degeneration and COL9A2 gene single nucleotide polymorphisms

    Institute of Scientific and Technical Information of China (English)

    陈涛; 黎观保; 梁科友; 贾世青

    2013-01-01

    BACKGROUND: Studies have shown that lumbar disc degeneration is closely related to genes. OBJECTIVE: To explore the relationship between COL9A2 gene single nucleotide polymorphisms (rsl2722877, rs3737820 and rs209914) and lumbar disc degeneration. METHODS: 280 patients with lumbar degenerative disc disease were selected, and 268 age- and sex-matched patients without lumbar degenerative disc disease were selected as control group. Al the patients came from Guangxi Zhuang Autonomous Region. The blood samples were col ected from the patients with lumbar degenerative disc disease and without lumbar degenerative disc disease to extract the genomic DNA and to design PCR primers and TaqMan probe for the rsl2722877 rs3737820 and rs209914 sites of COL9A2 gene. The al ele frequency and genotype frequency were analyzed with SPSS17.0 software. RESULTS AND CONCLUSION: The differences of genotype and the al ele frequency distribution of rsl2722877 rs3737820 and rs209914 sites were statistical y significant (P < 0.05). The COL9A2 gene single nucleotide polymorphisms rsl2722877, rs3737820 and rs209914 were closely related with susceptibility of lumbar degenerative disc disease in Guangxi Zhuang population.%  背景:有研究证实,腰椎间盘退变与基因有密切关系。目的:探讨 COL9A2基因单核苷酸多态性(rsl2722877、rs3737820和 rs209914)与腰椎间盘退变性疾病的关系。方法:腰椎间盘退变性疾病患者280例,年龄、性别匹配的268例非腰椎间盘退变性疾病患者作为正常对照组,均来自广西壮族。收集腰椎间盘退变性疾病患者、非腰椎间盘退变性疾病患者的血液样本,提取基因组 DNA,设计针对 COL9A2基因 rsl2722877、rs3737820和 rs209914位点的 PCR 引物、TaqMan 探针,利用 TaqMan 探针技术对 rsl2722877、rs3737820和 rs209914位点进行 PCR 荧光分型。采用 SPSS17.0软件进行等位基因频率及基因型频率分析。结果与结论:rsl2722877

  4. Mesenchymal stem cell regeneration of degenerated intervertebral discs:current status%间充质干细胞移植修复椎间盘退变的研究进展

    Institute of Scientific and Technical Information of China (English)

    王彦强; 张光武

    2014-01-01

    Low back pain, strongly associated with intervertebral disc (IVD) degeneration, affects a large proportion of the population and has major social and economic costs. Current first-line therapies for IVD degeneration such as physical therapy and spinal fusion address symptoms, but do not treat the underlying degeneration. As such, efforts are being directed towards development of therapies aimed at alleviating pain through the restoration of the IVD function. The use of tissue engineering to treat IVD degeneration provides an opportunity to correct the pathological process. Adult mesenchymal stem cells (MSCs), capable of differentiating down the discogenic lineage, have shown promise as a suitable cell source for IVD tissue engineering. However, the use of MSCs for IVD degeneration is still at the stage of preclinical and Phase 1 studies, a number of factors remain to be addressed, including understanding whether and how the MSCs survive and thrive in the hostile microenvironment of the degenerated IVD, identification of suitable biomaterials for cell implantation, and ensuring the safety of MSCs implantation.%下腰痛影响了不少人的生活和工作,造成沉重的社会、经济负担。下腰痛最主要的原因是椎间盘退变,目前临床上治疗椎间盘退变的方法有保守治疗和椎体融合等手术治疗,这些方法可以缓解症状但是不针对退变的原因。通过恢复椎间盘功能来缓解疼痛的方法受到人们关注,利用组织工程学方法逆转椎间盘退变已经实现。成体间充质干细胞可以分化为髓核样细胞为椎间盘组织工程提供了种子细胞。目前这种方法初步应用于临床前研究,但是许多问题有待进一步解决,例如间充质干细胞在宿主椎间盘中如何生存和增殖,移植过程中是否需要生物支架以及移植的安全性等。

  5. Cervical spine CT scan

    Science.gov (United States)

    ... defects of the cervical spine Bone problems Fracture Osteoarthritis Disc herniation Risks Risks of CT scans include: ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  6. 新型国产颈椎间盘实验山羊模型的建立及初步研究%Establishment of new home-made cervical disc experimental goat model and preliminary study

    Institute of Scientific and Technical Information of China (English)

    王逢贤; 徐林; 俞兴; 曹旭; 杨永栋

    2013-01-01

    Objective To observe the effect of new home-made cervical artificial disc system implantation goats,so as to provide a basis for further improvement and clinical applications.Methods 12 experimental goats were randomly divided into 2 groups:CDR group and control group.Neck 3/4 plate were removed in CDR group,replaced by home-made cervical disc prosthesis.The disc space height (DSH),intervertebral angle (ⅣA) and lordosis angle (LA) at this segment were observed by X ray preoperatively,and postoperatively,and analyzed statistically.Results All experiment goats survived after operation,without incision infection and paralysis,statistical comparison showed no significant difference between the 2 groups ofDSH,ⅣA and LA.Conclusion New home-made artificial cervical disc system is easy to operate,has less blood loss,shorter operative time,less complications and early recovery of movement,and maintaining postoperative disc space height and cervical lordosis.%目的 观察新型国产人工颈椎间盘系统植入山羊体内的效果,为其进一步改进和临床应用提供基础.方法 12只实验山羊随机分为2组,手术组摘除颈3/4间盘,行国产人工颈椎间盘植入术,对照组不手术.分不同时间点行颈椎正侧位X线检查,测量椎间隙高度、椎间角、前凸角,并进行统计学分析.结果 动物实验中所有山羊均成活,无切口感染及瘫痪,统计学比较显示,不同时间点的椎间隙高度、椎间角、前凸角无显著性差异.结论 新型国产人工颈椎间盘系统操作简便,手术中出血量少,手术时间短,术后动物并发症少,恢复活动早,术后较好的保持了椎间隙高度和生理曲度.

  7. The artificial disc: theory, design and materials.

    Science.gov (United States)

    Bao, Q B; McCullen, G M; Higham, P A; Dumbleton, J H; Yuan, H A

    1996-06-01

    Low back pain is one of the most common medical conditions in the Western world. Disc degeneration, an inevitable process of aging, of variable rate and degree, is one of the major causes of low back pain. Currently, there are two major surgical interventions for treating conditions related to the degenerative disc: discectomy and fusion. Although discectomy and fusion produce a relatively good short-term clinical result in relieving pain, both these surgical treatments alter the biomechanics of the spine, possibly leading to further degeneration of the surrounding tissues and the discs at adjacent levels. Over the past 35 years, a tremendous effort has been made to develop an artificial disc to replace the degenerated disc. The goal is the restoration of the natural biomechanics of the segment after disc excision, thus relieving pain and preventing further degeneration at adjacent segments. However, the artificial disc faces a complex biomechanical environment which makes replication of the biomechanics difficult and long-term survival challenging to designs and materials. The purpose of this article is to examine the factors of importance in designing a disc replacement. Topics covered include the structure and function of the natural disc, the changes that occur with disc degeneration and existing methods of treatment for the degenerative spine. The progress in achieving a functional, long-lasting disc replacement is outlined.

  8. Analysis of adjacent segment degeneration of patients with anterior cervical discectomy and fusion%颈椎前路减压植骨融合术后邻近节段退变情况分析

    Institute of Scientific and Technical Information of China (English)

    邓志龙; 张晓星; 王令; 李邦春

    2011-01-01

    目的 分析颈椎前路减压植骨融合术后融合椎体邻近节段退变的影响因素.方法 选取250例行颈椎前路减压植骨融合内固定手术治疗的患者作为研究对象,观察术后邻近节段退变的发生情况,对退变患者组与无退变患者组各项观察指标进行统计学比较.结果 共72例(75个节段)(28.8%)发生术后邻近节段退变,椎间盘退变程度按评分,1分48例,2分21例,3分3例;退变组术前D值(1.26±1.30)mm、术后D值(3.76±3.10)mm,明显小于无退变组的(1.90±1.30)mm与(5.85±3.04)mm(P0.05).结论 颈椎前路减压植骨融合术后融合椎体邻近节段退变发生率较高;颈椎前凸程度较小、且手术对颈椎前凸程度改善较小是导致邻近节段退变发生的重要影响因素.%Objective To analyze the influeneing factors of adjacent segment degeneration of patients with anterior cervical discectolny and fusion. Methods Totally 250 cases of anterior cervical discectolny and fusion were selected for study. The incidence of adjacent segment degeneration was observed and the indexes of degeneration group and non-degeneration group were compared statistically. Results There were 72 cases (75 segment) of adjacent segment degeneration( 28.8% ) ,including 48 cases of degradation score of 1, 21 cases of degradation score of 2,3 cases of degradation score of 3. The preoperative D value of degradation group was ( 1.26 ± 1.30 ) mm, while ( 3.76 + 3.10) mm after operation, indicating significantly lower than that of non-degradation group ( P < 0.05 ).The postoperative D value of degradation group increased by ( 2.5 + 3.21 ) mm,notably lower than that of non-degradation group (3.95 ± 3.13) mm ( P < 0.05 ) . The age, gender distribution, JOA score and Cobb' s angle of the two groups had no statistical difference( P < 0.05). Conclusion The incident rate of adjacent segment degeneration in patients with anterior cervical diseectolny and fusion is high. The small degree of

  9. 胸腰段陈旧性压缩性骨折患者椎体变形与相邻椎间盘退变的相关性%Correlation of vertebral body deformity and adjacent disc degeneration in patients with old thoracolumbar compression fractures

    Institute of Scientific and Technical Information of China (English)

    崔运能; 李绍林; 赵银霞; 岑黄

    2015-01-01

    Objective To assess the correlation between vertebral body deformity and degeneration of the adjacent intervertebral discs in patients with old thoracolumbar compression fractures. Methods Seventy-one patients who had been conservatively treated after single segment thoracolumbar compression fractures between April, 2011 and May, 2014 were enrolled in this study. Both radiographic and magnetic resonance (MR) images of the thoracolumbar segment were obtained. The involved vertebral body deformity was rated on radiography according to the Genant criterion, and the degeneration of the adjacent cephalic and caudal discs was assessed on MR images using the Oner and Pfirrmann classification schemes, respectively. The relationship between vertebral body deformity and adjacent disc changes was assessed using correlation analysis, and the changes in the adjacent cranial and caudal discs was compared. Results The Genant classification of the involved vertebral bodies was moderately correlated with Oner morphological scores (r=0.48, P0.05). The Oner classification of the adjacent cephalic discs was higher than that of the adjacent caudal discs (P0.05),变形椎体相邻头侧的椎间盘Oner分度较相邻尾侧椎间盘高(P0.05)。结论胸腰段椎体压缩性骨折主要影响相邻头侧椎间盘的形态,两者严重程度相一致,而相邻尾侧椎间盘不受影响。

  10. 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.)

  11. Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers

    OpenAIRE

    2009-01-01

    There have been few studies that investigated and clarified the relationships between progression of degenerative changes and sagittal alignment of the cervical spine. The objective of the study was to longitudinally evaluate the relationships among progression of degenerative changes of the cervical spine with age, the development of clinical symptoms and sagittal alignment of the cervical spine in healthy subjects. Out of 497 symptom-free volunteers who underwent MRI and plain radiography o...

  12. 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.

  13. 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

  14. Rehabilitation nursing of 37 patients with dynamic cervical implant for the treatment of cervical disc herniation%37例颈椎间盘突出症患者行颈椎动态稳定器治疗的康复护理

    Institute of Scientific and Technical Information of China (English)

    张俊娟; 王俊杰; 范丽娟; 田慧; 高坤; 翟艺恒

    2012-01-01

    This paper summarizes the rehabilitation nursing of 37 patients with dynamic cervical implant(DCI) for the treatment of cervical disc herniation. Perioperative sternocleidomastoid and trapezius muscles isometric contraction exercises could enhance the neck or back muscle strength, maintain cervical stability, restore and enhance the range of motion of the cervical spine. The patients could participate in early training without neck collars. The JOA score increased significantly at 14 months after operation and the cervical rigid sense was lower than traditional fusion surgery.%总结了37例颈椎动态稳定器治疗颈椎间盘突出症患者围手术期的康复护理.认为围手期胸锁乳突肌和斜方肌的等长等张收缩训练可增强颈背部肌肉力量,保持颈椎的稳定性,恢复及增进颈椎的活动范围.本组患者术后不用佩戴颈托即可早期训练,平均随访14个月,根据日本骨科学会评分标准,本组改善率均为优良,颈椎僵硬感较传统融合手术轻.

  15. Burned-out discs stop hurting: fact or fiction?

    DEFF Research Database (Denmark)

    Bendix, Tom; Kjaer, Per; Korsholm, Lars

    2008-01-01

    ). The risk for LBP during the past year attributed to black discs was 11%. CONCLUSION: The data could not support the hypothesis that severely degenerated discs are "burned out" and become less painful. People with black discs had a higher prevalence of LBP compared to those with grey or normal discs...

  16. Functional evaluation of the cervical spine after Bryan artificial disc replacement%Bryan人工颈椎间盘置换对颈椎功能影响的临床分析

    Institute of Scientific and Technical Information of China (English)

    田伟; 刘波; 李勤; 胡临; 李志宇; 袁强; 韩骁

    2008-01-01

    Objective To assess the effect of Bryan cervical disc replacement on the function of the cervical spine.Methods Bryan cervical artificial disc replacement was performed in 164 cases from Dec 2003 to Aug 2007,and all the cases were retrospectively followed up.Among them,1 disc replacement was done in 132 cases,2 discs in 28 cases and 3 discs in 4 eases with a total number of 200 artificial discs. There were 102 male patients and 62 female patients.Their age ranged from 25 to 70 years old(with an average of 47 years old).All the cases were operated according to the standard procedure for Bryan artificial disc replacement,and immobilized in a cervical collar for 2 weeks after operation.Motion of the replaced disc in sagittal direction,JOA score and satisfaction rate of the patients were followed up and evaluated.Results In this group,no acute complications happened during the operation.All patients returned to work 4 to 6 weeks after operation.The postoperative ameliorate rate of JOA score was 56%. Range of motion in sagittal direction of the operated disc was 14.4 degrees before operation,decreased to 5.7 degrees at 1 week after operation,but improved to 14.7 degrees at the time of final follow-up and was not significantly different from preoperative range.Motion in the upper adjacent disc to the replacement level was 10.9 degrees before operation,decreased to 5.5 degrees at 1 week after operation,and improved to 8.2 degees at the time of final follow-up but was significantly smaller than preoperative range.The satisfaction rate of the patients was 94%.Loosening of the prosthesis happened in 1 case 6 months after operation but remained stable afterwards.Subsidence up to 1 mm occurred in another case 7 months after operation but also remained stable afterwards.Automatic posterior union occurred in 3 cases in which relative small size artificial discs were implanted.Conclusions The clinical outcome of Bryan artificial disc replacement was quite

  17. Treatment of intervertebral disc degeneration by bone marrow mesenchymal stem cell transplantation%骨髓间充质干细胞治疗椎间盘退变的研究进展

    Institute of Scientific and Technical Information of China (English)

    赵泽; 张洋; 王娟; 陈长青

    2015-01-01

    Objective To review the research and progress of treating intervertebral disc degeneration ( IDD) by using BMSCs transplantation, and provide theoretical basis for further basic researches. Methods CNKI database and ISI Web of Knowledge database from 2000 to 2014 were retrieved by the first author with the key words of " bone marrow mesenchymal stem cells (BMSCs), cell therapy, intervertebral disc degeneration ( IDD )" in Chinese and in English, respectively. The biological characteristics and cultivation of BMSCs, the influence factors of BMSCs differentiate into intervertebral disc cells and cell therapy for IDD by BMSCs transplantation in vivo were summarized. Results We can obtain enough amount of BMSCs. BMSCs has low immunogenicity and good differentiation potential, and these make BMSCs a very good seed cell source for cell therapy of IDD. Under the condition of improving the micro environment of IDD, or a special support material system for cell cultivation, or the induction of cytokines, or co-cultured with intervertebral disc cell, BMSCs can differentiate into nucleus pulposus cells, express proteoglycan and collagen-Ⅱ. Whether autograft or allograft, even heterogeneous, BMSCs can survive and propagate in degenerative intervertebral disc for long-term, promote the secretion of intervertebral disc cells matrix. Conclusions As the study of BMSCs and cellular therapy, a lot of work has been done on treating IDD by using BMSCs transplantation and we have made some achievements. Although using BMSCs transplantation in the treatment of IDD also shows huge application prospect, there are still many problems need to be solved before applying it in clinical treatment.%目的:总结骨髓间充质干细胞(BMSCs)治疗椎间盘退变(IDD)的相关研究成果,为BMSCs 治疗 IDD 的临床应用提供理论基础。方法计算机检索 CNKI 数据库和 ISI Web of Knowledge数据库,限定时间为2000—2014年,中英文检索词分别为“骨髓间充质干

  18. A Combined Therapy for Cervical Spondylopathy

    Institute of Scientific and Technical Information of China (English)

    李佳

    2004-01-01

    @@ Cervical spondylopathy is a common disease frequently encountered in the middle-aged and old people. It is a consequence of degeneration, strain or deformation of the physiological curvature of the cervical vertebral body.

  19. 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

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

    Science.gov (United States)

    Dennison, Christopher R.; Wild, Peter M.; Wilson, David R.; Cripton, Peter A.

    2008-08-01

    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. 移植骨髓间充质干细胞对兔退变椎间盘髓核细胞凋亡的影响%Effects of mesenchymal stem cells transplantation on the apoptosis after rabbit intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    樊守刚; 吴小涛; 王运涛; 庄苏阳; 李果

    2010-01-01

    Objective To investigate the effects of the mesenchymal stem cells (MSCs) transplantation on the apoptosis of nucleus pulposus cells after rabbit intervertebral disc degeneration. Methods New Zealand white rabbits were used to stimulate allograft. Harvested rabbit MSCs and fibroblasts were cultured , proliferated and labeled in vitro. At the same time, degenerated intervertebral disc models were set up using 21-gauge needle to puncture the annulus. Four weeks later, 2 X 106 MSCs and fibroblasts were injected into the respective disc segments. After 1,2,4 and 8 weeks, specimens from degenerated models were obtained in order. The number of apoptotic nucleus pulposus cells and the expression of Caspase-3 were detected under laser scanning confocal microscopy in every disc from the experimental group and the control groups of the rabbits. The bcl-2 and bax mRNA expression of all discs was assayed by real time reverse transcription-polymerase chain reaction (RT-PCR). Results The transmission electron microscopy revealed that part of the nucleus pulposus cells became apoptosis in the initial stage in ultramicrostructure. Apoptosis rate was (16.75 ±2. 14)% and (31. 87 ±4. 16)% in the experimental group and the degenerated group, as well as Caspase-3 expression ratio was (20. 34 ± 1. 03)% and (31. 50 ±3. 78)% respectively , demonstrating that MSCs could relieve apoptosis after rabbit intervertebral disc degeneration. The levels of bcl-2 mRNA expression in experimental group were higher than in the degenerated group (P0.05).MSCs移植治疗组细胞凋亡率和Caspase-3表达率均高于正常组[细胞凋亡率分别为(16.75±2.14)%和(6.86±1.08)%;Caspase-3表达率分别为[(20.34±1.03)%和(6.09±0.77)%](P<0.05),低于退变组和SFs移植对照组[细胞凋亡率分别为(31.87±4.16)%和(29.02±2.16)%;Caspase-3表达率分别为(31.50±3.78)%和(30.20±4.93)%](P<0.05).结论 髓核细胞凋亡在椎间盘退变过程中起重要作用.MSCs移植能有效抑制

  2. 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.

  3. 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.

  4. Artificial cervical disc prosthesis and zero-profile interbody fixation and fusion system for cervical disease:2-year follow-up%人工颈椎间盘假体联合零切迹椎间融合内固定系统置入治疗颈椎病:2年随访

    Institute of Scientific and Technical Information of China (English)

    董振宇; 楚戈; 黄异飞; 袁凤云

    2015-01-01

    BACKGROUND:Artificial cervical disc prosthesis simulates range of motion and buffer shock function of normal intervertebral discs. Clinical experiments verify that artificial cervical disc prosthesis material has good biocompatibility and mechanical characteristics. OBJECTIVE:To evaluate artificial cervical disc replacement and zero-profile interbody fixation and fusion system for multilevel cervical disease in 2-year folow-up. METHODS:Artificial cervical disc replacement and zero-profile interbody fixation and fusion system were used to treat 42 patients with multilevel cervical disease. The patient presented typical symptoms and signs of spinal cord or nerve root compression. There were 18 cases of cervical myelopathy, 15 cases of nerve root cervical spondylosis and 10 cases of mixed type of cervical spondylosis. After treatment, mean operation time, blood loss and reoperation rate were measured. Postoperative complications, disability index of neck function, visual analog scale, function unit range of corresponding surgery segments of the cervical spine, Cobb angle of C2-C7 vertebral body, range of motion of adjacent segment of proximal and distal vertebral bodies were observed and clinical outcomes were evaluated. RESULTS AND CONCLUSION: Al cases finished the operation and were scored at various time points. After treatment, radiating pain of shoulder and neck and upper extremity were remarkably lessened. Numbness and sensory loss symptoms disappeared obviously. Quality of life elevated noticeably. Visual analog scale and the disability index of neck function score were decreased in final folow-up compared with pre-treatment (P < 0.001). C2-C7 vertebrae Cobb angle, FSU angle, range of motion of proximal surgery adjacent segment and range of motion of the distal surgery adjacent segment were elevated compared with pre-treatment (P < 0.001). These data indicate that cervical spondylosis was improved after treatment. Each index of cervical spondylosis after

  5. Adjacent segment degeneration after anterior cervical discectomy and fusion follow-up%颈椎前路融合术后邻近节段退变情况的研究

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      目的通过观察分析前路颈椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF)术后随访患者的影像学资料,探讨邻近节段病变的发生时间和发生率。方法分析2008年以来本科收治的94例施行 ACDF 手术并获得完整随访的患者,其中男性51例,女性43例;年龄28~70岁,平均50.5岁。融合节段:单节段42例,上节段30例,三节段22例。术前均常规行颈椎正、侧位 X 线、MRI 检查。术后评定患者神经功能恢复情况,根据 Kellgren 分级标准对临近节段颈椎间盘退变情况进行 X 线评价。结果94例患者随访时间12~45个月,平均随访时间为29.1月。术后患者神经功能改善明显,JOA 评分较术前提高5.8,改善率为64.3%,有效率为100%。临近节段颈椎间盘退变情况的 X 线评估显示,有19例发生临近节段的退变,其中12例有轻度退变表现,7例出现较严重退变表现,邻近节段退变发生率为20.2%。退变发生时间为术后5~40个月,平均为18.7±4.79个月。结论 ACDF 治疗颈椎间盘退行性疾病有良好的疗效,术后邻近节段发生退变时间为18.7±4.79月,随访29.1个月邻近节段退变发生率为20.2%。%Objective To study the clinical efficacy of anterior cervical discectomy and fusion(ACDF) for cervical spondylosis , also the rate and occurrence time of adjacent segment degeneration.Methods 94 cases (male: 51, female: 43, average age: 50.5, ranging from 28 to 70)of cervical spondylosis admitted to our department since 2008 were analyzed in this study.42 patients were performed with single-level ACDF, 30 patients with double-level ACDF,and 22 patients with three-level ACDF. The cervical anterior-posterior and lateral X-ray and MRI examination were performed before the operation.Neurological functional recovery was assessed after operation. X -ray was used to evaluate the degree of adjacent segment degeneration according to

  6. 颈椎病的MRI诊断价值%MRI diagnostic value of cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    袁忠武

    2013-01-01

    objective:to explore the value of MRI in the diagnosis of cervical spondylosis. Methods:more than 30, 180 cases of cervical spondylosis, which was confirmed by clinical diagnosis, image were retrospectively analyzed. Results:68 patients with cervical curvature change, vertebra smal joint bone hyperplasia, 180 cases of vertebral bodies, 21 cases, vertebral body bone marrow degeneration of intervertebral disc degeneration 357 intervertebral disc, disc herniation, 357 disc, longitudinal ligament hypertrophy or ossification after 49 cases, compression of the dural sac and spinal cord of al cases of intervertebral foramen change in 27 cases, cervical vertebra slippage 36 cases, 180 cases of cervical stenosis. Conclusion:MRI examination of cervical spondylosis has positive performance characteristic, and the diagnosis of cervical spondylosis and classification has a very high value, is the most ideal means of examination in the diagnosis of cervical spondylosis, for clinical treatment and prognosis judgment is of great significance.%目的:探讨MRI对颈椎病的诊断价值。方法:对30岁以上180例经临床确诊、影像证实的颈椎病进行回顾性分析。结果:颈椎曲度改变68例,椎体、椎小关节骨质增生180例,椎体内骨髓变性21例,椎间盘变性357个椎间盘,椎间盘突出357个椎间盘,后纵韧带肥厚或骨化49例,硬膜囊及脊髓受压占全部病例,椎间孔改变27例,颈椎滑脱36例,椎管狭窄180例。结论:颈椎病作MRI检查具有特征性阳性表现,对明确诊断具有极高的价值,是目前最理想的检查手段,对临床治疗及预后的判断具有重大意义。

  7. 动力位MRI对颈椎椎间盘突出症的诊断价值%The value of kinematic magnetic resonance imaging in diagnosis of cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    劳立峰; 钟贵彬; 李新锋; 刘祖德

    2013-01-01

    目的:评估过屈位和过伸位核MRI对颈椎椎间盘突出症的诊断价值。方法对50例患者进行中立位、过屈位和过伸位颈椎MRI检查。利用计算机软件对各个节段颈椎间盘突出程度进行客观测量评估。结果在过伸位上,各节段颈椎椎间盘突出同中立位相比均有显著性增加(t=2.05~5.05,P<0.05)。在中立位正常或椎间盘突出<3 mm,2.21%患者在过屈位椎间盘突出进展到>3 mm,16.54%患者在过伸位椎间盘突出进展到>3 mm。在中立位椎间盘突出>3 mm且<5 mm,3.57%患者在过屈位椎间盘突出进展到>5 mm,10.71%患者在过伸位椎间盘突出进展到>5 mm。结论与中立位相比,动力位 MRI 上颈椎椎间盘突出更加明显。动力位MRI对颈椎间盘突出症的评估有其独特价值,尤其是对那些有神经根症状而普通MRI无异常发现的患者。%Objective To determine if adding flexion and extension MRI studies to the traditional neutral views would be beneficial in the diagnosis of cervical disc herniations. Methods Fifty patients underwent MRI in neutral, flexional and extensional positions. The images were analyzed using computer software to objectively quantify the amount of disc herniation. Results Compared to neutral position, cervical disc herniations were significantly increased in extension MRI (P<0.05). For patients with normal or 3 mm of disc bulge in neutral, 2.21%demonstrated an increase in herniation to 3 mm bulge in flexion, and 16.54%demonstrated an increase to 3 mm bulge in extension. For patients in the neutral view that had a baseline disc bulge of 3 to 5 mm, 3.57%had increased herniations to 5mm in flexion and 10.71%had increased herniations to 5 mm in extension. Conclusion A significant increase in the degree of cervical disc herniation is found by examining flexion and extension views when compared with neutral views alone. Kinematic MRI views provide valuable added information

  8. Retrospective analysis of multi-level cervical artificial disc replacement compared with nearby segments fused for multi-level disc hernations%人工椎间盘置换与颈前路融合治疗多节段颈椎病回顾性分析

    Institute of Scientific and Technical Information of China (English)

    王衡; 刘英杰; 常江; 张锴; 朱卉敏

    2015-01-01

    目的 对比总结多节段颈椎间盘突出症患者分别实施人工椎间盘置换和颈前路融合固定的效果分析,判断人工椎间盘置换术后效果.方法 自2005年7月对16例多节段颈椎间盘突出患者进行了前路椎间盘切除、Bryan人工椎间盘置换术(A组),观察手术前后VAS评分及颈椎活动度变化,并与同期所做的多节段颈前路融合内固定23例患者(B组)相对照.结果 两组患者术后各时间点疼痛缓解、VAS评分较术前有明显提高(P<0.05),术后两组VAS评分比较差异未见统计学意义(P>0.05).术后12个月及2年时两组间整体活动度比较差异有统计学意义(P<0.05),A组人工椎间盘置换节段术后2年活动度与术前比较差异未见统计学意义(P>0.05).A组末次随访时较术后3d时显著增加(P<0.05);B组术后各时间点比较差异未见统计学意义(P>0.05).结论 人工椎间盘置换治疗多节段颈椎间盘突出症临床效果较好,术后对手术节段的活动度影响较小,是一种解决颈椎活动性与稳定性矛盾的较好的方法.%Objective To evaluate the therapeutic effects of the multi-level cervical artificial disc replacements compared with the anterial cervical artificial fusion on the multi-level disc fusion and to investigate their effect after the treatment.Methods The patient with discectomy underwent cervical artificial disc replacements (group A) in the C3-7 intervertebral discs from July.2005.The VAS score and the range of motion(ROM) of two groups was observed perioperatively.Results The patient could move his neck in all directions without pain.The spinal and neural symptoms were significantly alleviated,and there were obviously elevation in VAS score in each time point (P < 0.05),and there was no significant difference in VAS score between the two groups (P < 0.05).There were significant differences in the range of motion(ROM) of two groups according to the follow-up for 12 month and 2

  9. Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers.

    Science.gov (United States)

    Okada, Eijiro; Matsumoto, Morio; Ichihara, Daisuke; Chiba, Kazuhiro; Toyama, Yoshiaki; Fujiwara, Hirokazu; Momoshima, Suketaka; Nishiwaki, Yuji; Hashimoto, Takeshi; Ogawa, Jun; Watanabe, Masahiko; Takahata, Takeshi

    2009-11-01

    There have been few studies that investigated and clarified the relationships between progression of degenerative changes and sagittal alignment of the cervical spine. The objective of the study was to longitudinally evaluate the relationships among progression of degenerative changes of the cervical spine with age, the development of clinical symptoms and sagittal alignment of the cervical spine in healthy subjects. Out of 497 symptom-free volunteers who underwent MRI and plain radiography of the cervical spine between 1994 and 1996, 113 subjects (45 males and 68 females) who responded to our contacts were enrolled. All subjects underwent another MRI at an average of 11.3 years after the initial study. Their mean age at the time of the initial imaging was 36.6 +/- 14.5 years (11-65 years). The items evaluated on MRI were (1) decrease in signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk space narrowing. Each item was evaluated using a numerical grading system. The subjects were divided into four groups according to the age and sagittal alignment of the cervical spine, i.e., subjects under or over the age of 40 years, and subjects with the lordosis or non-lordosis type of sagittal alignment of the cervical spine. During the 10-year period, progression of decrease in signal intensity of the disk, posterior disk protrusion, and disk space narrowing were recognized in 64.6, 65.5, and 28.3% of the subjects, respectively. Progression of posterior disk protrusion was significantly more frequent in subjects over 40 years of age with non-lordosis type of sagittal alignment. Logistic regression analysis revealed that stiff shoulder was closely correlated with females (P = 0.001), and that numbness of the upper extremity was closely correlated with age (P = 0.030) and male (P = 0.038). However, no significant correlation between the sagittal alignment of the cervical spine and clinical symptoms was detected. Sagittal alignment of the

  10. 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.

  11. 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.

  12. 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.

  13. Clinical observation of heterotopic ossification after Discover cervical disc replacement%Discover人工颈椎间盘置换术后异位骨化的临床研究

    Institute of Scientific and Technical Information of China (English)

    梁英杰; 张光明; 温世锋; 郭东明; 徐中和; 刘恩志; 钟润泉; 肖文德; 尹庆水

    2015-01-01

    Objective To analyze the cause of heterotopic ossification of Discover artificial cervical disc replacement in the treatment of cervical vertebra disease and to explore preventive countermeasures. Methods We retrospectively reviewed radiographic and clinical outcomes in 23 patients who received the Discover cervical disc prosthesis. Static and dynamic X ray was taken for measurement of the range of motion. Replacement segment was assessed for heterotopic ossifications at the latest follow-up according to McAfee classification method. Results 23 patients were followed up for 27~36 months. In the last follow-up, the average sagittal range of motion was 5.5°±2.2°,and the average coronal range of motion was 3.4°±1.2° and 3.6°±0.8°. A total of 5 patientsdemonstrated the prosthesis replacement segmental heterotopic ossification at the last follow-up, the incidence being 21.7%. Conclusions heterotopic ossification can occur after DISCOVER artificial cervical disc replacement in the treatment of cervical spondylosis; the incidence is consistent with the literature report; the surgeon should try consciously to prevent the occurrence of heterotopic ossification in order to avoid the loss of the mobility of the replacement segment.%目的:分析Discover人工颈椎间盘置换术治疗颈椎病的异位骨化形成原因及防治对策。方法回顾性分析23例应用Discover人工颈椎间盘置换术治疗的颈椎病患者。在术前、术后1周及末次随访时的颈椎X线片上测量置换节段矢状位、冠状位活动度,并根据McAfee分级法判断末次随访时置换节段的异位骨化情况。结果术后患者23例患者均获随访,时间27~36个月。末次随访置换节段矢状位活动范围(5.5±2.2)°;冠状位左右侧屈活动范围分别为(3.4±1.2)°和(3.6±0.8)°。共有5例患者在末次随访时出现置换节段假体周围异位骨化,发生率21.7%。结论 DISCOVER人工颈椎间盘置换术治疗

  14. NURSING FOR PATIENTS RECEIVING OZONE NUCLEOPLASTY IN TREATING CERVICAL DISC HERNIATION%三氧髓核消融术治疗颈椎间盘突出的临床护理

    Institute of Scientific and Technical Information of China (English)

    赵莉华

    2016-01-01

    Objective To explore the nursing for patients receiving ozone nucleoplasty in treating cervical disc herniation .Methods 60 cases of cervical disc herni‐ation received ozone nucleoplasty and careful periopera‐tive clinical care .Results No complications occurred ,and the 3‐12 months of follow‐up surveys found that the total effective rate was 97% .Conclusion Full preoperative preparation ,intra‐operative coordination and postoperative rehabilitation as well as mental care can produce good effect on operation .%目的:探讨颈椎间盘突出患者三氧髓核消融术治疗的临床护理效果。方法对60例颈椎间盘突出患者在C臂可视导向下,将不同浓度的高科技医用三氧消融剂用专业注射针注射到病变突出处,使髓核体积缩小回纳到纤维环里面,并给予精心的围手术期护理。结果无一例并发症发生,随访3~12个月,总有效率达97%。结论做好术前准备,术中配合,术后康复训练及心理护理,对手术成功有重要意义。

  15. Radiation from optically thin accretion discs

    Energy Technology Data Exchange (ETDEWEB)

    Tylenda, R. (Polska Akademia Nauk, Torun. Pracownia Astrofizyki)

    1981-01-01

    Accretion discs in cataclysmic variables with low rates of mass transfer, M < or approx. 10/sup 16/g s/sup -1/, have outer regions optically thin in continuum. A simple approach that allows one to calculate the radiation spectra from such discs is presented. A great number of disc models has been obtained in order to study the influence of various parameters (accretion rate, outer radius of the disc, inclination angle, mass of the accreting degenerate dwarf, viscosity parameter) of discs on the outgoing continuous spectra, emission lines and the UBV colours.

  16. 颈椎人工椎间盘置换与颈前路减压融合术术后轴性症状的分析%The analysis of neck axial symptoms analysis after cervical artificial disc replacement and anterior cervical decompression and fusion

    Institute of Scientific and Technical Information of China (English)

    张杨; 王利民

    2013-01-01

    目的 对比人工椎间盘置换术和颈前路减压融合术术后的早期临床效果及轴性症状,探讨人工椎间盘对术后颈椎轴性症状(AS)的价值.方法 回顾性分析2010年8月至2012年2月间在郑州大学第一附属医院接受治疗的颈椎病患者86例,均为单节段病变.46例患者(ACDF组)行颈前路减压融合内固定术,其中男21例,女25例,平均年龄51.6岁.40例患者(ADR组)行颈椎人工椎间盘置换术,其中男18例,女22例,平均年龄49.1岁.观察两组患者术后随访时JOA评分、Odom评级情况、颈椎曲度指数(CCl)、颈椎总活动度(ROM)的变化情况,对比颈部AS的发生情况,并进行分析.结果 所有患者均获随访,随访时间6~ 24个月,平均15.2个月.术后两组患者JOA评分较术前均有明显改善(P<0.05);术后3、6个月和末次随访时ACDF组与ADR组Odom临床疗效评级优良率比较差异无统计学意义.颈椎曲度ACDF组术后较术前丢失明显(P<0.05),ADR组手术前后无明显变化(P>0.05);ACDF组ROM术前较术后有明显减少(P<0.05),而ADR组与术前相比差异无统计学意义(P>0.05).ACDF组AS发生率为47.83%,ADR组为20.00%,两组相比差异有统计学意义(P>0.05).结论 人工椎间盘置换术能保留颈椎生理曲度及颈椎ROM,未明显增加邻近节段的活动,且无需佩戴颈围领,可早期活动,从而能够有效减少AS的发生.%Objective To compare the early clinical effects and neck axial symptom (AS)after cervical artificial disc replacement and anterior cervical discectomy and fusion,and to explore the value of cervical artificial disc lower the incidence of the postoperative neck AS.Methods To analyse the 86 cases of cervical spondylosis who treated in the first affiliated hospital of Zhengzhou university from August 2010 to February 2012 retrospectively,all of the cases were single segmental lesions.Forty-six patients (ACDF group) underwent anterior cervical discectomy and fusion

  17. EFFECTS OF NOVEL ANGLED CERVICAL DISC REPLACEMENT ON FACET JOINT STRESS%角度人工颈椎间盘置换对关节突应力的影响

    Institute of Scientific and Technical Information of China (English)

    柏传毅; 张维杰; 凌伟; 田振兴; 党晓谦; 王坤正

    2012-01-01

    Objective To analyze the biomechanical changes of the adjacent cervical facet joints when the angled 'cervical prosthesis is replaced. Methods A total of 400 northwestern people were involved, with an age of 40 years or older. The cervical vertebra lateral X-ray films were taken, and the cervical angles were measured by professional computer aided design software, then the cervical intervertebral disc prosthesis with 10° angle was designed. The finite element models of G, 5 and C4-6 segments with intact cervical discs were developed; the C*, 5 disc was replaced by the cervical prosthesis with 0° and 10° angle respectively; and then all models were subjected to axial loading, flexion/extension, lateral bending, and torsion loading conditions; the stress effects on adjacent facet joints after replacement were observed by comparing with that of the intact model. Results The cervical angles were (9.97 ± 3.64)° in C3,4, (9.95 + 4.34)° in G, 5) (8.59 ± 3.75)° in C5,6, and (8.49 ± 3.39)° in C6,7, showing no significant difference between C3,4 and C4,5, Cs, 6 and C6,7 (P > 0.05) and showing significant differences between the other cervical angles (P < 0.05). When C4,5 model was axially loaded, no significant difference in equivalent shearing stress were observed in intact, 0°, and 10° groups; at flexion/extension loading, the stress was biggest in intact group, and was smallest in 10° group; at lateral bending, the stress got the high rank in intact group, and was minimum in 10° group; at torsion loading, the stress state of 10° group approached to the intact one condition. When C4-6 model was loaded, the facet joint stress of the replaced segment (C4,5) decreased significantly at axial loading, flexion/extension, and lateral bending; while no obvious decrease was observed at torsion loading; the stress of the adjacent inferior disc (Cs. 6) decreased significantly at axial loading and lateral bending condition, while less decrease was observed at torsion

  18. 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

  19. 单节段半限制型Activ-C人工椎间盘置换术的早期疗效观察%Observation of early results after single-level semi-constrained Activ-C cervical disc arthroplasty

    Institute of Scientific and Technical Information of China (English)

    李洪珂; 张长江; 王明君; 杨贤玉; 李来好

    2014-01-01

    目的:观察半限制型Activ-C人工椎间盘置换术治疗单节段颈椎病的早期临床疗效。方法2009年7月至2012年9月,在我院接受Activ-C人工椎间盘置换术并获得随访的单节段颈椎病患者共28例,男18例,女10例,年龄32~62岁,平均45.2岁。采用日本骨科协会(Japaneseorthopedicassociation,JOA)评分、颈椎活动障碍指数(neckdisabilityindex,NDI)和疼痛视觉模拟评分(visualanaloguescale,VAS)评价术后症状改善程度,比较手术前后的颈椎曲度、手术节段活动度变化,观察统计手术并发症情况。结果随访时间12~36个月,平均17.8个月,JOA脊髓功能评分从(8.5±2.5)分增加至(14.8±1.5)分,NDI评分从(24.8±6.9)分下降至(7.3±4.8)分,颈部VAS评分从(6.8±1.3)分下降至(1.2±0.4)分,上肢VAS评分从(7.4±1.2)分下降至(1.1±0.4)分,均有明显改善(P<0.05)。置换节段活动度从术前平均(9.6±4.3)°增加至末次随访时平均(10.8±3.5)°,差异无统计学意义(P>0.05);颈椎整体曲度术前为(12.9±10.5)°,末次随访时为(15.4±9.1)°,但差异无统计学意义(P>0.05)。结论单节段半限制型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。%Objective To evaluate the early clinical results of semi-constrained Activ-C cervical disc arthroplasty for single-level cervical spondylosis. Methods From July 2009 to September 2012, 28 patients with single-level cervical spondylosis underwent Activ-C cervical disc arthroplasty and were followed up. There were 18 males and 10 females, whose mean age was 45.2 years old ( range: 32-62 years ). The Japanese Orthopedic Association ( JOA ) scores, Neck Disability Index ( NDI ) and Visual Analogue Scale ( VAS ) were used to evaluate the postoperative improvement of symptoms, compare the preoperative and postoperative cervical curvature and segmental

  20. Early clinical observation on Mobi-C disc prosthesis in treatment of cervical spondylosis%Mobi-C人工颈椎椎间盘治疗颈椎病的早期临床观察

    Institute of Scientific and Technical Information of China (English)

    祁磊; 李牧; 侯勇; 聂林

    2011-01-01

    目的 观察应用Mobi-C人工颈椎椎间盘治疗颈椎病的早期临床疗效.方法 2009年5月~2010年6月应用Mobi-C人工颈椎椎间盘治疗35例患者,共进行了45个间隙的人工椎间盘置换.通过颈椎正侧位和过伸、过屈位X线片测量置换节段术前和术后的活动度(range of motion,ROM)和颈椎整体曲度.应用日本骨科学会(JapaneseOrthopaedic Association,JOA)评分和疼痛视觉模拟量表(visual analogue scale,VAS)评分评价术后颈脊髓功能以及颈部和上肢疼痛症状.对数据进行统计学分析.结果 所有患者随访12 ~24个月,平均17.5个月,本组病例置换节段术前ROM为8.6°±2.4°,末次随访时ROM为9.1°±2.1°,与术前相比差异无统计学意义(P>0.05).颈椎整体曲度术前为11.7°±9.6°,末次随访时为14.5°±7.3°,与术前相比差异有统计学意义(P<0.05).24例患者术前有颈脊髓受压的表现,JOA评分为9.4±1.4分,末次随访时为15.0±1.1分,与术前相比差异有统计学意义(P<0.05).26例患者术前有不同程度的颈肩痛和上肢痛,VAS评分为6.7±1.2分,术后为1.3±0.8分,与术前相比差异有统计学意义(P<0.05).结论 应用Mobi-C人工颈椎椎间盘置换术治疗颈椎病近期可以保持置换节段的运动,改善颈椎曲度,并取得良好的临床疗效.%Objective To observe the early clinical effect of Mobi-C disc prosthesis in treatment of cervical spondylosis. Methods A total of 35 patients (including 45 levels) undergoing anterior cervical discectomy and cervical total disc replacement with Mobi-C disc prosthesis from May 2009 to June 2010 were enrolled in the study. Range of motion (ROM) of operated segments and C2-7 lordosis angle were measured through neutral and dynamic hyperextension and hyperflexion reontgeno-graphs before and after operation. Cervical spinal cord function and pain of neck and upper extremities were evaluated through Japanese Orthopaedic Association (JOA) and visual analogue

  1. The Biomechanics of Cervical Spondylosis

    OpenAIRE

    Ferrara, Lisa A.

    2012-01-01

    Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture ...

  2. 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

  3. Prestige LP颈椎椎间盘置换术后“张口不良”原因分析%Cause analysis for “reverse gape” after Prestige LP cervical disc replacement

    Institute of Scientific and Technical Information of China (English)

    王林; 雷伟; 桑宏勋; 马真胜; 樊勇; 李天清

    2011-01-01

    目的 探讨Prestige LP颈椎椎间盘置换术术后“张口不良”原因.方法 2008年2月~2010年3月行Prestige LP颈椎椎间盘置换术26例.通过对患者术前及术后颈椎正侧位、动力位X线片及三维CT影像学资料的搜集和对比,分析Prestige LP颈椎椎间盘置换术术后“张口不良”原因,并对患者颈椎功能障碍指数(neck disability index,NDI)及颈部、上肢疼痛视觉模拟量表(visual analogue scale,VAS)评分,以及依据动力位X线片测量手术节段单间隙矢状面屈伸运动度进行统计学分析.结果 8例患者发生置换椎间盘“张口不良”.正常患者与“张口不良”患者术后VAS评分及NDI的差异无统计学意义(P>0.01),但“张口不良”患者术后颈椎活动度小于正常组,差异有统计学意义(P<0.01).出现置换椎间盘“张口不良”患者中,l例术前存在颈椎结构性后凸,术后颈椎后凸无改善;5例置入椎间盘与上下相邻椎间隙不平行,提示椎间隙处理不准确;1例椎间隙处理中椎体后缘骨质切除过多导致置换椎间盘“张口不良”.结论 Prestige LP颈椎椎间盘置换手术操作较简单方便,但手术依赖术者主观性和经验性较多,手术本身客观性和精确性较少,易出现局限性后凸和椎间盘“张口不良”.术后椎间盘“张口不良”不影响患者症状改善,但影响术后颈椎活动度;要获得满意的间盘动-静态平衡,需要严格掌握适应证、遵循手术关键原则和一个较长的学习曲线.%Objective To analyze the reasons for "reverse gape" after Prestige LP artificial cervical disc replacement. Methods Twenty-six patients who received Prestige LP disc replacement from February 2008 to March 2010 were enrolled in this study. They were all followed up for at least 2 years. Their radiographs including X-ray films at anteroposterior and dynamic positions, and 3D CT were collected and compared. Neck disability index (NDI

  4. Prosthetic Lumbar disc replacement for degenerative disc disease

    Directory of Open Access Journals (Sweden)

    Kulkarni Arvind

    2005-01-01

    Full Text Available Mechanical articulated device to replace intervertebral disc as a treatment for low back pain secondary to disc degeneration has emerged as a promising tool for selected patients. The potential advantages are prevention of adjacent segment degeneration, maintenance of mobility as well as avoidance of all the complications associated with fusion. The short-term results have been comparable to that of fusion, a few mid-term results have shown mixed outcome, but information on long-term results and performance are not available at present. The rationale for lumbar disc arthroplasty, indications, contraindications, the various artificial devices in the market and the concepts intrinsic to each of them, basic technique of insertion, complications are discussed and a brief summary of our experience with one of the devices is presented.

  5. Talk cervical spondylosis patient care%浅谈颈椎病病人的护理

    Institute of Scientific and Technical Information of China (English)

    李天琴

    2014-01-01

    Cervical disease is the result of cervical disc degeneration, cervical hypertrophy and hyperplasia and other diseases caused by neck injury is a common disease one frequently occurring. More common in patients over 40 years old .With changing nature of work and working conditions age of onset of cervical disease before the age of 40 has been moved up to cervical disease has become a common orthopedic serious condition. Patients need surgical treatment, more and more cervical spondylosis patient care has become one of the important works of the orthopedic ward.%颈椎病是指因颈椎间盘退行性变、颈椎肥厚增生以及颈部损伤等引起的疾病,是中、老年人的常见病、多发病之一,多见于40岁以上病人。随着人们工作性质和工作条件的改变,颈椎病的发病年龄已经提前到40岁以前,已成为骨科的常见病,需要手术治疗的病人也越来越多,颈椎病病人的护理已成为骨科病房的重要工作之一。

  6. 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

  7. Biomechanical study of intervertebral disc degeneration

    OpenAIRE

    González Guitiérrez, Ramiro Arturo

    2012-01-01

    La degeneración y edad afectan la biomecánica del disco intervertebral, reduciendo la capacidad de rigidez, flexibilidad y atenuación de impactos, contra el movimiento y carga del raquis. La caracterización biomecánica del disco se realiza con ensayos mecánicos a segmentos de vértebra-disco-vértebra y aplicando cargas axiales, cortantes, flexión y torsión, estáticas ó dinámicas, con magnitudes de carga según el intervalo fisiológico. Sin embargo, las pruebas tradicionales no dan una visión de...

  8. 经皮穿刺手动调压脉冲射频模式治疗颈椎间盘突出症%THE CLINICAL EFFECTS OF PERCUTANEOUS PUNCTURE MANUAL VOLTAGE REGULATION PULSED RADIOFREQUENCY MODE ON CERVICAL DISC HERNIATION

    Institute of Scientific and Technical Information of China (English)

    吴大胜; 刘娜; 宫小文; 宋永光

    2012-01-01

    Objective: To evaluate the clinical effects of percutaneous puncture manual voltage regulation pulsed radiofrequency mode on the treatment cervical disc herniation. Methods: From August 2010 to September 2011, 112 patients with cervical disc herniation were given with percutaneous puncture manual voltage regulation pulsed radiofrequency mode guided through C arm X-ray machine, CT or DSA. The visual analogue scale (VAS) score and clinical effects were recorded before and after treatment. Results: After 3 d the treatment, the excellent cases were 96, the good cases were 14, and the bad cases were 2, the excellent and good rate was 98.2%. There were 2 bad cases because the doctor failed to grasp the good indication. Compared with pre-operation (7.8 ± 0.4), the VAS at 3 d after operation (1.5 ± 0.3) was decreased (P < 0.05). Conclusion: Percutaneous puncture manual voltage regulation pulsed radiofrequency mode therapy is a suitable treatment for cervical disc herniation, with the advantages of simple operation, easy to master, small trauma, not influencing the stability of spine biomechanics, no serious complications.%目的:评估手动调压脉冲射频模式治疗颈椎间盘突出症的临床可行性.方法:2010年8月~2011年9月,112例颈椎间盘突出症患者,在C型臂X线机、CT或DSA引导下接受经皮穿刺手动调压脉冲射频模式治疗.观察并记录术前后的视觉模拟评分(visual analogue scale,VAS),并进行疗效评估.结果:本组112例患者,经过该技术治疗后3d,其中96例治疗效果达优级,14例治疗效果良好,2例效果差,优良率98.2%.其中,效果较差的2例是因为未把握好适应症.与术前VAS评分(7.8±0.4)相比,术后3天VAS评分(1.5±0.3)降低(P<0.05).结论:经皮穿刺手动调压脉冲射频模式治疗颈椎间盘突出症具有操作简单、易于掌握、创伤小、不影响脊柱生物力学稳定性、无严重并发症等特点.是一种可供临床选用的、效果确切又较

  9. Correlation research on gene polymorphism of interleukin-1α, interleukin-6 and intervertebral disc degeneration disease%白细胞介素-1α和白细胞介素-6基因多态性与椎间盘退变症相关性研究

    Institute of Scientific and Technical Information of China (English)

    段雄; 安菊霞; 赵岩; 杨学军

    2013-01-01

    Objective To research the correlation on gene polymorphism of interleukin-1α,interleukin-6 and intervertebral disc degeneration disease.Methods 42 patients with intervertebral disc degeneration disease treated by surgery from June 2009 to January 2012 in Affiliated Hospital of Wulanchabu Medical College were selected as cases group,85 patients without intervertebral disc degeneration disease treated surgery because of the fracture and trauma were chosen as control group.Gene frequency distribution of IL-1α-rs1800587 and IL-6-rs1800797 were analyzed by PCT-RFLP; influence of gene polymorphism of IL-1α-rs1800587 and IL-6-rs1800797 on intervertebral disc degeneration were analyzed by multivariable Logistic regression analysis model.Results ①Distribution percentage of C/C,C/T,T/T genotype in IL-1α-rs1800587 were 52.4%,40.5%,7.1% respectively in cases group,corresponding genotype were 55.3%,38.8%,5.9% in control group,the differences were not statistically significant (P =0.87).Distribution percentage of A/A,A/G,G/G genotype in IL-6-rs1800797 were 50.0%,33.3%,16.7% respectively in cases group,corresponding genotype were 64.7%,28.2%,7.1% in control group,the differences were not statistically significant (P =0.17).②Gene polymorphism of IL-1α-rs1800587 was found no function in increasing the probability of intervertebral disc degeneration disease,the OR (95%CI) value in C/T,T/T genotype were 1.28 (0.18-7.27) and 1.43(0.27-8.06) in IL-1α-rs1800587.Correlationship was found between A/G gene polymorphism in IL-6-rs1800797 and intervertebral disc degeneration disease according to multivariable Logistic regression analysis.Probability of intervertebral disc degeneration disease in G/G genotype of IL-6-rs1800797 was higher than that in A/A genotype of IL-6-rs1800797,the OR (95%CI) value was 5.52 (1.24-18.21).Conclusion IL-6 rs1800797 gene polymorphism has obvious influence in intervertebral disc degeneration disease,the detection of gene

  10. Clinical observation and analysis of adjacent segment degeneration after anterior cervical fusion%颈椎前路融合术后相邻节段退变的临床观察与分析

    Institute of Scientific and Technical Information of China (English)

    王义生; 邓俊森

    2012-01-01

    [Objective] To study whether the anterior cervical fusion inevitably lead to the adjacent segment degeneration (ASD) . [Methods] From 1986.1 to 1999. 12, a total of 346 patients with cervical degenerative disease underwent the surgery of enlarged decompression with circular saw and auto iliac bone grafting. Among them there were 1 segment in 55 patients, 2 segments in 223 patients and 3 segments in 68 patients. The two motion segments adjacent to the fused segment and interval from the fused segment were evaluated respectively for imaging changes and divided the results into groups for statistical test. [Results] The patients were followed up for 13. 5 (4.1 ~ 18) years on average. Total 156 cases (45. 1% ) had obvious adjacent segment degeneration, 23 cases (6. 6% ) had obvious interval segment degeneration. The interval segment degeneration was less than that of adjacent segment degeneration, and the comparative differences had statistically significance (P 0.05 ) . [ Conclusion] The anterior cervical fusion accelerated the occurrence of ASD. The incidence of cephalic adjacent segment ASD was higher than that of tail side adjacent segments. The incidences of postoperative ASD in single segment and several segment fusion have no significant differences.%[目的]研究颈椎前路融合术是否必然导致邻近节段退变(adjacent segment degeneration,ASD).[方法]1986~1999年,共346例采用“环锯法前路扩大脊髓减压+椎体间植骨内固定术”治疗颈椎退变性疾病,其中,1个间隙55例,2个间隙223例,3个间隙68例.分别评定融合节段头、尾侧相邻间隙及间隔间隙的影像学表现,对结果分组进行统计学检验.[结果]术后随访13.5 (4.1 ~18)年,发生邻近节段明显退变的156例(45.1%),间隔节段明显退变的23例(6.6%).间隔节段退变明显少于邻近节段退变,两者比较差异有统计学意义(P<0.05).单纯头侧邻近节段发生ASD 84例,单纯尾侧邻近节段发生ASD 27例,头

  11. 颈椎间盘突出程度与颈椎X线片相关指标测量值的相关性研究%The correlation analysis of the degree of cervical intervertebral disc herniation associated with cervical X-ray radiography index

    Institute of Scientific and Technical Information of China (English)

    蒋维利; 申才良; 董福龙; 章仁杰; 汪军; 朱晓红; 张华庆

    2015-01-01

    Objective To investigate the relationship of the related parameters of X-ray and the severity of cervical spinal cord compression caused by disc herniation in patients with single segment spondylotic myelopathy. Methods Clinical data of sixty paitents with single segment spondylotic myelopathy in the First Affiliated Hospital of Anhui Medical University from August 2012 to March 2014 were retrospectively analyzed. All the patients, aged from 42 to 65 (58. 4±9. 3), were male. According to the compression ratio ( E value) of cervical spinal cord in sagittal MRI images, all the patients were firstly divided into group Ⅰ, II and Ⅲ. The ratio of cervical spinal crosscutting area ( S1 ) to effective cervical canal crosscutting area ( S0 ) in cross-sectional imagings of cervical spine MRI was then calculated to reflect the degree of intervertebral disc herniation. Furthermore, the following indicators in cervical X-ray in different postures were measured for each case: the range of motion of the responsibility of intervertebral space ( B value) , the height of the anterior of intervertebral space ( D value) , Cobb angle of C2-7 , and the area of intervertebral foramen ( M value) . Linear correlation regression was used to study the relationship of the severity of cervical spinal cord compression and the above observation indexes. Results There were significant differences in the ratio of S1/S0 , E value, B value, D value, M value and Cobb angle of C2-7 among three groups (F values were 44. 187, 112. 789, 7. 232, 3. 778, 3. 232 and 15. 813, respectively. all P values<0. 05). E value, B value, D value, M value and Cobb angle of C2-7 decreased with the increase of the ratio of S1/S0 . These indicated that E value, B value, D value, M value and Cobb angle of C2-7 were negatively correlated with the ratio of S1/ S0 ( R values were-0. 821, -0. 581, -0. 378, -0. 419 and-0. 576, respectively, all P values<0. 05). The multiple linear regression results showed that B value, D

  12. Diagnosis and treatment of cervical intervertebral disc calcification in children%儿童颈椎间盘钙化的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    黎作旭; 张世民

    2004-01-01

    儿童颈椎间盘钙化症(cervical incervertebral dise calcification in children)是一种少见的疾病。1924年Baron首先报道本病.国内1982年至今陆续报道,迄今仅百余例。作者经治儿童颈椎间盘钙化症5例.结合文献对其诊断和治疗加以讨论。

  13. Adjacent segment disc degeneration after lumbar interbody fusion:a systematic review%腰椎融合术后发生邻近节段椎间盘退变的系统评价

    Institute of Scientific and Technical Information of China (English)

    郝俊龙; 陈永刚; 夏亚一; 汪玉良; 王栓科; 汪静; 王翠芳; 耿彬

    2011-01-01

    [ Objective] To assess the efficacy and safety of bone morphogenetic protein for fractures. [ Methods] We searched the Cochrane Central Register of Controlled Trials (CENTRAL) ( Issue 3, 2010) , MEDLINE, EMBASE, CBM,CNKI, VIP, Wanfang database, etc. from their inception to June 2010. Some relevant journals were handsearched as well. Two reviewers independently evaluated the quality of included studies and extracted the data. Meta - analysis was performed by RevMan 5.0 software. [ Results ] Four trials involving 451 patients were included. Meta analysis showed that as for functional training, lumbar fusion increased risk of adjacent segment disc degeneration (ASD) . The incidence of ASD after lumbar laminectomy is higher than non - laminectomy. The existence of ASD preoperative increased risk of postoperative ASD. The incidence of ASD had no relation with internal fixation or the number of fusion segments. [ Conclusion ] Lumbar fusion can increase the incidence of ASD, and is related with laminectomy and the existence of preoperative ASD, but is not related with internal fixation and the number of lumbar fusion segments. However, there is a moderate possibility of selection bias, performance bias and publication bias in this review because of the small number of the included studies, which may weaken the strength of the evidence of our results. More large sample size, high -quality RCTs are needed.%[目的]对腰椎融合术加速邻近节段椎间盘退变进行系统评价.[方法]按照Coehrane协作网制订的检索策略进行检索,计算机检索MEDLINE(1966~2010年8月)、EMBASE(1974~2010年8月)、Cochrane图书馆(2010年第8期)、中国生物医学文献数据库(CBM,1978~2010年8月)、中国期刊全文数据库(CNKI,1994~2010年8月)、中文科技期刊全文数据库(VIP,1989~2010年8月)及万方数据库(1979~2010年8月).手工检索相关的中英文骨科杂志和会议论文.纳入腰椎融合术后发生邻近节段椎间盘

  14. 颈椎人工椎间盘置换术与颈前路减压融合内固定术手术疗效比较%Comparing the effects of Bryan cervical Disc arthroplasty with anterior cervical decompres-sion and fusion

    Institute of Scientific and Technical Information of China (English)

    张涛; 王弘; 徐宏光; 李从明

    2016-01-01

    目的:比较颈椎人工椎间盘置换术( cervical disc arthroplasty ,CDA)与颈前路减压融合内固定术( anterior cervical de-compression and fusion ,ACDF)的手术疗效。方法:回顾分析2012年8月~2015年1月收治的退变性颈椎病50例,随机给予CDA(n=23),或者ACDF(n=27)治疗,术后12个月门诊随访。结果:两组术前性别、年龄、手术节段活动度(range of motion, ROM)、VAS( visual analogue scale )及JOA( Japanese orthopaedic association )无统计学差异,CDA组比ACDF组手术时间短,出血量少,具有明显统计学差异( P<0.01),两组住院时间无明显统计学差异。术后12个月,两组手术节段ROM差异具有统计学意义( P<0.01),CDA组ROM较术前得以维持,ACDF组降低。两组JOA及VAS无统计学差异。结论:CDA较ACDF能维持手术节段的活动度,CDA有望取代ACDF。%Objective:To compare curative effects of Bryan cervical disc arthroplasty ( CDA) with those of anterior cervical decompression and fusion ( AC-DF).Methods:A total of 50 patients with cervical spondylotic myelopathy treated in our hospital between August 2012 and January 2015 were randomly as-signed to two groups.One group were treated with CDA (n=23) and another with ACDF(n=27).Two groups of patients were postoperatively followed on outpatient basis for 12 months.Results:The two groups were not significantly different regarding the gender,ages,range of cervical motion(ROM) and sco-ring on visual analogue scale(VAS) and Japanese Orthopedic Association(JOA).CDA group had shorter operative time and intraoperative blood loss than ACDF group,the difference was significant( P<0.01) .The length of hospital stay remained similar for the two groups ,yet the two groups were different con-cerning the ROM 12 month after operation(P<0.01).Postoperative ROM was maintained in patients in CDA group,whereas was decreased in ACDF group. There was no

  15. Advances in Susceptibility Genetics of Intervertebral Degenerative Disc Disease

    Directory of Open Access Journals (Sweden)

    Yin'gang Zhang, Zhengming Sun, Jiangtao Liu, Xiong Guo

    2008-01-01

    Full Text Available The traditional view that the etiology of lumbar disc herniation is primarily due to age, gender, occupation, smoking and exposure to vehicular vibration dominated much of the last century. Recent research indicates that heredity may be largely responsible for the degeneration as well as herniation of intervertebral discs. Since 1998, genetic influences have been confirmed by the identification of several genes forms associated with disc degeneration. These researches are paving the way for a better understanding of the biologic mechanisms. Now, many researchers unanimously agree that lumbar disc herniation appears to be similar to other complex diseases, whose etiology has both environmental and hereditary influence, each with a part of contribution and relative risk. Then addressing the etiological of lumbar disc herniation, it is important to integrate heredity with the environment factors. For the purpose of this review, we have limited our discussion to several susceptibility genes associated with disc degeneration.

  16. 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

  17. The distribution of Schmorl's nodes in patients with low back pain or radiculopathy and their correlation with degeneration of lumbar intervertebral discs%许莫氏结节在腰腿痛患者中的分布特点及与腰椎间盘退变的相关性分析

    Institute of Scientific and Technical Information of China (English)

    陈意磊; 周志杰; 范顺武; 赵凤东; 方向前

    2013-01-01

    Objective To evaluate the distribution of Schmorl's nodes (SN) in patients with low back pain or radiculopathy,and to analyze the correlation between SN and degeneration of lumbar intervertebral discs.Methods In 2012,1024 patients with low back pain or sciatica were examined by magnetic resonance (MR) scan and plain film.There were 448 males and 576 females,with an average age of (54.3 ± 12.7) years (range,22-90).The features distribution of SN in lumbar endplate on age,sex,segment and the type and grade of intervertebral disc degeneration were analyzed retrospectively.Results Among 5120 lumbar intervertebral segments of the 1024 patients,295 (28.8%) cases and 532 (5.2%) endplates were involved with SN,302 located in the cranial and 230 in the caudal endplate.According to percent prevalence per lumbar segment,L1,2 was the most common level (29.1%),followed by L3,4 (23.7%) and L2,3 (21.1%).The incidence of SN was positively correlated with elder age,but not with sex,body weight,height,or body mass index.SN occurred more often in bulging,extrusion,Modic changes,spondylolisthesis and osteophyte comparing with normal disc or protrusion or high intensity zone.The distributions of the grade of intervertebral disc degeneration were significantly different between groups with and without adjacent SN.Intervertebral discs with adjacent SN were more degenerated than those without adjacent SN.The number,size and volume of SN were associated with the degrade of intervertebral discs degeneration.SN was divided into two types,i.e.,"acute edematous" SN and "non-acute"SN,according to the signal type on T1-and T2-weighted MR images,and the degeneration of the corresponding intervertebral discs was more severe in the latter than the former group.Conclusion SN occurred more often in the upper lumbar spine and cranial endplate in patients with low back pain or radiculopathy.SN were correlated with elder age and the degeneration of lumbar intervertebral discs.The number

  18. 磁共振测量腰骶椎矢状面参数与L5/S1椎间盘退变的关系%Lumbosacral sagittal parameters measured by magnetic resonance in association to L5/S1 intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    丁慕晨; 石志才; 卢春闻; 吴锦辉; 王超; 袁佳滨; 周振

    2016-01-01

    背景:以往已有一些关于腰骶椎矢状面参数与腰椎间盘退变性疾病相关性的报道,但试验对象多是笼统的椎间盘突出的患者,试验数据也多是在X射线片或CT上测得,而从磁共振成像得的腰骶段矢状面参数与出现腰骶椎间盘脱出的手术病例的相关性报道则较少见。  目的:磁共振测量和评价出现腰骶椎间盘脱出患者的腰骶矢状面参数变化,分析腰骶矢状面参数与椎间盘退变性疾病之间的关系。  方法:回顾性分析自2014年9月至2016年4月间上海第二军医大学附属长海医院骨科18-35岁腰痛患者90例,按有无L5/S1椎间盘突出分为无椎间盘突出组69例和脱出组21例,其中因L5/S1椎间盘脱出并行手术治疗的21例,其他69例为无椎间盘突出组;无椎间盘突出组按有无L5/S1椎间盘退变又分为退变组和对照组,其中仅有L5/S1椎间盘退变的35例作为退变组,剩余34例无椎间盘病变的作为对照组。测量的腰骶矢状面参数包括腰椎前凸角、骶骨平台角、腰骶关节角。  结果与结论:与对照组相比,退变组腰椎前凸角虽有减小但差异并不显著(P>0.05),而骶骨平台角及腰骶关节角均有明显减小(P OBJECTIVE:To measure and compare the lumbosacral sagittal parameters in L5/S1 disc extrusion patients, and to investigate the relationship between the lumbosacral sagittal parameters and L5/S1 disc degeneration diseases. METHODS:A total of 90 lumbago patients aged 18 to 35 years old were included from the Department of Orthopedics, Changhai Hospital Affiliated to The Second Military Medical University from September 2014 to April 2016 for retrospective analysis. According to with or without L5/S1 intervertebral disc protrusion, they were divided into intervertebral disc herniation group (69 cases) and disc extrusion group (21 cases received surgery). The intervertebral disc herniation group was

  19. DSC Study of Collagen in Disc Disease

    Directory of Open Access Journals (Sweden)

    S. Skrzyński

    2009-01-01

    Full Text Available Differential scanning calorimetry (DSC has been used to estimate the effect of disc disease on the collagen helix-coil transition and morphology for tissue extracted from patients during surgical operation. Forty discs were obtained from patients with degenerative disc disease undergoing surgery for low back pain. The patients were in the age between 20 and 70 years old. The specimens were kept wet during DSC experiment. The data allow the comparison between thermal stability of collagen tissue from healthy patients and from patients suffering from disc disease. In the paper the comparison between thermal helix-coil transition for collagen fibers from patients suffering from disc disease and collagen fibers from healthy organisms has been discussed. The heating rate has an influence on the position on denaturation temperatures of collagen in disc tissues. Higher helix-coil transition temperature of collagen in degenerated disc suggests that additional intermolecular cross linking of collagen fibers occurs. Denaturation temperatures of collagen in degenerated male disc possess smaller values than in female ones. Disc disease induces changes in collagen structure and leads to formation of additional crosslinks between collagen fibers.

  20. Bryan人工颈椎间盘对颈椎整体及置换节段曲度影响的中期观察%The mid-term effects of Bryan cervical disc prosthesis on sagital alignment of overall cervical spine and the functional spinal unit

    Institute of Scientific and Technical Information of China (English)

    姜宇; 田野; 王以朋; 邱贵兴; 翁习生; 冯宾

    2012-01-01

    Objective To investigate the mid-term radiological outcome of sagital alignment of overall cervical spine and the functional spinal unit after replacement surgery with Bryan cervical disc prosthesis.Methods Eighteen patients with cervical disc disorder were performed cervical disc replacement with 20 Bryan discs from November 2005 to May 2010,including single-level 16 cases and bi-level 2 cases.The patient consisted of 13 males and 5 females with age ranging from 38 to 59 years (average,(47 ± 6) years). Fourteen cases with overall cervical lordotic alignment and segmental lordotic alignment peroperatively ( group 1 ) and 4 others with segmental kyphotic alignment and overall cervical kyphotic alignment per-operatively (group 2 ).The overall sagital alignment (C2-7 ) and segmental sagital alignment were measured pre-operatively,post-operatively aud at final follow-up to evaluate the outcome. Results All cases obtained the follow-up with an average of ( 24 5 ) months ( range 12 to 53 months ).To the mean overall cervical alignment,there were 9.9° ± 1.9° per-operatively,12.8° ± 2.1° post-operatively and 11.6° ± 1.8° at final follow-up in group 1 and - 1.8° ±0.8° per-operatively,7.3° ± 1.3° post-operatively and 5.0° ± 2.1°at final follow-up in group 2.There were statistical significance between per-operatively and post-operatively(t =- 2.987 and - 5.058,P < 0.05 ) and no statistical significance between postoperatively and final follow-up ( P > 0.05 ) in both groups. To the mean segmental alignment there were 2.6° ±0.8° per-operatively,5.4° ± 1.0°post-operatively and 4.3° ±0.9°at final follow-up in group 1 and -3.0° ±0.8° per-operatively,3.8° ± 1.3° post-operatively and 0.3° ± 2.8° at final follow-up in group 2.There were statistical significance between per-operatively and post-operatively in both groups (t =-3.829 and - 4.086,P < 0.05 ) and between post-operatively and final follow-up in group 1 ( t =2.630,P <0.05 ) but

  1. 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

  2. Cervical myelopathy due to degenerative spondylolisthesis

    OpenAIRE

    Koakutsu, Tomoaki; Nakajo, Junko; Morozumi, Naoki; Hoshikawa, Takeshi; Ogawa, Shinji; Ishii, Yushin

    2011-01-01

    Objective To investigate clinical-radiological features of cervical myelopathy due to degenerative spondylolisthesis (DSL). Methods A total of 448 patients were operated for cervical myelopathy at Nishitaga National Hospital between 2000 and 2003. Of these patients, DSL at the symptomatic disc level was observed in 22 (4.9%) patients. Clinical features were investigated by medical records, and radiological features were investigated by radiographs. Results Disc levels of DSL were C3/4 in 6 ca...

  3. 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.

  4. Change of cervical balance following single to multi-level interbody fusion with cage.

    Science.gov (United States)

    Lin, Hung-Lin; Cho, Der-Yang; Liu, Yu-Fang; Lee, Wen-Yuan; Lee, Han-Chung; Chen, Chun-Chung

    2008-12-01

    Postoperative limitation of cervical movement and adjacent disc degeneration are major causes of postoperative neck pain after anterior cervical discectomy and interbody fusion (ACDF). We present a retrospective study of dynamic radiographic change following ACDF with cages. We performed ACDF in 50 patients with cervical degenerative diseases, divided into three groups based on the level of interbody fusion (Group A: one-level; Group B: two-level; Group C: three-level). Preoperative and postoperative flexion-extension X-rays were acquired and cervical range of motion (ROM), lordosis, fusion rate, cage subsidence rate, postoperative neck pain as evaluated by visual analogue scale (VAS) and upper adjacent level segmental movement were evaluated. The average following time was 14.6 months. The mean change in lordotic curve was -2.31 +/- 9.53 degrees for Group A, 5.60 +/- 6.96 degrees for Group B, and 3.23 +/- 7.50 degrees for Group C (p value = 0.03). The mean change in flexion angle was -5.46 +/- 8.69 degrees for Group A, -10.2 +/- 7.38 degrees for Group B, and -13.86 +/- 10.33 degrees for Group C (p value = 0.039). The mean change in total cervical ROM was -3.85 +/- 18.74 degrees for Group A, -12.73 +/- 10.31 degrees for Group B, and -16.95 +/- 10.57 degrees for Group C (p value = 0.02). Follow-up cervical MRI for patients with persistent neck pain showed no evidence of adjacent level degeneration. There were no significant differences between the three groups with respect to postoperative change in cervical extension angle, upper adjacent level segmental movement, neck pain VAS, fusion rate or cage subsidence rate. The further decrease in total cervical ROM and flexion movement after multi-level ACDF was observed. However, a more long-term follow-up was needed to assess the actual aetiologies of upper adjacent level degeneration.

  5. Bryan人工椎间盘置换术对颈椎曲度影响的研究%Effect of cervical arthroplasty with Bryan disc prosthesis on post-operative cervical curvature

    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

    2011-01-01

    Objective To investigate the angle changes of functional spine unit ( FSU) at operated segment after single-level Bryan disc replacement at different time points after operation. Methods A total of 60 patients receiving single-level Bryan disc replacement between December 2003 and December 2007 were enrolled in this study. The changes of FSU angle were measured and compared on lateral X-ray films. Results All 60 patients were followed up for an average of 32 months ( ranging 3-69 months). The levels of surgery included C3/C4 (2 cases), C4/C3 (14 cases) , C5/C6 (41 cases) and C6/C,7(3 cases). The mean FSU angle was 0. 3° before the surgery, and -0. 5° at the final follow-up, with statistically significant difference found between them ( P < 0.05 ). The patients were divided into three groups according the operation period: early stage group (2003-2004), middle stage group (2005) and late stage group (2006-2007). The average FSU kyphosis was increased by 1.6° after the operation in early stage group, but only by 0.1° in late stage group,and the difference had statistical significance ( P < 0.05 ). Conclusion FSU kyphosis mainly occurs in early stage after Bryan disc replacement. This complication could be avoided with surgical experience accumulation and surgical technique improvement.%目的 观察不同手术时期Bryan人工椎间盘置换术后置换节段脊柱功能单位(functional spine unit,FSU)曲度变化情况.方法 随访2003年12月~2007年12月接受单节段Bryan人工椎间盘置换术的患者,在侧位X线片上测量FSU角度变化.结果 60例患者获得随访,随访3~ 69个月,平均32个月,手术节段包括C3/C4节段2例,C4/C5节段14例,C5/C6节段41例,C6/C7节段3例.术前FSU平均曲度为0.3°,末次随访时为-0.5°(P<0.05).根据手术日期将全部病例分成早期(2003~ 2004年)、中期(2005年)和后期(2006 ~ 2007年)3维,统计分析发现早期病例随访时FSU后凸平均增加1.6°,后

  6. Effects of intervertebral injection of transforming growth factor beta 1 on proteoglycan expression in rabbit degenerated lumbar discs%椎间注射转化生长因子β1对兔退变腰椎间盘蛋白多糖表达的影响

    Institute of Scientific and Technical Information of China (English)

    吴彬; 张辉; 王海滨; 贾存岭; 赵益峰

    2011-01-01

    BACKGROUND: In vitro experiments have confirmed that transforming growth factor-β1 (TGF-β1) can promote proteoglycan synthesis and delay intervertebral disc degeneration, but its in vivo role remains unclear.OBJECTIVE: To study the effect of local utilization of TGF-β1 on proteoglycan expression in rabbit degenerated lumbar discs.METHODS: Thirty-six New Zealand white rabbits were divided into two groups randomly, with 6 in control group and 30 in model group. The lumbar structure was destroyed partly in the model group. After 12 weeks, the intervertebral disc degeneration was testified by X-ray in model group. Six rabbits chosen randomly from the model group and all rabbits in the control group were killed and the organizations of the intervertebral discs of L4-5 were harvested. Meanwhile, the rest rabbits in model group were divided into two groups randomly, which was injected with TGF-β1 saline. The rabbits were killed by 2 and 4 weeks after injection.The contents of proteoglycan in nucleus pulposus were tested by phloroglucinol method.RESULTS AND CONCLUSION: The content of proteoglycan in the nucleus pulposus was obviously decreased at 12 weeks after model preparation (P < 0.01). After TGF-β1 injection, the content of proteoglycan was notably increased (P < 0.01). It is suggested that intervertebral injection of TGF-β1 to rabbit can delay intervertebral disc degeneration and enhance the synthesis of proteoglycan in nucleus pulposus.%背景:体外研究证实转化生长因子β1可以促进蛋白多糖合成,延缓椎间盘退变,但体内实验鲜见报道.目的:观察局部应用转化生长因子β1对兔退变腰椎间盘髓核蛋白多糖表达的影响.方法:取30只新西兰大白兔建立兔腰椎间盘退变模型,造模12周,经X射线证实退变后,随机选择6只模型兔及6只未造模正常兔,处死取材.分别向剩余24只模型兔L4~5椎间隙注射转化生子因子β1和生理盐水.末次给药2,4周取材,间苯三酚法测

  7. 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

  8. The outcome and influence of artificial cervical disc replacement on adjacent non-responsible segment instability in patients with cervical spondylosis%人工颈椎间盘置换的疗效及其对相邻非责任节段失稳的影响

    Institute of Scientific and Technical Information of China (English)

    种涛; 俞兴; 徐林; 贾育松; 李春根; 毕连涌; 柳根哲

    2012-01-01

    Objectives: To investigate the clinical efficacy and imaging results of the adjacent segment instability in patients with cervical spondylosis treated by Bryan cervical disc replacement. Methods: A retrospective review was performed on 9 cases suffering from adjacent segment instability before surgery. All 9 cases underwent Bryan artificial cervical disc arthoplasty and were followed up from July 2005 to January 2009 in our hospital. There were 4 males and 5 females with an average age of 33.5 years (range, 26-43 years). Japanese Orthopaedic Association(JOA) score was 10.16±3.17(7-13), and visual analogue pain scale(VAS) was 4.3±2.7(l-7) before surgery. All patients underwent cervical flexion and extension plain film and cervical MRI before surgery. Imaging instability was confirmed in the adjacent segment, which was asymptomatic. C4/5 replacement, 1 cases instability in C5/6; C5/6 replacement 4 cases, 3 cases instability in C4/5, 1 cases instability in C6/7; C6/7 replacement, 2 cases instability in C5/6. The double segment replacement 2 cases, each 1 cases instability in C4/5, C5/6 and C5/6, C6/7, which both are adjacent to the head-end segment. Clinical outcome of surgery was evaluated by JOA, neck pain VAS and Odom before surgery and at 1 week, 3, 6, 12, 24, 36 months after surgery respectively; the range of motion(ROM) of the surgical segment, adjacent unstable segment, C2-C7 and cervical malalignment were assessed by cervical dynamic X-ray before operation and 3, 6, 12, 24, 36 months after surgery. Results: The JOA score, neck pain VAS were improved significantly at each follow-up 3 months later after surgery compared with those of preoperation, difference was statistically significant(P0.05), while decreased significantly at 24 and 36 months(P<0.05). ROM of implanted segment and cervical curve at 24 and 36 months after operation increased significantly(P<0.05) compared with preoper-ative ones. The postoperative ROM of C2-C7 remained unchanged at each follow

  9. Adjacent segment degeneration: observations in a goat spinal fusion study

    NARCIS (Netherlands)

    R.J.W. Hoogendoorn; M.N. Helder; P.I.J.M. Wuisman; R.A. Bank; V. Everts; T.H. Smit

    2008-01-01

    Study Design. The adjacent discs of 13 goats, originally used in a lumbar spinal fusion model study, were analyzed for symptoms of intervertebral disc degeneration by means of magnetic resonance imaging (MRI), macroscopy, and histology. These goats were followed for 6 months and the results were com

  10. Observation of short-term curative effect of multi-segmental anterior cervical artificial disc replacement under microscope%显微技术下前路多节段颈椎人工椎间盘置换术短期疗效观察

    Institute of Scientific and Technical Information of China (English)

    龙勇; 冯海龙

    2015-01-01

    目的:探讨显微镜下多节段颈椎人工椎间盘置换术的短期疗效,观察术后颈椎活动度及临床功能的变化,为多节段颈椎间盘突出症的外科治疗提供临床依据。方法因颈椎病( cervical spondylosis,CS)行显微镜下多节段颈椎人工椎间盘置换术患者,其中使用颈椎动态稳定器DCI 2例,使用Prestige-LP人工椎间盘3例。患者术前与术后6月均行颈椎正侧位、过伸过屈位X射线片、颈椎MRI检查,测量脊髓功能评分(JOA)和置换节段活动度(range of motion,ROM)。结果显微镜下微创手术未出现手术并发症,神经功能明显改善;术后6月颈椎运动范围与术前比较差异无统计学意义( P>0.05);所有患者的JOA评分较术前均有明显改善( P<0.05)。结论显微镜下手术创伤小,并发症少,多节段颈椎人工椎间盘置换术基本保留了颈椎的稳定性,具有良好的活动度,短期临床效果良好。%Objective To investigate the short-term curative effect of multiple segmental cervical artificial disc replacement ( msCDR) under microscope and observe the changes of postoperative cervical activity and clinical features in order to provide prelimi-nary clinical basis for surgical treatment of the disease.Methods A retrospective analysis of 5 cases of cervical spondylosis treated with microsurgical msCDR,including 2 cases with cervical dynamic implant(DCI)and 3 cases with artificial cervical disc(Prestige-LP) ,was performed.Data included the cervical motion X-ray, cervical MRI, JOA score evaluation and motion of replacement discs ( Range of motion,ROM) before and after 6 months of surgery.Results Minimally invasive surgery under the microscopic manipula-tions has less operative complications compared with“naked-eye” surgery.Neuro-function was significantly improved.The cervical mo-tion after 6 months of operation showed no significant difference when compared to pre

  11. Bryan颈椎间盘置换术与颈前路减压椎间融合术术后疗效的系统评价%The systematic review of clinical trails for postoperative effect of cervical disc replacement compared with anterior cervical discectomy and fusion

    Institute of Scientific and Technical Information of China (English)

    李冰; 王沛; 李晖; 刘保华; 冯世庆; 马信龙

    2009-01-01

    目的:收集并分析SCI收录的关于Bryan颈椎间盘置换术与颈前路减压椎间融合术(anterior cervicaldiseectomy and fusion,ACDF)术后疗效比较的文献,对Bryan颈椎间盘置换术和ACDF术后疗效进行系统评价.方法:检索Pubmed、Medline、Embase、Ovid、Cochrane Library等数据库.入选文献均为临床研究;各研究的干预组(治疗组)术式为Bryan颈椎间盘置换术,对照组术式为ACDF;治疗组和对照组例数均不小于10;术后疗效评价包括颈部功能残障指数(neck disability index,NDI),相应节段运动范围(range of motion,ROM)等常见指标.结果:共4篇文献符合纳入标准.纳入人数共588人,干预组303例,对照组285例;术后2年内NDI合并权重均差(weiishted meBJl difference,WMD)为-0.39(95%CI,-1.56-0.78),P>0.05.术后2年内相应颈椎节段运动范围(ROM)合并WMD值为8.95(95%CI,7.01~10.89),P0.05.The combined WMD of ROM was 8.95(95%CI,7.01- 10.89) less than 2 years after operation,P<0.05.Conclusion:Our results indicate that Bryan cervical disc re- placement is superior than ACDF in maintaining the ROM less than 2 years after operation.No evidence sup- ports that Bryan cervical disc replacement is better than ACDF less than 2 years after operation.

  12. 早期颈前路手术治疗多节段急性颈椎间盘突出并脊髓损伤的研究%Early anterior approach operation with internal fixation in treatment of acute multilevel cervical disc herniation patients with cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    李晓彬; 刘涛; 程应全; 王伟

    2012-01-01

    Objective To evaluate the clinical effect of early anterior approach operation with internal fixation in treating traumatic cervical disc herniation patients with cervical spinal cord injury.Methods Twenty-three patients with spinal cord injury caused by acute cervical disc herniation,admitted to our hospital from January 2010 to January 2011,were chosen in our study; all patients underwent anterior cervical surgery with the application of titanium mesh plate and cage to perform decompression and reconstruction; 14 patients received surgery within 72 h of injury and other 9 adopted surgery after 72 h of injury.The clinical data and postoperative recovery degree of the spinal cord injury were retrospectively analyzed.Results All patients were followed up for 6 to 13 months (averaged 11 months).X-ray examination showed bony fusion in the fusion segments without loosening/breakage of internal fixation or interbody fusion sinking.Except for 1 patient having grade A according to American Spinal Injury Association (ASIA) criteria enjoyed no recovery after the operation,the remaining patients enjoyed good improvement.The postoperative average Japanese Orthopedic Association (JOA) scale scores were significantly higher than those before surgery; the postoperative average JOA scale scores and recovery ratio of JOA in patients received surgery within 72 h of injury were obviously higher than those in patients received surgery over 72 h of injury (P<0.05).Conclusion Early anterior titanium mesh combined with cage and locking plate operation can make acute cervical disc herniation patients with spinal cord injury get rapid improvement and restoration; the earlier the operation time,the better the recovery degree; surgery can make cervical operation section obtain immediate stability,fusion and clinical effects are satisfied.%目的 探讨早期颈前路手术治疗多节段急性颈椎间盘突出引起的颈脊髓损伤的临床疗效. 方法 河南省人民

  13. 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.

  14. 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.

  15. 颈椎间盘置换术与前路减压椎间融合术术后疼痛及残障指数比较的Meta分析%Comparison of postoperative pain and neck function between cervical disc replacement and anterior cervical discectomy and fusion: a Meta-analysis

    Institute of Scientific and Technical Information of China (English)

    李冰; 王沛; 李晖; 阮文东; 冯世庆; 马信龙

    2009-01-01

    目的 收集并分析有关颈椎间盘置换术与颈前路减压椎间融合术(anterior cervical dis-cectomy and fusion,ACDF)术后疗效比较的文献,对颈椎间盘置换术和ACDF术后疼痛及残障指数进行Meta分析.方法 检索Medline(1966年1月至2008年11月)、Embase(1966年1月至2008年11月)、AMED(1985年1月至2008年11月)和Cochrane Library等数据库中关于颈椎间盘置换术和ACDF术后疗效比较的随机对照研究,纳入符合标准的文献,提取相关数据输入Review Manager4.2软件进行统计学分析.臂部疼痛及颈部疼痛的视觉模拟评分(visual analogue scale,VAS)、颈部功能残障指数(neckdisability index,NDI)均采用权重均差(weighted mean difference,WMD)进行评价.结果共4篇文献符合纳入标准,经改良Jadad评分判定均为高质最研究.共纳入213例,干预组(颈椎间盘置换组)和对照组(ACDF组)术后6周臂部疼痛VAS合并WMD为-2.91[95%置信区间(-4.19,-1.62),P<0.05],术后6个月合并WMD值为-2.67[95%置信区间(-4.02,-1.33),P<0.05].干预组和对照组术后6周NDI合并WMD值为-11.93[95%置信区间(-15.66,-8.19),P<0.05],术后6个月合并WMD值为-11.2[95%置信区间(-14.74,-7.69),P<0.05].结论 颈椎间盘置换术后6周和6个月时患者臂部疼痛程度低于ACDF;颈椎间盘置换术后6周和6个月患者颈部功能恢复程度高于ACDF.%Objective To evaluate the postoperative pain and neck function of patients who under-went cervical disc replacement or anterior cervical discectomy and fusion (ACDF) by Meta-analysis. Meth-otis In Medline (1966.1-2008.11), Embase (1966.1-2008.11), AMED (1985.1-2008.11) and Cochrane Li-brary, the randomized controlled trails about the comparison between cervical disc replacement and ACDF were collected. Then extracted the data of arm pain visual analogue scale (VAS), neck pain VAS and neck disability index (NDI) in these researches and made a Meta-analysis using Review Manager 4.2. Weighted mean difference

  16. The Biomechanics of Cervical Spondylosis

    Directory of Open Access Journals (Sweden)

    Lisa A. Ferrara

    2012-01-01

    Full Text Available Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture of the cervical spine will progress into kyphosis and continue if the load balance and lordosis is not restored. The content of this paper will address the physiological and biomechanical pathways leading to cervical spondylosis and the biomechanical principles related to the surgical correction and treatment of kyphotic progression.

  17. The biomechanics of cervical spondylosis.

    Science.gov (United States)

    Ferrara, Lisa A

    2012-01-01

    Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture of the cervical spine will progress into kyphosis and continue if the load balance and lordosis is not restored. The content of this paper will address the physiological and biomechanical pathways leading to cervical spondylosis and the biomechanical principles related to the surgical correction and treatment of kyphotic progression.

  18. 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