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Sample records for cervical disc degeneration

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

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

    2010-01-01

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

  2. Gene expression profile of degenerated cervical intervertebral disc tissues in rats

    Institute of Scientific and Technical Information of China (English)

    王拥军; 吕维加; 施杞; 周重建; 张强; 周泉; 卞琴; 刘梅; 梁智仁

    2004-01-01

    Objective: To analyze the gene expression profile of degenerated cervical intervertebral disc of Sprague Dawley rats on a large scale.Methods: Degenerated models of Sprague Dawley rats of 9 months old (degeneration group, n=9) and normal Sprague Dawley rats of 3 months old (control group, n=9) were prepared, respectively. mRNA was obtained from the cervical intervertebral disc of rats in both groups, respectively, and then labelled by Cy5 and Cy3 fluorescence respectively after reverse transcription to obtain intervertebral disc cDNA probes. cDNA probes were hybridized with BiostarR-40s gene expression profile chips and scanned by laser scanner. The results were treated with portrait analysis, standardization management, and ratio analysis with softwares.Results: Compared with the rats in the control group, 9.6% (381 pieces in total) gene expression changed obviously in the rats in the degeneration group, among which, the gene expression quantities of 171 pieces increased significantly (r=the ratio of the degeneration group to the control group >2.0), 52 pieces of which had certain function. While the gene expression quantities of 211 pieces decreased significantly (r<0.5), 41 pieces of which had certain function.Conclusions: Gene chip technology can be used to analyze the gene expression profile of degenerated intervertebral disc of rats in parallel, in quantity and on a large scale, which helps to testify the representative genes and protein expression, and plays an important role in clarifying the pathogenesis of degenerated intervertebral disc.

  3. 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...

  4. 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...

  5. 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.)

  6. 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

  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. 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

  12. 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.

  13. Cervical Disc Disease: Biomechanical Aspects

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    Kolstad, Frode

    2011-01-01

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

  14. Do We Need Biomarkers for Disc Degeneration?

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    Helen E. Gruber

    2006-01-01

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

  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. Reoperations Following Cervical Disc Replacement

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

    2015-01-01

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

  20. Do We Need Biomarkers for Disc Degeneration?

    OpenAIRE

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

    2007-01-01

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

  1. 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

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

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    Roenning Paal

    2010-03-01

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

  3. 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

  4. Stem cell horizons in intervertebral disc degeneration

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

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    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.

  6. 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

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

    Directory of Open Access Journals (Sweden)

    Markus Wenger

    2010-07-01

    Full Text Available Markus Wenger1, Thomas-Marc Markwalder21Neurosurgery, Klinik Beau-Site and Salem-Spital, Berne, Switzerland; 2Attending Neurosurgeon FMH, Private Practice Spine Surgery, Berne-Muri, SwitzerlandAbstract: Total disc arthroplasty is a new option in the treatment of cervical degenerative disc disease. Several types of cervical disc prostheses currently challenge the gold-standard discectomy and fusion procedures. This review describes the Bryan Cervical Disc System and presents the Bryan prosthesis, its indications, surgical technique, complications, and outcomes, as given in the literature.Keywords: cervical spine, degenerative disc disease, disc herniation, myelopathy, spine surgery, bryan prosthesis, complication, outcome

  8. Biomechanical analysis of the camelid cervical intervertebral disc

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    Dean K. Stolworthy

    2015-01-01

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

  9. 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.

  10. Fusion around cervical disc prosthesis: case report.

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    OpenAIRE

    Markus Wenger; Thomas-Marc Markwalder

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  13. Cervical disc hernia operations through posterior laminoforaminotomy

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    Coskun Yolas

    2016-01-01

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

  14. 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

  15. Activ C cervical disc replacement for myelopathy

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    L McGonagle

    2011-01-01

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

  16. 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.

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    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

  17. 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

  18. Bovine explant model of degeneration of the intervertebral disc

    OpenAIRE

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

    2008-01-01

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

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

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    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.

  20. 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,

  1. Gene expression profile analysis of human intervertebral disc degeneration

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    Kai Chen

    2013-01-01

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

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. Material Science in Cervical Total Disc Replacement

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    Martin H. Pham

    2015-01-01

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

  7. 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.

  8. 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.

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

    OpenAIRE

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

    2013-01-01

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

  10. Bovine explant model of degeneration of the intervertebral disc

    Directory of Open Access Journals (Sweden)

    Sivan Sarit

    2008-02-01

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

  11. 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

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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.

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

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    Kim Sung-Ha

    2012-06-01

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

  1. New treatment strategies for canine intervertebral disc degeneration

    OpenAIRE

    Smolders, L.A.

    2013-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

    Jawahar, Ajay; Nunley, Pierce

    2012-01-01

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

  4. 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.

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

    OpenAIRE

    Kim Sung-Ha; Park Man-Young; Lee Sang-Mi; Jung Ho-Hyun; Kim Jae-Kyoun; Lee Jong-Deok; Kim Dong-Woung; Yeom Seung-Ryong; Lim Jin-Young; Park Min-Jung; Park Se-Woon; Kim Sung-Chul

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  7. Application of Percutaneous Cervical Nucleoplasty Using the Navigable Disc Decompression Device in Patient of Cervical Herniated Intervertebral Disc: A Case Report

    OpenAIRE

    Lim, Ji-Hoon; Lee, Hye-Jin; Lee, Sang-Heon

    2013-01-01

    Recent years, various percutaneous procedures including cervical nucleoplasty have been developed for disc decompressions to relieve radicular pains caused by disc herniations. We report the application of percutaneous cervical nucleoplasty (PCN) by using the navigable disc decompression device in two patients of cervical herniated intervertebral discs (HIVD). A 38-year-old female diagnosed with C4-C5 disc extrusion with bilateral C5 roots impingement received nucleoplasty twice at C4-C5 disc...

  8. 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 benefit and reliability of HS for the treatment of cervical disk diseases. PMID:27227922

  9. 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.

  10. Concomitance of fibromyalgia syndrome and cervical disc herniation

    OpenAIRE

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

    2015-01-01

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

  11. 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.)

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

    OpenAIRE

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-02-01

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

  16. 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

  17. 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

  18. 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.)

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

    Science.gov (United States)

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

    2013-01-01

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

  20. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

  1. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chris Daly

    2016-01-01

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

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

    Science.gov (United States)

    Ghosh, Peter

    2016-01-01

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

  5. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

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

    Science.gov (United States)

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

    2016-06-23

    Traditionally tissue samples are analysed using protein or enzyme specific stains on serial sections to build up a picture of the distribution of components contained within them. In this study we investigated the potential of multivariate curve resolution-alternating least squares (MCR-ALS) to deconvolute 2nd derivative spectra of Fourier transform infrared (FTIR) microscopic images measured in transflectance mode of goat and human paraffin embedded intervertebral disc (IVD) tissue sections, to see if this methodology can provide analogous information to that provided by immunohistochemical stains and bioassays but from a single section. MCR-ALS analysis of non-degenerate and enzymatically in vivo degenerated goat IVDs reveals five matrix components displaying distribution maps matching histological stains for collagen, elastin and proteoglycan (PG), as well as immunohistochemical stains for collagen type I and II. Interestingly, two components exhibiting characteristic spectral and distribution profiles of proteoglycans were found, and relative component/tissue maps of these components (labelled PG1 and PG2) showed distinct distributions in non-degenerate versus mildly degenerate goat samples. MCR-ALS analysis of human IVD sections resulted in comparable spectral profiles to those observed in the goat samples, highlighting the inter species transferability of the presented methodology. Multivariate FTIR image analysis of a set of 43 goat IVD sections allowed the extraction of semi-quantitative information from component/tissue gradients taken across the IVD width of collagen type I, collagen type II, PG1 and PG2. Regional component/tissue parameters were calculated and significant correlations were found between histological grades of degeneration and PG parameters (PG1: p = 0.0003, PG2: p collagen type I and II showed significant correlations with total collagen content (p = 0.0204, p = 0.0127). In conclusion, the presented findings illustrate, that the

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

    OpenAIRE

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

    2009-01-01

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

  9. 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

  10. 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.

  11. 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.

  12. Intradural tumor and concomitant disc herniation of cervical spine

    Directory of Open Access Journals (Sweden)

    Mihir R Bapat

    2011-01-01

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

  13. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    A.C. Issy

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    A.C. Issy

    2013-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-03-15

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

  20. 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.

  1. 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.

  2. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

  3. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

  4. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

  5. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

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

    OpenAIRE

    Yang, Tianjing; Xu, Huaqing

    2015-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-12-01

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

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

    OpenAIRE

    Ruiz Wills, Carlos

    2015-01-01

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

  10. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

  11. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

  12. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

  13. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

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

  14. Return to Play After Cervical Disc Surgery.

    Science.gov (United States)

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

    2016-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2012-01-01

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

  16. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-02-15

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

  18. Human cartilage endplate permeability varies with degeneration and intervertebral disc site.

    Science.gov (United States)

    DeLucca, John F; Cortes, Daniel H; Jacobs, Nathan T; Vresilovic, Edward J; Duncan, Randall L; Elliott, Dawn M

    2016-02-29

    Despite the critical functions the human cartilage endplate (CEP) plays in the intervertebral disc, little is known about its structural and mechanical properties and their changes with degeneration. Quantifying these changes with degeneration is important for understanding how the CEP contributes to the function and pathology of the disc. Therefore the objectives of this study were to quantify the effect of disc degeneration on human CEP mechanical properties, determine the influence of superior and inferior disc site on mechanics and composition, and simulate the role of collagen fibers in CEP and disc mechanics using a validated finite element model. Confined compression data and biochemical composition data were used in a biphasic-swelling model to calculate compressive extrafibrillar elastic and permeability properties. Tensile properties were obtained by applying published tensile test data to an ellipsoidal fiber distribution. Results showed that with degeneration CEP permeability decreased 50-60% suggesting that transport is inhibited in the degenerate disc. CEP fibers are organized parallel to the vertebrae and nucleus pulposus and may contribute to large shear strains (0.1-0.2) and delamination failure of the CEP commonly seen in herniated disc tissue. Fiber-reinforcement also reduces CEP axial strains thereby enhancing fluid flux by a factor of 1.8. Collectively, these results suggest that the structure and mechanics of the CEP may play critical roles in the solute transport and disc mechanics. PMID:26874969

  19. 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

  20. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    International Nuclear Information System (INIS)

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

  4. 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.

  5. 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.

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

    OpenAIRE

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

    2014-01-01

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

  7. 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

  8. Angiogenesis in the degeneration of the lumbar intervertebral disc

    OpenAIRE

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

    2010-01-01

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

  9. 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

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

    Science.gov (United States)

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

    2014-01-01

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

  11. 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

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

    Directory of Open Access Journals (Sweden)

    In-Soo Oh

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-12-01

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

  14. Treatment of Protrusion of Cervical Intervertebral Disc by Tuina

    Institute of Scientific and Technical Information of China (English)

    YE Jian-guo

    2004-01-01

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

  15. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-04-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-03-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

  1. 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.

  2. 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

  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.

  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. 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

  6. 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.

  7. 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)

  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

    2016-01-01

    Abstract 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 disc interior via an anterior cervical approach is effective and safe for the treatment of cervical intervertebral disc herniation. PMID:27336892

  9. 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.

  10. 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. PMID:27336892

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    L. Eva

    2010-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Zhengming Sun; Miao Liu; Yingang Zhang

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Isu, Toyohiko; Iwasaki, Yoshinobu; Abe, Hiroshi; Miyasaka, Kazuo; Tashiro, Kunio (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1984-02-01

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

  16. 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.

  17. 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

  18. 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 swimme...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

  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. 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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Hanley Edward N

    2002-03-01

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

  5. 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.

  6. 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.

  7. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  9. 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.

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

    OpenAIRE

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

    2005-01-01

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

  11. 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.)

  12. 人工颈椎间盘植入治疗颈椎病%Artificial cervical disc replacement in cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    王贵怀; 陈思源; 杨俊

    2009-01-01

    Objective Anterior cervical fusion has been a routine method for the surgical treatment of cervical spondylosis, but concerns for the possibility of acceleration of adjacentsegment disease after fusion have been growing. The artificial cervical disc replacement provides the opportunity to preserve motion after neural decompression while providing stability, which opens a new pathway for the surgical therapy of cervical spondylosis. Method We summarized the results of 16 patients of cervical herniated disc treated by artificial cervical disc replacement after cervical microdecompression and arthroplasty from December 2005 to March 2008. The average followup time was 17 momths. Results All patients got improved neurological function postoperatively. The cervical flextion and extention X - film showed good curvature and motion. 1 patient developed temporary hoarseness and recovered within 1 week. There was no other complications. Conclusions Cervical microdecompression with Bryan disc replacement is a good choice for adequate patient of cervical degenerative disc disease.%目的 颈椎病前路融合术后颈椎活动度下降与邻近节段椎间盘退变加速越来越受到人们的重视,人工颈椎间盘置换术可在进行脊髓减压并提供稳定的同时保持手术节段颈椎的活动度,为颈椎病的外科治疗开辟了新的途径.方法 自2005年12月至2008年3月,对16例颈椎病患者进行显微减压后椎间植入Bryan人工颈椎间盘,平均随访时间17个月.结果 所有患者术后症状均明显缓解,脊髓功能明显改善,颈椎活动度良好,1例术后发生短暂声音嘶哑,无手术死亡率.结论 人工颈椎间盘植入为颈椎病的外科治疗开辟了新的手段,在提供颈椎稳定的同时保持手术节段颈椎的良好活动度,把握严格的适应证和手术技术能取得满意的效果.

  13. 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

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

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    Lan-Tao Liu

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

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

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    黄长安; 李军; 袁文旗; 周立

    2015-01-01

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

  17. 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.

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

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    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-08-01

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

  20. 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.

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

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    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.

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

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    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. 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 < 0.01]). Twenty-four weeks after injections, the discs injected with the low-dose MPC+PPS formulation recovered disc height, and their mean DHI was significantly greater than the DHI of PPS- and nil-injected discs (p < 0.001). Although the mean Pfirrmann MRI disc degeneration score for the low-dose MPC+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 < 0.005), whereas the low-dose MPC+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

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

    International Nuclear Information System (INIS)

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

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

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    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.

  6. 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

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

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    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.

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

    OpenAIRE

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

    2013-01-01

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

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

    International Nuclear Information System (INIS)

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

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

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

    1986-05-01

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

  11. 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.

  12. 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.

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

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    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.

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

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    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.

  15. [MicroRNAs: a type of novel regulative factor for intervertebral disc degeneration].

    Science.gov (United States)

    Wang, Cheng; Wang, Wenjun; Yang, Wei; Yu, Xiaohua; Yan, Yiguo; Zhang, Jian; Jiang, Zhisheng

    2016-03-01

    Intervertebral disc degeneration (IDD) is one of major causes for intervertebral disc degenerative diseases, and patients with IDD usually suffer from serious low back pain. The current treatments for patients with IDD only relieve the clinical symptom rather than restore biological balance of IDD, leading to inadequate and unsatisfactory results. MicroRNAs (miRNAs) are endogenous, non-coding, single-stranded RNA molecules, which regulate the gene expression at the post-transcription levels. Research evidences support the involvement of miRNAs in many biological processes, such as lipid metabolism, apoptosis, differentiation and organ development. Accumulating evidences indicate that the expressions of miRNAs change significantly in degenerative tissues. In addition, dysregulated miRNAs contribute to multiple pathological process of IDD, including proliferation and apoptosis of nucleus pulposus and extracellular matrix components, inflammatory response and cartilage endplates degeneration. In this review article, we summarize the expression profiles and roles of miRNAs in IDD, which may provide a novel strategy of biological therapy for the disease. PMID:27273991

  16. 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.

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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

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

    Institute of Scientific and Technical Information of China (English)

    彭宝淦; 王占朝; 唐家广; 侯树勋; 吴仕良

    2003-01-01

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

  7. 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

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

    Institute of Scientific and Technical Information of China (English)

    方军; 高克海; 李华壮; 褚俊良

    2002-01-01

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

  9. 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.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Abrishamkar Saeid

    2009-01-01

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

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

    Science.gov (United States)

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

    2016-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Oka Dominique N'Dri

    2015-12-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    程俊杰; 眭江涛; 马原; 田慧中

    2015-01-01

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

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

    OpenAIRE

    Korkut, Yasemin; Ayada, Ceylan; Toru, Ümran

    2015-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  18. 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.)

  19. 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.

  20. 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。

  1. 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.)

  2. 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

  3. 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.

  4. 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.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    The objective of the present study was to examine the associations between eleven putative predisposing single nucleotide polymorphisms (COL9A3, COL11A2, IL1A, IL1B, IL6 and VDR) and early disc degeneration (DD). The population consisted of 12 to 14-year-old Danish children (N=352). DD...... rs1800587 in CT/TT compared to CC resulted in OR 2.85 [1.19-6.83]. In IL6 promoter polymorphism rs1800796, the C-allele was more frequent among the subjects with DD, OR 6.71 [1.71- 26.3]. Of the IL6 haplotypes, GCG was associated with DD, OR 6.46 [1.61 – 26.0]. No associaamong boys. Our results...... was evaluated from magnetic resonance im- ages (MRI). We analysed the association between DD and single nucleotide polymorphisms or haplotypes using logis- tic regression analyses. Of the 352 children studied, 73 boys and 81 girls had no MRI changes, while 30 boys and 36 girls had lumbar DD. Among girls, IL1A...

  6. 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.

  7. 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.

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

    OpenAIRE

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2016-05-01

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

  10. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  12. 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.

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

    Science.gov (United States)

    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.

  14. 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

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

    OpenAIRE

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

    2009-01-01

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

  16. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Institute of Scientific and Technical Information of China (English)

    孔庆奎; 张立涛; 谢元忠; 付孟莉; 武玉恒; 程琮; 陈绪珠

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    吴向东; 刘绍武; 唐佩福

    2012-01-01

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

  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. A pilot study of the prevalence of lumbar disc degeneration in elite athletes with lower back pain at the Sydney 2000 Olympic Games

    Science.gov (United States)

    Ong, A; Anderson, J; Roche, J

    2003-01-01

    Objectives: To observe the prevalence of lumbar intervertebral disc degeneration in elite athletes as compared with published literature of changes seen in non-athletes—that is, normal population. Methods: The lumbar spines of 31 Olympic athletes who presented to the Olympic Polyclinic with low back pain and/or sciatica were examined using magnetic resonance imaging. Three criteria were looked at: (a) the loss of disc signal intensity; (b) the loss of disc height; (c) the presence of disc displacement. The results were then recorded and correlated with the lumbar levels. Results: The disc signal intensity was progressively reduced the more caudal the disc space. It was most common at the L5/S1 level, and, of the abnormal group, 36% (n = 11) showed the most degenerative change. Disc height reduction was also found to be most common at the L5/S1 level. However, the most common height reduction was only mild. A similar trend of increased prevalence of disc herniation was noted with more caudal levels. At the L5/S1 level, 58% were found to have an element of disc displacement, most of which were disc bulges. Compared with changes seen in the normal population (non-athletes) as described in the literature, disc degeneration defined by the above criteria was found to be significantly more severe in these Olympic athletes. Conclusions: Although the study was limited, the results suggest that elite athletes have a greater prevalence and greater degree of lumbar disc degeneration than the normal population. A more detailed follow up study should be considered to investigate which particular training activities have the most impact on the lumbar spine, and how to modify training methods so as to avoid the long term sequelae of degenerative disc disease of the lumbar spine. PMID:12782554

  1. 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.

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

    Science.gov (United States)

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

    2016-01-15

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

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

    Directory of Open Access Journals (Sweden)

    Dachuan Wang

    2014-01-01

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

  4. 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.

  5. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ismail Ismail

    2006-12-01

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

  8. 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

  9. 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

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

    Directory of Open Access Journals (Sweden)

    Andrea eMalandrino

    2015-02-01

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

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

    OpenAIRE

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

    2009-01-01

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

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

    Science.gov (United States)

    Ekşi, Murat Şakir; Özcan Ekşi, Emel Ece; Yılmaz, Baran; Toktaş, Zafer Orkun; Konya, Deniz

    2015-01-01

    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. PMID:25972718

  13. 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.

  14. 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.

  15. 椎间盘退变模型技术进展%Research advances in animal models of intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    黄振超; 夏建龙; 陈刚; 蔡平

    2014-01-01

    Intervertebral disc degeneration is a variety of factors, long-term and chronic stimulation of intervertebral disc, intervertebral disc structure stability decreased due to the reaction process, gradually change. Through the study of the animal model of degenerative intervertebral disc, study for the human intervertebral disc degeneration diseases provide an important means of. As the animal model making means continuously enriched and control index of accurate degree raise constantly, the simulated animal intervertebral disc degeneration model similarity has been signiifcantly improved, thus making animal model has a broad prospect in the research the degenerative disc disease. This article reviews the progress in recent years a variety of commonly used animal model of intervertebral disc degeneration.%椎间盘退变是多种因素长期慢性刺激椎间盘,从而引起的椎间盘结构稳定性下降,逐步缓慢发生相关变化的反应过程。通过对动物退变椎间盘模型的研究,可以为人椎间盘退变疾病的研究提供重要手段。随着动物模型制作手段不断丰富及控制指标精确程度不断提高,动物所模拟人椎间盘退变模型相似度有了显著提高,因此动物造模在椎间盘退变性疾病的研究中将具有更为广阔的发展前景。本文就近年来各种常用椎间盘退变模型的研究进展作一综述。

  16. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Marion Fusellier

    2016-01-01

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

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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。

  5. 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.

  6. 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

  7. 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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  10. 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.

  11. Value of preoperative cervical discography

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-15

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

  12. 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.

  13. Anterior cervical discectomy and fusion with titanium cages for simple or multilevel herniated discs and spur of the cervical spine: Report of 2 cases and experience in Bali

    Science.gov (United States)

    Mahadewa Tjokorda, G. B.; Nyoman, Golden; Sri, Maliawan; Junichi, Mizuno

    2016-01-01

    This report presents two cases of cervicobrachialgia and radiculopathy due to multiple cervical herniated discs and spur formation that dealt with anterior cervical discectomy and fusion (ACDF) using different titanium interbody cages. The description of the clinical presentation, magnetic resonance imaging (MRI) appearances and management strategy are discussed. Both cases showed chronic neck pain and radiating pain from the shoulder to the arm. They had a history of blurry vision, cluster head ache, weakness, and numbness on the shoulder for 2 years. MRI revealed multiple herniated discs between C4-7 and accompanied by the spur formation leading to the narrowness of the spinal canal and its foramina bilaterally. ACDF were performed and complete decompression of the spinal canal and its foramina were carried out. Twin M-cages (Ammtec Inc.-Japan) were placed in the first case at C5-7 levels and single cage of Smith Robinson (SR) was placed in the second case at C5-6 levels. There were no more blurry vision, cluster headache, weakness, and numbness, immediately after surgery. To our knowledge, this is the first reported cases of ACDF, using twin M-cages and single SR cage in Indonesia, with improvement immediately after surgery. Cervical spondylosis can present with cervicobrachialgia and radiculopathy and surgical treatment produces good functional outcome. PMID:27695567

  14. Clinical outcome of cervical disc replacement and adjacent cage fusion for multi-segmental cervical disc herniation%颈椎间盘置换与相邻节段融合的治疗选择

    Institute of Scientific and Technical Information of China (English)

    任先军; 初同伟; 蒋涛; 王卫东; 王建; 李长青

    2011-01-01

    目的 探讨椎间盘置换与相邻节段融合治疗多节段颈椎间盘突出症的临床疗效.方法 对39例多节段颈椎间盘突出症患者,Ⅰ期同时完成病变节段人工椎间盘置换和邻近节段Cage融合.本组39例多节段椎间盘突出症患者,双节段颈椎间盘突出29例,三节段颈椎间盘突出9例,四节段颈椎间盘突出1例.病变节段C3~4、C4~5,2例,C4~5、C5~6 15例,C5~6、C6-79例,C4~5、C6~7 3例,C3~4、C4~5、C5~6 4例,C4~5、C5~6、C6~7 5例,C3~4、C4~5、C5~6、C6~7 1例.临床症状以脊髓压迫为主者18例,以神经根性症状为主者21例,术后随访观察椎间盘假体稳定性、假体活动度、Cage融合状态及Cage位移等.依据日本骨科学会(JOA)评分,Odom标准评定神经功能改善情况,采用颈椎残障功能量表(neck disability index,NDI)评定术后临床症状改善和日常功能状态.结果29例双节段颈椎间盘突出症患者,选择1个节段的椎间盘置换和1个节段Cage植骨融合;9例三节段颈椎间盘突出症患者,7例行1个节段的人工椎间盘置换、2个节段Cage植骨融合;2例选择2个节段的人工椎间盘置换、1个节段Cage植骨融合.1例四节段颈椎间盘突出症患者行2个节段的人工椎间盘置换、2个节段Cage植骨融合.术后随访6个月~3年半,人工椎间盘稳定,椎间盘假体平均活动度为9.3°,Cage全部融合,无Cage松动沉陷.患者神经功能有明显改善,JOA评分由术前9.1分增加至13.2分;NDI评分由术前41.8分降至29.5分;Odom评分临床成功率(优/良/可)达到85%(33例).结论颈椎间盘置换与相邻节段融合为颈椎间盘突出症的治疗提供了新的选择方式,兼顾了颈椎的稳定和运动功能,其远期疗效有待于临床随访.%Objective To evaluate the clinical outcome of artificial cervical disc replacement and cage fusion in the treatment of multi-segmental cervical disc herniation. Methods A total of 39

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

    OpenAIRE

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

    2012-01-01

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

  16. 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.

  17. 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

  18. 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.

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

    Science.gov (United States)

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

    2005-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

    吴洁石; 包聚良; 徐瑞生; 陆华; 王刊石; 王雪松; 薛骏

    2012-01-01

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

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    H Cho

    2011-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Harrison J Westwick

    2014-01-01

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

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

    Science.gov (United States)

    Radcliff, Kris; Coric, Domagoj; Albert, Todd

    2016-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

    柳达; 黄瑛; 李彬; 贾长青; 许晓军; 梁峰; 付勤

    2013-01-01

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

  6. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  8. Total disc replacement.

    Science.gov (United States)

    Vital, J-M; Boissière, L

    2014-02-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  11. 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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    刘丹

    2015-01-01

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

  15. 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

  16. 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.

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

    Science.gov (United States)

    McCanless, Jonathan D.

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  19. 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

  20. How to make animal models of intervertebral disc degeneration that fully simulate the human intervertebral disc degeneration?%如何构建能较全面模拟人类椎间盘退变性疾病的椎间盘退变实验动物模型

    Institute of Scientific and Technical Information of China (English)

    巴穆登; 艾尔肯•阿木冬; 孟祥玉

    2015-01-01

    BACKGROUND:The pathogenesis of intervertebral disc degenerative disease has not been determined. To establish the ideal animal model of intervertebral disc degeneration is an important approach to study the pathogenesis or treatment of the disease. OBJECTIVE:To review model selection, modeling method and the advantages and disadvantages of the studies concerning various animal models of intervertebral disc degeneration. METHODS:We retrieved Wanfang database, China National Knowledge Infrastructure database, PubMed database and FMJS database for articles on animal models of intervertebral disc degeneration in vivo and in vitro published in recent five years al over the world. RESULTS AND CONCLUSION:The present literature shows that smal and medium-sized animals are now commonly used animal model. Building methods can be divided into two major categories of in vivo and in vitro models. The in vitro model revealed mechanism of intervertebral disc degeneration by the cel or tissue culture from the cel ular and molecular levels. In vivo model, different kinds of physical or chemical methods are used to intervene intervertebral disc, causing the intervertebral disc degeneration, proving the mechanism of intervertebral disc degeneration by the process of intervention. However, pathogenesis of human intervertebral disc degenerative disease is complex and has not been determined, so the current animal models are not comprehensive simulation of human intervertebral disc degenerative disease.%背景:椎间盘退变性疾病的发病机制目前尚无定论,建立理想的椎间盘退变动物模型是研究该病发病机制或治疗的重要途径。  目的:对近年来各种椎间盘退变动物模型研究的模型选择、建模方法以及优缺点做一综述。  方法:计算机检索万方数据库、知网数据库、PubMed数据库以及FMJS数据库近5年国内外关于椎间盘退变的体内及体外动物模型的文献。 

  1. 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

  2. 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.

  3. 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

  4. 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

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

    Science.gov (United States)

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

    2016-08-01

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

  6. 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.

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

    International Nuclear Information System (INIS)

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

  8. 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

  9. 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

  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. 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.

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

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    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

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Jun Liao

    2012-01-01

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

  15. 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 prosthesis placement (OR = 1.5 [1.0-2.0], P = 0.029), and vocal cord paralysis (OR = 11.6 [8.3-16.1], P 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 intervention appears underutilized in this population. PMID:23943072

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

    OpenAIRE

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

    2010-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  18. 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

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

    OpenAIRE

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

    2015-01-01

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

  20. 前入路射频盘内热凝术联合后入路胶原酶盘外溶解术治疗颈椎间盘突出症的临床研究%Clinical study of radiofrequency thermocoagulation in disc combined with collagenase injection out of disc in patients with cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    郭建; 黄桂明; 齐亮; 陈平国; 陈娟

    2013-01-01

    目的 探讨前入路射频盘内热凝术联合后入路胶原酶盘外溶解术治疗颈椎间盘突出症的临床效果和安全性.方法 颈椎间盘突出症患者92 例,在C型臂引导下经皮穿刺至椎间盘靶点,分别进行前路射频盘内热凝术和后路胶原酶盘外溶解术.术后1 周、1 个月、3 个月时采用视觉模拟评分法(VAS)及MacNab法进行疗效评价.结果 术后1 周、1 个月、3 个月VAS评分与术前比较差异有统计学意义(P<0.05),治疗后1 周、1 个月、3个月优良率分别为69.6%、75.0%、78.3%,总有效率均不低于80.0%.结论 前路射频盘内热凝术联合后路胶原酶盘外溶解术是治疗颈椎间盘突出症是一种安全有效的方法.%Objective To investigate the clinical effect and safety of radiofrequency thermocoagulation in disc combined with collagenase injection out of disc in patients with cervical intervertebral disc herniation. Methods Ninety-two patients with cervical intervertebral disc herniation were treated with percutaneous puncture of intervertebral disc under the guidance of C-arm and then with radiofrequency thermocoagulation in disc combined with collagenase injection out of disc. The effect of treatment was evaluated according to VAS and MacNab's method 1 week, 1 month and 3 months after operation. Results Compared with the preoperative VAS scores, the postoperative VAS scores were significantly improved (P<0.05). One week, 1 month and 3 months after treatment, the excellent and good rates were 69.6%, 75.0%, 78.3%, respectively. The total efficacy rate was more than 80.0%. Conclusion Radiofrequency thermocoagulation in disc and collagenase injection out of disc is safe and effective in treatment of cervical intervertebral disc herniation.

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

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    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. 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

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    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.

  3. 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

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张强; 刘萍; 张敏

    2013-01-01

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

  6. 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

  7. Epidural injection of collagenase into a goat model of lumbar disc degeneration%山羊腰椎间盘退变模型硬膜外胶原酶的注射

    Institute of Scientific and Technical Information of China (English)

    朱伟红; 朱海波; 马南; 解品亮; 邓红震; 朱建民

    2011-01-01

    采用椎间盘外、硬膜外腔注射胶原酶治疗椎间盘突出症的机制,目前尚不完全清楚.目的:观察硬膜外注射胶原酶对椎间盘退变动物模型的作用.方法:成年山羊6只,麻醉后作侧外方切口至腰椎体腹侧,椎板加压并用钢板螺钉固定,L1/L2,L3/L4椎间盘分别注射0.5同mL无水乙醇建立椎间盘退变模型.硬膜外注射实验用胶原酶1mL,2周后处死动物,取出椎间盘,作电镜切片观察.结果与结论:电镜下显示:退变的椎间盘纤维环上的裂隙渗透到盘内,退变的椎间盘的胶原纤维明显溶解,未退变的椎间盘未有明显溶解.提示硬膜外注射胶原酶通过纤维环上的裂隙渗透到盘内,发生化学溶解作用,从而达到治疗作用.%BACKGROUND: The mechanism of epidural injection of collagenase to treat lumbar disc degeneration is still unclear. OBJECTIVE: To assess the mechanism of epidural injection of collagenase in animal models of lumbar disc degeneration. METHODS: Six adult sheep were excessively pressed with steel plate and L1/L2, L3/L4 segments were injected with 0.5 mL absolute alcohol to prepare lumbar disc degeneration models. Two weeks after epidural injection of collagenase, the sheep was killed to take the disc for electronic microscope observation.RESULTS AND CONCLUSION: The electronic microscope showed that there were some fissures in the fibrous ring of the degenerated intervertebral disk, collagen fibers discs were dissolved, non-degenerative discs were unchanged. Collagenase can enter degenerated intervertebral disc and directly dissolve nucleus pulposus tissue.

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

    Institute of Scientific and Technical Information of China (English)

    楚磊; 刘超; 陈亮; 柯珍勇; 陈富; 邓忠良

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王鑫鑫; 王利民; 王卫东; 刘屹林

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    祝福贵

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  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. 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 ...

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

    Institute of Scientific and Technical Information of China (English)

    杨波; 谢景开; 尹飚; 宋磊; 方世兵; 万盛钰; 李健

    2011-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

  18. 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

  19. 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

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

    Institute of Scientific and Technical Information of China (English)

    吴兴林

    2014-01-01

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

  1. Early efficacy of Prestige LP artificial disc replacement on cervical disc gegenerative diseases%Prestige LP颈椎人工椎间盘置换治疗颈椎病的初期疗效

    Institute of Scientific and Technical Information of China (English)

    张亮; 冯新民; 倪斌; 卢旭华; 杨建东; 王永祥; 孙钰

    2013-01-01

    目的 探讨应用Prestige LP人工椎间盘置换治疗颈椎病的初期疗效.方法 采用Prestige LP人工颈椎间盘置换术治疗颈椎病14例,统计并分析患者术前和术后随访时相关指标并进行比较.结果 所有患者均为单节段置换,术后随访平均15.6个月.术后JOA评分由(10.3±2.1)分提高到(15.2±4.4)分,NDI评分由(42.30±10.15)%改善到(16.54±8.16)%,颈部疼痛VAS评分由(5.2±1.4)分改善到(1.6±0.7)分,上肢疼痛由(5.3±1.7)分改善到(1.7±0.8)分,差异均有统计学意义(P<0.05);术后患者生存质量明显改善,SF-36中物理评分从(34.2±5.1)%改善至(52.3±6.5)%,心理评分从(39.2±3.7)%改善至(55.3±4.6)%(P<0.05).术后手术节段颈椎曲度由(7.1±2.4)°改善至(12.8±3.1)°(P<0.05),颈椎的整体曲度由前(15.7±5.3)°改善至(17.1±6.0)°(P>0.05);手术前后手术节段活动度、手术节段邻近节段活动度无明显变化(P>0.05).结论 应用Prestige LP人工椎间盘置换术治疗颈椎病初期临床疗效良好,中远期疗效有待进一步观察.%Objective To evaluate the short-term radiological and functional outcome of Prestige LP artificial disc replacement for cervical disc degenerative diseases.Methods Fourteen patients with cervical disc degenerative diseases underwent Prestige LP artificial disc replacement.The JOA score,NDI score,VAS score for neck and arm pain,SF-36 scores were reviewed respectively preoperatively and postoperatively.The angulation of the treated level,the global cervical and the adjacent level above and below the treated level were also reviewed preoperatively and at the last follow-up.Results At an average of 15.6 month follow-up,the JOA score and NDI score were significantly improved from (10.3±2.1) to (15.2±4.4) and from (42.30±10.15)% to (16.54±8.16)%.The VAS for neck and arm pain were all significantly improved from (5.2±1.4) and (5.3±1.7) to (1.6±0.7) and (1.7±0.8) respectively.The mean

  2. Cervical radiculopathy.

    Science.gov (United States)

    Iyer, Sravisht; Kim, Han Jo

    2016-09-01

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

  3. 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.

  4. 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

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

    Institute of Scientific and Technical Information of China (English)

    徐宏光; 彭红心; 程加峰; 吕坤

    2011-01-01

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

  6. 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.

  7. 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

  8. 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.

  9. 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:

  10. [Analysis on 149 consecutive cases of intervertebral lumbar and cervical disc prolapse operated with microendoscopic (Metr'X) technique].

    Science.gov (United States)

    Latorraca, A; Forni Niccolai Gamba, C

    2004-01-01

    Herniated disc patients represent a limited subset of patients with low back pain. Incidence of surgical intervention for lumbar disc pathology is 3% to 4%. The goal of surgery is to achieve neural decompression and relief neurological symptoms. Discectomy through laminotomy is the most common approach. More recently percutaneous approaches to lumbar discectomy, include the use of suction, laser and spinal endoscopy have evolved with mixed results. Microendoscopic discectomy (MED) combines endoscopic technology with the principles of microdiscectomy: open surgical principles are used through a tubular retractor using endoscopic visualization. We present our experience with MED in 149 patients who underwent this procedure. The patient population consisted of 83 men and 66 women aged 18 to 88 years. All patients had substantial relief of their radiculopathy. PMID:15105907

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

    Institute of Scientific and Technical Information of China (English)

    欧云生; 刘显宏; 权正学; 唐可; 罗小辑; 蒋电明; 安洪

    2011-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  14. 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

  15. 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

  16. 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

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

    OpenAIRE

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

    2016-01-01

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

  18. 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

  19. Laenderyggens degeneration og radiologi

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Gosvig, Kasper Kjaerulf; Sonne-Holm, Stig

    2006-01-01

    is cyclic: exacerbations relieved by asymptomatic periods. New imaging modalities, including the combination of MR imaging and multiplanar 3-D CT scans, have broadened our awareness of possible pain-generating degenerative processes of the lumbar spine other than disc degeneration....

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

    Institute of Scientific and Technical Information of China (English)

    陈小余; 宋学文; 肖红

    2011-01-01

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

  1. 激光加臭氧交替治疗颈椎间盘突出症初步临床疗效观察%Clinical observation of laser combined with ozone treatment of cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    龙胜利; 周广勇; 陈晓敏; 尹磊; 王毅

    2011-01-01

    Objective To evaluate the application of percutancous laser disc decompression combined with ozone treatment for cervical disc herniation. Methods 131 cases of cervical disc herniation were treated with PI.DD plus ozone. Results Followed-up of 102 cases with complete data for 6-24 months, mean 14 months . According to Macnab standards, after 6 months of treatment, the. excellent ratio was 84.31% and the general effective ratio was 98.03 %. Conclusion PLDD combined with ozone is effective and safe,and it is an effective way to treatment of cervical disc herniation.%目的 探讨经皮激光椎间盘减压术(PLDD)加臭氧交替治疗颈椎间盘突出症的方法 及疗效.方法 对131例颈椎间盘突出症患者应用激光行PLDD加臭氧交替治疗.结果 随访资料完整102例,随访时间6~24个月,平均14个月,根据Macnab法评定疗效,治疗6个月后,优良率为84.31%,有效率为98.04%.结论 PLDD加臭氧交替治疗颈椎间盘突出症安全、有效,是颈椎间盘突出症的有效治疗方法 .

  2. 椎间盘突出临近退变节段是否导致腰痛%Can the degeneration adjacent to herniated disc in patients with lumbar disc herniation cause low pack pain?

    Institute of Scientific and Technical Information of China (English)

    王刚; 刘尚礼; 陈志维; 关宏刚; 韩敦富; 施彦璋

    2011-01-01

    背景:椎间盘突出症患者腰痛原因很难判断,一直以来,认为突出的椎间盘是椎间盘突出症患者腰痛及腿痛重要原因,椎间盘突出临近退变节段是否导致腰痛需进一步研究证实.目的:通过椎间盘造影判断突出临近退变节段是否是椎间盘突出症患者腰痛原因,并报告经椎间盘镜摘除椎间盘后残留腰痛在临近退变疼痛椎间盘经亚甲蓝注射治疗的效果.方法:20例同时具有腰痛和腿痛椎间盘突出症患者行椎间盘造影检查,这些患者腰椎MRI表现为有1个突出椎间盘外至少合并1个或1个以上的临近退变的椎间盘,全部患者均经椎间盘镜摘除椎间盘切除突出的椎间盘,5例临近退变椎间盘造影阳性患者在椎间盘镜切除后经椎间盘内注射亚甲蓝治疗.腰痛、腿痛采用目测类比评分评定.结果与结论:20例患者总共64个椎间盘行椎间盘造影,共11个椎间盘造影阳性,其中6个位于椎间盘突出临近退变节段,5个位于引起神经根性痛的椎间盘突出节段.全部病例腿痛行椎间盘镜切除突出椎间盘后明显缓解,腰痛有部分缓解,6例临近椎间盘造影阳性患者经椎间盘镜摘除椎间盘后腰痛明显,影响日常生活,其中5例行临近疼痛椎间盘亚甲蓝注射后腰痛缓解,1例患者拒绝亚甲蓝注射治疗仍有明显腰痛.结果显示椎间盘突出症患者腰痛可能来源于突出临近退变节段.%BACKGROUND: It is often difficult to determine the cause of low back pain (LBP) in the patients with lumbar disc herniation. The herniated disc has long been thought to be an important cause of the patient's complaint about LBP and sciatica. Whether the adjacent degenerative disc results in LBP needs further confirmations. OBJECTIVE: This study sought to determine whether the degenerative disc adjacent to the herniated disc in patients with LBP and radicular pain can result in discogenic LBP, as assessed by provocative

  3. 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.

  4. 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

  5. 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

  6. Cervical motion segment replacement

    OpenAIRE

    Bryan, Vincent E.

    2002-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    任斌; 蔡林; 陈志龙; 王建平; 胡超; 张桃根

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    方国芳; 雷高; 罗德民; 宋志会; 薛厚军; 敖俊; 林荔军

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    肖林; 王娴默; 黄亮; 徐澄; 张忠贵; 陈爱萍

    2013-01-01

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

  10. 椎间盘软骨终板的退变机理及相关实验研究概述%The endplate cartilage degeneration Mechanism and Empirical Study

    Institute of Scientific and Technical Information of China (English)

    郭艳军; 孙明亮; 蔡泽鹏

    2013-01-01

    Disc degeneration cervical spondylosis, vertebral instability , spondylolisthesis , disc herniation , spinal an important cause of the disease , the cartilage endplate and intervertebral disc degeneration closely related studies have demonstrated that disc degeneration was first from the cartilage endplate , the cartilage endplate degeneration is accelerated disc degeneration is an important reason . In recent years, research on the mechanism of degeneration of cartilage endplate increasing number of these studies, we can endplate cartilage lesions in degenerative disc disease mechanisms and the role of a further understanding of early prevention of degenerative intervertebral disc to build a new road, the following is a review of the progress in the study and treatment.%  椎间盘退变是颈椎病、椎体失稳、椎体滑脱、椎间盘突出等脊柱疾病的重要病因,而软骨终板与椎间盘退变关系密切,研究已经证明,椎间盘的退变最早是从软骨终板开始,软骨终板的退变也是加速椎间盘退变的一个重要原因。近年来有关软骨终板的退变机理的研究日渐增多,通过这些研究,可以对软骨终板在椎间盘退变性疾病中的病变机制和作用有进一步的认识,为椎问盘退变的早期预防和治疗开辟一条新的道路。

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-05-15

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

  13. 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.

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

    Institute of Scientific and Technical Information of China (English)

    吴成如; 张诗虎

    2013-01-01

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

  15. 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。

  16. Pathophysiology of Degenerative Disc Disease

    OpenAIRE

    Choi, Yong-Soo

    2009-01-01

    The intervertebral disc is characterized by a tension-resisting annulus fibrosus and a compression-resisting nucleus pulposus composed largely of proteoglycan. The most important function of the annulus and nucleus is to provide mechanical stability to the disc. Degenerative disc disease in the lumbar spine is a serious health problem. Although the three joint complex model of the degenerative process is widely accepted, the etiological basis of this degeneration is poorly understood. With th...

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

    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.

  18. Cerebellar Degeneration

    Science.gov (United States)

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

  19. Cell transplantation and tissue engineering reconstruction of nucleus pulposus in the treatment of intervertebral disc degeneration%细胞移植及髓核组织工程重建修复椎间盘退变

    Institute of Scientific and Technical Information of China (English)

    陈清河; 叶君健

    2011-01-01

    functional recovery of degenerated disc through thereversal and restoration of intervertebral disc cells.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  1. 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

  2. Spontaneous regression of an intraspinal disc cyst

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

    许思祥

    2011-01-01

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

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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

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

    Institute of Scientific and Technical Information of China (English)

    杨朝晖; 吴险峰; 邹磊

    2013-01-01

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

  10. 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

  11. 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

  12. 腰痛患者MRI上各节段腰椎间盘退变形式与年龄的相关性分析%Age-related degeneration of each lumbar intervertebral disc in symptomatic patients:MRI analysis

    Institute of Scientific and Technical Information of China (English)

    蒋欣; Yuichiro Morishita; Hymanson Henry; Jeffrey C.Wang

    2009-01-01

    目的:探讨腰痛患者MRI上各节段腰椎间盘退变形式与年龄的相关性.方法:回顾性分析2004-2006年共529例就诊于加州大学洛杉矶分校Santa Moniea骨科医院脊柱外科中心的腰痛伴或不伴有腿痛患者(男191例,女338例)的腰椎MRI资料,根据患者年龄分为5组,≤29岁、30~39岁、40~49岁、50~59岁及≥60岁组.按Pfirrmann's分级系统对每例患者腰椎各节段的椎间盘(LI/2~L5/S1)退变程度进行分级,所得数据采用SPSS 13.0进行统计学分析,总结其退变模式.结果:71例(13.4%)患者LI/2~L5/Si椎间盘退变程度表现为1-1-1-1-1,为正常椎间盘,是所有组合中最常见的.低年龄组发生严重退变(4级)的几率最低,L1/2、L2/3、L3,4椎间盘退变程度较IA/5、L5/S1低;1-1-1-1-1的发生率随着年龄的增加而明显降低,而1-1-1-1-2和1-1-1-1-3与之相反,发生率随着年龄的增加而明显升高.40岁以前,1-1-1-1-1的发生率最高;在40~49岁年龄组中.1-1-1-1-3的发生几率最高,为7.6%,而超过50岁,3-3-3-3-3发生的几率最高.单节段退变发生率与年龄呈负相关(P<0.01).随着年龄的增大而降低;而所有节段退变的发生率与年龄呈正相关(P(<0.01),随着年龄的增大而增加.结论:在腰痛患者中,腰椎单一节段退变所占比例随年龄增大而减小,而所有节段退变所占比例随年龄增大而增大.%Objective:To determine the most common patterns in symptomatic lumbar intervertibral disc degeneration at various age period.Method:The lumbar MRI imaging data of 529 patients treated for low back pain with or without skelagia in Santa Monica hospital in USA from 2004 to 2006 were reviewed retrospectively in this study .There were 191 females, 338 males.Degenerative grading was made for all disc levels in the lumbar spine for each patient. The patients were also classified into five age different groups starting from below age 30,with the intervals of a single decade,until over age 60

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2012-01-01

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

  15. 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

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

    Institute of Scientific and Technical Information of China (English)

    莫世奋; 李健; 曾勉东; 黄海; 吕玉明; 杨波

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Cervical facet dislocation adjacent to the fused motion segment

    Science.gov (United States)

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

    2016-01-01

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

  19. 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.

  20. 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.

  1. 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.

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

    Institute of Scientific and Technical Information of China (English)

    王渊; 牛文民

    2012-01-01

    目的:观察牵旋指振法结合腹针治疗单侧型颈椎间盘突出症的治疗效果.方法:将121名单侧型颈椎间盘突出症患者随机分为牵旋指振法结合腹针治疗组61例,常规推拿结合机械牵引针刺组对照组60例,分别于治疗2个疗程后,观察其疗效.结果:治疗组治愈率和总有效率分别为47.54%和91.80%,对照组治愈率和总有效率分别为31.66%和71.67%,两组比较差异有极其显著意义(P<0.01).结论:牵旋指振法结合腹针治疗单侧型颈椎间盘突出症疗效显著.%Objective: To observe the curative effect of unilateral cervical disc protrusion treated by the combination method of traction,rotation,finger- vibration and abdominal acupuncture. Methods-. 121 patients of unilateral cervical disc protrusion were divided into two groups at random,treatment group(including 61 patients treated by the combination method of traction,rotation, finger - vibration and abdominal acupuncture) and control group ( including 60 patients treated by the combination method of normal tuina therapy,mechanical traction and acupuncture). After two courses of treatment,we observed their curative effect. Results-. The curative ratio and total efficient ratio of treatment group respectively were 47. 54% and 91. 80% ,for control group were 31. 66% and 71.67%. There was remarkably significant difference between the two groups (P < 0. 01). Conclusion: There is prominent curative effect of unilateral cervical disc protrusion treated by the combination method of traction, rotation, finger - vibration and abdominal acupuncture.

  3. Lumbar Degenerative Disc Disease: Current and Future Concepts of Diagnosis and Management

    OpenAIRE

    Fadi Taher; David Essig; Lebl, Darren R.; Hughes, Alexander P.; Sama, Andrew A.; Cammisa, Frank P.; Girardi, Federico P.

    2012-01-01

    Low back pain as a result of degenerative disc disease imparts a large socioeconomic impact on the health care system. Traditional concepts for treatment of lumbar disc degeneration have aimed at symptomatic relief by limiting motion in the lumbar spine, but novel treatment strategies involving stem cells, growth factors, and gene therapy have the theoretical potential to prevent, slow, or even reverse disc degeneration. Understanding the pathophysiological basis of disc degeneration is essen...

  4. [Cervical radiculopathy].

    Science.gov (United States)

    Kuijper, B

    2014-10-01

    Cervical radiculopathy is a common cause of pain in the arm. It is caused by nerve root compression in the neck, as a consequence of a herniated disc, or spondyliotic foraminal stenosis. It causes severe pain, especially during the first few weeks, and paraesthesias in the forearm and hand. Patients also suffer from neck pain and loss of strength in the relevant arm. The arm pain can be exacerbated by certain movements of the head; these should be avoided as much as possible. Diagnosis can be made on the basis of history and physical examination. The pain generally disappears without active patient treatment. A semi-rigid cervical collar is recommended to accelerate pain relief. In cases of persistent pain, surgery will be considered. In such cases an MRI should be performed to show the cause and level of nerve root compression. PMID:26185991

  5. Clinical observation experience of radio frequency target ozone ablation treatment on cervical disc herniation%射频靶点臭氧消融术治疗颈椎间盘突出症临床观察体会

    Institute of Scientific and Technical Information of China (English)

    李靖; 吴成富; 余四海

    2014-01-01

    目的:探讨颈椎间盘突出症采取射频热凝靶点消融术联合臭氧进行治疗的细节及临床疗效。方法:2007年5月-2013年5月收治颈椎间盘突出症患者210例,回顾性分析经射频热凝靶点消融术复合臭氧的临床情况。患者在C臂机引导下,经颈前行颈椎间隙穿刺至靶点,感觉运动测试后,采用神经射频仪对靶点加热热凝,在70℃、80℃、86℃、90℃连续治疗4个周期,每周期60 s,最高温度点300 s。每个椎间盘给予45~50μg/mL 臭氧3 mL,对疗效、并发症进行观察分析。结果:本组经1年随访,优180例,良13例,可13例,差4例,优良率91.9%,术后吞咽疼痛30例,血肿2例,无脊髓损伤及椎间隙感染等并发症。结论:C臂引导下经颈前路穿刺射频热凝靶点热凝联合臭氧注射治疗颈椎间盘突出症是有效、安全的微创治疗,具有操作简单、效果好、并发症少等优点。%Objective:To explore the details and clinical curative effect of radio frequency thermosetting target ablation combined with ozone in the treatment of cervical disc herniation.Methods:210 patients with cervical disc herniation were selected from May 2007 to May 2013.The clinical circumstance of radio frequency thermosetting target ablation combined with ozone was retrospectively analyzed.Patients were guided under the C arm machine with cervical vertebra puncture to target through anterior portion,after sensorimotor tests,using nerve radiofrequency device on targets heating thermal coagulation,continuous treatment for 4 cycles at 70 ℃,80 ℃,86 ℃,90 ℃,60 s per cycle,and the highest temperature point was 300 s.Each disc was given 45 to 50 μg/mL ozone 3 mL.The effects and complications were observed and analyzed.Results:The group after 1 year of follow-up,180 cases were excellent;13 cases were good;13 cases were ok;4 cases were poor;the excellent and good rate was 91.9%.30 cases were swallowing pain

  6. Influence of degenerative changes of intervertebral disc

    OpenAIRE

    Wang, Yi; Chen, Hai-Bin; Zhang, Ling; ZHANG Li-ying; Liu, Jing-cheng; WANG Zheng-guo

    2012-01-01

    【Abstract】Objective: To investigate the material properties of normal and degenerated intervertebral discs (IVDs) and examine the effect of degenerative changes on IVD pathology. Methods: A computer-based online search was under-taken to identify English articles about material properties of IVDs published from January 1950 to 2011 in PubMed database. The retrieved keywords included material properties, intervertebral disc and degeneration. Based on the principle...

  7. 退变性腰椎滑脱症Modic分型和椎间盘退变分级的关系%The relationship between Modic changes and the degree of disc degeneration in degenerative spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    钱文武; 成意; 余利鹏; 殷国勇; 张宁

    2012-01-01

    Objective:To study the relationship between Modie changes and the degree of disc degeneration in patients with degenerative spondylolisthesis before surgery. Methods; From January 2009 to December 2011,44 cases of patients who had the degenerative spondylolisthesis were treated by operation. Preoperative MRI was performed to classify the Modic changes type. Pfirrmann grading assessment and modified Pfirrmann grading assessment were also perfomed. Then,the relationship between Modic changes and the degree of disc degeneration were analyzed in these patients with degenerative spondylolisthesis. Results; Among 44 cases, 12 cases had no Modic changes,Pfirrmann grades were 3.92 ± 0.29,modified Pfirrmann grades were of 5.92 ± 0.90; 16 cases were Modic I type,Pfirrmann grades were 4.31 ± 0.60,modified Pfirrmann grades were 6.88 ± 1.54; 15 cases were Modic type Ⅱ , Pfirrmann grades were 4.27 ± 0.46,modified Pfirrmann grades were 6.87 ± 0.83;Only 1 case of Modic type Ⅲ was found. Statistic analysis showed that modified Pfirrmann grades were significantly different between Modic I type group and no change group (P 0.05). Conclusion:In degenerative spondylolisthesis,there is a clear connection between the Modic changes and the degree o{ disc degeneration according to the Pfirrmann and modified Pfirrmann grading system assesment.%目的:研究退变性腰椎滑脱症需手术治疗患者术前Modic改变与椎间盘退变程度之间的关系.方法:2009年1月~2011年10月,腰椎滑脱症需手术治疗的患者44例,术前MRI对病变节段进行Modic分型,并用Pfirrmann分级和改良的Pfirrmann分级评定病变节段椎间盘的退变程度;分析不同类型的Modic改变之间椎间盘退变分级的差异;评价Modic改变与椎间盘退变程度之间的关系.结果:44例患者中,12例无Modic改变,Pfirrmann分级为3.92±0.29,改良分级为5.92±0.90;ModicⅠ型改变16例,Pfirrmann分级为4.31±0.60,改良分级为6.88±1.54;ModicⅡ型改变15

  8. 儿童颈椎间盘钙化伴髓核疝(附八例报告)%Calcification of Intervertebral Discs in Cervical Spine With Herniation of Nucleus Pulposus in Children

    Institute of Scientific and Technical Information of China (English)

    王舒; 吴秀芬; 朱葆伦; 周坤祥

    1991-01-01

    儿童椎间盘钙化是一种具有较明确的临床症状及X线表现的综合征.病程经过良好,钙化可自然吸收.钙化可见于脊柱任何水平,但好发于颈部.作者报道8例儿童颈椎间盘钙化,6例伴有髓核前疝.结合文献报道,对本病的症状、X线表现等进行讨论.%Eight cases with calcification of intervertebral discs in cervical spine are reported.Among them,six had anterior herniation of the nucleus pulposus.Symptoms disappeared within one to four weeks after cervical traction.The calcification was gradually absorbed,but the adjacent vertebral alterations were still in existence on X-ray film one year later.The etiology,clinical.manifestations and X-ray findings are briefly discussed.

  9. 人工间盘置换治疗颈椎病近期疗效及并发症分析%Analysis of Recent Curative Effects and Complications on Artiifcial Disc Replacement in the Treatment of Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    夏伊明; 仇立春; 韩学明; 赵疆; 吴鹏; 李威

    2014-01-01

    目的::评估15例Bryan人工颈椎间盘置换术治疗颈椎病的近期疗效,分析容易出现的并发症。方法:2011年1月至2013年10月,我院和镇江康复医疗集团医院、自治区中医院共同完成15例单节段Bryan人工颈椎间盘置换术,其中男6例,女9例;年龄33~57岁,平均45.2岁。脊髓型颈椎病7例,神经根型颈椎病6例,混合型2例。结果:全部病例随访6~18个月,平均随访13.2月。脊髓型颈椎病患者术前JOA评分为(8.5±1.0)分,末次随访时为(15.5±1.0)分,与术前比较有显著性差异(P<0.01)。颈痛视觉评分(VAS)、颈肩障碍疼痛指数(NDI)与术前相比均具有统计学意义(P<0.05)。神经根型颈椎病患者的症状完全消失。所有病例未见假体下沉、移位以及症状加重者。1例患者术后14个月随访时发现假体周围有异位骨化形成,2例术后置换节段出现颈椎曲度反曲后凸,随访后无明显改善。结论:Bryan人工颈椎间盘置换术治疗颈椎间盘疾患可取得良好的临床疗效,由于其手术操作较为复杂,并发症发生率较多,应重视手术适应证的选择和规范的手术操作。%[ABSTRACT]Objective: Appraised 15 examples Bryan artificial neck intervertebral disc replaces the short-term curative effect which the technique treatment cervical vertebra gets sick, the complication which the analysis often appears. Methods: From January,2011 to October, 2013,my courtyard and Zhenjiang Recovery Medical service Group Hospital,the autonomous region Chinese medicine hospital together completes 15 example single stage Bryan artificial neck intervertebral disc to replace the technique, in which male 6 examples, female 9 examples;Age 33~57 year old, average 45.2 years old.The spinal cord cervical vertebra gets sick 7 examples,the nerve root cervical vertebra gets sick 6 examples, the mixed 2 examples. Results:All patients were followed up for 6~18 months

  10. Subendplate microcirculation disturbance directly contributes to intervertebral disc degeneration%椎体终板下微循环障碍直接导致椎间盘退变的实验研究

    Institute of Scientific and Technical Information of China (English)

    郑召民; 吕游; 陈辉; 刘辉; 张奎渤; 李佛保

    2008-01-01

    Objective To build subendplate microcirculation disturbance animal model and to investigate the potential pathogenesis of intervertebral disc degeneration(IVDD).Methods Twenty four New Zealand white rabbits were divided into treatment group(Group A)and control group(Group B).In Group A,animals received endotoxin and corticosteroid application to build subendplate microcirculation disturbance animal model,validated by microthrombus staining.In Group B,animals were given no drug,but standard feeding.After 3 month,the extent of IVDD was evaluated by the water content,biochemistry analysis,and morphology.Results Subendplate microthrombus staining confirmed the exist of microcirculation disturbance.The water content and biochemistry components content of disc in Group A were lower than those of disc in Group B.and IVDD was observed in morphology.Conclusion Subendplate microcirculation disturbance can directly contribute to IVDD,the nutrients diffusion barrier is the potential pathogenesis of IVDD.%目的 通过建立椎体终板下微循环障碍动物模型,探讨椎间盘退变发病的可能机制.方法 将24只新西兰白兔随机分为实验组和对照组,实验组采用联合应用内毒素与激素的方法制备典型椎体终板下微循环障碍模型,并通过终板微血栓染色证实;对照组为阴性空白对照,不给予任何药物干扰,仅标准饲料喂养.3个月后分析实验组和对照组动物椎间盘的水含量、生化成分含量和组织形态学,从而评估椎间盘的退变程度.结果 终板微血栓染色证实实验组成功构建椎体终板下微循环障碍模型,3个月后实验组动物椎间盘水含量、生物化学成分含量均低于对照组,椎间盘切片染色可见椎间盘退变的表现.结论 椎体终板下微循环障碍可直接导致椎间盘退变,椎间盘营养供给障碍是椎间盘退变的发病机制之一.

  11. Lumbar Degenerative Disc Disease: Current and Future Concepts of Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Fadi Taher

    2012-01-01

    Full Text Available Low back pain as a result of degenerative disc disease imparts a large socioeconomic impact on the health care system. Traditional concepts for treatment of lumbar disc degeneration have aimed at symptomatic relief by limiting motion in the lumbar spine, but novel treatment strategies involving stem cells, growth factors, and gene therapy have the theoretical potential to prevent, slow, or even reverse disc degeneration. Understanding the pathophysiological basis of disc degeneration is essential for the development of treatment strategies that target the underlying mechanisms of disc degeneration rather than the downstream symptom of pain. Such strategies ideally aim to induce disc regeneration or to replace the degenerated disc. However, at present, treatment options for degenerative disc disease remain suboptimal, and development and outcomes of novel treatment options currently have to be considered unpredictable.

  12. 人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病%Artificial Disc Replacement Combined with Anterior Cervical Decompression and Autograft Bone Fusion for the Treatment of Multi-segment Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    廖维峰; 肖晟; 黄象望; 刘向阳; 张毅; 向铁城

    2014-01-01

    [目的]探讨人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病的临床疗效。[方法]湖南省人民医院2008年2月至2012年6月收治的12例多节段颈椎病手术病例,均行人工椎间盘置换加颈前路椎体次全切减压植骨融合术,随访时间为12~18个月,平均随访15.5个月,均摄术前、术后及末次随访时的颈椎正侧位及颈椎过伸过屈位X线片及磁共振检查,观察植骨融合、内固定及人工椎间盘的情况,以JO A评分评价神经功能改善情况。[结果]所有病例内置物无松动、移位,植骨融合时间在3~6个月,平均4.9个月。置换间隙活动度术后1年时为12.5°±5.0°,与术前(12.3°±4.9°)比较无统计学差异(P>0.05)。术前JOA 评分平均为9.3分,术后6个月时平均为16.1分,平均改善率为91.2%。[结论]人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病近期疗效满意,是治疗多节段颈椎病的一种可行方法。%[Objective]To explore the clinical efficacy of cervical artificial disc replacement combined with anterior cervical decompression and autograft bone fusion for the treatment of multi -segment cervical spon-dylosis .[Methods]Twelve patients with multi- segment cervical spondylosis operated in Hunan provincial people's hospital from Feb .2008 to June 2012 underwent cervical artificial disc replacement combined with an-terior cervical decompression and autograft bone fusion .The follow up time was 12~18 months(average 15 .5 months) .Cervical MRI and X-ray films of cervical normal lateral position ,hyperextension and hyperflexion position were performed before and after operation and at the last time of follow up .Bone fusion ,internal fixa-tion and artificial disc were observed .JOA score was used to evaluate the improvement of neurological func-tion .[Results]No loosening and displacement of

  13. Requirements for an artificial intervertebral disc

    NARCIS (Netherlands)

    Eijkelkamp, MF; van Donkelaar, CC; Veldhuizen, AG; van Horn, [No Value; Huyghe, JM; Verkerke, GJ

    2001-01-01

    Intervertebral disc degeneration is an important social and economic problem. Presently available artificial intervertebral discs (AIDs) are insufficient and the main surgical intervention is still spinal fusion. The objective of the present study is to present a list of requirements for the develop

  14. 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

  15. 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.

  16. 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

  17. 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

  18. 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

  19. Clinical report in treating cervical disc herniation by nucleoplasty of percutaneous radiofrequency abrasion%多靶点射频消融术治疗颈椎间盘突出症临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    卫秀洋; 陈勇忠; 周清碧; 王金星; 陈庆泉

    2013-01-01

    目的 探讨射频消融髓核成形术治疗颈椎间盘突出症的临床疗效.方法 回顾2009 年10月~2010年10月福州总医院476医院应用经皮穿刺多靶点射频消融髓核成形术治疗颈椎间盘突出症168 例.按Macnab 疗效评定标准和视觉模拟评分法(VAS),对比患者手术前后及随访时进行疗效评定.结果 按Macnab 疗效评分标准,术后即刻优76例,良64例,可22例,差6例,优良率为83.33%.本组术前VAS评分为(6.76±0.52)分,术后即刻为(2.15±0.58)分,术后3个月为(2.68±0.56)分,术后1年为(2.95±0.63)分,术后即刻、术后3个月、术后1年评分与术前比较差异有高度统计学意义(P < 0.01).结论 射频消融髓核成形术治疗颈椎病具有操作简单、安全微创、并发症少、起效快及近、中期疗效满意等特点,是治疗轻度颈椎间盘突出症较好的方法.%Objective To observe therapeutic effect of radiofrequency ablation nucleoplasty on cervical disc herniation. Methods From October 2009 to October 2010, 168 patient with cervical disc herniation were analyzed NO.476 Hospital of PLA, who were treated by percutaneous multi-target radiofrequency ablation nucleoplasty treatment. Therapeutic effects were evaluated before and after surgery, 3 month and 12 month by using the average scores of VAS and Mac-nab evaluation standard. Results All cases were followed-up from immediate postoperative to 12 months after operation. According to Macnab efficacy score, the immediate postoperative period were excellent in 76 cases, good in 64 cases, maybe 22 cases and poor in 6 cases, the total good rate of 83.33%. The preoperative VAS score was (6.76±0.52) scores, immediately after was (2.15 ±0.58) scores, 3 months after surgery was (2.68 ±0.56) scores, after an annual was (2.95±0.63) scores. There were significant difference between preoperative surgery and intraoperative immediately after surgery, 3 months after surgery, 1 year after surgery (P < 0

  20. Magnetic resonance imaging of cervical myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Chosa, Hirofumi; Yamano, Kouichirou; Ihara, Fumitoshi; Ueda, Yoshiaki; Maekawa, Masayuki; Tokuhisa, Ginichirou; Kuwano, Tadashi; Kamo, Yoshi; Nomura, Shigeharu (Kyushu Rosai Hospital, Fukuoka (Japan))

    1990-03-01

    Forty-three patients operated for cervical myelopathy were examined with a 1.5 T magnetic resonance imaging. Cord compression was demonstrated directly on the sagittal image in cases of cervical disc herniation, cervical spondylosis and O.P. L.L. Herniated disc material was seen positive on axial image. But factors of cord compression in cases of cervical spondylosis and O.P. L.L. were not clearly confirmed, so additional examinations such as myelogram, tomogram and CT was needed. (author).

  1. Preliminary results of Activ C artificial disc replacement for cervical spondylosis%Activ C人工椎间盘置换术治疗颈椎病的早期疗效

    Institute of Scientific and Technical Information of China (English)

    赵耀; 刘屹林; 王利民; 谭洪宇; 王卫东; 廖文胜; 鲍恒

    2012-01-01

    目的:观察Activ C人工椎间盘置换术治疗颈椎病的早期临床疗效,分析其临床应用价值.方法:2009年11月~2011年3月在我院接受Activ C人工椎间盘置换术并获得随访的颈椎病患者共43例(45个节段),平均年龄48.3岁,其中男18例,女25例,脊髓型颈椎病22例,神经根型颈椎病16例,混合型颈椎病5例;单节段置换41例(C3/4 2例,C4/5 17例,C5/6 21例,C6/7 1例),双节段置换2例(C4/5和C5/6 1例,C5/6和C6/7 1例).采用日本骨科协会JOA评分、颈椎活动障碍指数(NDI)和疼痛视觉模拟评分(VAS)评价术后症状改善程度,比较手术前后的颈椎曲度、手术节段及邻近上下节段活动度变化,观察统计手术并发症情况.结果:术后随访8~24个月,平均13.8个月.患者的JOA评分、NDI、颈部VAS评分、上肢VAS评分分别由术前的8.2±0.7、35.3±4.7、6.8±1.1和6.5±1.2分显著改善至末次随访时的14.7±0.4、16.2±3.4、1.3±0.8和1.8±0.9分(P均<0.05).颈椎生理曲度术前为7.97°±4.49°,末次随访时为9.15°±3.85°,手术前后无明显差异(P>0.05).置换节段活动度较术前明显增加(P<0.01),邻近上下节段活动度手术前后差异无统计学意义(P>0.05).术后人工椎间盘活动良好,无塌陷或移位,随访期间未见邻近节段明显退变,2例分别在术后7个月和10个月时异位骨化形成.结论:Activ C人工椎间盘置换术可有效改善颈椎病患者的临床症状,维持颈椎的生理曲度和活动度,早期临床疗效满意.%Objectives: To investigate the early clinical effects of cervical Activ C artificial disc replacement. Methods: 43 patients(mean age 48.3 years; 18 males and 25 females) of cervical spondylosis with a total of 45 levels involved underwent anterior cervical decompression and Activ C implantation between November 2009 and March 2011. There were 22 cases of cervical spondylotic myelopathy, 16 cases of cervical spondy-lotic radiculopathy and 5 cases of mixed

  2. 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

  3. 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

  4. 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

  5. Neuronal degeneration in spinal multiple sclerosis

    OpenAIRE

    Bernhardt, Lydia

    2010-01-01

    To elucidate neuronal degeneration in spinal multiple sclerosis the spinal cord of 27 post mortem patients of the years 1997 to 2000 was investigated in comparison to 29 controls matched for sex, age and year of death. In addition to immunohistochemical examinations and demonstration of pathological cell changes, we also quantified the neurons of the cervical and thoracic spinal cord. In comparison to controls, MS-patients show a significant loss of 43% of the cervical neurons and a signif...

  6. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  7. 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.

  8. 骨髓间充质干细胞-壳聚糖凝胶复合体移植治疗椎间盘退变%Treatment for the intervertebral disc degeneration by trasnsplantation with bone mesenchymal stem cell-chitosan hydrogel complex

    Institute of Scientific and Technical Information of China (English)

    刘杰; 王建; 周跃

    2009-01-01

    目的 观察兔骨髓间充质干细胞.壳聚糖凝胶复合体移植修复椎间盘髓核缺损退变的效果.方法 建立兔椎间盘髓核缺损退变模型,将兔骨髓间充质干细胞-壳聚糖凝胶复合体注射移植入缺损退变模型中,兔继续培养4周后处死,取出移植修复的椎间盘进行组织HE染色、Aggre-can番红O染色及Ⅱ-collagen免疫组织化学染色,与正常椎间盘及未行移植的缺损退变椎间盘进行随机对照,检测移植修复的效果.结果 骨髓间充质干细胞-壳聚糖凝胶复合体可以在缺损的椎间盘中正常生长,并呈现向类髓核细胞分化的趋势,合成分泌Ⅱ-collagen和Aggrecan,维持原椎间盘髓核组织的生物学特性,而缺损退变组髓核组织纤维化、完整性丧失,水分丢失,Ⅱ-collagen合成明显减少(P<0.05).结论 兔骨髓间充质干细胞-壳聚糖凝胶复合体能够修复椎间盘缺损退变.%Objective To explore the curative effects of transplantation with bone mesenchymal stem cell-chitosan hydrogel complex for intervertebral disc degeneration, and provide experimental base for clinical use. Methods The disc degenerative model of rabbits was established, and bone mesenchymal stem cell-chitosan hydrogel complex was injected into the degenerative disc. After feeding for another 4 weeks, the animals were sacrificed, and the disc transplanted with the complex was removed for HE stai-ning, Aggrecan safranin O staining, and Ⅱ-collagen immunohistochemical staining. The findings were com-pared with those of the untreated degenerative disc or normal discs. Results Rabbit bone mesenchymal stem cell-chitosan hydrogel complex could survive in the degenerative discs,the cells could differentiate to nucleus pulposus-like cells which synthesized and secreted Ⅱ-collagen and aggrecan, and the complex could maintain the biological characteristics of nucleus pulpesus. In contrast, in the untreated group, there was nucleus pulposus collapse and

  9. 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

  10. NF-κB信号转导通路及其与椎间盘退变的相关性研究进展%Research Progress of NF-κB Signaling Pathway and Its Relevance to Intervertebral Disc Degeneration

    Institute of Scientific and Technical Information of China (English)

    胡国超

    2012-01-01

    The nuclear factor-kappa B( NF-kB )is an inducible transcription factor that tightly regulates the expression of a large cohort of genes. The activation of NF-kB is closely controlled in both the cytoplasm and nucleus. Aberrant NF-kB activity has been implicated in the pathogenesis of several diseases including infections, inflammatory bowel disease, rheumatoid arthritis and cancer. NF-kB might play a key role in inter-vertebral disc degeneration. Recent research shows the expression of NF-kB in degenerative disc, regulating the expression of many cytokines and chemokines, adhesion molecules, inflammatory mediators, and several matrix degrading enzymes,which induces intervertebral disc degeneration.%核因子κB(NF-κB)是一个可诱导转录因子,紧密地调节着大群基因的表达.NF-κB的激活在细胞质及细胞核内被紧密地调控着,其异常激活与感染、炎症性肠病、风湿性关节炎及肿瘤等疾病相关.NF-κB可能在椎间盘退变中起重要作用.新近研究显示退变椎间盘中有NF-κB的表达,其在椎间盘中的激活,能调节许多细胞因子、趋化因子、黏附分子、炎性介质和基质降解酶的表达,从而诱发椎间盘的退变.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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

  16. Can repeat injection provide clinical benefit in patients with cervical disc herniation and stenosis when the first epidural injection results only in partial response?

    Science.gov (United States)

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-07-01

    Epidural steroid injection (ESI) is known to be an effective treatment for neck or radicular pain due to herniated intervertebral disc (HIVD) and spinal stenosis (SS). Although repeat ESI has generally been indicated to provide more pain relief in partial responders after single ESI, there has been little evidence supporting the usefulness of this procedure. The purpose of this study, therefore, was to determine whether repeat ESI at a prescribed interval of 2 to 3 weeks after the first injection would provide greater clinical benefit in patients with partial pain reduction than intermittent ESI performed only when pain was aggravated. One hundred eighty-four patients who underwent transforaminal ESI (TFESI) for treatment of axial neck and radicular arm pain due to HIVD or SS and could be followed up for 1 year were enrolled. We divided the patients into 2 groups. Group A (N = 108) comprised partial responders (numeric rating scale (NRS) ≥ 3 after the first injection) who underwent repeat injection at a prescribed interval of 2 to 3 weeks after the first injection. Group B (N = 76) comprised partial responders who did not receive repeat injection at the prescribed interval, but received intermittent injections only for aggravation of pain. Various clinical data were assessed, including total number of injections during 1 year, NRS duration of <3 during 1 year (NRS < 3 duration), and time interval until pain was increased to require additional injections after repeat injection in Group A, or after first injection in Group B (time to reinjection). Groups A and B were compared in terms of total population, HIVD, and SS. In the whole population, HIVD subgroup, and SS subgroup, patients in Group A required significantly fewer injections to obtain satisfactory pain relief during the 1-year follow-up period. Group A showed a significantly longer time to reinjection and longer NRS < 3 than Group B did. Repeat TFESI conducted at 2- to 3-week intervals

  17. Effects of Neonatal Enzyme Replacement Therapy and Simvastatin Treatment on Cervical Spine Disease in Mucopolysaccharidosis I Dogs

    Science.gov (United States)

    Chiaro, Joseph A; O’Donnell, Patricia; Shore, Eileen M; Malhotra, Neil R; Ponder, Katherine P; Haskins, Mark E; Smith, Lachlan J

    2014-01-01

    Mucopolysaccharidosis I (MPS I) is a lysosomal storage disease characterized by deficient α-L-iduronidase activity, leading to the accumulation of poorly degraded glycosaminoglycans (GAGs). Children with MPS I exhibit high incidence of spine disease, including accelerated disc degeneration and vertebral dysplasia, which in turn lead to spinal cord compression and kypho-scoliosis. In this study we investigated the efficacy of neonatal enzyme replacement therapy (ERT), alone or in combination with oral simvastatin (ERT+SIM) for attenuating cervical spine disease progression in MPS I, using a canine model. Four groups were studied: normal controls; MPS I untreated; MPS I ERT treated; and MPS I ERT+SIM treated. Animals were euthanized at one year-of-age. Intervertebral disc condition and spinal cord compression were evaluated from MRIs and plain radiographs, vertebral bone condition and odontoid hypoplasia were evaluated using microcomputed tomography, and epiphyseal cartilage to bone conversion was evaluated histologically. Untreated MPS I animals exhibited more advanced disc degeneration and more severe spinal cord compression than normal animals. Both treatment groups resulted in partial preservation of disc condition and cord compression, with ERT+SIM not significantly better than ERT alone. Untreated MPS I animals had significantly lower vertebral trabecular bone volume and mineral density, while ERT treatment resulted in partial preservation of these properties. ERT+SIM treatment demonstrated similar, but not greater, efficacy. Both treatment groups partially normalized endochondral ossification in the vertebral epiphyses (as indicated by absence of persistent growth plate cartilage), and odontoid process size and morphology. These results indicate that ERT begun from a very early age attenuates the severity of cervical spine disease in MPS I, particularly for the vertebral bone and odontoid process, and that additional treatment with simvastatin does not

  18. Autophagy: A double-edged sword in intervertebral disk degeneration.

    Science.gov (United States)

    Zhang, Shu-Jun; Yang, Wei; Wang, Cheng; He, Wen-Si; Deng, Hai-Yang; Yan, Yi-Guo; Zhang, Jian; Xiang, Yong-Xiao; Wang, Wen-Jun

    2016-06-01

    Autophagy is a homeostatic mechanism through which intracellular damaged organelles and proteins are degraded and recycled in response to increased metabolic demands or stresses. Although primarily cytoprotective, dysfunction of autophagy is often associated with many degenerative diseases, including intervertebral disc (IVD) degeneration (IDD). As a main contributing factor to low back pain, IDD is the pathological basis for various debilitating spinal diseases. Either higher or lower levels of autophagy are observed in degenerative IVD cells. Despite the precise role of autophagy in disc degeneration that is still controversial, with difference from protection to aggravation, targeting autophagy has shown promise for mitigating disc degeneration. In the current review, we summarize the changes of autophagy in degenerative IVD cells and mainly discuss the relationship between autophagy and IDD. With continued efforts, modulation of the autophagic process could be a potential and attractive therapeutic strategy for degenerative disc disease. PMID:27018178

  19. The degenerative cervical spine.

    Science.gov (United States)

    Llopis, E; Belloch, E; León, J P; Higueras, V; Piquer, J

    2016-04-01

    Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management. PMID:26878769