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Sample records for degenerative joint disease

  1. Etiology, pathophysiology and conservative management of degenerative joint disease

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    Jandrić Slavica

    2002-01-01

    Full Text Available Etiology of degenerative joint diseases Etiology of degenerative joint diseases is still not clearly understood and there is no specific management for this group of diseases. Various pathological conditions cause damage of the articular cartilage and lead to clinically and radiographically recognized impairment. Biomechanical, metabolic, genetic factors inflammation and other risk factors contribute to development of osteoarthrosis. Pathophysiology of degenerative joint diseases Osteoarthrosis is characterized by progressive erosion of articular cartilage and bone overgrowth at the joint margins. Cartilage integrity requires balance between synthesis and degradation of matrix components. Chondrocytes react to various mechanical and chemical stresses in order to stabilize and restore the tissue. Failures in stabilizing and restoring the tissue lead to cartilage degeneration that may be irreversibile. For better understanding of conservative management of degenerative joint diseases it is important to know the impact of pathophysiology mechanisms on development of degenerative joint diseases. There is great variability in the rate of progression of erosive processes in articular cartilage in clinical radiographic signs and course of the disease. This is in relation with many factors, as well as with management and response to therapy. Treatment of degenerative joint diseases Treatment should vary depending on the severity of disease and patient's expectations and level of activity. Besides analgesic and anti-inflammatory drugs, conventional and not conventional treatment and techniques can be used for management of osteoarthrosis. Physical therapy and exercises are very important for maintaining muscle strength, joint stability and mobility, but should be closely monitored for optimal efficacy.

  2. Long term results of radiotherapy of degenerative joint diseases

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    Lindner, H.; Freislederer, R.

    1982-04-01

    At the Radiologic Department of the Staedt. Krankenhaus Passau, 473 patients with degenerative diseases in the big joints and the spine were irradiated with the caesium unit between 1971 and 1979. Among these patients, 249 could be followed up during a prolonged period (1/2 to 9 years, i.e. 4.2 years on an average). According to the categories of v. Pannewitz, 11% were pain-free at this moment, 21% showed an essential improvement, 29% showed an improvement, and 39% were not influenced by the treatment. 13.5% showed recurrent pains; these were mentioned as 'not influenced' in the statistical analysis. It is proved that the relief of pain does not depend on the age of the patients, but on the anamnesis period, the results of the X-ray examiantion, and the degree of the restriction of mobility. Due to the delay of irradiation, a preliminary treatment mostly produces a less favorable radiotherapeutic result. Compared with other therapeutic methods, the long term results of radiotherapy of degenerative joint diseases are generally favorable. This conclusion is also confirmed by the results of patients checked up more than five years after the treatment.

  3. Pedicle marrow signal intensity changes in the lumbar spine: a manifestation of facet degenerative joint disease

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    Morrison, J.L.; Kaplan, P.A.; Dussault, R.G.; Anderson, M.W. [Dept. of Radiology, Univ. of Virginia Health System, Charlottesville, VA (United States)

    2000-12-01

    Objective. Signal intensity changes in lumbar pedicles, similar to those described in vertebral body endplates adjacent to degenerated discs, have been described as an ancillary sign of spondylolysis on MRI. The purpose of this study was to determine whether pedicle marrow signal intensity changes also occur in association with facet degenerative joint disease.Design. Eighty-nine lumbar spine MRI examinations without spondylolysis were reviewed for marrow signal intensity changes in pedicles and vertebral bodies as well as for facet degenerative joint disease.Results. Five percent (46/890) of lumbar pedicles in 23 patients had marrow signal intensity changes. Ninety-one percent (42/46) of the abnormal pedicles had adjacent degenerative joint disease of the facets, while only 21% (189/890) of normal pedicles had adjacent facet degenerative joint disease (p<0.001). Eighty-nine percent (41/46) of the pedicles with marrow signal intensity changes had adjacent degenerative disc disease.Conclusions. Pedicle marrow signal intensity changes are not a specific sign of spondylolysis; they are commonly seen with adjacent facet degenerative joint disease in the absence of spondylolysis. Pedicle marrow signal intensity changes are probably a response to abnormal stresses related to abnormal motion or loading caused by the degenerative changes in the spinal segment. (orig.)

  4. Degenerative joint disease in cattle and buffaloes in the Amazon region: a retrospective study

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    José Diomedes Barbosa; Danillo Henrique S. Lima; Alessandra S. Belo-Reis; Cleyton P. Pinheiro; Melina G.S. Sousa; Jenevaldo B. Silva; Felipe M. Salvarani; Carlos Magno C. Oliveira

    2014-01-01

    A retrospective study of the epidemiological and clinic-pathological aspects of cattle and buffaloes with degenerative joint disease (DJD) was conducted in the state of Pará, Brazil. From 1999 to 2014, eleven cattle and 24 buffaloes were evaluated. All the treated animals with suspected DJD underwent a clinical examination of the musculoskeletal system. In seven cattle and eight buffaloes with clinical signs of the disease postmortem examination was performed. The common clinical signs observ...

  5. Degenerative joint disease on MRI and physical activity: a clinical study of the knee joint in 320 patients

    International Nuclear Information System (INIS)

    We examined 320 patients with MRI and arthroscopy after an acute trauma to evaluate MRI in diagnosis of degenerative joint disease of the knee in relation to sports activity and clinical data. Lesions of cartilage and menisci on MRI were registered by two radiologists in consensus without knowledge of arthroscopy. Arthroscopy demonstrated grade-1 to grade-4 lesions of cartilage on 729 of 1920 joint surfaces of 320 knees, and MRI diagnosed 14 % of grade-1, 32 % of grade-2, 94 % of grade-3, and 100 % of grade-4 lesions. Arthroscopy explored 1280 meniscal areas and showed degenerations in 10 %, tears in 11.4 %, and complex lesions in 9.2 %. Magnetic resonance imaging was in agreement with arthroscopy in 81 % showing more degenerations but less tears of menisci than arthroscopy. Using a global system for grading the total damage of the knee joint into none, mild, moderate, or severe changes, agreement between arthroscopy and MRI was found in 82 %. Magnetic resonance imaging and arthroscopy showed coherently that degree of degenerative joint changes was significantly correlated to patient age or previous knee trauma. Patients over 40 years had moderate to severe changes on MRI in 45 % and patients under 30 years in only 22 %. Knee joints with a history of trauma without complete structural or functional reconstitution showed marked changes on MRI in 57 %, whereas stable joints without such alterations had degenerative changes in only 26 %. There was no correlation of degenerative disease to gender, weight, type, frequency, and intensity of sports activity. Therefore, MRI is an effective non-invasive imaging method for exact localization and quantification of chronic joint changes of cartilage and menisci that recommends MRI for monitoring in sports medicine. (orig.) (orig.)

  6. Preliminary results of automated removal of degenerative joint disease in bone scan lesion segmentation

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    Chu, Gregory H.; Lo, Pechin; Kim, Hyun J.; Auerbach, Martin; Goldin, Jonathan; Henkel, Keith; Banola, Ashley; Morris, Darren; Coy, Heidi; Brown, Matthew S.

    2013-03-01

    Whole-body bone scintigraphy (or bone scan) is a highly sensitive method for visualizing bone metastases and is the accepted standard imaging modality for detection of metastases and assessment of treatment outcomes. The development of a quantitative biomarker using computer-aided detection on bone scans for treatment response assessment may have a significant impact on the evaluation of novel oncologic drugs directed at bone metastases. One of the challenges to lesion segmentation on bone scans is the non-specificity of the radiotracer, manifesting as high activity related to non-malignant processes like degenerative joint disease, sinuses, kidneys, thyroid and bladder. In this paper, we developed an automated bone scan lesion segmentation method that implements intensity normalization, a two-threshold model, and automated detection and removal of areas consistent with non-malignant processes from the segmentation. The two-threshold model serves to account for outlier bone scans with elevated and diffuse intensity distributions. Parameters to remove degenerative joint disease were trained using a multi-start Nelder-Mead simplex optimization scheme. The segmentation reference standard was constructed manually by a panel of physicians. We compared the performance of the proposed method against a previously published method. The results of a two-fold cross validation show that the overlap ratio improved in 67.0% of scans, with an average improvement of 5.1% points.

  7. Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats

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    Lascelles B Duncan X

    2012-01-01

    Full Text Available Abstract Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD and examination findings were assessed to determine sensitivity, specificity and likelihood estimations. Results Pain response to palpation was elicited in 0-67% of the joints with DJD, with a specificity ranging from 62-99%; crepitus was detected in 0-56% of the joints and its specificity varied between 87 and 99%; for effusion, values ranged between 6 and 38% (specificity, 82-100%, and thickening, 0-59% (specificity, 74-99%. Joints with DJD tended to have a decreased range of motion. The presence of pain increased the odds of having DJD in the elbow (right: 5.5; left: 4.5; the presence of pain in the lower back increased the odds of spinal DJD being present (2.97 for lumbar; 4.67 for lumbo-sacral. Conclusions Radiographic DJD cannot be diagnosed with certainty using palpation or goniometry. However, negative findings tend to predict radiographically normal joints. Palpation and goniometry may be used as a tool to help to screen cats, mostly to rule out DJD.

  8. Degenerative joint disease in cattle and buffaloes in the Amazon region: a retrospective study

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    José Diomedes Barbosa

    2014-09-01

    Full Text Available A retrospective study of the epidemiological and clinic-pathological aspects of cattle and buffaloes with degenerative joint disease (DJD was conducted in the state of Pará, Brazil. From 1999 to 2014, eleven cattle and 24 buffaloes were evaluated. All the treated animals with suspected DJD underwent a clinical examination of the musculoskeletal system. In seven cattle and eight buffaloes with clinical signs of the disease postmortem examination was performed. The common clinical signs observed in both species were chronic lameness, stiff gait, postural changes, audible crackles in the affected limb, prolonged recumbency, difficulty in getting up and progressive weight loss. The lesions observed at necropsy were: irregular articular surfaces, erosion of the articular cartilage and the underlying bone tissue, and proliferation of the periarticular bone tissue with formation of osteophytes. The most affected joints in cattle and buffaloes wereof the hind limb. In buffaloes, the main predisposing factor to the onset of DJD was phosphorus deficiency. In cattle, defects of the anatomical conformation of the hind limbs, chronic trauma due to the activities performed, such as semen collection, and advanced age possibly contributed to the emergence of the disease.

  9. Pathophysiology of Degenerative Disc Disease

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    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...

  10. Degenerative Nerve Diseases

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    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical ...

  11. Effect of Age on the Hemostatic Function in Patients with Degenerative Diseases of the Large Joints

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    Igor L. Shlykov, PhD¹, ScD¹

    2013-06-01

    Full Text Available Background: Aging is associated with an increased hypercoagulable state. Degenerative diseases of the large joints are also accompanied by increased coagulation activity. We investigated the effect of age on the hemostatic function in patients with osteoarthritis. Material and Methods: The study included 192 patients with osteoarthritis admitted to the clinic for primary hip or knee arthroplasty. The patients were categorized into 5 age groups: the age group under 40 years, the 41–to-50 -year age group, the 51–to-60-year age group, the 61-to-70- year age group, and the age group over 70 years. The general blood clotting tests, platelet number, fibrinogen, antithrombin, protein C, TAT, D-dimer, vonWillebrand factor (vWF, PAI-1, ß-thromboglobulin were determined. Results: Among patients with osteoarthritis, the antithrombin III level significantly decreased by the age of 50; however, above the age of 60 there was a distinct decrease in platelet count, and over the age of 70 the activity of the extrinsic coagulation pathway and the plasminogen level dropped significantly. TAT and D-dimer levels were elevated in most of the patients. Conclusion: The decrease in platelet count coupled with the activity of the extrinsic coagulation pathway in elderly osteoarthritic patients may increase blood loss during total arthroplasty; also, the drop in the anticoagulant and fibrinolytic potential may play a negative role in strengthening the prothrombotic state during the postoperative period.

  12. Low back pain and degenerative disc disease

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    Jandrić Slavica; Antić Branislav

    2006-01-01

    Introduction. Various clinical conditions can cause low back pain, and in most cases it is of a degenerative origin. Degenerative disc disease is a common condition which affects young to middle-aged men and women equally. Changes in the mechanical properties of the disc lead to degenerative arthritis in the intervertebral joints, osteophytes, and narrowing the intervertebral foramen or the spinal canal. Pathophysiology. Degenerative cascade, described by Kirkaldy-Willis, is the widely accept...

  13. Clinical cases of joint disease in horse. Total glycosaminoglycans sulphate and keratansulphate in synovial fluid as markers of degenerative cartilage processes

    International Nuclear Information System (INIS)

    Total glycosaminoglycans sulphate (GAGs) and keratan sulphate (KS) were measured in synovial fluid (SF) obtained from 28 horses with different joint diseases (degenerative joint disease (DJD), osteochondrosis (OCD), positivity to Flex Test (FT)) and 15 horses without any clinical sign of lameness. All groups of animals with joint disease showed levels of total GAGs significantly higher (P0.001) than normal. On the contrary, only DJD affected joints showed a significantly (P0.01) higher level of KS

  14. Imaging of degenerative and posttraumatic disease in the shoulder joint with ultrasound

    International Nuclear Information System (INIS)

    This article reviews the examination technique of shoulder ultrasound, normal and abnormal ultrasound findings in acute (posttraumatic) and chronic (degenerative) lesions. Moreover, it reviews the effectiveness of ultrasound in relation to magnetic resonance (MR) imaging. Most authors report that full-thickness tears of the supraspinatus can reliably be diagnosed by ultrasound. However, the simple diagnosis of a full-thickness rotator cuff tear is no longer sufficient for surgical management. The precise localization and size of rotator cuff tears as well as the extent of muscle degeneration is important for surgical planning. For this aspect and for partial-thickness tears of the supraspinatus, for subscapularis lesions as well as for lesions of the long biceps tendons there is no consensus regarding the diagnostic value of ultrasound. To the present, ultrasound (contrary to MR imaging) has failed to demonstrate that it consistently influences the clinician's degree of confidence in the clinical diagnosis or the treatment plan. Therefore, some orthopedic surgeons prefer MR imaging to ultrasound in the evaluation of rotator cuff tears and other abnormalities of the glenohumeral joint. Moreover, MR imaging, especially when combined with arthrography, represents a one-step investigation, which not only allows for assessment of rotator cuff lesion but also of lesions of the labrum (Bankart lesions, SLAP lesions), the joint capsule and the biceps tendon. It also demonstrates muscle atrophy, which represents an important predictor of surgical outcome in rotator cuff repair

  15. Usefulness of pinhole collimator in differential diagnosis of metastatic disease and degenerative joint disease in the vertebrae; Evaluation by receiver operating characteristics (ROC) analysis

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    Kosuda, Shigeru; Kawahara, Syunji; Ishibashi, Akihiko; Tamura, Kohei; Tsukatani, Yasushi; Fujii, Hiroshi (Okura National Hospital, Tokyo (Japan)); Kubo, Atsushi; Hashimoto, Shozo

    1989-11-01

    In order to evaluate the diagnostic efficacy of pinhole collimator (PHC) imaging combined with an X-ray for vertebral metastasis, our prospective study has employed receiver operating characteristics (ROC) analysis in 21 patients, 11 with osseous metastasis and 15 with degenerative joint disease in the lumbar vertebrae. PHC imaging provided better anatomic information on the extent of {sup 99m}Tc-MDP accumulation. PHC vertebral scintigraphy had a considerable impact on the decision-making process, although with variations and not very satisfactory results among the physicians with little experience. Our study suggests that PHC imaging and X-ray film are useful in differentiating between osseous metastasis and degenerative joint disease in the vertebra. (author).

  16. Degenerative disease of the spine.

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    Gallucci, Massimo; Limbucci, Nicola; Paonessa, Amalia; Splendiani, Alessandra

    2007-02-01

    Degenerative disease of the spine is a definition that includes a wide spectrum of degenerative abnormalities. Degeneration involves bony structures and the intervertebral disk, although many aspects of spine degeneration are strictly linked because the main common pathogenic factor is identified in chronic overload. During life the spine undergoes continuous changes as a response to physiologic axial load. These age-related changes are similar to pathologic degenerative changes and are a common asymptomatic finding in adults and elderly persons. A mild degree of degenerative changes is paraphysiologic and should be considered pathologic only if abnormalities determine symptoms. Imaging allows complete evaluation of static and dynamic factors related to degenerative disease of the spine and is useful in diagnosing the different aspects of spine degeneration.

  17. Relationship between degenerative joint disease and hip joint laxity by use of distraction index and Norberg angle measurement in a group of cats

    International Nuclear Information System (INIS)

    Objective: To determine the relationship between degenerative joint disease (DJD) and passive laxity of the hip joint in a group of cats. Design: Prospective study. Animals: A select (nonrandomized) group of 78 cats. Procedure: Standard hip-extended radiographic views and compression and distraction views of the pelvis were obtained from cats during sedation. Radiographs were evaluated, using an Orthopedic Foundation for Animals (OFA)-like scoring system for dogs. Passive joint laxity was measured, using Norberg angle (NA) and distraction index (DI). Hip laxity in cats with DJD was compared with hip laxity in cats without DJD. Results: Hip dysplasia (HD) was subjectively diagnosed radiographically in 25 of 78 (32%) cats using the OFA-like scoring system. Nineteen cats had mild HD 4 had moderate HD, and 2 had severe HD. Fifteen of the 25 cats with HD had DJD. The NA ranged from 56 to 105. The mean NA in cats with DJD was (84 degrees) significantly lower than in cats without DJD (95 degrees). The DI ranged from 0.2 to 0.84. The mean DI for cats with DJD was (0.6) significantly higher than that for cats without DJD (0.49). Cats with a DI < 0.4 did not have DJD. Cats had an increased likelihood of having DJD with increased laxity in the coxofemoral joint, as measured by NA or DI. Clinical Implications: The mean NA for radiographically normal cats (92.4 degrees) was lower than that in radiographically normal dogs (103 degrees). The overall mean DI for cats in this group (0.51) is similar to dogs of breeds with high joint laxity, such as the Labrador Retriever (0.5). As in dogs, there is a relationship between DJD and laxity in the hip joint of cats

  18. Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats

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    Lascelles B Duncan X; Dong Yaa-Hui; Marcellin-Little Denis J; Thomson Andrea; Wheeler Simon; Correa Maria

    2012-01-01

    Abstract Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to...

  19. Low back pain and degenerative disc disease

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    Jandrić Slavica

    2006-01-01

    Full Text Available Introduction. Various clinical conditions can cause low back pain, and in most cases it is of a degenerative origin. Degenerative disc disease is a common condition which affects young to middle-aged men and women equally. Changes in the mechanical properties of the disc lead to degenerative arthritis in the intervertebral joints, osteophytes, and narrowing the intervertebral foramen or the spinal canal. Pathophysiology. Degenerative cascade, described by Kirkaldy-Willis, is the widely accepted pathophysiologic model describing the degenerative process as it affects the lumbar spine in 3 phases. Diagnosis. There are two forms of low back pain secondary to degenerative disc disease: a lumbalgia and b lumbar radiculopathy. Limitation of movement, problems with balance, pain, loss of reflexes in the extremities, muscle weakness, loss of sensation or other signs of neurological damage can be found on physical examination. For accurate diagnosis, it is often necessary to combine clinical examination and sophisticated technology. Treatment. Coservative treatment consists of rest, physical therapy, pharmacological therapy and injection therapy. Physical rehabilitation with active patient participation is a key approach to treatment of patients with discogenic pain. Physical therapy, occupational therapy and kinesitherapy are important for improving muscle strength, endurance, and flexibility. Disc surgery is performed if surgical intervention is required. .

  20. Degenerative diseases of the vertebral column.

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    Resnick, D

    1985-07-01

    Several distinct degenerative processes affect the articulations of the vertebral column; each is associated with characteristic radiographic and pathologic abnormalities, and many are accompanied by significant clinical manifestations. A discussion of these processes is best accomplished according to the type of joint that is involved. With regard to cartilaginous articulations, of which the intervertebral disk is most important, intervertebral (osteo)chondrosis, spondylosis deformans, and, in the cervical spine, uncovertebral arthrosis are the major degenerative disorders. Osteoarthritis (osteoarthrosis) affects any of the synovium-lined joints of the vertebral column, including the apophyseal, costovertebral, transitional lumbosacral, median atlantoaxial, and sacroiliac articulations. Fibrous articulations, ligaments, or entheses (sites of tendon or ligament attachment to bone) are involved in diffuse idiopathic skeletal hyperostosis, ossification of the posterior spinal ligaments, and Baastrup disease. Of the many complications of these degenerative processes, alignment abnormalities (including segmental instability, degenerative spondylolisthesis, senile kyphosis, and degenerative scoliosis), intervertebral disk displacement, calcification or ossification, and spinal stenosis are the most important. PMID:3923556

  1. Genetic and somatic radiation doses in radiotherapy of inflammatory and degenerative diseases of bones, joints and soft parts

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    Kirsch, M.; Keinert, K.; Schumann, E. (Medizinische Akademie, Erfurt (German Democratic Republic). Radiologische Klinik)

    1983-01-01

    Dose measurements were performed in several body regions of patients suffering from inflammatory degenerative diseases (humeral epicondylitis, humeroscapular periarthritis, gonarthrosis, axillary hidradenitis, rheumatoid arthritis, coxarthrosis, parotitis). The problem of the radiation induction of neoplasms is predominant concerning somatic as well as genetic risk, discussed by example of the most frequently occurring organ cancer. Compared to the rate of breast cancer in the highly developed industrial states (5,000 to 6,000 cancers/100,000 women) the 'radiation induction' calculated according to a mathematical model of ICRP 26 (1.25 cases of death for breast cancers/100,000 women following for example irradiation of epicondylitis) is behind several powers of ten and not demonstrable. The genetic radiation exposure is also low. Derived from the measurements it is wrong to give up reliable and approved indications of radiotherapy of non-malignant diseases because of unfounded radiophobia.

  2. [Dysexecutive syndromes and degenerative diseases].

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    Pillon, B; Czernecki, V; Dubois, B

    2004-04-01

    A dysexecutive syndrome is observed not only in frontotemporal lobar degeneration, but also in subcortical degenerative diseases, and even in Alzheimer's disease whose lesions predominate in temporoparietal associative areas. The association between a dysexecutive syndrome and various cerebral localisations may be explained by the fact that cognitive and behavioral organisation recruits anatomofunctional frontostriatal and frontoparietal circuits. Both animal experimentation and human clinical observation argue in favour of a functional continuity and complementarity among these loops. The prefrontal cortex would be particularly needed in new situations, to inhibit old programs of action not adapted to the present context and to elaborate new ones; the basal ganglia would be rather required by the repetition of the situation to progressively transform the new program in routine. If we refer to Shallice model, we can hypothesize that optimal executive functions require the preservation not only of the Supervisory Attentional System, mainly dependent on the prefrontal cortex, but also of the Contention Scheduling, recruiting the basal ganglia, and of the Schemas of Action, represented in parietal and premotor areas. Therefore, the neuropsychological assessment of patients with degenerative diseases contributes to the understanding of the anatomofunctional architecture of executive functions.

  3. Destructive discovertebral degenerative disease of the lumbar spine.

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    Charran, A K; Tony, G; Lalam, R; Tyrrell, P N M; Tins, B; Singh, J; Eisenstein, S M; Balain, B; Trivedi, J M; Cassar-Pullicino, V N

    2012-09-01

    The uncommon variant of degenerative hip joint disease, termed rapidly progressive osteoarthritis, and highlighted by severe joint space loss and osteochondral disintegration, is well established. We present a similar unusual subset in the lumbar spine termed destructive discovertebral degenerative disease (DDDD) with radiological features of vertebral malalignment, severe disc resorption, and "bone sand" formation secondary to vertebral fragmentation. Co-existing metabolic bone disease is likely to promote the development of DDDD of the lumbar spine, which presents with back pain and sciatica due to nerve root compression by the "bone sand" in the epidural space. MRI and CT play a complimentary role in making the diagnosis.

  4. Neuro degenerative diseases: clinical concerns

    International Nuclear Information System (INIS)

    Idiopathic Parkinson's disease (PD) and Alzheimer's disease (AD) are the main neuro-degenerative diseases (NDDs) seen clinically. They share some common clinical symptoms and neuro-pathological findings. The increase of life expectancy in the developed countries will inevitably contribute to enhance the prevalence of these diseases. Behavioral disorders, common in NDDs, will produce major care management challenges. Idiopathic Parkinson's disease corresponds to a histopathological diagnosis, based on the observation of a de-pigmentation and a neuronal loss in the substantia nigra, as well as on the presence of intra-neuronal inclusion bodies. AD is insidious with slowly progressive dementia in which the decline in memory constitutes the main complaint. The diagnosis of definite AD requires the presence of clinical criteria as well as the histopathological confirmation of brain lesions. The two main lesions are the presence of senile plaques and neuro-fibrillary tangles. Positron emission tomography (PET) explores cerebral metabolism and neurotransmitter kinetics in NDDs using principally [18F]-deoxyglucose and [18F]-dopa. Nigrostriatal dopaminergic function is altered in PD, as evidenced by the low uptake of [18F]-dopa in the posterior putamen as compared to anterior putamen and caudate nucleus. In contrast, [18F]-dopa uptake is equally depressed in all striatal structures in progressive supra-nuclear palsy. Regional glucose metabolism at rest is preserved in elderly once cerebral atrophy is taken into account. On the contrary, glucose metabolism is globally reduced in AD, with marked decrease in the parietal and temporal regions. PET has proved to be useful to study in vivo neurochemical processes in patients suffering from NDDs. The potential of this approach is still largely unexploited, and depends on new ligand production to establish early diagnosis and treatment follow-up. (author)

  5. Study of the lateral raise in foot wear for the management of medial compartment degenerative joint disease of knee

    International Nuclear Information System (INIS)

    A wide spread disease, which may lead the patient to severe outcomes e.g. pain, loss of joint motion, inflexibility and even disability, is Knee osteoarthritis (OA). It is most common among adults of older age and should not be ignored at all. Literature does not show any clear pathogenesis for occurrence of Knee OA, but most of the indications point toward biomechanical stresses which may influence the articular cartilage and sub chondral bone. Objective: The Aim of this study is to become aware of the effects of physical therapy with and without laterally raised footwear in the management of medial knee osteoarthritis. Methodology: We have used experimental comparative study in 35 patients which were randomly selected from Department of Physiotherapy, Fatima Memorial Hospital, Shadman, Lahore. The study consisted of 2 groups, Group I (Experimental Group): In experimental group, patients were treated with laterally raised foot wear and physical therapy both. Group II (Control Group): Whereas in control group patients were treated by physical therapy alone. Kellgren and Lawrence (KL) scale was used to assess radiograph of the knee joints after an anteroposterior weight-bearing standing. The assessment of disease in patients was done by using the Western Ontario and McMaster Universities (WOMAC) Index, Muscle flexibility, Muscle strengthening and Tolerance scales. Results: In group-I the mean age of patients observed was 59.52+-13.66 years and 65+-12.87 years in Group-II. In Group-I, 9 (52.9%) patients were males and 8 (47.1%) patients were females while in Group-II, 9 patients (50%) were male and 9 (50%) were female. In Group-I 2 (11.8%) patients used flat and open shoes, 6 (35.3%) used flat and close shoe, 3 (17.6%) patients used dress shoes and 2 (11.8%) used flat shoes. In Group-I, the frequency of patients wearing laterally raised foot wear in terms of duration was; 5 (29.4%) patients for 20 days, 4 (23.5%) for 24 days, 4 (23.5%) for 25 days, whilst 2 patients

  6. 宣痹合剂治疗腰椎退行性骨关节病疼痛的临床研究%Clinical Study on Xuanbi Mixture in the Treatment of Lumbar Degenerative Bone Joint Disease Pain

    Institute of Scientific and Technical Information of China (English)

    崔长锋

    2016-01-01

    Objective To investigate the effect Xuanbi mixture in the treatment of lumbar degenerative bone joint disease pain symptoms. Methods The control group received routine clinical. The research group used Xuanbi mixture on the basis of the Western medicine. The improvement of lumbar degenerative bone joint disease pain before and after treatment was recorded, and the resulting data were implemented statistical test. Results The two groups had no significant difference in pain intensity ( P >0. 05 ) . After corresponding treatment, the improvement of lumbar degenerative bone joint disease pain of the two groups was significantly improved, the research group was better than the control group, and the difference was statistically significant (P0.05);治疗后两组疼痛程度均较之前显著改善,且研究组改善效果优于对照组,对比结果具有统计学意义(P<0.05)。结论对腰椎退行性骨关节病患者给予常规治疗联合宣痹合剂可获得更为理想的临床疗效,有利于保障患者生活质量及身心健康。

  7. Morgan line and its relationship with distraction index, angle of inclination and degenerative joint disease in the diagnosis of canine hip dysplasia

    Directory of Open Access Journals (Sweden)

    F.G. Miranda

    2016-08-01

    Full Text Available ABSTRACT We evaluated 160 hip joint radiographs of 40 dogs of different large breeds (25 females and 15 males from the metropolitan area of Belo Horizonte, Minas Gerais, Brazil. The radiographs of each dog were obtained at two different stages: stage 1 (mean 7.23 months and stage 2 (mean 14.25. The conventional radiographic method (CRM and the radiographic distraction method (RDM were used, carried out in both stages. CRM measured the Norberg angle (NA, the angle of inclination (AI and evaluated the presence of degenerative joint disease (DJD. The MRD was performed to establish the distraction index (DI. The aims were to evaluate the presence of the Morgan line and other signs of DJD and correlate them with the degree of canine hip dysplasia (CHD and also check if the DI greater than 0.3 (first stage was associated with the presence of ML (second stage. It was found that DI, AI and changes of femoral neck and the formation of osteophytes were associated with the presence of ML. It was observed that if the DI is greater than 0.3 at the first stage, the chance of a positive outcome of ML in the second stage increases by 7.2 times. Thus, 49 joints showed DI > 0.3 at the first stage, in which 31 (63.3 % presented ML at the second stage. Of the 31 animals that showed DI ≤ 0.3 at first, six (19.4% had LM at the second stage. There has been a significant association between the presence of ML and the degree of CHD. The more severe the CHD, the higher the percentage of positive ML results. Thus, among the 24 (60 % animals that showed ML, 11 (45.83 % were classified as severe dysplastics, 5 (20.83% as moderate and 8 (33.33 % as mild. None of the animals classified as normal or borderline presented ML. Among the 8 animals classified as mild dysplastics, 5 showed only ML as DJD.

  8. Physiochemical basis of human degenerative disease

    Directory of Open Access Journals (Sweden)

    Zeliger Harold I.

    2015-03-01

    Full Text Available The onset of human degenerative diseases in humans, including type 2 diabetes, cardiovascular disease, neurological disorders, neurodevelopmental disease and neurodegenerative disease has been shown to be related to exposures to persistent organic pollutants, including polychlorinated biphenyls, chlorinated pesticides, polybrominated diphenyl ethers and others, as well as to polynuclear aromatic hydrocarbons, phthalates, bisphenol-A and other aromatic lipophilic species. The onset of these diseases has also been related to exposures to transition metal ions. A physiochemical mechanism for the onset of degenerative environmental disease dependent upon exposure to a combination of lipophilic aromatic hydrocarbons and transition metal ions is proposed here. The findings reported here also, for the first time, explain why aromatic hydrocarbons exhibit greater toxicity than aliphatic hydrocarbons of equal carbon numbers.

  9. TU-C-12A-12: Differentiating Bone Lesions and Degenerative Joint Disease in NaF PET/CT Scans Using Machine Learning

    International Nuclear Information System (INIS)

    Purpose: [F-18]NaF PET can be used to image bone metastases; however, tracer uptake in degenerative joint disease (DJD) often appears similar to metastases. This study aims to develop and compare different machine learning algorithms to automatically identify regions of [F-18]NaF scans that correspond to DJD. Methods: 10 metastatic prostate cancer patients received whole body [F-18]NaF PET/CT scans prior to treatment. Image segmentation resulted in 852 ROIs, 69 of which were identified by a nuclear medicine physician as DJD. For all ROIs, various PET and CT textural features were computed. ROIs were divided into training and testing sets used to train eight different machine learning classifiers. Classifiers were evaluated based on receiver operating characteristics area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV). We also assessed the added value of including CT features in addition to PET features for training classifiers. Results: The training set consisted of 37 DJD ROIs with 475 non-DJD ROIs, and the testing set consisted of 32 DJD ROIs with 308 non-DJD ROIs. Of all classifiers, generalized linear models (GLM), decision forests (DF), and support vector machines (SVM) had the best performance. AUCs of GLM (0.929), DF (0.921), and SVM (0.889) were significantly higher than the other models (p<0.001). GLM and DF, overall, had the best sensitivity, specificity, and PPV, and gave a significantly better performance (p<0.01) than all other models. PET/CT GLM classifiers had higher AUC than just PET or just CT. GLMs built using PET/CT information had superior or comparable sensitivities, specificities and PPVs to just PET or just CT. Conclusion: Machine learning algorithms trained with PET/CT features were able to identify some cases of DJD. GLM outperformed the other classification algorithms. Using PET and CT information together was shown to be superior to using PET or CT features alone. Research supported by the Prostate

  10. TU-C-12A-12: Differentiating Bone Lesions and Degenerative Joint Disease in NaF PET/CT Scans Using Machine Learning

    Energy Technology Data Exchange (ETDEWEB)

    Perk, T; Bradshaw, T; Muzahir, S; Jeraj, R [University of Wisconsin, Madison, Wisconsin (United States); Meyer, E [Case Western Reserve University School of Medicine, Cleveland, Ohio (United States)

    2014-06-15

    Purpose: [F-18]NaF PET can be used to image bone metastases; however, tracer uptake in degenerative joint disease (DJD) often appears similar to metastases. This study aims to develop and compare different machine learning algorithms to automatically identify regions of [F-18]NaF scans that correspond to DJD. Methods: 10 metastatic prostate cancer patients received whole body [F-18]NaF PET/CT scans prior to treatment. Image segmentation resulted in 852 ROIs, 69 of which were identified by a nuclear medicine physician as DJD. For all ROIs, various PET and CT textural features were computed. ROIs were divided into training and testing sets used to train eight different machine learning classifiers. Classifiers were evaluated based on receiver operating characteristics area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV). We also assessed the added value of including CT features in addition to PET features for training classifiers. Results: The training set consisted of 37 DJD ROIs with 475 non-DJD ROIs, and the testing set consisted of 32 DJD ROIs with 308 non-DJD ROIs. Of all classifiers, generalized linear models (GLM), decision forests (DF), and support vector machines (SVM) had the best performance. AUCs of GLM (0.929), DF (0.921), and SVM (0.889) were significantly higher than the other models (p<0.001). GLM and DF, overall, had the best sensitivity, specificity, and PPV, and gave a significantly better performance (p<0.01) than all other models. PET/CT GLM classifiers had higher AUC than just PET or just CT. GLMs built using PET/CT information had superior or comparable sensitivities, specificities and PPVs to just PET or just CT. Conclusion: Machine learning algorithms trained with PET/CT features were able to identify some cases of DJD. GLM outperformed the other classification algorithms. Using PET and CT information together was shown to be superior to using PET or CT features alone. Research supported by the Prostate

  11. Diagnostic Testing for Degenerative Disc Disease

    OpenAIRE

    Hasz, Michael W.

    2012-01-01

    The diagnostic of degenerative disc disease should be reached with the help of various diagnostic studies. This article briefly review the information gained by the following tests: radiographs, computed tomography, magnetic resonance, and discography. The article explains how each modality provides a piece of the diagnostic puzzle and how discography confirms the origin of the patient's pain.

  12. Inherited Retinal Degenerative Disease Registry

    Science.gov (United States)

    2016-03-21

    Eye Diseases Hereditary; Retinal Disease; Achromatopsia; Bardet-Biedl Syndrome; Bassen-Kornzweig Syndrome; Batten Disease; Best Disease; Choroidal Dystrophy; Choroideremia; Cone Dystrophy; Cone-Rod Dystrophy; Congenital Stationary Night Blindness; Enhanced S-Cone Syndrome; Fundus Albipunctatus; Goldmann-Favre Syndrome; Gyrate Atrophy; Juvenile Macular Degeneration; Kearns-Sayre Syndrome; Leber Congenital Amaurosis; Refsum Syndrome; Retinitis Pigmentosa; Retinitis Punctata Albescens; Retinoschisis; Rod-Cone Dystrophy; Rod Dystrophy; Rod Monochromacy; Stargardt Disease; Usher Syndrome

  13. MR imaging of degenerative disc disease

    International Nuclear Information System (INIS)

    Highlights: • This systematic literature review summarizes the current knowledge on MR imaging in degenerative disc disease. • Different classification systems for segmental spine degeneration are summarized. • It outlines the diagnostic limitations of MR imaging. - Abstract: Magnet resonance imaging (MRI) is the most commonly used imaging modality for diagnosis of degenerative disc disease (DDD). Lack of precise observations and documentation of aspects within the complex entity of DDD might partially be the cause of poor correlation of radiographic findings to clinical symptoms. This literature review summarizes the current knowledge on MRI in DDD and outlines the diagnostic limitations. The review further sensitizes the reader toward awareness of potentially untended aspects of DDD and the interaction of DDD and endplate changes. A summary of the available classifications for DDD is provided

  14. MR imaging of degenerative disc disease

    Energy Technology Data Exchange (ETDEWEB)

    Farshad-Amacker, Nadja A., E-mail: nadja.farshad@usz.ch [Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich (Switzerland); Farshad, Mazda [Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich (Switzerland); Winklehner, Anna; Andreisek, Gustav [Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich (Switzerland)

    2015-09-15

    Highlights: • This systematic literature review summarizes the current knowledge on MR imaging in degenerative disc disease. • Different classification systems for segmental spine degeneration are summarized. • It outlines the diagnostic limitations of MR imaging. - Abstract: Magnet resonance imaging (MRI) is the most commonly used imaging modality for diagnosis of degenerative disc disease (DDD). Lack of precise observations and documentation of aspects within the complex entity of DDD might partially be the cause of poor correlation of radiographic findings to clinical symptoms. This literature review summarizes the current knowledge on MRI in DDD and outlines the diagnostic limitations. The review further sensitizes the reader toward awareness of potentially untended aspects of DDD and the interaction of DDD and endplate changes. A summary of the available classifications for DDD is provided.

  15. Imaging and translational research: neuro degenerative diseases

    Energy Technology Data Exchange (ETDEWEB)

    Hantraye, P. [CEA Fontenay-aux-Roses, MIRC, 92 (France)

    2009-07-01

    Advances in neuroimaging of neuro-degenerative diseases over the past two decades are the product of breakthroughs in imaging technology, more powerful computers, image-processing software, and expanding knowledge in basic and clinical neuro-science. In addition to the insights into normal brain structure and function that such methods provide, and the information that can be gained from disease-related changes in structure and function, functional imaging offers the promise of monitoring brain lesions and quantifying the therapeutic efficacy of innovative treatments for these largely incurable disorders. (author)

  16. Stem cell treatment of degenerative eye disease

    Directory of Open Access Journals (Sweden)

    Ben Mead

    2015-05-01

    Full Text Available Stem cell therapies are being explored extensively as treatments for degenerative eye disease, either for replacing lost neurons, restoring neural circuits or, based on more recent evidence, as paracrine-mediated therapies in which stem cell-derived trophic factors protect compromised endogenous retinal neurons from death and induce the growth of new connections. Retinal progenitor phenotypes induced from embryonic stem cells/induced pluripotent stem cells (ESCs/iPSCs and endogenous retinal stem cells may replace lost photoreceptors and retinal pigment epithelial (RPE cells and restore vision in the diseased eye, whereas treatment of injured retinal ganglion cells (RGCs has so far been reliant on mesenchymal stem cells (MSC. Here, we review the properties of non-retinal-derived adult stem cells, in particular neural stem cells (NSCs, MSC derived from bone marrow (BMSC, adipose tissues (ADSC and dental pulp (DPSC, together with ESC/iPSC and discuss and compare their potential advantages as therapies designed to provide trophic support, repair and replacement of retinal neurons, RPE and glia in degenerative retinal diseases. We conclude that ESCs/iPSCs have the potential to replace lost retinal cells, whereas MSC may be a useful source of paracrine factors that protect RGC and stimulate regeneration of their axons in the optic nerve in degenerate eye disease. NSC may have potential as both a source of replacement cells and also as mediators of paracrine treatment.

  17. MR imaging of degenerative disc disease.

    Science.gov (United States)

    Farshad-Amacker, Nadja A; Farshad, Mazda; Winklehner, Anna; Andreisek, Gustav

    2015-09-01

    Magnet resonance imaging (MRI) is the most commonly used imaging modality for diagnosis of degenerative disc disease (DDD). Lack of precise observations and documentation of aspects within the complex entity of DDD might partially be the cause of poor correlation of radiographic findings to clinical symptoms. This literature review summarizes the current knowledge on MRI in DDD and outlines the diagnostic limitations. The review further sensitizes the reader toward awareness of potentially untended aspects of DDD and the interaction of DDD and endplate changes. A summary of the available classifications for DDD is provided. PMID:26094867

  18. 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 ...

  19. Canine Degenerative Valve Disease: A Case Report

    Directory of Open Access Journals (Sweden)

    Carmenza Janneth Benavides Melo

    2014-07-01

    Full Text Available Degenerative valvular disease or endocardiosis is the most common cardiovascular pathology in dogs. It is characterized by regurgitation of blood into the atria with decreased cardiac output, leading to volume overload with eccentric hypertrophy and congestive heart failure. This report describes the clinical and autopsy findings of a dog, suggestive of valvular endocardiosis. The patient was admitted to the outpatient Veterinary Clinic “Carlos Martínez Hoyos” at the University of Nariño (Pasto, Colombia. His owner said the dog was sick for two months, with signs of respiratory disease, weight loss, and decay. Clinical examination showed very pale mucous membranes, inspiratory dyspnea, rale, split S2, grade 4 mid-systolic murmur of regurgitation, and abdominal dilatation with sign of positive shock wave. Necropsy evidenced plenty of translucent watery material in the abdominal, chest and pericardium cavity, severely enlarged and rounded heart with thickened atrioventricular valves, moderate reduction in liver size and signs of lobulation, severely diminished and pale kidneys with irregular surface showing the presence of multiple cystic areas in corticomedullary region. Samples were taken from these tissues and fixed in 10% buffered formalin to be processed for histopathological analysis at the Laboratory of Pathology at the University of Nariño, using hematoxylin and eosin stain. This way, degenerative valvular disease was diagnosed.

  20. Degenerative disease of the lumbar spine.

    Science.gov (United States)

    Kovacs, F M; Arana, E

    2016-04-01

    In the last 25 years, scientific research has brought about drastic changes in the concept of low back pain and its management. Most imaging findings, including degenerative changes, reflect anatomic peculiarities or the normal aging process and turn out to be clinically irrelevant; imaging tests have proven useful only when systemic disease is suspected or when surgery is indicated for persistent spinal cord or nerve root compression. The radiologic report should indicate the key points of nerve compression, bypassing inconsequential findings. Many treatments have proven inefficacious, and some have proven counterproductive, but they continue to be prescribed because patients want them and there are financial incentives for doing them. Following the guidelines that have proven effective for clinical management improves clinical outcomes, reduces iatrogenic complications, and decreases unjustified and wasteful healthcare expenditures.

  1. Time estimation in Parkinson's disease and degenerative cerebellar disease

    NARCIS (Netherlands)

    Beudel, Martijin; Galama, Sjoukje; Leenders, Klaus L.; de Jong, Bauke M.

    2008-01-01

    With functional MRI, we recently identified fronto-cerebellar activations in predicting time to reach a target and basal ganglia activation in velocity estimation, that is, small interval assessment. We now tested these functions in patients with Parkinson's disease (PD) and degenerative cerebellar

  2. Computed tomography in lumbar degenerative disease

    Energy Technology Data Exchange (ETDEWEB)

    Isu, Toyohiko; Miyasaka, Kazuo; Abe, Satoru; Takei, Hidetoshi; Kaneda, Kiyoshi (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1984-02-01

    We reported the 18 patients which underwent surgical exploration and reviewed these CT findings. Method All CT scans were obtained on Somatom II, high resolution CT scanner, with the patient in the supine position. A lateral localizer image (Topogram) was used to select the appropriate intervertebral disk space. The slice thickness was 4 mm. Results 1) CT findings in lumbar degenerative diseases include bony canal stenosis (central canal stenosis, narrowed lateral recess), soft tissue abnormalities (herniated nucleus pulposus, bulging annulus, hypertrophy and/or ossification of ligamentum flavum, no delineation of nerve root in lateral recess), and spinal instability (spondylolisthesis, vacuum phenomenon). 2) The above three factors contribute to narrowing of spinal canal. 3) No delineation of nerve root or soft tissue replacement of epidural fat in lateral recess suggests that the nerve root may be compressed by some factors. 4) Herniated nucleus pulposus may cause nerve root compression with or without canal stenosis. Conclusion This study revealed that the CT findings correlated closely with the surgical findings and the site of nerve root compression could be determined.

  3. Operative Management of Lumbar Degenerative Disc Disease

    Science.gov (United States)

    Lee, Yu Chao; Osti, Orso Lorenzo

    2016-01-01

    Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term. PMID:27559465

  4. Operative Management of Lumbar Degenerative Disc Disease.

    Science.gov (United States)

    Lee, Yu Chao; Zotti, Mario Giuseppe Tedesco; Osti, Orso Lorenzo

    2016-08-01

    Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term. PMID:27559465

  5. Total Disc Arthroplasty for Treating Lumbar Degenerative Disc Disease

    OpenAIRE

    Mostofi, Keyvan

    2015-01-01

    Study Design Lumber disc arthroplasty is a technological advancement that has occurred in the last decade to treat lumbar degenerative disk diseases. Purpose The aim of this retrospective study was to establish the impact and outcomes of managing patients with lumbar degenerative disk disease who have been treated with lumbar total disc arthroplasty (TDA). Overview of Literature Several studies have shown promising results following this surgery. Methods We reviewed the files of 104 patients ...

  6. Imaging of lumbar degenerative disk disease: history and current state

    Energy Technology Data Exchange (ETDEWEB)

    Emch, Todd M. [Cleveland Clinic, Division of Neuroradiology, Imaging Institute, Neuroradiology L-10, Cleveland, OH (United States); Modic, Michael T. [Cleveland Clinic, Division of Neuroradiology, Imaging Institute, Neurological Institute T-13, Cleveland, OH (United States)

    2011-09-15

    One of the most common indications for performing magnetic resonance (MR) imaging of the lumbar spine is the symptom complex thought to originate as a result of degenerative disk disease. MR imaging, which has emerged as perhaps the modality of choice for imaging degenerative disk disease, can readily demonstrate disk pathology, degenerative endplate changes, facet and ligamentous hypertrophic changes, and the sequelae of instability. Its role in terms of predicting natural history of low back pain, identifying causality, or offering prognostic information is unclear. As available modalities for imaging the spine have progressed from radiography, myelography, and computed tomography to MR imaging, there have also been advances in spine surgery for degenerative disk disease. These advances are described in a temporal context for historical purposes with a focus on MR imaging's history and current state. (orig.)

  7. Non degenerative disease in MRI cervical spine of symptomatic patients

    Directory of Open Access Journals (Sweden)

    Dan B Karki

    2016-01-01

    Full Text Available Background & Objectives: The most common etiology of neck pain is degenerative disc disease, however non-degenerative disease can be important cause of neck pain. This study aims to study the non-degenerative findings in cervical MRI in symptomatic patients with neck and radicular pain.Materials & Methods: The study was a institutional record based retrospective study performed for the duration of 3 years. MRI performed for patients with neck pain and/ or radiculopathy were reviewed. Patients with post operative findings were excluded from the study. Statistical analysis was done using SPSS 21.0.Results: A total of 721 MRI were performed for neck pain and radiculopathy, among which 91 (12.13% cases had non-degenerative changes. Most common non degenerative change was traumatic lesions followed by neoplastic lesions and syrinx. Traumatic lesions were more common in males as compared to females. Infection was more common in females as compared to males. C5 and C6 vertebrae were most common vertebra involved in trauma and infection. Some cases like signal change in spinal cord, and syrinx were also noted in our study.Conclusion: Non degenerative cause of neck pain were less common but important cause of neck pain. Traumatic lesions were the most common cause of non degenerative neck pain.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 20-23

  8. Skipping Posterior Dynamic Transpedicular Stabilization for Distant Segment Degenerative Disease

    Directory of Open Access Journals (Sweden)

    Bilgehan Solmaz

    2012-01-01

    Full Text Available Objective. To date, there is still no consensus on the treatment of spinal degenerative disease. Current surgical techniques to manage painful spinal disorders are imperfect. In this paper, we aimed to evaluate the prospective results of posterior transpedicular dynamic stabilization, a novel surgical approach that skips the segments that do not produce pain. This technique has been proven biomechanically and radiologically in spinal degenerative diseases. Methods. A prospective study of 18 patients averaging 54.94 years of age with distant spinal segment degenerative disease. Indications consisted of degenerative disc disease (57%, herniated nucleus pulposus (50%, spinal stenosis (14.28%, degenerative spondylolisthesis (14.28%, and foraminal stenosis (7.1%. The Oswestry Low-Back Pain Disability Questionnaire and visual analog scale (VAS for pain were recorded preoperatively and at the third and twelfth postoperative months. Results. Both the Oswestry and VAS scores showed significant improvement postoperatively (P<0.05. We observed complications in one patient who had spinal epidural hematoma. Conclusion. We recommend skipping posterior transpedicular dynamic stabilization for surgical treatment of distant segment spinal degenerative disease.

  9. Neuromuscular exercise as treatment of degenerative knee disease

    DEFF Research Database (Denmark)

    Ageberg, Eva; Roos, Ewa M.

    2015-01-01

    Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional instabil......Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional...... instability associated with the degenerative knee disease than traditionally used training methods.SUMMARY FOR TABLE OF CONTENTS PAGECurrent data suggests that the effect from neuromuscular exercise on pain and function is comparable to the effects seen from other forms of exercise....

  10. Effects of interspinous spacers on lumbar degenerative disease.

    Science.gov (United States)

    Zhou, Dong; Nong, Lu-Ming; DU, Rui; Gao, Gong-Ming; Jiang, Yu-Qing; Xu, Nan-Wei

    2013-03-01

    The present study aimed to evaluate the early effects of interspinous spacers on lumbar degenerative disease. The clinical outcomes of 23 patients with lumbar degenerative disease, treated using interspinous spacer implantation alone or combined with posterior lumbar fusion, were retrospectively studied and assessed with a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Pre-operative and post-operative interspinous distance, disc space height, foraminal width and height and segmental lordosis were determined. The early effects and complications associated with the interspinous spacers were recorded. The surgical procedures performed with the in-space treatment were easy and minimally invasive. The VAS scores and ODI were improved post-operatively compared with pre-operatively. Significant changes in the interspinous distance, disc space height, foraminal width and height and segmental lordosis were noted. In-space treatment for degenerative lumbar disease is easy and safe, with good early effects. The in-space system provides an alternative treatment for lumbar degenerative disease.

  11. Vitiligo: a possible model of degenerative diseases.

    Directory of Open Access Journals (Sweden)

    Barbara Bellei

    Full Text Available Vitiligo is characterized by the progressive disappearance of pigment cells from skin and hair follicle. Several in vitro and in vivo studies show evidence of an altered redox status, suggesting that loss of cellular redox equilibrium might be the pathogenic mechanism in vitiligo. However, despite the numerous data supporting a pathogenic role of oxidative stress, there is still no consensus explanation underlying the oxidative stress-driven disappear of melanocytes from the epidermis. In this study, in vitro characterization of melanocytes cultures from non-lesional vitiligo skin revealed at the cellular level aberrant function of signal transduction pathways common with neurodegenerative diseases including modification of lipid metabolism, hyperactivation of mitogen-activated protein kinase (MAPK and cAMP response element-binding protein (CREB, constitutive p53-dependent stress signal transduction cascades, and enhanced sensibility to pro-apoptotic stimuli. Notably, these long-term effects of subcytotoxic oxidative stress are also biomarkers of pre-senescent cellular phenotype. Consistent with this, vitiligo cells showed a significant increase in p16 that did not correlate with the chronological age of the donor. Moreover, vitiligo melanocytes produced many biologically active proteins among the senescence-associated secretory phenotype (SAPS, such as interleukin-6 (IL-6, matrix metallo proteinase-3 (MMP3, cyclooxygenase-2 (Cox-2, insulin-like growth factor-binding protein-3 and 7 (IGFBP3, IGFBP7. Together, these data argue for a complicated pathophysiologic puzzle underlying melanocytes degeneration resembling, from the biological point of view, neurodegenerative diseases. Our results suggest new possible targets for intervention that in combination with current therapies could correct melanocytes intrinsic defects.

  12. Vitiligo: A Possible Model of Degenerative Diseases

    Science.gov (United States)

    Bellei, Barbara; Pitisci, Angela; Ottaviani, Monica; Ludovici, Matteo; Cota, Carlo; Luzi, Fabiola; Dell'Anna, Maria Lucia; Picardo, Mauro

    2013-01-01

    Vitiligo is characterized by the progressive disappearance of pigment cells from skin and hair follicle. Several in vitro and in vivo studies show evidence of an altered redox status, suggesting that loss of cellular redox equilibrium might be the pathogenic mechanism in vitiligo. However, despite the numerous data supporting a pathogenic role of oxidative stress, there is still no consensus explanation underlying the oxidative stress-driven disappear of melanocytes from the epidermis. In this study, in vitro characterization of melanocytes cultures from non-lesional vitiligo skin revealed at the cellular level aberrant function of signal transduction pathways common with neurodegenerative diseases including modification of lipid metabolism, hyperactivation of mitogen-activated protein kinase (MAPK) and cAMP response element-binding protein (CREB), constitutive p53-dependent stress signal transduction cascades, and enhanced sensibility to pro-apoptotic stimuli. Notably, these long-term effects of subcytotoxic oxidative stress are also biomarkers of pre-senescent cellular phenotype. Consistent with this, vitiligo cells showed a significant increase in p16 that did not correlate with the chronological age of the donor. Moreover, vitiligo melanocytes produced many biologically active proteins among the senescence-associated secretory phenotype (SAPS), such as interleukin-6 (IL-6), matrix metallo proteinase-3 (MMP3), cyclooxygenase-2 (Cox-2), insulin-like growth factor-binding protein-3 and 7 (IGFBP3, IGFBP7). Together, these data argue for a complicated pathophysiologic puzzle underlying melanocytes degeneration resembling, from the biological point of view, neurodegenerative diseases. Our results suggest new possible targets for intervention that in combination with current therapies could correct melanocytes intrinsic defects. PMID:23555779

  13. Comparación de los efectos de dos técnicas de electroanalgesia en la enfermedad articular degenerativa tarsometatarsiana del equino Comparison between the effects of two electroanalgesical technics in the tarsometatarsal degenerative joint disease

    Directory of Open Access Journals (Sweden)

    J.A. García Liñeiro

    2006-12-01

    effective in equine medicine. The clinical model consisted of 10 horses with a standardized diagnostic protocol of tarsometatarsial degenerative joint disease; these were subjected to both treatments with an interval of 6 months, then results were compared. Treatments were performed every day and the clinic evaluation every two days (five controls. The clinic parameters considered were: a- straight and circle trot, in hard and soft surface. b- Tarsus Flexion test c- Tarsus Test (Churchill test. McNemar's test was performed in order to compare lameness and forced flexion tests at 'control 5' stage, after applying TENS and RAME treatments; no significant differences were found between both treatments (p=0,2568. The Mc Nemar's test also used to compare tarsal flexion tests (Churchill's Test after TENS and RAME treatments, showed no significant differences between Both (p=0,7055. It was therefore concluded that there is little difference between the two methods, while there is an important decrease as from 'control 2'. This situation lets us assume that both methods may be used indistinctly in an effective manner, choosing to use one or the other according to the advantages and disadvantages of its applications.

  14. Adjacent segment disease in degenerative pathologies with posterior instrumentation

    Directory of Open Access Journals (Sweden)

    Ana Guadalupe Ramírez Olvera

    2015-03-01

    Full Text Available OBJECTIVE: To establish the real incidence of adjacent segment disease after fusion, and to identify the levels and predisposing factors for the pathology, as well as the functional results. METHODS: a retrospective case series study with level of evidence IIB, in a sample of 179 patients diagnosed with stenosis of the lumbar spine, spondylolisthesis and degenerative scoliosis, submitted to surgery in the period 2005 to December 2013, with posterior instrumentation and posterolateral fusion, with follow-up from 2007 until May 2014, in which the symptomology and radiographic findings were evaluated, to establish the diagnosis and treatment. RESULTS: the study included 179 patients diagnosed with stenosis of the lumbar spine (n=116, isthmic and degenerative spondylolisthesis (n=50 and degenerative scoliosis (n=13; during the study, 20 cases of adjacent level segment were identified, 80% of which were treated surgically with extension of the instrumentation, while 20% were treated conservatively with NSAIDs and therapeutic blocks. CONCLUSION: An incidence of 11% was found, with an average of 3.25 years in diagnosis and treatment, a prevalence of females and diagnosis of stenosis of the lumbar canal on posterior instrumentation, a predominance of levels L4-L5; 80% were treated with extension of the instrumentation. The complications were persistent radiculopathy, infection of the surgical wound, and one death due to causes not related to the lumbar pathology.

  15. MR imaging of the spine: trauma and degenerative disease

    Energy Technology Data Exchange (ETDEWEB)

    Wilmink, J.T. [Department of Radiology, University Hospital Maastricht (Netherlands)

    1999-09-01

    The purpose of this paper is to discuss the capabilities and drawbacks of MR imaging in patients with trauma to the spine and degenerative spinal conditions. In spinal trauma MR imaging is secondary to plain X-ray films and CT because of the greater availability and ease of performance of these techniques and their superior capability for detecting vertebral fractures. Magnetic resonance imaging is useful for detecting ligamentous ruptures and intraspinal mass lesions such as hematoma, and for assessing the state of the spinal cord and prognosis of a cord injury. In degenerative spinal disease the necessity is emphasized of critically evaluating the clinical relevance of any abnormal feature detected, as findings of degenerative pathology are common in individuals without symptoms. Magnetic resonance myelography permits rapid and accurate assessment of the state of the lumbar nerve roots (compressed or not). In the cervical region the quality of the myelographic picture is often degraded in patients with a narrow spinal canal. (orig.) With 10 figs., 14 refs.

  16. Neuro degenerative diseases: clinical concerns; Les maladies neuro-degeneratives: problemes cliniques

    Energy Technology Data Exchange (ETDEWEB)

    Ibanez, V. [Hopitaux Universitaires de Geneve (HUG), Unite de Neuroimagerie, Dept. de Psychiatrie (Switzerland)

    2005-04-15

    Idiopathic Parkinson's disease (PD) and Alzheimer's disease (AD) are the main neuro-degenerative diseases (NDDs) seen clinically. They share some common clinical symptoms and neuro-pathological findings. The increase of life expectancy in the developed countries will inevitably contribute to enhance the prevalence of these diseases. Behavioral disorders, common in NDDs, will produce major care management challenges. Idiopathic Parkinson's disease corresponds to a histopathological diagnosis, based on the observation of a de-pigmentation and a neuronal loss in the substantia nigra, as well as on the presence of intra-neuronal inclusion bodies. AD is insidious with slowly progressive dementia in which the decline in memory constitutes the main complaint. The diagnosis of definite AD requires the presence of clinical criteria as well as the histopathological confirmation of brain lesions. The two main lesions are the presence of senile plaques and neuro-fibrillary tangles. Positron emission tomography (PET) explores cerebral metabolism and neurotransmitter kinetics in NDDs using principally [{sup 18}F]-deoxyglucose and [{sup 18}F]-dopa. Nigrostriatal dopaminergic function is altered in PD, as evidenced by the low uptake of [{sup 18}F]-dopa in the posterior putamen as compared to anterior putamen and caudate nucleus. In contrast, [{sup 18}F]-dopa uptake is equally depressed in all striatal structures in progressive supra-nuclear palsy. Regional glucose metabolism at rest is preserved in elderly once cerebral atrophy is taken into account. On the contrary, glucose metabolism is globally reduced in AD, with marked decrease in the parietal and temporal regions. PET has proved to be useful to study in vivo neurochemical processes in patients suffering from NDDs. The potential of this approach is still largely unexploited, and depends on new ligand production to establish early diagnosis and treatment follow-up. (author)

  17. MRI of degenerative lumbar spine disease: comparison of non-accelerated and parallel imaging

    Energy Technology Data Exchange (ETDEWEB)

    Noelte, Ingo; Gerigk, Lars; Brockmann, Marc A.; Kemmling, Andre; Groden, Christoph [Medical Faculty Mannheim of the University of Heidelberg, Department of Neuroradiology, Mannheim (Germany)

    2008-05-15

    Parallel imaging techniques such as GRAPPA have been introduced to optimize image quality and acquisition time. For spinal imaging in a clinical setting no data exist on the equivalency of conventional and parallel imaging techniques. The purpose of this study was to determine whether T1- and T2-weighted GRAPPA sequences are equivalent to conventional sequences for the evaluation of degenerative lumbar spine disease in terms of image quality and artefacts. In patients with clinically suspected degenerative lumbar spine disease two neuroradiologists independently compared sagittal GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (25 patients) and transverse GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (23 lumbar segments in six patients). Comparative analyses included the minimal diameter of the spinal canal, disc abnormalities, foraminal stenosis, facet joint degeneration, lateral recess, nerve root compression and osteochondrotic vertebral and endplate changes. Image inhomogeneity was evaluated by comparing the nonuniformity in the two techniques. Image quality was assessed by grading the delineation of pathoanatomical structures. Motion and aliasing artefacts were classified from grade 1 (severe) to grade 5 (absent). There was no significant difference between GRAPPA and non-accelerated MRI in the evaluation of degenerative lumbar spine disease (P > 0.05), and there was no difference in the delineation of pathoanatomical structures. For inhomogeneity there was a trend in favour of the conventional sequences. No significant artefacts were observed with either technique. The GRAPPA technique can be used effectively to reduce scanning time in patients with degenerative lumbar spine disease while preserving image quality. (orig.)

  18. Nuclear microscopy in medical research. Investigations into degenerative diseases

    Energy Technology Data Exchange (ETDEWEB)

    Makjanic, J.; Thong, P.; Watt, F. [National University of Singapore (Singapore). Dept. of Physics

    1997-03-01

    The high energy (1-4MeV) focused ion beam (nuclear microbeam) has found uses in many scientific disciplines through a wide variety of ion beam based techniques. Of the many techniques available, the powerful combination of Particle Induced X-Ray Emission (PIXE), Rutherford Backscattering Spectrometry (RBS), and Scanning Transmission Ion Microscopy (STIM) is proving to be extremely useful, particularly in the characterisation and elemental analysis of thin specimens. In this paper we briefly review these ion beam techniques, as well as the hardware required for their application. Finally, we describe the application of the PIXE, RBS and STIM techniques in conjunction with a scanning focused 2MeV proton microbeam (nuclear microscopy). The examples chosen to illustrate the potential of nuclear microscopy are recent investigations into the degenerative diseases atherosclerosis (coronary heart disease), Parkinson`s disease and Alzheimer`s disease. (author)

  19. Complement, a target for therapy in inflammatory and degenerative diseases.

    Science.gov (United States)

    Morgan, B Paul; Harris, Claire L

    2015-12-01

    The complement system is a key innate immune defence against infection and an important driver of inflammation; however, these very properties can also cause harm. Inappropriate or uncontrolled activation of complement can cause local and/or systemic inflammation, tissue damage and disease. Complement provides numerous options for drug development as it is a proteolytic cascade that involves nine specific proteases, unique multimolecular activation and lytic complexes, an arsenal of natural inhibitors, and numerous receptors that bind to activation fragments. Drug design is facilitated by the increasingly detailed structural understanding of the molecules involved in the complement system. Only two anti-complement drugs are currently on the market, but many more are being developed for diseases that include infectious, inflammatory, degenerative, traumatic and neoplastic disorders. In this Review, we describe the history, current landscape and future directions for anti-complement therapies.

  20. Complement, a target for therapy in inflammatory and degenerative diseases.

    Science.gov (United States)

    Morgan, B Paul; Harris, Claire L

    2015-12-01

    The complement system is a key innate immune defence against infection and an important driver of inflammation; however, these very properties can also cause harm. Inappropriate or uncontrolled activation of complement can cause local and/or systemic inflammation, tissue damage and disease. Complement provides numerous options for drug development as it is a proteolytic cascade that involves nine specific proteases, unique multimolecular activation and lytic complexes, an arsenal of natural inhibitors, and numerous receptors that bind to activation fragments. Drug design is facilitated by the increasingly detailed structural understanding of the molecules involved in the complement system. Only two anti-complement drugs are currently on the market, but many more are being developed for diseases that include infectious, inflammatory, degenerative, traumatic and neoplastic disorders. In this Review, we describe the history, current landscape and future directions for anti-complement therapies. PMID:26493766

  1. Biomechanical analysis of press-extension technique on degenerative lumbar with disc herniation and staggered facet joint.

    Science.gov (United States)

    Du, Hong-Gen; Liao, Sheng-Hui; Jiang, Zhong; Huang, Huan-Ming; Ning, Xi-Tao; Jiang, Neng-Yi; Pei, Jian-Wei; Huang, Qin; Wei, Hui

    2016-05-01

    This study investigates the effect of a new Chinese massage technique named "press-extension" on degenerative lumbar with disc herniation and facet joint dislocation, and provides a biomechanical explanation of this massage technique. Self-developed biomechanical software was used to establish a normal L1-S1 lumbar 3D FE model, which integrated the spine CT and MRI data-based anatomical structure. Then graphic technique is utilized to build a degenerative lumbar FE model with disc herniation and facet joint dislocation. According to the actual press-extension experiments, mechanic parameters are collected to set boundary condition for FE analysis. The result demonstrated that press-extension techniques bring the annuli fibrosi obvious induction effect, making the central nucleus pulposus forward close, increasing the pressure in front part. Study concludes that finite element modelling for lumbar spine is suitable for the analysis of press-extension technique impact on lumbar intervertebral disc biomechanics, to provide the basis for the disease mechanism of intervertebral disc herniation using press-extension technique. PMID:27275119

  2. Biomechanical analysis of press-extension technique on degenerative lumbar with disc herniation and staggered facet joint

    Directory of Open Access Journals (Sweden)

    Hong-gen Du

    2016-05-01

    Full Text Available This study investigates the effect of a new Chinese massage technique named “press-extension” on degenerative lumbar with disc herniation and facet joint dislocation, and provides a biomechanical explanation of this massage technique. Self-developed biomechanical software was used to establish a normal L1–S1 lumbar 3D FE model, which integrated the spine CT and MRI data-based anatomical structure. Then graphic technique is utilized to build a degenerative lumbar FE model with disc herniation and facet joint dislocation. According to the actual press-extension experiments, mechanic parameters are collected to set boundary condition for FE analysis. The result demonstrated that press-extension techniques bring the annuli fibrosi obvious induction effect, making the central nucleus pulposus forward close, increasing the pressure in front part. Study concludes that finite element modelling for lumbar spine is suitable for the analysis of press-extension technique impact on lumbar intervertebral disc biomechanics, to provide the basis for the disease mechanism of intervertebral disc herniation using press-extension technique.

  3. Degenerative spine disease : pathologic findings in 985 surgical specimens.

    Science.gov (United States)

    Pytel, Peter; Wollmann, Robert L; Fessler, Richard G; Krausz, Thomas N; Montag, Anthony G

    2006-02-01

    A number of pathologic changes have been reported in spinal surgery specimens. The frequency of many of these is not well defined. We retrospectively reviewed the histologic features of 985 extradural spinal surgery specimens. Of the cases, 1.6% were identified clinically as synovial cysts. In addition, synovial tissue was seen in another 5.3% of cases, often embedded within disk material. Neovascularization of disk tissue was present in 8.1% of cases, chondrocyte clusters in 18.3%, and calcium pyrophosphate crystals in 2.8%, predominantly within disk material. With the exception of crystal deposits, all of these changes were significantly more common in the lumbar spine. A better understanding of cell-based degenerative changes will become essential with increasing research into cell-based therapies for spinal disk disease. We report data on the frequency of different pathologic changes and describe synovial metaplasia as a reactive change not previously reported.

  4. Chondroprotectant therapy in rats with degenerative joint disease experimentally transected cranial cruciate
    Reprodução experimental da doença articular degenerativa, pelo método cirúrgico associado à terapia condroprotetora, em ratos

    OpenAIRE

    Marcos Marini Melo; Paulo Ricardo Mallmann; Dábila Aráujo Sonego; Alessandro Tadeu Marques; Gentil Ferreira Gonçalves; Rosana Zanatta; Marcos Almeida Souza; Pedro Eduardo Brandini Néspoli; Roberto Lopes de Souza

    2013-01-01

    Osteoarthritis (OA) is the most common joint disease in both humans and animals, and it results in movement restriction and pain at the affected area. This disorder affects more than 25% of people over 60 years of age, and it is considered universal for 70-year-old people. OA is estimated to affect over 20% of the canine population from the United States of America. The present study aimed to evaluate the treatment of rats that were surgically induced to OA using two different drug therapies,...

  5. The value of fat saturation sequences and contrast medium administration in MRI of degenerative disease of the posterior/perispinal elements of the lumbosacral spine

    Energy Technology Data Exchange (ETDEWEB)

    D' Aprile, P. [San Paolo Hospital, Department of Neuroradiology, Bari (Italy); U.O. Radiologia, Sezione di Neuroradiologia, Ospedale ' ' S. Paolo' ' , Via Caposcardicchio, Bari (Italy); Tarantino, A. [San Paolo Hospital, Department of Neuroradiology, Bari (Italy); Jinkins, J.R. [State University of New York, Department of Radiology, Downstate Medical Center, Brooklyn, NY (United States); Brindicci, D. [San Paolo Hospital, Department of Radiology, Bari (Italy)

    2007-02-15

    Degenerative-inflammatory lumbar spinal pathology is one of the most common reasons why individuals seek medical care, and low back pain is the main symptom among those most commonly associated with this pathologic condition. Pain is commonly attributed to degenerative disc disease, particularly herniated discs, but many different spinal and perispinal structures may undergo degenerative-inflammatory phenomena and produce pain: discs, bone, facet joints, ligaments and muscles. In particular, in patients with non-radicular low back pain, this syndrome may arise from changes of the posterior elements/perispinal tissues of the lumbar spine (i.e., the ''posterior vertebral compartment''). They include: facet joint pathology (e.g., osteoarthritis, joint effusion, synovitis and synovial cysts), spondylolysis, spinal/perispinal ligamentous degenerative-inflammatory changes and perispinal muscular changes. It is well known that magnetic resonance is the most sensitive imaging method for the evaluation of spinal degenerative pathology, even in the initial stages of the disease. T2-weighted sequences with fat saturation, and when indicated the use of contrast-enhanced T1-weighted images with fat saturation, permit the visualization of degenerative-inflammatory changes of the posterior elements of the lumbar spine that in most cases would have been overlooked with conventional non-fat suppressed imaging. (orig.)

  6. Vertebral degenerative disc disease severity evaluation using random forest classification

    Science.gov (United States)

    Munoz, Hector E.; Yao, Jianhua; Burns, Joseph E.; Pham, Yasuyuki; Stieger, James; Summers, Ronald M.

    2014-03-01

    Degenerative disc disease (DDD) develops in the spine as vertebral discs degenerate and osseous excrescences or outgrowths naturally form to restabilize unstable segments of the spine. These osseous excrescences, or osteophytes, may progress or stabilize in size as the spine reaches a new equilibrium point. We have previously created a CAD system that detects DDD. This paper presents a new system to determine the severity of DDD of individual vertebral levels. This will be useful to monitor the progress of developing DDD, as rapid growth may indicate that there is a greater stabilization problem that should be addressed. The existing DDD CAD system extracts the spine from CT images and segments the cortical shell of individual levels with a dual-surface model. The cortical shell is unwrapped, and is analyzed to detect the hyperdense regions of DDD. Three radiologists scored the severity of DDD of each disc space of 46 CT scans. Radiologists' scores and features generated from CAD detections were used to train a random forest classifier. The classifier then assessed the severity of DDD at each vertebral disc level. The agreement between the computer severity score and the average radiologist's score had a quadratic weighted Cohen's kappa of 0.64.

  7. Chondroprotectant therapy in rats with degenerative joint disease experimentally transected cranial cruciateReprodução experimental da doença articular degenerativa, pelo método cirúrgico associado à terapia condroprotetora, em ratos

    Directory of Open Access Journals (Sweden)

    Marcos Marini Melo

    2013-06-01

    Full Text Available Osteoarthritis (OA is the most common joint disease in both humans and animals, and it results in movement restriction and pain at the affected area. This disorder affects more than 25% of people over 60 years of age, and it is considered universal for 70-year-old people. OA is estimated to affect over 20% of the canine population from the United States of America. The present study aimed to evaluate the treatment of rats that were surgically induced to OA using two different drug therapies, one with pentosan polysulfate, one with betamethasone, and one with chondroitin sulfate/ glucosamine. In order to produce joint disease, the cranial cruciate ligament was surgically transected. Animals were kept and treated for eight days after surgery and were assessed via both radiographies and tomographies taken before surgery and eight weeks later. All animals were euthanized having both macroscopic and microscopic analysis performed to evaluate the disorder progression and therapeutic action. Macroscopic analysis showed lesion in the knees subjected to OA induction. The untreated animals presented major lesions whereas the treated ones presented mild to moderate lesions. In conclusion, pentosan polysulfate is recommendable for the treatment of iatrogenic joint lesions in rats since the other treatments showed no significant difference. A osteoartrite (OA é a doença articular mais comum em humanos e animais, o que ocasiona restrição de movimentos e dor, na região acometida. Tal enfermidade afeta mais de 25% dos humanos acima de 60 anos e, aos 70 anos, ela é considerada universal. Estima-se que nos Estados Unidos da América, 20% ou mais da população canina é acometida pela OA. O presente estudo tem como finalidade avaliar a terapia medicamentosa (polisulfato de pentosano, betametasona e sulfato de condroitina/glucosamina, em um modelo experimental de OA cirurgicamente induzido, em ratos. A doença articular foi promovida pela transecção cir

  8. Short term outcome of posterior dynamic stabilization system in degenerative lumbar diseases

    Directory of Open Access Journals (Sweden)

    Mingyuan Yang

    2014-01-01

    Conclusion: Dynamic stabilization system treating lumbar degenerative disease showed clinical benefits with motion preservation of the operated segments, but does not have the significant advantage on motion preservation at adjacent segments, to avoid the degeneration of adjacent intervertebral disk.

  9. Motor Training in Degenerative Spinocerebellar Disease: Ataxia-Specific Improvements by Intensive Physiotherapy and Exergames

    OpenAIRE

    Matthis Synofzik; Winfried Ilg

    2014-01-01

    The cerebellum is essentially involved in movement control and plays a critical role in motor learning. It has remained controversial whether patients with degenerative cerebellar disease benefit from high-intensity coordinative training. Moreover, it remains unclear by which training methods and mechanisms these patients might improve their motor performance. Here, we review evidence from different high-intensity training studies in patients with degenerative spinocerebellar disease. These s...

  10. Laser technologies in treatment of degenerative-dystrophic bone diseases in children

    Science.gov (United States)

    Abushkin, Ivan A.; Privalov, Valery A.; Lappa, Alexander V.; Noskov, Nikolay V.; Neizvestnykh, Elena A.; Kotlyarov, Alexander N.; Shekunova, Yulia G.

    2014-03-01

    Two low invasive laser technologies for treatment of degenerative-dystrophic bone diseases in children are presented. The first is the transcutaneous laser osteoperforation developed by us and initially applied for treatment of different inflammatory and traumatic diseases (osteomyelitides, osteal and osteoarticular panaritiums, delayed unions, false joints, and others). Now the technology was applied to treatment of aseptic osteonecrosis of different localizations in 134 children aged from 1 to 16 years, including 56 cases with necrosis of femoral head (Legg-Calve-Perthes disease), 42 with necrosis of 2nd metatarsal bone head (Kohler II disease), and 36 with necrosis of tibial tuberosity (Osgood-Schlatter disease). The second technology is the laser intracystic thermotherapy for treatment of bone cysts. The method was applied to 108 children aged from 3 to 16 years with aneurismal and solitary cysts of different localizations. In both technologies a 970 nm diode laser was used. The suggested technologies increase the efficiency of treatment, reduce its duration, can be performed on outpatient basis, which resulted in great economical effect.

  11. Induced pluripotent stem cells for retinal degenerative diseases: a new perspective on the challenges

    Indian Academy of Sciences (India)

    Zi-Bing Jin; Satoshi Okamoto; Michiko Mandai; Masayo Takahashi

    2009-12-01

    Retinal degenerative diseases, including age-related macular degeneration and retinitis pigmentosa, are the prodominant causes of human blindness in the world; however, these diseases are difficult to treat. Currently, knowledge on the mechanisms of these diseases is still very limited and no radical drugs are available. Induced pluripotent stem (iPS) cells are an innovative technology that turns somatic cells into embryonic stem (ES)-like cells with pluripotent potential via the exogenous expression of several key genes. It can be used as an unlimited source for cell differentiation or tissue engineering, either of which is a promising therapy for human degenerative diseases. Induced pluripotent cells are both an unlimited source for retinal regeneration and an expectant tool for pharmaprojects and developmental or disease modelling. In this review, we try to summarize the advancement of iPS-based technologies and the potential utility for retinal degenerative diseases. We also discuss the challenges of using this technology in the retinology field.

  12. Novel Insights into Acid-Sensing Ion Channels: Implications for Degenerative Diseases.

    Science.gov (United States)

    Zhou, Ren-Peng; Wu, Xiao-Shan; Wang, Zhi-Sen; Xie, Ya-Ya; Ge, Jin-Fang; Chen, Fei-Hu

    2016-08-01

    Degenerative diseases often strike older adults and are characterized by progressive deterioration of cells, eventually leading to tissue and organ degeneration for which limited effective treatment options are currently available. Acid-sensing ion channels (ASICs), a family of extracellular H(+)-activated ligand-gated ion channels, play critical roles in physiological and pathological conditions. Aberrant activation of ASICs is reported to regulate cell apoptosis, differentiation and autophagy. Accumulating evidence has highlighted a dramatic increase and activation of ASICs in degenerative disorders, including multiple sclerosis, Parkinson's disease, Huntington's disease, intervertebral disc degeneration and arthritis. In this review, we have comprehensively discussed the critical roles of ASICs and their potential utility as therapeutic targets in degenerative diseases. PMID:27493834

  13. Intervertebral Fusion with Mobile Microendoscopic Discectomy for Lumbar Degenerative Disc Disease.

    Science.gov (United States)

    Xu, Bao-Shan; Liu, Yue; Xu, Hai-Wei; Yang, Qiang; Ma, Xin-Long; Hu, Yong-Cheng

    2016-05-01

    The aim of this article is to introduce a technique for lumbar intervertebral fusion that incorporates mobile microendoscopic discectomy (MMED) for lumbar degenerative disc disease. Minimally invasive transforaminal lumbar interbody fusion is frequently performed to treat degenerative diseases of the lumbar spine; however, the scope of such surgery and vision is limited by what the naked eye can see through the expanding channel system. To expand the visual scope and reduce trauma, we perform lumbar intervertebral fusion with the aid of a MMED system that provides a wide field through freely tilting the surgical instrument and canals. We believe that this technique is a good option for treating lumbar degenerative disc disease that requires lumbar intervertebral fusion.

  14. Intervertebral Fusion with Mobile Microendoscopic Discectomy for Lumbar Degenerative Disc Disease.

    Science.gov (United States)

    Xu, Bao-Shan; Liu, Yue; Xu, Hai-Wei; Yang, Qiang; Ma, Xin-Long; Hu, Yong-Cheng

    2016-05-01

    The aim of this article is to introduce a technique for lumbar intervertebral fusion that incorporates mobile microendoscopic discectomy (MMED) for lumbar degenerative disc disease. Minimally invasive transforaminal lumbar interbody fusion is frequently performed to treat degenerative diseases of the lumbar spine; however, the scope of such surgery and vision is limited by what the naked eye can see through the expanding channel system. To expand the visual scope and reduce trauma, we perform lumbar intervertebral fusion with the aid of a MMED system that provides a wide field through freely tilting the surgical instrument and canals. We believe that this technique is a good option for treating lumbar degenerative disc disease that requires lumbar intervertebral fusion. PMID:27384734

  15. Activation of α2A-adrenergic signal transduction in chondrocytes promotes degenerative remodelling of temporomandibular joint

    Science.gov (United States)

    Jiao, Kai; Zeng, Guang; Niu, Li-Na; Yang, Hong-xu; Ren, Gao-tong; Xu, Xin-yue; Li, Fei-fei; Tay, Franklin R.; Wang, Mei-qing

    2016-01-01

    This study tested whether activation of adrenoreceptors in chondrocytes has roles in degenerative remodelling of temporomandibular joint (TMJ) and to determine associated mechanisms. Unilateral anterior crossbite (UAC) was established to induce TMJ degeneration in rats. Saline vehicle, α2- and β-adrenoreceptor antagonists or agonists were injected locally into the TMJ area of UAC rats. Cartilage degeneration, subchondral bone microarchitecture and the expression of adrenoreceptors, aggrecans, matrix metalloproteinases (MMPs) and RANKL by chondrocytes were evaluated. Chondrocytes were stimulated by norepinephrine to investigate signal transduction of adrenoreceptors. Increased α2A-adrenoreceptor expression was observed in condylar cartilage of UAC rats, together with cartilage degeneration and subchondral bone loss. Norepinephrine depresses aggrecans expression but stimulates MMP-3, MMP-13 and RANKL production by chondrocytes through ERK1/2 and PKA pathway; these effects were abolished by an α2A-adrenoreceptor antagonist. Furthermore, inhibition of α2A-adrenoreceptor attenuated degenerative remodelling in the condylar cartilage and subchondral bone, as revealed by increased cartilage thickness, proteoglycans and aggrecan expression, and decreased MMP-3, MMP-13 and RANKL expressions in cartilage, increased BMD, BV/TV, and decreased Tb.Sp in subchondral bone. Conversely, activation of α2A-adrenoreceptor intensified aforementioned degenerative changes in UAC rats. It is concluded that activation of α2A-adrenergic signal in chondrocytes promotes TMJ degenerative remodelling by chondrocyte-mediated pro-catabolic activities. PMID:27452863

  16. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  17. When dialogue fails. Music therapy with elderly with neurological degenerative diseases

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2004-01-01

    When dialogue fails. Music therapy with elderly with neurological degenerative diseases. In persons suffering from neurological degenerative diseases we often see the following symptoms: difficulties in remembering, concentrating, perceiving input, and controlling and timing movements. Normal every....... By communicative parameters such as proximity, touch, movements, rhythmic rocking or “dancing”, the music therapist can apply his/her presence to stimulate or calm down the person. Altogether these techniques are inherent in our communicative musicality (Trevarthen 1999). 3. On some occasions the therapist needs...... Dialogue. Music therapy with persons in advanced stages of dementia. A case study research design. PhD-thesis, Institute for Music and Music Therapy, Aalborg University....

  18. THE MITOCHONDRIAL DERANGEMENTS IN NEURONAL DEGENER ATION AND NEURODEGENERATIVE DISEASES

    Institute of Scientific and Technical Information of China (English)

    Xue, Qi-ming; Gao, Feng; Chen, Qin-tang

    2000-01-01

    @@There are diverse concepts on the pathogenesis of neuronal degeneration and the neurodegenerative diseases. Among them there are different factors which might influence the initiation of neuronal degeneration as well as the pathogenesis of neurodegenerative diseases, such as Alzheimer′s disease, Parkinson′s disease, motor neuron disease, and so on.

  19. Clinical outcome of stand-alone ALIF compared to posterior instrumentation for degenerative disc disease

    DEFF Research Database (Denmark)

    Udby, Peter M.; Bech-Azeddine, Rachid

    2015-01-01

    low back pain resulting from degenerative disc disease. ALIF surgery has previously been linked with certain high risk complications and unfavorable long term fusion results. Newer studies suggest that stand-alone ALIF can possibly be advantageous compared to other types of posterior instrumented...

  20. Short aggrecan gene repetitive alleles associated with lumbar degenerative disc disease in Turkish patients.

    Science.gov (United States)

    Eser, O; Eser, B; Cosar, M; Erdogan, M O; Aslan, A; Yıldız, H; Solak, M; Haktanır, A

    2011-01-01

    We investigated a possible association between aggrecan gene polymorphism and lumbar degenerative disc disease in Turkish patients. One hundred 20-30-year-old patients with or without low back pain were selected for the study. Lumbar magnetic resonance imaging was performed on all patients. The patient group had low back pain clinically and degenerative disc disease radiographically. The control group included patients with and without low back pain: all were negative radiographically for degenerative disc disease. Genomic DNA was extracted from all participants. A PCR assay were used to evaluate variable number of tandem repeat polymorphism of aggrecan gene alleles to determine if there was any correlation with degenerative disc disease. Significant associations were found between short repeated alleles of the aggrecan gene and severe disc degeneration. A significant association was also found between short repeated alleles of the aggrecan gene and multilevel disc herniation as well as extrusion and sequestration types of disc herniation. In Turkish population, short repeated alleles of the aggrecan gene are associated with increased disc degeneration and disc herniation. PMID:21948754

  1. Motor Training in Degenerative Spinocerebellar Disease: Ataxia-Specific Improvements by Intensive Physiotherapy and Exergames

    Science.gov (United States)

    2014-01-01

    The cerebellum is essentially involved in movement control and plays a critical role in motor learning. It has remained controversial whether patients with degenerative cerebellar disease benefit from high-intensity coordinative training. Moreover, it remains unclear by which training methods and mechanisms these patients might improve their motor performance. Here, we review evidence from different high-intensity training studies in patients with degenerative spinocerebellar disease. These studies demonstrate that high-intensity coordinative training might lead to a significant benefit in patients with degenerative ataxia. This training might be based either on physiotherapy or on whole-body controlled videogames (“exergames”). The benefit shown in these studies is equal to regaining one or more years of natural disease progression. In addition, first case studies indicate that even subjects with advanced neurodegeneration might benefit from such training programs. For both types of training, the observed clinical improvements are paralleled by recoveries in ataxia-specific dysfunctions (e.g., multijoint coordination and dynamic stability). Importantly, for both types of training, the retention of the effects seems to depend on the frequency and continuity of training. Based on these studies, we here present preliminary recommendations for clinical practice, and articulate open questions that might guide future studies on neurorehabilitation in degenerative spinocerebellar disease. PMID:24877117

  2. No publication bias in industry funded clinical trials of degenerative diseases of the spine.

    Science.gov (United States)

    Son, Colin; Tavakoli, Samon; Bartanusz, Viktor

    2016-03-01

    Industry sponsorship of clinical research of degenerative diseases of the spine has been associated with excessive positive published results as compared to research carried out without industry funding. We sought the rates of publication of clinical trials of degenerative diseases of the spine based on funding source as a possible explanation for this phenomenon. We reviewed all clinical trials registered at clinicaltrials.gov relating to degenerative diseases of the spine as categorized under six medical subject heading terms (spinal stenosis, spondylolisthesis, spondylolysis, spondylosis, failed back surgery syndrome, intervertebral disc degeneration) and with statuses of completed or terminated. These collected studies were categorized as having, or not having, industry funding. Published results for these studies were then sought within the clinicaltrials.gov database itself, PubMed and Google Scholar. One hundred sixty-one clinical trials met these criteria. One hundred nineteen of these trials had industry funding and 42 did not. Of those with industry funding, 45 (37.8%) had identifiable results. Of those without industry funding, 17 (40.5%) had identifiable results. There was no difference in the rates of publication of results from clinical trials of degenerative diseases of the spine no matter the funding source.

  3. Motor Training in Degenerative Spinocerebellar Disease: Ataxia-Specific Improvements by Intensive Physiotherapy and Exergames

    Directory of Open Access Journals (Sweden)

    Matthis Synofzik

    2014-01-01

    Full Text Available The cerebellum is essentially involved in movement control and plays a critical role in motor learning. It has remained controversial whether patients with degenerative cerebellar disease benefit from high-intensity coordinative training. Moreover, it remains unclear by which training methods and mechanisms these patients might improve their motor performance. Here, we review evidence from different high-intensity training studies in patients with degenerative spinocerebellar disease. These studies demonstrate that high-intensity coordinative training might lead to a significant benefit in patients with degenerative ataxia. This training might be based either on physiotherapy or on whole-body controlled videogames (“exergames”. The benefit shown in these studies is equal to regaining one or more years of natural disease progression. In addition, first case studies indicate that even subjects with advanced neurodegeneration might benefit from such training programs. For both types of training, the observed clinical improvements are paralleled by recoveries in ataxia-specific dysfunctions (e.g., multijoint coordination and dynamic stability. Importantly, for both types of training, the retention of the effects seems to depend on the frequency and continuity of training. Based on these studies, we here present preliminary recommendations for clinical practice, and articulate open questions that might guide future studies on neurorehabilitation in degenerative spinocerebellar disease.

  4. Motor training in degenerative spinocerebellar disease: ataxia-specific improvements by intensive physiotherapy and exergames.

    Science.gov (United States)

    Synofzik, Matthis; Ilg, Winfried

    2014-01-01

    The cerebellum is essentially involved in movement control and plays a critical role in motor learning. It has remained controversial whether patients with degenerative cerebellar disease benefit from high-intensity coordinative training. Moreover, it remains unclear by which training methods and mechanisms these patients might improve their motor performance. Here, we review evidence from different high-intensity training studies in patients with degenerative spinocerebellar disease. These studies demonstrate that high-intensity coordinative training might lead to a significant benefit in patients with degenerative ataxia. This training might be based either on physiotherapy or on whole-body controlled videogames ("exergames"). The benefit shown in these studies is equal to regaining one or more years of natural disease progression. In addition, first case studies indicate that even subjects with advanced neurodegeneration might benefit from such training programs. For both types of training, the observed clinical improvements are paralleled by recoveries in ataxia-specific dysfunctions (e.g., multijoint coordination and dynamic stability). Importantly, for both types of training, the retention of the effects seems to depend on the frequency and continuity of training. Based on these studies, we here present preliminary recommendations for clinical practice, and articulate open questions that might guide future studies on neurorehabilitation in degenerative spinocerebellar disease. PMID:24877117

  5. Restoration of synaptic function in sight for degenerative retinal disease

    OpenAIRE

    Schubert, Timm; Wissinger, Bernd

    2015-01-01

    Synaptic disorganization is a prominent feature of many neurological diseases of the CNS, including Parkinson’s disease, intellectual development disorders, and autism. Although synaptic plasticity is critical for learning and memory, it is unclear whether this innate property helps restore synaptic function in disease once the primary cause of disease is abrogated. An answer to this question may come from a recent investigation in X-linked retinoschisis, a currently untreatable retinopathy. ...

  6. Efficacy of a Human Amniotic Tissue-derived Allograft, NuCel, in Patients Undergoing Posteriolateral Lumbar Fusions for Degenerative Disc Disease

    Science.gov (United States)

    2016-10-13

    Lumbar Degenerative Disc Disease; Spinal Stenosis; Spondylolisthesis; Spondylosis; Intervertebral Disk Displacement; Intervertebral Disk Degeneration; Spinal Diseases; Bone Diseases; Musculoskeletal Diseases; Spondylolysis

  7. A Study of the Association Between Sleep Bruxism, Low Quality of Sleep, and Degenerative Changes of the Temporomandibular Joint.

    Science.gov (United States)

    Dias, Glaucia Marques; Bonato, Letícia Ladeira; Guimarães, Josemar Parreira; Silva, Jesca Neftali Nogueira; Ferreira, Luciano Ambrosio; Grossmann, Eduardo; Carvalho, Antonio Carlos Pires

    2015-11-01

    The aim of this study was to evaluate the presence of degenerative bone changes of the temporomandibular joint (TMJ) in individuals suffering from sleep bruxism (SB), associating these characteristics with the quality of sleep. For this, we followed the International Classification of Sleep Disorders for the diagnosis of SB, in addition to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for the classification of TMD and cone beam computed tomography. It was found that 97.7% of the individuals with bruxism had at least 1 RDC/TMD group III diagnosis, 75.6% of the subjects considered their sleep quality as poor, and the largest group (23%) had centric bruxism. There was no significant association between the pattern of sleep quality (P = 0.36), the type of SB (P = 0.277), and the presence of degenerative changes of the TMJ. Regardless of the quality of sleep and the type of bruxism presented, the prevalence of degenerative bone disorders was high (67%) among women with a mean age of 46 years and a clinical diagnosis of SB. PMID:26501968

  8. Lumbar spine degenerative disease : effect on bone mineral density measurements in the lumbar spine and femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Juhng, Seon Kwan [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of); Koplyay, Peter; Jeffrey Carr, J.; Lenchik, Leon [Wake Forest Univ. School of Medicine, Winston-salem (United States)

    2001-04-01

    To determine the effect of degenerative disease of the lumbar spine on bone mineral density in the lumbar spine and femoral neck. We reviewed radiographs and dual energy x-ray absorptiometry scans of the lumbar spine and hip in 305 Caucasian women with suspected osteoporosis. One hundred and eight-six patient remained after excluding women less than 40 years of age (n=18) and those with hip osteoarthritis, scoliosis, lumbar spine fractures, lumbar spinal instrumentation, hip arthroplasty, metabolic bone disease other than osteoporosis, or medications known to influence bone metabolism (n=101). On the basis of lumbar spine radiographs, those with absent/mild degenerative disease were assigned to the control group and those with moderate/severe degenerative disease to the degenerative group. Spine radiographs were evaluated for degenerative disease by two radiologists working independently; discrepant evaluations were resolved by consensus. Lumbar spine and femoral neck bone mineral density was compared between the two groups. Forty-five (24%) of 186 women were assigned to the degenerative group and 141 (76%) to the control group. IN the degenerative group, mean bone mineral density measured 1.075g/cm? in the spine and 0.788g/cm{sup 2} in the femoral neck, while for controls the corresponding figures were 0.989g/cm{sup 2} and 0.765g/cm{sup 2}. Adjusted for age, weight and height by means of analysis of variance, degenerative disease of the lumbar spine was a significant predictor of increased bone mineral density in the spine (p=0.0001) and femoral neck (p=0.0287). Our results indicate a positive relationship between degenerative disease of the lumbar spine and bone mineral density in the lumbar spine and femoral neck, and suggest that degenerative disease in that region, which leads to an intrinsic increase in bone mineral density in the femoral neck, may be a good negative predictor of osteoporotic hip fractures.

  9. PET studies in Alzheimer disease and other degenerative dementias

    International Nuclear Information System (INIS)

    Neurodegenerative disorders cause a variety of dementia including Alzheimer disease, frontotemporal dementia, dementia with Lewy bodies, corticobasal degeneration, progressive supranuclear palsy, and Huntington's disease. PET scan is useful for early detection and differential diagnosis of theses dementing disorders. Also, it provides valuable information about clinico-anatomical correlation, allowing better understanding of function of brain. Here we discuss recent achievements PET studies regarding these dementing disorders. Future progress in PET technology, new tracers, and image analysis will play an important role in further clarifying the disease pathophysiology and brain functions

  10. Restoration of synaptic function in sight for degenerative retinal disease.

    Science.gov (United States)

    Schubert, Timm; Wissinger, Bernd

    2015-07-01

    Synaptic disorganization is a prominent feature of many neurological diseases of the CNS, including Parkinson's disease, intellectual development disorders, and autism. Although synaptic plasticity is critical for learning and memory, it is unclear whether this innate property helps restore synaptic function in disease once the primary cause of disease is abrogated. An answer to this question may come from a recent investigation in X-linked retinoschisis, a currently untreatable retinopathy. In this issue of the JCI, Ou, Vijayasarathy, and colleagues showed progressive disorganization of key functional elements of the synapse between photoreceptors and ON-bipolar cells in a retinoschisin-deficient mouse model. Moreover, they demonstrated that adeno-associated virus-mediated (AAV-mediated) delivery of the retinoschisin gene restores structure and function to the photoreceptor to ON-bipolar cell synapse in mouse models, even in adults at advanced stages of the disease. The results of this study hold promise that AAV-based supplemental gene therapy will benefit patients with X-linked retinoschisis in a forthcoming clinical trial. PMID:26098210

  11. The Degenerative Spine.

    Science.gov (United States)

    Clarençon, Frédéric; Law-Ye, Bruno; Bienvenot, Peggy; Cormier, Évelyne; Chiras, Jacques

    2016-08-01

    Degenerative disease of the spine is a leading cause of back pain and radiculopathy, and is a frequent indication for spine MR imaging. Disc degeneration, disc protrusion/herniation, discarhtrosis, spinal canal stenosis, and facet joint arthrosis, as well as interspinous processes arthrosis, may require an MR imaging workup. This review presents the MR imaging patterns of these diseases and describes the benefit of the MR imaging in these indications compared with the other imaging modalities like plain radiographs or computed tomography scan. PMID:27417397

  12. [Whiplash injury of the cervical spine--on the role of pre-existing degenerative diseases].

    Science.gov (United States)

    Meenen, N M; Katzer, A; Dihlmann, S W; Held, S; Fyfe, I; Jungbluth, K H

    1994-06-01

    Radiological investigations contribute little in differentiating the problems of patients with whiplash injuries. Nevertheless the more prolonged cases of whiplash injuries must not be attributed to preexisting degenerative disease, despite radiologically-proven medicolegal opinion. In this study, 60 patients who were seen for whiplash injuries in the Department for Trauma and Reconstructive Surgery at the University Hospital Hamburg-Eppendorf for clinical and radiological evaluation, an average of 5.7 years post injury, were divided into two groups (n = 30) depending on radiologically-proven preexisting degenerative changes of the cervical spine. On average the patients with degenerative changes were 11.2 years older than those with healthy vertebral columns and also demonstrated an increase in acute symptoms in the lower cervical spine (cervicobrachial syndrome). The chronicity of individual symptoms such as neck-pain, dizziness, nausea and psychological illness was also observed in both groups. Problems such as paresthesias as well as pain in the shoulder-arm-area appeared to increase in subsequent check-ups, irrespective of the earlier degenerative changes. Patients with typical posterior headaches recovered faster when they had radiologically normal spines. Presenting late, there was a significant accumulation of patients with pre-existing degenerative changes complaining merely of tinnitus. The earlier changes in any individual motion segment do not determine the clinical course of whiplash injuries, but merely represent an area of increased vulnerability to trauma. On the other hand, trauma has not been proven to influence the development or aggravation of degenerative changes in normal or diseased spines. We are not able to differentiate the posttraumatic course from the natural history of the degenerative process, either clinically or radiologically. Considering the involvement of sensitive neurological structures the classical objective organic diagnosis

  13. When dialogue fails. Music therapy with elderly with neurological degenerative diseases

    DEFF Research Database (Denmark)

    Wigram, Anthony Lewis

    2004-01-01

    When dialogue fails. Music therapy with elderly with neurological degenerative diseases. In persons suffering from neurological degenerative diseases we often see the following symptoms: difficulties in remembering, concentrating, perceiving input, and controlling and timing movements. Normal every...... traces in the brain. Using the same “hello-song” in the beginning of a session - session after session - gives stability. Stability is constancy and familiarity of cues over time (Roberts & Algase 1988), and even people with severe memory deficits are capable of creating new memory traces and of learning...... day conversation is building on abilities to remember facts or episodes, to sustain attention, to listen, and to time a response. Without these fundamental cognitive abilities it is difficult to communicate with others – unless the communication is adjusted to the person. Clients with a neurological...

  14. Neuroimaging and genetic risk for Alzheimer's disease and addiction-related degenerative brain disorders.

    Science.gov (United States)

    Roussotte, Florence F; Daianu, Madelaine; Jahanshad, Neda; Leonardo, Cassandra D; Thompson, Paul M

    2014-06-01

    Neuroimaging offers a powerful means to assess the trajectory of brain degeneration in a variety of disorders, including Alzheimer's disease (AD). Here we describe how multi-modal imaging can be used to study the changing brain during the different stages of AD. We integrate findings from a range of studies using magnetic resonance imaging (MRI), positron emission tomography (PET), functional MRI (fMRI) and diffusion weighted imaging (DWI). Neuroimaging reveals how risk genes for degenerative disorders affect the brain, including several recently discovered genetic variants that may disrupt brain connectivity. We review some recent neuroimaging studies of genetic polymorphisms associated with increased risk for late-onset Alzheimer's disease (LOAD). Some genetic variants that increase risk for drug addiction may overlap with those associated with degenerative brain disorders. These common associations offer new insight into mechanisms underlying neurodegeneration and addictive behaviors, and may offer new leads for treating them before severe and irreversible neurological symptoms appear.

  15. Revisiting the application of integrated physiotherapy in degenerative-dystrophic diseases of the musculoskeletal system

    Directory of Open Access Journals (Sweden)

    Kotenko K.V.

    2014-12-01

    Full Text Available Aim. The authors described a comprehensive program of frozen shoulder treatment, including extracorporeal shock wave therapy and pelotherapy. Objective: To evaluate the effectiveness of the inclusion of extracorporeal shock wave therapy and pelotherapy in rehabilitation of patients with degenerative diseases of the musculoskeletal system. Materials and Methods: there had been examined 120 patients during the study. Results: The result of the application of complex physiotherapy normalized indicators of metabolic and electrolyte imbalances that are important in the formation of a therapeutic effect. Conclusion: The application of extracorporeal shock wave therapy and in combination with pelotherapy in patients with scapula-humeral periarthritis is the elimination of metabolic and electrolyte imbalance, which is important in degenerative diseases of the musculoskeletal system

  16. Oxygen-ozone therapy for degenerative spine disease in the elderly: a prospective study.

    Science.gov (United States)

    Bonetti, Matteo; Fontana, Alessandro; Martinelli, Francesco; Andreula, Cosma

    2011-01-01

    We describe our experience of oxygen-ozone therapy to treat degenerative spine disease in the elderly. From April 2004 to March 2008 we selected 129 patients with CT and/or MR evidence of spondyloarthrosis and disc degeneration of the lumbar spine. All patients enrolled in the study had contraindications to the administration of commonly used analgesic and anti-inflammatory drugs.Oxygen-ozone therapy was given by CT-guided intraforaminal injection as the first treatment followed by 4 weekly paralumbar infiltrations on an outpatient basis. The full treatment lasted a month. Clinical outcome was assessed 3 months and 1 year after treatment. The good results obtained indicate that oxygen-ozone therapy is an ideal treatment with no side-effects in elderly patients with degenerative spine disease. PMID:21107950

  17. Polyetheretherketone (PEEK) rods: short-term results in lumbar spine degenerative disease.

    Science.gov (United States)

    Colangeli, S; Barbanti Brodàno, G; Gasbarrini, A; Bandiera, S; Mesfin, A; Griffoni, C; Boriani, S

    2015-06-01

    Pedicle screw and rod instrumentation has become the preferred technique for performing stabilization and fusion in the surgical treatment of lumbar spine degenerative disease. Rigid fixation leads to high fusion rates but may also contribute to stress shielding and adjacent segment degeneration. Thus, the use of semirigid rods made of polyetheretherketone (PEEK) has been proposed. Although the PEEK rods biomechanical properties, such as anterior load sharing properties, have been shown, there are few clinical studies evaluating their application in the lumbar spine surgical treatment. This study examined a retrospective cohort of patients who underwent posterior lumbar fusion for degenerative disease using PEEK rods, in order to evaluate the clinical and radiological outcomes and the incidence of complications.

  18. 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.

  19. [Role of defective intracellular proteolysis in human degenerative diseases].

    Science.gov (United States)

    Nezelof, Christian

    2012-11-01

    the nature of proteolysis. In this article, therefore, the following distinction should be made:--Lysosomal failures. They represent hereditary metabolic disorders involving all categories of cells. They are characterized by the accumulation of homogeneous material related to the underlying disease. Young people are predominantly affected--UPS failures. They represent sporadic conditions principally involving long-lived cells. The accumulated material is heterogeneous, composed of abnormal proteins and various "garbage-like" waste, including pigments. The elderly are predominatly affected, suggesting an epigenetic wear and tear process. Hypothetically, most the sporadic neurodegenerative diseases, from retinal macular degeneration and its associated drüsen to Alzheimer's disease, Parkinson's disease may represent fairly good examples of the UPS deficit. PMID:24313014

  20. Vitamin A derivatives as treatment options for retinal degenerative diseases.

    Science.gov (United States)

    Perusek, Lindsay; Maeda, Tadao

    2013-07-12

    The visual cycle is a sequential enzymatic reaction for vitamin A, all-trans-retinol, occurring in the outer layer of the human retina and is essential for the maintenance of vision. The central source of retinol is derived from dietary intake of both retinol and pro-vitamin A carotenoids. A series of enzymatic reactions, located in both the photoreceptor outer segment and the retinal pigment epithelium, transform retinol into the visual chromophore 11-cis-retinal, regenerating visual pigments. Retina specific proteins carry out the majority of the visual cycle, and any significant interruption in this sequence of reactions is capable of causing varying degrees of blindness. Among these important proteins are Lecithin:retinol acyltransferase (LRAT) and retinal pigment epithelium-specific 65-kDa protein (RPE65) known to be responsible for esterification of retinol to all-trans-retinyl esters and isomerization of these esters to 11-cis-retinal, respectively. Deleterious mutations in these genes are identified in human retinal diseases that cause blindness, such as Leber congenital amaurosis (LCA) and retinitis pigmentosa (RP). Herein, we discuss the pathology of 11-cis-retinal deficiency caused by these mutations in both animal disease models and human patients. We also review novel therapeutic strategies employing artificial visual chromophore 9-cis-retinoids which have been employed in clinical trials involving LCA patients.

  1. Vitamin A Derivatives as Treatment Options for Retinal Degenerative Diseases

    Directory of Open Access Journals (Sweden)

    Tadao Maeda

    2013-07-01

    Full Text Available The visual cycle is a sequential enzymatic reaction for vitamin A, all-trans-retinol, occurring in the outer layer of the human retina and is essential for the maintenance of vision. The central source of retinol is derived from dietary intake of both retinol and pro-vitamin A carotenoids. A series of enzymatic reactions, located in both the photoreceptor outer segment and the retinal pigment epithelium, transform retinol into the visual chromophore 11-cis-retinal, regenerating visual pigments. Retina specific proteins carry out the majority of the visual cycle, and any significant interruption in this sequence of reactions is capable of causing varying degrees of blindness. Among these important proteins are Lecithin:retinol acyltransferase (LRAT and retinal pigment epithelium-specific 65-kDa protein (RPE65 known to be responsible for esterification of retinol to all-trans-retinyl esters and isomerization of these esters to 11-cis-retinal, respectively. Deleterious mutations in these genes are identified in human retinal diseases that cause blindness, such as Leber congenital amaurosis (LCA and retinitis pigmentosa (RP. Herein, we discuss the pathology of 11-cis-retinal deficiency caused by these mutations in both animal disease models and human patients. We also review novel therapeutic strategies employing artificial visual chromophore 9-cis-retinoids which have been employed in clinical trials involving LCA patients.

  2. Neurochemical imaging of Alzheimer's disease and other degenerative dementias

    International Nuclear Information System (INIS)

    A wide variety of neurochemical and functional imaging approaches have been applied to the study of progressive dementias, particularly Alzheimer's disease (Ad) and related disorders. Despite considerable progress in the past decade, the cause((s) of most cases of Ad remain undetermined and preventive or protective therapies are lacking. Specifically-designed imaging procedures have permitted the testing of pathophysiological hypotheses of the etiology and progression of Ad, and have yielded important insights in several areas including the potential roles of cerebral cortical cholinergic lesions, cellular inflammation, and losses of cortical synapses. From the perspective of clinical diagnosis, PET glucose metabolism imaging with use of (18F)2-fluorodeoxyglucose (FDG) is the most sensitive and specific imaging modality yet identified. The overall performance of PET FDG is favorable for routine clinical evaluation of suspected Ad, and will likely gain increasing utilization in the near future. Assessments of glucose metabolism and other, specific aspects of neurochemistry in Ad will provide direct measures of therapeutic drug actions and may permit distinction of symptomatic versus disease-modifying therapies as they are developed and introduced in clinical trials

  3. Neuroimaging and Genetic Risk for Alzheimer’s Disease and Addiction-Related Degenerative Brain Disorders

    OpenAIRE

    Roussotte, Florence F.; Daianu, Madelaine; Jahanshad, Neda; Leonardo, Cassandra D.; Thompson, Paul M.

    2014-01-01

    Neuroimaging offers a powerful means to assess the trajectory of brain degeneration in a variety of disorders, including Alzheimer’s disease (AD). Here we describe how multimodal imaging can be used to study the changing brain during the different stages of AD. We integrate findings from a range of studies using magnetic resonance imaging (MRI), positron emission tomography (PET), functional MRI (fMRI) and diffusion weighted imaging (DWI). Neuroimaging reveals how risk genes for degenerative ...

  4. Is there a role for wine in cancer and the degenerative diseases of aging?

    OpenAIRE

    Creina S Stockley

    2009-01-01

    Creina S StockleyThe Australian Wine Research Institute, Adelaide, South Australia, AustraliaAbstract: Population aging is associated with the increased incidence cancer and of degenerative diseases. Population aging is occurring on a global scale, with faster aging projected for the coming decades than has occurred in the past. Globally, the population aged 60 years and over is projected to nearly triple by 2050, while the population aged 80 years and over is projected to experience a more t...

  5. Operative Outcomes for Cervical Degenerative Disease: A Review of the Literature

    OpenAIRE

    Kazuya Nishizawa; Kanji Mori; Yasuo Saruhashi; Yoshitaka Matsusue

    2012-01-01

    To date, several studies were conducted to find which procedure is superior to the others for the treatment of cervical myelopathy. The goal of surgical treatment should be to decompress the nerves, restore the alignment of the vertebrae, and stabilize the spine. Consequently, the treatment of cervical degenerative disease can be divided into decompression of the nerves alone, fixation of the cervical spine alone, or a combination of both. Posterior approaches have historically been considere...

  6. Anterior Cervical Corpectomy and Fusion Accelerates Degenerative Disease at Adjacent Vertebral Segments

    OpenAIRE

    Pickett, Gwynedd E.; Duggal, Neil; Theodore, Nicholas; Sonntag, Volker K.H.

    2008-01-01

    Background Anterior cervical corpectomy provides the most direct and thorough surgical approach for anterior decompression when spinal cord compression is found directly behind the vertebral body. However, anterior cervical fusion has been shown to be associated with the development of new degenerative changes at levels immediately adjacent to the fused segments. Th e incidence of adjacent segment disease (ASD) following anterior cervical corpectomy has not been widely reported. We set out to...

  7. Revisiting the application of integrated physiotherapy in degenerative-dystrophic diseases of the musculoskeletal system

    OpenAIRE

    Kotenko K.V.; Korchazhkina N.B.; Mikhaylova A.A.; Epifanov A.V.; Portnov V.V.; Danilova D.P.

    2014-01-01

    Aim. The authors described a comprehensive program of frozen shoulder treatment, including extracorporeal shock wave therapy and pelotherapy. Objective: To evaluate the effectiveness of the inclusion of extracorporeal shock wave therapy and pelotherapy in rehabilitation of patients with degenerative diseases of the musculoskeletal system. Materials and Methods: there had been examined 120 patients during the study. Results: The result of the application of complex physiotherapy normalized ind...

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

    OpenAIRE

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

    2012-01-01

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

  9. 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.

  10. Is there a role for wine in cancer and the degenerative diseases of aging?

    Directory of Open Access Journals (Sweden)

    Creina S Stockley

    2009-06-01

    Full Text Available Creina S StockleyThe Australian Wine Research Institute, Adelaide, South Australia, AustraliaAbstract: Population aging is associated with the increased incidence cancer and of degenerative diseases. Population aging is occurring on a global scale, with faster aging projected for the coming decades than has occurred in the past. Globally, the population aged 60 years and over is projected to nearly triple by 2050, while the population aged 80 years and over is projected to experience a more than fivefold increase. Increased numbers of older individuals may have implications for associated expenditure on income support, housing and health services, although a healthy, independent older population can also form a valued social resource, for example in providing care for others, sharing skills and knowledge, and engaging in volunteer activities. Simple dietary measures such as moderate wine consumption to supplement a healthy exercise and nutrition routine, or as an adjunct to prescription medicines when appropriate, are thus needed to maintain an aging population. The role of wine in cancer and the degenerative diseases of aging is thus discussed.Keywords: population aging, wine, degenerative disease, cancer

  11. Preliminary evaluation of posterior dynamic lumbar stabilization in lumbar degenerative disease in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    JIA Yu-hua; SUN Peng-fei

    2012-01-01

    Background There has been some controversy related to the use of the Wallis system,rather than disc fusion in the treatment of patients with degenerative spine disease.Furthermore,there are no reports concerning the application of this dynamic stabilization system in Chinese patients,who have a slightly different lifestyle with Western patients.The aim of this study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases in Chinese patients.Methods The clinical outcomes of 20 patients with lumbar degenerative disease treated by posterior decompression with the Wallis posterior dynamic lumbar stabilization implant were studied.All of the patients completed the visual analogue scale and the Chinese version of the Oswestry Disability Index.The following radiologic parameters were measured in all patients:global lordotic angles and segmental lordotic angles (stabilized segments,above and below adjacent segments).The range of motion was then calculated.Results Nineteen patients (95%) were available for follow-up.The mean follow-up period was (27.25±5.16) months (range 16-35 months).The visual analogue scale decreased from 8.55±1.21 to 2.20±1.70 (P <0.001),and the mean score on the Chinese version of the Oswestry Disability Index was improved from 79.58%±15.93% to 22.17%±17.24% (P <0.001).No significant changes were seen in the range of motion at the stabilized segments (P=0.502) and adjacent segments (above,P=0.453; below,P=0.062).The good to excellent result was 94.4% at the latest follow-up.No complications related to the use of the Wallis posterior dynamic lumbar stabilization occurred.Conclusions It was found to be both easy and safe to use the Wallis posterior dynamic lumbar stabilization implant in the treatment of degenerative lumbar disease,and the early therapeutic effectiveness is good.The Wallis system provides an alternative method for the treatment of lumbar degenerative

  12. Update on the pathophysiology of degenerative disc disease and new developments in treatment strategies

    Directory of Open Access Journals (Sweden)

    Adam H Hsieh

    2010-10-01

    Full Text Available Adam H Hsieh1,2 , S Tim Yoon31Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA; 2Department of Orthopedics, University of Maryland, Baltimore, MD, USA; 3Department of Orthopedic Surgery, Emory University, Chief of Orthopedic Surgery, Veterans Affairs Medical Center, Atlanta, GA, USAAbstract: Degenerative disc disease (DDD continues to be a prevalent condition that afflicts populations on a global scale. The economic impact and decreased quality of life primarily stem from back pain and neurological deficits associated with intervertebral disc degeneration. Although much effort has been invested into understanding the etiology of DDD and its relationship to the onset of back pain, this endeavor is a work in progress. The purpose of this review is to provide focused discussion on several areas in which recent advances have been made. Specifically, we have categorized these advances into early, middle, and late phases of age-related or degenerative changes in the disc and into promising minimally invasive treatments, which aim to restore mechanical and biological functions to the disc.Keywords: degenerative disc disease, quality of life, intervertebral, aging

  13. Degenerative disc disease in the lumbar spine: Another cause for focally reduced activity on marrow scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, M. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology); Miles, K.A. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Nuclear Medicine); Wraight, E.P. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Nuclear Medicine); Dixon, A.K. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology Cambridge Univ. (United Kingdom))

    1992-05-01

    A patient is presented in whom a focal reduction in marrow activity in the lumbar spine on both leucocyte and nanocolloid marrow scintigraphy was subsequently shown to be due to fatty infiltration of marrow in association with disc degeneration. Degenerative disease in the lumbar spine has not been previously described as a cause of abnormal bone marrow distribution by such means and needs to be distinguished from a more serious pathology, such as malignant infiltration and vertebral infection, which it may mimic. In a retrospective review of 33 nanocolloid bone marrow and 117 leucocyte scintigrams, 8 showed a degree of reduced marrow activity in the lumbar spine consistent with that caused by degenerative changes. (orig.).

  14. Imaging of degenerative spine disease--the state of the art.

    Science.gov (United States)

    Sasiadek, Marek J; Bladowska, Joanna

    2012-01-01

    The authors review the current state of imaging of degenerative spinal disease (DSD), which is one of the most common disorders in humans. The most important definitions as well as short descriptions of the etiopathology and clinical presentation of DSD are provided first, followed by an overview of conventional and advanced imaging methods that are used in DSD. The authors then discuss in detail the imaging patterns of particular types of degenerative changes. Finally, the current imaging algorithm in DSD is presented. The imaging method of choice is magnetic resonance, including advanced techniques--especially diffusion tensor imaging. Other imaging methods (plain radiography, computed tomography, vascular studies, scintigraphy, positron emission tomography, discography) play a supplementary role ).

  15. Magnetic resonance (MR) imaging of lumbar spine: use of a shortened protocol for initial investigation of degenerative disease.

    OpenAIRE

    Mullan, C. P.; Kelly, B. E.

    2005-01-01

    PURPOSE: To assess the potential use of shortened protocol MRI of lumbar spine in the investigation of degenerative disc disease in Northern Ireland. MATERIALS & METHODS: Prospective study of 35 patients having MR imaging of lumbar spine performed during a 12-month period by one consultant radiologist. T1-weighted and T2-weighted sagittal images of lumbar spine were obtained in all cases, as well as T2-weighted axial images. The detection of degenerative disc disease by sagittal T2-weighted i...

  16. Evidence Report: Risk of Cardiovascular Disease and Other Degenerative Tissue Effects from Radiation Exposure

    Science.gov (United States)

    Patel, Zarana; Huff, Janice; Saha, Janapriya; Wang, Minli; Blattnig, Steve; Wu, Honglu; Cucinotta, Francis

    2015-01-01

    Occupational radiation exposure from the space environment may result in non-cancer or non-CNS degenerative tissue diseases, such as cardiovascular disease, cataracts, and respiratory or digestive diseases. However, the magnitude of influence and mechanisms of action of radiation leading to these diseases are not well characterized. Radiation and synergistic effects of radiation cause DNA damage, persistent oxidative stress, chronic inflammation, and accelerated tissue aging and degeneration, which may lead to acute or chronic disease of susceptible organ tissues. In particular, cardiovascular pathologies such as atherosclerosis are of major concern following gamma-ray exposure. This provides evidence for possible degenerative tissue effects following exposures to ionizing radiation in the form of the GCR or SPEs expected during long-duration spaceflight. However, the existence of low dose thresholds and dose-rate and radiation quality effects, as well as mechanisms and major risk pathways, are not well-characterized. Degenerative disease risks are difficult to assess because multiple factors, including radiation, are believed to play a role in the etiology of the diseases. As additional evidence is pointing to lower, space-relevant thresholds for these degenerative effects, particularly for cardiovascular disease, additional research with cell and animal studies is required to quantify the magnitude of this risk, understand mechanisms, and determine if additional protection strategies are required.The NASA PEL (Permissive Exposure Limit)s for cataract and cardiovascular risks are based on existing human epidemiology data. Although animal and clinical astronaut data show a significant increase in cataracts following exposure and a reassessment of atomic bomb (A-bomb) data suggests an increase in cardiovascular disease from radiation exposure, additional research is required to fully understand and quantify these adverse outcomes at lower doses (less than 0.5 gray

  17. Effects of chondroitin sulfate and sodium hyaluronate on chondrocytes and extracellular matrix of articular cartilage in dogs with degenerative joint disease Efeitos do sulfato de condroitina e do hialuronato de sódio nos condrócitos e na matriz extracelular na cartilagem articular de cães com doença articular degenerativa

    Directory of Open Access Journals (Sweden)

    G. Gonçalves

    2008-02-01

    Full Text Available Samples of articular cartilage of femur, tibia and patella of 15 dogs with experimentally induced degenerative joint disease (DJD were microscopically analyzed. Animals were distributed into three groups (n=5: the control group received no medication; the second group was treated with chondroitin sulfate and the third received sodium hyaluronate. Samples were processed and stained with HE and toluidine blue for morphological evaluation. The metabolic and proliferative activity of the chondrocytes was evaluated by the measurement of nucleolar organizer regions (NORs after impregnation by silver nitrate. Significant differences were not observed (P>0.05 in the morphology among the groups, however, the group treated with sodium hyaluronate had a higher score suggesting a trend to a greater severity of the lesions. Significant differences were not observed (P>0.05 in the measurement of NORs, cells and NORs/cells among the groups. Although differences were not significant, sodium hyaluronate group showed higher NOR and cell counts which suggested an increase of the proliferation rate of chondrocytes. In addition, a higher NOR/cell ratio in the group treated with chondroitin sulfate suggested that this drug may have stimulated the metabolic activity of the chondrocytes, minimizing the lesions resulting from DJD.Foram utilizadas amostras de cartilagem articular do fêmur, tíbia e patela de 15 cães com doença articular degenerativa (DAD, induzida experimentalmente. Foram constituídos três grupos de cinco animais: grupo 1 - controle, não medicado; grupo 2 - tratado com sulfato de condroitina e grupo 3 - tratado com hialuronato de sódio. As amostras foram processadas e coradas pelas técnicas de HE e de azul de toluidina para avaliação das alterações morfológicas, e impregnadas pelo nitrato de prata para análise da atividade metabólica e/ou proliferativa dos condrócitos, por meio da visualização e quantificação de regiões organizadoras

  18. Analysis of crucial molecules involved in herniated discs and degenerative disc disease

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    Zhigang Qu

    2013-01-01

    Full Text Available OBJECTIVES: Herniated discs and degenerative disc disease are major health problems worldwide. However, their pathogenesis remains obscure. This study aimed to explore the molecular mechanisms of these ailments and to identify underlying therapeutic targets. MATERIAL AND METHODS: Using the GSE23130 microarray datasets downloaded from the Gene Expression Omnibus database, differentially co-expressed genes and links were identified using the differentially co-expressed gene and link method with a false discovery rate ,0.25 as a significant threshold. Subsequently, the underlying molecular mechanisms of the differential co-expression of these genes were investigated using Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. In addition, the transcriptional regulatory relationship was also investigated. RESULTS: Through the analysis of the gene expression profiles of different specimens from patients with these diseases, 539 differentially co-expressed genes were identified for these ailments. The ten most significant signaling pathways involving the differentially co-expressed genes were identified by enrichment analysis. Among these pathways, apoptosis and extracellular matrix-receptor interaction pathways have been reported to be related to these diseases. A total of 62 pairs of regulatory relationships between transcription factors and their target genes were identified as critical for the pathogenesis of these diseases. CONCLUSION: The results of our study will help to identify the mechanisms responsible for herniated discs and degenerative disc disease and provides a theoretical basis for further therapeutic study.

  19. Comparison of the Dynesys Dynamic Stabilization System and Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease.

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    Yang Zhang

    Full Text Available There have been few studies comparing the clinical and radiographic outcomes between the Dynesys dynamic stabilization system and posterior lumbar interbody fusion (PLIF. The objective of this study is to compare the clinical and radiographic outcomes of Dynesys and PLIF for lumbar degenerative disease.Of 96 patients with lumbar degenerative disease included in this retrospectively analysis, 46 were treated with the Dynesys system and 50 underwent PLIF from July 2008 to March 2011. Clinical and radiographic outcomes were evaluated. We also evaluated the occurrence of radiographic and symptomatic adjacent segment degeneration (ASD.The mean follow-up time in the Dynesys group was 53.6 ± 5.3 months, while that in the PLIF group was 55.2 ± 6.8 months. At the final follow-up, the Oswestry disability index and visual analogue scale score were significantly improved in both groups. The range of motion (ROM of stabilized segments in Dynesys group decreased from 7.1 ± 2.2° to 4.9 ± 2.2° (P < 0.05, while that of in PLIF group decreased from 7.3 ± 2.3° to 0° (P < 0.05. The ROM of the upper segments increased significantly in both groups at the final follow-up, the ROM was higher in the PLIF group. There were significantly more radiographic ASDs in the PLIF group than in the Dynesys group. The incidence of complications was comparable between groups.Both Dynesys and PLIF can improve the clinical outcomes for lumbar degenerative disease. Compared to PLIF, Dynesys stabilization partially preserves the ROM of the stabilized segments, limits hypermobility in the upper adjacent segment, and may prevent the occurrence of ASD.

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

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    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.

  1. Dynamic Stabilisation in the Treatment of Degenerative Disc Disease with Modic Changes

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    Olcay Eser

    2013-01-01

    Full Text Available Objective. Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2. Modic types 1 and 2 degeneration can be painful. Classic approach in such cases is spine fusion. We operated 88 DDD patients with Modic types 1 and 2 via posterior dynamic stabilization. Good results were obtained after 2 years of followup. Methods. A total of 88 DDD patients with Modic types 1 and 2 were selected for this study. The patients were included in the study between 2004 and 2010. All of them were examined with lumbar anteroposterior (AP and lateral X-rays. Lordosis of the lumbar spine, segmental lordosis, and ratio of the height of the intervertebral disc spaces (IVSs were measured preoperatively and at 3, 12, and 24 months after surgery. Magnetic resonance imaging (MRI analysis was carried out, and according to the data obtained, the grade of disc degeneration was classified. The quality of life and pain scores were evaluated by visual analog scale (VAS score and Oswestry Disability Index (ODI preoperatively and at 3, 12, and 24 months after surgery. Appropriate statistical method was chosen. Results. The mean 3- and 12-month postoperative IVS ratio was significantly greater than that of the preoperative group (P0.05. Furthermore, the mean preoperative and 1 and 2 postoperative angles of lumbar lordosis and segmental lordosis were not significantly different (P>0.05. The mean VAS score and ODI, 3, 12, and 24 months after surgery, decreased significantly, when compared with the preoperative scores in the groups (P=0.000. Conclusion. Dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2 was effective.

  2. Degenerative periodontal-diseases and oral osteonecrosis: The role of gene-environment interactions

    International Nuclear Information System (INIS)

    Chronic-degenerative dentistry diseases, including periodontal diseases and oral osteonecrosis, are widespread in human populations and represent a significant problem for public health. These diseases result from pathogenic mechanisms created by the interaction between environmental genotoxic risk-factors and genetic assets conferring individual susceptibility. Osteonecrosis occurs in subjects undergoing exposure to high doses of DNA-damaging agents for chemo- and radiotherapy of neoplastic diseases. In susceptible patients, ionizing radiation and biphosphonate-chemotherapy induce severe, progressive, and irreversible degeneration of facial bones, resulting in avascular necrosis of the jaw. This may also occur in patients receiving biphosphonate for osteoporosis therapy. Periodontal diseases include chronic, aggressive, and necrotizing periodontitis, often resulting in severe alteration of periodontal tissues and tooth loss. Cigarette smoking and chronic inflammation caused by specific bacteria are the main risk factors for periodontitis. Oxidative damage plays a fundamental pathogenic role, as established by detection of mitochondrial DNA damage in the gingival tissue of patients with periodontitis. Endogenous risk factors in dental diseases include polymorphisms for metabolic enzymes such as glutathione transferases M1 and T1, N-acetyl transferase 2, and CYP 1A1. Other genetic polymorphisms that confer susceptibility to dentistry diseases affect genes encoding metalloproteases (involved in periodontal tissue remodeling and degradation), cytokines (involved in inflammation), prothrombin, and DNA repair activities. These findings provide evidence that dentistry diseases are related to risk factors associated with environmental mutagenesis. This issue warrants future investigations aimed at improving oral health and preventing oral degenerative diseases using molecular and experimental approaches currently utilized in mutagenicity studies.

  3. Degenerative periodontal-diseases and oral osteonecrosis: The role of gene-environment interactions

    Energy Technology Data Exchange (ETDEWEB)

    Baldi, D. [Department of Medical, Biophysical, and Dentistry Sciences and Technologies, University of Genoa (Italy); Izzotti, A. [Department of Health Sciences, University of Genoa, Via A. Pastore 1 (Italy); Bonica, P.; Pera, P. [Department of Medical, Biophysical, and Dentistry Sciences and Technologies, University of Genoa (Italy); Pulliero, A., E-mail: alessandra.pulliero@unige.it [Department of Health Sciences, University of Genoa, Via A. Pastore 1 (Italy)

    2009-07-10

    Chronic-degenerative dentistry diseases, including periodontal diseases and oral osteonecrosis, are widespread in human populations and represent a significant problem for public health. These diseases result from pathogenic mechanisms created by the interaction between environmental genotoxic risk-factors and genetic assets conferring individual susceptibility. Osteonecrosis occurs in subjects undergoing exposure to high doses of DNA-damaging agents for chemo- and radiotherapy of neoplastic diseases. In susceptible patients, ionizing radiation and biphosphonate-chemotherapy induce severe, progressive, and irreversible degeneration of facial bones, resulting in avascular necrosis of the jaw. This may also occur in patients receiving biphosphonate for osteoporosis therapy. Periodontal diseases include chronic, aggressive, and necrotizing periodontitis, often resulting in severe alteration of periodontal tissues and tooth loss. Cigarette smoking and chronic inflammation caused by specific bacteria are the main risk factors for periodontitis. Oxidative damage plays a fundamental pathogenic role, as established by detection of mitochondrial DNA damage in the gingival tissue of patients with periodontitis. Endogenous risk factors in dental diseases include polymorphisms for metabolic enzymes such as glutathione transferases M1 and T1, N-acetyl transferase 2, and CYP 1A1. Other genetic polymorphisms that confer susceptibility to dentistry diseases affect genes encoding metalloproteases (involved in periodontal tissue remodeling and degradation), cytokines (involved in inflammation), prothrombin, and DNA repair activities. These findings provide evidence that dentistry diseases are related to risk factors associated with environmental mutagenesis. This issue warrants future investigations aimed at improving oral health and preventing oral degenerative diseases using molecular and experimental approaches currently utilized in mutagenicity studies.

  4. [Algorithm of the diagnostics of trauma and degenerative diseases of the spine].

    Science.gov (United States)

    Shchedrenok, V V; Sebelev, K I; Anikeev, N V; Tiul'kin, O N; Kaurova, T A; Moguchaia, O V

    2011-01-01

    Clinico-radial data were compared in 583 patients with trauma and degenerative diseases of the spine. The clinico-diagnostic complex included radiography of the spine (round-up and functional), magnetic resonance imaging, computerized helical tomography of the spine with spondylometric measurements. Indices of the measurements of the cross-section area of the vertebral artery canal at the level of C3-C6 vertebrae and the volume of the intervertebral canal at different levels in health among men and women are presented. An algorithm of radiation diagnostics in pathology of the spine is proposed.

  5. Transplantation of Fetal Stem Cells: a New Horizon for Treat¬ment of Degenerative Diseases

    Directory of Open Access Journals (Sweden)

    Farideh RAZI

    2015-10-01

    Full Text Available Background: The purpose of the current study was to present an overview of different types of stem-cells and their application for treatment different degenerative disorders with specific focus on ongoing clinical trials. Methods: For the purpose of the current narrative review article, a comprehensive search was carried out on the existing literature in Google Scholar, PubMed and Scopus using the keywords: stem-cell (fetal and mesenchymal, regenerative. Relevant articles published from 1957 to 2013 are extracted and presented. Results: During the past decades, different types of stem-cells (including adult and fetal have been used for treatment of a wide range of immunologic (Severe Combined Immunodeficiency, Di George syndrome, neurologic (Parkinson’s disease, Huntington Chorea, Cerebral Palsy, musculoskeletal (ALS, and cardiovascular diseases (heart failure and cardiomyopathies as well as chronic and acute ulcers, and diabetes. Conclusion: The results of our study demonstrated that during the past decades, stem-cell technology has been applied for treatment of a wide range of degenerative disorders with considerable success. The current ongoing clinical trials clearly demonstrate a great potential and a promising future for the technology in terms of offering curative treatment for a wide range of hitherto-incurable diseases. Keywords: Stem cell, Transplantation, Treatment, Review Article 

  6. Efficacy of the Dynamic Interspinous Assisted Motion system in clinical treatment of degenerative lumbar disease

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yu; WANG Yi-peng; QIU Gui-xing; ZHAO Hong; ZHANG Jian-guo; ZHOU Xi

    2010-01-01

    Background The Dynamic Interspinous Assisted Motion (DIAM) system was designed to stabilize degenerative spinal segments without fusion surgery, maintain segment motion and prevent adjacent segment degeneration. The aim of thisstudy was to investigate clinical efficacy of the DIAM system in treatment of degenerative lumbar disease in China.Methods Eight cases of lumbar vertebral instability were treated with the DIAM system at Peking Union MedicalCollege Hospital from June 2006 to January 2008. There were 6 female and 2 male subjects with a mean age of 46.9years and a range of 40-52 years. Radiographs and scores on outcome measures included the visual analogue scale (VAS) for pain and the Oswestry disability index (ODI). These scores were recorded before surgery and after surgery at intervals of 3-month, 6-month, 1-year and the final follow-up visit.Results The follow-up time ranged from 12-31 months, with an average of 20.6 months. There were significant differences between preoperative and postoperative scores at each follow-up evaluation (P <0.05). However, there was no significant difference between each postoperative follow-up score (P >0.05). There were significant differences between preoperative and postoperative L4-5 segment activity at each time interval (P <0.05), but no obvious difference was found within each postoperative follow-up evaluation (P >0.05). The ODI and VAS score improvements were directly correlated with segment activity (r >0.7, P <0.05).Conclusions The DIAM system appears to be a useful and effective treatment in the surgical management of degenerative lumbar disease in certain patients. However, long-term follow-up is needed to evaluate the clinical outcomes of the device.

  7. Dynesys dynamic stabilization system for the lumbar degenerative disease: a preliminary report from China

    Institute of Scientific and Technical Information of China (English)

    LI Hai-peng; LI Fang; GUAN Kai; ZHAO Guang-ming; SHAN Jian-lin; SUN Tian-sheng

    2013-01-01

    Background Dynesys dynamic stabilization system was first implanted in patients in 1994,and introduced to China in 2007.Therefore,it was a new technique for Chinese orthopedics and hence necessary to collect clinical data about Dynesys in China.The objective of this study was to report the preliminary results of Dynesys for the lumbar degenerative disease in China.Methods Twenty-seven patients were treated with the Dynesys between July 2007 and January 2009.The diagnosis included degenerative spondylolisthesis (12 cases),degenerative spinal stenosis (nine cases),and lumbar intervertebral disc herniation (six cases).Back pain and leg pain were evaluated using 100-mm visual analog scales (VAS).The Oswestry Disability Index (ODI) was used to evaluate the patients' function.The intervertebral disc height and range of motion at the operative level were taken on radiographs.Results All the patients were followed-up,with an average of (22.40±4.23) months (range 15-32 months).VAS of back pain and leg pain were improved significantly (P <0.05) at follow-up.The ODI scores were reduced from (62.58±12.01)%preoperatively to (15.01±5.71)% at follow-up (P <0.05).The preoperative mean height of the intervertebral disc was (11.21±1.58) mm (range 8.5-13.8 mm) and mean was (10.10±1.78) mm (range 7.0-13.4 mm) at follow-up (P <0.05).The mean range of motion of the implanted segment was (6.00±1.79)° (range 2.5-9.3°) preoperatively and (5.47±1.27)°(range 2.9-7.8°) at follow-up (P=0.11).Conclusions The preliminary results of Dynesys for the lumbar degenerative disease in China are similar to the published results of other countries.It can significantly improve the clinic symptoms and preserved motion at the level of implantation.However,the long-term follow-up data need to be collected.

  8. MR imaging of degenerative lumbar disc disease emphasizing on signal intensity changes in vertebral body

    Energy Technology Data Exchange (ETDEWEB)

    Toyoda, Keiko; Ida, Masahiro; Murakami, Yoshitaka; Harada, Junta; Tada, Shimpei (Jikei Univ., Tokyo (Japan). School of Medicine)

    1992-12-01

    Magnetic resonance imaging was performed in 400 patients with degenerative disc disease. Signal changes and their sites in the vertebral body were classified and referred to narrowing of the intervertebral disc space. MR findings were compared with those of plain roentgenograms of the lumbar spine. Signal changes in the vertebral body were noted in 83 cases (102 vertebral bodies). Low-intensity abnormality on both T1- and T2-weighted images (WI) was the most common finding, and was most frequently seen at the end plate and/or the angle. These changes were correlated with narrowing of the disc space and osteosclerosis on the plain roentgenogram of the lumbar spine. Signal changes occasionally occurred in the inner region of the vertebral body, and these lesions tended to show a high-intensity abnormality on T1-WI. We conclude that signal changes in degenerative disc disease are not specific, but are sometimes difficult to distinguish from the signal changes in other conditions such as spinal tumor or bone marrow disorder. (author).

  9. MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION IN DEGENERATIVE LUMBAR SPINE DISEASE

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    Pankaj

    2015-12-01

    Full Text Available OBJECTIVE To assess the clinical and radiological outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion (MI-TLIF and to analyze the surgical outcome for degenerative lumbar spine disease. METHODS A multicenter retrospective analysis of 20 patients who underwent a MI-TLIF by image guidance from 1 January 2012 to April 2015. The study included 13 males and 7 females (Mean age 53 year. CT scan of operating area was done to evaluate the pedicle screw, cage placement and fusion at 6 months post operatively. Oswestry Disability Index (ODI scores and Visual Analogue Scale (VAS were recorded pre-operatively and at 6-month followup. RESULTS Eighteen (90% patients had evidence of fusion at 6 months post operatively with a mean improvement of 34 on the ODI score. Mean length of hospital stay was 4 days. The mean operative time was 170min. One patient developed transient nerve root pain in the postoperative period which was managed conservatively and one patient developed superficial wound infection. There was no case of CSF leak. CONCLUSION MI-TLIF is a safe and effective surgical procedure for management of degenerative lumbar spine disease.

  10. The Impact of Obesity on Perioperative Resource Utilization after Elective Spine Surgery for Degenerative Disease.

    Science.gov (United States)

    Planchard, Ryan F; Higgins, Dominique M; Mallory, Grant W; Puffer, Ross C; Jacob, Jeffrey T; Curry, Timothy B; Kor, Daryl J; Clarke, Michelle J

    2015-08-01

    Study Design Retrospective case series. Objective To determine the effect of obesity on the resource utilization and cost in 3270 consecutive patients undergoing elective noninstrumented decompressive surgeries for degenerative spine disease at Mayo Clinic Rochester between 2005 and 2012. Methods Groups were assessed for baseline differences (age, gender, and American Society of Anesthesiologists [ASA] classification, procedure type, and number of operative levels). Outcome variables included the transfusion requirements during surgery, the total anesthesia and surgical times, intensive care unit (ICU) admissions, standardized costs, as well as the ICU and hospital length of stay (LOS). Regression analysis was used to evaluate for strength of association between obesity and outcome variables. Results Baseline differences between the groups (nonobese: n = 1,853; obese: n = 1,417) were found with respect to age, ASA class, gender, procedure type, and number of operative levels. After correcting for differences, we found significant associations between obesity and surgical (p degenerative spine disease.

  11. Prognosis of intervertebral disc loss from diagnosis of degenerative disc disease

    Science.gov (United States)

    Li, S.; Lin, A.; Tay, K.; Romano, W.; Osman, Said

    2015-03-01

    Degenerative Disc Disease (DDD) is one of the most common causes of low back pain, and is a major factor in limiting the quality of life of an individual usually as they enter older stages of life, the disc degeneration reduces the shock absorption available which in turn causes pain. Disc loss is one of the central processes in the pathogenesis of DDD. In this study, we investigated whether the image texture features quantified from magnetic resonance imaging (MRI) could be appropriate markers for diagnosis of DDD and prognosis of inter-vertebral disc loss. The main objective is to use simple image based biomarkers to perform prognosis of spinal diseases using non-invasive procedures. Our results from 65 subjects proved the higher success rates of the combination marker compared to the individual markers and in the future, we will extend the study to other spine regions to allow prognosis and diagnosis of DDD for a wider region.

  12. Redox Signaling as a Therapeutic Target to Inhibit Myofibroblast Activation in Degenerative Fibrotic Disease

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    Natalie Sampson

    2014-01-01

    Full Text Available Degenerative fibrotic diseases encompass numerous systemic and organ-specific disorders. Despite their associated significant morbidity and mortality, there is currently no effective antifibrotic treatment. Fibrosis is characterized by the development and persistence of myofibroblasts, whose unregulated deposition of extracellular matrix components disrupts signaling cascades and normal tissue architecture leading to organ failure and death. The profibrotic cytokine transforming growth factor beta (TGFβ is considered the foremost inducer of fibrosis, driving myofibroblast differentiation in diverse tissues. This review summarizes recent in vitro and in vivo data demonstrating that TGFβ-induced myofibroblast differentiation is driven by a prooxidant shift in redox homeostasis. Elevated NADPH oxidase 4 (NOX4-derived hydrogen peroxide (H2O2 supported by concomitant decreases in nitric oxide (NO signaling and reactive oxygen species scavengers are central factors in the molecular pathogenesis of fibrosis in numerous tissues and organs. Moreover, complex interplay between NOX4-derived H2O2 and NO signaling regulates myofibroblast differentiation. Restoring redox homeostasis via antioxidants or NOX4 inactivation as well as by enhancing NO signaling via activation of soluble guanylyl cyclases or inhibition of phosphodiesterases can inhibit and reverse myofibroblast differentiation. Thus, dysregulated redox signaling represents a potential therapeutic target for the treatment of wide variety of different degenerative fibrotic disorders.

  13. Identification of subgroups of inflammatory and degenerative MRI findings in the spine and sacroiliac joints

    DEFF Research Database (Denmark)

    Arnbak, Bodil; Jensen, Rikke Krüger; Manniche, Claus;

    2016-01-01

    BACKGROUND: The aim of this study was to investigate subgroups of magnetic resonance imaging (MRI) findings for the spine and sacroiliac joints (SIJs) using latent class analysis (LCA), and to investigate whether these subgroups differ in their demographic and clinical characteristics. METHODS......: The sample included 1037 patients aged 18-40 years with persistent low back pain (LBP). LCA was applied to MRI findings of the spine and SIJs. The resulting subgroups were tested for differences in self-reported demographic and clinical characteristics. RESULTS: A five-class model was identified: Subgroup 1...... the subgroups with predominantly spinal findings (Subgroups 1-3), median age, prevalence of men, being overweight and previous LBP episodes were statistically significantly lower in Subgroup 1, higher in Subgroup 2 and highest in Subgroup 3. CONCLUSIONS: Five distinct subgroups of MRI findings in the spine...

  14. Neurophysiological evaluation of patients with degenerative diseases of the cervical spine

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    Ilić Tihomir V.

    2011-01-01

    Full Text Available Bacground/Aim. Diagnostic protocol for patients with degenerative diseases of the cervical spine demands, in parallel with neuroimaging methods, functional evaluation through neurophysiological methods (somatosensitive and motor evoked potentials and electromyoneurography aiming to evaluate possible subclinical affection of spinal medula resulting in neurological signs of long tract abnormalities. Considering diversities of clinical outcomes for these patients, complex diagnostic evaluation provides a prognosis of the disease progression. Methods. The study included 21 patients (48.24 ± 11.01 years of age with clinical presentation of cervical spondylarthropathy, without neuroradiological signs of myelopathy. For each patient, in addition to conventional neurophysiological tests (somatisensory evoked potentials - SSEP, motor evoked potentials - MEP, electromyoneurography - EMG, nerve conduction studies, we calculated central motor conduction time (CMCTF, as well the same parameter in relation to a different position of the head (maximal anteflexion and retroflexion, so-called dynamic tests. Results. Abnormalities of the peripheral motor neurone by conventional EMNeG was established in 2/3 of the patients, correponding to the findings of root condution time. Prolonged conventional CVMPF were found in 29% of the patients, comparing to 43% CVMPF abnormalities found with the dynamic tests. In addition, the SSEP findings were abnormal in 38% of the patients with degenerative diseases of the cervical spine. Conclusion. An extended neurophysiological protocol of testing corticospinal functions, including dynamic tests of central and periheral motor neurons are relevant for detection of subclinical forms of cervical spondylothic myelopathy, even at early stages. In addition to the conventional neurophysiological tests, we found usefull to include the dynamic motor tests and root conduction time measurement in diagnostic evaluation.

  15. Visuo-proprioceptive interactions in degenerative cervical spine diseases requiring surgery.

    Science.gov (United States)

    Freppel, S; Bisdorff, A; Colnat-Coulbois, S; Ceyte, H; Cian, C; Gauchard, G; Auque, J; Perrin, P

    2013-01-01

    Cervical proprioception plays a key role in postural control, but its specific contribution is controversial. Postural impairment was shown in whiplash injuries without demonstrating the sole involvement of the cervical spine. The consequences of degenerative cervical spine diseases are underreported in posture-related scientific literature in spite of their high prevalence. No report has focused on the two different mechanisms underlying cervicobrachial pain: herniated discs and spondylosis. This study aimed to evaluate postural control of two groups of patients with degenerative cervical spine diseases with or without optokinetic stimulation before and after surgical treatment. Seventeen patients with radiculopathy were recruited and divided into two groups according to the spondylotic or discal origin of the nerve compression. All patients and a control population of 31 healthy individuals underwent a static posturographic test with 12 recordings; the first four recordings with the head in 0° position: eyes closed, eyes open without optokinetic stimulation, with clockwise and counter clockwise optokinetic stimulations. These four sensorial situations were repeated with the head rotated 30° to the left and to the right. Patients repeated these 12 recordings 6weeks postoperatively. None of the patients reported vertigo or balance disorders before or after surgery. Prior to surgery, in the eyes closed condition, the herniated disc group was more stable than the spondylosis group. After surgery, the contribution of visual input to postural control in a dynamic visual environment was reduced in both cervical spine diseases whereas in a stable visual environment visual contribution was reduced only in the spondylosis group. The relative importance of visual and proprioceptive inputs to postural control varies according to the type of pathology and surgery tends to reduce visual contribution mostly in the spondylosis group.

  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.

    Directory of Open Access Journals (Sweden)

    Demissew S Mern

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

  17. Imaging techniques for diagnosis after surgery for degenerative disc disease. Bildgebende Diagnostik nach spinaler Diskushernienoperation

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    Trattnig, S. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)); Kramer, J. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)); Muehlbauer, M. (Neurochirurgische Univ.-Klinik, Vienna (Austria)); Kainberger, F. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)); Imhof, H. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria))

    1993-10-01

    The magnetic resonance imaging findings recorded in patients after surgery for degenerative disc disease in the lumbar and cervical spine are discussed in comparison with conventional radiographs and computed tomography findings. In the lumbar spine normal postoperative findings in the immediate postoperative period can be demonstrated by MR imaging. Contrast-enhanced MR imaging can differentiate disc herniation from postoperative scar formation with a greater degree of confidence than other imaging modalities. MR imaging improves differentiation between other causes of failed back syndrome such as postoperative hematoma and infection, lateral spinal stenosis and arachnoiditis. In the cervical spine types of operative approaches, the appearance of bony stenosis and disc herniations by MR imaging are discussed. Computer tomography still has a role in the assessment of osseous complications such as central or foraminal stenosis. (orig.)

  18. Dynamic Stabilization for Challenging Lumbar Degenerative Diseases of the Spine: A Review of the Literature

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    Tuncay Kaner

    2013-01-01

    Full Text Available Fusion and rigid instrumentation have been currently the mainstay for the surgical treatment of degenerative diseases of the spine over the last 4 decades. In all over the world the common experience was formed about fusion surgery. Satisfactory results of lumbar spinal fusion appeared completely incompatible and unfavorable within years. Rigid spinal implants along with fusion cause increased stresses of the adjacent segments and have some important disadvantages such as donor site morbidity including pain, wound problems, infections because of longer operating time, pseudarthrosis, and fatigue failure of implants. Alternative spinal implants were developed with time on unsatisfactory outcomes of rigid internal fixation along with fusion. Motion preservation devices which include both anterior and posterior dynamic stabilization are designed and used especially in the last two decades. This paper evaluates the dynamic stabilization of the lumbar spine and talks about chronologically some novel dynamic stabilization devices and thier efficacies.

  19. Chemical pathology of homocysteine. V. Thioretinamide, thioretinaco, and cystathionine synthase function in degenerative diseases.

    Science.gov (United States)

    McCully, Kilmer S

    2011-01-01

    Hyperhomocysteinemia was first associated with degenerative disease by observation of accelerated arteriosclerosis in children with inherited disorders of cystathionine synthase, methionine synthase, and methylene tetrohydrofolate reductase. The metabolic blockade of sulfate synthesis from homocysteine thiolactone in malignant cells is ascribed to a deficiency of a chemopreventive derivative of homocysteine thiolactone that occurs in normal cells. Its chemical structure was elucidated by the organic synthesis of thioretinamide from retinoic acid and homocysteine thiolactone. Oxidation of the sulfur atom of homocysteine is inhibited in scorbutic guinea pigs, demonstrating ascorbate function in sulfate synthesis from homocysteine. Studies of homocysteine metabolism in protein energy malnutrition led to the conclusion that the biosynthesis of thioretinamide from the retinol of transthyretin is catalyzed by dehydroascorbate and superoxide generated from the heme oxygenase group of cystathionine synthase. Newly synthesized thioretinamide is complexed with cobalamin to form thioretinaco, which is activated by ozone and oxygen to function as the active site of oxidative phosphorylation. In accordance with the trophoblastic theory of cancer, pancreatic enzymes are believed to be oncolytic because they hydrolyze the homocysteinylated proteins, nucleic acids and glycosaminoglycans of malignant tissues. The clonal selection of malignant cells that are deficient in the heme oxygenase function of cystathionine synthase produces cells dependent upon glycolysis for ATP synthesis, since they are deficient in synthesis of thioretinamide, thioretinaco and thioretinaco ozonide. The vulnerable plaque of arteriosclerosis originates from complexes of microbes with homocysteinylated lipoproteins, obstructing vasa vasorum narrowed by endothelial dysfunction, causing arterial ischemia, and intimal micro-abscesses. Degenerative diseases may be ameliorated by a proposed therapeutic protocol

  20. Association between nutritional status and Modic classification in degenerative disc disease

    Science.gov (United States)

    Seyithanoglu, Hakan; Aydin, Teoman; Taşpınar, Ozgur; Camli, Adil; Kiziltan, Huriye; Eris, Ali Hikmet; Hocaoglu, Ilknur Turk; Ozder, Aclan; Denizli, Ebru; Kepekci, Muge; Keskin, Yasar; Mutluer, Ahmet Serdar

    2016-01-01

    [Purpose] This study was conducted to examine the association between Modic classification and the eating habits in patients with degenerative disc disease (DDD) and to determine the influence of nutrition on disease severity. [Subjects and Methods] Sixty patients with DDD visiting a low back pain outpatient clinic were enrolled. Through face-to-face interviews, they completed questionnaires regarding their demographics, disease activity, smoking and alcohol use, concomitant diseases, disease duration, and nutritional status.Exclusion criteria were age 65 years, other comorbidities, missing MRI data, and inability to speak Turkish. [Results] Forty patients were finally included in the study. The frequency with which they consumed water, salt, fast food, eggs, milk, yogurt, cheese, whole wheat bread, white bread, butter, and margarine was recorded. A weak negative correlation was observed between the Modic types and fish and egg consumption. [Conclusion] Modic changes, which indicate the severity of DDD, seem to be correlated to patients’ dietary habits. However, studies with comparison groups and larger samples are needed to confirm our promising results before any cause-and-effect relationship can be proposed. PMID:27190462

  1. Association between nutritional status and Modic classification in degenerative disc disease.

    Science.gov (United States)

    Seyithanoglu, Hakan; Aydin, Teoman; Taşpınar, Ozgur; Camli, Adil; Kiziltan, Huriye; Eris, Ali Hikmet; Hocaoglu, Ilknur Turk; Ozder, Aclan; Denizli, Ebru; Kepekci, Muge; Keskin, Yasar; Mutluer, Ahmet Serdar

    2016-04-01

    [Purpose] This study was conducted to examine the association between Modic classification and the eating habits in patients with degenerative disc disease (DDD) and to determine the influence of nutrition on disease severity. [Subjects and Methods] Sixty patients with DDD visiting a low back pain outpatient clinic were enrolled. Through face-to-face interviews, they completed questionnaires regarding their demographics, disease activity, smoking and alcohol use, concomitant diseases, disease duration, and nutritional status.Exclusion criteria were age 65 years, other comorbidities, missing MRI data, and inability to speak Turkish. [Results] Forty patients were finally included in the study. The frequency with which they consumed water, salt, fast food, eggs, milk, yogurt, cheese, whole wheat bread, white bread, butter, and margarine was recorded. A weak negative correlation was observed between the Modic types and fish and egg consumption. [Conclusion] Modic changes, which indicate the severity of DDD, seem to be correlated to patients' dietary habits. However, studies with comparison groups and larger samples are needed to confirm our promising results before any cause-and-effect relationship can be proposed. PMID:27190462

  2. Chronic degenerative diseases in elderly: physiotherapeutic data - doi:10.5020/18061230.2011.p221

    Directory of Open Access Journals (Sweden)

    Lais Keylla Felipe

    2012-01-01

    Full Text Available Objective: To assess the most frequent chronic diseases in the elderly population of a private clinic of Physiotherapy. Methods: We assessed medical records of clients who received treatment at a Physiotherapy clinic in the period 2005 to 2008, looking for chronic diseases as diagnosis and/or related to them. Of these, we selected those which contained birth date and/or aged sixty-five years or above. An instrument like a check list, developed by the researchers, identified: quantity, gender, medical diagnosis and comorbidities. For quantification of variables we applied simple percentage calculation. Results: In the study period, there were four hundred fifty-eight records, of which forty-nine corresponded to the survey’s inclusion criteria. The majority 59.2% (n=29 referred to the year 2008; 26.6% (n=13 being males and 73.4% (n=36 females. The most commonly found diagnosis comprised osteoarthritis 57.1% (n=28, fracture and/or history of fractures 24.4% (n=12 and other diagnosis 48.9% (n=24. Associated chronic diseases included diabetes mellitus 18.3% (n=9 and systemic hypertension 57.1% (n=23. Conclusion: Chronic degenerative diseases in elderly have received increasing attention from health professionals; osteoarthritis being the most common diagnosis in this study, followed by fracture and/or history of fractures. The comorbidities represented a greater negative impact in the quality of life of elderly.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  4. Heparanase isoform expression and extracellular matrix remodeling in intervertebral disc degenerative disease

    Directory of Open Access Journals (Sweden)

    Luciano Miller Reis Rodrigues

    2011-01-01

    Full Text Available OBJECTIVE: To determine the molecules involved in extracellular matrix remodeling and to identify and quantify heparanase isoforms present in herniated and degenerative discs. INTRODUCTION: Heparanase is an endo-beta-glucuronidase that specifically acts upon the heparan sulfate chains of proteoglycans. However, heparanase expression in degenerative intervertebral discs has not yet been evaluated. Notably, previous studies demonstrated a correlation between changes in the heparan sulfate proteoglycan pattern and the degenerative process associated with intervertebral discs. METHODS: Twenty-nine samples of intervertebral degenerative discs, 23 samples of herniated discs and 12 samples of non-degenerative discs were analyzed. The expression of both heparanase isoforms (heparanase-1 and heparanase-2 was evaluated using immunohistochemistry and real-time RT-PCR analysis. RESULTS: Heparanase-1 and heparanase-2 expression levels were significantly higher in the herniated and degenerative discs in comparison to the control tissues, suggesting a possible role of these proteins in the intervertebral degenerative process. CONCLUSION: The overexpression of heparanase isoforms in the degenerative intervertebral discs and the herniated discs suggests a potential role of both proteins in the mediation of inflammatory processes and in extracellular matrix remodeling. The heparanase-2 isoform may be involved in normal metabolic processes, as evidenced by its higher expression in the control intervertebral discs relative to the expression of heparanase-1.

  5. Gd-DTPA-enhanced Three-dimensional MR imaging of degenerative disease of the cervical spine

    International Nuclear Information System (INIS)

    This paper assesses cervical spine three-dimensional (3D) MR imaging with Gd-DTPA, with the hypothesis that an enhanced 3D sequence with reconstructions would suffice for the evaluation of degenerative disease. Sixty patients were examined with (1) T1-weighted spin-echo and axial 2D gradient-echo low-flip-angle images representing the standard examination; and (2) one of two different enhanced 3D gradient-echo techniques: 30 patients with 3D fast low-angle shot (FLASH) imaging (TR 40/TE 7, 40 degrees flip angle, 64 2-mm sagittal partitions, one excitation, 10:67 minutes) and 30 with 3D Turbo FLASH imaging (MP RAGE) (7/5, 10 degrees, 128 1.5-mm partitions, one excitation, 6:07 minutes). 3D studies were reconstructed at 45 degrees obliquities for foramina, and axially. Standard and 3D studies were evaluated independently by two neuroradiologists for the location and size of extradural disease

  6. National trends in outpatient surgical treatment of degenerative cervical spine disease.

    Science.gov (United States)

    Baird, Evan O; Egorova, Natalia N; McAnany, Steven J; Qureshi, Sheeraz A; Hecht, Andrew C; Cho, Samuel K

    2014-08-01

    Study Design Retrospective population-based observational study. Objective To assess the growth of cervical spine surgery performed in an outpatient setting. Methods A retrospective study was conducted using the United States Healthcare Cost and Utilization Project's State Inpatient and Ambulatory Surgery Databases for California, New York, Florida, and Maryland from 2005 to 2009. Current Procedural Terminology, fourth revision (CPT-4) and International Classification of Diseases, ninth revision Clinical Modification (ICD-9-CM) codes were used to identify operations for degenerative cervical spine diseases in adults (age > 20 years). Disposition and complication rates were examined. Results There was an increase in cervical spine surgeries performed in an ambulatory setting during the study period. Anterior cervical diskectomy and fusion accounted for 68% of outpatient procedures; posterior decompression made up 21%. Younger patients predominantly underwent anterior fusion procedures, and patients in the eighth and ninth decades of life had more posterior decompressions. Charlson comorbidity index and complication rates were substantially lower for ambulatory cases when compared with inpatients. The majority (>99%) of patients were discharged home following ambulatory surgery. Conclusions Recently, the number of cervical spine surgeries has increased in general, and more of these procedures are being performed in an ambulatory setting. The majority (>99%) of patients are discharged home but the nature of analyzing administrative data limits accurate assessment of postoperative complications and thus patient safety. This increase in outpatient cervical spine surgery necessitates further discussion of its safety.

  7. Haemophilia and joint disease: pathophysiology, evaluation, and management

    Directory of Open Access Journals (Sweden)

    Karen Knobe

    2011-12-01

    Full Text Available In patients with haemophilia, regular replacement therapy with clotting factor concentrates (prophylaxis is effective in preventing recurrent bleeding episodes into joints and muscles. However, despite this success, intra-articular and intramuscular bleeding is still a major clinical manifestation of the disease. Bleeding most commonly occurs in the knees, elbows, and ankles, and is often evident from early childhood. The pathogenesis of haemophilic arthropathy is multifactorial, with changes occurring in the synovium, bone, cartilage, and blood vessels. Recurrent joint bleeding causes synovial proliferation and inflammation (haemophilic synovitis that contribute to end-stage degeneration (haemophilic arthropathy; with pain and limitation of motion severely affecting patients’ quality of life. If joint bleeding is not treated adequately, it tends to recur, resulting in a vicious cycle that must be broken to prevent the development of chronic synovitis and degenerative arthritis. Effective prevention and management of haemophilic arthropathy includes the use of early, aggressive prophylaxis with factor replacement therapies, as well as elective procedures, including restorative physical therapy, analgesia, aspiration, synovectomy, and orthopaedic surgery. Optimal treatment of patients with haemophilia requires a multidisciplinary team comprising a haematologist, physiotherapist, orthopaedic practitioner, rehabilitation physician, occupational therapist, psychologist, social workers, and nurses.

  8. Quantitative analysis of CT scan in degenerative diseases of the nervous system

    International Nuclear Information System (INIS)

    Quantitative analysis was made on cranial CT scans of 142 patients with spinocerebellar degeneration (SCD), 16 with dentato-rubro-pallido-luysian atrophy (DRPLA), 12 with Huntington's chorea (HC), and four with chorea-acanthocytosis (CA). One hundred sex- and age-matched persons without any neurologic signs served as controls. Regarding parameters for atrophy in the infratentorial brain tissue, there was statistically significant difference between the SCD group and the control group. This indicated remarkable atrophy in the cerebellum and brain stem in SCD. According to subgroups of SCD, both bilateral atrophy of the pons and dilation of the prepontine cistern were significantly greater in the group of sporadic olivo-ponto-cerebellar atrophy than the group of Menzel type of olivo-ponto-cerebellar atrophy. The subgroup of hereditary spastic paraplegia had the mildest atrophy of the brain on CT, although there was still a significant atrophy compared with controls. In the DRPLA group, finding in the infratentorial brain tissue were similar to those in the SCD group. The HC group was characterized by having the greatest atrophy in the lateral ventricle, especially the caudate nuclei. Similar findings were seen in the CA group, although atrophy was generally mild. The results indicate the usefulness of quantitative analysis on CT in the diagnosis of degenerative diseases of the nervous system. (Namekawa, K.)

  9. Role of Diffusion Tensor MR Imaging in Degenerative Cervical Spine Disease: a Review of the Literature.

    Science.gov (United States)

    Banaszek, A; Bladowska, J; Podgórski, P; Sąsiadek, M J

    2016-09-01

    In the article we review the current role of diffusion tensor imaging (DTI), a modern magnetic resonance (MR) technique, in the diagnosis and the management of cervical spondylotic myelopathy (CSM), the most serious complication of degenerative cervical spine disease (DCSD). The pathogenesis of DCSD is presented first with an emphasis placed on the pathological processes leading to myelopathy development. An understanding of the pathophysiological background of DCSD is necessary for appropriate interpretation of MR images, both plain and DTI. Conventional MRI is currently the imaging modality of choice in DCSD and provides useful information concerning the extent of spondylotic changes and degree of central spinal canal stenosis; however its capability in myelopathy detection is limited. DTI is a state of the art imaging method which recently has emerged in spinal cord investigations and has the potential to detect microscopic alterations which are beyond the capability of plain MRI. In the article we present the physical principles underlying DTI which determine its sensitivity, followed by an overview of technical aspects of DTI acquisition with a special consideration of spinal cord imaging. Finally, the scientific reports concerning DTI utility in DSCD are also reviewed. DTI detects spinal cord injury in the course of DCSD earlier than any other method and could be useful in predicting surgical outcomes in CMS patients, however technical and methodology improvement as well as standardization of acquisition protocols and postprocessing methods among the imaging centers are needed before its implementation in clinical practice.

  10. The Standardization of the Terminologies Used in the Reporting of Degenerative Disc Disease

    Directory of Open Access Journals (Sweden)

    M. Barzin

    2008-01-01

    Full Text Available Many different groups have expressed the need to standardize the terms and classifications used in the reporting of spine MRI, particularly in the lumbar spine."nSeveral studies have shown "moderate" (17-20% ob-server variations in MRI lumbar spine reporting. The main discrepancies occur when deciding what consti-tutes a bulging or herniated disc and this represents more than 50% of all inter-observer disagreement. A variety of different terms are used to describe disc pathology on the preference of the reporting individ-ual."nRecently, there is a universal consensus of terms and a nomenclature framework for degenerative disc dis-ease which using of them are encouraged by the American Society of Neuroradiology (ASNR."nIn this presentation, first some inter-observer varia-tions of MRI reporting in our center will be shown. "nThen a review of articles about standard MRI report-ing nomenclature with some relevant interesting cases from our MRI center will be presented.

  11. Radiographic evaluation of the use of transverse traction device in vertebral arthrodesis for degenerative diseases

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    Edgar Takao Utino

    2014-03-01

    Full Text Available OBJECTIVE: Perform radiographic analysis of the use of Transverse Traction Device (DTT with respect to fusion rate in patients submitted to vertebral arthrodesis for degenerative lumbar diseases. METHODS: We selected x-ray images on anteroposterior, lateral and oblique views and with maximum flexion and extension dynamics of 23 patients submitted to posterolateral arthrodesis of the lumbar spine with a minimum follow-up period of six months. The images were evaluated and classified by the Linovitz's system by two spine surgeons. RESULTS: We evaluated the radiographs of 23 patients after the minimum postoperative period of 6 months and of these, 11 have used DTT. With regard to the consolidation rate, seven patients (63.6% in the group of DTT were classified as fusion as well as six patients (50% who were not submitted to the treatment. There was no statistical difference between the groups regarding the consolidation rate. CONCLUSION: The use of transverse traction device in this study showed no significant difference in the rate of consolidation in radiographic evaluation. Studies on the effective participation of this device in the stability of pedicle fixation systems are still lacking in the literature.

  12. Prevalence of degenerative and spondyloarthritis-related magnetic resonance imaging findings in the spine and sacroiliac joints in patients with persistent low back pain

    International Nuclear Information System (INIS)

    To estimate the prevalence of degenerative and spondyloarthritis (SpA)-related magnetic resonance imaging (MRI) findings in the spine and sacroiliac joints (SIJs) and analyse their association with gender and age in persistent low back pain (LBP) patients. Degenerative and SpA-related MRI findings in the whole spine and SIJs were evaluated in Spine Centre patients aged 18-40 years with LBP. Among the 1,037 patients, the prevalence of disc degeneration, disc contour changes and vertebral endplate signal (Modic) changes were 87 % (±SEM 1.1), 82 % (±1.2) and 48 % (±1.6). All degenerative spinal findings were most frequent in men and patients aged 30-40 years. Spinal SpA-related MRI findings were rare. In the SIJs, 28 % (±1.4) had at least one MRI finding, with bone marrow oedema being the most common (21 % (±1.3)). SIJ erosions were most prevalent in patients aged 18-29 years and bone marrow oedema in patients aged 30-40 years. SIJ sclerosis and fatty marrow deposition were most common in women. SIJ bone marrow oedema, sclerosis and erosions were most frequent in women indicating pregnancy-related LBP. The high prevalence of SIJ MRI findings associated with age, gender, and pregnancy-related LBP need further investigation of their clinical importance in LBP patients. (orig.)

  13. Prevalence of degenerative and spondyloarthritis-related magnetic resonance imaging findings in the spine and sacroiliac joints in patients with persistent low back pain

    Energy Technology Data Exchange (ETDEWEB)

    Arnbak, Bodil; Jensen, Tue S.; Manniche, Claus [Hospital Lillebaelt, Research Department, Spine Centre of Southern Denmark, Middelfart (Denmark); University of Southern Denmark, Institute of Regional Health Research, Odense C (Denmark); Egund, Niels; Zejden, Anna [Aarhus University Hospital, Department of Radiology, Aarhus C (Denmark); Hoerslev-Petersen, Kim [University of Southern Denmark, Institute of Regional Health Research, Odense C (Denmark); King Christian 10th Hospital for Rheumatic Diseases, Graasten, Graasten (Denmark); Jurik, Anne G. [Hospital Lillebaelt, Research Department, Spine Centre of Southern Denmark, Middelfart (Denmark); University of Southern Denmark, Institute of Regional Health Research, Odense C (Denmark); Aarhus University Hospital, Department of Radiology, Aarhus C (Denmark)

    2016-04-15

    To estimate the prevalence of degenerative and spondyloarthritis (SpA)-related magnetic resonance imaging (MRI) findings in the spine and sacroiliac joints (SIJs) and analyse their association with gender and age in persistent low back pain (LBP) patients. Degenerative and SpA-related MRI findings in the whole spine and SIJs were evaluated in Spine Centre patients aged 18-40 years with LBP. Among the 1,037 patients, the prevalence of disc degeneration, disc contour changes and vertebral endplate signal (Modic) changes were 87 % (±SEM 1.1), 82 % (±1.2) and 48 % (±1.6). All degenerative spinal findings were most frequent in men and patients aged 30-40 years. Spinal SpA-related MRI findings were rare. In the SIJs, 28 % (±1.4) had at least one MRI finding, with bone marrow oedema being the most common (21 % (±1.3)). SIJ erosions were most prevalent in patients aged 18-29 years and bone marrow oedema in patients aged 30-40 years. SIJ sclerosis and fatty marrow deposition were most common in women. SIJ bone marrow oedema, sclerosis and erosions were most frequent in women indicating pregnancy-related LBP. The high prevalence of SIJ MRI findings associated with age, gender, and pregnancy-related LBP need further investigation of their clinical importance in LBP patients. (orig.)

  14. Controversies about interspinous process devices in the treatment of degenerative lumbar spine diseases: past, present, and future.

    Science.gov (United States)

    Gazzeri, Roberto; Galarza, Marcelo; Alfieri, Alex

    2014-01-01

    A large number of interspinous process devices (IPD) have been recently introduced to the lumbar spine market as an alternative to conventional decompressive surgery in managing symptomatic lumbar spinal pathology, especially in the older population. Despite the fact that they are composed of a wide range of different materials including titanium, polyetheretherketone, and elastomeric compounds, the aim of these devices is to unload spine, restoring foraminal height, and stabilize the spine by distracting the spinous processes. Although the initial reports represented the IPD as a safe, effective, and minimally invasive surgical alternative for relief of neurological symptoms in patients with low back degenerative diseases, recent studies have demonstrated less impressive clinical results and higher rate of failure than initially reported. The purpose of this paper is to provide a comprehensive overview on interspinous implants, their mechanisms of action, safety, cost, and effectiveness in the treatment of lumbar stenosis and degenerative disc diseases.

  15. Controversies about Interspinous Process Devices in the Treatment of Degenerative Lumbar Spine Diseases: Past, Present, and Future

    Directory of Open Access Journals (Sweden)

    Roberto Gazzeri

    2014-01-01

    Full Text Available A large number of interspinous process devices (IPD have been recently introduced to the lumbar spine market as an alternative to conventional decompressive surgery in managing symptomatic lumbar spinal pathology, especially in the older population. Despite the fact that they are composed of a wide range of different materials including titanium, polyetheretherketone, and elastomeric compounds, the aim of these devices is to unload spine, restoring foraminal height, and stabilize the spine by distracting the spinous processes. Although the initial reports represented the IPD as a safe, effective, and minimally invasive surgical alternative for relief of neurological symptoms in patients with low back degenerative diseases, recent studies have demonstrated less impressive clinical results and higher rate of failure than initially reported. The purpose of this paper is to provide a comprehensive overview on interspinous implants, their mechanisms of action, safety, cost, and effectiveness in the treatment of lumbar stenosis and degenerative disc diseases.

  16. SENILE DEGENERATIVE CHANGES IN ADULT LUMBAR SPINE! - A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Garjesh Singh

    2015-11-01

    Full Text Available : BACKGROUND: Low back pain (LBP is a common presenting complaint affecting mostly middle aged and older person and traditionally considered as ageing process, but now-a-days large number of younger people are also affected by this debilitating chronic disorder. The cause of early onset of degenerative spine disease is multifactorial, but genetical predisposition plays very important role. AIMS AND OBJECTIVE: To find out association between genetic predisposition and degenerative spine disease in adult patients and to assess the pattern of MRI findings of various degenerative diseases in lumbo-sacral spine. MATERIAL AND METHOD: The present cross-sectional study had been performed among 100 selected patients in 1yr period, who presented with chief complaint of chronic low back pain. After taking detailed clinical and professional history, MRI of lumbosacral spine had been performed. Total 100 patients were divided in two groups on the basis of genetical predisposition. Prevalence and spectrum of degenerative changes were compared between both groups. RESULTS: Hundred patients of 20 to 35-year age had been selected with mean age of 27yr. Out of 100 patients; 47 were male and 53 were female. The most common degenerative findings were desiccation of disc (95% followed by disc bulge, herniation, spinal canal stenosis, ligamentum flavum hypertrophy, facet joint hypertrophy and modic changes. L4-L5 and L5- S1 were the most commonly involved spinal levels for any degenerative pathology. CONCLUSION: Good association is seen between early onset of degenerative spine disease and genetical predisposition in patients who have history of similar type degenerative spine disease in one or more first degree relatives in comparison to those patients who do not have any genetical predisposition. So it can be concluded that heredity play important role in early onset of degenerative spine disease in adults.

  17. Degenerative alterations in noradrenergic neurons of the locus coeruleus in Alzheimer’s disease****

    Institute of Scientific and Technical Information of China (English)

    Lihua Liu; Saiping Luo; Leping Zeng; Weihong Wang; Liming Yuan; Xiaohong Jian

    2013-01-01

    Mice carrying mutant amyloid-β precursor protein and presenilin-1 genes (APP/PS1 double trans-genic mice) have frequently been used in studies of Alzheimer’s disease; however, such studies have focused mainly on hippocampal and cortical changes. The severity of Alzheimer’s disease is known to correlate with the amount of amyloid-βprotein deposition and the number of dead neurons in the locus coeruleus. In the present study, we assigned APP/PS1 double transgenic mice to two groups according to age: young mice (5–6 months old) and aged mice (16–17 months old). Age-matched wild-type mice were used as controls. Immunohistochemistry for tyrosine hydroxylase (a marker of catecholaminergic neurons in the locus coeruleus) revealed that APP/PS1 mice had 23%fewer cel s in the locus coeruleus compared with aged wild-type mice. APP/PS1 mice also had increased numbers of cel bodies of neurons positive for tyrosine hydroxylase, but fewer tyrosine hydroxylase-positive fibers, which were also short, thick and broken. Quantitative analysis using unbiased stereology showed a significant age-related increase in the mean volume of tyrosine hy-droxylase-positive neurons in aged APP/PS1 mice compared with young APP/PS1 mice. Moreover, the mean volume of tyrosine hydroxylase-positive neurons was positively correlated with the total volume of the locus coeruleus. These findings indicate that noradrenergic neurons and fibers in the locus coeruleus are predisposed to degenerative alterations in APP/PS1 double transgenic mice.

  18. 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 ...

  19. The Mircen project, neuro-degenerative disease: mechanisms, therapeutics and imaging research Unit URA Cea Cnrs 2210

    International Nuclear Information System (INIS)

    During the post-genomic era, significant advances in our understanding of the molecular basis of disease have been made. The power of functional and molecular imaging in translating this knowledge into effective therapy is now being more and more recognized. Thus, molecular imaging plays a vital role in the early identification of disease-related molecular markers, in the development of molecular-targeted therapies, and in monitoring phenotypic response to therapy both in experimental animals and in human patients. In this context, MIRCen (acronym for Molecular Imaging Research Center ) provides a comprehensive resource available to empower basic, translational, and clinical research through the application of imaging and drug, cell, and gene based technologies. The MIR center will be dedicated to the development of pre-clinical trials for the treatment of various seriously debilitating diseases such as neuro-degenerative diseases, cardiac and hepatic disorders, and infectious diseases (AIDS). Despite the fact that many of these pathologies are still incurable, recent advances in drug, cell and gene therapy point to the feasibility of new therapeutic approaches. The long term goals of MIRCen are therefore to develop and validate: - pertinent animal models for neuro-degenerative, hepatic, cardiac and infectious diseases in rodents as well as non-human primates, - novel technologies for in vivo sensing and imaging of disease-related molecular events,- drug, gene and cell based palliative and or curative therapeutic strategies aiming at protecting and /or restoring damaged or lost functions. (author)

  20. The role of stem cell therapies in degenerative lumbar spine disease: a review.

    Science.gov (United States)

    Oehme, David; Goldschlager, Tony; Rosenfeld, Jeffrey V; Ghosh, Peter; Jenkin, Graham

    2015-07-01

    Degenerative conditions of the lumbar spine are extremely common. Ninety percent of people over the age of 60 years have degenerative change on imaging; however, only a small minority of people will require spine surgery (Hicks et al. Spine (Phila Pa 1976) 34(12):1301-1306, 2009). This minority, however, constitutes a core element of spinal surgery practice. Whilst the patient outcomes from spinal surgeries have improved in recent years, some patients will remain with pain and disability despite technically successful surgery. Advances in regenerative medicine and stem cell therapies, particularly the use of mesenchymal stem cells and allogeneic mesenchymal precursor cells, have led to numerous clinical trials utilising these cell-based therapies to treat degenerative spinal conditions. Through cartilage formation and disc regeneration, fusion enhancement or via modification of pain pathways, stem cells are well suited to enhance spinal surgery practice. This review will focus on the outcomes of lumbar spinal procedures and the role of stem cells in the treatment of degenerative lumbar conditions to enhance clinical practice. The current status of clinical trials utilising stem cell therapies will be discussed, providing clinicians with an overview of the various cell-based treatments likely to be available to patients in the near future.

  1. Analysis of trace element in intervertebral disc by Atomic Absorption Spectrometry techniques in degenerative disc disease in the Polish population

    Directory of Open Access Journals (Sweden)

    Andrzej Nowakowski

    2015-05-01

    Full Text Available Objective. Although trace elements are regarded crucial and their content has been determined in number of tissue there are only few papers addressing this problem in intervertebral disc in humans. Most of the trace elements are important substrates of enzymes influencing metabolism and senescence process. Others are markers of environmental pollution. Therefore the aim of the research was to analyzed of the trace element content in the intervertebral disc, which may be a vital argument recognizing the background of degenerative changes to be the effect of the environment or metabolic factors. Materials and methods. Material consist of 18 intervertebral disc from 15 patients, acquired in surgical procedure of due to the degenerative disease with Atomic Absorption Spectrometry content of Al, Cd, Co, Pb, Cu, Ni, Mo, Mg, Zn was evaluated. Results. Only 4 of the trace elements were detected in all samples. The correlation analysis showed significant positive age correlation with Al and negative in case of Co. Among elements significant positive correlation was observed between Al/Pb, Co/Mo, Al/Mg, Al/Zn Pb/Zn and Mg/Zn. Negative correlation was observed in Al/Co, Cd/Mg, Co/Mg, Mo/Mg, Co/Zn and Mo/Zn. Conclusions. This study is the first to our knowledge that profiles the elements in intervertebral disc in patients with degenerative changes. We have confirmed significant differences between the trace element contents in intervertebral disc and other tissue. It can be ground for further investigation.

  2. 刘柏龄教授腰椎退行性疾病治疗经验总结%The treatment experience of Professor Liu Bailing in lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    刘钟华; 闻辉; 赵文海

    2015-01-01

    腰椎退行性疾病多由腰椎间盘和关节突关节的关节软骨及周围韧带组织的退行性改变所致,属于中医“腰腿痛”“腰痛”“痹症”的范畴。刘柏龄教授以“二步十法”联合中药和运动疗法治疗腰椎退行性疾病疗效较好,本文总结了刘柏龄教授的治疗经验,为临床治疗提供参考。%The retrogression of lumbar disc and arthritis and joint of articular cartilage and ligament around the organization lead to the lumbar degenerative disease, and the lumbar degenerative disease belongs to “lumbocrural pain”“back pain”“poliomyelitis” category of Chinese medicine. Professor Liu Bailing lumbar degenerative disease curative effect is better, who with “two step method of ten” ,chinese traditional medicine and exercise effect,in order to provide a reference for clinical treatment.

  3. Comparison of the costs of nonoperative care to minimally invasive surgery for sacroiliac joint disruption and degenerative sacroiliitis in a United States Medicare population: potential economic implications of a new minimally-invasive technology

    Directory of Open Access Journals (Sweden)

    Ackerman SJ

    2013-11-01

    Full Text Available Stacey J Ackerman1, David W Polly Jr2, Tyler Knight3, Karen Schneider4, Tim Holt5, John Cummings61Covance Market Access Services Inc, San Diego, CA, USA; 2University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, USA; 3Covance Market Access Services Inc, Gaithersburg, MD, USA; 4Covance Market Access Services Inc, Sydney, NSW, Australia; 5Montgomery Spine Center, Orthopaedic Surgery, Montgomery, AL, USA; 6Community Health Network, Neurosurgery, Indianapolis, IN, USAIntroduction: The economic burden associated with the treatment of low back pain (LBP in the United States is significant. LBP caused by sacroiliac (SI joint disruption/degenerative sacroiliitis is most commonly treated with nonoperative care and/or open SI joint surgery. New and effective minimally invasive surgery (MIS options may offer potential cost savings to Medicare.Methods: An economic model was developed to compare the costs of MIS treatment to nonoperative care for the treatment of SI joint disruption in the hospital inpatient setting in the US Medicare population. Lifetime cost savings (2012 US dollars were estimated from the published literature and claims data. Costs included treatment, follow-up, diagnostic testing, and retail pharmacy pain medication. Costs of SI joint disruption patients managed with nonoperative care were estimated from the 2005–2010 Medicare 5% Standard Analytic Files using primary International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM diagnosis codes 720.2, 724.6, 739.4, 846.9, or 847.3. MIS fusion hospitalization cost was based on Diagnosis Related Group (DRG payments of $46,700 (with major complications - DRG 459 and $27,800 (without major complications - DRG 460, weighted assuming 3.8% of patients have complications. MIS fusion professional fee was determined from the 2012 Medicare payment for Current Procedural Terminology code 27280, with an 82% fusion success rate and 1.8% revision rate. Outcomes were

  4. Foot drop caused by lumbar degenerative disease: clinical features, prognostic factors of surgical outcome and clinical stage.

    Directory of Open Access Journals (Sweden)

    Kun Liu

    Full Text Available OBJECTIVE: The purpose of this study was to analyze the clinical features and prognostic factors of surgical outcome of foot drop caused by lumbar degenerative disease and put forward the clinical stage. METHODS: We retrospectively reviewed 135 patients with foot drop due to lumbar degenerative disease. The clinical features and mechanism were analyzed. Age, sex, duration of palsy, preoperative muscle strength of tibialis anterior (TA, sensation defect of affected lower limb, affected foot, diagnosis and compressed nerve roots were recorded and compared with surgical outcome. RESULTS: Foot drop was observed in 8.1% of all inpatients of lumbar degenerative disease. L5 nerve root compression was observed in 126 of all 135 patients (93.3%. Single, double and triple roots compression was observed respectively in 43, 83, and 9 patients (31.9%, 61.5%, and 6.6%. But there was no significant relationship between preoperative muscle strength of TA and the number of compressed roots. The muscle strength of TA was improved in 113 (83.7% patients after surgery, but it reached to >=4 in only 21 (15.6% patients. Improvement of the muscle strength of TA was almost stable at the 6-month follow-up. At the last follow-up, the muscle strength of TA was 1, 2, 3, 4, 5 respectively in 28, 24, 62, 13, 8 patients. Multivariate logistic regression showed duration of palsy (p=0.0360, OR=2.543, preoperative muscle strength of TA (p=0.0064, OR=5.528 and age (p=0.0309, OR=3.208 were factors that influenced recovery following an operation. CONCLUSIONS: L5 nerve root was most frequently affected. The muscle strength of TA improved in most patients after surgery, but few patients can get a good recovery from foot drop. Patients of shorter duration of palsy, better preoperative muscle strength of TA and younger age showed a better surgical outcome.

  5. A comparison of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion for lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    Yang Xiaoming; Wang Hong; Zhao Quanlai; Xu Hongguang; Liu Ping; Jin Yuelong

    2014-01-01

    Background Bilateral transpedicular screw fixation in conjunction with interbody fusion is widely used to treat lumbar degenerative diseases; however,there are some disadvantages of using this fixation system.This study comparatively analyzes the results of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion (TLIF) for one-level lumbar degenerative diseases.Methods Sixty-six cases with one-level lumbar degenerative diseases were studied.The patients were divided according to surgical approach into a unilateral group (Group A) and a bilateral group (Group B).The patients were evaluated for pain by visual analog scale (VAS) and Oswestry Disability Index (ODI).Operating time,blood loss,duration of hospitalization,and complication rate were also evaluated.Patients were examined at 1,3,6,and 12 months postoperatively and every year thereafter.Results Group A patients' average preoperative VAS and ODI scores were 7.03 ± 0.98 and (64.22±6.38)%,respectively,significantly decreased to 2.91 ± 0.88 and (14.42±2.08)%,respectively,at the last follow-up (P =0.000).In Group B,the average preoperative VAS and ODI scores were 6.79±0.86 and (63.22±4.70)%,respectively,significantly decreased to 3.12±0.96 and (14.62±2.08)%,respectively,at the last follow-up (P=0.000).No significant difference in the duration of hospitalization was found between groups.Operating time and blood loss of (125.9±13.0) minutes and (211.4±28.3) ml,respectively,in Group A were significantly less than (165.2±15.3) minutes and (258.6±18.3) ml,respectively,in Group B (P=-0.000).All patients achieved good bone union and had no pseudarthrosis at the last follow-up.Conclusions There are no clinical differences between unilateral and bilateral pedicle screw fixation combined with TLIF for one-level lumbar degenerative diseases.Unilateral fixation reduces operating time,bleeding,and cost of hospitalization.

  6. Correlation between Modic changes in cervical spine and cervical degenerative disease%颈椎Modic改变与颈椎退行性疾病的关系

    Institute of Scientific and Technical Information of China (English)

    许耀丰; 马智佳; 姜宏; 俞鹏飞; 俞振翰; 陈梦菲

    2014-01-01

    Objective To investigate the association between Modic changes in cervical spine and cervical degenera-tive disease. Methods 78 outpatients with both Modic changes in cervical spine and cervical degenerative disease were calculated. The correlation between Modic changes in cervical spine and cervical degenerative disease were ana-lyzed. Results 30 patients (38. 5%) were diagnosed with mild cervical degenerative disease;26 (33. 3%) were diagnosed with moderate cervical degenerative disease, 22 (28. 2%) were diagnosed with severe cervical degenera-tive disease. Conclusions Modic changes in cervical spine often occurs in old patients, mostly type Ⅱ, in C5~6 , C6~7 segments. There is no obvious correlation between Modic changes and the severity of cervical degenerative dis-ease.%目的:探讨颈椎Modic改变与颈椎退行性疾病之间的关系。方法对78例Modic改变患者的颈椎退行性疾病进行统计,分析其与Modic改变之间的关系。结果78例患者中30例(38.5%)诊断为轻度颈椎退行性疾病,26例(33.3%)诊断为中度颈椎退行性疾病,22例(28.2%)诊断为重度颈椎退行性疾病。结论颈椎Modic改变好发于老年患者,以Ⅱ型改变居多,多发生于C5~6、C6~7节段,与颈椎退行性疾病的程度无明显关系。

  7. Degenerative Scoliosis: A Review

    OpenAIRE

    Kotwal, Suhel; Pumberger, Matthias; Hughes, Alex; Girardi, Federico

    2011-01-01

    Degenerative lumbar scoliosis is a coronal deviation of the spine that is prevalent in the elderly population. Although the etiology is unclear, it is associated with progressive and asymmetric degeneration of the disc, facet joints, and other structural spinal elements typically leading to neural element compression. Clinical presentation varies and is frequently associated with axial back pain and neurogenic claudication. Indications for treatment include pain, neurogenic symptoms, and prog...

  8. Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases.

    Science.gov (United States)

    Barrey, Cédric; Jund, Jérôme; Noseda, Olivier; Roussouly, Pierre

    2007-09-01

    Retrospective analysis of the spino-pelvic alignment in a population of 85 patients with a lumbar degenerative disease. Several previous publications reported the analysis of spino-pelvic alignment in the normal and low back pain population. Data suggested that patients with lumbar diseases have variations of sagittal alignment such as less distal lordosis, more proximal lumbar lordosis and a more vertical sacrum. Nevertheless most of these variations have been reported without reference to the pelvis shape which is well-known to strongly influence spino-pelvic alignment. The objective of this study was to analyse spino-pelvic parameters, including pelvis shape, in a population of 85 patients with a lumbar degenerative disease and compare these patients with a control group of normal volunteers. We analysed three different lumbar degenerative diseases: disc herniation (DH), n = 25; degenerative disc disease (DDD), n = 32; degenerative spondylolisthesis (DSPL), n = 28. Spino-pelvic alignment was analysed pre-operatively on full spine radiographs. Spino-pelvic parameters were measured as following: pelvic incidence, sacral slope, pelvic tilt, lumbar lordosis, thoracic kyphosis, spino-sacral angle and positioning of C7 plumb line. For each group of patients the sagittal profile was compared with a control population of 154 asymptomatic adults that was the subject of a previous study. In order to understand variations of spino-pelvic parameters in the patients' population a stratification (matching) according to the pelvic incidence was done between the control group and each group of patients. Concerning first the pelvis shape, patients with DH and those with DDD demonstrated to have a mean pelvic incidence equal to 49.8 degrees and 51.6 degrees, respectively, versus 52 degrees for the control group (no significant difference). Only young patients, less than 45 years old, with a disc disease (DH or DDD) demonstrated to have a pelvic incidence significantly lower (48

  9. Usefulness of the Core Outcome Measures Index in Daily Clinical Practice for Assessing Patients with Degenerative Lumbar Disease

    Directory of Open Access Journals (Sweden)

    Carlos Lozano-Álvarez

    2012-01-01

    Full Text Available Introduction. Outcome evaluation is an important aspect of the treatment of patients with degenerative lumbar disease. We evaluated the usefulness of the Core Outcome Measures Index (COMI in assessing people affected by degenerative lumbar disease in daily clinical practice. Methods. We evaluated 221 patients who had completed preoperatively and 2 years after surgery VAS pain, Short Form-36 (SF-36, Oswestry Disability Index (ODI and COMI. We calculated the change of scores and its sensitivity to change. The internal consistency of the COMI items and the correlation between the COMI scores and the scores of the other measurements were assessed. Results. Statistically significant differences were observed between the mean scores of the preoperative and 2 years questionnaires for nearly all measurements. COMI showed a good internal consistency, except for the preoperative pain subscale. The sensitivity to change was high for the total COMI and its pain and well-being subscales and moderate for the rest. The COMI demonstrated strong correlation with the other measurements. Conclusions. The COMI is a useful tool for assessing the patient-based outcome in the studied population. Given its simplicity, good correlation with the SF-36 and ODI and its good sensitivity to change, it could replace more cumbersome instruments in daily clinical practice.

  10. Clinical results of posterolateral fusion for degenerative lumbar spinal diseases. A follow-up study of more than 10 years

    Energy Technology Data Exchange (ETDEWEB)

    Kuroki, Hiroshi; Tajima, Naoya; Kubo, Shinichiro [Miyazaki Medical Coll., Kiyotake (Japan)

    2002-07-01

    The objective of this retrospective study was to evaluate the long-term clinical outcomes and the effects on unfused motion segments of posterolateral fusion. This study involved 35 cases (37 intervertebral levels) of posterolateral fusion performed to treat degenerative lumbar spinal diseases. There were 20 male and 15 female patients ranging in age from 30 to 67 years, with a mean age of 49 years. The postoperative period ranged from 10 years to 17 years and 8 months, with a mean period of 13 years. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score for assessment of treatment for low back pain. The effects on unfused motion segments were investigated with radiographic and magnetic resonance (MR) imaging. Postoperative satisfactory improvement (mean recovery rate, 66.9%) reached a plateau at 1 year and was maintained at final follow-up. Radiographically, the union rate was 86.5%. There were few cases of induced instability of unfused motion segments. On MR imaging, increased signal intensity in both T{sub 1}- and T{sub 2}-weighted images was seen in the paravertebral muscles in 15 of 20 cases (75.0%). Posterolateral fusion is a useful technique for the treatment of degenerative lumbar spinal diseases. Clinical outcomes were stable throughout follow-up. Instability of unfused motion segments rarely occurred. (author)

  11. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 1: introduction and methodology.

    Science.gov (United States)

    Kaiser, Michael G; Eck, Jason C; Groff, Michael W; Watters, William C; Dailey, Andrew T; Resnick, Daniel K; Choudhri, Tanvir F; Sharan, Alok; Wang, Jeffrey C; Mummaneni, Praveen V; Dhall, Sanjay S; Ghogawala, Zoher

    2014-07-01

    Fusion procedures are an accepted and successful management strategy to alleviate pain and/or neurological symptoms associated with degenerative disease of the lumbar spine. In 2005, the first version of the "Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine" was published in the Journal of Neurosurgery: Spine. In an effort to incorporate evidence obtained since the original publication of these guidelines, an expert panel of neurosurgical and orthopedic spine specialists was convened in 2009. Topics reviewed were essentially identical to the original publication. Selected manuscripts from the first iteration of these guidelines as well as relevant publications between 2005 through 2011 were reviewed. Several modifications to the methodology of guideline development were adopted for the current update. In contrast to the 2005 guidelines, a 5-tiered level of evidence strategy was employed, primarily allowing a distinction between lower levels of evidence. The qualitative descriptors (standards/guidelines/options) used in the 2005 recommendations were abandoned and replaced with grades to reflect the strength of medical evidence supporting the recommendation. Recommendations that conflicted with the original publication, if present, were highlighted at the beginning of each chapter. As with the original guideline publication, the intent of this update is to provide a foundation from which an appropriate treatment strategy can be formulated.

  12. Quantitative magnetic resonance imaging and studies of degenerative diseases of the developing human brain

    Energy Technology Data Exchange (ETDEWEB)

    Caviness, V.S. Jr. (Massachusetts General Hospital, Boston, MA (United States)); Phil, D.; Filipek, P.A.; Kennedy, D.N.

    1992-05-01

    The Rett syndrome is a progressive disorder which is associated with regression of psychomotor development and precipitous deceleration of brain growth during the first year of life. General histopathological surveys in postmortem specimens have identified degeneration of subpopulations of neurons of the nigrostriatal system but no other evidence of degenerative process. Magnetic resonance imaging-based morphometry may usefully guide application of rigorous but demanding quantitative histologic search for evidence of neuronal degeneration. The volumes of the principal set of cortical and nuclear structures of principal interest in the disorder may be measured by currently avaiable MRI-based methods. Opimized levels of precision now allow detection of volumetric changes over time in the same brain of approximately 10% at the 95% confidence level. (author).

  13. Development of PET tracers for neuro inflammation imaging in neuro degenerative diseases

    International Nuclear Information System (INIS)

    Inflammatory processes such as micro-glial or endothelial activation are involved in many neuro-degenerative conditions. Neuro-inflammation imaging is considered an attractive tool for fundamental research, diagnosis and therapeutic evaluation in neuro-pathologies. First, an aptamer was selected against a recombinant fragment of the endothelial target VCAM-1, but proved unable to bind the target protein in native conformation, as expressed by a cell line. Second, five radioligands of the peripheral benzodiazepine receptor (PBR), a marker of micro-glial activation, were evaluated in vivo using PET (Positron Emission Tomography) imaging in a rat model of neuro-inflammation, and were compared to [11C]PK11195. Four radiotracers displayed a better contrast than [11C]PK11195. In a competitive field of research, this work demonstrates the efficiency of in vivo screening of radiotracers for fast selection of clinically relevant molecules. (author)

  14. Study on the role of CTGF in the degenerative disc disease%CTGF在椎间盘退行性病变中的作用研究

    Institute of Scientific and Technical Information of China (English)

    宋永利

    2015-01-01

    This article elaborates the physiological characteristics of the intervertebral disc,the research progress of CTGF and the expression of CTGF in the degenerative disc disease.It shows that CTGF has a great significance in the degenerative disc disease.%本文对椎间盘的生理特点、CTGF 的研究进展及 CTGF 在椎间盘退行性病变中的表达情况进行阐述,表明CTGF在椎间盘退行性病变中具有重要的意义。

  15. Ultrasonographic evaluation of degenerative changes in the distal radioulnar joint: Correlation of findings with gross anatomy and MR arthrography in cadavers

    Energy Technology Data Exchange (ETDEWEB)

    Buck, Florian M., E-mail: florian.buck@gmail.com [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Nico, Marcelo A.C., E-mail: nico.marcelo@gmail.com [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Gheno, Ramon, E-mail: ramon.gheno@yahoo.com [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Trudell, Debra J., E-mail: debtrudell@hotmail.com [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Resnick, Donald, E-mail: dresnick@ucsd.edu [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States)

    2011-02-15

    Objective: To determine the accuracy of ultrasonography (US) in the evaluation of degenerative changes in the distal radioulnar joint (DRUJ). Methods and materials: Ten cadaveric specimens were obtained. US evaluation of cartilage degeneration and thickness was performed by two independent and blinded readers (R1 and R2). Gross anatomy and MR arthrography evaluated by two readers in consensus served as the reference standard. The joint surface not accessible to US was measured. Results: US interreader agreement was non-existent for cartilage thickness measurements and moderate for cartilage degeneration grading (weighted kappa = 0.41). Comparing US and MR imaging evaluation, there was no correlation between US R1 and MR imaging (Pearson correlation coefficient [PCC] = 0.352) and a moderate correlation between US R2 and MR imaging (PCC = 0.570) concerning cartilage thickness measurements. Concerning cartilage degeneration grading, there was a moderate to strong (R1 Spearman correlation coefficient [SCC] = 0.729)/R2 SCC = 0.767) correlation concerning cartilage degeneration grading. Comparing US and gross anatomic evaluation, there was no correlation for US R1 (PCC = 0.220) and a strong correlation for US R2 (PCC = 0.922) concerning cartilage thickness measurements, and a strong to moderate correlation (R1 SCC = 0.808/R2 SCC = 0.597) concerning cartilage degeneration grading. The mean sector of the articular surface of the ulna head not accessible to US was 13{sup o}. Conclusion: In conclusion the DRUJ is accessible to US except in the central 13{sup o} sector of the joint surface. US was approved to be sufficient in demonstrating advanced stages of cartilage degeneration. Thus, US of the DRUJ is recommended in patients suffering from ulnar-sided wrist pain.

  16. Non-familial degenerative disease and atrophy of brainstem and cerebellum. Clinical and CT data in 47 patients.

    Science.gov (United States)

    Staal, A; Meerwaldt, J D; van Dongen, K J; Mulder, P G; Busch, H F

    1990-03-01

    We studied the clinical features of 47 patients with a non-hereditary degenerative disease and with atrophy of brainstem or cerebellum or both in CT scanning. There was no relation between the CT findings and duration or severity of the disease, nor with the kind of the neurological signs which comprised ataxia, a hypokinetic rigid syndrome, oculomotor abnormalities, upper and lower motor neuron signs, orthostatic hypotension and dementia. The 2 main diagnoses were olivopontocerebellar atrophy (OPCA), or a combination of OPCA and striatonigral degeneration (SND). The differential diagnosis with Parkinson's disease and progressive supranuclear palsy was discussed. We concluded, that a CT scan is warranted in all cases of suspected Parkinson's disease, especially in those without tremor, and in cases of motoneuron disease with broad-based gait. In our patients with mainly hypokinesia and rigidity, levodopa treatment had no or brief beneficial effects. If ataxia predominated, OPCA appeared the most sensible diagnosis; if a hypokinetic-rigid syndrome predominated, the diagnoses SND plus OPCA appeared the most suitable. We assessed the degree of atrophy on CT subjectively, because an interobserver study of 60 normal CT scans, did not produce reliable measurements.

  17. Degenerative disorders of the spine

    International Nuclear Information System (INIS)

    Patients with back pain and degenerative disorders of the spine have a significant impact on health care costs. Some authors estimate that up to 80% of all adults experience back pain at some point in their lives. Disk herniation represents one of the most frequent causes. Nevertheless, other degenerative diseases have to be considered. In this paper, pathology and imaging of degenerative spine diseases will be discussed, starting from pathophysiology of normal age-related changes of the intervertebral disk and vertebral body. (orig.)

  18. Degenerative disorders of the spine

    Energy Technology Data Exchange (ETDEWEB)

    Gallucci, Massimo; Puglielli, Edoardo; Splendiani, Alessandra [University of L' Aquila, Department of Radiology, L' Aquila (Italy); Pistoia, Francesca; Spacca, Giorgio [S. Salvatore Hospital, Department of Neuroscience, L' Aquila (Italy)

    2005-03-01

    Patients with back pain and degenerative disorders of the spine have a significant impact on health care costs. Some authors estimate that up to 80% of all adults experience back pain at some point in their lives. Disk herniation represents one of the most frequent causes. Nevertheless, other degenerative diseases have to be considered. In this paper, pathology and imaging of degenerative spine diseases will be discussed, starting from pathophysiology of normal age-related changes of the intervertebral disk and vertebral body. (orig.)

  19. Management of sacroiliac joint disruption and degenerative sacroiliitis with nonoperative care is medical resource-intensive and costly in a United States commercial payer population

    Directory of Open Access Journals (Sweden)

    Ackerman SJ

    2014-02-01

    Full Text Available Stacey J Ackerman,1 David W Polly Jr,2 Tyler Knight,3 Tim Holt,4 John Cummings5 1Covance Market Access Services Inc, San Diego, CA, USA; 2University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, USA; 3Covance Market Access Services Inc, Gaithersburg, MD, USA; 4Montgomery Spine Center, Orthopaedic Surgery, Montgomery, AL, USA; 5Community Health Network, Neurosurgery, Indianapolis, IN, USA Introduction: Low back pain is common and originates in the sacroiliac (SI joint in 15%–30% of cases. Traditional SI joint disruption/degenerative sacroiliitis treatments include nonoperative care or open SI joint fusion. To evaluate the usefulness of newly developed minimally-invasive technologies, the costs of traditional treatments must be better understood. We assessed the costs of nonoperative care for SI joint disruption to commercial payers in the United States (US. Methods: A retrospective study of claim-level medical resource use and associated costs used the MarketScan® Commercial Claims and Encounters as well as Medicare Supplemental Databases of Truven Healthcare. Patients with a primary ICD-9-CM diagnosis code for SI joint disruption (720.2, 724.6, 739.4, 846.9, or 847.3, an initial date of diagnosis from January 1, 2005 to December 31, 2007 (index date, and continuous enrollment for ≥1 year before and 3 years after the index date were included. Claims attributable to SI joint disruption with a primary or secondary ICD-9-CM diagnosis code of 71x.xx, 72x.xx, 73x.xx, or 84x.xx were identified; the 3-year medical resource use-associated reimbursement and outpatient pain medication costs (measured in 2011 US dollars were tabulated across practice settings. A subgroup analysis was performed among patients with lumbar spinal fusion. Results: The mean 3-year direct, attributable medical costs were $16,196 (standard deviation [SD] $28,592 per privately-insured patient (N=78,533. Among patients with lumbar spinal fusion (N=434, attributable 3-year

  20. MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis

    Energy Technology Data Exchange (ETDEWEB)

    Jans, L., E-mail: lennartjans@hotmail.com [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium); Van Praet, L.; Elewaut, D.; Van den Bosch, F.; Carron, P. [Department of Rheumatology, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium); Jaremko, J.L. [Department of Radiology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta (Canada); Behaeghe, M.; Denis, A.; Huysse, W.; Lambrecht, V.; Verstraete, K. [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium)

    2014-01-15

    Purpose: To determine the prevalence of clinically relevant non-inflammatory disease on MRI of the sacroiliac (SI) joints in patients suspected of sacroiliitis. To assess the added value of axial imaging of the pelvis in these patients. Methods: In a retrospective study of 691 patients undergoing MRI of the SI joints from January 2006 to December 2012 for inflammatory back pain the prevalence of sacroiliitis and non-inflammatory disease was recorded. Results: In 285 (41%) patients MRI did not show any abnormal findings. In 36% of patients MRI features of sacroiliitis were present. Spinal degenerative changes were the most common non-inflammatory finding in 305 patients (44.1%) and consisted of disc degeneration in 222 (32%) patients, facet joint arthrosis in 58 (8.4%) patients and disc herniation in 25 (3.6%) patients. Hip joint disease in 44 (6.4%) patients, lumbosacral transitional anomaly in 41 (5.9%) patients, SI joint degenerative changes in 25 (3.6%) patients and diffuse idiopathic skeletal hyperostosis in 24 (3.5%) patients were also common. Osteitis condensans ilii in 17 (2.5%) patients, tumour in 11 (1.6%) patients, fracture in 8 (1.2%) patients, infection in 4 (0.6%) patients and acute spondylolysis in 2 patients (0.3%) were less frequently seen. Conclusion: Our study shows that non-inflammatory disease is more common than true sacroiliitis on MRI of the SI joints in patients with inflammatory type back pain. Axial pulse sequences may demonstrate unexpected findings that remain undetected if only coronal images are obtained. Clinical relevance statement:, MRI of the SI joints may demonstrate conditions that clinically mimic sacroiliitis. Axial imaging of the pelvis may help detect these unexpected findings.

  1. 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

  2. HMGB1 expression and muscle regeneration in idiopathic inflammatory myopathies and degenerative joint diseases.

    Science.gov (United States)

    Cseri, Karolina; Vincze, János; Cseri, Julianna; Fodor, János; Csernátony, Zoltán; Csernoch, László; Dankó, Katalin

    2015-06-01

    The High-Mobility Group Box 1 protein (HMGB1) is a known nuclear protein which may be released from the nucleus into the cytoplasm and the extracellular space. It is believed that the mobilized HMGB1 plays role in the autoimmune processes as an alarmin, stimulating the immune response. In addition, muscle regeneration and differentiation may also be altered in the inflammatory surroundings. Biopsy specimens derived from patients with idiopathic inflammatory myopathies (IIM) such as polymyositis or dermatomyositis were compared to muscle samples from patients undergoing surgical interventions for coxarthrosis. The biopsy and surgery specimens were used for Western blot analysis, for immunohistochemical detection of HMGB1 in histological preparations and for cell culturing to examine cell proliferation and differentiation. Our data show lower HMGB1 expression, impaired proliferation and slightly altered fusion capacity in the primary cell cultures started from IIM specimens than in cultures of coxarthrotic muscles. The ratio of regenerating muscle fibres with centralised nuclei (myotubes) is lower in the IIM samples than in the coxarthrotic ones but corticosteroid treatment shifts the ratio towards the coxarthrotic value. Our data suggest that the impaired regeneration capacity should also be considered to be behind the muscle weakness in IIM patients. The role of HMGB1 as a pathogenic signal requires further investigation.

  3. Degenerative diseases of the spine. Rare and often unrecognized causes of pain syndromes

    International Nuclear Information System (INIS)

    The aim of this article is to describe rare and often unrecognized causes of spinal pain syndromes. Intervertebral disc degeneration frequently appears in early adulthood and can have a symptomatic or asymptomatic course. This article discusses incidence, pathophysiology, imaging, and pain symptomatology involved in the origin of back pain. Anulus tears are often found in asymptomatic individuals but could be implicated in lumbar pain symptomatology in correlation with the provocative discography. Transient disorders can lead to pseudarthrosis of the iliac bone and to degeneration or to a reactive hypermobility with intervertebral disc degeneration in the level above. Modic type 1 erosive osteochondrosis is characterized by bone marrow edema near the hyaline cartilage end plate, which mostly elicits severe pain and results in serious limitations in everyday activities. The most important differential diagnosis is spondylodiscitis. Schmorl's nodes can exhibit considerable surrounding bone marrow edema that can be mistaken for metastases. A combination of MRI and CT should be employed for the diagnostic work-up of fatigue fracture of the interarticular portion, which is often overlooked due to its location. Synovial cysts of the facet joints can lead to radicular symptoms. Insufficiency fracture of the sacrum is frequently mistaken for metastasis due to intense scintigraphic enhancement and its signal behavior in MRI. CT provides instructive information. Differential diagnosis should include less common causes such as anulus tears, transient disorders, activated Schmorl's nodes, synovial cysts of the facet joints, fatigue fractures of the interarticular portion of the spine and the sacrum and distinguish from metastases in particular. (orig.)

  4. Varus deformity of the left lower extremity causing degenerative lesion of the posterior horn of the left medial meniscus in a patient with Paget’s disease of bone

    Directory of Open Access Journals (Sweden)

    Al Kaissi, Ali

    2014-09-01

    Full Text Available [english] We report on a 42-year-old woman who presented with persistent pain in her left knee with no history of trauma. Sagittal T1-weighted MRI of the left knee showed discontinuity between the anterior and posterior horns of the left medial meniscus, causing effectively the development of degenerative lesion of the posterior horn. The latter was correlated to varus deformity of the left lower extremity associated with subsequent narrowing of the medial knee joint. The unusual craniofacial contour of the patient, the skeletal survey and the elevated serum alkaline phosphatase were compatible with the diagnosis of Paget’s disease of the bone. To alleviate the adverse effect of the mal-alignment of the left femur onto the left knee, corrective osteotomy of the left femoral diaphysis by means of fixators was performed. To the best of our knowledge this is the first clinical report describing the management and the pathological correlation of a unilateral varus deformity of the femoral shaft and degenerative lesions of the left knee in a patient with Paget’s disease of the bone.

  5. Radiology of chronic diseases of the ankle joint; Chronische Krankheitsbilder am Sprunggelenk

    Energy Technology Data Exchange (ETDEWEB)

    Rand, T. [Vienna Univ. (Austria). Einrichtung fuer Magnetresonanztomographie]|[Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Trattnig, S.; Breitenseher, M.; Imhof, H. [Vienna Univ. (Austria). Einrichtung fuer Magnetresonanztomographie; Kreuzer, S. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Wagesreither, S. [Vienna Univ. (Austria). Klinik fuer Zahn-, Mund- und Kieferheilkunde

    1999-01-01

    The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemoplici patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or

  6. Nuclear magnetic resonance in the evaluation of the disk luxation in the temporomandibular articulation conditioned for degenerative osseous changes

    International Nuclear Information System (INIS)

    Purpose: The temporomandibular dysfunction is a common pathology. It appears with many symptoms as: joint pain, mechanic disturbance, and loss of mouth motion. The Magnetic Resonance Image is the chose method to study these alterations. The purposes of this paper are to demonstrate according to sex, the distribution of temporomandibular dysfunction and to determinant the relationships between the disc dislocation and the degenerative disease of the junction. Material and Method: 215 patients were evaluated between January 1999 and August 2004. An Elscint MRI 2 Tesla machine was used with Spin-echo (T1 and T2) Fat-sat sequences, in coronal, axial and sagittal planes. The follow alterations were evaluated: dislocation, degenerative disease of articular surface, osteochondritis, discal perforation, and retrodiscal lesions. Results: 175 of all showed pathologic alterations in IRM examination. The other 40 patients were excluded due to present a normal (MRI) study. The patients were 146 females and 29 men. The most common dislocation site was the anterior. Performance of the IRM was useful in all the cases to demonstrate degenerative changes in the temporomandibular joint (TMJ). And was a very precise relationship between the dislocation and degenerative disease of the joint. Conclusion: the female patient is the most frequently affected by temporomandibular joint pathology. The IRM is the selection method to study the TMJ. The degenerative changes are responsible for joint dislocation without reduction. (author)

  7. Clinical potential and limitation of MRI for degenerative lumbar spinal diseases. Comparison of MRI, myelography, CT and selective nerve root infiltration

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Michihiro; Kikuchi, Shinichi [Fukushima Medical Coll. (Japan)

    1994-12-01

    To assess the clinical potential and limitations of magnetic resonance imaging (MRI) in degenerative lumbar spinal diseases, the findings of MR imaging were compared with those of myelography and CT. The subjects were 80 patients with intervertebral disc herniation (46), spondylosis (28), degenerative spondylolisthesis (5), and spondylolysis (one). There was a good correlation between sagittal MRI (T1-weighted images) and myelography in measuring the anteroposterior diameter and the compression rate of the injured dural canal in all disease categories. However, MRI was inferior, irrespective of sagittal and coronal images, to myelography in detecting blocking of the dural canal and intradural findings such as redundant nerve roots. MRI was inferior to selective nerve root infiltration in visualizing the compression of the nerve root, irrespective of diseases; however, there was no difference in abnormal findings of the running of nerve root between the two modalities. Transverse MRI was superior to CT in visualizing the nerve root. Thus, MRI alone is insufficient for the diagnosis of degenerative lumbar spinal diseases, and the other modalities should be supplementary for pathophysiological understanding of these diseases. (N.K.).

  8. Idiopathic REM sleep behavior disorder in the transition to degenerative disease.

    Science.gov (United States)

    Postuma, Ronald B; Gagnon, Jean-Francois; Vendette, Melanie; Montplaisir, Jacques Y

    2009-11-15

    Idiopathic REM sleep behavior disorder (RBD) predicts Parkinson's disease (PD) and dementia. However, the nature of the disease that emerges from RBD has not been fully characterized. Since 2004, we have been conducting a prospective study of idiopathic RBD patients, providing an opportunity to directly observe patients as they transitioned to a defined neurodegenerative syndrome. Patients with idiopathic RBD underwent an extensive annual evaluation of motor function, olfaction, color vision, autonomic function, cognition and psychiatric symptoms. Neurodegenerative disease was defined according to standard criteria. We compared these measures in patients who had developed PD to those with dementia, all within the first year of developing disease. Of 67 patients, 6 developed PD and eleven developed dementia. Except for cognitive functioning, all tests of olfaction, color vision, autonomic function, depression, and quantitative measures of motor speed were similar in patients with PD and dementia. Of dementia patients, seven met criteria for probable Lewy body dementia (LBD) and four for Alzheimer's disease (or, possible LBD). In all probable LBD cases, the diagnosis was made because of parkinsonism, with no patient experiencing hallucinations or fluctuations. Patients with "Alzheimer's disease" seemed to have LBD, as they demonstrated typical LBD cognitive profiles on neuropsychological testing and were indistinguishable from LBD patients in ancillary measures. Therefore, among RBD patients with new-onset LBD, hallucinations or fluctuations are absent, suggesting that RBD is a reliable early sign of LBD. The indistinguishability of dementia and PD in all ancillary measures suggests a single unitary "RBD-then-neurodegeneration" process, the clinical presentation of which depends upon selective neuronal vulnerability. PMID:19768814

  9. Huntington disease: a single-gene degenerative disorder of the striatum.

    Science.gov (United States)

    Nopoulos, Peggy C

    2016-03-01

    Huntington disease (HD) is an autosomal dominant, neurodegenerative disorder with a primary etiology of striatal pathology. The Huntingtin gene (HTT) has a unique feature of a DNA trinucleotide (triplet) repeat, with repeat length ranging from 10 to 35 in the normal population. Repeat lengths between 36 and 39 cause HD at reduced penetrance (some will get the disease, others won't) and when expanded to 40 or more repeats (mHTT), causes HD at full penetrance (every person with this length or beyond will definitely develop the disease). The symptoms of HD may be motor, cognitive, and psychiatric, and are consistent with the pathophysiology of frontostriatal circuitry malfunction. Expressed ubiquitously and throughout the entire life cycle (development through adulthood), mHTT causes initial dysfunction and eventual death of a specific cell population within the striatum. Although all areas of the brain are eventually affected, the primary pathology of the disease is regionally specific. As a single-gene disorder, HD has the distinction of having the potential of treatment that is aimed directly at the known pathogenic mechanism by gene silencing, providing hope for neuroprotection and ultimately, prevention.

  10. Instrumented posterior lumbar interbody fusion (PLIF) with interbody fusion device (Cage) in degenerative disc disease (DDD): 3 years outcome.

    Science.gov (United States)

    Ahsan, M K; Hossain, M A; Sakeb, N; Khan, S I; Zaman, N

    2013-10-01

    This prospective interventional study carried out at Bangabandhu Sheikh Mujib Medical University and a private hospital in Dhaka, Bangladesh during the period from October 2003 to September 2011. Surgical treatment of degenerative disc disease (DDD) should aim to re-expand the interbody space and stabilize until fusion is complete. The present study conducted to find out the efficacy of using interbody fusion device (Cage) to achieve interbody space re-expansion and fusion in surgical management of DDD. We have performed the interventional study on 53 patients, 42 female and 11 male, with age between 40 to 67 years. All the patients were followed up for 36 to 60 months (average 48 months). Forty seven patients were with spondylolisthesis and 06 with desiccated disc. All subjects were evaluated with regard to immediate and long term complications, radiological fusion and interbody space re-expansion and maintenance. The clinical outcome (pain and disability) was scored by standard pre and postoperative questionnaires. Intrusion, extrusion and migration of the interbody fusion cage were also assessed. Forty seven patients were considered to have satisfactory outcome in at least 36 months follow up. Pseudoarthrosis developed in 04 cases and 06 patients developed complications. In this series posterior lumbar interbody fusion (PLIF) with interbody cage and instrumentation in DDD showed significant fusion rate and maintenance of interbody space. Satisfactory outcome observed in 88.68% cases.

  11. Application of stable isotopic techniques in the prevention of degenerative diseases like obesity and NIDDM in developing societies.

    Science.gov (United States)

    Shetty, Prakash; Iyengar, Venkatesh; Sawaya, Ana; Diaz, Erik; Ma, Guansheng; Hernandez-Triana, Manuel; Yajnik, Chittaranjan; Forrester, Terrence; Valencia, Mauro; Rush, Elaine; Adeyemo, Adebowale; Jahoor, Farook; Roberts, Susan

    2002-09-01

    Economic development in developing societies characterized by industrialization, urbanization, and globalization has seen the emergence of an epidemic of diet- and life-style-related chronic degenerative diseases. A research project was initiated under the aegis of the International Atomic Energy Agency (IAEA), Vienna, Austria under its Coordinated Research Programme (CRP) to promote the use of stable isotopic techniques to document the extent of the problem and to understand the determinants of this epidemic. The principal objectives of this CRP involving countries both in the North and the South are to define the magnitude of the problem of obesity and non-insulin dependent diabetes mellitus (NIDDM) in developing countries, to identify the vulnerable groups at increased risk, and to attempt to describe the metabolic and physiological mechanisms underlying this phenomenon. These comparative international studies of obesity and NIDDM are looking at the effects of childhood malnutrition (Brazil) and socioeconomic differentials (Mexico) on adult risk factors; the composition of the daily diet on obesity (Chile); levels of patterns of physical activity of older adults (China) as well as their influence on weight gain and obesity (Cuba, Nigeria); the impact of body composition and energy expenditure on the evolution frank diabetes from impaired glucose tolerance (Jamaica), and of body compositional changes and the role of inflammatory cytokines on impaired glucose tolerance (India). The last study conducted in New Zealand was aimed at comparing the energy expenditures of Maori (Pacific Island) with New Zealanders of European descent.

  12. Assistive technology in occupational therapy practice with a child with degenerative disease of the central nervous system

    Directory of Open Access Journals (Sweden)

    Tácia Caroline de Lima Rodrigues

    2015-07-01

    Full Text Available This paper aims to report the effects of the interventions, using the resource of assistive technology, carried out with a child with degenerative disease of the central nervous system at his home. This is a study case, which was conducted in seven meetings, addressing the child and his caregivers during a process of evaluation, preparation of assistive devices, family orientation, and evaluation of the family environment repercussion. The results showed that the child presents significant motor, cognitive, and psychosocial impairments, resulting in difficulties in performing activities of daily living, communication, and play. Adjustments were proposed to facilitate the child’s involvement and alleviate family difficulties on equipment and environments, such as wheelchair, bedroom, bathroom, orthosis, toys and communication. Finally, it was possible to note that the assistive technology resources were used according to the child’s needs and his own reality, and that the domiciliary visits contributed positively to the family’s life because they facilitated the child’s care, despite the limitations faced.

  13. Estrogen’s action on cognitive function, memory processes, neuro- degenerative diseases: A Review.

    OpenAIRE

    Robel Abay

    2015-01-01

    Estrogen has an effect on cognitive enhancing and neuroprotection and in the incidence progress and manifestations of most of central nervous system disorders, including neurodegenerative disease. Estrogen effects on cognition depend on the cognitive task and its dependent brain regions. In hippocampus estrogen induces increased numbers of synapses on multiple synaptic boutons between neurons not previously connected. There are fundamental differences between men and women in the underlying p...

  14. National Trends in Outpatient Surgical Treatment of Degenerative Cervical Spine Disease

    OpenAIRE

    Baird, Evan O.; Egorova, Natalia N.; McAnany, Steven J.; Qureshi, Sheeraz A.; Hecht, Andrew C.; Cho, Samuel K.

    2014-01-01

    Study Design Retrospective population-based observational study. Objective To assess the growth of cervical spine surgery performed in an outpatient setting. Methods A retrospective study was conducted using the United States Healthcare Cost and Utilization Project's State Inpatient and Ambulatory Surgery Databases for California, New York, Florida, and Maryland from 2005 to 2009. Current Procedural Terminology, fourth revision (CPT-4) and International Classification of Diseases, ninth revis...

  15. Estrogen’s action on cognitive function, memory processes, neuro- degenerative diseases: A Review.

    Directory of Open Access Journals (Sweden)

    Robel Abay

    2015-12-01

    Full Text Available Estrogen has an effect on cognitive enhancing and neuroprotection and in the incidence progress and manifestations of most of central nervous system disorders, including neurodegenerative disease. Estrogen effects on cognition depend on the cognitive task and its dependent brain regions. In hippocampus estrogen induces increased numbers of synapses on multiple synaptic boutons between neurons not previously connected. There are fundamental differences between men and women in the underlying pathophysiology, incidence, manifestation, severity, and/or progression of CNS disorders such as PD, schizophrenia, attention deficit/hyperactivity disorder, and autism.

  16. Posterior Transpedicular Dynamic Stabilization versus Total Disc Replacement in the Treatment of Lumbar Painful Degenerative Disc Disease: A Comparison of Clinical Results

    OpenAIRE

    Tunc Oktenoglu; Ali Fahir Ozer; Mehdi Sasani; Yaprak Ataker; Cengiz Gomleksiz; Irfan Celebi

    2013-01-01

    Study Design. Prospective clinical study. Objective. This study compares the clinical results of anterior lumbar total disc replacement and posterior transpedicular dynamic stabilization in the treatment of degenerative disc disease. Summary and Background Data. Over the last two decades, both techniques have emerged as alternative treatment options to fusion surgery. Methods. This study was conducted between 2004 and 2010 with a total of 50 patients (25 in each group). The mean age of the pa...

  17. Interspinous spacer decompression (X-STOP) for lumbar spinal stenosis and degenerative disk disease: a multicenter study with a minimum 3-year follow-up.

    Science.gov (United States)

    Puzzilli, Fabrizio; Gazzeri, Roberto; Galarza, Marcelo; Neroni, Massimiliano; Panagiotopoulos, Konstantinos; Bolognini, Andrea; Callovini, Giorgio; Agrillo, Umberto; Alfieri, Alex

    2014-09-01

    Interspinous distraction devices provide an effective treatment for patients suffering from lumbar spinal stenosis and/or degenerative disk disease. The aim of this multicenter study was the prospective evaluation of patients treated for symptomatic lumbar spinal stenosis with interspinous process decompression (IPD) implants compared with a population of patients managed with conservative treatment. 542 patients affected by symptomatic lumbar spine degenerative disease were enrolled in a controlled trial. 422 patients underwent surgical treatment consisting of X-STOP device implantation, whereas 120 control cases were managed conservatively. Both patient groups underwent follow-up evaluations at 6, 12, 24, and 36 months using the Zurich Claudication Questionnaire, the Visual Analog Scale score and spinal lumbar X-rays, CT scans and MR imaging. One-year follow-up evaluation revealed positive good results in the 83.5% of patients treated with IPD with respect to 50% of the nonoperative group cases. During the first three years, in 38 out of the 120 control cases, a posterior decompression and/or spinal fixation was performed because of unsatisfactory results of the conservative therapy. In 24 of 422 patients, the IPD device had to be removed, and a decompression and/or pedicle screw fixation was performed because of the worsening of neurological symptoms. Our results support the effectiveness of surgery in patients with stenosis. IPD may offer an effective and less invasive alternative to classical microsurgical posterior decompression in selected patients with spinal stenosis and lumbar degenerative disk diseases.

  18. Degenerative diseases of the spine. Rare and often unrecognized causes of pain syndromes; Degenerative Erkrankungen der Wirbelsaeule. Seltene und oft verkannte Ursachen von Schmerzsyndromen

    Energy Technology Data Exchange (ETDEWEB)

    Baur-Melnyk, A.; Triantafyllou, M.; Reiser, M. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Institut fuer Klinische Radiologie, Muenchen (Germany); Birkenmaier, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Orthopaedische Klinik und Poliklinik (Germany)

    2006-06-15

    The aim of this article is to describe rare and often unrecognized causes of spinal pain syndromes. Intervertebral disc degeneration frequently appears in early adulthood and can have a symptomatic or asymptomatic course. This article discusses incidence, pathophysiology, imaging, and pain symptomatology involved in the origin of back pain. Anulus tears are often found in asymptomatic individuals but could be implicated in lumbar pain symptomatology in correlation with the provocative discography. Transient disorders can lead to pseudarthrosis of the iliac bone and to degeneration or to a reactive hypermobility with intervertebral disc degeneration in the level above. Modic type 1 erosive osteochondrosis is characterized by bone marrow edema near the hyaline cartilage end plate, which mostly elicits severe pain and results in serious limitations in everyday activities. The most important differential diagnosis is spondylodiscitis. Schmorl's nodes can exhibit considerable surrounding bone marrow edema that can be mistaken for metastases. A combination of MRI and CT should be employed for the diagnostic work-up of fatigue fracture of the interarticular portion, which is often overlooked due to its location. Synovial cysts of the facet joints can lead to radicular symptoms. Insufficiency fracture of the sacrum is frequently mistaken for metastasis due to intense scintigraphic enhancement and its signal behavior in MRI. CT provides instructive information. Differential diagnosis should include less common causes such as anulus tears, transient disorders, activated Schmorl's nodes, synovial cysts of the facet joints, fatigue fractures of the interarticular portion of the spine and the sacrum and distinguish from metastases in particular. (orig.) [German] Darstellung seltener und oft verkannter Ursachen von Wirbelsaeulenschmerzsyndromen. Eine Bandscheibendegeneration tritt haeufig im fruehen Erwachsenenalter auf und kann symptomatisch oder asymptomatisch

  19. Vegetables as a Source of Dietary Fiber to Prevent Degenerative Diseases

    Directory of Open Access Journals (Sweden)

    Deddy Muchtadi

    2001-04-01

    Full Text Available For long time vegetables were thought only as sources of several vitamins; however, it has been shown that vegetables contain other component, which is also important for maintaining body's health, i.e., dietary fiber. Dietary fiber is a group of polysaccharides oan other polymers, which cannot be digested by upper gastro-intestinal system of human. Dietary fiber can be grouped as soluble and insoluble dietary fiber, showing in different physiological effect. Soluble dietary fiber (SDF is effective in preventing cardiovascular disease, while insoluble dietary fiber (IDF can prevent the development of colon cancer, diverticulosis as well as obesity.Local vegetables found to contain high SDF (higher than 3,06% db are: watercress, green bean, carrot, eggplant, lettuce, broccoli, spinach, string bean, and aubergine; while which contain high IDF (higher than 40,60% db are: winged bean, watercress, chinese leaves, katuk leaves, lettuce, green bean, broccoli, carrot and spinach. Cooking (i.e. boiling, steaming and pan frying decrease the IDF content of vegetables, while their SDF content is not affected by cooking treatments.

  20. Custom cerium oxide nanoparticles protect against a free radical mediated autoimmune degenerative disease in the brain.

    Science.gov (United States)

    Heckman, Karin L; DeCoteau, William; Estevez, Ana; Reed, Kenneth J; Costanzo, Wendi; Sanford, David; Leiter, James C; Clauss, Jennifer; Knapp, Kylie; Gomez, Carlos; Mullen, Patrick; Rathbun, Elle; Prime, Kelly; Marini, Jessica; Patchefsky, Jamie; Patchefsky, Arthur S; Hailstone, Richard K; Erlichman, Joseph S

    2013-12-23

    Cerium oxide nanoparticles are potent antioxidants, based on their ability to either donate or receive electrons as they alternate between the +3 and +4 valence states. The dual oxidation state of ceria has made it an ideal catalyst in industrial applications, and more recently, nanoceria's efficacy in neutralizing biologically generated free radicals has been explored in biological applications. Here, we report the in vivo characteristics of custom-synthesized cerium oxide nanoparticles (CeNPs) in an animal model of immunological and free-radical mediated oxidative injury leading to neurodegenerative disease. The CeNPs are 2.9 nm in diameter, monodispersed and have a -23.5 mV zeta potential when stabilized with citrate/EDTA. This stabilizer coating resists being 'washed' off in physiological salt solutions, and the CeNPs remain monodispersed for long durations in high ionic strength saline. The plasma half-life of the CeNPs is ∼4.0 h, far longer than previously described, stabilized ceria nanoparticles. When administered intravenously to mice, the CeNPs were well tolerated and taken up by the liver and spleen much less than previous nanoceria formulations. The CeNPs were also able to penetrate the brain, reduce reactive oxygen species levels, and alleviate clinical symptoms and motor deficits in mice with a murine model of multiple sclerosis. Thus, CeNPs may be useful in mitigating tissue damage arising from free radical accumulation in biological systems.

  1. One decade follow up after nucleoplasty in the management of degenerative disc disease causing low back pain and radiculopathy

    Science.gov (United States)

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

    2015-01-01

    Objectives: Nucleoplasty is a minimally invasive procedure that is developed to treat patients with symptomatic, but contained disc herniations or bulging discs. The purpose of this study was to evaluate a decade follow-up of coblation nucleoplasty treatment for protruded lumbar intervertebral disc. Methods: In this retrospective study there a total 50 patients who underwent intradiscal coblation therapy for symptomatic, but contained lumbar degenerative disc disease were included. Relief of low back pain, leg pain and numbness after the operation were assessed by visual analog pain scale (VAS). Function of lower limb and daily living of patients were evaluated by the Oswestry disability index (ODI) and subjective global rating of overall satisfaction were recorded and analyzed. Results: There were 27 male and 23 female with followup mean follow up of 115 months (range 105–130 months) with a mean age was 52 years (range 26–74 years). Analgesic consumption was reduced or stopped in 90% of these cases after 1 year. At 24 months follow up VAS was four points and ODI was 7.2. In three patients, we repeated the cool ablation after 36 months, at L3–4 level in two cases. Ten patients continue to be asymptomatic after 114 months of intervention. There were no complications with the procedure including nerve root injury, discitis or allergic reactions. Conclusions: Nucleoplasty may provide intermittent relief in contained disc herniation without significant complications and minimal morbidity. In accordance with the literature the evidence for intradiscal coablation therapy is moderate in managing chronic discogenic low back pain; nucleoplasty appears to be safe and effective. PMID:25767571

  2. Application of stable isotopic techniques in the prevention of degenerative diseases like obesity and NIDDM in developing societies

    International Nuclear Information System (INIS)

    Economic development in developing societies characterized by industrialization, urbanization and globalization has seen the emergence of an epidemic of diet and life-style related chronic degenerative diseases. A research project has been initiated under the aegis of the International Atomic Energy Agency (IAEA), Vienna, Austria, under its Co-ordinated Research Programme (CRP) to promote the use of stable isotopic techniques to document the extent of the problem and to understand the determinants of this epidemic. The principal objectives of this CRP involving countries both in the North and the South are to define the magnitude of the problem of obesity and non-insulin Dependent diabetes mellitus (NIDDM) in developing countries, to identify the vulnerable groups at increased risk and to attempt to describe the metabolic and physiological mechanisms underlying this phenomenon. These comparative international studies of obesity and NIDDM are looking at the effects of childhood malnutrition (Brazil and socio-economic differentials (Mexico) on adult risk factors; the composition of the daily diet on obesity (Chile); levels of patterns of physical activity of older adults (China) as well as their influence on weight gain and obesity (Cuba, Nigeria); the impact of body composition and energy expenditure on the evolution frank diabetes from impaired glucose tolerance (Jamaica), and of body compositional changes and the role of inflammatory cytokines on impaired glucose tolerance (India). The last study conducted in New Zealand was aimed at comparing the energy expenditures of Maori (Pacific Island) with New Zealanders of European descent. The findings of the CRP of the MEA in this area carried out in several countries are presented in this article. (author)

  3. Study on risk factors for lumbar degenerative disc disease%腰椎间盘退变性疾病危险因素分析及治疗

    Institute of Scientific and Technical Information of China (English)

    李军; 麻文谦; 秦涛; 朱玮; 王逸群; 曹磊; 徐晓彬

    2011-01-01

    目的 探索腰椎间盘退变性疾病的危险因素,为该类疾病的预防和治疗提供依据.方法 采用病例对照研究方法,在2008-06-2010-03我院脊柱专科门诊确诊为腰椎间盘退变性疾病的960例患者中随机抽取118例设为病例组,体检中心随机抽取167例无下腰痛病史人员为对照组,问卷调查性别、年龄、身高、体重、职业工种、腰背部外伤史、腰椎疾病家族史等,建立单因素四格表资料的F检验和多因素非条件LogiStie回归分析.结果 单因素四格表资料的F检验和非条件Logistic回归分析结果显示超重、固定工作体位、腰背部外伤史、腰椎疾患家族史是该地区居民腰椎间盘退变的危险因素.结论 腰椎间盘退变性疾病患者的发病与肥胖、职业工种、腰椎疾患家族史、腰背部外伤史等因素有密切的关系,治疗应个体化多样化,并加强健康卫生宣教.%Objective To explore risk factors for lumbar degenerative disc disease. Methods With a case-control study, 118 cases of 960 patients diagnosed by CT/Mfll as lumbar degenerative disc disease and 202 controls without low back pain, questionnaires were used to collect information on the exposure to risk factors including gender,age,occupation、weight、back injury history Jamily history of lumbar degenerative disc disease and analyzed by non-conditional logistic method. Results Through non-conditional logistic regression analysis,Obesity Jamily history of lumbar degenerative disc disease,back injury history .permanent work pose were the risk factors among residents from the area. Conclusion Obesity,Family history,back injury history,permanent work pose are the main risk factors for lumbar degenerative disc disease.

  4. Proximal Vertebral Body Fracture after 4-Level Fusion Using L1 as the Upper Instrumented Vertebra for Lumbar Degenerative Disease: Report of 2 Cases with Literature Review

    Directory of Open Access Journals (Sweden)

    Yasuhara,Takao

    2013-06-01

    Full Text Available Some cases with lumbar degenerative diseases require multi-level fusion surgeries. At our institute, 27 and 4 procedures of 3- and 4-level fusion were performed out of a total 672 posterior lumbar interfusions (PLIFs on patients with lumbar degenerative disease from 2005 to 2010. We present 2 osteoporotic patients who developed proximal vertebral body fracture after 4-level fusion. Both cases presented with gait disability for leg pain by degenerative lumbar scoliosis and canal stenosis at the levels of L1/2-4/5. After 4-level fusion using L1 as the upper instrumented vertebra, proximal vertebral body fractures were found along with the right pedicle fractures of L1 in both cases. One of these patients, aged 82 years, was treated as an outpatient using a hard corset for 24 months, but the fractures were exacerbated over time. In the other patient, posterolateral fusion was extended from Th10 to L5. Both patients can walk alone and have been thoroughly followed up. In both cases, the fracture of the right L1 pedicle might be related to the subsequent fractures and fusion failure. In consideration of multi-level fusion, L1 should be avoided as an upper instrumented vertebra to prevent junctional kyphosis, especially in cases with osteoporosis and flat back posture.

  5. Cell-Based Therapies Used to Treat Lumbar Degenerative Disc Disease: A Systematic Review of Animal Studies and Human Clinical Trials

    Directory of Open Access Journals (Sweden)

    David Oehme

    2015-01-01

    Full Text Available Low back pain and degenerative disc disease are a significant cause of pain and disability worldwide. Advances in regenerative medicine and cell-based therapies, particularly the transplantation of mesenchymal stem cells and intervertebral disc chondrocytes, have led to the publication of numerous studies and clinical trials utilising these biological therapies to treat degenerative spinal conditions, often reporting favourable outcomes. Stem cell mediated disc regeneration may bridge the gap between the two current alternatives for patients with low back pain, often inadequate pain management at one end and invasive surgery at the other. Through cartilage formation and disc regeneration or via modification of pain pathways stem cells are well suited to enhance spinal surgery practice. This paper will systematically review the current status of basic science studies, preclinical and clinical trials utilising cell-based therapies to repair the degenerate intervertebral disc. The mechanism of action of transplanted cells, as well as the limitations of published studies, will be discussed.

  6. Analytical comparison study of the clinical and radiological outcome of spine fixation using posterolateral, posterior lumber interbody and transforaminal lumber interbody spinal fixation techniques to treat lumber spine degenerative disc disease

    OpenAIRE

    Al Barbarawi, Moh’d M; Audat, Ziad M; Allouh, Mohammed Z.

    2015-01-01

    Background Degenerative disc disease is a common cause of chronic and disabling back pain that requires surgical intervention, posterolateral and posterior instrumental fixation (PLF), posterior lumber interbody fusion (PLIF) and transforaminal lumber interbody fusion (TLIF) are the techniques used to deal with such a problem. Objective To compare the clinical and radiological outcome of the variable surgical techniques used to deal with Lumber degenerative disc disease and to recommend the t...

  7. [Degenerative adult scoliosis].

    Science.gov (United States)

    García-Ramos, C L; Obil-Chavarría, C A; Zárate-Kalfópulos, B; Rosales-Olivares, L M; Alpizar-Aguirre, A; Reyes-Sánchez, A A

    2015-01-01

    Adult scoliosis is a complex three-dimensional rotational deformity of the spine, resulting from the progressive degeneration of the vertebral elements in middle age, in a previously straight spine; a Cobb angle greater than 10° in the coronal plane, which also alters the sagittal and axial planes. It originates an asymmetrical degenerative disc and facet joint, creating asymmetrical loads and subsequently deformity. The main symptom is axial, radicular pain and neurological deficit. Conservative treatment includes drugs and physical therapy. The epidural injections and facet for selectively blocking nerve roots improves short-term pain. Surgical treatment is reserved for patients with intractable pain, radiculopathy and/ or neurological deficits. There is no consensus for surgical indications, however, it must have a clear understanding of the symptoms and clinical signs. The goal of surgery is to decompress neural elements with restoration, modification of the three-dimensional shape deformity and stabilize the coronal and sagittal balance.

  8. Structural Studies on Acetylcholinesterase and Paraoxonase Directed Towards Development of Therapeutic Biomolecules for the Treatment of Degenerative Diseases and Protection Against Chemical Threat Agents

    Science.gov (United States)

    Sussman, Joel L.; Silman, Israel

    Acetylcholinesterase and paraoxonase are important targets for treatment of degenerative diseases, Alzheimer's disease and atherosclerosis, respectively, both of which impose major burdens on the health care systems in Western society. Acetylcholinesterase is the target of lethal nerve agents, and paraoxonase is under consideration as a bioscavenger for their detoxification. Both are thus the subject of research and development in the context of nerve agent toxicology. The crystal structures of the two enzymes are described, and structure/function relationships are discussed in the context of drug development and of development of means of protection against chemical threats.

  9. Arthroscopical treatment of elbow joint disease

    Directory of Open Access Journals (Sweden)

    C.M.F. Rezende

    2012-02-01

    Full Text Available Elbow arthroscopy was performed in 30 dogs of different breeds. The procedure was performed bilaterally in 20 of these dogs, yielding a total of 50 joints. Different lesions were found, varying from cartilage fissures (8 to fragmentation (42 of medial coronoid process (FCP of the ulna. Osteochondritis dissecans (OCD of the humerus medial condyle was associated in four of them. All of these cases displayed varying degrees of synovitis. Osteoarthrosis (OA in varying intensity was observed in 44 joints. The majority of cases were treated two to four months after the manifestation of clinical signs. Good clinical recovery occurred in dogs with minimal joint lesions, where these were diagnosed and treated within four weeks of the onset of clinical symptoms. Early diagnosis and arthroscopic treatment prevent osteoarthrosis and preserve locomotor function.

  10. New aspects of radionuclide therapy of bone and joint diseases

    International Nuclear Information System (INIS)

    Whereas in developing countries P-32 is widely used for radionuclide therapy of painful bone metastases, in Europe three radionuclides or radiopharmaceutical agents are available for pain palliation: Sr-89, Sm-153-EDTMP, and Re-186-HEDP. Radionuclide therapy for pain palliation is indicated for bone pain due to metastatic malignancy that has involved multiple skeletal sites and has evoked an osteoblastic response on bone scintigraphy. Response rates of about 70-80% in patients with breast or prostate cancer is reported in the literature, less in metastatic lesions of other primary malignancies. Sm-153-EDTMP may also be used for curative treatment of primary bone tumours or their metastases. Radiosynovectomy as therapeutic procedure or rheumatoid arthritis, other inflammatory joint diseases, persistent synovial perfusion, and other joint diseases is widely used. Using Y-90 for the knee joint, Re-186 for middle sized joints, and Er-169 for small joints an improvement of symptoms may be observed in about 70-80%. (author)

  11. Comparing minimally invasive and open transforaminal lumbar interbody fusion for treatment of degenerative lumbar disease: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    SUN Zhi-jian; LI Wen-jing; ZHAO Yu; QIU Gui-xing

    2013-01-01

    Background Transforaminal lumbar interbody fusion (TLIF) through a minimally invasive approach (mTLIF) was introduced to reduce soft tissue injury and speed recovery.Studies with small numbers of patients have been carried out,comparing mTLIF with traditional open TLIF (oTLIF),but inconsistent outcomes were reported.Methods We conducted a meta-analysis to evaluate the effectiveness of mTLIF and oTLIF in the treatment of degenerative lumbar disease.We searched PubMed,Embase and Cochrane Database of Systematic Reviews in March 2013 for studies directly comparing mTLIF and oTLIF.Patient characteristics,interventions,surgical-related messages,early recovery parameters,long-term clinical outcomes,and complications were extracted and relevant results were pooled.Results Twelve cohort studies with a total of 830 patients were identified.No significant difference regarding average operating time was observed when comparing mTLIF group with oTLIF group (-0.35 minute,95% confidence interval (C/):-20.82 to 20.13 minutes).Intraoperative blood loss (-232.91 ml,95% CI:-322.48 to-143.33 ml) and postoperative drainage (-111.24.ml,95% CI:-177.43 to-45.05 ml) were significantly lower in the mTLIF group.A shorter hospital stay by about two days was observed in patients who underwent mTLIF (-2.11 days,95% CI:-2.76 to-1.45 days).With regard to long-term clinical outcomes,no significant difference in visual analog scale score (-0.25,95% CI:-0.63 to 0.13) was observed; however,there was a slight improvement in Oswestry Disability Index (-1.42,95% CI:-2.79 to-0.04) during a minimum of 1-year follow-up between the two groups.The incidence of complications did not differ significantly between the procedures (RR=1.06,95% CI:0.7 to 1.59).Reoperation was more common in patients in mTLIF group than in oTLIF group (5% vs.2.9%),but this difference was not significant (RR=1.62,95% CI:0.75 to 3.51).Conclusion Current evidence suggests that,compared with traditional open surgery

  12. Treatment of Nongout Joint Deposition Diseases: An Update

    Directory of Open Access Journals (Sweden)

    Tristan Pascart

    2014-01-01

    Full Text Available This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD, basic calcium phosphate (BCP deposition disease, hemochromatosis (HH, ochronosis, oxalosis, and Wilson’s disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1 treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators’ effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson’s disease. NSAIDs should be avoided because of the liver affection they may worsen.

  13. Treatment of nongout joint deposition diseases: an update.

    Science.gov (United States)

    Pascart, Tristan; Richette, Pascal; Flipo, René-Marc

    2014-01-01

    This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson's disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators' effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson's disease. NSAIDs should be avoided because of the liver affection they may worsen. PMID:24895535

  14. 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...

  15. [Concomitant diseases in primary joint hypermobility syndrome].

    Science.gov (United States)

    Skoumal, Martin; Haberhauer, Günther; Mayr, Hans

    2004-10-15

    The primary joint hypermobility syndrome (pJH) is an overlap disorder of connective-tissue dysplasias, which incorporates features seen in the Marfan syndromes (MFS), Ehlers-Danlos syndromes (EDS), and osteogenesis imperfecta. Patients with pJH usually present arthralgia, back pain, soft-tissue lesions, recurrent joint dislocation, or subluxation. Extraarticular features may include, e. g., striae cutis, keratoconus, easy bruising, mitral valve prolapse, aortic incompetence, aneurysms, pneumothorax, hernia, urinary incontinence, and pelvic floor prolapse. Due to the high frequency of critical dissection and rupture, the early recognition of rare life-threatening complications such as dilatation of the aortic root and aneurysms is important. Therefore, patients (and their family members) with pJH should also be examined for life-threatening features seen in MFS and EDS. PMID:15490074

  16. Joint hypermobility: emerging disease or illness behaviour?

    Science.gov (United States)

    Grahame, Rodney

    2013-12-01

    Joint hypermobility syndrome is a common clinical entity which is much misunderstood, overlooked, misdiagnosed and mistreated. It was first described in the 1960s as a purely musculoskeletal condition due to joint laxity and hypermobility occurring in otherwise healthy individuals. Some four decades later it is now perceived to be a multi-systemic heritable disorder of connective tissue with manifestations occurring far beyond the confines of the locomotor system and with ramifications potentially affecting most, if not all, of the bodily systems in one way or another. Most authorities in the field find it clinically indistinguishable from the Ehlers-Danlos syndrome--hypermobility type (formerly, EDS type III). In >50% of patients the diagnosis is delayed for ≥10 years. Failure to diagnose and treat the condition correctly results in needless pain and suffering and in many patients to a progressive decline in their quality of life and in some to a loss of independence. PMID:24298184

  17. Degenerative myelopathy in dogs

    Directory of Open Access Journals (Sweden)

    Nikolovski Goran

    2010-05-01

    Full Text Available One of the chronic progressive disorders of the spinal cord in dogs is the degenerative myelopathy (DM. The most predisposed age in dog is 5 to 14 years, while rarely noted in younger, there is no gender predisposition. This disorder most commonly appears in dogs of the German shepherd breed, but it can appear in other breeds too. The main changes about this disease are degeneration of the myelin, especially in the thoracic-lumbar segments of the spinal cord and the dorsal nerve roots. The progression of the disease is slow and can last months to years. Undoubtedly, diagnosis is made by examinations of the CSF and establishing elevated level of protein segments.

  18. Treatment of Nongout Joint Deposition Diseases: An Update

    OpenAIRE

    Tristan Pascart; Pascal Richette; René-Marc Flipo

    2014-01-01

    This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson’s disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive...

  19. Joint diseases in animal paleopathology: Veterinary approach

    OpenAIRE

    Oliver Stevanović,; Maciej Janeczek,; Aleksander Chrószcz; Nemanja Marković

    2015-01-01

    Animal paleopathology is not a very well known scientific discipline within veterinary science, but it has great importance for historical and archaeological investigations. In this paper, authors attention is focused on the description of one of the most common findings on the skeletal remains of animals - osteoarthropathies. This review particularly emphasizes the description and classification of the most common pathological changes in synovial joints. The authors have provided their obser...

  20. Clinical study to evaluate the safety and effectiveness of the Aesculap Activ-L™ artificial disc in the treatment of degenerative disc disease

    OpenAIRE

    Mo Fred F; Yue James J

    2010-01-01

    Abstract Background The objective of this clinical study is to evaluate the safety and effectiveness of the Activ-L Artificial Disc for treatment of single-level degenerative disc disease of the lumbar spine in patients who have been unresponsive to at least six months of prior conservative care. The hypothesis of the study is that the Activ-L Disc is non-inferior to the control (the Charité® Artificial Disc [DePuy Spine] or ProDisc-L® Total Disc Replacement [Synthes Spine]) with respect to t...

  1. Research Progress of Lumbar Degenerative Disease%腰椎间盘退变性疾病的研究进展

    Institute of Scientific and Technical Information of China (English)

    乔成钢; 杨学军

    2015-01-01

    As a common spinal diseases, lumbar degenerative disk diease (LDDD) is defined by relevant scholars as the general name of a series of disease which have the clinical manifestation of waist and leg pain caused by degenerative changes of lumbar disc, articular process cartilages and surrounding ligament, and it always results in degenerative lumbar spinal stenosis and spondylolisthesis. Its clinical effect is not good because of complex causes and undefined pathogenesis. This paper reviews the progress of many new technologies such as gene technology and biology which greatly improve the research progress of LDDD in recent years so as to provide reference for clinical study.%LDDD属于临床常见脊柱疾病,相关学者将其定义为,因腰椎间盘与关节突的关节软骨及周围韧带退行性变化所致腰腿疼痛等临床表现一系列疾病总称,多造成退变性腰椎管狭窄、腰椎滑脱等病变。 LDDD病因较为复杂,且尚未明确其发病机制,因而临床未能取得理想疗效。近年来,诸多新技术如基因技术生物学,极大促进了LDDD的研究进展,该研究对其具体进展进行综合论述,以期为临床研究提供参考。

  2. Effects of age, replicative lifespan and growth rate of human nucleus pulposus cells on selecting age range for cell-based biological therapies for degenerative disc diseases.

    Science.gov (United States)

    Lee, J S; Lee, S M; Jeong, S W; Sung, Y G; Lee, J H; Kim, K W

    2016-07-01

    Autologous disc cell implantation, growth factors and gene therapy appear to be promising therapies for disc regeneration. Unfortunately, the replicative lifespan and growth kinetics of human nucleus pulposus (NP) cells related to host age are unclear. We investigated the potential relations among age, replicative lifespan and growth rate of NP cells, and determined the age range that is suitable for cell-based biological therapies for degenerative disc diseases. We used NP tissues classified by decade into five age groups: 30s, 40s, 50s, 60s and 70s. The mean cumulative population doubling level (PDL) and population doubling rate (PDR) of NP cells were assessed by decade. We also investigated correlations between cumulative PDL and age, and between PDR and age. The mean cumulative PDL and PDR decreased significantly in patients in their 60s. The mean cumulative PDL and PDR in the younger groups (30s, 40s and 50s) were significantly higher than those in the older groups (60s and 70s). There also were significant negative correlations between cumulative PDL and age, and between PDR and age. We found that the replicative lifespan and growth rate of human NP cells decreased with age. The replicative potential of NP cells decreased significantly in patients 60 years old and older. Young individuals less than 60 years old may be suitable candidates for NP cell-based biological therapies for treating degenerative disc diseases. PMID:27149303

  3. Nise (Nimesulide) in treatment nf joint diseases

    OpenAIRE

    N. V. Cliichasova; G. R. Imametdinova

    2004-01-01

    Selectivity of nonsteroidal anti-inflammatory drugs (NSAID) and connected with it treatment adverse events are discussed. Effecacy, tolerability and problem of a selective NSAID nise (nimesulid) optimal dose selection in inflammatory and non inflammatory rheumatic diseases are considered.

  4. Temporomandibular joint dysfunction in various rheumatic diseases

    Directory of Open Access Journals (Sweden)

    F.J. Aceves-Avila

    2013-07-01

    Full Text Available Temporomandibular disorder (TMD is an inclusive term in which those conditions disturbing the masticatory function are embraced. It has been estimated that 33% of the population have signs of TMD, but less than 5% of the population will require treatment. The objective of this study was to measure the frequency of TMD in rheumatoid arthritis (RA, osteoarthrosis (OA, ankylosing spondylitis (AS and systemic lupus erythematosus, and to define the limitations in everyday’s life that patients perceive when present. A six-month survey of consecutive outpatients in a rheumatology clinic in a teaching hospital in Mexico was carried out. We defined TMD as: 1 the presence of pain; 2 difficulty on mouth opening, chewing or speaking; 3 the presence of non-harmonic movements of the temporomaxilar joints. All three characteristics had to be present. Z test was used to define differences between proportions. We present the results of 171 patients. Overall, 50 patients had TMD according to our operational definition (29.24%. Up to 76% of the sample had symptoms associated with the condition. TMD is more frequent in OA and in AS (29.24% vs 38% OA, P=0.009; 39% AS; P=0.005. We found no association between the severity of TMD and the request for specific attention for the discomfort produced by the condition. Only 8 of 50 (16% patients with TMD had requested medical help for their symptoms, and they were not the most severe cases. TMD is more frequent in RA and OA. Although it may produce severe impairment, patients seem to adapt easily.

  5. Temporomandibular joint dysfunction in various rheumatic diseases.

    Science.gov (United States)

    Aceves-Avila, F J; Chávez-López, M; Chavira-González, J R; Ramos-Remus, C

    2013-01-01

    Temporomandibular disorder (TMD) is an inclusive term in which those conditions disturbing the masticatory function are embraced. It has been estimated that 33% of the population have signs of TMD, but less than 5% of the population will require treatment. The objective of this study was to measure the frequency of TMD in rheumatoid arthritis (RA), osteoarthrosis (OA), ankylosing spondylitis (AS) and systemic lupus erythematosus, and to define the limitations in everyday's life that patients perceive when present. A six-month survey of consecutive outpatients in a rheumatology clinic in a teaching hospital in Mexico was carried out. We defined TMD as: 1) the presence of pain; 2) difficulty on mouth opening, chewing or speaking; 3) the presence of non-harmonic movements of the temporomaxilar joints. All three characteristics had to be present. Z test was used to define differences between proportions. We present the results of 171 patients. Overall, 50 patients had TMD according to our operational definition (29.24%). Up to 76% of the sample had symptoms associated with the condition. TMD is more frequent in OA and in AS (29.24% vs 38% OA, P=0.009; 39% AS; P=0.005). We found no association between the severity of TMD and the request for specific attention for the discomfort produced by the condition. Only 8 of 50 (16%) patients with TMD had requested medical help for their symptoms, and they were not the most severe cases. TMD is more frequent in RA and OA. Although it may produce severe impairment, patients seem to adapt easily. PMID:23884028

  6. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 11: interbody techniques for lumbar fusion.

    Science.gov (United States)

    Mummaneni, Praveen V; Dhall, Sanjay S; Eck, Jason C; Groff, Michael W; Ghogawala, Zoher; Watters, William C; Dailey, Andrew T; Resnick, Daniel K; Choudhri, Tanvir F; Sharan, Alok; Wang, Jeffrey C; Kaiser, Michael G

    2014-07-01

    Interbody fusion techniques have been promoted as an adjunct to lumbar fusion procedures in an effort to enhance fusion rates and potentially improve clinical outcome. The medical evidence continues to suggest that interbody techniques are associated with higher fusion rates compared with posterolateral lumbar fusion (PLF) in patients with degenerative spondylolisthesis who demonstrate preoperative instability. There is no conclusive evidence demonstrating improved clinical or radiographic outcomes based on the different interbody fusion techniques. The addition of a PLF when posterior or anterior interbody lumbar fusion is performed remains an option, although due to increased cost and complications, it is not recommended. No substantial clinical benefit has been demonstrated when a PLF is included with an interbody fusion. For lumbar degenerative disc disease without instability, there is moderate evidence that the standalone anterior lumbar interbody fusion (ALIF) has better clinical outcomes than the ALIF plus instrumented, open PLF. With regard to type of interbody spacer used, frozen allograft is associated with lower pseudarthrosis rates compared with freeze-dried allograft; however, this was not associated with a difference in clinical outcome.

  7. Magnetic resonance imaging of peripheral joints in rheumatic diseases

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Duer, Anne; Møller, Uffe;

    2004-01-01

    The need for better methods than the conventional clinical, biochemical and radiographical examinations in the management of inflammatory joint diseases is evident, since these methods are not sensitive or specific to early pathologies and subtle changes. Magnetic resonance imaging (MRI) offers...

  8. Studies on the pathogenesis of the degenerative lumbar canal stenosis by CT, 3. Clinical studies on the pathogenesis of the degenerative LCS

    Energy Technology Data Exchange (ETDEWEB)

    Kido, Kenji

    1988-03-01

    Computed tomography (CT) scans of lumbar canal stenosis (LCS, n = 20), osteoarthritis (OA, n = 65), disk herniation (n = 21), and lumbar pain (n = 23) were reviewed for the quanlitative evaluation of the vertebral canal and stenosis factors. Trefoil type on transverse sections of the bony vertebral canal was observed in 23 %, having no implications for pathologic significance at the L5 level. The degree of degeneration in soft tissues inside the vertebral canal varied according to diseases. This was most noticeable at the L4/L5 level in the LCS group. The morphological CT appearance of vertebral arch were divided into three types: I - the concave inner part, II - the linear inner part, and III - the convex inner part to the vertebral canal. In the group of LCS, the incidences of types II and III were high at the L5/S1 and at the L4/L5 levels, respectively. As for the angle of apophyseal joint, the incidence of sagittal joint was high at the L3/L4 and L4/L5 levels in the group of LCS. The incidence of degenerative changes was high in the groups of LCS and OA, suggesting some relationship between degenerative degree and both sagittal and asymmetric joints. This was noticeable at the L4/L5 level. Calcification surrounding the joint was seen in 13 %, reflecting the relationship to the degenerative changes. There was no relationship between degenerative changes and vacuum joint phenomenon observed in 18 %. As for the area less than 90 mm/sup 2/ of the dural canal, there was no morphological change between the LCS and OA groups. In the symptomatic mechanism in the case of LCS, morphological dynamic and unstable factors may be involved. (Namekawa, K.) 67 refs.

  9. Clinical outcomes of lumbar degenerative disc disease treated with posterior lumbar interbody fusion allograft spacer: a prospective, multicenter trial with 2-year follow-up.

    Science.gov (United States)

    Arnold, Paul M; Robbins, Stephen; Paullus, Wayne; Faust, Stephen; Holt, Richard; McGuire, Robert

    2009-07-01

    The clinical benefits and complications of posterior lumbar interbody fusion (PLIF) have been studied over the past 60 years. In recent years, spine surgeons have had the option of treating low back pain caused by degenerative disc disease using PLIF with machined allograft spacers and posterior pedicle fixation. The purpose of this clinical series was to assess the clinical benefits of using a machined PLIF allograft spacer and posterior pedicle fixation to treat degenerative disc disease, both in terms of fusion rates and patient outcomes, and to compare these results with those in previous studies using autograft and metal interbody fusion devices. Results were also compared with results from studies using transverse process fusion. This prospective, nonrandomized clinical series was conducted at 10 US medical centers. Eighty-nine (55 male, 34 female) patients underwent PLIF with a presized, machined allograft spacer and posterior pedicle fixation between January 2000 and April 2003. Their outcomes were compared with outcomes in previous series described in the literature. All patients had experienced at least 6 months of low back pain that had been unresponsive to nonsurgical treatment. Physical examinations were performed before surgery, after surgery, and at 4 follow-up visits (6 weeks, 6 months, 12 months, 24 months). At each interval, we obtained radiographs and patient outcome measures, including SF-36 Bodily Pain Score, visual analog scale pain rating, and Oswestry Disability Index. The primary outcome was fusion results at 12 and 24 months; the secondary outcomes were pain, disability, function/quality of life, and satisfaction. One-level PLIFs were performed in 65 patients, and 2-level PLIFs in 24 patients. Flexion-extension radiographs at 12 and 24 months revealed a 98% fusion rate. Of the 72 patients who reached the 12-month follow-up, 86% reported decreased pain and disability as measured with the Oswestry Disability Index. Decreased pain as measured

  10. Comparison of degree of postoperative muscle damage between MIS-TLIF- and PLIF treatment for single-level degenerative lumbar disease

    Directory of Open Access Journals (Sweden)

    Liang ZHOU

    2014-01-01

    Full Text Available Objective To compare the postoperative muscle damage after either posterior lumbar interbody fusion (PLIF or minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF with the aid of X-Tube system in patients with singlelevel degenerative lumbar spinal disease. Methods The clinical data of 52 patients (males 28, females 24, aged 54.3±7.8 years with single-level degenerative lumbar spinal disease undergoing MIS-TLIF assisted by the X-Tube system from Oct 2010 to Sep 2011 was analyzed retrospectively. The operative time, intraoperative blood loss, postoperative drainage volume, postoperative bedtime, and serum creatine kinase (CK level 1 day before surgery and 1, 3 and 5 days after surgery were recorded and compared with those of 38 patients (males 20, females 18, aged 51.6±8.6 years with the same disease undergoing conventional open PLIF during the corresponding period. The back pain visual analogue score (VAS, Oswestry disability index (ODI score and imaging examination were performed before operation, after operation and during follow-up duration for each patient. Results There was no significant difference in the gender, age, clinical diagnosis, lesion location, preoperative CK level, VAS and ODI scores between the two groups (P>0.05. The operative time was longer in MIS-TLIF group than in PLIF group (P0.05. Radiological followup observation revealed good fusion 6 months after operation in all the patients. Conclusion The X-Tube-assisted MIS-TLIF has several advantages over conventional open PLIF, such as less intraoperative blood loss, milder muscle damage, and lighter back pain. DOI: 10.11855/j.issn.0577-7402.2013.12.04

  11. Novel information on the non-neuronal cholinergic system in orthopedics provides new possible treatment strategies for inflammatory and degenerative diseases

    Directory of Open Access Journals (Sweden)

    Sture Forsgren

    2009-07-01

    Full Text Available Anti-cholinergic agents are used in the treatment of several pathological conditions. Therapy regimens aimed at up-regulating cholinergic functions, such as treatment with acetylcholinesterase inhibitors, are also currently prescribed. It is now known that not only is there a neuronal cholinergic system but also a non-neuronal cholinergic system in various parts of the body. Therefore, interference with the effects of acetylcholine (ACh brought about by the local production and release of ACh should also be considered. Locally produced ACh may have proliferative, angiogenic, wound-healing, and immunomodulatory functions. Interestingly, cholinergic stimulation may lead to anti-inflammatory effects. Within this review, new findings for the locomotor system of a more widespread non-neuronal cholinergic system than previously expected will be discussed in relation to possible new treatment strategies. The conditions discussed are painful and degenerative tendon disease (tendinopathy/tendinosis, rheumatoid arthritis, and osteoarthritis.

  12. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 2: assessment of functional outcome following lumbar fusion.

    Science.gov (United States)

    Ghogawala, Zoher; Resnick, Daniel K; Watters, William C; Mummaneni, Praveen V; Dailey, Andrew T; Choudhri, Tanvir F; Eck, Jason C; Sharan, Alok; Groff, Michael W; Wang, Jeffrey C; Dhall, Sanjay S; Kaiser, Michael G

    2014-07-01

    Assessment of functional patient-reported outcome following lumbar spinal fusion continues to be essential for comparing the effectiveness of different treatments for patients presenting with degenerative disease of the lumbar spine. When assessing functional outcome in patients being treated with lumbar spinal fusion, a reliable, valid, and responsive outcomes instrument such as the Oswestry Disability Index should be used. The SF-36 and the SF-12 have emerged as dominant measures of general health-related quality of life. Research has established the minimum clinically important difference for major functional outcomes measures, and this should be considered when assessing clinical outcome. The results of recent studies suggest that a patient's pretreatment psychological state is a major independent variable that affects the ability to detect change in functional outcome.

  13. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 5: correlation between radiographic outcome and function.

    Science.gov (United States)

    Dhall, Sanjay S; Choudhri, Tanvir F; Eck, Jason C; Groff, Michael W; Ghogawala, Zoher; Watters, William C; Dailey, Andrew T; Resnick, Daniel K; Sharan, Alok; Mummaneni, Praveen V; Wang, Jeffrey C; Kaiser, Michael G

    2014-07-01

    In an effort to diminish pain or progressive instability, due to either the pathological process or as a result of surgical decompression, one of the primary goals of a fusion procedure is to achieve a solid arthrodesis. Assuming that pain and disability result from lost mechanical integrity of the spine, the objective of a fusion across an unstable segment is to eliminate pathological motion and improve clinical outcome. However, conclusive evidence of this correlation, between successful fusion and clinical outcome, remains elusive, and thus the necessity of documenting successful arthrodesis through radiographic analysis remains debatable. Although a definitive cause and effect relationship has not been demonstrated, there is moderate evidence that demonstrates a positive association between radiographic presence of fusion and improved clinical outcome. Due to this growing body of literature, it is recommended that strategies intended to enhance the potential for radiographic fusion are considered when performing a lumbar arthrodesis for degenerative spine disease.

  14. Combined transforaminal lumbar interbody fusion with posterolateral instrumented fusion for degenerative disc disease can be a safe and effective treatment for lower back pain

    Directory of Open Access Journals (Sweden)

    Ara J Deukmedjian

    2015-01-01

    Full Text Available Background: Lumbar fusion is a proven treatment for chronic lower back pain (LBP in the setting of symptomatic spondylolisthesis and degenerative scoliosis; however, fusion is controversial when the primary diagnosis is degenerative disc disease (DDD. Our objective was to evaluate the safety and effectiveness of lumbar fusion in the treatment of LBP due to DDD. Materials and Methods: Two-hundred and five consecutive patients with single or multi-level DDD underwent lumbar decompression and instrumented fusion for the treatment of chronic LBP between the years of 2008 and 2011. The primary outcome measures in this study were back and leg pain visual analogue scale (VAS, patient reported % resolution of preoperative back pain and leg pain, reoperation rate, perioperative complications, blood loss and hospital length of stay (LOS. Results: The average resolution of preoperative back pain per patient was 84% (n = 205 while the average resolution of preoperative leg pain was 90% (n = 190 while a mean follow-up period of 528 days (1.5 years. Average VAS for combined back and leg pain significantly improved from a preoperative value of 9.0 to a postoperative value of 1.1 (P ≤ 0.0001, a change of 7.9 points for the cohort. The average number of lumbar disc levels fused per patient was 2.3 (range 1-4. Median postoperative LOS in the hospital was 1.2 days. Average blood loss was 108 ml perfused level. Complications occurred in 5% of patients (n = 11 and the rate of reoperation for symptomatic adjacent segment disease was 2% (n = 4. Complications included reoperation at index level for symptomatic pseudoarthrosis with hardware failure (n = 3; surgical site infection (n = 7; repair of cerebrospinal fluid leak (n = 1, and one patient death at home 3 days after discharge. Conclusion: Lumbar fusion for symptomatic DDD can be a safe and effective treatment for medically refractory LBP with or without leg pain.

  15. Clinical study to evaluate the safety and effectiveness of the Aesculap Activ-L™ artificial disc in the treatment of degenerative disc disease

    Directory of Open Access Journals (Sweden)

    Mo Fred F

    2010-04-01

    Full Text Available Abstract Background The objective of this clinical study is to evaluate the safety and effectiveness of the Activ-L Artificial Disc for treatment of single-level degenerative disc disease of the lumbar spine in patients who have been unresponsive to at least six months of prior conservative care. The hypothesis of the study is that the Activ-L Disc is non-inferior to the control (the Charité® Artificial Disc [DePuy Spine] or ProDisc-L® Total Disc Replacement [Synthes Spine] with respect to the rate of individual subject success at 24 months. Individual subject success is a composite of effectiveness and safety. Methods/Design The study proposed is a prospective, randomized, single-masked, controlled, multi-center clinical trial consisting of an estimated 414 subjects with single-level DDD of the lumbar spine (L4/L5, or L5/S1 who have failed to improve with conservative treatment for at least six months prior to enrollment. After enrollment, subjects will be randomized in a 2:1 ratio to either the Activ-L Disc (investigational device or the control (Charité or ProDisc-L. Radiographic endpoints will be evaluated by an independent reviewer at an imaging core laboratory. Each subject will be followed for 5 years post-treatment. Discussion The safety and effectiveness of the Activ-L Artificial Disc for treatment of single-level degenerative disc disease of the lumbar spine will be equivalent to Charité® Artificial Disc [DePuy Spine] or ProDisc-L® Total Disc Replacement [Synthes Spine] at 24 months. Trial Registration Current Controlled Trials NCT00589797.

  16. Assessment of the trauma degree and spinal cord function of para-median minimally invasive and open TLIF for single segmental lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    Zheng Bo-long; He Bao-rong; Yang Xiao-bin; Yang Ming; Yan Liang; Bai Xiao-fan; Hao Ding-jun

    2016-01-01

    Objective:To study the trauma degree of para-median minimally invasive and open TLIF for single segmental lumbar degenerative disease and the effect on spinal cord function.Methods:A total of 78 cases of patients with single segmental lumbar disc herniation who received TLIF treatment in our hospital were selected as the research subjects and randomly divided into two groups, minimally invasive group received para-median minimally invasive TLIF and open group received open TLIF. Perioperative serum levels of oxidative stress indicators and pain mediators as well as spinal cord function were compared between two groups.Results: 1 d and 3 d after operation, serum SOD, GSH-Px and SP levels of minimally invasive group were significantly higher than those of open group, and MDA, AOPP, NO,β-EP, PGE2 and CGRP levels were significantly lower than those of open group; 1 week after operation, NCV and DL of common peroneal nerve and tibial nerve of two groups were not different from those before operation; 4 weeks and 16 weeks after operation, NCV of common peroneal nerve and tibial nerve of both groups were higher than those before operation while DL were lower than those before operation, and NCV of common peroneal nerve and tibial nerve of minimally invasive group were significantly higher than those of open group while DL were significantly lower than those of open group.Conclusion:The trauma degree of para-median minimally invasive TLIF for single segmental lumbar degenerative disease is less and the postoperative spinal cord function recovery is more ideal.

  17. Sex differences in subjective and objective measures of pain, functional impairment, and health-related quality of life in patients with lumbar degenerative disc disease.

    Science.gov (United States)

    Gautschi, Oliver P; Corniola, Marco V; Smoll, Nicolas R; Joswig, Holger; Schaller, Karl; Hildebrandt, Gerhard; Stienen, Martin N

    2016-05-01

    Sex differences in pain perception are known to exist; however, the exact pathomechanism remains unclear. This work aims to elucidate sex differences in subjective and objective measures of pain, functional impairment, and health-related quality of life (HRQoL) in patients with lumbar degenerative disc disease. In a prospective 2-center study, back and leg pain (visual analogue scale [VAS]), functional disability (Oswestry Disability Index and Roland-Morris Disability Index), and HRQoL (EuroQol-5D and Short Form [SF12]) were collected for consecutive patients undergoing lumbar spine surgery. Objective functional impairment (OFI) was estimated using age-adjusted and sex-adjusted cutoff values for the timed-up-and-go (TUG) test. A healthy cohort of n = 110 subjects served as the control group. Univariate and multivariate analyses were performed to test the association between sex and pain, subjective and OFIs, and HRQoL. The study comprised n = 305 patients (41.6% females). Female patients had more VAS back pain (P = 0.002) and leg pain (P = 0.014). They were more likely to report higher functional impairment in terms of Oswestry Disability Index (P = 0.005). Similarly, HRQoL measured with the EuroQol-5D index (P = 0.012) and SF12 physical composite score (P = 0.005) was lower in female patients. Female patients reported higher VAS back and leg pain, functional impairment, and reduced HRQoL than male patients. However, there were no sex differences with respect to the presence and degree of OFI measured by the TUG test using age-adjusted and sex-adjusted cutoff values. As such, the TUG may be a good test to overcome sex bias for the clinical assessment of patients with degenerative disc disease. PMID:26761383

  18. Can combined use of low-level lasers and hyaluronic acid injections prolong the longevity of degenerative knee joints?

    Directory of Open Access Journals (Sweden)

    Ip D

    2015-08-01

    Full Text Available David Ip, Nga Yue FuAsia Medical Pain Centre, Grand Plaza, Mong Kok, Hong KongBackground: This study evaluated whether half-yearly hyaluronic acid injection together with low-level laser therapy in addition to standard conventional physical therapy can successfully postpone the need for joint replacement surgery in elderly patients with bilateral symptomatic tricompartmental knee arthritis.Methods: In this prospective, double-blind, placebo-controlled study, 70 consecutive unselected elderly patients with bilateral tricompartmental knee arthritis were assigned at random to either one of two conservative treatment protocols to either one of the painful knees. Protocol A consisted of conventional physical therapy plus a sham light source plus saline injection, and protocol B consisted of protocol A with addition of half-yearly hyaluronic acid injection as well as low-level laser treatment instead of using saline and a sham light source. Treatment failure was defined as breakthrough pain necessitating joint replacement.Results: Among the 140 painful knees treated with either protocol A or protocol B, only one of the 70 painful knees treated by protocol B required joint replacement, whereas 15 of the 70 painful knees treated by protocol A needed joint replacement surgery (P<0.05.Conclusion: We conclude that half-yearly hyaluronic acid injections together with low-level laser therapy should be incorporated into the standard conservative treatment protocol for symptomatic knee arthritis, because it may prolong the longevity of the knee joint without the need for joint replacement.Keywords: knee osteoarthritis, hyaluronic acid injection, low-level laser, outcome

  19. Contralateral interlaminar approach for intraforaminal lumbar degenerative disease with special emphasis on L5-S1 level: A technical note

    Science.gov (United States)

    Zekaj, Edvin; Menghetti, Claudia; Saleh, Christian; Isidori, Alessandra; Bona, Alberto R.; Aimar, Enrico; Servello, Domenico

    2016-01-01

    Background: Intraforaminal disc herniations at the L5-S1 level are extremely surgically challenging lesions. Intracanal approaches frequently require partial or total facetectomy, which may lead to instability. Solely extraforaminal approaches may offer limited visualization of the more medial superiorly exiting and inferiorly exiting nerve roots; this approach is also more complicated at L5-S1 due to the often large L5 transverse process and the iliac wing. Methods: Nine patients with intraforaminal L5-S1 disc herniations, foraminal stenosis, or synovial cysts underwent contralateral interlaminar approaches for lesion resection. Preoperative and postoperative visual analog scale scores were evaluated, and complications were reviewed. Results: All 9 patients demonstrated immediate postoperative clinical improvement. None of the patients exhibited complications and none developed instability or neuropathic disorders. Conclusions: Although the number of cases in our sample was very small (9 in total), the contralateral interlaminar approach appeared to effectively address multiple degenerative L5-S1 foraminal pathologies. Large studies are needed to further evaluate the pros and cons of this approach. PMID:27713854

  20. Clinical Effect of Joint Replacement in the Treatment of Elderly Patients with Knee OsteoarthritisSenile degenerative osteoarthritis of knee joint line treatment the clinical effect of analysis of joint replacement%关节置换术治疗老年膝关节退行性骨关节炎患者的临床疗效

    Institute of Scientific and Technical Information of China (English)

    张冠东

    2015-01-01

    目的:探讨关节置换术治疗老年膝关节退行性骨关节炎患者的临床疗效。方法选取2012年6月至2014年5月阜新市中医医院收治的52例老年膝关节退行性骨关节炎患者作为研究对象,所有患者均行膝关节置换术。术后6个月,比较患者术前、术后的骨性关节炎指数评分(WOMAC)评分、日常生活能力量表(ADL)评分。结果患者术后WOMAC评分为(5.1±2.1)分,明显低于手术前的(9.4±1.5)分,差异有统计学意义(χ2=6.362,P<0.05);术后患者的完全依赖率明显低于术前,轻度依赖、中度依赖率均明显高于术前,差异均有统计学意义(均P<0.05)。结论关节置换术治疗老年膝关节退行性骨关节炎临床疗效明显,可有效改善患者的关节功能、活动度,提高生活能力。%Objective To explore the clinical effect of the treatment of knee joint replacement in elderly patients with knee osteoarthritisto explore the senile degenerative osteoarthritis of knee joint line of the clinical curative effect of joint replacement therapy.Methods From June 2012 to May 2014,52 cases of elderly patients with knee osteo- arthritis were treated as the research object,and al patients underwent knee joint replacement.6 months after surgery, compared with preoperative and postoperative Osteoarthritis Index (WOMAC)score,daily life ability scale(ADL) scor- eselect our hospital from June 2012 to May 2014 were 52 patients with senile degenerative osteoarthritis of knee joint as the research object, this group of patients in our hospital line joint replacement, compare the treatment of patients with preoperative and postoperative effect.Results Postoperative WOMAC score was(5.1±2.1)points,significantly lower than before surgery(9.4±1.5)points,the diference was statisticaly significant(χ2=6.362,P<0.05);totaly dependent on the rate of patients was significantly lower before surgery,mild dependence

  1. Radiotherapy of degenerative joint disorders. Indication, technique and clinical results; Radiotherapie bei schmerzhaften degenerativ-entzuendlichen Gelenkerkrankungen. Indikation, Technik und klinische Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Keilholz, L.; Sauer, R. [Erlangen-Nuernberg Univ. (Germany). Strahlentherapeutische Klinik und Poliklinik; Seegenschmiedt, M.H. [Erlangen-Nuernberg Univ. (Germany). Strahlentherapeutische Klinik und Poliklinik]|[Alfred-Krupp-Krankenhaus, Essen (Germany). Klinik fuer Strahlentherapie und Radioonkologie

    1998-05-01

    From 1984 to 1994, 85 patients with painful osteoarthritis were treated. The mean follow-up was 4 (1 to 10) years. Seventy-three patients (103 joints) were available for long-term analysis: 17 patients (27 joints) with omarthrosis, 19 (20 joints) with rhizarthrosis, 31 (49 joints) with osteoarthritis of the knee and 6 patients (7 joints) with osteoarthritis of the hip. All patients were intensively pretreated over long time. Mean symptom duration prior to radiotherapy was 4 (1 to 10) years. Orthovoltage or linac photons were applied using some technical modifications depending upon the joint. Two radiotherapy series (6 x 1 Gy, total dose: 12 Gy, 3 weekly fractions) were prescribed. The interval between the 2 series was 6 weeks. The subjective pain profil was assessed prior to and 6 months after radiotherapy and at last follow-up. Forty-six (63%) patients (64 joints) achieved a reduction of pain symptoms; 16 of those had a `major pain relief` and 14 `complete pain relief`. Large joints - knee and hip - responded better (64% each) than the rhizarthrosis (53%). All pain categories and grades and their combined pain score were significantly reduced. The pain reduction was mostly pronounced for the symptom `pain at rest`. The orthopedic score correlated well with the subjective response of the patients. The thumb score improved in 11 (57%) joints, the shoulder score of Constant and Murley in 16 (59%), the Japonese knee score of Sasaki et al. in 33 (67%), the hip score of Harris in 5 (71%) joints. Only 9 of 19 patients which were treated to avoid surgery, had to be operated, and 3 of those received a total arthroplasty of the hip or knee. In multivariate analysis for the endpoint `complete` or `major pain relief` only the criterion `symptom duration {>=}2 years prior to radiotherapy` was an independent negative prognostic parameter. (orig./MG) [Deutsch] Von 1984 bis 1994 wurden 85 Patienten wegen schmerzhaft arthrotischer Gelenkerkrankungen bestrahlt. 73 Patienten (103

  2. Amyloid ß-derived switch-peptides as tool to study conformational changes relevant in degenerative diseases

    OpenAIRE

    Camus, Marie-Stéphanie; Mutter, Manfred

    2008-01-01

    The rapid growing number of patients diagnosed with a neurodegenerative disease and more particularly with Alzheimer's disease (AD) has stimulated intensive research in determining and understanding biological phenomena causing such devastating diseases and hence allowing for the elaboration of adapted therapeutic treatments. These diseases are also commonly called "conformational" diseases because they result from the misfolding of a protein leading to the formation of self-associated β-shee...

  3. Effect of complications within 90 days on patient-reported outcomes 3 months and 12 months following elective surgery for lumbar degenerative disease.

    Science.gov (United States)

    Chotai, Silky; Parker, Scott L; Sivaganesan, Ahilan; Sielatycki, J Alex; Asher, Anthony L; McGirt, Matthew J; Devin, Clinton J

    2015-12-01

    OBJECT There is a paradigm shift toward rewarding providers for quality rather than volume. Complications appear to occur at a fairly consistent frequency in large aggregate data sets. Understanding how complications affect long-term patient-reported outcomes (PROs) following degenerative lumbar surgery is vital. The authors hypothesized that 90-day complications would adversely affect long-term PROs. METHODS Nine hundred six consecutive patients undergoing elective surgery for degenerative lumbar disease over a period of 4 years were enrolled into a prospective longitudinal registry. The following PROs were recorded at baseline and 12-month follow-up: Oswestry Disability Index (ODI) score, numeric rating scales for back and leg pain, quality of life (EQ-5D scores), general physical and mental health (SF-12 Physical Component Summary [PCS] and Mental Component Summary [MCS] scores) and responses to the North American Spine Society (NASS) satisfaction questionnaire. Previously published minimum clinically important difference (MCID) threshold were used to define meaningful improvement. Complications were divided into major (surgicalsite infection, hardware failure, new neurological deficit, pulmonary embolism, hematoma and myocardial infarction) and minor (urinary tract infection, pneumonia, and deep venous thrombosis). RESULTS Complications developed within 90 days of surgery in 13% (118) of the patients (major in 12% [108] and minor in 8% [68]). The mean improvement in ODI scores, EQ-5D scores, SF-12 PCS scores, and satisfaction at 3 months after surgery was significantly less in the patients with complications than in those who did not have major complications (ODI: 13.5 ± 21.2 vs 21.7 ± 19, lumbar spine surgery have significant impact on the short-term PROs. Patients with complications, however, do eventually achieve clinically meaningful outcomes and report satisfaction equivalent to those without major complications. This information allows a physician to

  4. Non-invasive investigation in patients with inflammatory joint disease

    Institute of Scientific and Technical Information of China (English)

    Elisabetta Dal Pont; Renata DТncá; Antonino Caruso; Giacomo Carlo Sturniolo

    2009-01-01

    Gut inflammation can occur in 30%-60% of patients with spondyloarthropathies. However, the presence of such gut inflammation is underestimated, only 27% of patients with histological evidence of gut inflammation have intestinal symptoms, but subclinical gut inflammation is documented in two-thirds of patients with inflammatory joint disease. There are common genetic and immunological mechanisms behind concomitant inflammation in the joints and intestinal tract. A number of blood tests, e.g. erythrocyte sedimentation rate, orosomucoid, C-reactive protein, and white cell and platelet counts, are probably the most commonly used laboratory markers of inflammatory disease, however, these tests are difficult to interpret in arthropathies associated with gut inflammation, since any increases in their blood levels might be attributable to either the joint disease or to gut inflammation. Consequently, it would be useful to have a marker capable of separately identifying gut inflammation. Fecal proteins, which are indirect markers of neutrophil migration in the gut wall, and intestinal permeability, seem to be ideal for monitoring intestinal inflammation:they are easy to measure non-invasively and are specific for intestinal disease in the absence of gastrointestinal infections.Alongside the traditional markers for characterizing intestinal inflammation, there are also antibodies, in all probability generated by the immune response to microbial antigens and auto-antigens, which have proved useful in establishing the diagnosis and assessing the severity of the condition, as well as the prognosis and the risk of complications. In short, noninvasive investigations on the gut in patients with rheumatic disease may be useful in clinical practice for a preliminary assessment of patients with suspected intestinal disease.

  5. Management of sacroiliac joint disruption and degenerative sacroiliitis with nonoperative care is medical resource-intensive and costly in a United States commercial payer population

    OpenAIRE

    Ackerman SJ; Polly Jr DW; Knight T; Holt T; Cummings J

    2014-01-01

    Stacey J Ackerman,1 David W Polly Jr,2 Tyler Knight,3 Tim Holt,4 John Cummings5 1Covance Market Access Services Inc, San Diego, CA, USA; 2University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, USA; 3Covance Market Access Services Inc, Gaithersburg, MD, USA; 4Montgomery Spine Center, Orthopaedic Surgery, Montgomery, AL, USA; 5Community Health Network, Neurosurgery, Indianapolis, IN, USA Introduction: Low back pain is common and originates in the sacroiliac (SI) joint in 15%–...

  6. Clinical research of surgical treatment of degenerative lumbar spinal stenosis disease%退变性腰椎管狭窄手术治疗的临床研究

    Institute of Scientific and Technical Information of China (English)

    胡祥怀; 高宏斌; 徐宏光

    2011-01-01

    Objective To analyze and summarize surgical indications, operation methods selection and complications of treatment in degenerative lumbar spinal stenosis disease (LSS) . Methods Totally 32 cases with lumbar spinal stenosis merger instability lumbar degenerative spondylolisthesis choose omni -posterior excision, side fossae and intervertebral foramen decompression, vertebral pedicle screw, small joints between vertebral bodies and the poster lateral using bone graft, follow - up and evluat operation effect. Results All cases were followed up for 8 months to 6 years. The results were evaluated in accordance with the standard of Amundsen, which were excellent in 21 cases, good in 8, fair in 3, no difference magnitude cases. Conclusions According to the clinical symptoms, signs and considering its diagnostic imaging and its complications to choose the scope and surgical decompression of bone fusion and (or) inside fixed or not, so as to improve the clinical symptoms, improve their quality of life.%目的 探讨退变性腰椎管狭窄症(ISS)手术指征、手术方式的选择及合并症的处理.方法 对32例腰椎管狭窄合并不稳定性腰椎退变性滑脱选择全椎板切除、侧隐窝及椎间孔减压、椎弓根螺钉固定、椎体间及小关节后外侧植骨术,术后随访,评价手术效果.结果 32例均获随访,时间8个月~6年.采用参照Amundsen评分标准评价术后疗效,优21例,良8例,可3例,无差级病例.结论 根据患者的临床症状、体征及影像学综合考虑其诊断及其合并症来选择手术减压的范围和植骨融合和(或)内固定与否,从而改善临床症状,提高其生活质量.

  7. 腰椎退行性疾病椎旁肌的渐进变化%Change of paravertebral muscle in patients with lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    乔培柳; 塔依尔·阿不都哈德尔

    2014-01-01

    BACKGROUND:Lumbar paravertebral muscles play an important role for lumbar spinal stability. Increasing studies emphasize on the change of paravertebral muscles in patients with lumbar degenerative disease and therefore have important clinical significance for the rehabilitation training of paravertebral muscle in patients with lumbar degenerative disease. OBJECTIVE:To review the research progress of the change of paravertebral muscle in patients with lumbar degenerative disease and to look into the future development prospects. METHODS:A computer-based online search of PubMed and WANFANG DATA between 1986 and 2014 was performed with the key words“lumbar vertebra, paravertebral muscle, psoas major, multifidus muscle, cross sectional area, muscle atrophy, fatty infiltration, muscle biopsy, MRI, electromyography”in English and Chinese, respectively. The clinical and experimental studies addressing the changes of paravertebral muscle in patients with lumbar degenerative disease were included. According to the inclusion and exclusion criteria, 48 literatures were included into the final analysis, 8 Chinese and 40 English. RESULTS AND CONCLUSION:The change of paravertebral muscle in patients with lumbar degenerative disease includes muscle atrophy and fatty infiltration. The changes of paravertebral muscles are often detected with B-ultrasound, CT, MRI, EMG and muscle biopsy. Due to the differences of sample size, age and study method, there are different results, even conflicting. So some limitations of sample size, age and study method are needed to obtain accurate results. In addition, further studies wil focus on the verification of which nerve specifical y dominants lumbar paravertebral muscles.%背景:腰部椎旁肌对于腰椎稳定具有重要作用,关于腰椎退行性疾病患者椎旁肌改变的研究越来越多,此类研究对于腰椎椎旁肌康复训练具有重要临床意义。  目的:综述腰椎退行性疾病椎旁肌变化的

  8. Jacob's disease associated with temporomandibular joint dysfunction: a case report.

    Science.gov (United States)

    Capote, Ana; Rodríguez, Francisco J; Blasco, Ana; Muñoz, Mario F

    2005-01-01

    Jacob's disease is regarded a rare condition in which a joint formation is established between an enlarged mandibular coronoid process and the inner aspect of the zygomatic body. Chronic temporomandibular joint (TMJ) disk displacement has been proposed as etiological factor of coronoid process enlargement. We present a 23-year-old woman with long-standing TMJ dysfunction and restricted interincisal opening, who developed a progressive zygomatic asymmetry. The patient underwent treatment by intraoral coronoidectomy and homolateral TMJ arthroscopy in the same surgery. The histopathological diagnosis of the coronoid sample was cartilage-capped exostoses with presence of articular fibrous cartilage. Although the low prevalence of this entity, it should be considered as a possible diagnosis in patients with progressive limitation of mouth opening, although a TMJ syndrome may be present as a cause of this entity.

  9. Co-ordinated research project on application of nuclear techniques in the prevention of degenerative diseases (obesity and non-insulin dependent diabetes) in ageing

    International Nuclear Information System (INIS)

    In the developed countries, research using nuclear methods has been substantially used to examine the physiological and biochemical mechanisms involved in obesity-related diseases. This Co-ordinated Research Project (CRP) is intended to promote the use of these techniques in the developing world. The specific objectives of this CRP are: 1. To define the magnitude of the obesity/NIDDM problem in developing countries. 2. To identify vulnerable groups at high risk. 3. To describe the metabolic mechanisms involved. The purpose of this first Research Co-ordination Meeting (RCM) was thus to develop a worldwide collaboration in the use of nuclear and isotopic techniques to investigate the aetiology of degenerative diseases in ageing. All countries participating in this CRP are going through the epidemiological transition with changes in lifestyles to approach those seen in the developed nations. This first meeting was held in the Agency's headquarters in Vienna, with participation of contract and agreement holders, experts, observer, and in-house staff

  10. 椎间盘退行性疾病生物治疗研究的进展%Advances in biotherapies for the treatment of degenerative disc diseases

    Institute of Scientific and Technical Information of China (English)

    何守玉; 邱勇

    2013-01-01

    Degenerative disc disease ( DDD ) is one of the leading causes of low back pain in the adult population, and the surgical treatment is known as the gold standard for such diseases. A large percentage of patients are relieved after undergoing disc resection and spinal fusion. Older patients who are easily to suffer from DDDs have limited tolerance of the surgical treatment. And meanwhile, there are some surgical risks and complications. In some researches, it is found that DDDs occur when the cells of intervertebral disc die or become dysfunctional. Therefore, there is a great clinical need for biotherapies to alleviate pain associated with DDDs. In the past decade, the number of treatment methods for DDDs has dramatically increased due to the advances in biologicals and biomaterials and the deepened understanding of the spinal physiology and pathology. In this article, advances in biotherapies used for treating DDDs in recent years are mainly reviewed, including cell therapy, bioactive factor therapy, gene therapy and the technique of intervertebral disc tissue engineering scaffold. As some of these methods are still in experimental phases, defects and limitations of each biotherapy are noted in this review. Finally, the research direction and challenge of biotherapies for the treatment of DDDs in the next few years are proposed.

  11. 改良TLIF治疗腰椎退变性疾病%Modified transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    荣树; 马兆钦

    2011-01-01

    目的 探讨改良TLIF治疗腰椎退变性疾病的疗效.方法 用改良TLIF手术治疗L~S退变性疾病患者24例,共融合40个节段,其中单节段8例,双节段16例.男14例,女lO例;年龄56~78岁,平均64.6岁.退变性滑脱伴椎管狭窄6例,峡不连性滑脱4例,退变性腰椎管狭窄症10例,巨大椎间盘脱出合并椎间失稳4例.术中根据病情需要,采用椎管扩大减压后切除整个下关节突,切除上关节突上部的内侧半,部分开放椎间孔后壁,椎间隙自体微粒骨打压植骨,Cage斜向中线40.方向植入椎间隙,辅以椎弓根螺钉固定完成改良TLIF.结果 术中无并发症发生,24例均获得随访,时间12~20个月,平均17.4个月.所有患者于术后1年随访时均达椎体间融合,无螺钉断裂和Cage移位、沉陷.10例腰椎滑脱者滑脱完全复位并维持良好.根据JOA评分法,本组术前(13.8±4.1)分,末次随访时(24.9±3.0)分,临床改善程度达优16例,良6例,可2例,平均改善率79.5%.结论 改良TLIF扩大了手术适应证,贯彻了TLIF技术的设计思想和微创理念,使操作更加简单、安全,用于下腰椎退变性疾患的治疗效果满意.%Objective To analyze the clinical effects Of modified transforaminal lumbar interbody fusion (TLIF)for the treatment of lumbar degenerative disease. Mothods 24 patients with lumbar degenerative disease (L3-S1) were treated by modified TLIF. There were 14 males and 10 females with an average age of 64.6years(56~78years). A total of 40 levels were fused, including 8 cases of single level and 16 cases of double levels. The results of preoperative diagnosis were lumbar degenerative spondylolisthesis with stenosis (6cases), isthmic spondylolisthesis (4cases), degenerative lumbar stenosis (10cases), huge herniated disc with segmental instability (4cases). During the modified TLIF procedure, total inferior facet process and inner half summit of superior facet process of TLIF side were resected to make the

  12. Degenerative Suspensory Ligament Desmitis – A New Reality

    Directory of Open Access Journals (Sweden)

    Jaroslava Halper*, Ahrar Khan1 and P. O. Eric Mueller2

    2011-01-01

    Full Text Available Degenerative suspensory ligament desmitis (DSLD is a chronic, debilitating disease occurring primarily in Peruvian Pasos and Peruvian Paso crosses. However, many other breeds are afflicted as well. DSLD is characterized by a slowly progressing bilateral or quadrilateral lameness. Typically, the owner does not recall any trauma or performance related injury. Fetlock effusion, static and dynamic hyperextension and degenerative joint disease are hallmarks on physical examination. Ultrasonography of affected ligaments reveals diffuse loss of echogenicity, and an irregular fiber pattern. Though until recently DSLD was considered a collagen disorder strictly limited to suspensory ligaments (SLs, our data show that it is a systemic disease involving tissues with high content of collagen. We have identified abnormal accumulations of proteoglycans not only in the SLs, but also in the superficial and deep digital flexor tendons, patellar and nuchal ligaments, aorta, coronary arteries and sclerae of DSLD-affected horses. Our most recent data point to the presence of an abnormal form of decorin in these proteoglycan deposits. This decorin also exhibited altered biological activity. Treatment for DSLD-affected horses is empirical and directed at minimizing musculoskeletal pain and providing support for the suspensory apparatus. Restricted exercise, supportive bandages and nonsteroidal anti-inflammatory drugs provide some, but usually only temporary relief. Unfortunately, unrelenting pain, severe lameness and suffering require all too often humane euthanasia.

  13. Surgical treatment of degenerative lumbar spine diseases in elderly patients%高龄患者腰椎退变性疾病的手术治疗

    Institute of Scientific and Technical Information of China (English)

    苏庆军; 刘铁; 康南; 杨晋才; 藏磊; 孟祥龙; 袁帅; 海涌

    2013-01-01

    Objective To investigate the safety and clinical effects of surgical treatment of degenerative lumbar spine diseases in elderly patients. Methods 42 patients with degenerative lumbar spine diseases who were enrolled from January 2008 to December 2011 selectively underwent surgical treatment, including 6 patients with lumbar disc herniation, 10 patients with lumbar disc herniation and spinal stenosis, 6 patients with degenerative lumbar spondylolisthesis and 20 patients with spinal stenosis. There were 28 males and 14 females, with an average age of 77.2 years old ( range;75-84 years ). They were followed up for a mean period of 31 months ( range;17-64 months ). The preoperative concomitant diseases, postoperative complications and relevant treatment methods were analyzed. The clinical effects were evaluated by the Oswestry Disability Index ( ODI ) and the Visual Analogue Scale ( VAS ). Based on the anteroposterior ( AP ), lateral and dynamic X-ray iflms of the lumbar spine during the follow-up, the lumbar spinal stability, lumbar spinal fusion and implants were observed after the surgery. Results The postoperative complications included 7 cases of increased blood pressure, 1 case of angina, 1 case of cerebral infarction, 4 cases of pulmonary infection and 3 cases of cerebrospinal lfuid leakage. Operational segment instability or internal ifxation failure was not found based on the X-ray films 1 year after the surgery or in the latest follow-up. The ODI was improved from ( 71.1±19.2 )%preoperatively to ( 22.0±11.3 )%postoperatively ( P<0.01 ). The VAS of low back pain was improved from ( 6.0±2.1 ) preoperatively to ( 2.2±1.7 ) postoperatively ( P<0.01 ). The VAS of lower leg pain was improved from ( 7.9±1.7 ) to ( 3.1±2.1 ) ( P<0.01 ). 39 of 42 patients got satisifed results, and the other 3 patients were basically content with the results. Conclusions With the concomitant diseases and postoperative complications actively controlled, elderly patients with

  14. Measurement of Intervertebral Motion Using Quantitative Fluoroscopy: Report of an International Forum and Proposal for Use in the Assessment of Degenerative Disc Disease in the Lumbar Spine

    Directory of Open Access Journals (Sweden)

    Alan C. Breen

    2012-01-01

    Full Text Available Quantitative fluoroscopy (QF is an emerging technology for measuring intervertebral motion patterns to investigate problem back pain and degenerative disc disease. This International Forum was a networking event of three research groups (UK, US, Hong Kong, over three days in San Francisco in August 2009. Its aim was to reach a consensus on how best to record, analyse, and communicate QF information for research and clinical purposes. The Forum recommended that images should be acquired during regular trunk motion that is controlled for velocity and range, in order to minimise externally imposed variability as well as to correlate intervertebral motion with trunk motion. This should be done in both the recumbent passive and weight bearing active patient configurations. The main recommended outputs from QF were the true ranges of intervertebral rotation and translation, neutral zone laxity and the consistency of shape of the motion patterns. The main clinical research priority should initially be to investigate the possibility of mechanical subgroups of patients with chronic, nonspecific low back pain by comparing their intervertebral motion patterns with those of matched healthy controls.

  15. Segmental mobility, disc height and patient-reported outcomes after surgery for degenerative disc disease: a prospective randomised trial comparing disc replacement and multidisciplinary rehabilitation.

    Science.gov (United States)

    Johnsen, L G; Brinckmann, P; Hellum, C; Rossvoll, I; Leivseth, G

    2013-01-01

    This prospective multicentre study was undertaken to determine segmental movement, disc height and sagittal alignment after total disc replacement (TDR) in the lumbosacral spine and to assess the correlation of biomechanical properties to clinical outcomes.A total of 173 patients with degenerative disc disease and low back pain for more than one year were randomised to receive either TDR or multidisciplinary rehabilitation (MDR). Segmental movement in the sagittal plane and disc height were measured using distortion compensated roentgen analysis (DCRA) comparing radiographs in active flexion and extension. Correlation analysis between the range of movement or disc height and patient-reported outcomes was performed in both groups. After two years, no significant change in movement in the sagittal plane was found in segments with TDR or between the two treatment groups. It remained the same or increased slightly in untreated segments in the TDR group and in this group there was a significant increase in disc height in the operated segments. There was no correlation between segmental movement or disc height and patient-reported outcomes in either group.In this study, insertion of an intervertebral disc prosthesis TDR did not increase movement in the sagittal plane and segmental movement did not correlate with patient-reported outcomes. This suggests that in the lumbar spine the movement preserving properties of TDR are not major determinants of clinical outcomes.

  16. Posterior Transpedicular Dynamic Stabilization versus Total Disc Replacement in the Treatment of Lumbar Painful Degenerative Disc Disease: A Comparison of Clinical Results

    Directory of Open Access Journals (Sweden)

    Tunc Oktenoglu

    2013-01-01

    Full Text Available Study Design. Prospective clinical study. Objective. This study compares the clinical results of anterior lumbar total disc replacement and posterior transpedicular dynamic stabilization in the treatment of degenerative disc disease. Summary and Background Data. Over the last two decades, both techniques have emerged as alternative treatment options to fusion surgery. Methods. This study was conducted between 2004 and 2010 with a total of 50 patients (25 in each group. The mean age of the patients in total disc prosthesis group was 37,32 years. The mean age of the patients in posterior dynamic transpedicular stabilization was 43,08. Clinical (VAS and Oswestry and radiological evaluations (lumbar lordosis and segmental lordosis angles of the patients were carried out prior to the operation and 3, 12, and 24 months after the operation. We compared the average duration of surgery, blood loss during the surgery and the length of hospital stay of both groups. Results. Both techniques offered significant improvements in clinical parameters. There was no significant change in radiologic evaluations after the surgery for both techniques. Conclusion. Both dynamic systems provided spine stability. However, the posterior dynamic system had a slight advantage over anterior disc prosthesis because of its convenient application and fewer possible complications.

  17. Degenerative diseases of the cervical spine: comparison of a multiecho data image combination sequence with a magnetisation transfer saturation pulse and cervical myelography and CT

    Energy Technology Data Exchange (ETDEWEB)

    Dorenbeck, U. [Department of Neuroradiology, University Hospital of the Saarland, 66421, Homburg (Germany); Department of Diagnostic Radiology, University Hospital of Regensburg, Franz-Josef-Strauss Allee 11, 93042, Regensburg (Germany); Schreyer, A.G.; Held, P.; Feuerbach, S.; Seitz, J. [Department of Diagnostic Radiology, University Hospital of Regensburg, Franz-Josef-Strauss Allee 11, 93042, Regensburg (Germany); Schlaier, J. [Department of Neurosurgery, University Hospital of Regensburg, Franz-Josef-Strauss Allee 11, 93042, Regensburg (Germany)

    2004-04-01

    Assessing degenerative disease in the cervical spine remains a challenge. There is much controversy about imaging the cervical spine using MRI. Our aim in this prospective study was to compare a T2*-weighted 2D spoiled gradient-echo multiecho sequence (MEDIC) with a magnetisation transfer saturation pulse with cervical myelography and postmyelographic CT. Using an assessment scale we looked at the vertebral bodies, intervertebral discs, neural foramina, anterior and posterior nerve roots, grey matter, ligamenta flava, oedema in the spinal cord and stenosis of the spinal canal. We also evaluated postmyelography CT and the MEDIC sequence for assessing narrowing of the neural foramina in a cadaver cervical spine. We examined 67 disc levels in 18 patients, showing 18 disc prolapses and 21 osteophytes narrowing the spinal canal or the neural foramina. All MRI studies showed these abnormalities findings equally well. Postmyelography CT was significantly better for showing the bony structures and the anterior and posterior nerve roots. The MEDIC sequence provided excellent demonstration of soft-tissue structures such as the intervertebral disc and ligamentum flavum. No statistical differences between the imaging modalities were found in the assessment of narrowing of the neural foramina or the extent of spinal stenosis. The cadaver measurements showed no overestimation of abnormalities using the MEDIC sequence. (orig.)

  18. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 14: brace therapy as an adjunct to or substitute for lumbar fusion.

    Science.gov (United States)

    Dailey, Andrew T; Ghogawala, Zoher; Choudhri, Tanvir F; Watters, William C; Resnick, Daniel K; Sharan, Alok; Eck, Jason C; Mummaneni, Praveen V; Wang, Jeffrey C; Groff, Michael W; Dhall, Sanjay S; Kaiser, Michael G

    2014-07-01

    The utilization of orthotic devices for lumbar degenerative disease has been justified from both a prognostic and therapeutic perspective. As a prognostic tool, bracing is applied prior to surgery to determine if immobilization of the spine leads to symptomatic relief and thus justify the performance of a fusion. Since bracing does not eliminate motion, the validity of this assumption is questionable. Only one low-level study has investigated the predictive value of bracing prior to surgery. No correlation between response to bracing and fusion outcome was observed; therefore a trial of preoperative bracing is not recommended. Based on low-level evidence, the use of bracing is not recommended for the prevention of low-back pain in a general working population, since the incidence of low-back pain and impact on productivity were not reduced. However, in laborers with a history of back pain, a positive impact on lost workdays was observed when bracing was applied. Bracing is recommended as an option for treatment of subacute low-back pain, as several higher-level studies have demonstrated an improvement in pain scores and function. The use of bracing following instrumented posterolateral fusion, however, is not recommended, since equivalent outcomes have been demonstrated with or without the application of a brace.

  19. Clinical Treatment Of Degenerative Disc Disease%关于椎间盘退变性疾病的手术治疗

    Institute of Scientific and Technical Information of China (English)

    闫国良; 钱济先

    2013-01-01

    椎间盘退变性疾病(degenerative disc disease,DDD)是脊柱外科最常见的疾病之一,数十年来,融合手术一直是治疗的金标准,但对其随访结果仍存在争论,一些前瞻性试验显示效果优于常规的保守治疗,而别一些则相反.由于存在对融合术的有效性和在邻近节段可能引起的退变的争议,多种非融合技术逐渐发展起来.本文的目的是对目前临床上针对椎间盘退变性疾病开展的手术治疗方案作一综述,为医师选择手术方案提供一定的依据.

  20. Antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease: a cost effectiveness analysis

    NARCIS (Netherlands)

    P. Krijnen (Pieta); C.J. Kaandorp; E.W. Steyerberg (Ewout); D. van Schaardenburg (Dirkjan); H.J. Moens; J.D.F. Habbema (Dik)

    2001-01-01

    textabstractOBJECTIVE: To assess the cost effectiveness of antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease. METHODS: In a decision analysis, data from a prospective study on bacterial arthritis in 4907 patients with joint dise

  1. Degenerative alterations of the cementum-periodontal ligament complex and early tooth loss in a young patient with periodontal disease.

    Science.gov (United States)

    Petruţiu, S A; Buiga, Petronela; Roman, Alexandra; Danciu, Theodora; Mihu, Carmen Mihaela; Mihu, D

    2012-01-01

    Premature exfoliation of primary or permanent teeth in children or adolescents is extremely rare and it can be a manifestation of an underlying systemic disease. This study aims to present the histological aspects associated with early tooth loss in a case of periodontal disease developed without local inflammation and with minimal periodontal pockets and attachment loss. The maxillary left second premolar was extracted together with a gingival collar attached to the root surface. The histological analysis recorded the resorption of the cementum in multiple areas of the entire root surface with the connective tissue of the desmodontium invading the lacunae defects. The connective tissue rich in cells occupied the periodontal ligamentar space and the resorptive areas. No inflammation was obvious in the periodontal ligament connective tissue. This report may warn clinicians about the possibility of the association of cemental abnormalities with early tooth loss.

  2. Oleuropein Aglycone: A Possible Drug against Degenerative Conditions. In Vivo Evidence of its Effectiveness against Alzheimer's Disease

    OpenAIRE

    Casamenti F; Grossi C.; Rigacci S; Pantano D; Luccarini I; Stefani M

    2015-01-01

    The amyloid plaques and neurofibrillary tangles found in the Alzheimer's disease (AD) brain arise as a result of self-assembly into fibrillar material of amyloid-β protein (Aβ) and hyperphosphorylated tau, respectively, through a pathological process starting with the appearance of aggregation nuclei and neurotoxic oligomers. Accordingly, the search of inhibitors of oligomer nucleation and growth is considered a promising target to prevent amyloid toxicity. In recent years, a number of dietar...

  3. ROLE OF NEEDLE SYNOVIAL BIOPSY IN JOINT DISEASES

    Directory of Open Access Journals (Sweden)

    Venkataraman

    2015-05-01

    Full Text Available J oint disease is a common problem affecting all age groups presenting in orthopedic and rheumatology clinics. Diagnostic difficulties are encountered , particularly , in early stages when radiology and blood tests are inconclusive. The role of synovial analysis ( S ynovium and fluid using the Parker Pearson technique was studied in 50 patients with various j oint afflictions. There were 44 cases of monoarthritis and 6 cases of polyarthritis. Synovial fluid could be completely analyzed in 43 out of 50 cases and based on their physical , biochemical and cytological properties they were grouped as – a Non inflammat ory group b Mild to moderate inflammation and c Septic or severe inflammatory group. In this study , there were 6 cases of rheumatoid arthritis , 8 tuberculous arthritis , 16 non - specific synovitis , 4 traumatic arthritis , 4 osteoarthritis , 2 septic arthriti s , 6 normal synovium and one each of gout , villo - nodular synovitis , neuropathic joint and AVN femoral head. With Parker Pearson needle and their technique adequate representative synovial tissue could be obtained for histopathology in 41 out of 50 (82% cases. In the rest 9 cases , it was negative and open biopsy was done t o reach a diagnosis. Closed needle synovial biopsy is a simple , cost effective outpatient procedure and a helpful adjuvant for the diagnosis of joint diseases.

  4. Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage.

    Science.gov (United States)

    Ames, Bruce N

    2006-11-21

    Inadequate dietary intakes of vitamins and minerals are widespread, most likely due to excessive consumption of energy-rich, micronutrient-poor, refined food. Inadequate intakes may result in chronic metabolic disruption, including mitochondrial decay. Deficiencies in many micronutrients cause DNA damage, such as chromosome breaks, in cultured human cells or in vivo. Some of these deficiencies also cause mitochondrial decay with oxidant leakage and cellular aging and are associated with late onset diseases such as cancer. I propose DNA damage and late onset disease are consequences of a triage allocation response to micronutrient scarcity. Episodic shortages of micronutrients were common during evolution. Natural selection favors short-term survival at the expense of long-term health. I hypothesize that short-term survival was achieved by allocating scarce micronutrients by triage, in part through an adjustment of the binding affinity of proteins for required micronutrients. If this hypothesis is correct, micronutrient deficiencies that trigger the triage response would accelerate cancer, aging, and neural decay but would leave critical metabolic functions, such as ATP production, intact. Evidence that micronutrient malnutrition increases late onset diseases, such as cancer, is discussed. A multivitamin-mineral supplement is one low-cost way to ensure intake of the Recommended Dietary Allowance of micronutrients throughout life. PMID:17101959

  5. Correlation between 3D microstructural and 2D histomorphometric properties of subchondral bone with healthy and degenerative cartilage of the knee joint.

    Science.gov (United States)

    Lahm, Andreas; Kasch, Richard; Spank, Heiko; Erggelet, Christoph; Esser, Jan; Merk, Harry; Mrosek, Eike

    2014-11-01

    Cartilage degeneration of the knee joint is considered to be a largely mechanically driven process. We conducted a microstructural and histomorphometric analysis of subchondral bone samples of intact cartilage and in samples with early and higher- grade arthritic degeneration to compare the different states and correlate the findings with the condition of hyaline cartilage. These findings will enable us to evaluate changes in biomechanical properties of subchondral bone during the evolution of arthritic degeneration, for which bone density alone is an insufficient parameter. From a continuous series of 80 patients undergoing implantation of total knee endoprosthesis 30 osteochondral samples with lesions macroscopically classified as ICRS grade 1b (group A) and 30 samples with ICRS grade 3a or 3b lesions (group B) were taken. The bone samples were assessed by 2D histomorphometry (semiautomatic image analysis system) and 3D microstructural analysis (high-resolution micro-CT system). The cartilage was examined using the semiquantitative real-time PCR gene expression of collagen type I and II and aggrecan. Both histomorphometry and microstructural and biomechanical analysis of subchondral bone in groups A and B consistently revealed progressive changes of both bone and cartilage compared with healthy controls. The severity of cartilage degeneration as assessed by RT PCR was significantly correlated with BV/TV (Bone Volume Fraction), Tb.Th (Trabecular Thickness) showed a slight increase. Tb.N (Trabecular Number), Tb.Sp (Trabecular separation) SMI (Structure Model Index), Conn.D (Connectivity Density) and DA (Degree of Anisotropy) were inversely correlated. We saw sclerotic transformation and phagocytic reticulum cells. Bone volume fraction decreased with an increasing distance from the cartilage with the differences compared with healthy controls becoming greater in more advanced cartilage damage. The density of subchondral bone alone is considered an unreliable

  6. Associative learning in degenerative neostriatal disorders: contrasts in explicit and implicit remembering between Parkinson's and Huntington's diseases.

    Science.gov (United States)

    Sprengelmeyer, R; Canavan, A G; Lange, H W; Hömberg, V

    1995-01-01

    The performances of 12 patients with Parkinson's disease (PD), 16 with Huntington's disease (HD), and young and old healthy controls were assessed on a number of tests of verbal and nonverbal declarative memory, on a test of nonmotor conditional associative learning (words and colors), and on a number of reaction time (RT) tasks. The RT tasks consisted of cued simple and choice reactions. The relationship between the precue and the imperative stimulus in the S1-S2 paradigm was nonarbitrary in the first series and arbitrary in the second series. The series with arbitrary S1-S2 associations was repeated across two successive blocks of trials. The rationale of the study was to investigate the function of the basal ganglia "complex loop," and it was postulated that HD patients would show greater deficits because of greater involvement of the caudate nucleus. The patients with HD had the slowest RTs. Across the two blocks with arbitrary S1-S2 associations, the patients with HD but not PD nevertheless showed evidence of learning in their precued RTs. In contrast, the patients with PD were better able to remember the associations in free recall than were the HD patients. It is concluded that patients with PD have relatively greater deficits in procedural learning, whereas those with HD have relatively more impairments in declarative memory, and the greater level of cognitive impairment in HD overall is interpreted as being due to more serious damage to the caudate loop. PMID:7885356

  7. CT-guided ozone/steroid therapy for the treatment of degenerative spinal disease - effect of age, gender, disc pathology and multi-segmental changes

    Energy Technology Data Exchange (ETDEWEB)

    Oder, Bernhard; Loewe, Maria; Reisegger, Michael; Thurnher, Siegfried A. [Hospital Brothers of St. John of God, Department of Radiology and Nuclear Medicine, Vienna (Austria); Lang, Wilfried [Hospital Brothers of St. John of God, Department of Neurology, Vienna (Austria); Ilias, Wilfried [Hospital Brothers of St. John of God, Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Vienna (Austria)

    2008-09-15

    Oxygen-ozone nucleolysis (ONL) is a new, minimally invasive procedure for the treatment of discogenic low back pain with or without radicular symptoms. The aim of the present study was to determine associations between the morphology of the basic disease, patient-specific factors and the outcome of the treatment. Six hundred and twelve patients not responding to conservative therapy were divided into five groups (disc bulging, disc herniation, postoperative patients, osteochondrosis, others) and subjected to nucleolysis with ozone and to periradicular infiltration with steroids and local anaesthesia. The success of treatment was assessed by means of a visual analog pain scale (VAS) and the Oswestry Disability Index (ODI). A significant reduction in the VAS was registered after 2 and 6 months (from 8.6 to 5.4 and 6.0; p<0.001) in all patient groups; an excellent therapy response (VAS below 3.0) was achieved by about a third of the patients. A significant improvement in ODI was registered in all patients (46 to 31; p<0.001), most pronounced in the herniation group (25.5, p=0.015). Patients below 50 years had significantly better values in the VAS and ODI score 6 months after treatment. Final VAS and ODI scores for patients with a single diseased segment were 4.2 and 28.0, in two affected segments 6.5 and 32 and in three segments 6.7 and 38.5 (p<0.001 and p=0.051). ONL with periradicular steroid therapy might exert a functional and sustained analgesic effect in patients with degenerative changes in the lumbar spine not responding to conservative therapy and was most effective below 50 years with disc herniation in one segment. (orig.)

  8. 腰椎退行性疾病的临床疗效评价%Clinical Efficacy Evaluation of Lumbar Degenerative Disease

    Institute of Scientific and Technical Information of China (English)

    李逸峰; 徐宏光

    2011-01-01

    Objective : To find out the scoring standard of lumbar disc degeneration for Chinese people in order to better assist the clinical treatment. Methods : To describe the various score table history at home and abroad , summarize its advantages and disadvantages, as well as its indications. Results : There are many different score tables about lumbar disc degenerative disease, different scoring criteria focus on the different clinical conditions , but there are few authority score tables for Chinese People. Conclusions : An authority scoring standard for Chinese people based on clinical medical records is urgently needed to treat different patients with different diseases.%目的:寻找一种适合国人腰椎退行性疾病患者的评分标准,以更好地协助临床治疗.方法:阐述国内外各种不同评分表的发展史,总结其优缺点及适应证.结果:针对腰椎退行性疾病的疗效,临床上有很多不同的评分标准,不同的评分标准其评价的侧重点不同;但国内的评分标准较少且不够权威.结论:针对不同的病人及病情,选择合适的评分标准;急需针对国内临床病历,总结出一套权威的适合国人的腰椎退变性疾病的评分标准.

  9. Research Process of Treatment of Spinal Degenerative Diseases that Based on Syndrome Differentiation from Liver and Spleen%从肝脾论治脊柱退行性疾病研究进展

    Institute of Scientific and Technical Information of China (English)

    夏梦; 陈少清; 王诗忠

    2015-01-01

    通过检索中国期刊全文数据库(CNKI)、万方数据知识服务平台、维普数据库,外文检索Science Direct、PubMed查找相关近5年的文献资料,并基于“肝主筋,脾主肌肉”的中医理论指导,采用综合分析法论述脊柱退行性疾病的发病机制和研究最新进展。发现肝脾虚对脊柱退行性病变的重要因素均产生不良影响,可促进脊柱退变的发生、发展。通过从肝脾角度探讨脊柱退行性疾病机制,有利于临床从调理肝脾角度治疗脊柱退行性疾病。%Through searching the related literature in recent 5 years by retrieving the CNKI, Wanfang Data knowledge service platform, VIP database and foreign language databases like Science Direct and PubMed, to discuss the pathogenesis and latest process of spinal degenerative diseases with comprehensive analysis. The job has found that the important factors of spinal degenerative diseases can be harmfully affected by deficiency of liver and spleen, which also promotes the occurrence and development of spinal degeneration. Discussing the pathogenesis of spinal degenerative diseases from the perspective of liver and spleen is propitious to the clinical treatment of spinal degenerative diseases with conditioning liver and spleen.

  10. Second research co-ordination meeting for the coordinated research project on 'Application of nuclear techniques in the prevention of degenerative diseases (obesity and non-insulin dependent diseases) in ageing'. Summary report

    International Nuclear Information System (INIS)

    In the developed countries, research using nuclear methods has been substantially used to examine the physiological and biochemical mechanisms involved in obesity-related diseases. This Co-ordinated Research Project (CRP) is intended to promote the use of these techniques in the developing world. The specific objectives of this CRP are: 1. To define the magnitude of the obesity/NIDDM problem in developing countries. 2. To identify vulnerable groups at high risk. 3. To describe the metabolic mechanisms involved. The purpose of this first Research Co-ordination Meeting (RCM) was thus to develop a worldwide collaboration in the use of nuclear and isotopic techniques to investigate the aetiology of degenerative diseases in ageing. All countries participating in this CRP are going through the epidemiological transition with changes in lifestyles to approach those seen in the developed nations

  11. Co-ordinated research project on application of nuclear techniques in the prevention of degenerative diseases (obesity and non-Insulin dependent diseases) in ageing. Report on the second research co-ordination meeting

    International Nuclear Information System (INIS)

    In the developed countries, research using nuclear methods has been substantially used to examine the physiological and biochemical mechanisms involved in obesity-related diseases. This Co-ordinated Research Project (CRP) is intended to promote the use of these techniques in the developing world. The specific objectives of this CRP are: 1. To define the magnitude of the obesity/NIDDM problem in developing countries. 2. To identify vulnerable groups at high risk. 3. To describe the metabolic mechanisms involved. The purpose of this first Research Co-ordination Meeting (RCM) was thus to develop a worldwide collaboration in the use of nuclear and isotopic techniques to investigate the aetiology of degenerative diseases in ageing. All countries participating in this CRP are going through the epidemiological transition with changes in lifestyles to approach those seen in the developed nations

  12. 腰椎退行性病变与原发性膝关节骨关节炎发病的关系%Primary study of relationship between lumbar degenerative disease and morbidity of primary knee osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    姜军; 任中华; 吕厚山

    2010-01-01

    Objective To study the relationship between lumbar degenerative disease and morbidity of primary unilateral knee osteoarthritis.Methods The clinical data of 115 unilateral knee osteoarthritis patients and 119 bilateral knee osteoarthritis patients undergoing TKR(total knee replacement)at our hospital in 2008 were retrospectively analyzed.According to clinical signs of lumbar degenerative disease and radiological changes,these patients were divided into upper / lower / whole / none lumbar degenerative disease group respectively.X~2 test was performed to compare the difference of lumbar degenerative conditions between unilateral knee osteoarthritis and bilateral knee osteoarthritis patients.Results The morbidity side of lumbar intervertebral disc protrusion or nerve root canal stenosis in primary unilateral osteoarthfitis patients was the same as the morbidity side of primary unilateral osteoarthritis.Lumbar degenerative disease morbidity [(34+20+15)/115=60%]of primary unilateral knee osteoarthritis was higher than that[(3+5+4+6+19)/119=31.1%]of primary bilateral knee osteoarthritis(X~2=19.723,P=0.000);Upper lumbar degenerative disease morbidity(34/115=29.6%)of primary unilateral knee osteoarthritis was higher than that[(3+5)/119=6.7%]of primary bilateral knee osteoarthritis,(X~2=20.720,P=0.000);lower lumbar degenerative disease morbidity(20/115=17.4%)of primary unilateral knee osteoarthritis was higher than that[(4+6)/119=8.4%]of primary bilateral knee osteoarthritis(X~2=4.227,P=0.040);there was no difference for whole lumbar degenerative disease morbidity between primary unilateral and bilateral knee osteoarthritis patients(X~2=0.402,P=0.526).Conclusion The primary unilateral knee osteoarthritis morbidity is correlated with lumbar degenerative disease for the same elder patient.Upper lumbar degenerative disease can induce the incidence and aggravation of primary unilateral knee osteoarthritis;the flexion deformity of primary knee osteoarthritis may cause the

  13. D-penicillamine induced degenerative dermopathy

    Directory of Open Access Journals (Sweden)

    Sujay Khandpur

    2015-01-01

    Full Text Available D-penicillamine interferes with elastin and collagen metabolism and produces several cutaneous and multi-systemic side-effects. We present two cases of Wilson′s disease who on long-term penicillamine therapy developed drug-induced degenerative dermopathy manifesting as skin fragility over pressure sites and cutis laxa-like changes.

  14. Increasing Incidence of Degenerative Spinal Diseases in Japan during 25 Years: The Registration System of Spinal Surgery in Tohoku University Spine Society.

    Science.gov (United States)

    Aizawa, Toshimi; Kokubun, Shoichi; Ozawa, Hiroshi; Kusakabe, Takashi; Tanaka, Yasuhisa; Hoshikawa, Takeshi; Hashimoto, Ko; Kanno, Haruo; Morozumi, Naoki; Koizumi, Yutaka; Sato, Tetsuro; Hyodo, Hironori; Kasama, Fumio; Ogawa, Shinji; Murakami, Eiichi; Kawahara, Chikashi; Yahata, Jun-Ichiro; Ishii, Yushin; Itoi, Eiji

    2016-01-01

    Spinal disorders affect mainly older people and cause pain, paralysis and/or deformities of the trunk and/or extremities, which could eventually disturb locomotive functions. For ensuring safe and high-quality treatment of spinal disorders, in 1987, the Tohoku University Spine Society (TUSS) was established by orthopedic departments in Tohoku University School of Medicine and its affiliated hospitals in and around Miyagi Prefecture. All spine surgeries have been enrolled in the TUSS Spine Registry since 1988. Using the data from this registration system between 1988 and 2012, we demonstrate here the longitudinal changes in surgical trends for spinal disorders in Japan that has rushed into the most advanced "aging society" in the world. In total, data on 56,744 surgeries were retrieved. The number of spinal surgeries has annually increased approximately 4-fold. There was a particular increase among patients aged ≥ 70 years and those aged ≥ 80 years, with a 20- to 90-fold increase. Nearly 90% of the spinal operations were performed for degenerative disorders, with their number increasing approximately 5-fold from 705 to 3,448. The most common disease for surgery was lumbar spinal stenosis (LSS) (35.9%), followed by lumbar disc herniation (27.7%) and cervical myelopathy (19.8%). In 2012, approximately half of the patients with LSS and cervical myelopathy were ≥ 70 years of age. In conclusion, the number of spinal operations markedly increased during the 25-year period, particularly among older patients. As Japan has a notably aged population, the present study could provide a near-future model for countries with aging population.

  15. Degenerative disc disease as a cause of back pain in the thalassaemic population: a case-control study using MRI and plain radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Desigan, S.; Hall-Craggs, M.A.; Ho, C.-P. [Department of Imaging, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Eliahoo, J. [University College London Hospitals NHS Trust, Research and Development Directorate, London (United Kingdom); Porter, J.B. [University College Hospital, Department of Haematology, University College London Hospitals NHS Trust, London (United Kingdom)

    2006-02-15

    The aim of this study was to test our observation that back pain in thalassemic patients could be caused by premature and extensive lumbar degenerative disc disease, when compared to non-thalassemic patients with back pain. Sixteen thalassemic patients with their sex- and age-matched controls were recruited into the study, 12 with thalassemia major, and 4 with thalassemia intermedia. Both the thalassemia patients and control subjects suffered from back pain, which was subjective rather than measured/pain scored. All subjects underwent magnetic resonance (MR) imaging of the lumbar spine, and 11 of the cases and 8 controls had lumbar spine radiographs. Each lumbar disc was scored for radiographic appearances and MR features of disc degeneration and disc protrusion. Proportion values for these parameters and median scores were derived at each disc level, and were analyzed and compared. There was a statistically-significant difference between proportion values of cases and controls for the MR features (P value=0.01, n=16) and the radiographic features (P value=0.01, n=11 cases, n=8 controls) of disc degeneration. The median disc level scores for the thalassemic group were uniformly high across all lumbar discs, and at all levels except at L 4/5. The control group conversely demonstrated a predilection for disc degeneration at L4/5 level. The distribution of lumbar disc degeneration in thalassemic patients with back pain is more extensive, severe and multi-level in nature compared to matched controls, and disc degeneration should be considered as a significant cause of back pain in this population group. (orig.)

  16. Increasing Incidence of Degenerative Spinal Diseases in Japan during 25 Years: The Registration System of Spinal Surgery in Tohoku University Spine Society.

    Science.gov (United States)

    Aizawa, Toshimi; Kokubun, Shoichi; Ozawa, Hiroshi; Kusakabe, Takashi; Tanaka, Yasuhisa; Hoshikawa, Takeshi; Hashimoto, Ko; Kanno, Haruo; Morozumi, Naoki; Koizumi, Yutaka; Sato, Tetsuro; Hyodo, Hironori; Kasama, Fumio; Ogawa, Shinji; Murakami, Eiichi; Kawahara, Chikashi; Yahata, Jun-Ichiro; Ishii, Yushin; Itoi, Eiji

    2016-01-01

    Spinal disorders affect mainly older people and cause pain, paralysis and/or deformities of the trunk and/or extremities, which could eventually disturb locomotive functions. For ensuring safe and high-quality treatment of spinal disorders, in 1987, the Tohoku University Spine Society (TUSS) was established by orthopedic departments in Tohoku University School of Medicine and its affiliated hospitals in and around Miyagi Prefecture. All spine surgeries have been enrolled in the TUSS Spine Registry since 1988. Using the data from this registration system between 1988 and 2012, we demonstrate here the longitudinal changes in surgical trends for spinal disorders in Japan that has rushed into the most advanced "aging society" in the world. In total, data on 56,744 surgeries were retrieved. The number of spinal surgeries has annually increased approximately 4-fold. There was a particular increase among patients aged ≥ 70 years and those aged ≥ 80 years, with a 20- to 90-fold increase. Nearly 90% of the spinal operations were performed for degenerative disorders, with their number increasing approximately 5-fold from 705 to 3,448. The most common disease for surgery was lumbar spinal stenosis (LSS) (35.9%), followed by lumbar disc herniation (27.7%) and cervical myelopathy (19.8%). In 2012, approximately half of the patients with LSS and cervical myelopathy were ≥ 70 years of age. In conclusion, the number of spinal operations markedly increased during the 25-year period, particularly among older patients. As Japan has a notably aged population, the present study could provide a near-future model for countries with aging population. PMID:26876801

  17. Degenerative cervical myelopathy.

    Science.gov (United States)

    Kato, So; Fehlings, Michael

    2016-09-01

    Cervical myelopathy is the most common cause of acquired spinal cord compromise. The concept of degenerative cervical myelopathy (DCM), defined as symptomatic myelopathy associated with degenerative arthropathic changes in the spine axis, is being introduced. Given its progressive nature, treatment options have to be chosen in a timely manner. Surgical options include anterior discectomy and fusion (ACDF), anterior corpectomy and fusion (ACCF), arthroplasty (in highly select cases), posterior laminectomy with/without fusion, and laminoplasty. Indications for each should be carefully considered in individual patients. Riluzole, a sodium-glutamate antagonist, is a promising option to optimize neurologic outcomes post-surgery and is being examined in the CSM-Protect Randomized Controlled Trial. Preoperative risk assessment is mandatory for prognostication. Sagittal alignment is known to play an important role to optimize surgical outcome. Guidelines for optimal management of DCM are in process. In principle, all but the mildest cases of DCM should be offered surgery for optimal outcome. PMID:27250040

  18. Atherosclerotic cardiovascular disease in patients with chronic inflammatory joint disorders.

    Science.gov (United States)

    Agca, R; Heslinga, S C; van Halm, V P; Nurmohamed, M T

    2016-05-15

    Inflammatory joint disorders (IJD), including rheumatoid arthritis (RA), ankylosing spondylitis (ASp) and psoriatic arthritis (PsA), are prevalent conditions worldwide with a considerable burden on healthcare systems. IJD are associated with increased cardiovascular (CV) disease-related morbidity and mortality. In this review, we present an overview of the literature. Standardised mortality ratios are increased in IJD compared with the general population, that is, RA 1.3-2.3, ASp 1.6-1.9 and PsA 0.8-1.6. This premature mortality is mainly caused by atherosclerotic events. In RA, this CV risk is comparable to that in type 2 diabetes. Traditional CV risk factors are more often present and partially a consequence of changes in physical function related to the underlying IJD. Also, chronic systemic inflammation itself is an independent CV risk factor. Optimal control of disease activity with conventional synthetic, targeted synthetic and biological disease-modifying antirheumatic drugs decreases this excess risk. High-grade inflammation as well as anti-inflammatory treatment alter traditional CV risk factors, such as lipids. In view of the above-mentioned CV burden in patients with IJD, CV risk management is necessary. Presently, this CV risk management is still lacking in usual care. Patients, general practitioners, cardiologists, internists and rheumatologists need to be aware of the substantially increased CV risk in IJD and should make a combined effort to timely initiate CV risk management in accordance with prevailing guidelines together with optimal control of rheumatic disease activity. CV screening and treatment strategies need to be implemented in usual care. PMID:26888573

  19. Charcot-like joints in calcium pyrophosphate dihydrate deposition disease

    Energy Technology Data Exchange (ETDEWEB)

    Helms, C.A.; Chapman, G.S.; Wild, J.H.

    1981-10-01

    Two cases of Charcot-like joints in patients with pseudogout who were otherwise neurologically intact are presented. The arthropathy of pseudogout should include Charcot-like joints and it is emphasized that an apparent Charcot joint should raise the question of pseudogout.

  20. Minimum 5-year follow-up study on the effects of the Wallis dynamic stabilization system in the treatment of lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    Chen Zheng; Peng Baogan; Li Duanming; Pang Xiaodong; Yang Hong

    2014-01-01

    Background Short-term outcomes of the Wallis system in the treatment of lumbar degenerative disease (LDD) have been shown to be effective,whereas there is a paucity of studies on the mid-long-term effects of the treatment of the Wallis system.This study was to evaluate the mid-long-term effects of the Wallis dynamic stabilization system in the treatment of LDD.Methods A total of 26 patients who received the treatment of the Wallis system between February 2008 and January 2009 were included in the study,with 14 patients (Group 1) with L4/5 disc herniation and 12 patients (Group 2) with L5/S1 disc herniation and L4/5 intervertebral disc degeneration (IDD).Visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical outcomes and lumbar x-rays and MRI were obtained to observe imaging changes before and after operation.Results The mean follow-up period was (63.50±2.12) months.The mean ODI and VAS scores decreased obviously three months and five years after operation (P <0.05).In Groups 1 and 2,L4/5 Cobb angle and range of motion (ROM) decreased and L4/5 posterior disc height increased at the last follow-up (P <0.05).There were no statistically significant changes in L4/5 anterior disc height and L3/4 University of California at Los Angeles grading before and after operation.There was no statistically significant change in Pfirrmann grading system of L4/5 IDD in Group 2 before and after operation.Adjacent segment degeneration at the last follow-up was found in two patients (2/26,7.69%) and Modic changes in L4/5 endplates were detected in one patient (1/26,3.85%).Conclusions The mid-long-term effects of the Wallis system in the treatment of LDD were satisfied.The Wallis system,as a dynamic stabilization system,which can preserve some ROM of the fixed segment,sustain the lumbar stabilization,and prevent adjacent segment disease and fixed segment degeneration,is an effective instrument to treat LDD.

  1. Diagnosis and treatment for degenerative lumbar spinal disease%退变性腰椎疾病的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    林红; 董健

    2005-01-01

    腰腿痛是困扰人类的常见病和多发病,引起腰腿痛的主要原因是退变性腰椎疾病(degenerative lumbar spinal dis-ease,DLSD)。笔者对DLSD的诊断及治疗进展作一综述。

  2. Dementia neuro degenerative diseases and bio markers: a new strategy for an early diagnosis; Affections neurodegeneratives dementielles et biomarqueurs: une nouvelle strategie pour un diagnostic precoce

    Energy Technology Data Exchange (ETDEWEB)

    Mahieu, F.; Du Boisgueheneuc, F.; Andrieux, A.; Neau, J.P.; Gil, R.; Houeto, J.L. [CHU de Poitiers, Service de neurologie, 86 (France); Salmon, F. [CHU de Poitiers, Service de neurologie, 86 (France); Paccalin, M. [CHU de Poitiers, Service de medecine nucleaire, 86 (France); Lecron, J.C. [universite de Poitiers, EA 4331, laboratoire inflammation, tissus epitheliaux et cytokines, pole biologie sante, 86 (France); Ingrand, P. [CHU de Poitiers, unite de methodologie de la recherche clinique, centre d' investigation clinique P 802, 86 (France)

    2010-07-01

    the neuro degenerative dementia (particularly focal beginning forms) can be diagnosed earlier by analyzing the combination of the rate of phosphorylated tau protein, IITE score and perfusion in right anterior cingulate gyrus, the Broca area, and left angular gyrus. A prospective study is underway to validate this model. (N.C.)

  3. 脊柱退行性疾病的骨质疏松影响分析%Analysis of the effect of osteoporosis on the spinal degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    陈戈; 段洪; 卞鸿燕; 贺云; 尹劲; 吴波; 杨海青; 周兆文

    2014-01-01

    质疏松加速脊柱退行性变、脊柱不稳、胸腰椎骨折、椎管狭窄、脊柱畸形、颈椎病、脊柱滑脱等脊柱退行性疾病的发病。%Objective To investigate the relationship between low remodelling osteoporosis and the spinal degenerative diseases, and to explore the damage of osteoporosis on the spine degeneration in the elderly patients.Methods The bone mineral density ( BMD) was detected using dual-energy X-ray absorptiometry.The clinical observation and the collection of the imaging data were performed.The large-sample random sampling was also performed.A SPSS 13.0 statistical software was used to analyze all the data of 505 patients over 50 years old in a year.The data of the spinal diseases with low remodelling osteoporosis were collected. Results The comparison of BMD of different lumbar vertebrae in each group was performed using single factor analysis of variance.The enumeration data were analyzed using Spearman rank correlation analysis.The correlation between osteoporosis and diseases such as the lumbar instability was analyzed using non-conditional logistic regression analysis.The results revealed that the partial regression coefficient of the thoraco-lumbar fracture was 1.026 (P=0.021, OR 2.789).The partial regression coefficient of the spinal degeneration was 0.225 (P=0.035, OR 2.253).The partial regression coefficient of the lumbar instability was 0.828 (P=0.004, OR 2.289).The partial regression coefficient of the spondylolisthesis was 0.782 (P=0.024, OR 2.185).The partial regression coefficient of the cervical spondylosis was 0.691 (P=0.045, OR 1.211).The partial regression coefficient of the spinal stenosis was 0.972 (P=0.031, OR 2.57).The partial regression coefficient of the spinal deformity was 0.972 (P=0.025, OR 1.002).The partial regression coefficient of age was 0.048 (P=0.000, OR 1.049).The partial regression coefficient of gender was -1.035 (P=0.000, OR 0.355).Osteoporosis and the spinal degenerative diseases

  4. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Juhl, C B; Roos, E M;

    2015-01-01

    OBJECTIVE: To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Pain and physical function...... and absent at one to two years after surgery. Knee arthroscopy is associated with harms. Taken together, these findings do not support the practise of arthroscopic surgery for middle aged or older patients with knee pain with or without signs of osteoarthritis. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD....... DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...

  5. PERIPROSTHETIC INFECTION AFTER ENDOPROSTHETIC REPLACEMENT OF THE HIP JOINT IN PATIENTS WITH RHEUMATOID DISEASES

    Directory of Open Access Journals (Sweden)

    Vadim Petrovich Pavlov

    2013-01-01

    Full Text Available Periprosthetic infection (PI in patients with rheumatoid diseases (RD after total hip joint endoprosthesis (THJE is a relevant problem of rheumoorphopedics that has not been solved yet. The relative assessment of PI incidence rate after THJE and treatment outcomes in patients with this complication is expected to be carried out. A total of 1201 THJE performed in 1069 patients with RD are considered. The female : male ratio was 3.6 : 1; the mean age was 49.6 years (range: 16 to 83 years. 323 patients had rheumatoid arthritis (RA; 124 patients had juvenile rheumatoid arthritis (JRA; 80 patients had ankylosing spondylitis (AS; 79 patients had systemic lupus erythematosus (SLE; 11 patients had systemic sclerodermatitis (SSD; 18 patients had psoriatic arthropathy (PsA; and 353 patients had osteoarthritis (OA. Other RD were revealed in 81 patients. PI were detected in 9 (0.84% of 1069 patients with RD, including 7 (2.17% of 323 patients with RA; 1 (0.8% of 124 patients with JRA; and 1 (0.28% of 353 patients with OA. No PI were detected in 81 patients who had other RD. An eightfold (in patients with RA and a threefold (in patients with JRA increase in PI compared to that in patients with OA attests to the high risk of this complication in patients with inflammatory as compared to the patients with degenerative RD. After integrated treatment (revision surgery, sanation, continuous irrigation with antibiotics/lavasept, the graft was preserved in OA patients; the complication was prevented in RA patients. Six patients will be subjected to repeated revision surgery; one patient died of diabetes complications after the graft had been removed. A significant increase in PI incidence rate after THJE in patients with RA and JRA as compared to that in OA patients allows one to regard inflammatory RD as risk factors of this complication. The low effectiveness of the procedure for integrated therapy for PI in RD patients indicates that it needs to

  6. Estudio comparativo de las funciones ejecutivas entre pacientes con enfermedad de Parkinson y pacientes con enfermedad degenerativa cerebelosa Comparison study of executive functions in Parkinson's disease and degenerative cerebellar disease's patients

    Directory of Open Access Journals (Sweden)

    Carlos G. Abel

    2006-09-01

    Full Text Available OBJETIVO: Comparar el rendimiento en tareas de función ejecutiva (FE en sujetos con enfermedad de Parkinson (EP leve a moderada (Hoehn y Yahr OBJECTIVE: To compare executive functions (EF in non-demented mild to moderate Parkinson's disease (PD (Hoehn and Yahr <3 and pure degenerative cerebellar disease (CD in order to evaluate the relative contribution and differential role of basal ganglia and cerebellum in those functions. METHOD: 14 patients with PD and 14 patients with CD matched by sex, education, disease's duration and MMSE were selected. A standardized neuropsychological battery and the Wisconsin Card Sorting Test (WCST were administered. Z scores were compared for both groups through t-test for independent samples were used. RESULTS: The cerebellar group showed significant lower performance in measures of attention and EF, with a significant increase in both perseverative and non perseverative errors during the WCST. On the other hand the PD group showed a selective increase of non perseverative errors, without reaching significant between group difference. CONCLUSION: The CD group appears to have greater deficits in EF with a pattern of prefrontal dysfunction.

  7. Clinical Value of Elastic Fixation in Operation for Lumbar Degenerative Disease%弹性内固定在腰椎退行性病变手术治疗中的临床价值

    Institute of Scientific and Technical Information of China (English)

    高峰; 王大麟

    2014-01-01

    Objective Analysis the clinical value of elastic fixation in treatment of lumbar degenerative diseases in operation. Methods The author selected 64 patients with lumbar degenerative diseases according to the treatment methods were divided into the observation group of 30 cases (elastic fixation) and 34 cases of the control group (non elastic fixation), compared the effect of two groups of patients . Results In the observation group, the clinical curative effect of the excellent and good rate was significantly higher than that of control group (P<0.05). Conclusion Lumbar degenerative diseases in the back operation is used in the treatment of elastic fixation, can reduce the pain of patients.%目的:分析弹性内固定在腰椎退行性病变手术治疗中的临床价值。方法64例腰椎退行性病变患者根据治疗方式分为观察组30例(弹性内固定)及对照组34例(非弹性内固定),对比两组患者治疗效果。结果观察组临床疗效优良率明显高于对照组,疼痛程度轻于对照组,并发症发生率少于对照组(P <0.05)。结论在腰椎退行性病变手术治疗中采用弹性内固定,可减轻患者疼痛。

  8. 脊椎退行性疾病患者生命质量量表的编制%Development of a quality of life scale for Chinese patients with degenerative spine disease

    Institute of Scientific and Technical Information of China (English)

    徐宏光; 贾瑞平; 王弘; 吴志宏; 邱贵兴

    2011-01-01

    目的 编制适用于我国脊椎退行性疾病患者的生命质量量表(QLS-DSD).方法 采用议题小组和核心小组的程序化决策方式并借鉴国内外建立量表的经验制定量表,对296例脊椎退行性疾病患者进行调查,采用离散趋势法、相关系数法、反应度分析、逐步回归法和因子分析法等统计学方法对结果进行分析.结果 采用上述5种方法删除3个条目,最终得到23个条目.结论 QLS-DSD准确反映脊椎退行性疾病患者的生命质量.%Objective Objective To develop a quality of life scale for Chinese patients with degenerative spine disease (QLS-DSD). Methods The scale was established by using the methods of programmed decisions of the team and the core team issues and referencing the experience at home and abroad. Totally 296 degenerative spine disease patients were investigated in this study. Discrete trend method, correlation coefficient method, degree of reaction analysis, stepwise regression method and factor analysis was applied to analyze the survey results. Results According to the above 5 methods, we deleted 4 items and formed a scale with 23 entries at last. Conclusion QLS-DSD exactly reflects the quality of life for Chinese patients with vertebrae degenerative disease.

  9. Misdiagnosis of Lumbar Disc Degenerative Diseases in Patients with Low Back Pain Syndrome (A Report of 36 Cases)%误诊为腰椎退行性疾病的腰腿痛症候群(附36例报告)

    Institute of Scientific and Technical Information of China (English)

    张超; 何勍; 阮狄克

    2015-01-01

    Objective To investigate the causes and clinical features of misdiagnosis of lumbar disc degenerative dis-eases. Methods We conducted a retrospective analysis of a hospital database, including all patients admitted to the depart-ment of orthopaedic surgery of General Hospital of PLA Navy, with a diagnosis of lumbar disc degenerative diseases and subse-quent diagnosis of other diseases during January 2007 and December 2011. Results All the patients were found with low back pain syndrome, misdiagnosed as lumbar degenerative diseases including 18 cases of disc herniation, 8 cases of lumbar stenosis, 6 cases of discogenic low back pain, 2 cases of lumbar spondylolisthesis and 2 cases of lumbar joints abnormality. Definite diagnoses were primary spinal tumor (4 cases), metastatic tumor (3 cases), arterial occlusion of lower extremity (3 cases), sacroiliitis (3 cases), lumbar tuberculosis (5 cases), avascular necrosis of femoral head (6 cases), osteoarthrosis of hip (6 cases), etc. All patients underwent specific treatments after the exact diagnosis and showed obvious improvement. Conclusion Because low back pain syndrome may be misdiagnosed as disc degenerative diseases such as inflammation, tumor and blood vessel diseases, at an early stage, therefore a careful understanding of history and neurological examination, including impulse test is mandatory to maximally reduce the misdiagnosis rate.%目的:探讨腰腿痛症候群的背景疾病,以及与腰椎退行性疾病的鉴别诊断要点。方法对我科2007年1月—2011年12月误诊为腰椎退行性疾病36例临床资料进行回顾性分析。结果本组均以腰腿痛症候群为主诉,分别在本院及外院误诊,误诊疾病:腰椎间盘突出症18例,腰椎管狭窄症8例,椎间盘源性下腰痛6例,腰椎滑脱及腰椎小关节紊乱各2例。最终确诊疾病:股骨头缺血性坏死及髋关节骨性关节炎各6例,腰椎结核5例,腰椎管内肿瘤4例,腰椎转移性

  10. Wallis棘突间动态稳定系统在腰椎退行性疾病手术治疗中的应用%Early effect of posterior dynamic lumbar stabilization in lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    李斌; 牛光峰; 孙建民; 蒋振松; 崔新刚; 杨超群; 王乃国

    2012-01-01

    [Objective] To evaluate the early effect of posterior dynamic lumbar stabilization in lumbar degenerative disease. [Methods] The clinical outcomes of 65 patients with lumbar degenerative disease treated by posterior decompression with Wallis posterior dynamic lumbar stabilization implant or combined with posterior lumbar fusion were retrospectively studied, and assessed with visual analogue scale (VAS) and spinal operative standard of Chinese Medical Association. The early effect and complications associated with Wallis posterior dynamic lumbar stabilization were recorded. [ Results ] The operative procedure of Wallis posterior dynamic lumbar stabilization implant was easy and less invasive. The VAS scores were improved significantly at one day preoperatively, two week postoperatively and final follow - up, respectively. The good to excellent result was 92% at the final follow-up. No completion related with Wallis posterior dynamic lumbar stabilization was found. [Conclusion] It is easy and safe to use Wallis posterior dynamic lumbar stabilization in treatment of degenerative lumbar disease, and the early effect is good. The Wallis system provides an alternative for treatment of lumbar degenerative disease.%[目的]探讨椎管减压加Wallis棘突间动态稳定系统治疗腰椎退行性疾病的初期效果.[方法]分析自2008~2011年65例单独采用Wallis棘突间动态稳定系统或结合固定融合方法治疗腰椎退行性疾病的临床疗效和初期随访结果,采用VAS疼痛10分法和中华医学会骨科分会脊柱外科学组腰椎手术疗效标准评估手术疗效,随访有无Wallis动态固定系统相关并发症及疗效.[结果]Wallis棘突间动态稳定系统手术操作简便、创伤小,术前ld、术后2周及末次随访疼痛VAS评分改善明显,影像学检查未发现内置物移位、邻近节段退变加重.[结论]Wallis棘突间动态稳定系统或结合固定融合方法治疗腰椎退行性疾病简便安全,初期

  11. 人工腰椎间盘置换治疗退行性腰椎间盘疾病16例分析%Preliminary clinical results of artificial disc replacement for degenerative disc disease in 16 cases

    Institute of Scientific and Technical Information of China (English)

    吴亮; 孙晓亮; 张雷; 吴国峰; 周剑; Yve Cartonne; Pascal Moussellard

    2012-01-01

    背景:与传统的单纯腰椎间盘切除和脊柱融合治疗方法相比,人工腰椎间盘置换具有明显的理论优势,已成为治疗退行性腰椎间盘疾病的最有希望的方法.目的:总结人工腰椎间盘置换治疗退行性腰椎间盘疾病的初步临床疗效.方法:2007-05/2010-10行人工腰椎间盘置换治疗退行性腰椎间盘疾病16例,其中男9例,女7例,平均年龄40.5岁(28~55岁).结果与结论:随访时间6~36个月,置换后目测类比评分、Oswestry功能障碍指数、椎间隙高度均较置换前有显著改善(P 0.05).结果显示人工腰椎间盘置换治疗退行性腰椎间盘疾病的初步临床结果令人满意,但其远期效果尚待进一步观察.%BACKGROUND: Simple discectomy and spinal fusion surgery were the classical methods for the degenerative disc disease.Comparing to them, artificial disc replacement (ADR) showed more theoretical superiority.OBJECTIVE: To present the preliminary clinical results of ADR for the treatment of degenerative disc disease.METHODS: From May 2007 to October 2010, ADR were preformed on 16 cases for the treatment of degenerative disc disease. 9 males and 7 females with average age of 40.5 years underwent ADR.RESULTS AND CONCLUSION: The follow-up time averaged 21.5 months (6 -36 months). Postoperative visual analogue scale,Oswestry Disability Index and intervertebral height were significantly improved as compared with those in preoperation (P 0.05). ADR can acquire satisfactory preliminary clinical results for the treatment of degenerative disc disease. However, further research is needed to study its long-term impact.

  12. The differential diagnosis of inflammatory joint disease in maternal-fetal microchimerism

    Directory of Open Access Journals (Sweden)

    Seme Youssef Reda

    2013-12-01

    Full Text Available This study aimed at making the differential diagnosis of joint disease in a case of genetic chimerism in a female multiparous donor from the Regional Blood Bank of Guarapuava-PR (Hemocentro Regional de Guarapuava-PR, who had had three pregnancies of male fetuses. The patient showed joint pain prior to the last donation. It was possible to identify fetal cells remaining in circulation 20 years after her last pregnancy. Laboratory tests for acute phase proteins revealed possible termination of immune tolerance to circulating fetal cells. Thus, a hypothesis of graft-versus-host disease was formulated to explain the joint disease manifested by the donor.

  13. 脊柱退行性疾病对腰椎前后位骨密度的影响分析%The impact analysis of degenerative spinal disease on lumbar bone mineral density in the anteroposterior view

    Institute of Scientific and Technical Information of China (English)

    臧渊; 雷伟; 吴子祥

    2012-01-01

    双能X线骨密度仪检测骨密度是诊断骨质疏松症的“金标准”,学者推荐50岁以上人群采用腰椎前后位进行测量.然而骨质疏松症发病率较高的老年人群,常常合并罹患多种脊柱退行性疾病,例如腰椎间盘突出、退行性侧凸、骨赘增生等,这些病理改变可导致腰椎前后位骨密度值准确性降低.因此,提高腰椎骨密度测量准确性,对于骨质疏松症的诊断和治疗具有重要意义.本文就常见的脊柱退行性疾病对腰椎前后位骨密度的影响作一综述,以期帮助临床医生全面评估和诊断骨质疏松症.%Objective Bone mineral density (BMD) detected by dual-energy X-ray absorptiometry can be regarded as the "gold standard" for the diagnosis of osteoporosis. The scholars recommend that all adults over SO years old should conduct the anteroposterior position measurement. However, the elderly population with high incidence of osteoporosis often combines with many degenerative spinal diseases, such as intervertebral disc herniation, degenerative scoliosis, osteophyte formation, etc. These pathological changes in the lumbar spine might reduce the accuracy of BMD in anteroposterior position. So the increase of BMD accuracy is of great significance in diagnosis and treatment of osteoporosis. This article reviews the impacts of spinal degenerative diseases on lumbar bone mineral density and aims to facilitate clinicians to assess and diagnose osteoporosis comprehensively.

  14. Disk degenerative disease in childhood: Scheuermann`s disease, Schmorl`s nodes, and the limbus vertebra: MRI findings in 12 patients

    Energy Technology Data Exchange (ETDEWEB)

    Swischuk, L.E. [Departments of Radiology and Pediatrics, Children`s Hospital, University of Texas, Galveston, TX (United States); John, S.D.; Allbery, S. [Children`s Hospital, University of Texas Medical Branch, Galveston, Texas (United States)

    1998-05-01

    Twelve pediatric patients were studied with MRI. All had various disk problems including Scheuermann`s disease, Schmorl`s nodes and limbus vertebrae. All patients shared loss of disk height, altered disk hydration and variable herniation of nuclear material. (orig.) With 6 figs., 1 tab., 14 refs.

  15. Rheumatoid arthritis affecting temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Amandeep Sodhi

    2015-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

  16. Patient and implant survival following joint replacement because of metastatic bone disease

    DEFF Research Database (Denmark)

    Sørensen, Michala S; Gregersen, Kristine G; Grum-Schwensen, Tomas;

    2013-01-01

    Patients suffering from a pathological fracture or painful bony lesion because of metastatic bone disease often benefit from a total joint replacement. However, these are large operations in patients who are often weak. We examined the patient survival and complication rates after total joint...

  17. Computed arthrography: Its role in the screening of joint diseases in pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Paille, P.; Quesnel, C.; Baunin, C.; Railhac, J.J.

    1988-07-01

    The purpose of this study was to analyse the accuracy of combined arthrography and computed tomography in pediatric radiology. 23 patients were selected and the joints studied (n = 25) were: Elbow (1), shoulder (2), knee (8) and hip (14). The contribution of computed arthrography varies according to the joint and the disease concerned. Osteochondritis dissecans of the knee appears to be the best indication.

  18. 老年退行性心脏瓣膜病超声心动图的临床应用%The diagnostic value of echocardiogram in degenerative valvular disease

    Institute of Scientific and Technical Information of China (English)

    许慧敏

    2013-01-01

    目的 探讨超声心动图在老年退行性瓣膜病中的应用价值,评价超声心动图对老年退行性心脏瓣膜病的检查价值.方法 回顾分析2010-2011年600例60岁以上老年人的彩色多谱勒超声心动图及临床资料.通过超声观察心脏瓣膜的形态、回声、厚度、活动度、室间隔、左室后壁厚度、心腔大小及左心功能.结果 检出退行性钙化瓣病350例,总患病率58.3%,其中男性检出150例(42.9%),女性检出200例(57.1%).随着年龄的增长,男、女的检出率变化差异无统计学意义(P>0.05),但检出率逐渐增高,差异有统计学意义(P<0.01).结论 随着年龄的增长,老年退行性瓣膜病呈递增趋势,超声心动图可及早发现,为临床早期治疗提供诊断依据.%Objective To discuss eehocardiographic features of senile degenerative valvular disease, and evaluate the application value of echocardiogram in elderly degenerative valvular disease and analyze the relative risk factors of these diseases. Methods 600 patients at the age of over 60 years from 2010 to 2011 were retrospectively analyzed. Echocardiography was used to observe the morphology, echo, thickness and activity of the heart valve, the thickness of interventricular septum and ventricular posterior wall, and left cardiac size and function. Results Detection degenerative disc disease calcification in 350, the total rates by 58.3%. The detection rate of men 150 cases (42.9%), women detection rate 200 cases (57.1%). As the growth of the age, the change of the men and women have no obvious difference (P>0.05), as the growth of the age, the detection rate was higher, there was significant difference (P<0.01). Conclusion With the growth of age, the positive rate of degenerative valvular disease is increasing. Echocardiogram may get degenerative valvular disease detected in the early stage and provide defining characteristics for early clinic treatment.

  19. 非融合技术在腰椎退行性疾病中的临床应用%Clinical Application of Non-Fusion Technology in the Lumbar Degenerative Disease

    Institute of Scientific and Technical Information of China (English)

    李新炜

    2011-01-01

    腰椎融合手术一段时间以来是治疗腰椎退行性疾病的有效方法.近年来,由于融合手术术后并发症的发生,使得非融合手术应运而生并得到发展.通过研究国内外非融合手术的随访文献发现非融合技术在保持病变节段一定的活动度、减缓邻近节段的退行性变、限制异常活动等方面有独特的优势.因此,非融合技术可以作为一种行之有效的手术方式来治疗腰椎退行性疾病.%Fusion surgery has been an effective way for the treatment of lumbar degenerative diseases for a long time. Due to the complications after surgery seen in recent years,the non-fusion technology has appeared and developed. According to studies of the recent follow-up literatures,it's learned that the non-fusion technology has some advantages such as retaining some residual motion, delaying degeneration of adjacent segment,and limiting abnormal activity etc.. Therefore,the non-fusion technology can be applied as an effective way of treating lumbar degenerative disease.

  20. The Influence of Magnetic Resonance Imaging Findings of Degenerative Disease on Dual-Energy X-ray Absorptiometry Measurements in Middle-Aged Men

    Energy Technology Data Exchange (ETDEWEB)

    Donescu, O.S.; Battie, M.C.; Videman, T. [Faculty of Rehabilitation Medicine and Dept. of Physical Therapy, Univ. of Alberta (Canada)

    2007-02-15

    Purpose: To examine degenerative features based on magnetic resonance imaging (MRI) measurements at the lumbar spine in relation to dual-energy X-ray absorptiometry (DXA), and to investigate whether bone mineral density (BMD) is reflected in the substitution of bone trabecular structure by fat at the vertebral body level indicated by MRI T1 relaxation time, endplate concavity, and hypertrophic (osteophytes and endplate sclerosis) MRI findings. Material and Methods: The sample for this cross-sectional study was composed of 102 subjects, 35-70 years old, from a population-based cohort. Data collection included DXA in the anterior-posterior projection at the L1-L4 vertebrae and right femoral neck, and MRI of the lumbar spine in the midsagittal plane. Results: Age, vertebral signal intensity, osteophytes, and endplate concavity collectively explained 20% of the variance in spine BMD. Conclusion: The study findings suggest that degenerative findings based on MRI measurements at the lumbar spine have an influence on bone assessment using DXA. Therefore, an overall bone assessment such as DXA might not offer an accurate measure of BMD.

  1. The Influence of Magnetic Resonance Imaging Findings of Degenerative Disease on Dual-Energy X-ray Absorptiometry Measurements in Middle-Aged Men

    International Nuclear Information System (INIS)

    Purpose: To examine degenerative features based on magnetic resonance imaging (MRI) measurements at the lumbar spine in relation to dual-energy X-ray absorptiometry (DXA), and to investigate whether bone mineral density (BMD) is reflected in the substitution of bone trabecular structure by fat at the vertebral body level indicated by MRI T1 relaxation time, endplate concavity, and hypertrophic (osteophytes and endplate sclerosis) MRI findings. Material and Methods: The sample for this cross-sectional study was composed of 102 subjects, 35-70 years old, from a population-based cohort. Data collection included DXA in the anterior-posterior projection at the L1-L4 vertebrae and right femoral neck, and MRI of the lumbar spine in the midsagittal plane. Results: Age, vertebral signal intensity, osteophytes, and endplate concavity collectively explained 20% of the variance in spine BMD. Conclusion: The study findings suggest that degenerative findings based on MRI measurements at the lumbar spine have an influence on bone assessment using DXA. Therefore, an overall bone assessment such as DXA might not offer an accurate measure of BMD

  2. A Joint Lab Against Viral Diseases Created in Southwest China

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    @@ With approval of the CAS Steering Committee for Research Bases in Southwest China, a laboratory devoted to the development of natural anti-virus medicines is to be set up under the joint sponsorship of the CAS Kunming Institute of Botany (KIB)and the CAS Kunming Institute of Zoology (KIZ).

  3. QLS-DSD与JOA评分量表在脊柱退行性疾病患者评分应用中的比较%A comparison between QLS-DSD and JOA scale in assessment of spinal degenerative disease

    Institute of Scientific and Technical Information of China (English)

    徐宏光; 张敏; 王弘; 刘平; 吴志宏; 邱贵兴

    2013-01-01

    背景:脊柱退行性疾病的发病率日渐上升,目前我国对疾病病情及愈合的评估一直沿用国外的统计量表,因此制定一套适合我国国情的关于脊柱退行性疾病患者的评估量表成为当务之急。  目的:比较脊椎生活量表(QLS-DSD)与汉化版JOA颈、腰椎评分量表在脊柱退行性疾病患者评价中的使用情况,评估两种量表的信度、区分效度和反应度。  方法:采用横、纵联合调查法利用QLS-DSD与汉化版JOA颈、腰椎量表分别对符合纳入标准的44例颈椎和61例腰椎退行性疾病手术治疗患者进行问卷调查,采用Cronbachα系数和分半信度评价两类量表的信度;计算患者术前、术后各量表在各领域得分和总得分,再进行t检验分析,来评价量表的区分效度和反应度。  结果:QLS-DSD总Cronbachα系数为0.891,总分半信度系数为0.908;JOA颈椎量表总Cronbachα系数为0.896,总分半信度系数为0.842;JOA腰椎量表总的Cronbachα系数为0.845,总分半信度系数为0.852。JOA量表在颈、腰椎患者手术前后的总分比较均有显著差异(P<0.05)。QLS-DSD仅在颈椎患者的手术前后总分中有显著差异(P<0.05),而在腰椎患者中差异无统计学意义(P>0.05)。  结论:QLS-DSD和JOA量表一样其使用信度良好,故可将其用在临床上对脊柱疾病患者的评价中。但QLS-DSD主要是为评估脊柱退行性疾病患者生活质量而制定的,不能较好的反映手术治疗后短期内治疗效果,但通过观察其改变趋势,可预见QLS-DSD可以很好的反映术后较长时间内的治疗效果对患者生活质量的影响。%Background:The incidence of spinal degenerative diseases has been gradually increasing. Foreign statistical scale has been used for the assessment of the disease in China. Therefore it becomes imperative to develop a set of assessment scale for Chinese with

  4. Degenerative lumbosacral stenosis in dogs

    NARCIS (Netherlands)

    Suwankong, N.

    2007-01-01

    Degenerative lumbosacral stenosis (DLS) is now recognized as a significant cause of caudal lumbar pain and pelvic limb lameness in dogs. The condition includes lumbosacral intervertebral disc degeneration and protrusion, spondylosis deformans, sclerosis of the vertebral end plates, osteoarthrosis of

  5. Development of PET tracers for neuro inflammation imaging in neuro degenerative diseases; Developpement de radiotraceurs de la neuroinflammation pour l'imagerie des pathologies neurodegeneratives

    Energy Technology Data Exchange (ETDEWEB)

    Chauveau, F

    2007-10-15

    Inflammatory processes such as micro-glial or endothelial activation are involved in many neuro-degenerative conditions. Neuro-inflammation imaging is considered an attractive tool for fundamental research, diagnosis and therapeutic evaluation in neuro-pathologies. First, an aptamer was selected against a recombinant fragment of the endothelial target VCAM-1, but proved unable to bind the target protein in native conformation, as expressed by a cell line. Second, five radioligands of the peripheral benzodiazepine receptor (PBR), a marker of micro-glial activation, were evaluated in vivo using PET (Positron Emission Tomography) imaging in a rat model of neuro-inflammation, and were compared to [11C]PK11195. Four radiotracers displayed a better contrast than [11C]PK11195. In a competitive field of research, this work demonstrates the efficiency of in vivo screening of radiotracers for fast selection of clinically relevant molecules. (author)

  6. Combined therapy of integration and non-fusion fixation to lumbar degenerative disease%融合联合非融合固定治疗腰椎退行性病

    Institute of Scientific and Technical Information of China (English)

    孙义忠; 刘宝平; 何强; 范先东; 李铁军; 王锋宝

    2012-01-01

    Objective To investigate the clinical efficacy of the combined therapy of integration and non-fusion fixation to lumbar degenerative disease. Methods Forty-two patients who received integration and non-fusion fixation for the treatment of lumbar disc herniation and another 30 patients who received spondylolisthesis merge adjacent segments intcrvcrtebral herniation between May 2006 to December 2011 were in included in the study. After surgery, patients had an average follow-up of 19 (6-50) months. Visual analogue scales (VAS) and Oswestry disability index (ODI) were employed to assess postoperative efficacy. Results No postoperative infection, nerve root injury, cerebrospinal fluid leakage and other complications occurred. VAS and ODI evaluation results showed that postoperative changes in VAS and ODI scores were statistically significant (P<0. 01) . Conclusion Integration and non-fusion fixation for the treatment of lumbar degenerative disease has marked decompression effect with reliable fixation. It can effectively mitigate the adjacent inter-vcrtebral disc degeneration. Thus it is an effective method in the treatment of lumbar degenerative disease.%目的 探讨融合联合非融合固定联合治疗腰椎退行性病的临床疗效.方法 选取我院2006年5月~2011年12月作者采用融合联合非融合固定治疗腰椎间盘突出症患者42例及腰椎滑脱合并椎间盘突出症30例.术后患者获得平均19(6~50)个月的随访,采用视觉模拟评分法(VAS)及腰椎功能障碍指数(ODI)评定患者手术后的治疗疗效.结果 本组患者术后均无感染、神经根损伤、脑脊液漏等并发症发生.VAS及ODI评定结果显示患者术后VAS及ODI分值改善优于术前,手术前后比较差异有统计学意义(P<0.01).结论 融合联合非融合固定治疗腰椎退行性病减压效果明显、固定可靠,有效减缓了相邻椎间盘退变,是治疗腰椎退行性病的一种有效方法.

  7. 改良的腰椎后路植骨融合术治疗腰椎退行性疾病的疗效%Modified Posterior Lumbar Interbody Fusion for Lumbar Degenerative Diseases

    Institute of Scientific and Technical Information of China (English)

    高松; 马勇; 张斌; 刘远

    2014-01-01

    目的:探讨改良的腰椎后路椎间植骨融合术治疗腰椎退行性疾病的临床疗效。方法对76例腰椎退行性疾病患者均采用改良的腰椎后路椎间植骨融合术治疗,并采用视觉模拟评分(VAS)法、日本骨科协会评估治疗分数(JOA)评分法对76例患者术前、术后随访3个月时进行VAS、JOA评分。术后随访1年,行X线检查,同时观察植骨融合率的情况。结果76例患者术后随访3个月VAS得分明显低于术前、JOA得分明显高于术前(P<0.05)。术后随访1年,X线检查示76例患者植骨块无明显移位,无断钉、断棒和松动;植骨融合率为97.4%(74/76)。结论改良的腰椎后路椎间植骨融合术是治疗腰椎退行性疾病的一种有效方法。%Objective To explore the clinical efficacy of modified posterior lumbar interbody fusion (PLIF) in the treatment of lumbar degenerative diseases. Methods Seventy-six patients with lumbar degenerative diseases were treated with the modified PLIF. The clinical outcomes were evaluated by visual analog scale (VAS) and Japanese Orthopedic Association (JOA) scores before and 3 months after operation. The rate of fusion was measured by X-ray 1 year after operation. Results VAS scores decreased and JOA scores increased after operation (P<0.05). No obvious bone graft displacement, screw breakage, rod breakage and screw loosening were found in all patients after 1 year of follow-up. The bone graft fusion rate was 97.4%(74/76).Conclusion The modified posterior lumbar interbody fusion is effective for lumbar degenerative diseases.

  8. 动态中和固定系统治疗腰椎退行性疾病的研究进展%Progress on dynamic neutralization system in treating lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    陈喜君; 范顺武

    2013-01-01

    动态固定技术治疗腰椎退行性疾病日益成为基础和临床研究的热点.动态中和固定系统(dynamic neutralization system,Dynesys)作为动态固定技术的一种,既能保持脊柱的活动能力,改善患者的临床症状,还在延缓邻近节段退变方面表现出一定的优势.Dynesys技术可作为腰椎融合之外治疗腰椎退行性疾病的另一最佳选择,主要适用于轻至中度的腰椎退变性疾病,但它缺乏保持和恢复腰椎前凸的机制需要患者主动伸展实现前凸.如何延长使用寿命、预防并发症发生等问题有待解决,其远期疗效及延缓邻近节段退变作用机制需进一步明确.%Dynamic stabilization technology has increasingly become the hot spot in basic and clinical research for treating lumbar degenerative diseases.As one kind of dynamic stabilization technology,dynamic neutralization system (Dynesys) keeps the spinal motion ability and improve clinical symptoms of patients,moreover,it shows a certain advantage in delaying the degeneration of adjacent segments.From the available documents,the preliminary biomechanical and clinical results of Dynesys were optimistically,it has become another choice in treating the lumbar degenerative diseases besides the lumbar fusion,and it primarily applies to the treatment of mild to moderate lumbar degenerative disease.However,it lacks a mechanism to maintain and restore the lumbar lordosis and patients need active stretching to achieve lordosis.What's more,how to extend the service life and prevent complications remain to be solved,the long-term effect and the mechanism of delaying the adjacent segment degeneration need further investigation.In this article,the design principle,biomechanical research,clinical outcome and clinical application of Dynesys was reviewed.

  9. X-STOP棘突间撑开器治疗腰椎退行性疾病的中期临床疗效%Mid-term Follow-up Outcome of X-STOP Interspinous Implant for Degenerative Lumbar Disease

    Institute of Scientific and Technical Information of China (English)

    赵泉来; 李逸峰; 徐宏光; 宋俊兴; 王弘; 刘平; 王凌挺; 陈学武; 杨晓明; 张玙

    2012-01-01

    目的:探讨X-STOP棘突间撑开器治疗腰椎退行性疾病的中期临床疗效.方法:2008年1月~2011年3月,我院采用X-STOP棘突间撑开器治疗腰椎退行性疾病患者30例,其中男12例,女18例;记录并比较术前、术后及末次随访患者的腰腿痛情况、腰椎间活动度、椎间盘高度.结果:平均随访(2.9±1.23) a.术后患者腰腿痛明显缓解;JOA评分、ODI评分与椎间高度术后及末次随访数据与术前比较,差异有统计学意义(P﹤0.05);终板夹角术后及末次随访数据与术前比较,差异均无统计学意义(P>0.05).结论:正确选择合适的病例,X-STOP棘突间撑开器治疗腰椎退行性疾病的中期临床疗效满意.%Objective:To investigate the mid -term follow -up outcome of X - STOP interspinous implant for degenerative lumbar disease . Methods:From January 2008 to March 2011 ,30 cases(12 males, 18 females) with degenerative lumbar disease were treated with X - STOP interspinous implant. Low back pain score, restoration of intervertebral disc height and lumbar range of movement were observed in all patients . All data were recorded during peroperation , postoperation and final follow -up. Results:The average follow-up period was (2. 9 ± 1. 23) months. Patients' low back pain gained significant relief. JO A and ODI had significant difference between preoperation and postoperation ,preoperation and final follow -up data (P 0.05 ) . Restoration of intervertebral disc height had significant difference between preoper -ation and postoperation ,preoperation and final follow-up data (P < 0. 05 ) . Conclusions; Mid-term follow-up outcome of X - STOP interspinous implant is an effective and reliable option for degenerative lumbar disease if the case is favorable to this procedure .

  10. Degenerative disc disease of the lumbar spine: a prospective comparison of fast T1-weighted fluid-attenuated inversion recovery and T1-weighted turbo spin echo MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, L. Oktay [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey)]. E-mail: sunarerdem@yahoo.com; Erdem, C. Zuhal [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey); Acikgoz, Bektas [Department of Neurosurgery, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey); Gundogdu, Sadi [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey)

    2005-08-01

    Objective: To compare fast T1-weighted fluid-attenuated inversion recovery (FLAIR) and T1-weighted turbo spin-echo (TSE) imaging of the degenerative disc disease of the lumbar spine. Materials and methods: Thirty-five consecutive patients (19 females, 16 males; mean age 41 years, range 31-67 years) with suspected degenerative disc disease of the lumbar spine were prospectively evaluated. Sagittal images of the lumbar spine were obtained using T1-weighted TSE and fast T1-weighted FLAIR sequences. Two radiologists compared these sequences both qualitatively and quantitatively. Results: On qualitative evaluation, CSF nulling, contrast at the disc-CSF interface, the disc-spinal cord (cauda equina) interface, and the spinal cord (cauda equina)-CSF interface of fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.001). On quantitative evaluation of the first 15 patients, signal-to-noise ratios of cerebrospinal fluid of fast T1-weighted FLAIR imaging were significantly lower than those for T1-weighted TSE images (P < 0.05). Contrast-to-noise ratios of spinal cord/CSF and normal bone marrow/disc for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.05). Conclusion: Results in our study have shown that fast T1-weighted FLAIR imaging may be a valuable imaging modality in the armamentarium of lumbar spinal T1-weighted MR imaging, because the former technique has definite superior advantages such as CSF nulling, conspicuousness of the normal anatomic structures and changes in the lumbar spinal discogenic disease and image contrast and also almost equally acquisition times.

  11. Risk factors for septic arthritis in patients with joint disease: A prospective study

    NARCIS (Netherlands)

    C.J. Kaandorp; D. van Schaardenburg (Dirkjan); P. Krijnen (Pieta); J.D.F. Habbema (Dik); M.A.F.J. van de Laar (Mart)

    1995-01-01

    markdownabstractObjective. To quantify potential risk factors for septic arthritis, in order to identify a basis for prevention. Methods. The occurrence of potential risk factors for septic arthritis in patients with joint diseases attending a rheumatic disease clinic was prospectively monitored

  12. Development of modulators against degenerative aging using radiation fusion technology

    Energy Technology Data Exchange (ETDEWEB)

    Jo, S. K.; Park, H. R.; Jang, B. S.; Roh, C. H.; Eom, H. S.; Choi, N. H.; Seol, M. A.; Kim, S. H.; Choi, H. M.; Park, M. K.; Shin, H. J.; Ryu, D. K.; Oh, W. J.; Kim, S. H; Yee, S. T.

    2012-04-15

    1. Objectives Establishment of modelling of degenerative aging using radiation technology Development of aging modulators using radiation degenerative aging model 2. Project results Establishment of the modeling of degenerative aging using radiation technology - The systematic study on the comparison of radiation-induced degeneration and natural aging process in animals and cells confirmed the biological similarity between these two degeneration models - The effective biomarkers were selected for the modelling of degenerative aging using radiation (10 biomarkers for immune/hematopoiesis, 1 for oxidative stress, 6 for molecular signaling, 3 for lipid metabolism) - The optimal irradiation condition was established for the modelling of degerative aging (total 5Gy with fractionation by over 10 times, lapse of over 4 months) - The molecular mechanisms of radiation-induced degeneration were studied including chronic inflammation (lung), inflammation-related lipid metabolism disturbance, mitochondria biogenesis and dynamics - The radiation degenerative model was evaluated with previously known natural substances (resveratrol, EGCG, etc) Development of aging modulators using radiation degenerative aging model - After the screening of about 800 natural herb extracts, 5 effective substances were selected for aging modulation. - 3 candidate compositions were selected from 20 compositions made from effective substances by in vitro evaluation (WAH2, WAH6, WAH7) - 1 composition (WAH6) was selected as the best aging modulator by in vivo evaluation in radiation-induced aging models and degenerative disease models. 3. Expected benefits and plan of application The modelling of degenerative aging using radiation can facilitate the aging research by providing the useful cell/animal models for aging research A large economic benefits are expected by the commercialization of developed aging modulators (over 10 billion KW in 2015.

  13. BioFlex Dynamic Stabilization System in Treatment of Lumbar Degenerative Diseases%BioFlex动态稳定系统治疗腰椎退行性变疾病

    Institute of Scientific and Technical Information of China (English)

    黄升峰; 李展振; 张海存; 吴沧陆; 黄明

    2015-01-01

    BioFlex动态稳定系统是目前临床运用较多的后路非融合系统之一,具有容易安装、对组织损伤小、去除病变并保留手术节段功能等优点,治疗腰椎退行性变疾病疗效肯定。%BioFlex dynamic stabilization system is one of the currently most used posterior non-fusion systems, which has some advantages such as easy installing, slight tissue damage, lesions removing and the functions of operated segments can be kept, and significant curative effect would be got when it's used in treatment of lumbar degenerative diseases.

  14. 退变性腰椎间盘病外科治疗现状与研究%The present status of surgical treatment and research of degenerative lumbar disk disease

    Institute of Scientific and Technical Information of China (English)

    党耕町

    2002-01-01

    @@ 本期刊登有关脊柱疾患的论文9篇,其中5篇是关于腰椎间盘病的病理与手术治疗的研究.作者根据临床实践或实验研究中的问题,进行了系统地观察、分析、总结,得出结论并提出各自的观点. 退变性椎间盘病 (degenerative disk disease, DDD)是中老年人群中的常见病、多发病,是脊柱外科医生或骨科医生几乎每天都要处理的临床问题.

  15. Complications and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion for the treatment of one- or two-level degenerative disc diseases of the lumbar spine in patients older than 65 years

    Institute of Scientific and Technical Information of China (English)

    WU Wen-jian; LIANG Yu; ZHANG Xin-kai; CAO Peng; ZHENG Tao

    2012-01-01

    Background Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been successfully used to treat degenerative diseases of the lumbar spine.There are few reports comparing the complications and clinical outcomes in older patients who have undergone one- or two-level MIS-TLIF with those of younger patients.The aim of this study was to investigate the clinical outcomes of MIS-TLIF in the treatment of degenerative disc disease of lumbar spine of the patients older than 65 years,with an emphasis on perioperative complications compared to the younger patients.Methods One hundred and fifty-one consecutive cases of one- or two-level degenerative disc disease of lumbar spine treated with MIS-TLIF were reviewed for the radiological and clinical outcomes.They were divided into elderly group (age ≥65 years old) and younger group (age <65 years old),and were followed for at least 6 months.Radiographs were obtained before and after surgery,3 months postoperatively,and at the final follow-up to determine the presence of fusion,hardware-related problems.The clinical outcomes were evaluated using the Oswestry Disability Index (ODI)before and after surgery,and at the final follow-up.The visual analogue scale (VAS) score of back and leg pain were evaluated as well.The intra-operative data and peri-operative complications were recorded.Results The mean age of these patients at operation was (57.7±14.2) years (range 26-82 years).Of 151 patients,62were 65 years or older.The elderly patients had more comorbidities and more porportion of lumbar canal stenosis.The overall fusion rate was 88.4% at the final follow-up,with no significant difference between younger and elderly patients.The ODI,the VAS of back pain and radicular pain of both young and elderly group were significantly improved aftersurgery and at the final follow-up,without significant difference between two groups.There were 16 complications with an incidence of 10.6%,including 7 major complications

  16. Current of mesenchymal stem cells for treatment of intervertebral disc degenerative diseases%间充质干细胞治疗椎间盘退变性疾病的研究进展

    Institute of Scientific and Technical Information of China (English)

    朱伟荣

    2010-01-01

    @@ 椎间盘退变性疾病(degenerative disc disease,DDD)是指由椎间盘退变(intervertebral disc degeneration,IDD)引起的一系列疾病如腰椎间盘突出症、颈椎病、椎间盘源性疼痛、椎管狭窄症以及脊柱节段不稳等的总称.治疗DDD的传统方法包括保守治疗和手术治疗,可以在一定程度上缓解部分临床症状,但未能从根本上解决椎间盘本身的病变问题,切除椎间盘还可因脊柱不稳而导致退变的进一步恶化.

  17. 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。

  18. Treatment of modified minimally invasive TLIF and unilateral nail holding system for lumbar degenerative disease%微创改良TLIF联合单侧钉棒系统固定治疗腰椎退行性疾病

    Institute of Scientific and Technical Information of China (English)

    赖征文; 李敏; 熊卜贵; 李平安; 刘云彬

    2011-01-01

    [目的]探讨采用微创(minimally invasive)改良经腰椎间孔椎体间融合(modified transforaminal lumbar interbody fusion,TLIF)联合单侧钉棒系统治疗腰椎退行性疾病(lumbar vertebrae degenerative disease)的适应证、手术方法、初步疗效及并发症.[方法]2010年1月~2011年3月,随机选取有微创TLIF术适应证腰椎退行性疾病病例30例,其中微创改良TLIF联合单侧钉棒系统固定组(A组)15例,常规开放TLIF组(B组)15例,行各自术式手术并进行对照研究.[结果]术后6个月A组同B组在腰椎椎间植骨融合率、JOA评分等比较差异均显著,具有统计学意义(P(0.05).[结论]微创改良TLIF联合单侧钉棒系统固定治疗腰椎退行性疾病具有软组织损伤小、出血量少、不破坏对侧正常结构、住院时间短、腰椎椎间植骨融合率高、临床症状、体征及括约肌功能改善率高、并发症发生率低的优点,值得在临床推广应用.%[Objective]To discuss the treatment indications, surgical methods, preliminary results and complications of modified minimally invasive TLIF and unilateral nail holding system for lumbar degenerative disease.[Method]Thirty patients with indications of minimally invasive TLIF technique for degenerative illness were randomly selected from January 2010 to March 2011,15 cases were for minimally invasive TLIF improved holding system of the united unilateral screw fixation group ( group A ),15 cases were for conventional open TLIF technique ( group B).Controlled study was made for each surgical procedure.[Result]The lumbar interbody fusion rate, JOA scores between groups A and B showed statistically significant difference ( P < 0.05 ).[Conclusion]Modified minimally invasive TLIF and unilateral nail holding system for lumbar degenerative diseases has advantages of less soft tissue injury,less blood loss, avoiding destroying normal structure of contralateral, shorter hospital stay, higher lumbar interbody fusion rate

  19. Chronic Lyme disease arthritis: review of the literature and report of a case of wrist arthritis.

    Science.gov (United States)

    Scerpella, T A; Engber, W D

    1992-05-01

    A case of Lyme arthritis with advanced degenerative changes localized to the midcarpal joint was treated with a limited wrist arthrodesis with relief of pain and improved function. Chronic Lyme arthritis occurs as the third stage of Lyme disease. Serologic testing and a history of a characteristic rash may be helpful in the diagnosis. Radiographic and histopathologic findings are nonspecific, with both degenerative and inflammatory characteristics. Intravenous antibiotics provide an effective treatment of chronic Lyme arthritis.

  20. The degenerative and traumatized knee: Use of radioisotopes for diagnosis, evaluation and treatment

    International Nuclear Information System (INIS)

    Full text: Bone SPECT is a highly valuable method of investigation for the assessment of the knee joint. Its speed and low cost probably make it a suitable screening procedure for most knee traumatic and degenerative diseases. Consequently, bone SPECT is inevitably seen as a competitive and complementary procedure to MRI. The technique of radiation synovectomy has been available for more than 40 years in the management of joint diseases. Recently, there has been renewed interest in radiation synovectomy, following the introduction of some new and efficient radiopharmaceuticals. We present here our experience with the diagnosis and treatment of the traumatized and degenerative knees in 358 patients, together with the review of the literature. A special emphasis will be placed on the following topics: 1. Correlative imaging of planar and SPECT scintigraphy with correlation to MRI. 2. Quantitative and prognostic parameters. 3. The value of the method in sports and military medicine. 4. The value of bone scintigraphy in choosing candidates and planning arthroscopic and radiation synovectomy. 5. The clinical efficacy of particulate versus colloid radiopharmaceutical for radiation synovectomy. 6. The response rate to a single injection versus routine repeated injections of the radiopharmaceutical. 7. The clinical importance of some different techniques of treatment in different clinics, including injected dose, injection procedure, safety precautions, etc. 8. Comparison of the efficacy of radiation synovectomy to intra-articular corticosteroid injection. 9. The use of different 90Y colloids (resin, citrate, cilicate and ferric hydroxide), comparing especially the extent of regional lymph node irritation as a result of joint leakage. 10. The clinical importance of co-injection of corticosteroids with the radiopharmaceutical, in either colloidal or particular radiopharmaceuticals. 11. The importance of combined procedures of saline irrigation with radiopharmaceutical and

  1. 微创经椎间孔腰椎间融合术治疗腰椎退变性疾病%Clinical outcome of minimally invasive transforaminal lumbar interbody fusion in the treat-ment of lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    高爱国; 赵鹏; 张钦; 程力

    2016-01-01

    目的:探讨微创经椎间孔腰椎间融合术( MIS-TLIF)治疗腰椎退变性疾病的可行性和早期疗效。方法采用MIS-TLIF治疗30例腰椎退变性疾病患者,其中Ⅰ~Ⅱ度退行性或峡部裂型腰椎滑脱症12例,退行性腰椎管狭窄伴节段性不稳8例,腰椎间盘突出症10例。均为单节段融合。结果手术时间127~209(168±41) min;术中出血量23~361(192±169) ml;术中X线照射时间72~136(104±32) s;术后首次下床活动时间1.4~3.8(2.6±1.2) d。疼痛VAS评分术前(7.20±1.02)分,末次随访(1.71±0.66)分,差异有统计学意义(P<0.01)。末次随访椎间融合率为100%。未发生并发症。 X线片显示cage无移位、松动、下沉,椎弓根钉无松动、折断。结论 MIS-TLIF对腰椎的解剖结构破坏小,对椎旁肌肉的剥离少,患者术后恢复快,是一种有效、安全、损伤较小的手术方法,可用于腰椎不稳、局限节段椎间盘病变、≤Ⅱ度以下腰椎滑脱的患者;但手术时间较长,医患X线暴露较多。%Objective To investigate the feasibility and early curative effect of minimally invasive transforaminal lum-bar interbody fusion ( MIS-TLIF) in the treatment of low lumbar degenerative disease. Methods A total of 30 pa-tients underwent MIS-TLIF for low lumbar degenerative disease. They contained 12 cases ofⅠ~Ⅱdegree spondylo-listhesis,8 cases of degenerative lumbar spinal stenosis with segmental instability and 10 cases of protrusion of lumbar intervertebral disc. All the patients underwent one-level fusion by the same surgeon. Results The surgical time, in-traoperative blood loss volume, X-ray exposed time and the first leaving bed time after surgery were 127~209(168 ± 41) min, 23~361(192 ± 169) ml, 72~136(104 ± 32) s,1. 4~3. 8(2. 6 ± 1. 2) d. VAS of the preoperative and the last follow-up were (7. 20 ± 1. 02)points and (1. 71 ± 0. 66)points,the difference had statistical significance(P<0. 01

  2. The degenerative spine: pattern recognition and guidelines to image interpretation.

    Science.gov (United States)

    Parizel, P M; Van Hoyweghen, A J L; Bali, A; Van Goethem, J; Van Den Hauwe, L

    2016-01-01

    Degenerative disease of the spine, in the form of intervertebral disc degeneration and bony growth, causing osteophytes and impinging upon the spinal canal and neural foramina, is the most frequent disorder affecting the spine. In this chapter we first discuss briefly the indications for computed tomography or magnetic resonance imaging in suspected degenerative spine disease. We then describe changes of disc height, signal intensity, and disc contour with aging and repeated microtrauma, as well as the imaging techniques most appropriate to image them. A grading system for lumbar disc changes is provided. Stenosis of the canal and neural foramina is reviewed next, concluding with a description of degenerative changes affecting the vertebral endplates and bone marrow.

  3. The degenerative spine: pattern recognition and guidelines to image interpretation.

    Science.gov (United States)

    Parizel, P M; Van Hoyweghen, A J L; Bali, A; Van Goethem, J; Van Den Hauwe, L

    2016-01-01

    Degenerative disease of the spine, in the form of intervertebral disc degeneration and bony growth, causing osteophytes and impinging upon the spinal canal and neural foramina, is the most frequent disorder affecting the spine. In this chapter we first discuss briefly the indications for computed tomography or magnetic resonance imaging in suspected degenerative spine disease. We then describe changes of disc height, signal intensity, and disc contour with aging and repeated microtrauma, as well as the imaging techniques most appropriate to image them. A grading system for lumbar disc changes is provided. Stenosis of the canal and neural foramina is reviewed next, concluding with a description of degenerative changes affecting the vertebral endplates and bone marrow. PMID:27430442

  4. Study on 3.0 T Superconducting MR Imaging in the Diagnosis of Senile Degenerative Osteoarthrosis of Knee Joints%3.0T超导磁共振成像对老年膝关节退行性骨关节病的诊断研究

    Institute of Scientific and Technical Information of China (English)

    王志利; 徐丹凤; 赵树军; 刘兵; 孟凡州

    2015-01-01

    目的:探讨3.0T超导磁共振成像对老年膝关节退行性骨关节病的诊断价值。方法回顾性分析2012年6月至2013年4月衡水市哈励逊国际和平医院临床确诊的90例老年膝关节退行性骨关节病患者的磁共振影像表现。结果90例患者均出现不同程度的关节软骨损伤(Ⅱ级36例,Ⅲ级54例),骨质增生改变及不等量的关节腔积液;关节软骨下骨质破坏68例;骨髓水肿34例;半月板退变及损伤72例(Ⅰ级15例,Ⅱ级44例,Ⅲ级13例);韧带损伤18例(交叉韧带10例,侧副韧带8例);关节腔游离体5例(软骨游离体2例,骨性游离体3例)。结论3.0T超导磁共振成像能清晰地显示老年膝关节退行性骨关节病患者的关节骨质、关节软骨、滑膜、韧带及半月板等结构,为临床准确诊断与评估损伤程度提供直接影像依据。%Objective To study the diagnostic value of 3.0 T superconducting MR imaging in senile degenerative osteoarthrosis of knee joints.Methods MR imaging manifestations of 90 aged patients with degenerative osteoarthrosis of knee joints diagnosed in Hengshui Halison International Peace Hospital from Jun.2012 to Apr.2013 were retrospectively analyzed.Results There were different degrees of arthrodial cartilage damage in all the cases(grade Ⅱ in 36 cases,grade Ⅲ in 54 cases),as well as bone hyperplasia and different amounts of arthroedema;there were also destruction of bone under arthrodial cartilage in 68 cases,bone marrow edema in 34 cases, meniscus degeneration and injury in 72 cases( gradeⅠin 15 cases, grade Ⅱ in 44 cases,grade Ⅲ in 13 cases),ligament injury in 18 cases(cruciate ligament injury in 10 cases,collateral ligament injury in 8 cases) ,joint loose body in 5 cases ( cartilage loose body in 2 cases,bone loose body in 3 cases) among all the 90 cases.Conclusion Structures of joint bone,articular cartilage, synovium, ligament and meniscus of elderly patients

  5. Distribution of Aggrecan Gene VNTR in a Family of Multiple Degenerative Disc Disease%1个多发性椎间盘退行性变疾病家系Aggrecan基因串联重复多态性的分析

    Institute of Scientific and Technical Information of China (English)

    丛琳; 屠剑桥; 李雨辰; 屠冠军

    2012-01-01

    目的 分析1个多发性椎间盘退行性变疾病(DDD)家系的聚合蛋白聚糖(Aggrecan)基因串联重复多态性(VNTR).方法 应用PCR技术检测家系成员血液中Aggrecan VNTR的分布情况.结果 被检测的家系成员中未发现超过25次重复的等位基因者,家系患DDD成员Aggrecan基因VNTR分布:均为杂合子,且有1个等位基因≤20个重复序列.结论 本家系中遗传因素是DDD的主要诱发因素,且可能与相对较小重复序列Aggrecan VNTR有关.%Objective To analyze the distribution of Aggrecan gene VNTR in a family of multiple degenerative disc disease. Methods Four membeis of a family living in different areas when they were underage. They were engaged with various jobs. They all suffered from degenerative disc disease. The Aggrecan gene VNTR region was analyzed by PCR. Results There was no participant with more than 25 allele repeats in this family. All degenerative disc disease patients in this family were heterozygous with 1 allele ≤ 20 repeats. Conclusion Genetic factor is the main causative factor of degenerative disc disease in this family. In addition, this study observed an association between the low tendency of allele repeats distribution of Aggiecan gene VNTR polymorphism with degenerative disc disease.

  6. Economic evaluation of interventions for inflammatory rheumatic joint diseases

    OpenAIRE

    2015-01-01

    The effectiveness of biologic disease-modifying antirheumatic drugs (bDMARDs) in the treatment of rheumatoid arthritis (RA) has been documented in randomized controlled clinical trials (RCTs). The medical costs of using bDMARDs are substantially higher than those of synthetic DMARDs (sDMARDs). The overarching aim of this thesis was to compare costs and effectiveness of bDMARDs versus sDMARDs for patients with RA. The papers constituting the thesis used observational data from the Norwegia...

  7. Emphasis on the integration of advanced biological technology in retinal degenerative diseases%重视前沿生物技术在视网膜退行性疾病中的整合应用

    Institute of Scientific and Technical Information of China (English)

    张敬学; 卢清君

    2015-01-01

    Retinal degenerative diseases , such as retinitis pigmentosa ( RP ) , age-related macular degeneration ( AMD ) , as well as glaucoma and other diseases the main pathological basis of abnormal structure and function of retinal neurons at all levels ,resulting in irreversible damage to the visual acuity ,is the leading cause of irreversible blindness , and lack of effective treatment methods .With the rapid development of science and technology in recent years , gene therapy , stem cell therapy , adaptive optics technology and artificial vision to the treatment of these diseases may be provided .The completion of the human genome project and the wide application of the related sequencing technology have brought a new revolution to the nature of the disease ,and also brought new impetus to the disease molecular classification , biological diagnosis and gene therapy .People′s understanding of the eye disease is also more comprehensive , the treatment plan on the basis of gene replacement therapy ,and further integrated cell factor therapy ,and the treatment of light genetics , etc..The gene therapy technology has made great progress in Department of Ophthalmology ,but it can not stop some of the functions of cell apoptosis , which requires us to combine a class of genes that can save the cell apoptosis ,or need to use alternative treatment ,the functional cells instead of the injured cells , thereby restoring its function .Because of the unlimited proliferation and multi differentiation potential of stem cells ,it has become a new hope for cell replacement therapy .The retinal stem cell transplantation ,which is integrated into the retina ,and differentiated into the target cells ,to reconstruct the retinal function , has brought the light to the irreversible blindness .The self-renewal and multiple differentiation potential of neural stem cells ,which are suitable for the cell transplantation ,and the expansion of the widely used neural stem cells in vitro and in

  8. Dynesys dynamic neutralization system for the treatment of lumbar degenerative disease and the effect on the adjacent segment%Dynesys系统治疗腰椎退行性疾病对邻近节段的影响**☆

    Institute of Scientific and Technical Information of China (English)

    杨波; 万盛钰; 曾勉东; 吕玉明; 方世兵; 谢景开

    2013-01-01

      背景:大多数文献报道Dynesys动态中和稳定系统在治疗腰椎退行性疾病中取得了较好的临床疗效,但能否防止邻近节段退行性病变发生仍然存在争议。  目的:观察Dynesys系统治疗腰椎退行性疾病的临床疗效及对邻近节段的影响。  方法:自2009年3月至2012年10月收治20例腰椎退行性疾病患者,均采用手术减压加Dynesys系统动态固定治疗。Dynesys动态系统由Zimmer公司提供,由钛合金椎弓根螺钉、聚氨基甲酸乙酯套管和聚对苯二甲酸乙酯绳索组成。以目测类比评分、Oswestry 功能障碍指数进行临床疗效评价;依照Woodend评分评估邻近椎间盘退变程度;治疗有效率按Macnab标准评价。  结果与结论:20例患者全部获得随访,时间22-31个月。临床疗效按Macnab标准评价:优11例,良6例,可3例,优良率达85%。末次随访时,患者目测类比评分显著低于治疗前[(2.25±1.67)分,(8.29±1.50)分,P0.05)。提示Dynesys系统动态固定治疗腰椎退变性疾病早期疗效确切,长期疗效及其防止或延缓邻近节段退变的作用尚需多中心随机对照临床试验来证实。%BACKGROUND:Numerous studies show Dynesys dynamic neutralization system has achieved good clinical efficacy in the treatment of lumbar degenerative disease. But whether Dynesys dynamic neutralization system can prevent the adjacent segment degenerative disease is stil controversial. OBJECTIVE:To investigate the efficacy of the Dynesys system for the treatment of lumbar degenerative disease and impact on adjacent segments. METHODS:From March 2009 to October 2012, 20 consecutive patients with lumbar degenerative disease were included in this study. Al the patients were treated with surgical decompression plus Dynesys system dynamic fixation. The Dynesys system was provided by Zimmer Company, and composed with titanium al oy pedicle screws, polyurethane sleeve and

  9. Comparison of the costs of nonoperative care to minimally invasive surgery for sacroiliac joint disruption and degenerative sacroiliitis in a United States commercial payer population: potential economic implications of a new minimally invasive technology

    Directory of Open Access Journals (Sweden)

    Ackerman SJ

    2014-05-01

    Full Text Available Stacey J Ackerman,1 David W Polly Jr,2 Tyler Knight,3 Karen Schneider,4 Tim Holt,5 John Cummings Jr6 1Covance Market Access Services Inc., San Diego, CA, USA; 2University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, USA; 3Covance Market Access Services Inc., Gaithersburg, MD, USA; 4Covance Market Access Services Inc., Sydney, Australia; 5Montgomery Spine Center, Orthopedic Surgery, Montgomery, AL, USA; 6Community Health Network, Neurosurgery, Indianapolis, IN, USA Introduction: Low back pain is common and treatment costly with substantial lost productivity and lost wages in the working-age population. Chronic low back pain originating in the sacroiliac (SI joint (15%–30% of cases is commonly treated with nonoperative care, but new minimally invasive surgery (MIS options are also effective in treating SI joint disruption. We assessed whether the higher initial MIS SI joint fusion procedure costs were offset by decreased nonoperative care costs from a US commercial payer perspective. Methods: An economic model compared the costs of treating SI joint disruption with either MIS SI joint fusion or continued nonoperative care. Nonoperative care costs (diagnostic testing, treatment, follow-up, and retail pharmacy pain medication were from a retrospective study of Truven Health MarketScan® data. MIS fusion costs were based on the Premier's Perspective™ Comparative Database and professional fees on 2012 Medicare payment for Current Procedural Terminology code 27280. Results: The cumulative 3-year (base-case analysis and 5-year (sensitivity analysis differentials in commercial insurance payments (cost of nonoperative care minus cost of MIS were $14,545 and $6,137 per patient, respectively (2012 US dollars. Cost neutrality was achieved at 6 years; MIS costs accrued largely in year 1 whereas nonoperative care costs accrued over time with 92% of up front MIS procedure costs offset by year 5. For patients with lumbar spinal fusion, cost neutrality

  10. 旁正中入路单侧固定椎间融合治疗腰椎退行性疾病%Unilateral Fixation and Intervertebral Fusion by Paramedian Approach to Treat Lumbar Degenerative Diseases

    Institute of Scientific and Technical Information of China (English)

    王晓斌

    2015-01-01

    Objective To analyze the clinical effects of lumbar degenerative diseases treated with unilateral fixation and transforaminal lumbar interbody fusion (TLIF) by paramedian approach. Methods 60 patients who suffered from lumbar degenerative diseases admitted to our hospital were selected. All patients were treated with unilateral pedicle screw internal fixation combined with TLIF. The intraoperative blood loss, operation time and length of incision were observed. Visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate the back pain, leg pain, and functional recovery before surgery, 3 months after surgery and at last follow-up. Results All the operations were successful, with the length of incision of (4.3 ± 0.4) cm (3.5~5.2 cm), intraoperative blood loss of (169 ± 73) mL (120 ~340 mL), and operation time of (104 ± 13) min (80 ~130 min). No serious complication was found after surgery, and the VAS scores of back pain and leg pain, and ODI after surgery were significantly lower than those before surgery (P<0.05). Conclusions The therapy of unilateral fixation and transforaminal lumbar interbody fusion (TLIF) by paramedian approach for lumbar degenerative diseases has the advantages of less trauma, less bleeding and faster postoperative recovery, which can help to alleviate back pain, and improve quality of life. Surgical indications must be considered comprehensively to ensure the best clinical outcomes.%目的 探讨旁正中入路单侧固定经椎间孔椎间融合 (TLIF) 治疗腰椎退行性疾病的临床效果. 方法 选取我院2012年1月至2015年1月收治的60例腰椎退行性疾病患者, 均采用旁正中入路单侧椎弓根螺钉内固定TLIF治疗, 观察术中出血量、手术时间、 切口长度等, 采用疼痛VAS评分、 功能障碍指数 (ODI) 于术前、 术后3个月及末次随访对患者腰痛、 腿痛、 功能恢复进行评估. 结果 60例患者均顺利完成手术, 手术切口长度3

  11. 经后路椎体间融合术治疗腰椎退变性疾病的临床疗效分析%Clinical efficacy analysis of PLIF in the treatment of degenerative lumbar disease

    Institute of Scientific and Technical Information of China (English)

    周先爱; 王利民; 谭洪宇

    2014-01-01

    Objective To investigate the clinical efficacy of posterior lumbar interbody fusion on degenerative lumbar disease.Methods The clinical data of 96 patients with degenerative lumbar disease who were treated in our hospital from August 2003 to February 2009 were analyzed retrospectively.All patients were treated by posterior lumbar interbody fusion(PLIF).The JOA score,VAS score and imaging evaluation of treatment were evaluated.Results All of the patients were followed-up for 12-35 months (average of 18.5 months),the preoperative JOA score was(6.55 ± 1.35),and JOA score was(12.65 ± 2.43) after 3 months,the JOA score at last follow-up was(13.33 ± 1.80) ; the preoperative VAS score was(7.80 ± 1.62),and VAS score was (2.64 ± 1.42) after 3 months,the VAS score at last follow-up was (1.09 ± 0.27).All patients had perfect interbody fusion by imaging examination after half a year,except for one patient with pedicle fracture caused by an accident,the remaining patients had no loosening or fracture.One case was complicated with incision infection,and cured by antibiotics.Two cases had cerebrospinal fluid leakage,and they were cured after improved nutrition and drainage.Conclusions PLIF is effiective and reliable in the treatment of degenerative lumbar disease.%目的 探讨腰椎退变患者行经后路椎体间融合术(PLIF)治疗的临床疗效.方法 对2003年8月至2009年2月入院治疗的96例腰椎退变疾病患者的临床资料行回顾性分析,所有患者均行PLIF术,分别对比患者术前、术后3个月及末次随访JOA评分、VAS评分以及影像学检查,评价患者的治疗效果.结果 术后随访12~35个月,平均18.5个月,术前JOA、VAS评分分别为(6.55±1.35)分、(7.80±1.62)分;术后3个月分别为(12.65±2.43)分、(2.64±1.42)分;末次随访分别为(13.33±1.80)分、(1.09±0.27)分.所有患者术后半年影像学检查均显示椎间融合良好,除1例患者术后发生车祸导致钉棒断裂外,其余患者内固

  12. Clinical outcomes of Isobar TTL dynamic stabilization system in the treatment of lumbar degenerative diseases%滑动牵张技术对膝关节创伤术后功能康复的影响

    Institute of Scientific and Technical Information of China (English)

    万里; 卞荣; 朱奕

    2012-01-01

    Objective To investigate the clinical outcomes of Isobar TTL dynamic stabilization system in the treatment of lumbar degenerative diseases. Methods A total of 74 patients with lumbar degenerative diseases was treated by decompressive surgery via posterior approach with Isobar TTL dynamic fixation operation(36 cases.group A) or with conventioal rigid fixation(38 cases,group B). The patients were followed up for 2 years and the clinical outcomes were compared. Results There was no difference in the operation time, intraoperative blood loss and complications of two groups were similar. The correct values of lumbar lordotic angle and sacral slope angle of group A were (20. 5 ± 2. 2) degrees and (15. 8±2. 9) degrees, which were greater than (14. 1±1.1) degrees and (12. 3± 2. 2) degrees of group B(P<0. 05). The excellence rates of JOA scores at 6 months, 1 year and 2 years were 88. 89%,94. 44% and 97. 22% in group A,which were greater than 65. 79%,73. 68% and 76. 32% in group B (P<0. 05). Conclusion Isobar TTL dynamic stabilization system is better than conventioal rigid fixation in the treatment of degenerative lumbar disease.%目的 探讨滑动牵张技术对膝关节创伤术后功能康复的影响.方法 膝关节创伤术后功能障碍患者70例均分为治疗组和对照组.对照组进行物理因子、运动疗法及手法治法,每天1小时.10d为1个疗程,共治疗4个疗程.治疗组在上述治疗的基础上,增加对髌股关节及胫股关节的滑动牵张治疗,每次20分钟.评估患膝关节治疗前后的关节活动范围(ROM);应用HSS全膝关节评定系统,评估患者治疗前后膝关节功能.结果 治疗后,两组膝关节ROM及HSS评分均较治疗前明显提高(P<0.05).治疗组膝关节ROM和HSS评分高于对照组[(115.2±14.7)度vs.(90.3±12.6)度和(83.7±14.4)分vs.(60.8±11.6)分](P<0.05).结论 加用膝关节滑动牵张技术能有效提高膝关节创伤术后的功能康复.

  13. The clinical effects of osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation%骨质疏松腰椎退行性疾病的手术治疗分析

    Institute of Scientific and Technical Information of China (English)

    孔祥瑞; 刘德政; 刘海峰; 杨计策; 赵志超

    2015-01-01

    ObjectiveTo explore the clinical effects of osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. Methods 82 cases of patients with lumbar degenerative dis-ease of osteoporosis word randomly divided into experiment group(41 cases) and control group(41 cases). The control group were treated by transpedicle screws fixation, the experiment group were treated by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. The time of operation, mean bleeding volum, the scores of VAS, ODI, JOA were com-pared for the two groups. ResultsThe time of operation, mean bleeding volum for the experiment group were better than the control group; There was no significant difference on the scores of VAS, ODI, JOA; The scores of VAS, ODI for the experiment group were lower than the control group postoperation for 1 week, 2 months, 12 months; The scores of JOA for the experiment group were higher than the control group postoperation for 1 week, 2 months, 12 months. ConclusionIt can improve the scores of VAS, ODI, JOA for the patients with osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. It is worthy of clinical promotion.%目的:探讨可注射硫酸钙骨水泥强化椎弓根钉内固定治疗骨质疏松腰椎退行性疾病的临床疗效。方法:按照随机数字表法将我院收治的82例骨质疏松腰椎退行性疾病患者均分为实验组和对照组,对照组给予单纯椎弓根内固定治疗,实验组给予可注射硫酸钙骨水泥强化椎弓根钉内固定治疗。比较两组患者手术时间、术中出血量以及治疗前后疼痛视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)、JOA 腰椎病疗效评分变化情况。结果:实验组患者手术时间和术中出血量显著高于对照组;两组患者术前 VAS 评分、ODI 评分、JOA

  14. Wallis动态稳定系统治疗腰椎退行性疾病%Preliminary observation of Wallis dynamic stabilization system for treatment of lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    普有登; 汤逊; 周田华; 石健; 姜伟; 张金鹏

    2011-01-01

    Objective To analyze the early clinical effects of Wallis dynamic stabilization system for the treatment of lumbar degenerative diseases, and to discuss the indications of this technique.Methods The clinical outcomes of 26 patients with lumbar degenerative diseases treated by only Wallis interspinous dynamic stabilization system or combined with posterior lumbar fusion were studied retrospectively.The visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores were recorded pre- and postoperatively.The ratio of JOA was applied to evaluate the curative effect.Results All the cases were followed up for a mean period of 14months ( rangel 6-24 months).Imaging showed all implants no loosening, dislocation or fracture.The VAS scores were 7.62 ± 1.50, 2.42 ± 1.03, 0.85 ± 0.73 at 1 d preoperative, 2 weeks postoperative and the final follow-up respectively.JOA scores were 10.12 ± 2.42, 20.62 ± 2.28, 24.92 ± 2.45 at 1 d preoperative, 2 weeks postoperative and the final follow-up respectively.The JOA improvement rates of 24 cases(92.3% ) were good/excellent at the final follow-up.Conclusion It is benefit to use Wallis interspinous dynamic stabilization system or combination with postreior lumbar fusion for remaining motor function of reserved spinal segments, with the advantage of mini-tissue damage and excellent effects.It is a good choice for the treatment of lumbar degenerative diseases.%目的 分析Wallis棘突间动态稳定系统治疗腰椎退行性疾病的早期效果,并探讨其手术适应证.方法 分析26例单独采用Wallis棘突间动态稳定系统或联合固定融合术治疗腰椎退行性疾病患者的临床疗效和初期随访结果,记录术前及术后疼痛视觉模拟量表(visual analogue scale,VAS)评分(10分法)、下腰痛日本骨科协会(Japanese Orthopaedic Association,JOA)评分(29分法),计算JOA改善率评估手术疗效.结果 经6~24个月(平均14个月)的随访,影像学显示内置物无

  15. 小针刀治疗早期退行性下颈椎失稳症的临床观察%Clinical study of akupotomye therapy on early degenerative disease of cervical spine instability

    Institute of Scientific and Technical Information of China (English)

    陈青; 龚志贤; 张月娟; 周芳

    2011-01-01

    Objective To observe and compare the clinical efficacy of the treatment in early degenerative disease of cervical spine instability with the akupotomye and neck collar protection.Methods 60 patients the disease were randomly divided into test group (akupotomye group)and control group(cervical collar group), 30 patients in each group.The indexes of neck pain before and after treatment and the changes of AD HD imaging value were measured.Results 1.After treatment, the indexes of pain in both groups were significantly lowered, and the test group was much lower than that in control group (P<0.05); the total effective rate was 83.3% in test group and 73.3% in control group (P<0.05).2.The imaging values of HD in test group was better than that in control group (P<0.05), but the D-value of AD was not significant (P>0.05).Conclusion The akupotomye therapy for early degenerative disorder of lower cervical spine instability can significantly reduce the neck pain index figure and significantly improve the HD and AD values, which is effective therapy for early degenerative disease of the lower cervical spine instability.%目的 观察并比较小针刀与颈托保护治疗早期退行性下颈椎失稳症的临床疗效.方法 早期退行性下颈椎失稳症患者60例,随机分为试验组(针刀组)和对照组(颈托组),每组各30例.观察两组患者治疗前后疼痛指数、影像学水平位移之和(HD)值及角位移(AD)值变化.结果 1.两组治疗后疼痛指数积分均显著降低,试验组优于对照组(P<0.01);颈痛指数疗效试验组总有效率达83.3%,对照组为73.3%,试验组优于对照组(P<0.05).2.两组治疗前后影像学HD差值试验组优于对照组(P<0.05);AD差值两组差异无统计学意义(P<0.05).结论 小针刀治疗早期退行性下颈椎失稳症能明显降低患者颈痛指数,并显著改善HD值及AD值,是治疗早期退行性下颈椎失稳症的一种疗效确切的治疗方法.

  16. Unilateral instrumented transforaminal lumbar interbody fusion in low lumbar degenerative diseases%单侧椎弓根固定经椎间孔椎体间融合术治疗下腰椎退行性疾病

    Institute of Scientific and Technical Information of China (English)

    贾其余; 俞宇; 王林; 郭万根; 胡联英; 程晓东

    2014-01-01

    目的:评价单侧椎弓根固定经椎间孔腰椎椎体间融合术( TLIF)治疗下腰椎退行性疾病的疗效。方法采用单侧TLIF术治疗41例下腰椎退行性疾病患者,均为单节段手术。观察手术时间、术中出血量及并发症情况。采用腰痛和腿痛视觉模拟评分( VAS)与Oswestry功能障碍指数( ODI)评价临床效果,并通过影像学检查对椎体间融合情况进行评价。结果41例均获随访,时间24~59(38±6)个月。手术时间80~180(125±10)min,术中出血量100~550(310±30)ml。手术切口均一期愈合。腰痛VAS分值由术前的(6.5±2.1)分下降至末次随访时的(2.3±0.9)分(P<0.01),腿痛VAS分值由术前的(7.6±2.3)分下降至末次随访时的(1.2±0.8)分(P<0.01),ODI由术前的54.2±10.9下降至末次随访时的13.8±2.1(P<0.01)。末次随访融合率为95%,未发现继发性脊柱侧弯、螺钉松动、断裂及Cage移位等情况。结论单侧TLIF术可有选择地治疗下腰椎退行性疾病,其疗效确切,并具有创伤小、手术时间短、出血少、并发症少等优点。%Objective To investigate the effect of unilateral instrumented transforaminal lumbar interbody fusion ( TLIF) in the treatment of low lumbar degenerative diseases. Methods 41 patients with low lumbar degenerative diseases in single segment were treated with unilateral pedicle screw fixation TLIF. Operative time, intraoperative blood loss and complications were observed. The visual analogue scale ( VAS ) and the Oswestry disability index ( ODI) were used to evaluate clinical effect, and radiographic parameters were used to evaluate the fusion rates. Re-sults All cases were followed up for 24~59(38 ±6)months. The operative time was 80~180(125 ±10)min, the intraoperative blood loss was 100~550(310 ± 30) ml. All incisions healed by first intention. The lumbar pain VAS scores dropped from 6. 5 ± 2. 1 preoperatively to 2. 3 ± 0. 9 at final followed-up (P <0. 01), the limb pain VAS

  17. Application of expandable spinal spacer in lumbar degenerative disease%可膨胀性椎间融合器在腰椎退行性疾病治疗中的临床应用

    Institute of Scientific and Technical Information of China (English)

    王宏波; 燕军; 刘世学; 赵有春; 彭军; 李春华

    2011-01-01

    Objective: To explore the clinical therapeutic effect of expandable spinal spacer in lumbar degenerative disease. Methods: 50 patients in lumbar degenerative disease were treated with expandable spinal spacer from April 2009 to May 2010 in our hospital, of which there were 41 cases who obtained the microscopic posterior disc operation treatment, 9 cases who obtained the lateral percutaneous wear treatment. The clinical data of treatment effect, fusion rate, bone graft height and complications were analyzed retrospectively. Results: In the follow-up time for 8-38 months, the effects were evaluated according to the standard of Odom. The results showed that, 36 cases were excellent, accounting for 72%; 9 cas -es were well, accounted for 18%; 4 cases were common, accounted for 8%; 1 case was inferior, accounted for 2%. The symptoms of patients improved obviously, its good rate could amount to 90%. CT image showed that there was no disc her-niation and vertebra canal stenosis, and also no shift phenomenon between vertebra and expandable spinal spacer, the bone had merged, bone graft height had not obviously decreased. Patients were followed up with the results of only 3 cases of complications with the incidence rate was 6%. Conclusion: Expandable spinal spacer applied to treat the lumbar degenerative disease has small trauma, high safety, fusion rate high, good restore and other advantages, which has a good applica -tion prospect and is worthy of clinical application.%目的:探讨可膨胀性椎间融合器治疗腰椎退行性疾病的效果.方法:2009 年4 月~2010 年5 月我院对50 例患者采用可膨胀性椎间融合器治疗腰椎退行性疾病,其中采用后路椎间盘镜下操作治疗的有41 例,采用后外侧经皮穿治疗的有9 例.回顾性分析其临床资料,对其治疗效果、植骨融合率、椎间隙高度及并发症等进行分析.结果:术后随访时间8~38 个月,平均16 个月,按照Odom 标准对治疗效

  18. 退变性腰椎间盘病患者围手术期护理干预体会%Experience of peri-operation period nursing intervention on patients suffered degenerative lumbar disc disease

    Institute of Scientific and Technical Information of China (English)

    周丽芳

    2015-01-01

    目的:探讨退变性腰椎间盘病患者围手术期的有效护理干预措施,并分析护理效果。方法本文的调查对象选用的是我院退变性腰椎间盘病患者,共88例。将此88例患者随机分为A、B两组,两组患者均选用手术方法治疗。 A组退变性腰椎间盘病患者在围手术期间选用常规护理方法,B组患者则选用针对性护理干预方法,比较两组患者的护理效果及满意程度。结果 B组患者经针对性护理干预方法护理后的手术时间、出血量、住院时间等指标均显著少于A组患者,差异显著,P<0.05,具有统计学意义;且两组患者对护理方法的满意程度比较时,B组高于 A组,具有统计学意义(P<0.05)。结论针对性护理干预方法可有效缓解退变性腰椎间盘病患者手术前期的恐惧、抑郁等不良心理,提高了患者对治疗的配合度,同时也在一定程度上促进了护理工作的发展。%Objective We aimed to explore effective and perioperative nursing interventions for patients with degenerative lumbar disc disease and analyze nursing effect.Methods A total of 88 cases who suffered from degenerative lumbar disc disease were enrolled in this study.This 88 patients were randomly divided into A and B group, patients in both groups received surgical treatment.Patients in group A received conventional care during the perioperative period, however, patients in group B were given targeted nursing interventions, the effect and care satisfaction were compared.Results The operation time, blood loss, hospital stay and other indicators of patients group B were significantly less than those of patients in group A, the differences were statistically significant (P<0.05).The degree of satisfaction in group B was higher than that in group A, the difference was statistically significant (P<0.05).Conclusions Targeted nursing interventions can effectively alleviate the pre-fear, depression

  19. El ejercicio físico y su prescripción en pacientes con enfermedades crónicas degenerativas Physical exercise and its prescription in patients with chronic degenerative diseases

    Directory of Open Access Journals (Sweden)

    Rossana Gómez

    2010-09-01

    Full Text Available Las enfermedades crónicas degenerativas constituyen una de las principales causas de muerte a nivel mundial, por lo que su crecimiento significativo ha puesto en alerta a varios países, los cuales están adoptando medidas para combatir los factores de riesgos, algunos de los cuales son modificables; siendo el ejercicio regular, un medio de prevención y rehabilitación de estas enfermedades. Esta revisión tiene por objetivo, analizar los parámetros necesarios a tomar en cuenta en la prescripción de un programa de ejercicios en pacientes con obesidad, hipertensión arterial, dislipidemia y diabetes mellitus tipo 2.Chronic degenerative diseases constitute one of the main causes of death at a global level, and their significant increase has alerted many countries, which are taking measures to reduce risk factors, some of which are modifiable; being the regular exercise a means of prevention and rehabilitation of these diseases. The objective of this revision is to analyze the necessary parameters to take into account for the prescription of an exercise program in patients with obesity, high blood pressure dyslipidemia and diabetes mellitus type 2.

  20. Clinical results of pedicle screws with cement augmentation for treating lumbar degenerative diseases in the elderly%椎弓根螺钉骨水泥强化修复老年腰椎退变的早期效果

    Institute of Scientific and Technical Information of China (English)

    陈荣国; 代凤雷; 欧先锋; 杨超; 钱建吉; 曾怿; 任家云; 虞泽龙

    2014-01-01

    背景:老年腰椎退变患者在手术中常面临椎弓根螺钉把持力不足情况,易发生脱钉、固定不牢靠等风险,如何增加螺钉的把持力成为研究的热点。目的:探讨使用椎弓根螺钉骨水泥强化方案治疗老年腰椎退变的早期临床效果。方法:选择2012年8月至2014年4月收治的患腰椎退行性疾病行腰椎内固定治疗的患者65例,根据修复方案分为2组,椎弓根螺钉内固定骨水泥强化组24例,常规椎弓根螺钉内固定组41例。比较两组患者的一般情况,采用目测类比评分法和日本矫形科学学会腰椎功能评分表对患者腰背疼痛及下肢神经功能恢复情况进行评估。结果与结论:65例患者均完成手术,获得随访,随访时间为3-20个月,随访中均行腰椎正侧位片X射线片,未发现螺钉松动、脱落、断裂、椎间隙高度丢失等情况。椎弓根螺钉内固定骨水泥强化组患者的手术出血量、住院时间与常规椎弓根螺钉内固定组差异无显著性意义(P>0.05),椎弓根螺钉内固定骨水泥强化组术后3,6个月日本矫形科学学会腰椎功能评分及术后3个月的目测类比评分均较常规椎弓根螺钉内固定组显著改善(P 0.05)。提示将骨水泥沿椎弓根螺钉钉道注入椎弓根及椎体,可达到螺钉骨水泥强化的目的,增加螺钉的把持力,重建腰椎的稳定性,取得了满意的近期疗效。%BACKGROUND:Elderly patients with degenerative lumbar degeneration often appear insufficient holding power of pedicle screw in spine surgery, which is prone to occur de-pinning and leads to insecure fixation. How to increase the holding power of screws has become a hot research. OBJECTIVE:To observe the early clinical effect of pedicle screws with cement augmentation for treating lumbar degenerative diseases in elderly patients. METHODS:A total of 65 old patients with lumbar degenerative diseases received a treatment

  1. Continuous clinical observation of the Dynesys dynamic neutralization system for degenerative lumbar spine diseases%Dynesys动态稳定系统治疗下腰椎疾病效果观察

    Institute of Scientific and Technical Information of China (English)

    刘先哲; 许伟华; 叶树楠; 冯勇; 张波; 杨述华

    2013-01-01

    Objective To evaluate the clinical indications and outcomes of dynesys neutralization system in the treatment of degenerative lumbar diseases.Methods From January 2007 to December 2011,102 consecutive patients with degenerative lumbar spine diseases underwent posterior decompression and internal fixation with the Dynesys dynamic neutralization system.Among them,69 patients were followed up,including 39 males and 30 females,aged from 30 to 62 years (average,44 years).The series of cases were composed of 24 cases of lumber disc herniation,35 cases of degenerative spinal stenosis,10 cases of degenerative changes of lumbar discs.Results The mean follow-up period was 35 months (range,6-44 months).The visual analogue scale (VAS) score decreased from preoperative 8.6 (range,6-9) to postoperative 2.8 (range,0-5),and the Oswestry disability index (ODI) improved from preoperative 73% (range,30%-91%) to postoperative 30% (range,0-61%).There were no implant failure or infection.According to the evaluation criteria of surgical treatment for low back pain,which was established by the Chinese Orthopaedic Association,the result was excellent in 53 patients,good in 12 patients,fair in 4 patients and poor in 1 patient.Conclusion The Dynesys dynamic neutralization system is effective in the treatment of degenerative lumbar spine disease,which can reserve the range of motion of stabilized segments,prevent degeneration of adjacent segments and improve clinical outcomes.%目的 探讨Dynesys动态稳定系统治疗腰椎退行性疾病的应用指征及安全性.方法 回顾性分析2007年1月至2011年12月采用后路减压+Dynesys动态内固定系统治疗102例腰椎退行性疾病患者中69例完整的随访资料,男39例,女30例;年龄30~62岁,平均44岁;单纯腰椎间盘突出24例,腰椎间盘突出并退行性椎管狭窄35例,椎间盘退行性改变10例.手术固定节段:L2,32例,L3,44例,L4,5 42例,L5S115例,L3~L5 5例,T12~L4 1

  2. Dynesys 治疗腰椎退变性疾病的临床疗效%Clinical results of the Dynesys system in the treatment of lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    王华东; 侯树勋; 李利; 史亚民; 郭继东; 马超

    2013-01-01

      目的回顾性分析 Dynesys 作为非融合器械治疗腰椎退变性疾病的临床疗效。方法2010年2月至2012年6月,应用 Dynesys 治疗腰椎退变性疾病患者42例,其中男24例,女18例;年龄38~74岁,平均54.6岁。全部病例均为退行性腰椎管狭窄、合并或不合并椎间盘突出。单节段32例,两节段10例。按标准操作置入 Dynesys 螺钉后行病变节段椎板间开窗减压,切除或保留椎间盘。清除增厚的黄韧带,切除增生内聚的上关节突的内侧部分,开放侧隐窝。测量椎弓根钉间距,截取 PCU 管,将 PET 绳索穿入 PCU 管和上下椎弓根钉间,收紧并锁定绳索与椎弓根钉连接处。术后5天戴腰围下地,腰围佩戴时间为3周。通过 ODI 和 VAS 评分评估临床疗效,并通过动态侧位 X 线片评估非融合节段的椎间运动功能保留及椎间隙高度和近端相邻节段活动度。结果随访10~36个月,平均24.7个月。ODI 指数术前(60.4±21.5)%,术后(23.9±13.5)%,( P<0.05);VAS 腰痛评分术前6.0±1.8,术后2.1±1.7,( P<0.05);VAS 腿痛术前评分7.2±1.9,术后1.9±1.1,( P<0.05),临床疗效满意。影像学评价非融合节段保留有一定椎间活动度,活动范围2°~5°,平均3.7°。结论Dynesys 动态固定治疗腰椎退变性疾病临床疗效满意,能够部分保留固定节段的运动功能,可作为退变性腰椎管狭窄及退变性椎间盘疾病的治疗选择。%  Objective To retrospectively study the preliminary clinical results of the Dynesys system, as a non-fusion device, in the treatment of lumbar degenerative disease. Methods From February 2010 to June 2012, 42 patients with degenerative lumbar stenosis with or without disc protrusion were treated by the Dynesys system, including 32 cases of single segment and 10 cases of double segments. There were 24 males and 18 females, whose mean age was 54.6 years old ( range; 38

  3. Coflex与传统手术方法治疗腰椎退行性疾病疗效的Meta分析%Coflex versus posterior lumbar interbody fusion in the treatment of lumbar spine degenerative diseases: a Meta analysis

    Institute of Scientific and Technical Information of China (English)

    赵海恩; 郭明君; 梅玉峰; 于洋; 王育才; 马保安; 姬振伟; 范清宇

    2012-01-01

    [Objective] To analyze the efficacy and safety of Coflex versus posterior lumbar interbody fusion in the treatment of lumbar spine degenerative diseases such as LSS. [ Methods ] A systematic computer - based search of Medline, EM-BASE, Cochrance Central, and manual search of related journals were performed for collecting controlled trials. RevMan 5. 1 software was used for meta analysis. [Results] Twelve studies involving a total of 684 patients were included. The meta - analysis indicated that statistically significance were noted between two procedures for the operation time, length of hospital stay, blood loss and range of motion of lumbar. While no differences were noted for the low back VAS, ODI and JO A. [Conclusion] Both procedures were effective and safe in pain relief and functional recovery for lumbar spine degenerative diseases. Coflex could also shorten the operation time and length of hospital stay, decrease the blood loss. It showed that Coflex had biomechanical superiority in a short follow - up period.%[目的]系统评价Coflex与传统融合固定两种手术方法治疗腰椎退行性病变的有效性和安全性.[方法]计算机检索数据库,手工检索骨科相关杂志,纳入关于Coflex与传统治疗腰椎退行性病变的研究并进行Meta分析.[结果]纳入12篇研究共684病例,Meta分析结果显示:Coflex与传统手术方法相比较,前者在手术时间和住院时间上短于后者,失血量少于后者,手术节段的ROM大于后者,差异具有统计学意义.后背VAS和JOA差异无统计学意义.[结论]在达到相同治疗效果的情况下,Coflex可以明显减少手术时间、术中出血量和住院时间,而且可以保持手术节段腰椎存在一定活动度,避免了邻近节段的退变,术后短期内随访显示了其生物力学上优越性.

  4. Diagnosis and Treatment Technology for Degenerative Disc Disease%退化性椎间盘疾病诊断与治疗技术的研究进展

    Institute of Scientific and Technical Information of China (English)

    施长城; 姚海

    2015-01-01

    退化性椎间盘疾病(Degenerative Disc Disease, DDD)是严重影响人们正常生活的重大疾病之一。随着人类现代生活方式的改变,其已呈现了发病率逐年递增与发病人群年轻化的趋势。因此,针对该疾病的诊断与治疗技术亟需不断提高与完善。本文简单介绍了人体椎间盘的解刨学基础与其组织中的生化成分和功能,着重分析了针对该疾病的各种医学诊断技术,包括传统的分级评价系统以及各种定量化磁共振成像技术,重点介绍比较了现今临床上两种主要的手术治疗方法——脊柱融合术与全椎间盘置换术,并最终在总结诊断与治疗方法研究中所存在问题的基础上,对未来研究的发展趋势提出展望。%Degenerative disc disease (DDD) is a major health concern which signiifcantly affects people’s daily activities due to limited functionality of the spine. Considering modern ways of living and working, the annual incidence of DDD has been continuously increasing as well as afficting an increasingly younger age group. Therefore, the technologies for the diagnosis and treatment of DDD need to be further developed. The basic anatomy of the human intervertebral disc (IVD) as well as its biochemical components and their related functions are brielfy introduced in this review. Furthermore, the different diagnostic techniques for DDD are summarized and compared, including the conventional IVD grading system as well as varied quantitative magnetic resonance imaging (MRI) methods. In addition, two current surgical treatments, e.g., spinal fusion and total disc replacement, were discussed and analyzed. After evaluating the literatures and identifying existing issues involving available diagnostic techniques and clinical treatment options for DDD, the future directions of DDD related research and studies were presented.

  5. Climical application of Wallis mechanical normalization system in lumbar degenerative disease%棘突间动态稳定系统(Wallis)在腰椎退变性疾病中的临床应用

    Institute of Scientific and Technical Information of China (English)

    徐西强; 李峰; 吴华

    2012-01-01

    Objective To observe the clinical effects of the lumbar spinal canal decompression and the implantation of Wallis mechanical normalization system to treat lumbar degenerative disease. Methods All of 20 cases of lumbar degenerative disease were treated with lumbar spinal canal decompression and the implantation of Wallis mechanical normalization system. Results Nineteen patients were followed up for 28 to 40 months, with 30 months on average. JOA score and VAS score before operation were (10.65±2.43) and (7.50±0.95) respectively, and two years later they were (26.87±1.43) and (0.21 ±0.01) respectively. Conclusion Wallis mechanical normalization system (Wallis) has the merits of less trauma, less bleeding and better human biomechanics. As a soft fixation, it plays a palliative role from rigid fusion to the non-fusion, and it's a promising alternative treatment to the end-stage treatment of the spine (spinal fusion surgery).%目的 评价棘突间动态稳定系统(Wallis)治疗腰椎退变性疾病的临床效果.方法 对20例腰椎退变性疾病行髓核摘除并Wallis置入固定手术.结果 本组19例获随访28~40个月,平均30个月.术前JOA和VAS评分分别为(10.65±2.43)分、(7.50±0.95)分,术后2年JOA和VAS评分分别为(26.87±1.43)分、(0.21±0.01)分.结论 脊柱后路Wallis具有创伤小、出血少、符合人体生物力学等特点.其作为一种软性固定可以起到从僵硬融合节段向正常非融合活动节段的缓冲连接作用,同时亦是延缓脊柱终末期治疗(脊柱融合手术)的有应用前景的中间替代治疗措施.

  6. 高血压合并老年退行性心瓣膜病的超声资料分析%Analysis of ultrasound data in aged patients with hypertension complicated degenerative valvular heart disease

    Institute of Scientific and Technical Information of China (English)

    钱岚; 张勇; 吴亚丹; 王武; 周德聪; 李海燕

    2012-01-01

    Objective: To analyze the influence of essential hypertension (EH) on senile degenerative valvular heart disease (SDVHD). Methods: Age, valvular features and complications of SDVHD were retrospectively summarized and analyzed in 90 aged EH + SDVHD patients (EH+ SDVHD group) and 63 aged SDVHD patients with normal blood pressure (SDVHD group). Results: Compared with SDVHD group, there were significant increase in incidence rates of aortic valve calcification (52. 4% vs. 78. 9%), mitral valve calcification (15. 9% vs. 24. 4%), aortic valve calcification complicated mitral valve calcification (31. 7% vs. 52. 2%), and aortic valve stenosis + moderate reflux (31. 7% vs. 63. 3%) in EH + SDVHD group, P<0. 05 all; age of EH + SDVHD group was also significantly lower than that of SDVHD group [ (67. 5 ?6. 28) years vs. (76. 5 + 7. 33) years, P<0. 05]. Conclusion: Hypertension possesses important influence on incidence and complication of SDVHD, and it's an important risk factor of senile degenerative valvular heart disease.%目的:分析高血压对老年退行性心瓣膜病(SDVHD)的影响.方法:对90例老年高血压合并SDVHD患者(高血压+SDVHD组)和63例老年血压正常的SDVHD患者(SDVHD组)的年龄结构,瓣膜特征,SDVHD并发症进行回顾性总结、分析.结果:与老年SDVHD组比较,老年高血压+SDVHD组主动脉瓣钙化发生率(52.4%比78.9%)、二尖瓣钙化发生率(15.9%比24.4%)、主动脉瓣钙化合并二尖瓣钙化发生率(31.7%比52.2%)、主动脉瓣瓣膜狭窄及中度以上反流的发生率(31.7%比63.3%)均明显升高(P<0.05);老年高血压+SDVHD组的年龄也明显小于老年SDVHD组[(67.5±6.28)比(76.5±7.33),P<0.05].结论:高血压对老年退行性心瓣膜病的发生和发展有重要影响,加重其并发症;是形成老年退行性心瓣膜病的重要危险因素.

  7. Pelvic bone and hip joint hydatid disease revealing a retroperitoneal location

    Directory of Open Access Journals (Sweden)

    Abdelhalim El Ibrahimi

    2009-07-01

    Full Text Available Echinococcosis is a parasitic disease produced by the larval stage of Echinococcus granulosus. Hydatid disease of bone is rarely seen in humans and it has been reported in only 1-2% of cases of echinococcosis. We present a patient who developed hydatid disease of the left pelvic and femoral bones with cartilage destruction of the ipsilateral hip joint revealing a retroperitoneal location of hydatid cyst. Hydatid bone must be present in the differential diagnosis of chronic monoarthritis; the risk is to perform a total hip replacement in a septic environment.

  8. Lessons from a non-domestic canid: joint disease in captive raccoon dogs (Nyctereutes procyonoides

    Directory of Open Access Journals (Sweden)

    Dennis F. Lawler

    2012-12-01

    Full Text Available The purpose of this study was to describe pathological changes of the shoulder, elbow, hip and stifle joints of 16 museum skeletons of the raccoon dog (Nyctereutes procyonoides. The subjects had been held in long-term captivity and were probably used for fur farming or research, thus allowing sufficient longevity for joint disease to become recognisable. The prevalence of disorders that include osteochondrosis, osteoarthritis and changes compatible with hip dysplasia, was surprisingly high. Other changes that reflect near-normal or mild pathological conditions, including prominent articular margins and mild bony periarticular rim, were also prevalent. Our data form a basis for comparing joint pathology of captive raccoon dogs with other mammals and also suggest that contributing roles of captivity and genetic predisposition should be explored further in non-domestic canids.

  9. DEGRO guidelines for the radiotherapy of non-malignant disorders. Part II: Painful degenerative skeletal disorders

    International Nuclear Information System (INIS)

    The purpose of this article is to summarize the updated DEGRO consensus S2e guideline recommendations for the treatment of benign painful degenerative skeletal disorders with low-dose radiotherapy. This overview reports on the role of low-dose radiotherapy in the treatment of enthesiopathies (shoulder syndrome, trochanteric bursitis, plantar fasciitis, and elbow syndrome) and painful arthrosis (knee, hip, hand, and finger joints). The most relevant aspects of the DEGRO S2e Consensus Guideline Radiation Therapy of Benign Diseases 2014 regarding diagnostics, treatment decision, dose prescription as well as performance of radiotherapy and results are summarized. For all indications mentioned above, retrospective and some prospective analyses have shown remarkable effects in terms of pain relief. Nevertheless, the Level of Evidence (LoE) and the Grade of Recommendation (GR) vary: LoE 1b-4 and GR A-C. Low-dose radiotherapy for painful degenerative skeletal disorders is effective in the majority of the patients and therefore it may be a reasonable therapeutic alternative when simple and non-invasive methods have been used without persistent success. For all discussed entities, single fraction doses of 0.5-1.0 Gy and total doses of 3.0-6.0 Gy/series applied with 2-3 fractions per week are recommended. (orig.)

  10. RISK FACTORS OF PEDICLE FIXATION INSTABILITY AT PATIENTS WITH DEGENERATIVE LUMBAR SPINE PATHOLOGY

    Directory of Open Access Journals (Sweden)

    A. E. Bokov

    2016-01-01

    Full Text Available Objective. To assess risk factors оf pedicle screw instability after decompression and fusion in patients with degenerative lumbar spine disease.Materials and methods. This is a prospective non-randomized study, the results of 130 surgical interventions with pedicle instrumentation in patients with degenerative lumbar spine diseases were studied. Minimal follow up period accounts for 18 months. Before intervention computed tomography (CT was applied and cancellous bone radiodensity was measured.Patients were treated with nerve root decompression and pedicle screw fixation stand-alone or with lumbar interbody fusion. During follow-up period computed tomography was applied and cases with evidence of pedicle screw loosening were detected. Radiodensity of cancellous bone, extension of fixation, extensiveness of decompression, application of interbody fusion, incomplete vertebra body reduction and heterogeneity of studied group were taken into account as potential risk factors of implant instability development. The correlation between pedicle screws loosening rate and mentioned predictors was estimated using logistic regression analysis.Results. Radiodensity of vertebra body cancellous bone getting decreased, the increase number of fixed levels and extensiveness of facet joints and ligaments resection are associated with the increased risk of a screw loosening development. Laminectomy, interbody fusion, altered biomechanics associated with incomplete vertebra body reduction and L5–S1 segment included into fixed zone did not have a significant influence on pedicle screws loosening rate. Bias related to heterogeneity of studied group was also insignificant. Goodness-of-fit of estimated general logistic regression model: № 2 = 67,57851; p < 0,0001. This model classified correctly 81,5% cases with sensitivity and specificity of 77,4% and 85,3% respectively.Conclusion. Radiodensity of a vertebra cancellous bone, number of fixed levels and

  11. Meta-analysis of incidence of degenerative and sprained/strained cervical spine diseases in military aviators%军事飞行人员劳损退变性颈椎疾病荟萃分析

    Institute of Scientific and Technical Information of China (English)

    陈立君; 卫杰; 龚成; 孔德良; 王飞; 范宇; 赵平; 王建昌

    2013-01-01

    目的:分析归纳军事飞行人员劳损退变性颈椎疾病的发病情况。方法检索Medline、Pubmed、中国生物医学文献数据库、中国生物医学期刊引文数据库、中华医学会数字化期刊全文数据库、维普中文生物医学期刊、中国学术期刊全文数据库,时间范围从各数据库起始收录年至2013年6月有关飞行人员劳损退变性颈椎疾病发病率的相关文献。依据荟萃分析原则,从调查方法、研究对象、样本量、调查结果、研究机构等方面对入选文献进行分析,将文献质量等级分为A~D共4级。分析文献的科学价值,归纳总结这类颈椎病的发病情况。结果共检索出军事飞行人员劳损退变性颈椎疾病相关中文文献121篇,英文文献393篇。其中与发病率有关中文文献12篇,英文文献22篇;A级2篇,B级7篇,C级17篇,D级8篇。飞行相关颈痛发病率为57.98%,颈椎病发病率为32.53%,住院率为5.42%,神经根型颈椎病发病率为0.50%。颈腰椎疾病军事飞行人员住院疾病构成比为10.01%,占停飞疾病的10.60%,均居第一位。结论近60%军事飞行人员会发生飞行相关性颈痛,颈椎病的发病率高达30%以上。颈腰椎疾病是军事飞行人员住院和停飞的第一大病种。%Objective Our goal was to analyze and conclude the incidence of degenerative and sprained/strained cervical spine diseases in military aviators.Methods We systematically searched Medline and Pubmed from 1950,CMB from 1978,CMCI from 1994,CMADP from 1998,CMJD from 1989 and CHKD from 1994 to June 2013 for literatures about incidence of degenerative and sprained/strained cervical spine diseases in military aviators,and critically reviewed literature.Then we assessed the quality of the literatures using a 4-grade scale, concerning study design,objects,sample size,results and research institutes,and concluded the incidence of disease.Results Of 121 Chinese literatures

  12. Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association For European Cardiovascular Pathology: II. Noninflammatory degenerative diseases - nomenclature and diagnostic criteria.

    Science.gov (United States)

    Halushka, Marc K; Angelini, Annalisa; Bartoloni, Giovanni; Basso, Cristina; Batoroeva, Lubov; Bruneval, Patrick; Buja, L Maximilian; Butany, Jagdish; d'Amati, Giulia; Fallon, John T; Gallagher, Patrick J; Gittenberger-de Groot, Adriana C; Gouveia, Rosa H; Kholova, Ivana; Kelly, Karen L; Leone, Ornella; Litovsky, Silvio H; Maleszewski, Joseph J; Miller, Dylan V; Mitchell, Richard N; Preston, Stephen D; Pucci, Angela; Radio, Stanley J; Rodriguez, E Rene; Sheppard, Mary N; Stone, James R; Suvarna, S Kim; Tan, Carmela D; Thiene, Gaetano; Veinot, John P; van der Wal, Allard C

    2016-01-01

    Surgical aortic specimens are usually examined in Pathology Departments as a result of treatment of aneurysms or dissections. A number of diseases, genetic syndromes (Marfan syndrome, Loeys-Dietz syndrome, etc.), and vasculopathic aging processes involved in vascular injury can cause both distinct and nonspecific histopathologic changes with degeneration of the media as a common denominator. Terminology for these changes has varied over time leading to confusion and inconsistencies. This consensus document has established a revised, unified nomenclature for the variety of noninflammatory degenerative aortic histopathologies seen in such specimens. Older terms such as cystic medial necrosis and medionecrosis are replaced by more technically accurate terms such as mucoid extracellular matrix accumulation (MEMA), elastic fiber fragmentation and/or loss, and smooth muscle cell nuclei loss. A straightforward system of grading is presented to gauge the extent of medial degeneration and synoptic reporting tables are provided. Herein we present a standardized nomenclature that is accessible to general pathologists and useful for future publications describing these entities. PMID:27031798

  13. 经椎间孔行椎体间融合术治疗腰椎退行性疾病的临床分析%Clinical Analysis of Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Disease

    Institute of Scientific and Technical Information of China (English)

    吴永忠

    2015-01-01

    Objective:To explore the clinical curative effect of transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disease.Method:The clinical data of 60 patients with lumbar degenerative disease who were treated by transforaminal lumbar interbody fusion in our hospital from January 2011 to May 2013 were retrospectively analyzed. And 65 patients with posterolateral lumbar fusion at the same time were compared and analyzed.Result:(1)The ODI dysfunction index and the VAS scores of waist and leg pain of patients in the two groups postoperative were significantly lower than those of preoperative(P<0.01),and the VAS scores of waist and leg pain of patients in the TLIF group postoperative were significantly lower than those of patients in the PLF group(P<0.05).(2)The postoperative osseous fusion rate of patients in the TLIF group was 100%,which was obviously higher than 86.15% of patients in the PLF group,the difference was statistically significant(P<0.05).(3)The lumbar lordosis angle and relative height of intervertebral disc in the two groups postoperative were significantly improved compared with preoperative,and the lumbar lordosis angle and relative intervertebral disc height in the TLIF group were increased obviously compared with the PLF group,the differences were statistically significant(P<0.05).Conclusion:The transforaminal lumbar interbody fusion and posterolateral lumbar fusion have preferable clinical curative effects for patients with lumbar degenerative diseases, but the extent of the waist and leg pain relief,convergence rate and intervertebral height adjustment of patients by the transforaminal lumbar interbody fusion are superior than those of patients by posterolateral lumbar fusion,so will the transforaminal lumbar interbody fusion can be regarded as a optimizing operation scheme for lumbar degenerative disease.%目的:探讨经椎间孔行椎体间融合术对腰椎退行性疾病的临床疗效。方法:对本院2011年1

  14. Expression and significance of type A lamin in lumbar spinal degenerative disease%A 型核纤层蛋白在腰椎退行性疾病中的表达及其意义

    Institute of Scientific and Technical Information of China (English)

    欧定强; 吴承志; 刘钰瑜; 戎利民; 徐义春; 王其友

    2015-01-01

    Objective To preliminarily explore the expression levels and clinical significance of type A lamin (lamin A)in lumbar spinal degenerative disease.Methods Seventy four patients diagnosed with lumbar spinal degenerative disease were divided into the lumbar disc herniation (n =32)and lumbar spinal stenosis groups (n =42)and healthy subjects were recruited into the control group (n =12).The expression of lamin A in the lumbar tissue samples from three groups was assessed by immunohistochemical examination and western blotting.Results Immunohistochemical analysis revealed that lamin A was expressed in the interver-tebral disk cells from all three groups.The staining of lamin A in the tissue from lumbar spinal stenosis group was stronger than those from the other two groups.Western blot demonstrated that lamin A was expressed in the fibrous ring tissue of intervertebral disk from all three groups.In the lumbar spinal stenosis group,the expres-sion level of lamin A was 3.55 ±0.16(gray level),1.02 ±0.13 in the lumbar disc herniation group and 0.78 ± 0.14 in the control group with statistical significance among three groups (F =14.326,P <0.01).Statistical significance was noted between the lumbar spinal stenosis and lumbar disc herniation group /the control group (both P <0.001).There was no statistically significant difference between the lumbar disc herniation and con-trol groups (P =0.134).Conclusions Over the progression of degenerative lumbar spinal disease,the ex-pression level of lamin A is gradually up-regulated,which is probably associated with the incidence and devel-opment of degenerative lumbar spinal disease.%目的:初步探讨A型核纤层蛋白(Lamin A)在腰椎退行性疾病中的表达特点及意义。方法将74例腰椎退行性疾病患者分为腰椎间盘突出组(32例)及腰椎管狭窄组(42例),另设腰椎正常组(12例)作为对照。采用免疫组织化学检查(免疫组化)及蛋白免疫印迹法检测 Lamin A

  15. Radiopharmaceuticals for SPECT exploration of dopaminergic systems. Diagnosis and surveillance of neuro-degenerative diseases; Les radiopharmaceutiques pour l`exploration des system dopaminergique en TEMP. Interet pour le diagnostic et le suivi des maladies neurodegeneratives

    Energy Technology Data Exchange (ETDEWEB)

    Gouilloteau, D.; Prunier-Levallon, C.; Zimmer, L.; Autret, A.; Besnard, J-Cl.; Baulieu, J-L. [CHU TOURS (France)

    1997-12-31

    New radiopharmaceuticals were developed to explore the pre- or post-synaptic slopes of the dopaminergic terminations. At present, their interest is recognized for the differential diagnosis of the extra-pyramidal syndromes. Other various applications in neurology and psychiatry are in view. On the pre-synaptic slope, implied in the Parkinson`s disease, the dopamine carrier, able to be visualized due to its iodine derivatives of cocaine, is localized. The {beta}CIT, which is presently the best known specificity-free derivative, has actually an equivalent affinity for the dopamine carrier and the serotonin carrier. Besides, its kinetic does not allow its imaging in the day of injection. We have developed and validated another derivative, the PE2I: N-(3-Iodoprop-(2E)-enyl) -2{beta}-carbometoxy -3{beta}-(4`-methyl-phenyl) nortropane which displays the properties required by kinetic and specificity. On the post-synaptic slope the type-D2 dopaminergic receptors were localized, which can be explored by means of (iodolisuride) ergolenes and benzamide derivatives (IBZM). These ligands have not an AMM yet, therefore their utilization may be approached by magistral preparation. The scintigraphy of the D2 receptors and dopamine carrier could be useful for the earlier diagnosis and the therapeutic surveillance of the neuro-degenerative decease. The coupling of the pre- and post-synaptic scintigraphies may be taken into consideration to augment diagnosis potentiality

  16. 腰椎融合联合Coflex动态固定手术治疗腰椎退行性疾病%Spinal fusion combined with dynamic interspinous fixation with Coflex system for lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    李忠海; 王诗媛; 唐昊; 马辉; 张秋林; 侯铁胜

    2011-01-01

    目的:总结腰椎后路椎间融合术联合Coflex动态固定术治疗腰椎退行性疾病的临床疗效.方法:对2008年3月至2010年3月应用腰椎后路椎间融合术联合Coflex动态固定治疗的18例腰椎退行性疾病患者(均为双节段)的临床资料进行回顾性总结分析.男11例,女7例;年龄41~62岁,平均50.2岁.分析内容包括:ODI指数、腰痛和下肢痛的VAS评分,并通过腰椎动力位X线观察活动度(ROM)、椎间隙高度(DHI)的变化情况.结果:所有患者获得随访,时间6~30个月,平均12个月.在末次随访时.腰痛VAS评分、下肢痛VAS评分及ODI指数均较术前明显改善(P<0.001).腰痛VAS评分术前(7.20±0.90)分.末次随访(1.50±0.90)分;下肢痛VAS评分术前(5.20±0.90)分,末次随访(1.10±0.80)分.ODI指数术前(52.50±5.90)%,未次随访(15.90±5.80)%.Coflex置入节段的DHI术前0.23±O.05,术后0.35±0.06,末次随访0.33±0.04,椎间隙高度未见明显丢失.Coflex置入节段的ROM术前(8.90±1.80)°,术后降至(8.30±1.90)°,末次随访(8.10±1.80)°.与术前差异无统计学意义(P=0.19).Conex置入节段活动度未见明显改变.L2-S1 ROM术前为(20.20±5.60)°,术后(14.40±5.70)°,末次随访(15.50±5.20)°.与术前比较有统计学差异(P=0.01).结论:腰椎后路椎间融合术联合Coflex动态固定治疗双节段腰椎退变性疾病能取得满意的中短期临床疗效,但没有充分证据证明这项技术优于多节段融合术.手术适应证的合理选择十分重要.%Objective:To summarize the effect of the implantation of Coflex interspious stabilization device combined with spinal fusion for the treatment of lumbar degenerative disease.Methods: From March 2008 to March 2010, 1 8 patients with two levels lumbar degenerative disease were treated with spinal fusion and dynamic interspinous fixation with Coflex system. There were 11 males and 7 females. The average age was 50.2 years (range 41 to 62 years). The VAS and the Oswestry

  17. Lumbar interbody fusion vs dynamic stabilization system for degenerative lumbar disease%腰椎椎间融合术与动态固定术治疗腰椎退行性疾病的临床评价

    Institute of Scientific and Technical Information of China (English)

    马辉; 李忠海; 朱晓东; 白玉树; 王传峰; 吴大江; 陈誉; 李明

    2011-01-01

    目的 通过比较分析腰椎椎间融合术与动态固定术治疗腰椎退行性疾病的临床疗效和术后并发症,探讨腰椎退行性疾病治疗方法的合理选择.方法 2009年1月~2010年12月,选择32例腰椎退行性疾病(L4/L5)患者,按配对设计分为对照组和治疗组,对照组16例患者均行椎弓根螺钉固定并单枚融合器置入;治疗组16例患者行常规椎板切除减压、髓核摘除和Isobar动态固定.比较观察2组病例的治疗效果、手术时间、出血量、手术并发症等.治疗效果评价采用Oswestry功能障碍指数(Oswestry disability index,ODI)及疼痛视觉模拟量表(visual analogue scale,VAS)评分,手术邻近节段(L3/L4和L5/S1)及腰椎(L2~S1)的活动度(range of motion,ROM)采用过伸过屈动力侧位X线片检查进行评价.结果 所有患者均获6~24个月的随访,平均15.8个月.与术前相比,2组患者术后症状均有明显改善,术后ODI及VAS评分与术前相比差异有统计学意义(P0.05);2组均未出现内固定相关并发症;2组术后邻近节段(L3/L4和L5/S1)的ROM与术前相比差异无统计学意义(P>0.05).腰椎(L2~S1)的ROM,融合组较术前显著下降,差异有统计学意义(P0.05).结论 腰椎椎间融合术与Isobar动态固定术治疗单节段腰椎退变性疾病均可取得满意的短期临床疗效,但理论上动态固定技术内固定失败的风险高于椎间融合术,故采用动态固定技术治疗腰椎退变性疾病应慎重.%Objective To assess the clinical effectiveness and postoperative complications of lumbar interbody fusion and dynamic stabilization system( the Isobar system ) for degenerative lumbar disease, in an attempt to explore an optimal surgical procedure. Methods From January 2009 to December 2010, 32 degenerative disease ( L4/L5 ) cases were randomly and equally assigned to an experimental group of decompression and dynamic stabilization with Isobar system ( n = 16 ) and a control group of

  18. 单侧椎弓根螺钉内固定治疗腰椎退行性疾病的研究进展%Progress of unilateral pedicle screw internal fixation for the treatment of lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    谷金(综述); 梁斌(审校)

    2015-01-01

    Unilateral pedicle screw internal fixation is one of the important means of treatment of lumbar de-generative diseases.It plays an important role on solving the postoperative immediate stability of the lumbar spine, and provide enough rigid internal fixation for intervertebral fusion.This paper expounds the research present situation, advantages, limitations and future research direction of unilateral pedicle screw internal fixation.%单侧椎弓根螺钉内固定是治疗腰椎退行性疾病的重要手段之一,其在解决腰椎术后的即刻稳定性方面起着重要作用,为椎间融合术提供足够刚性内固定。该文对单侧椎弓根螺钉内固定的研究现状、优势、局限性与未来的研究方向进行综述。

  19. Multiple Bone and Joint Diseases in a Nigerian Sickle Cell Anaemia: a Case Report

    OpenAIRE

    Olaniyi, John A.; Alagbe, Adekunle E.; Olutoogun, Toluwalase A.; Busari, Oluwasogo E.

    2012-01-01

    This case highlights the fact that bone involvement is the commonest clinical manifestation of Sickle Cell Disease (SCD) both in the acute settings such as painful vaso-occlusive crisis (VOC) and as a source of chronic, progressive debility such as avascular necrosis (AVN), chronic osteomyelitis and fixed flexion deformity of joints. Protracted multiple bone involvement i.e. bilateral femoral and left humeral chronic osteomyelitis, Left elbow, Left knee and right humeral septic arthritis toge...

  20. Ranking of MR in the diagnosis of diseases of the shoulder joint

    International Nuclear Information System (INIS)

    In a prospective study 43 patients with shoulder pain were examined by sonography and MRI. The findings were controlled by plain radiography, arthrography, and CT arthrography. Joint effusions and humeral head defects were equally identified by MR and sonography. In the diagnosis of labrum lesions, rotator cuff lesions, subacromial spurs, and synovial inflammatory disease sonography was not as accurate as MR. A special MR scoring system improved the diagnosis of an impingement syndrome. (orig.)

  1. Treatment of lumbar degenerative disease with modified transforaminal lumbar interbody fusion%改良经椎间孔椎体间融合术治疗腰椎退变性疾病

    Institute of Scientific and Technical Information of China (English)

    刘阳; 杨群; 唐开; 马凯; 姜长明; 吴春明; 王宏

    2011-01-01

    目的 探讨改良经椎间孔椎体间融合术治疗腰椎退变性疾病的临床疗效.方法 2007年6月至2009年5月对62例腰椎退变性疾病患者行改良经单侧椎间孔椎体间植骨融合,相应节段椎弓根钉内固定术.其中腰椎间盘突出合并腰椎不稳28例,腰椎间盘突出合并椎管狭窄27例,退变性滑脱7例.累及单节段48例,累及双节段14例.通过观察融合情况,记录术前、术后3个月和末次随访时的视觉模拟评分(VAS)和日本矫形外科学会(JOA)评分判定治疗效果.结果 62例患者均获得随访,随访时间15~30(22.77±3.82)个月.无神经损伤、脑脊液漏、感染及椎弓根钉断裂等并发症.术后1年椎体间融合率为96.8%.依据JOA评分,优34例,良24例,可4例,差0例,优良率为93.5%(58/62).术后VAS和JOA评分与术前比较差异有统计学意义(P<0.05),术后3个月VAS和JOA评分与末次随访时比较差异无统计学意义(P>0.05).结论 改良经椎间孔椎体间融合术在充分减压同时能减少进入椎管带来的并发症,临床疗效好,是治疗腰椎退变性疾病的有效术式.%Objective To investigate the chnical effect of modified transforaminal lumbar interbody fusion (TLIF) on the treatment of lumbar degenerative disease. Methods Sixty-two patients with lumbar degenerative disease were treated by the modified TLIF from June 2007 to May 2009. The preoperative diagnosis was lumbar intervertebral disc herniation with spinal instability (28 cases), lumbar intervertebral disc herniation with lumbar stenosis (27 cases ), degenerative spondylohsthesis (7 cases ). Forty-eight cases were single-level and 14 cases were two-level. The patients were evaluated by observing the fusion rate and comparing the visual analog score( VAS ) and Japanese orthopaedics association (JOA) score of preoperation with those of postoperation. Results All the patients were followed up from 15 to 30 (22.77 ± 3.82)months,no nerve injury,leakage of

  2. Bioflex动态稳定系统在多节段腰椎退行性疾病中的应用%Application of Bioflex dynamic stabilization system in treating multi-segment lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    李大伟; 马远征; 胡明; 罗展鹏; 罗小波

    2011-01-01

    目的:探讨Bioflex动态稳定系统在多节段腰椎退行性疾病中的应用价值.方法:回顾性分析2008年4月至2009年5月收治的多节段腰椎退行性疾病患者13例,男8例,女5例;年龄51-72岁,平均65.0岁.病变节段:L3.4、L4.5、L5S1 7例,L2.3、L4.5、L5S1 3例,L3.4、L4.5 1例,L4.5、L5S1 2例.手术方法:椎管减压、Bioflex系统固定、根据椎间盘退变程度选择椎体间融合或不融合.观察疼痛视觉模拟评分(visual analog scale,VAS).Oswestry功能障碍指数(Oswestry disability index,ODI),节段活动范围(range of motion,ROM).椎间融合节段的融合情况.结果:术后经12~26个月随访,平均19.5个月.手术时间90~240 min,平均183.4 min,术中出血量400~1 220ml,平均610.2 ml.术前VAS为(7.8±1.3)分,术后为(2.3±0.9)分,末次随访为(2.1±0.8)分;术前ODI为(60.50±4.40)%,术后为(17.80±2.10)%.末次随访为(16.20±2.40)%.与术前比较,术后VAS、ODI差异均具有统计学意义(P0.05).手术前后ROM:整个腰椎和非融合节段活动度明显减低,邻近节段略增加.融合节段融合率95.O%(19/20).结论:Bioflex系统固定结合椎体问融合是治疗多节段腰椎退行性疾病的一种安全、有效的外科方法,远期效果待进一步观察.%Objective :To explore the value of application of Bioflex dynamic stabilization system in treating multi-segment lumbar degenerative disease.Methods:Clinical datas of 13 patients with multi-segment lumbar degenerative disease (8 males and 5 females,ranging in age from 51 to 72 year with an average of 65.0) were retrospectively analyzed between April 2008 and May 2009.The involved area included L3-S1 in 7 cases,L2-S1 in 3 cases,L3-L5 in 1 cases,L4-S1 in 2 cases.All patients underwent decompression,dynamic stabilization with Bioflex system, according to the severity of degenerative disc with/without interbody fusion.The clinical effects were evaluated by VAS,ODI.ROM and fusion segments were also observed

  3. Comparative diagnostic imaging of the canine shoulder joint ultrasonography and radiography

    CERN Document Server

    Mayer, B

    2000-01-01

    radiographically. 6 of 17 supraspinatus insertion tendinopathies (35.3 %) and 4 of 5 bicipital tendon calcifications (80 %) were detected only with ultrasonography. Radiographic findings of bony proliferations in the intertuberal groove without signs of degenerative joint disease of the shoulder joint are indicative of severe or chronic biciptal tendon disease. In many cases, the stage and severity of cartilaginous and subchondral bone lesions with osteochondritis dissecans can be determined ultrasonographically. Osteochondritis dissecans defects not seen on radiographs are occasionally visible with ultrasound, although a negative finding is not always accurate. Ultrasonography of shoulder joint disease has been applied in humans for some time. In this study, the use of radiography and ultrasonography as diagnostic imaging modalities to determine shoulder joint lesions is presented. The ultrasonographic anatomy and pathology of the shoulder joint are described. Comparative radiographic and ultrasonographic fi...

  4. Flexible Stabilisation of the Degenerative Lumbar Spine Using PEEK Rods

    OpenAIRE

    Jacques Benezech; Bruno Garlenq; Gilles Larroque

    2016-01-01

    Posterior lumbar interbody fusion using cages, titanium rods, and pedicle screws is considered today as the gold standard of surgical treatment of lumbar degenerative disease and has produced satisfying long-term fusion rates. However this rigid material could change the physiological distribution of load at the instrumental and adjacent segments, a main cause of implant failure and adjacent segment disease, responsible for a high rate of further surgery in the following years. More recently,...

  5. 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

  6. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, J B; Juhl, C B; Roos, E M;

    2015-01-01

    . DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...... included symptomatic deep venous thrombosis (4.13 (95% confidence interval 1.78 to 9.60) events per 1000 procedures), pulmonary embolism, infection, and death. CONCLUSIONS: The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time...

  7. Psoriatic nail involvement and its relationship with distal interphalangeal joint disease.

    Science.gov (United States)

    Lai, T L; Pang, H T; Cheuk, Y Y; Yip, M L

    2016-08-01

    Psoriatic nail disease and distal interphalangeal (DIP) arthritis both are common manifestations of psoriatic arthritis (PsA). Several clinical characteristics are allegedly associated with DIP joint damage, particularly nail psoriasis. However, there is little evidence to substantiate this phenomenon. The purpose of this study is to investigate the relationship between DIP involvement, nail psoriasis and other parameters. A cross-sectional study involved 45 patients from local rheumatology clinic. Four hundred fifty psoriatic fingernails scored, and the radiographs of all these fingers were reviewed to define PsA DIP arthritic changes. 64.4 % patients had nail psoriasis and 35.6 % had DIP arthritis. Univariate analysis identified that swollen joint-count, digits with chronic dactylitis, HLA-B27 status and nail psoriasis were associated with DIP arthritis. Regression model supported that nail disease was the most significant associated factor of DIP arthritis (OR 9.7, p = 0.05). Nail psoriasis was identified in 40.2 % of digits. Pitting (29.6 %), onycholysis (15.1 %), crumbling (8.2 %), nail bed hyperkeratosis (2.0 %) were noted with the mean modified Nail Psoriasis Severity Index of 0.95 +/-1.68. Among all digits, 57 had DIP arthritis while 393 did not. Within DIP joints with PsA radiological change, 59.6 % had nail disease. Chi-square test with the Bonferroni correction further supported an association between nail psoriasis and DIP involvement with p value of 0.001. Two specific nail subtypes-crumbling and onycholysis-were found to be significantly associated with DIP disease. A significant proportion of PsA patients had nail involvement and DIP arthritis. PsA patients with nail changes may be more susceptible to DIP disease. PMID:27251673

  8. 微创经椎间孔腰椎椎间融合术治疗老年腰椎退变性疾病%Minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative diseases in elder-ly

    Institute of Scientific and Technical Information of China (English)

    陈云生; 陈荣春; 郭朝阳; 游辉; 钟红发; 张树芳

    2013-01-01

    Objectives: To evaluate outcomes of posterior transforaminal lumbar interbody fusion (MI-TLIF) under Pipeline expandable access system for lumbar degenerative diseases in elderly. Methods: From Febru-ary 2010 to June 2012, 46 elderly patients with lumbar degenerative diseases who underwent TLIF by using two different approaches were retrospectively analyzed. All patients were classified into observation group(MI-TLIF group) and control group(conventional open TLIF, CO-TLIF) according to the operative methods. There were 24 cases in observation group including 15 males and 9 females, aged from 60 to 79 years (average, 66.3 years), and the course of diseases ranging from 6 to 60 months(average, 18.5 months); 22 cases in con-trol group including 10 males and 12 females, aged from 62 to 75 years(average, 67.0 years), and course of diseases ranging from 8 to 64 months(average, 22.6 months). The blood loss, operation time, amount of blood transfusion and postoperative complications were compared. The clinical outcomes of both groups were evalu-ated by using the VAS(at postoperative 1 week, 3 months and the final follow-up) and ODI(at postoperative 3 months and the final follow-up), respectively. The bony fusion of both groups were assessed by the Suk stan-dard at the final follow-up. Results: There were significant differences on blood loss, amount of blood trans-fusion and postoperative complications (P0.05). All patients were followed up for an average of 18 months(range, 13 to 26 months). The VAS and ODI of both groups at each time point postoperatively experienced improvement compared with the preoperation (P0.05). Conclusions: MI-TLIF has similar surgical outcome with CO-TLIF for lumbar degenerative diseases in elderly, but the former has less blood loss and complications than the latter.%目的:探讨Pipeline可扩张通道辅助下行后路经椎间孔腰椎椎间融合术(minimally invasive transforam-inal lumbar interbody fusion,MI-TLIF)治疗老年腰

  9. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders

    DEFF Research Database (Denmark)

    Agca, R; Heslinga, S C; Rollefstad, S;

    2016-01-01

    Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors a...

  10. Iron behaving badly: inappropriate iron chelation as a major contributor to the aetiology of vascular and other progressive inflammatory and degenerative diseases

    Directory of Open Access Journals (Sweden)

    Kell Douglas B

    2009-01-01

    Full Text Available Abstract Background The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular 'reactive oxygen species' (ROSs can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. Review We review the considerable and wide-ranging evidence for the involvement of this combination of (superoxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation. The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, since in some circumstances (especially the presence of poorly liganded iron molecules that are nominally antioxidants can actually act as pro

  11. Novel BAC mouse model of Huntington’s disease with 225 CAG repeats exhibits an early widespread and stable degenerative phenotype

    Science.gov (United States)

    Wegrzynowicz, Michal; Bichell, Terry Jo; Soares, Barbara D.; Loth, Meredith K.; McGlothan, Jennifer L.; Alikhan, Fatima S.; Hua, Kegang; Coughlin, Jennifer M.; Holt, Hunter K.; Jetter, Christopher S.; Mori, Susumu; Pomper, Martin G.; Osmand, Alexander P.; Guilarte, Tomás R.; Bowman, Aaron B.

    2015-01-01

    BACKGROUND Unusually large CAG repeat expansions (>60) in exon one of Huntingtin (HTT) are invariably associated with a juvenile-onset form of Huntington’s disease (HD), characterized by a more extensive and rapidly progressing neuropathology than the more prevalent adult-onset form. However, existing mouse models of HD that express the full-length Htt gene with CAG repeat lengths associated with juvenile HD (ranging between ~75 to ~150 repeats in published models) exhibit selective neurodegenerative phenotypes more consistent with adult-onset HD. OBJECTIVE To determine if a very large CAG repeat (>200) in full-length Htt elicits neurodegenerative phenotypes consistent with juvenile HD. METHODS Using a bacterial artificial chromosome (BAC) system, we generated mice expressing full-length mouse Htt with ~225 CAG repeats under control of the mouse Htt promoter. Mice were characterized using behavioral, neuropathological, biochemical and brain imaging methods. RESULTS BAC-225Q mice exhibit phenotypes consistent with a subset of features seen in juvenile-onset HD: very early motor behavior abnormalities, reduced body weight, widespread and progressive increase in Htt aggregates, gliosis, and neurodegeneration. Early striatal pathology was observed, including reactive gliosis and loss of dopamine receptors, prior to detectable volume loss. HD-related blood markers of impaired energy metabolism and systemic inflammation were also increased. Aside from an age-dependent progression of diffuse nuclear aggregates at 6 months of age to abundant neuropil aggregates at 12 months of age, other pathological and motor phenotypes showed little to no progression. CONCLUSIONS The HD phenotypes present in animals 3 to 12 months of age make the BAC-225Q mice a unique and stable model of full-length mutant Htt associated phenotypes, including body weight loss, behavioral impairment and HD-like neurodegenerative phenotypes characteristic of juvenile-onset HD and/or late-stage adult

  12. Joint effects of smoking and silicosis on diseases to the lungs.

    Directory of Open Access Journals (Sweden)

    Lap Ah Tse

    Full Text Available Smokers are subject to being more susceptible to the long-term effects of silica dust, whilst it remains unclear whether the joint effect of smoking and silicosis differs amongst diseases to the lungs; this study aims to address this knowledge gap. This was a historical cohort study comprised of 3202 silicotics in Hong Kong during 1981-2005 who were followed up till 31/12/2006. We estimated the standardized mortality ratio (SMR in the smoking and never smoking silicotics using the mortality rates of male general population indiscriminately by smoking status, but these SMRs were regarded as biased. We adjusted these biased SMRs using "smoking adjustment factors (SAF". We assessed the multiplicative interaction between smoking and silicosis using 'relative silicosis effect (RSE' that was the ratio of SAF-corrected SMR of smoking silicotics to the never smokers. A RSE differs significantly from one implies the presence of multiplicative interaction. A significant excess SMR was observed for respiratory diseases (lung cancer, chronic obstructive pulmonary diseases [COPD], silicosis and other diseases to the lungs (pulmonary heart disease, tuberculosis. All the 'biased-SMRs' in smokers were higher than those in never smokers, but the SAF-corrected SMRs became higher in never smokers. The RSE was 0.95 (95%CI: 0.37-3.55, 0.94 (95%CI: 0.42-2.60, and 0.81 (95%CI: 0.60-1.19 for lung cancer, COPD, and silicosis; whilst it was 1.21 (95%CI: 0.32-10.26 for tuberculosis and 1.02 (95%CI: 0.16-42.90 for pulmonary heart disease. This study firstly demonstrated the joint effect of smoking and silicosis may differ amongst diseases to the lungs, but power is limited.

  13. Joint effects of smoking and silicosis on diseases to the lungs.

    Science.gov (United States)

    Tse, Lap Ah; Yu, Ignatius T S; Qiu, Hong; Leung, Chi Chiu

    2014-01-01

    Smokers are subject to being more susceptible to the long-term effects of silica dust, whilst it remains unclear whether the joint effect of smoking and silicosis differs amongst diseases to the lungs; this study aims to address this knowledge gap. This was a historical cohort study comprised of 3202 silicotics in Hong Kong during 1981-2005 who were followed up till 31/12/2006. We estimated the standardized mortality ratio (SMR) in the smoking and never smoking silicotics using the mortality rates of male general population indiscriminately by smoking status, but these SMRs were regarded as biased. We adjusted these biased SMRs using "smoking adjustment factors (SAF)". We assessed the multiplicative interaction between smoking and silicosis using 'relative silicosis effect (RSE)' that was the ratio of SAF-corrected SMR of smoking silicotics to the never smokers. A RSE differs significantly from one implies the presence of multiplicative interaction. A significant excess SMR was observed for respiratory diseases (lung cancer, chronic obstructive pulmonary diseases [COPD], silicosis) and other diseases to the lungs (pulmonary heart disease, tuberculosis). All the 'biased-SMRs' in smokers were higher than those in never smokers, but the SAF-corrected SMRs became higher in never smokers. The RSE was 0.95 (95%CI: 0.37-3.55), 0.94 (95%CI: 0.42-2.60), and 0.81 (95%CI: 0.60-1.19) for lung cancer, COPD, and silicosis; whilst it was 1.21 (95%CI: 0.32-10.26) for tuberculosis and 1.02 (95%CI: 0.16-42.90) for pulmonary heart disease. This study firstly demonstrated the joint effect of smoking and silicosis may differ amongst diseases to the lungs, but power is limited. PMID:25105409

  14. Dynamic stabilization using the Dynesys system versus posterior lumbar interbody fusion for the treatment of degenerative lumbar spinal disease: a clinical and radiological outcomes-based meta-analysis.

    Science.gov (United States)

    Lee, Chang-Hyun; Jahng, Tae-Ahn; Hyun, Seung-Jae; Kim, Chi Heon; Park, Sung-Bae; Kim, Ki-Jeong; Chung, Chun Kee; Kim, Hyun-Jib; Lee, Soo-Eon

    2016-01-01

    OBJECTIVE The Dynesys, a pedicle-based dynamic stabilization (PDS) system, was introduced to overcome the drawbacks of fusion procedures. Nevertheless, the theoretical advantages of PDS over fusion have not been clearly confirmed. The aim of this study was to compare clinical and radiological outcomes of patients who underwent PDS using the Dynesys system with those who underwent posterior lumbar interbody fusion (PLIF). METHODS The authors searched PubMed, Embase, Web of Science, and the Cochrane Database. Studies that reported outcomes of patients who underwent PDS or PLIF for the treatment of degenerative lumbar spinal disease were included. The primary efficacy end points were perioperative outcomes. The secondary efficacy end points were changes in the Oswestry Disability Index (ODI) and back and leg pain visual analog scale (VAS) scores and in range of motion (ROM) at the treated and adjacent segments. A meta-analysis was performed to calculate weighted mean differences (WMDs), 95% confidence intervals, Q statistics, and I(2) values. Forest plots were constructed for each analysis group. RESULTS Of the 274 retrieved articles, 7 (which involved 506 participants [Dynesys, 250; PLIF, 256]) met the inclusion criteria. The Dynesys group showed a competitive advantage in mean surgery duration (20.73 minutes, 95% CI 8.76-32.70 minutes), blood loss (81.87 ml, 95% CI 45.11-118.63 ml), and length of hospital stay (1.32 days, 95% CI 0.23-2.41 days). Both the Dynesys and PLIF groups experienced improved ODI and VAS scores after 2 years of follow-up. Regarding the ODI and VAS scores, no statistically significant difference was noted according to surgical procedure (ODI: WMD 0.12, 95% CI -3.48 to 3.72; back pain VAS score: WMD -0.15; 95% CI -0.56 to 0.26; leg pain VAS score: WMD -0.07; 95% CI -0.47 to 0.32). The mean ROM at the adjacent segment increased in both groups, and there was no substantial difference between them (WMD 1.13; 95% CI -0.33 to 2.59). Although the

  15. Application of ISOBAR Dynamic Stabilization System in Treatment of Degenerative Lumbar Disease%腰椎退行性疾病ISOBAR动态固定早期临床观察

    Institute of Scientific and Technical Information of China (English)

    李忠海; 王诗媛; 付强; 马辉; 唐昊; 张秋林

    2011-01-01

    目的 探讨后路ISOBAR动态稳定系统在腰椎退行性疾病治疗中的应用指征、短期疗效和安全性.方法 将自2008年9月~2009年12月收治腰椎退行性疾病(L4、5)28例,随机分为常规减压加ISOBAR动态固定组(治疗组14例)和传统椎间融合内固定组(对照组14例).结果 所有患者获得6~24个月(平均14.6个月)的随访.术后随访VAS评分及ODI均得到明显改善,与术前相比均有显著性差异(P <0.001).对照组术后L4、5及L2~S1节段的ROM均较术前明显下降(P<0.05),而相邻节段L3、4、L5S1的(活动度)ROM无显著变化(P>0.05).治疗组术后各节段和L2~S1的ROM较术前均无明显变化(P>0.05).结论 ISOBAR动态固定系统治疗单节段腰椎退变性疾病取得了满意的短期临床疗效,但没有充分证据证明动态固定技术可以取代传统的融合技术,手术适应证的合理选择十分重要.%Objective To assess the indication,safety and efficacy of the dynamic stabilization system (the ISOBAR system) in the treatment of degenerative lumbar disease. Methods Between September 2008 and December 2009, 28 consecutive patients seeking medical treatment for one level (L4、5) lumbar degenerative disease in our department were included in this study. They were randomly and evenly assigned into an experimental group of decompression and dynamic stabilization with the ISOBAR system (n=14) and a control group of traditional interbody fusion (n=14). Results All cases were followed up for 14.6 months averagely. The postoperative VAS and ODI showed a significant postoperative reduction of disability during the whole period of follow-up (P 0.05). In the dynamic stabilization group, no signifcant changes of global lumbar spine ROM (L2~S1) and segmental ROM (index level and cranial/caudal adjacent levels) were seen (P >0.05). Conclusion This study shows that monosegmental posterior dynamic stabilization with the ISOBAR system demonstrates excellent outcome

  16. 椎旁肌间隙入路选择性治疗腰椎退行性病变%Surgical treatment of lumbar degenerative disease by selective transmuscular paraspinal approach

    Institute of Scientific and Technical Information of China (English)

    江渟; 郭风劲; 张锟; 杨卿

    2012-01-01

    Objective To assess the feasibility of the selective transmuscular paraspinal approach ( TPA )for partial lumbar degenerative disease and to compare it with the traditional approach. Methods Fifty patients were divided randomly into two groups. Patients in control group received surgical treatment of spinal posterior approach, and those in experimental group received TPA surgery. Lumbar spinal canal decompression was performed in both groups; pedicle screw rod system was implemented for those who needed internal fixation, reduction for spondylolisthesis or scoliosis, and interbody fusion for lumbar spinal instability. The intraoperative blood loss, visual analogue scale( VAS ) score and Oswestry disability index ( ODI )in the two groups were analyzed. Results Patients included in this study were all followed up for more than 1 year. Surgical treatment significantly relieved the low back pain in patients; Spondylolisthesis and scoliosis were well reduced; Fusion occurred 1 year after surgery in alls patients undergoing interbody fusion. The intraoperative blood loss, VAS and ODI after surgery of TPA group were significantly better than those of the control group. Conclusion Compared with the traditional approach, TPA is a better therapy choice for certain partial lumbar degenerative disease. It can not only facilitate the surgical treatment, such as decompression, reduction, fixation and inter body fusion, but also restore the original structure of spines and reduce iatrogenic trauma more effectively.%目的 评价椎旁肌间隙入路选择性治疗部分腰椎退行性病变的可行性,并与传统后正中入路相比较.方法 50例患者随机分为两组,一组采用脊柱后正中入路(后正中入路组),另一组采用椎旁肌间隙入路(肌间隙入路组).均行腰椎管减压;对需要行内固定者置入椎弓根钉棒系统,对有腰椎滑脱或侧凸者进行复位,对腰椎不稳定者行椎间植骨融合.对两组病例的术中出血量、

  17. Cause and Clinical Effect of Reoperation for Degenerative Lumbar Disc Disease Patient in Short Term%腰椎间盘退变性疾病术后短期内再手术原因分析与疗效

    Institute of Scientific and Technical Information of China (English)

    周毅; 苏庆军; 海涌; 杨晋才; 康南; 孟祥龙; 徐子彧

    2012-01-01

    Objective To discuss the cause and effect of reoperation of degenerative lumbar disc disease in short term. Methods From August 2010 to February 2011,238 patients with degenerative lumbar disc disease,including lumbar disc herniation (LDH),lumbar spinal stenosis (LSS),lumbar spondylolisthesis,were treated by surgical intervention. The procedures include discectomy,decompressive laminotomy,posterior lumbar interbody fusion (PLIF) ,instrumentation with pedicle screw. Seven failure cases with persistence low back pain and symptoms of radiculopathy received reoperation in short term. The average age of the 2 males and 5 females was 53. 3 years (range 47~ 67 years). The revision procedures including residual discectomy,reposition of pedicle screw,decompression and lumbar interbody fusion were accomplished corresponding the cause of reoperation including incomplete decompression,malposition of pedicle screw,adjacent segmental degeneration (ASD) and iatrogenic instability. Results Seven revision cases were accomplished and followed up for 6 ~12 months successfully. The score of visual analogue scales (VAS) and Oswestry dysfunction index (ODD were decrease and all patients' symptom of low back pain and radiculopathy was relieved. Conclusion The bad clinical result after first surgical intervention for prolapsed lumbar disc herniation is more likely frequency from incomplete decompression. The new symptoms of radiculopathy are associated with malposition of pedicle screws. It is a key point to choose the fusion segments and procedures for multiple segment involved and pay more attention to corresponding factors of ASD and prevention of ASD after fusion procedure.%目的 探讨腰椎间盘退变性疾病手术后短期内再次手术的原因及干预方法.方法 2010年8月至2011年2月手术治疗腰椎管狭窄症、腰椎间盘突出症等腰椎间盘退变性疾病238例,手术方式包括髓核摘除、椎管减压、椎间融合、椎

  18. 膝关节退行性病变的物理治疗观察%Physiotherapy Observation of Degeneration of Knee Joint Disease

    Institute of Scientific and Technical Information of China (English)

    谢昆岭

    2011-01-01

    目的:探讨治疗膝关节退行性病的办法,主要是通过物理治疗或者理疗来缓解痛疼控制病情的发.方法:自我手法按摩患处关节15min,扶床蹲下起立及跑车运动各15min后,用超短波治疗,微温量20min,每日1次,10次为1疗程.结果:痊愈3例(33.3%);显效3例(33.3%):好转2例(22.2%);无效1例(11.11%).总有效率为88.89%.结论:科学的物理治疗对轻、中度患者效果还是比较明显的.%Objective: to investigate the treatment of degenerative knee joint disease, primarily through physical therapy or physical therapy to ease the pain and control the disease. Methods: Self-articular manual massage for 15min and supporting bed stand and squat for15min respectively, the use of ultrashort wave treatment, lukewarm amount of 20min, one time a day, 10 times as a course of treatment. Results: 3 recovery cases (33.3%); 3 effective cases (33.3%); 2 improvement cases (22.2%); 1 ineffective case (11.11%). The total effective rate was 88.89%. Conclusion: The scientific physical therapy has quite obvious effect to moderate patients.

  19. 非融合技术在老年退变性腰椎疾病中的应用%Non-fusion motion preservation stabilization techniques for degenerative lumbar diseases in the elderly

    Institute of Scientific and Technical Information of China (English)

    伍骥; 文偃伍; 黄蓉蓉

    2012-01-01

    腰椎非融合外科技术因不固定脊柱节段,也许较融合术具有更多的优势.本文讨论了对于适合的老年患者,腰椎非融合术的主要类型、进展、适应证及禁忌证、存在的优势与不足.并对非融合技术在老年退变性腰椎疾病中的应用前景进行了展望.我们认为,各主要非融合技术在延缓治疗节段椎间盘退变的速度、保留该节段的运动功能、预防相邻节段的退变、减轻临床症状及改善生活质量等方面都显示出较融合术所具有的更多优势和更少的负面影响.%The non-fusion dynamic stabilization techniques maintain the motion of the lumbar vertebrae without fusion spinal segments, so it may have more advantages than fusion surgery. In this review, we discussed the main types, advance, indications and contraindications, advantages and disadvantages of the lumbar non-fusion surgical treatment for the eligible elderly patients. We believed that major non-fusion techniques had more advantages and less disadvantages in delaying the process of disc degeneration of the targeted segment, preserving the motion of segment, preventing degeneration of adjacent segments, alleviating clinical symptoms, and improving quality of life. There would be great prospect of the lumbar non-fusion surgery in the treatment of degenerative lumbar diseases.

  20. Lumbar degenerative diseases of 38 cases of surgical treatment for analysis of observation%腰椎退行性病变38例手术治疗分析观察

    Institute of Scientific and Technical Information of China (English)

    吴海龙

    2014-01-01

    腰椎退行性病变是椎间盘内的髓核突出,椎间盘纤维环破裂等引起腰腿痛和神经功能障碍,是一种随年龄改变的一种生理过程。治疗上多采取手治疗法,疗效确切。本文采用单枚Cage 斜放加后路椎弓根钉行节段性内固定,一种比较理想的腰椎融合术式;术后脊柱融合可靠,有效地维持了患者椎间隙高度。手术操作简单,手术时间短,术中出血少,创伤小,降低了费用。达到了预期的治疗效果。%Lumbar degenerative diseases is a herniated intervertebral disc,disc bulgin caused lumbocrural pain and neural dysfunction,is a kind of a physiological process of change with age.Treatment on how to take the hand therapy,the curative effect.This paper adopt single pieces of Cage inclined to add segmental internal fixation of posterior pedicle screw line,a kind of ideal lumbar spinal fusion sur- gery;Patients with postoperative spinal fusion and reliable,effectively maintain the intervertebral height.Simple operation,shorter operation time,intraoperative bleeding,less trauma,reduces the cost. The desired therapeutic effect.

  1. Retrospective study of application of interspinous implants for degenerative lumbar diseases%棘突间固定系统治疗腰椎退变性疾患的短期临床随访

    Institute of Scientific and Technical Information of China (English)

    李淳德; 孙浩林; 刘宪义; 林景荣; 邑晓东; 刘洪; 卢海霖

    2009-01-01

    目的 探讨腰椎棘突间固定系统临床应用的适应征选择及临床效果.方法 2007年9月至2008年9月期间68例腰椎退变性疾患病例应用棘突间固定系统,采用腰痛VAS评分,下肢痛VAS评分,腰椎JOA评分(29分法)评定临床症状改善情况;采用Prelo腰椎功能评定标准评定术后功能改善情况;术后拍摄腰椎正侧位X线判定内固定物的位置、有无棘突骨折;测量术前和末次随访标准侧位片手术节段前凸角;末次随访拍摄腰椎过伸过屈位x线,测定手术节段活动度为过伸位前凸角-过屈位前凸角.结果 64例病例获得完整随访,平均随访11.4个月,末次随访腰痛VAS评分(1.7±1.5)、下肢痛VAS评分(1.3±1.0)、腰椎JOA评分(23.5±3.1)和Prolo功能评分(8.6±1.4);较术前腰痛VAS评分(4.94-3.3)、下肢痛VAS评分(7.2 4-2.8)、腰椎JOA评分(13.4 4-4.9)和Prolo功能评分(4.2±2.8)均有显著性改善(P<0.01),末次随访手术节段前凸角(15.4±4.2).较术前前凸角为(19.6±4.7).明显降低(P<0.01);末次随访手术节段椎间活动度为(10.3±4.5)°;2例腰椎间盘突出患者术后半年内复发行二次手术.结论 治疗腰椎退变性疾患应用棘突间固定系统仍然处于起步阶段,临床适应征的选择非常重要,短期的临床随访显示了其临床效果、安全性,也预示了良好的应用前景.%Objective To assess the indications,efficacy and safety of applying interspinous implants for degenerative lumbar diseases.Methods From September 2007 to September 2008,68 cases with degenerative lumbar diseases were treated with interspinous implants.The clinical outcome was assessed by VAS of pain in back and lower extremities,lumbar JOA score and Prolo functional score;the radiological results including implant position,segmental lodosis and segment movement degree were assessed by lumbar X ray including dynamic post-operative versus pre-operative X ray.Results Sixty-four cases had a complete follow

  2. 棘突间Coflex固定系统治疗腰椎退行性疾病的疗效分析%The analysis of the efficacy of Coflex interspinous fixation system in the treatment of lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    吴清涛; 王哲; 罗卓荆

    2012-01-01

    Objective To summarize and analyze the efficacy of coflex interspinous fixation system in the treatment of lumbar degenerative diseases and the causes of postoperative disc re-herniation. Methods The clinical data of 40 patients with degenerative lumbar diseases who were treated with coflex interspinous fixation system from December 2008 to January 2011 were retrospectively summarized and analyzed. There were 16 males and 24 females, whose mean age was 58.3 years old (range; 39-77 years). Simple posterior decompression+coflex fixation were used in 15 patients and decompression+discectomy+coflex fixation in 25 patients. The oswestry disability index (ODI) and visual analogue scale (VAS) of lumbocrural pain were used to evaluate the clinical efficacy. The anteroposterior, lateral, hyperextension and hyperflexion X-ray films of the lumbar spine were taken in the preoperative and postoperative follow-up. The range of motion (ROM) of the lumbar of the operational segments and changes in disc height index were observed. The patients without significant symptom relief were examined with lumbar spine MRI. Results All patients were followed up. The mean follow-up time was 11.2 months (range; 6-24 months). The ODI index scores dropped from 43.88±16.34 preoperatively to 14.63±6.84 in the latest follow-up. The VAS scores dropped from 5.94±1.39 preoperatively to 1.13±0.96 in the latest follow-up. The differences were statistically significant (PO.05). The intervertebral space ROM was 8.32±3.56 preoperatively and 3.64±2.72 postoperatively The differences were statistically significant (P0.05). The disc height index had a significant increase postoperatively (P0.05). The index of the disc height was gradually decreased at the end of the follow-up. The differences were not statistically significant comparing with the preoperative data (P>0.05). Within 6 months postoperatively, original symptoms aggravated in 3 cases receiving single segment decompression and intervertebral

  3. Application of percutaneous pedicle screw fixation for lumbar degenerative disease%应用经皮椎弓根螺钉技术治疗腰椎退行性疾病

    Institute of Scientific and Technical Information of China (English)

    吴浩; 陈永杰; 张璨; 陈赞; 菅凤增

    2014-01-01

    目的:评估在X线透视下经皮椎弓根螺钉微创内固定技术治疗腰椎退行性病变的安全性和准确性。方法回顾性分析首都医科大学宣武医院2012年3月至2013年10月采用X线透视下经皮椎弓根螺钉微创内固定技术,结合显微镜下微创经椎间孔入路椎间盘摘除、椎体间融合术(TLIF)治疗64例腰椎退行性疾病患者的临床资料,随访3个月或以上,统计术中出血量、住院时间、并发症、术前与术后采用视觉模拟量表(VAS)和Oswestry功能障碍指数(ODI)进行疗效评估,计算患者症状改善率;术后生活质量调查(SF-36);术后复查X线及腰椎CT平扫及腰椎核磁,评估螺钉位置及融合率。结果手术平均时间(3.4±0.9)h,术中出血平均(193±100)ml,住院平均时间(7±2)d,并发症发生率7.8%(5/64)。随访3个月显示,VAS和ODI改变差异有统计学意义(P<0.01)。临床症状改善显著,ODI改善率为50.8%,SF-36平均86.2%;64例患者共植入316颗螺钉,术后X线显示306颗螺钉位置良好,10颗螺钉位置可接受,无螺钉松动;螺钉植入成功率达100%,融合率达96%。结论X线透视下微创内固定技术完全可以获得准确、理想的螺钉植入位置,结合显微镜下微创TLIF治疗腰椎退行性疾病是安全、有效的方法。%Objective To evaluate the accuracy and safety of mini-invasive and percutaneous pedicle screw fixation with fluoroscopy for lumbar degenerative disease.Methods For this retrospective study, 64 cases of lumbar degenerative disease underwent mini-invasive transforaminal lumbar interbody fusion ( TLIF) under microscope plus percutaneous pedicle screw fixation with fluoroscopy of lumbar spine from March 2012 to October 2013.The parameters of operative duration , intraoperative blood loss volume , hospital stay and complications were recorded and analyzed.The clinical outcomes were assessed

  4. Coflex棘突间动力重建系统治疗腰椎退变性疾病18例%Coflex interspinous process dynamic reconstruction system for treatment of lumbar degenerative diseases in 18 cases

    Institute of Scientific and Technical Information of China (English)

    刘进; 刘浩; 李涛; 曾建成; 李光辉

    2011-01-01

    process dynamic reconstruction system in the treatment of lumbar degenerative diseases and its early clinical efficacy.METHODS: From October 2008 to September 2010, 31 patients with lumbar degenerative diseases were treated by Coflex interspinous process dynamic reconstruction system, of which 18 cases were followed up more than 1 year, and we analyzed and summarized their clinical data . Surgical procedures were posterior resection of nucleus pulposus, decompression of spinal canal and implantation Coflex interspinous dynamic reconstruction system, only 1 patient was implanted 2 Coflexes in surgery. The patients' JOA, VAS, and ODI scores, the intervertebral height of the implanted segment and the range of motion (ROM) of adjacent segments, and the angle of the upper and lower plates of the Coflex in each position were evaluated before and after the operation, and at every follow-up.RESULTS AND CONCLUSION: All cases were followed up for 15.4 (12-20) months. The patients' JOA, VAS, ODI scores have been significantly improved at the last follow-up. The intervertebral height of the implanted segment and the ROM of adjacent segments had no significant change (P > 0.05), the angle of the upper and lower plates of the Coflex in the hyperextension position is significantly increased than in the neutral position at the last follow-up (P < 0.05). Coflex interspinous process dynamic reconstruction system is a safe and effective technique for treatment lumbar degenerative diseases ,such as lumbar disc herniation, spinal stenosis and lumbar instability, and it not only have little impact on physical fu nction of lumbar but also effectively share the load when the lumbar spine extend backward , so its early clinical efficacy is positive.

  5. MRI of cystic collection of the three joint; Les collections kystiques du genou en IRM

    Energy Technology Data Exchange (ETDEWEB)

    Boutry, N.; Cotten, A.; Dewatre, F.; Chastanet, P.; Gougeon, F. [Hopital R. Salengro, C.H.U., 59 - Lille (France)

    1997-09-01

    We present the main MR features of cystic lesions around the knee joint. Popliteal cysts are the most frequently seen. The usually result from extrusion of joint fluid into the gastrocnemio-semimembranosus bursa but they can have an atypical location or extension. They are most often due to a meniscal, ligamentous, degenerative or inflammatory joint disease responsible for a chronic joint effusion. Meniscal cysts are always associated with a horizontal tear. Medial meniscal cysts are larger and can extend far from the joint. Bursitis occur as a result of inflammation or infection of a bursa. Their location is stereotyped and they do not communicate with the knee joint. Ganglion cysts or ganglia are benign cystic lesions which can affect peri-articular tissues as well as subchondral bone or cruciate ligaments. MRI is now a simple and noninvasive way of obtaining etiologic diagnosis and guiding therapy. (authors). 46 refs.

  6. Research progress on the relationship between brain-derived neurotrophic factor and neural degenerative diseases%脑源性神经营养因子与神经退行性疾病的关系研究进展

    Institute of Scientific and Technical Information of China (English)

    王婷婷; 新燕

    2014-01-01

    Brain-derived neurotrophic factor(Bdnf)is a kind of nerve growth factor widely distributed in the adult mammalian brain. it is very important to maintain the peripheral and central neurons of survival, growth, differentiation and the repair and regeneration after nerve injury[1]. alzheimer's disease (ad) is a kind of degenerative disease which mainly occured in the elderly. the clinical characteristics is memory loss which gradually appeared, cognitive dysfunction, abnormal behavior and social disorder, with senile plaques (SP) and neurofibrillary tangles (NFT) as the main pathological changes. Recent studies have found that the declined level of brain derived neurotrophic factor Bdnf in the brain and its receptor trkB are closely related with the onset of Alzheimer's disease, which had made significant progress. It is summarized as follows.%脑源性神经营养因子(Bdnf)是一类广泛分布于成年哺乳动物脑内的神经营养因子类物质。它对维持周围和中枢神经元的存活、生长、分化及神经损伤后的修复与再生具有十分重要的意义[1]。阿尔茨海默病(ad)是一类多发生在老年的神经退行性疾病,临床特点是逐渐出现记忆力减退、认知功能障碍、行为异常和社交障碍,以老年斑(sP)、神经元纤维缠结(nft)为主要病理改变。近年研究发现脑内脑源性神经营养因子 Bdnf 及其受体 trkB 水平的下降与阿尔茨海默病(ad)的发病密切相关,并取得了显著的进展,现综述如下。

  7. Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

    International Nuclear Information System (INIS)

    A 9-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis affecting multiple sites. During an 8-year follow-up he developed premature closure of a distal radial epiphysis and degenerative changes in the adjacent radiocarpal joint. (orig.)

  8. Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Piddo, C. [Pediatric Radiology, Children' s Hospital, Winnipeg, Manitoba (Canada); Reed, M.H. [Pediatric Radiology, Children' s Hospital, Winnipeg, Manitoba (Canada); Department of Pediatrics and Child Health, Children' s Hospital and the University of Manitoba, Winnipeg (Canada); Black, G.B. [Department of Pediatrics and Child Health, Children' s Hospital and the University of Manitoba, Winnipeg (Canada); F.R.C.S. Section of Orthopedics, Children' s Hospital and the University of Manitoba, Winnipeg, Manitoba (Canada)

    2000-02-01

    A 9-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis affecting multiple sites. During an 8-year follow-up he developed premature closure of a distal radial epiphysis and degenerative changes in the adjacent radiocarpal joint. (orig.)

  9. ULTRASONOGRAPHY OF THE HIP JOINT EXAMINATION HIP JOINT IN THE ASSESSMENT OF THE EFFECTIVENESS OF TREATMENT IN CHILDREN WITH LEGG-CALVE-PERTHES DISEASE AND HIP OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Татьяна Ивановна Тихоненко

    2014-09-01

    Full Text Available We performed dynamic hip doppler ultrasonography in children with Legg-Calve-Perthes disease (LCPD in order to determine the effectiveness of the conservative and surgical treatment. The study included children aged from 3 to 7 years old with LCPD who had pain in the hip joints during admission. We assessed the structural changes in the head of the femur and the hip joint (B-mode, when the Doppler study analyzed diameter of enveloping hip vessels, blood velocity and resistance index. The study found that severe pain and contracture of the hip during admission appeared as a manifestation of concomitant hip osteoarthritis. On admission all patients had signs of arterial spasm and venous stasis in the hip joints, which determined the administration of a comprehensive arthrologic, osteogenesis stimulating and angioprotective therapy, according to the data of dynamic ultrasound.

  10. Vitiligo: A Possible Model of Degenerative Diseases

    OpenAIRE

    Barbara Bellei; Angela Pitisci; Monica Ottaviani; Matteo Ludovici; Carlo Cota; Fabiola Luzi; Maria Lucia Dell'Anna; Mauro Picardo

    2013-01-01

    Vitiligo is characterized by the progressive disappearance of pigment cells from skin and hair follicle. Several in vitro and in vivo studies show evidence of an altered redox status, suggesting that loss of cellular redox equilibrium might be the pathogenic mechanism in vitiligo. However, despite the numerous data supporting a pathogenic role of oxidative stress, there is still no consensus explanation underlying the oxidative stress-driven disappear of melanocytes from the epidermis. In thi...

  11. Using Nutrition Against Aging and Degenerative Disease.

    Science.gov (United States)

    Rokosz, Francis M.

    A review of historical and research literature presents various perspectives on the growing controversy surrounding the use of vitamin and mineral supplements to maintain good health and for preventive health care. Several points are made in opposition to many health professionals' opinions that most nutritional supplements are unnecessary.…

  12. Stem Cell Therapy for Degenerative Disc Disease

    Directory of Open Access Journals (Sweden)

    Doniel Drazin

    2012-01-01

    Full Text Available Low back pain is widely recognized as one of the most prevalent pathologies in the developed world. In the United States, low back pain is the most common health problem for adults under the age of 50, resulting in significant societal and personal costs. While the causes of low back pain are myriad, it has been significantly associated with intervertebral disc (IVD degeneration. Current first-line therapies for IVD degeneration such as physical therapy and spinal fusion address symptoms, but do not treat the underlying degeneration. The use of tissue engineering to treat IVD degeneration provides an opportunity to correct the pathological process. Novel techniques are currently being investigated and have shown mixed results. One major avenue of investigation has been stem cell injections. Mesenchymal stem cells (MSCs have shown promise in small animal models, but results in larger vertebrates have been mixed.

  13. Associations between APOE Genotypes and Disease Susceptibility, Joint Damage and Lipid Levels in Patients with Rheumatoid Arthritis

    OpenAIRE

    Maehlen, Marthe T.; Provan, Sella A.; de Rooy, Diederik P. C.; van der Helm-van Mil, Annette H. M.; Annemarie Krabben; Tore Saxne; Elisabet Lindqvist; Anne Grete Semb; Till Uhlig; Désirée van der Heijde; Inger Lise Mero; Olsen, Inge C.; Kvien, Tore K; Lie, Benedicte A.

    2013-01-01

    Objective: Apolipoprotein E (APOE) genotypes are associated with cardiovascular disease (CVD) and lipid levels. In rheumatoid arthritis (RA), an association has been found with disease activity. We examined the associations between APOE genotypes and disease susceptibility and markers of disease severity in RA, including radiographic joint damage, inflammatory markers, lipid levels and cardiovascular markers. Method: A Norwegian cohort of 945 RA patients and 988 controls were genotyped for tw...

  14. Preliminary results of the interspinous implants for treatment of lumbar degenerative diseases%棘突间移植物治疗腰椎关节突关节退变的初期结果

    Institute of Scientific and Technical Information of China (English)

    刘宝戈; Giovanni Alessi; Hendrik Fransen; Luc F.De Waele

    2009-01-01

    Objective To describe our initial experience and evaluate the preliminary results as well as the possible complications of interspinous implant (device for intervertebral assisted motion, DIAMTM) in managing symptomatic lumbar degenerative disorders. Methods A group of 22 patients were analyzed ret-rospectively. Fourteen female and eight male patients were treated. Mean age was 38.5 (range, 24 -59) years. They had clinical evidence for lumbar facet joint pain and a facet joint injection therapy had good result. Pre-operatively MRI and CT scan was done to evaluate the lumbar spinous process, lumbar disc and facet joints. Fourteen patients were operated at single level, eight patients at double levels. Radiographic imaging, pain scores, and clinical assessments were obtained at 24th week, 66th week postoperatively. Results Pa-tients were evaluated clinically through the Odom's criteria: 31.8% (7 patients) excellent, 45.4% (10 patients) good, 4.5% (1 patient) fair and 18.1% (4 patients) poor results. A significant difference was observed in im-provement of visual analogue scale that decreased from preoperative mean 7.09±0.92 to postoperative mean 3.23±1.82. Statistically significant differences were noted in neural foraminal height and posterior disc height when comparing patients pre-and postoperatively. For the follow-up period, no migration and loosening of implant was found, and no revision surgery was needed in all cases. Conclusion In this preliminary result, it could be observed that the DIAMTM prosthesis can offer a pain relief in well selected patients suffering lum-bar facet joint pain. The indication should be very strict. The implant acts as: 1) A shock absorber, give dis-traction of the neuroforamina, realign facet interface; 2) Restore posterior column height and share in load transmission.%目的 评价棘突间移植物-DIAM(device for intervertebral assisted motion)对腰椎关节突关节退变的治疗效果及相关

  15. Hip and pelvis diseases on lumbar AP radiographs including both hip joints

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyun Soo; Juhng, Seon Kwan; Kim, Eun A; Kim, Jeong Ho; Song, Ha Heon; Shim, Dae Moo [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2002-12-01

    To determine the frequency of disease, and to evaluate the methods used for lumbar spine radiography in Korea. Sixty university and training hospitals were randomly selected and asked to describe the projections, film size and radiographic techniques employed for routine radiography in patients with suspected disease of the lumbar spine. Plain radiographs of 1215 patients, taken using 14x17 inch film and depicting both hip joints and the lumbar region, were analysed between March 1999 and February 2000. In 15 patients (1.2%), the radiographs revealed hip or pelvic lesion, confirmed as follows: avascular necrosis of the femoral head (n=11, with bilateral lesion in four cases); sustained ankylosing spondylitis (n=2); acetabular dysplasia (n=1); and insufficiency fracture of the pubic rami secondary to osteoporosis (n=1). In 11 or the 20 hospitals which responded, 14{sup x}17{sup f}ilm was being used for lumbar radiography, while in the other nine, film size was smaller. Plain radiography of the lumbar spine including both hip joints, may be a useful way to simultaneously evaluate lesions not only of the lumbar spine but also of the hip and/or pelvis.

  16. Canonical feature selection for joint regression and multi-class identification in Alzheimer's disease diagnosis.

    Science.gov (United States)

    Zhu, Xiaofeng; Suk, Heung-Il; Lee, Seong-Whan; Shen, Dinggang

    2016-09-01

    Fusing information from different imaging modalities is crucial for more accurate identification of the brain state because imaging data of different modalities can provide complementary perspectives on the complex nature of brain disorders. However, most existing fusion methods often extract features independently from each modality, and then simply concatenate them into a long vector for classification, without appropriate consideration of the correlation among modalities. In this paper, we propose a novel method to transform the original features from different modalities to a common space, where the transformed features become comparable and easy to find their relation, by canonical correlation analysis. We then perform the sparse multi-task learning for discriminative feature selection by using the canonical features as regressors and penalizing a loss function with a canonical regularizer. In our experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset, we use Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) images to jointly predict clinical scores of Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) and Mini-Mental State Examination (MMSE) and also identify multi-class disease status for Alzheimer's disease diagnosis. The experimental results showed that the proposed canonical feature selection method helped enhance the performance of both clinical score prediction and disease status identification, outperforming the state-of-the-art methods. PMID:26254746

  17. Use of Coflex interspinous dynamic stabilization device for L5/S1 degenerative disease%Coflex动态稳定装置在L5/S1退变性疾病中的应用

    Institute of Scientific and Technical Information of China (English)

    周洋; 徐华梓; 池永龙; 吴立军; 杨建生; 陈一衡

    2011-01-01

    目的:探讨Coflex动态稳定装置在L5/S1退变性疾病中应用的可行性及其临床效果.方法:首先在腰椎CT像上测量100例(男女各50例)骶骨发育正常成人S1棘突的解剖参数和Coflex假体的大小,并进行比较.然后于2007年11月~2010年2月对46例腰椎退变性疾病患者在椎管减压后棘突间置入Coflex动态稳定装置,按置入节段不同,分为L4/5组和L5/Sl组.L4/5组患者25例,年龄33~73岁,平均50.6岁,随访17~39个月,平均25个月;L5/Sl组21例,年龄34~65岁,平均48.8岁,随访16~38个月,平均24个月.观察术前和末次随访时Oswestry功能障碍指数(ODI)、VAS疼痛评分,手术节段椎体间背侧高度、腹侧高度和椎间孔高度,手术节段和上相邻节段活动度(ROM)及上相邻节段椎间盘MRI信号Pfirmann分级.结果:男性S1棘突的长、宽、高分别为20.48±5.82mm、14.94±3.56mm、18.78±5.08mm,女性分别为18.81±3.45mm、11.58±2.95mm、17.39±3.72mm;与Coflex假体比较,70例S1棘突能支撑假体,30例S1棘突过短但通过将Coflex假体倒置置入可得到解决.两组患者均成功置入Coflex假体,L5/S1组12例因S1棘突过短而将Coflex假体倒置置入.两组患者术中及术后均无严重并发症发生,末次随访时ODI及VAS评分较术前有明显改善(P0.05).末次随访时两组患者手术节段椎体间腹侧高度、背侧高度及椎间孔高度均较术前明显增高(P0.05),以上各指标末次随访时的变化程度两组之间无显著性差异(P>0.05),L4/5组5例、L5/S1组1例上相邻节段椎间盘MRI信号分级加重1级.结论:在椎管减压后置入Coflex动态稳定装置治疗L5/S1退变性疾病可行且有效.%Objective:To investigate the feasibility and clinical efficacy of Coflex interspinous dynamic stabilization device for L5/S1 degenerative disease. Method:Anatomic parameters of S1 interspinous process and Coflex prosthesis were measured in CT scan on 100 cases (50 males and 50 females) with

  18. Connecting Malfunctioning Glial Cells and Brain Degenerative Disorders

    Directory of Open Access Journals (Sweden)

    Natalie Kaminsky

    2016-06-01

    Full Text Available The DNA damage response (DDR is a complex biological system activated by different types of DNA damage. Mutations in certain components of the DDR machinery can lead to genomic instability disorders that culminate in tissue degeneration, premature aging, and various types of cancers. Intriguingly, malfunctioning DDR plays a role in the etiology of late onset brain degenerative disorders such as Parkinson’s, Alzheimer’s, and Huntington’s diseases. For many years, brain degenerative disorders were thought to result from aberrant neural death. Here we discuss the evidence that supports our novel hypothesis that brain degenerative diseases involve dysfunction of glial cells (astrocytes, microglia, and oligodendrocytes. Impairment in the functionality of glial cells results in pathological neuro-glial interactions that, in turn, generate a “hostile” environment that impairs the functionality of neuronal cells. These events can lead to systematic neural demise on a scale that appears to be proportional to the severity of the neurological deficit.

  19. Degenerative spine disorders in the context of clinical findings

    International Nuclear Information System (INIS)

    Hardly any other structure in the human body is held responsible for so many complaints, pain, and costs as the spine and its degenerative disorders. In the following article, the role of imaging procedures in diagnosing disorders of the spine is presented. Due to the fact that disk herniation represents the most frequent cause for degenerative disorders the anatomy of the intervertebral disk and the pathology of the entities that can cause diseases of the disks are described. In particular, the authors focus on the significance of radiological findings with respect to patient history, subjective symptoms, and objective clinical findings. In addition to presenting the technical procedures and their indications and contraindications also practical tips and tricks in conducting these examinations are presented in this paper

  20. Degenerative spine disorders in the context of clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Freund, Michael [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany) and Abteilung fuer Neuroradiologie, Universitaetsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany)]. E-mail: michael.freund@klinikum-aschaffenburg.de; Sartor, Klaus [Abteilung fuer Neuroradiologie, Universitaetsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany)

    2006-04-15

    Hardly any other structure in the human body is held responsible for so many complaints, pain, and costs as the spine and its degenerative disorders. In the following article, the role of imaging procedures in diagnosing disorders of the spine is presented. Due to the fact that disk herniation represents the most frequent cause for degenerative disorders the anatomy of the intervertebral disk and the pathology of the entities that can cause diseases of the disks are described. In particular, the authors focus on the significance of radiological findings with respect to patient history, subjective symptoms, and objective clinical findings. In addition to presenting the technical procedures and their indications and contraindications also practical tips and tricks in conducting these examinations are presented in this paper.

  1. Outcomes observed during a 1-year clinical and radiographic follow-up of patients treated for 1- or 2-level cervical degenerative disease using a biodegradable anterior cervical plate.

    Science.gov (United States)

    Chen, Mengcun; Yang, Shuhua; Yang, Cao; Xu, Weihua; Ye, Shunan; Wang, Jing; Feng, Yong; Yang, Wen; Liu, Xianzhe

    2016-08-01

    OBJECTIVE The purpose of this study was to present an initial surgical experience in the management of 1- or 2-level degenerative disc disease of the cervical spine using biodegradable anterior cervical plates (bACPs) in anterior cervical discectomy and fusion (ACDF). The authors also aimed to provide insight into this critical and controversial clinical issue by clarifying outcomes for patients receiving bACPs and by comparing their outcomes with those achieved using a traditional metallic anterior cervical plate (mACP) implant. METHODS A retrospective review was conducted for 2 series of patients who had undergone ACDF using either bACP (31 patients, 38 segments) or mACP (47 patients, 57 segments) instrumentation. The patients were followed up for a mean 13.5 ± 0.9 months (range 12-18 months) in the bACP group and 14.8 ± 1.5 months (range 14-22 months) in the mACP group. Clinical outcomes were determined according to scores on the visual analog scale (VAS), the modified Japanese Orthopaedic Association (mJOA) scoring system, and Odom's criteria. Radiological images were used to assess fusion rates, intervertebral height, Cobb's angle, and the width of prevertebral soft tissue. RESULTS Both VAS and mJOA scores were significantly improved at each follow-up in both groups. Excellent or good results according to Odom's criteria were achieved in 93.5% (29/31) of patients in the bACP group and 93.6% (44/47) of patients in the mACP group. At 6 months postoperatively, the fusion rate was 94.7% (36/38) in the bACP group and 96.5% (55/57) in the mACP group, but subsidence of the intervertebral space at the surgical level was more evident in the bACP group. Angulation, as measured by Cobb's angle, demonstrated obvious healing in both groups, while better maintenance was observed in the mACP group. The local inflammatory reaction was uneventful during follow-up. Dysphonia and dysphagia were observed in both groups during the follow-up. CONCLUSIONS The relatively comparable

  2. MTADM: The new Joint Master Programme in Transboundary Animal Disease Management for Eastern Africa

    International Nuclear Information System (INIS)

    Full text: New Partnership for Africa's Development (NEPAD) flagship Comprehensive Africa Agriculture Development Programme (CAADP). Focus is on livestock for trade and export. Better policies, institutions, regulatory framework and technologies are sought for livestock production and management and delivery of veterinary services and disease control. The disease status of African countries places the pivotal constraints on trade possibilities. Animal health standards imposed by importing countries for international, regional or bi-lateral trade, and through the World Trade Organisation's (WTO) Sanitary and Phytosanitary (SPS) agreement must be met. 12 of the 15 most important transboundary animal diseases persist in Africa. Disease control under SPS, entailing new standards, regulations and technologies, can and is not be covered by conventional veterinary training. This specialist area of its own has to be addressed in a specialised postgraduate course for young personnel already involved and responsible for public, private and hybrid animal disease control services. Ambitious visions of a new African livestock sector with changed focus on production, disease, trade, marketing, organisation, delivery and internationality are only realistic with newly trained animal disease control personnel. To target these issues at the academic level the Addis Ababa University / Ethiopia with universities of 3 regional partner countries (Kenya, Uganda, Sudan) and the Freie Universitaet Berlin, Germany, successfully applied for a grant to establish a Joint Master Course in Transboundary Animal Disease Management (MTADM) for Africa. The 3-year project is funded under the EU - EDULINK Programme of the 9th European Development Funds (EDF) as from 2008 to 2010. Currently, preparatory work is ongoing on the final technical details of the MTADM Course. The overall objective of the programme is to strengthen the capacity of national veterinary services in Africa to control and manage

  3. 潜行减压单侧改良TLIF手术治疗腰椎退行性疾患%Preliminary efficacy of decompressive unilateral improved transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    张居适; 胡松峰; 李志龙

    2014-01-01

    目的:观察椎管潜行减压单侧改良经椎间孔腰椎间融合术(transforaminal lumbar interbody fusion,TLIF)手术治疗腰椎退行性疾病的临床疗效。方法:自2009年8月至2011年12月,采用椎管潜行减压单侧改良TLIF手术治疗腰椎退行性疾病患者28例,其中男16例,女12例;年龄46~71岁,平均61岁;病程6个月~6年。腰椎管狭窄症20例,腰椎间盘突出症8例。潜行减压范围:单节段24例,双节段4例。左侧15例,右侧13例。采用JOA下腰痛评分系统(29分)评价手术前后临床症状、体征及括约肌功能;并采用视觉模拟评分(VAS)评估手术前后腰腿痛情况。结果:28例患者获随访,时间6~28个月,平均14个月。术后JOA、VAS评分(17.9±2.2、2.8±0.7)与术前(8.5±1.7、8.6±1.2)比较有明显改善(P<0.05)。28例患者椎间均达到骨性融合。结论:采用椎管潜行减压单侧改良TLIF手术治疗单侧根性症状的腰椎管狭窄症、腰椎间盘突出症,具有创伤小、疗效确切的优点;能明显节省医疗费用,值得临床研究推广。%Objective:To observe preliminary efficacy of decompressive unilateral improved transforaminal lumbar inter-body fusion(TLIF) for the treatment of lumbar degenerative diseases. Methods:From August 2009 to December 2011,28 pa-tients with lumbar degenerative diseases were treated by decompressive unilateral improved TLIF ,including 16 males and 12 females with an average of 61 (aged 46 to 71) years old,the courses of disease ranged from 6 months to 6 years. Among them , 20 cases suffered from lumbar spinal stenosis ,8 cases were lumbar disc herniation. Decompressive range included single seg-ment in 24 cases,and double segments in 4 cases;15 cases were performed operation on the left side,13 cases on the right side. JOA lower back pain scoring system (29 points) were applied for evaluate preoperative and postoperative

  4. 微创TLIF单侧或双侧固定治疗腰椎退行性疾病的临床疗效%The clinical outcomes of minimally invasive unilateral or bilateral TLIF for lumbar degenerative dis-ease

    Institute of Scientific and Technical Information of China (English)

    邹海波; 绳厚福; 李中实; 陈栋; 赵景鑫

    2013-01-01

    Objectives: To evaluate the clinical outcomes of minimally invasive unilateral or bilateral trans-foraminal lumbar interbody fusion (TLIF) for lumbar degenerative disease. Methods: From January 2011 to November 2012, 52 patients with single-level lumbar degeneration disease were treated through mini-TLIF for unilateral(31 cases) and bilateral(21 cases) pedicle screw fixation assisted by Mast Quadrant. The average age of patients was 52.9 years(ranged, 30-77), including 27 males and 25 females. The operation time, in-traoperative blood loss, postoperative hospital stay and surgical cost were recorded. The pre- and post-opera-tive clinical outcomes were assessed by visual analogue scale (VAS) and Oswestry disability index (ODI). The pre- and post-operative radiologic parameters were compared which included the sagittal Cobb angle and the disc height. Results: The mean follow-up time was 12 months (ranged, 3-18). There were significant differ-ences between two groups on operation time, hospital stay and surgical cost(P0.05). The postoperative radiologic indexes of all patients were higher than the preoperative ones(P0.05). Except one patient with bilateral fixation adjusted pedicle screw because of leg pain after operation, at final follow-up, all the patients achieved radiographic fusion without instrument failure and other complications. Conclusions: Mini-TLIF through Mast Quadrant regardless of unilateral or bilateral fixation is reliable for degenerative lumbar disease. Unilateral fixation is of-less surgical time, less duration of postoperative hospital and less medical costs.%目的:评价微创通道下经椎间孔腰椎椎体间融合术(TLIF)单侧或双侧固定治疗腰椎退行性疾病的临床疗效。方法:2011年1月~2012年11月应用Mast Quadrant通道对52例单节段腰椎退变性疾病的患者经椎旁多裂肌入路行TLIF单侧(31例)或双侧(21例)固定治疗。男27例,女25例,年龄30~77岁,平均52.9岁。观

  5. Translational and rotational knee joint stability in anterior and posterior cruciate-retaining knee arthroplasty.

    Science.gov (United States)

    Lo, JiaHsuan; Müller, Otto; Dilger, Torsten; Wülker, Nikolaus; Wünschel, Markus

    2011-12-01

    This study investigated passive translational and rotational stability properties of the intact knee joint, after bicruciate-retaining bi-compartmental knee arthroplasty (BKA) and after posterior cruciate retaining total knee arthroplasty (TKA). Fourteen human cadaveric knee specimens were used in this study, and a robotic manipulator with six-axis force/torque sensor was used to test the joint laxity in anterior-posterior translation, valgus-varus, and internal-external rotation. The results show the knee joint stability after bicruciate-retaining BKA is similar to that of the native knee. On the other hand, the PCL-retaining TKA results in inferior joint stability in valgus, varus, external rotation, anterior and, surprisingly, posterior directions. Our findings suggest that, provided functional ligamentous structures, bicruciate-retaining BKA is a biomechanically attractive treatment for joint degenerative disease.

  6. Wallis棘突间动态固定防治腰椎退变的短期效果%Early clinical observation of Wallis interspinous dynamic stabilization in treatment of lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    杨述华; 许伟华; 叶树楠; 唐欣; 吴星火; 刘先哲; 王晶

    2009-01-01

    Objective To summarize the early experience of the implantation of Wallis posterior dynamic stabilization system for the treatment of early lumbar degenerative disease.Methods During January 2007 to May 2008, 36 patients (37 intervertebral spaces) with early lumbar degenerative disease were treated with Wallis system.There were 23 males and 13 females; 1 case of L2-3, 1 case L3-4-5 intervertebral space, and 35 cases are L4-5 intervertebral space.The spinous process of the segment with intervertebral disk hernia was not excised, and the Wallis system was implanted after the excision of herniated disk with spinal microscope.The JOA and visual analogue scale (VAS) were given before and after the operation.The patients were followed up for average 13.5 months (range, 3-17 months) after the operation.Results The evaluation of therapeutic effect was excellent except 1 case.JOA score were 15-17 with the average of 16.3, and VAS were 0-2 with the average of 0.6.The MRI showed that no compression of spinal cord and improvement of disc signal.The degeneration of the proximal disc did not aggravate.No leakage of cerebrospinal fluid, infection or hernia of residual intervertebral disk.No recur of intervertebral disk hernia and displace of the Wallis system.Conclusion The Wallis posterior dynamic stabilization system, as a non-rigid fixation technique, can preserve the mobility, anatomy and stability of operated lumbar vertebral bodies, promote the recover of the lesion discs, and prevent the degeneration of adjacent discs.%目的 总结Wallis棘突间动态稳定系统置入治疗早期腰椎退变性疾病的短期疗效.方法 2007年1月至2008年5月,共治疗36例(37间隙)腰椎间盘突出症患者.L2-3 1例,L3-4并L4-5 1例,其余均为L4-5间隙.男23例,女13例;年龄38~55岁,平均43岁.手术保留椎间盘突出节段棘突,以脊柱显微镜配合摘除突出的椎间盘,置入Wallis棘突间动态稳定系统并固定缝合.对

  7. Clinical efficacy of treatment of lumbar degenerative disease under the Quadrant minimally invasive treatment system%Quadrant微创系统治疗腰椎退行性疾病的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    黎华; 李荣祝; 韦建勋; 丘德赞; 梁斌; 尹东; 韦敏克

    2012-01-01

    [Objective]To investigate the clinical efficacy of applying the Quadrant minimally invasive treatment system for the treatment of lumbar degenerative disease. [Method] From February 2011 to April 2012,34 patients treated with lumbar fusion under Quadrant minimally invasive treatment system were analysed. The postoperative indexes, the intervertebral height recovery and complications were recorded. The clinical efficacy was evaluated according to the Japanese Orthopaedic Association (JOA) scores and visual analogue scale(VSA) scores. [Result]The average operation time was 174 min,the incision length was 4.2 cm,surgical blood loss was 252ml,surgical draining loss was 97ml,the postoperative ambulation time was 1.9 d,the hospital stay was 7.6 d. Complication was noted in one patient, which was the transient nerve root irritation symptom and ceased after treatment. The mean follow-up was 11.8 months. The JOA scores and the lumbocrural pain VSA scores before discharge and of the final follow-up improved than that of preoperation, and the difference was statistically significant(P <0. 01). The average improvement rate of life quality was 85.6% at final follow-up. The intervertebral height increased from( 5.68 ± 1.82) mm to( 10. 01 ± 1.31)mm. [Conclusion] Applying the Quadrant minimally invasive treatment system to treat the lumbar degenerative disease has many advantages such as less damage to the spine stability,less tissue trauma,less bleeding and quicker recovery and so on, beside of those advantages, it is easy to operate and has defined clinical efficacy. All of these suggest the clinical promotion.%[目的]探讨应用Quadrant微创系统治疗腰椎退行性疾病的临床疗效.[方法]对2011年2月~2012年4月本院应用Quadrant微创系统行腰椎融合手术患者34例进行分析,观察手术后各项指标、椎间隙高度恢复及并发症发生情况,并采用日本骨科学会(JOA)评分和疼痛视觉模拟量表(VAS)

  8. Clinical application of Dynesys system for treatment of lumbar degenerative disc disease%Dynesys动态稳定系统在腰椎退变性疾病治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    李放; 张志成; 任大江

    2012-01-01

    Objective To explore the clinical efficacy of Dynesys system for treatment of lumbar degenerative disc disease. Methods The clinical data (from July 2008 to May 2012) of 120 patients with lumbar degenerative disc disease, who were treated with Dynesys system, were retrospectively reviewed. A total of 108 cases were followed; and 52 cases were fol-lowed-up for more than 2 years, including 24 males and 28 females. There were 40 cases having lumbar canal stenosis and 12 having lumbar disc herniation. The mean preoperative visual analogue scales( VAS) score was 5.5(3-9) for the low back pain and 5. 36 ( 2.6 -9.0) for the leg pain, with the Oswestry disability index ( ODI) being 61.4%. The height and range of motion ( ROM) of fixed disc were measured preoperatively and postoperatively. The ROM of proximal adjacent segment was measured at the same time. Results The mean follow-up period was 29 months in the 52 cases. The operation time was 95 min ?16 min, with blood loss of 183 mL ?2 mL. There were no death patient, no aggravation of symptom, or deterioration of neurological function. One case developed cerebrospinal fluid leakage and was cured with changing position and local dressing; one case with wound fat liquefaction was cured with debridement and dressing. The postoperative VAS score of the low back pain was significantly reduced (P 0.05). The ROM of fixed segment was significantly reduced ( P 0.05). Conclusion Dynamic fixation system Dynesys is simple and easy to master, and it can avoid fusion surgery-related complications. The clinical result is satisfactory. Certain ROM does exist in fixed segment. The ROM of proximal adjacent segment increase slightly. However, its long-term clinical efficacy and the ability to reduce the postoperative adjacent segment degeneration should be verified with long time, multicenter clinical observation.%目的 探讨Dynesys动态稳定系统在腰椎退变性疾病治疗中的临床疗效.方法 回顾分析2008年7月~2012年5

  9. 渐进式功能锻炼对腰椎退行性变患者术后功能恢复的影响%Effect of progressive functional exercises on post--operative rehabilitation of function for patients with degenerative diseases of lumbar vertebrae

    Institute of Scientific and Technical Information of China (English)

    王飞; 潘淑慧; 程红梅; 朱红芳

    2011-01-01

    Objective To study the effect of progressive functional exercises on post--operative rehabilitation of function for patients with degenerative diseases of lumbar vertebrae. Method 32 patients with degenerative diseases of lumbar vertebrae receive rehabilitation exercise by progressive functional exercises method from 2 days before to 3 months after the surgry. Result The accuracy of straight leg raising, lumbar posture correction training and dorsal abdominal muscle are 100%at discharge. Pre--operation score of Oswestry functional disorder is (32. 09±5. 16) and 3 months post-operation score is (14. 09±3. 17). Flucuation of scores for 23 patients is more than 15. Conclusion progressive functional exercise can improve rehabilitation of physical function for patients with degenerative diseases of lumbar vertebrae effectively.%目的 探讨渐进式功能锻炼对腰椎退行性变患者术后功能恢复的效果.方法 对32例腰椎退行性变患者于术前2 d至术后3个月采用渐进式功能锻炼方案实施康复锻炼.结果 出院时直腿抬高、腰椎姿势纠正训练、腹背肌训练等项目的 正确率为100%;Oswestry功能障碍评分术前(32.09±5.16)分、术后3个月(14.09±3.17)分,其中23例患者评分变化>15分.结论 渐进式功能锻炼可有效促进腰椎退行性变患者术后功能恢复.

  10. Clinical efficacy and operation strategy of intervertebral foramen intervertebral fusion for degenerative lumbar disease%经椎间孔椎间融合治疗退变性腰椎疾病的临床疗效及手术策略

    Institute of Scientific and Technical Information of China (English)

    王福贵; 娄颜伟; 朱俊昭; 邹扬道; 陈伟

    2015-01-01

    目的::探讨经椎间孔椎间单枚融合器融合、椎弓根钉内固定治疗退变性腰椎疾病的临床疗效。方法:采用经椎间孔椎体内单枚椎间融合器结合椎弓根钉棒系统治疗退变性腰椎疾病21例。通过下腰痛JOA评分和Dswestry功能障碍指数评分,评估其临床效果。结果:本组获随访4~14个月,术后3个月及1年JOA及ODI评分与术前比较差异显著(P﹤0.05)。结论:经椎间孔单枚融合器融合结合单侧或双侧椎弓根钉内固定治疗退变性腰椎疾病是一种创伤小、疗效确切的治疗方法。%Objective:To evaluate the clinical effect of foraminal single fusion cage, pedicle screw fixation for the treatment of lumbar degenerative disease. Methods:21 cases with using transforaminal lumbar vertebral body single fusion cage combined with pedicle in treat-ment of degenerative lumbar disease . The pain score of JOA and Dswestry disability index score evaluated the clinical effect. Results:The patients were followed up for 4~14 months, after 3 months and 1 years of compared with the preoperative JOA and ODI score difference was significant (P < 0. 05). Conclusion:Transforaminal single fusion cage combined with unilateral or bilateral pedicle screw fixation for the treatment of lumbar degenerative disease might be a safe,and effective method.

  11. Hand osteoarthritis: Differential diagnosis with inflammatory joint diseases and treatment policy

    Directory of Open Access Journals (Sweden)

    Yu. A. Olyunin

    2015-01-01

    Full Text Available Osteoarthritis (OA usually affects certain joint groups selectively and the hand joints (HJ are one of its classical locations. Hand OA is widespread in the population. In their practice rheumatologists encounter HJ injury in OA in 38% of cases. It is conventional to identify three main types of hand OA. These are 1 interphalangeal OA that may or may not be accompanied by nodulation; 2 first carpometacarpal OA; and 3 erosive OA. At the same time, the rate of clinical forms ranges from 2.0 to 6.2%; it is 4.7 to 20.4% in the elderly. Nonsteroidal antiinflammatory drugs (NSAIDs are most commonly used to relieve pain that is the main manifestation of the disease. The risk for NSAID-related adverse gastrointestinal (GI events is substantially reduced by the drugs that exert their effects mainly on cyclooxygenase 2. These include nimesulide in particular. Undesirable GI effects may be also considerably minimized by using NSAIDs that have both their gastroprotective and antiinflammatory activities. By suppressing pain and inflammatory changes, the recently designed NSAID amtolmetin guacil simultaneously exerts a protective effect on the GI mucosa, by elevating its nitric oxide levels.

  12. Morphology of endplate in lumbar degenerative disc disease, a MRI study%腰椎间盘退变性疾患下腰椎终板形态的MRI观察

    Institute of Scientific and Technical Information of China (English)

    李春林; 李放; 张志成

    2012-01-01

    Objectives: To investigate the morphology of endplate shape in lumbar degenerative disc disease by means of magnetic resonance imaging (MRI) and the correlation between endplate shape and lumbar disc degeneration. Methods: A retrospective review was carried out in this study. The preoperative lumbar MRIs of 110 patients with single lumbar intervertebral disc herniation (group A) and 35 patients suffering from disco-genic low back pain(group B) were reviewed and analyzed respectively. The morphology of endplate was classified into three groups: concave, flat and irregular based on the midsagittal Tl -weighed MRI; the degree of disc degeneration was graded on T2 -weighed MRI according to the Pfirrmann's method, with one to five points behaving grade 1 to V; all endplates were determined by Modic grading system. The associations between morphology of endplate in lower lumbar spine and disc degenerative degree as well as Modic changes were evaluated retrospectively. Results: (DAmong the 435 lower lumbar spine endplates, concave represented the maximum proportion(215/435), with 50.6% in group A(167/330) and 45.7% in group B(48/105), and they almost sited in L3/4(108/215) and 14/5(83/215). Flat accounted for 29.0%(126/435). mostly sited in L5/S1 (76/126). Irregular represented the least proportion(94/435), with 23.0% in group A(76/330) and 17.1% in group B(18/105), almost sited in L5/Sl(45/94). ?In group A, the average degenerative degree for concave, flat and irregular endplate was 3.31±0.81 point, 3.66±0.64 point and 4.16±0.67 point respectively, which showed significant difference (P0.05). ?In group B, the average degeneration degree for concave, flat and irregular endplale was 3.23±0.86 point, 3.54±0.85 point and 3.94±0.54 point respectively, with significant difference existing only in concave and irregular shape(P<0.05). Conclusions: Endplate morphology is associated with degree of disc degeneration and Modic changes. Disc degeneration presents from concave

  13. Coflex棘突间动态内固定治疗退行性腰椎间盘疾病的临床分析%Clinical Analysis on Colfex Interspinous Dynamic Internal Fixation in the Treatment of Lumbar Degenerative Disc Disease

    Institute of Scientific and Technical Information of China (English)

    张雨

    2016-01-01

    目的:探讨Coflex棘突间动态内固定治疗退行性腰椎间盘疾病临床应用效果。方法90例退行性腰椎间盘疾病患者均接受Coflex棘突间动态内固定手术治疗,指定具有专业知识及丰富经验的临床医生完成其相应操作。结果90例退行性腰椎间盘疾病患者治疗前Oswestry评价结果为(82.34±12.43)%,经治疗后其Oswestry评价结果降低至(10.92±4.71)%,治疗前后Oswestry评价结果对比,差异具有统计学意义,P<0.05。结论退行性腰椎间盘疾病患者经Coflex棘突间动态内固定治疗,可改善其腰椎功能,有利于保障患者生活质量。%Objective Analyse the coflex interspinous dynamic internal ifxation in the treatment of lumbar degenerative disc disease.Methods 90 cases of patients with degenerative lumbar disc disease were treated with colfex interspinous dynamic internal ifxation, speciifed the clinician with expertise and experience to completed their respective operations.Results Oswestry evaluation results in 90 patients with degenerative lumbar disc disease before treatment was (82.34 ± 12.43)%, after treatment its Oswestry evaluation reduced to (10.92 ± 4.71)%, Oswestry evaluation results compared before and after treatment had significant difference,P<0.05. Conclusion Patients with degenerative lumbar disc disease treated with coflex interspinous dynamic internal fixation can significantly improve lumbar function and protect the quality of life.

  14. Structural and biomechanical aspects of equine sacroiliac joint function and their relationship to clinical disease.

    Science.gov (United States)

    Goff, L M; Jeffcott, L B; Jasiewicz, J; McGowan, C M

    2008-06-01

    Pain originating from the sacroiliac joint (SIJ) in horses has long been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction (SID) has been difficult to achieve. Clinical presentation of SID appears to fall into two categories. The first, presenting as pain and poor performance, is responsive to local analgesia of periarticular structures with poorly defined pathology. The second presents primarily as poor performance with bony pathological changes as a result of chronic instability. Diagnostic tests based on biomechanics as well as manual provocation for SIJ pain have formed the basis of tests currently used to diagnose SIJ dysfunction in humans. This review summarises the anatomy and biomechanics of the equine SIJ and current biomechanical, innervation and motor control concepts in human SID. The relationship between abnormal SIJ motion and altered neuromotor control with clinical disease of the equine SIJ are discussed. Future utilisation of these principles to develop new diagnostic and management tools for the equine SID is promising. PMID:17493851

  15. Structural and biomechanical aspects of equine sacroiliac joint function and their relationship to clinical disease.

    Science.gov (United States)

    Goff, L M; Jeffcott, L B; Jasiewicz, J; McGowan, C M

    2008-06-01

    Pain originating from the sacroiliac joint (SIJ) in horses has long been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction (SID) has been difficult to achieve. Clinical presentation of SID appears to fall into two categories. The first, presenting as pain and poor performance, is responsive to local analgesia of periarticular structures with poorly defined pathology. The second presents primarily as poor performance with bony pathological changes as a result of chronic instability. Diagnostic tests based on biomechanics as well as manual provocation for SIJ pain have formed the basis of tests currently used to diagnose SIJ dysfunction in humans. This review summarises the anatomy and biomechanics of the equine SIJ and current biomechanical, innervation and motor control concepts in human SID. The relationship between abnormal SIJ motion and altered neuromotor control with clinical disease of the equine SIJ are discussed. Future utilisation of these principles to develop new diagnostic and management tools for the equine SID is promising.

  16. MRI of the wrist and finger joints in inflammatory joint diseases at 1-year interval: MRI features to predict bone erosions

    Energy Technology Data Exchange (ETDEWEB)

    Savnik, Anette [Department of Rheumatology, Parker Institute, Frederiksberg Hospital, Copenhagen (Denmark); Department of Radiology, University Hospital at Herlev, Copenhagen (Denmark); Department of Radiology, Frederiksberg Hospital, Copenhagen (Denmark); Malmskov, Hanne; Graff, Lykke B.; Danneskiold-Samsoee, Bente; Bliddal, Henning [Department of Rheumatology, Parker Institute, Frederiksberg Hospital, Copenhagen (Denmark); Thomsen, Henrik S. [Department of Radiology, University Hospital at Herlev, Copenhagen (Denmark); Nielsen, Henrik [Department of Rheumatology, University Hospital at Herlev, Copenhagen (Denmark); Boesen, Jens [Department of Radiology, Frederiksberg Hospital, Copenhagen (Denmark)

    2002-05-01

    The aim of this study was to assess the ability of MRI determined synovial volumes and bone marrow oedema to predict progressions in bone erosions after 1 year in patients with different types of inflammatory joint diseases. Eighty-four patients underwent MRI, laboratory and clinical examination at baseline and 1 year later. Magnetic resonance imaging of the wrist and finger joints was performed in 22 patients with rheumatoid arthritis less than 3 years (group 1) who fulfilled the American College of Rheumatology (ACR) criteria for rheumatoid arthritis, 18 patients with reactive arthritis or psoriatic arthritis (group 2), 22 patients with more than 3 years duration of rheumatoid arthritis, who fulfilled the ACR criteria for rheumatoid arthritis (group 3), and 20 patients with arthralgia (group 4). The volume of the synovial membrane was outlined manually before and after gadodiamide injection on the T1-weighted sequences in the finger joints. Bones with marrow oedema were summed up in the wrist and fingers on short-tau inversion recovery sequences. These MRI features was compared with the number of bone erosions 1 year later. The MR images were scored independently under masked conditions. The synovial volumes in the finger joints assessed on pre-contrast images was highly predictive of bone erosions 1 year later in patients with rheumatoid arthritis (groups 1 and 3). The strongest individual predictor of bone erosions at 1-year follow-up was bone marrow oedema, if present at the wrist at baseline. Bone erosions on baseline MRI were in few cases reversible at follow-up MRI. The total synovial volume in the finger joints, and the presence of bone oedema in the wrist bones, seems to be predictive for the number of bone erosions 1 year later and may be used in screening. The importance of very early bone changes on MRI and the importance of the reversibility of these findings remain to be clarified. (orig.)

  17. Clinical observation of Coflex interspious instrumentation in the surgical treatment of lumbar degenerative disease%Coflex治疗腰椎退行性疾患的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    李忠海; 王诗媛; 付强; 王聪; 唐昊; 马辉

    2011-01-01

    [Objective]To treat degenerative lumbar spinal disorders by Coflex interspinous instrumentation and fusion fixation, and evaluate the clinical effect and influence on the adjacent segments.[Methods]Forty -two consecutive patients with one level ( L4、5 ) lumbar degenerative disease treated in our study between June 2007 and June 2009 were included in.They were randomly and evenfly assigned into an experimental group of decompression and interspinous instrumentation with the Coflex system (n = 21 ) and a control group of traditional interbody fusion (n = 21 ).A score of VAS and the Oswestry Disability Index were used to assess clinical outcome preoperatively and postoperatively.All patients experienced flexion/extension radiographs before surgery and at the latest follow - up.ROM was assessed at the index level ( L4、5 ), the cranial/caudal adjacent levels ( L3、4/L5S1 ), and at the lumbar spine from L2 to S1.[Results]All cases were followed up for 24 months averagely.The postoperative VAS and ODI showed a significant postoperative reduction of disability during the whole period of follow - up.There was a signifcant reduction of the global ROM of the lumbar spine ( L2S1 ) and the segmental ROM at the index level ( L4、5 ) in the fusion group, whereas adjacent level ROM did not change signifcantly.In the Coflex group, there was a signifcant improvement of the global ROM of the lumbar spine ( L2S1 ) and the segmental ROM at the index level ( L3、4 ).No signifcant changes of L4、5 and L5S1 were noted.[Conclusion]This study shows that monosegmental posterior interspinous stabilization with the Coflex system demonstrates excellent outcome for improvement in back pain, neurogenic claudication and patient satisfaction in short and mid - term follow - up duration.At present, there is no overwhelming evidence to suggest that the system performs better than traditional fusion as far as the long - term results are concerned.The selection of suitable surgical candidates

  18. Dynesys动态稳定系统治疗腰椎退行性疾病的短期临床疗效观察%Dynesys dynamic stability system treatment the short-term clinical effect of the treatment of lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    宁旭

    2014-01-01

    Objective:To retrospective analysis Dynesys dynamic stability system short-term clinical curative effect for the treatment of lumbar degener-ative disease.Methods:Collected in April 2011-April 2013 use Dynesys dynamic stability system treatment of the clinical data of 28 cases of lumbar degen-erative disease.Postoperative follow-up of 12 to 24 months,an average of 18.8 months.To observe the postoperative symptoms,compared preoperative VAS score,postoperative JOA scores and Oswestry scores,evaluate JOA postoperative period.Results:All cases of postoperative clinical symptoms im-proved significantly,the Dynesys screw loose rope without fracture,postoperative VAS score,Oswestry scores,preoperative JOA score difference statisti-cally (P<0.05),postoperative period JOA 68.2±3.66%.Conclusion:The treatment of lumbar degenerative disease Dynesys dynamic stability system short-term curative effect is satisfied,which get stability of lumbar spine and keep the function of lumbar spine lesions segment part activities at the same time. It is a kind of treatment of degenerative lumbar disease effective method of fusion elastic fixed,long-term clinical curative effect observation to be operation quantity and long-term follow-up.%目的:回顾分析Dynesys动态稳定系统治疗腰椎退行性疾病的短期临床疗效。方法:收集2011年4月-2013年4月使用Dynesys动态稳定系统治疗的腰椎退行性疾病28例临床资料。术后随访12-24个月,平均18.8个月。观察术后症状,比较术前术后 VAS评分、JOA评分以及 Oswestry评分,评估JOA术后改善率。结果:所有病例术后临床症状明显改善,Dynesys钉绳无松动断裂,术前术后 VAS评分、Oswestry评分、JOA评分具有统计学差异(P<0.05),JOA术后改善率68.2±3.66%。结论:Dynesys动态稳定系统治疗腰椎退行性疾病短期疗效满意,腰椎获得稳定性的同时,保留了腰椎病变节段部分活动功能,是一种治

  19. Health Care Providers’ Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Desta Hiko Gemeda

    2016-01-01

    Full Text Available Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02% health care providers participated in the study. Three hundred sixteen (97.8% of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2% of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers’ knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance.

  20. Health Care Providers' Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia.

    Science.gov (United States)

    Gemeda, Desta Hiko; Sime, Abiot Girma; Hajito, Kifle Woldemichael; Gelalacha, Benti Deresa; Tafese, Wubit; Gebrehiwot, Tsegaye Tewelde

    2016-01-01

    Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02%) health care providers participated in the study. Three hundred sixteen (97.8%) of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2%) of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers' knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance. PMID:27579311

  1. Computer-aided diagnosis of knee-joint disorders via vibroarthrographic signal analysis: a review.

    Science.gov (United States)

    Wu, Yunfeng; Krishnan, Sridhar; Rangayyan, Rangaraj M

    2010-01-01

    The knee is the lower-extremity joint that supports nearly the entire weight of the human body. It is susceptible to osteoarthritis and other knee-joint disorders caused by degeneration or loss of articular cartilage. The detection of a knee-joint abnormality at an early stage is important, because it helps increase therapeutic options that may slow down the degenerative process. Imaging-based arthrographic modalities can provide anatomical images of the joint cartilage surfaces, but fail to demonstrate the functional integrity of the cartilage. Knee-joint auscultation, by means of recording the vibroarthrographic (VAG) signal during bending motion of a knee, could be used to develop a noninvasive diagnostic tool. Computer-aided analysis of VAG signals could provide quantitative indices for screening of degenerative conditions of the cartilage surface and staging of osteoarthritis. In addition, the diagnosis of knee-joint pathology by means of VAG signal analysis may reduce the number of semi-invasive diagnostic arthroscopic examinations. This article reviews studies related to VAG signal analysis, first summarizing the pilot studies that demonstrated the diagnostic potential of knee-joint auscultation for the detection of degenerative diseases, and then describing the details of recent progress in analysis of VAG signals using temporal analysis, frequency-domain analysis, time-frequency analysis, and statistical modeling. The decision-making methods used in the related studies are summarized, followed by a comparison of the diagnostic performance achieved by different pattern classifiers. The final section is a perspective on the future and further development of VAG signal analysis.

  2. PERIPROSTHETIC JOINT INFECTION IN PATIENTS WITH RHEUMATIC DISEASES: THE PROBLEMS OF DIAGNOSIS, PREVENTION, AND TREATMENT

    Directory of Open Access Journals (Sweden)

    A. E. Khramov

    2015-01-01

    Full Text Available One of the most menacing complications of large joint total endoprosthesis (TE in patients with rheumatic diseases (RD is the development of periprosthetic infection (PI, progression of which may give rise not only to limb loss, but also death. At the same time, early diagnosis and adequate surgical care make it possible not only to arrest the infectious process, but also to preserve an implanted joint.Objective: to define criteria for the diagnosis, prevention, and treatment of PI after hip and knee joint (HJ and KJ TE in patients with RD.Subjects and methods. In 2009 to 2013, 654 KJ and 549 HJ TE was performed in the V.A. Nasonova Research Instituteof Rheumatology performed KJ (n = 654 and HJ (n = 549 joint ERs.Results and discussion. PI developed in 12 (3.63% and 8 (2.95% patients after KJ and HJ ER, respectively. Early, delayed, and late PI was seen in 11, 6, and 3 patients, respectively. Eleven patients with early PI underwent joint revision/ debridement with preservation of an endoprosthesis and replacement of HJ endoprosthetic inserts and heads. The operations were completed with the collagen hemobiotics being left in the wound and its drainage. Systemic antibiotic therapy was used for 4–6 weeks. No recurrent infection was observed in 9 cases. Two patients underwentresurgery, by setting suction-irrigation systems. Nine patients with delayed or late PI had the following operations: A single-stage revision operation (the endoprosthesis was removed and a new one was implanted was performed in two cases of stable endoprosthetic components and accurately verified low-virulent microorganisms susceptible to certain antibiotics. It was imperative to use cement with an antibiotic, collagen hemobiotics, and systemic antibiotic therapy for 6 weeks. The other 7 patients with unstable endoprosthetic components underwent two-stage revision: Stage 1, endoprosthetic removal and antibiotic-loaded spacer implantation; 6-12 weeks after

  3. Manifestações articulares nas viroses exantemáticas Joint complaints in exanthematic diseases

    Directory of Open Access Journals (Sweden)

    Solange Artimos de Oliveira

    1999-04-01

    Full Text Available A freqüência de manifestações articulares foi avaliada em 251 pacientes com diagnóstico clínico e laboratorial (detecção de IgM por ensaio imunoenzimático de virose exantemática. As artropatias (artralgia e/ou artrite foram mais observadas nos casos de dengue (49% e de rubéola (38,2% do que naqueles com parvovirose humana (30% e sarampo (28,1%. Com exceção do sarampo, as artropatias predominaram nos adultos (315 anos de idade, sendo tal diferença estatisticamente significativa. A ocorrência maior de artropatias em adultos foi mais evidente nos pacientes com parvovirose (75%, rubéola (65% e dengue (57,7% do que naqueles com sarampo (31%. As queixas articulares também predominaram nos pacientes do sexo feminino para todas as viroses avaliadas. Os resultados encontrados demonstram o freqüente acometimento articular nas doenças estudadas, e indicam a necessidade de comprovação laboratorial para o diagnóstico diferencial entre elas.The frequency of arthropathy was evaluated in 251 patients with clinical and serological diagnosis (specific IgM detection by enzyme immunoassay of exanthematic disease. Arthropathy (arthralgia and/or arthritis was more frequent in dengue fever (49% and rubella (38.2% cases than in human parvovirus (30% and measles (28.1% cases. Except for measles cases, joint complaints prevailed in adults (315 years of age and this difference was significant. The higher frequency of arthropathy in adults was more evident in human parvovirus (75%, rubella (65% and dengue fever (57.7% cases than in measles cases (31%. Arthropathy was also more frequent in females for all rash diseases studied. The results of this study showed the high occurrence of joint complaints in the diseases described here and the importance of laboratory confirmation for their differential diagnosis.

  4. The role of nutrition in joint health promotion

    NARCIS (Netherlands)

    Schaafsma, Gertjan

    2007-01-01

    Many people experience with advancing age complaints caused by degenerative changes of the cartilage in their joints, often leading to osteoarthritis (OA). Prevention and/or reduction of OA may include stimulation of the formation of new cartilage, the reduction of degenerative changes and the treat

  5. Surgical treatment of an aseptic fistulized acromioclavicular joint cyst: a case report and review of the literature.

    Science.gov (United States)

    Murena, Luigi; D'angelo, Fabio; Falvo, Daniele A; Vulcano, Ettore

    2009-01-01

    An acromioclavicular joint cyst is an uncommonly reported condition, which seems to result from a massive rotator cuff tear and degenerative osteoarthritis of the acromioclavicular joint. We present the case of an 81-year-old man affected by an acromioclavicular joint cyst, associated to a massive rotator cuff tear, proximal migration of the humeral head and osteoarthritis of the gleno-humeral joint. The mass was 7 x 2.5 cm in size and the overlying skin presented a fistula that drained clear synovial-like fluid. Plain X-ray examination of the left shoulder showed proximal migration of the humeral head migration and osteoarthritis of the gleno-humeral joint, and further MRI evaluation confirmed the clinical diagnosis of a complete rotator cuff tear and observed a large subcutaneous cyst in communication with the degenerative acromioclavicular joint. The patient underwent surgical excision of the cyst and lateral resection of the clavicle to prevent disease recurrence. To the best of our knowledge, this is the first reported case of an acromioclavicular joint cyst complicated by an aseptic fistula resulting from multiple aspirations. PMID:19918423

  6. Magnetic resonance imaging analysis and Fisher's linearity discrimination for the selection of fixed and fused segments during treatment of degenerative low lumbar spinal diseases%MRI影像学测量分析及Fisher's线性判别在退变性下腰椎固定融合节段选择中的意义

    Institute of Scientific and Technical Information of China (English)

    杨振东; 解京明; 王迎松; 张颖

    2011-01-01

    BACKGROUND: Studies addressing MRI data and treated segment selection during the treatment of senile lumbar degenerative diseases are rare.OBJECTIVE: To investigate the clinical significance of the MRI in the selection of fixed and fused segments for treatment of degenerative low lumbar spinal diseases in the elderly.METHODS: The clinical data of 152 patients with lumbar degenerative diseases were divided into two groups: operation group and control group. They were followed up for 3, 6, 12, 24 months post treatment. Clinical function of pre and post-treatment of all the cases were determined by using Japanese Orthopaedic Association (JOA) score. The JOA score between the operation group and control group was compared. And using discriminate analysis, we studied the change of MRI, tried to find out the clinical significance of MRI in the selection of treated segment during the treatment of degenerative low lumbar spinal diseases.RESULTS AND CONCLUSION: JOA score was significantly improved post operation in the operation group (P < 0.05).Compared to the control group, JOA score was significantly higher in the operation group (P < 0.05). Discriminant Functions were established depending on the analysis of clinical and imaging information by using statistical software, and proved whose have statistical significance. Discriminant functions were effective to distinguish degenerative low lumbar spinal diseases and institute individualization operation project and choice possible treated segment and gain all-right clinical outcome.%背景:对下腰椎退变的MRI资料与老年人下腰椎退变性疾患中治疗节段选择的相关性报道较少.目的:分析MRI对老年人下腰椎退变性疾病中固定融合节段选择的临床指导意义.方法:选择152例退变性腰椎疾病患者,根据治疗方案分为对照组及固定融合组,对照组47例采用保守治疗,固定融合组105例均采用经腰椎后路全椎板减压、固定

  7. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: gout (especially ...

  8. Systems to assess the progression of finger joint osteoarthritis and the effects of disease modifying osteoarthritis drugs.

    Science.gov (United States)

    Verbruggen, G; Goemaere, S; Veys, E M

    2002-06-01

    Our objective was to assess the progression of osteoarthritis (OA) using scoring systems based on the anatomical changes recorded in the finger joints on standard radiographs and to test how far these scoring systems could be used to evaluate the effects of candidate "disease modifying osteoarthritis drugs" (DMOAD). The appearance and growth of osteophytes, narrowing of the joint space and subchondral bone changes allowed the classic OA-associated anatomical lesions to be used to score the progression of finger joint OA. Progression of OA in the finger joints was also assessed by the their evolution through previously described and predictable anatomical phases on standard X-rays. These phases were characterised by complete loss of the joint space preceding or coinciding with the appearance of subchondral cysts eroding the entire subchondral plate, and have been described in "inflammatory" or "erosive" OA. The erosive episodes were followed by processes of remodelling. In order to interfere with the progression of osteoarthritis, two chondroitin sulphates with possible DMOAD effects were used in two series of patients with OA of the finger joints. The patients were included in two separate randomised, double-blind placebo-controlled trials: 46 of them received chondroitin polysulphate and 34 received chondroitin sulphate. Eighty-five patients were kept on placebo medication and were used as controls. All 165 patients were followed for 3 years. Posteroanterior X-rays of the metacarpophalangeal and interphalangeal (IP) finger joints were obtained at the start of this prospective study and at yearly intervals thereafter. Almost 80% of the distal IP and 50% of the proximal IP were affected at study entry. In approximately 40% of the patients the classic picture of OA of the IP joints was complicated by manifest erosive OA changes. The two systems to score the progression of OA (Anatomical Lesion and Anatomical Phase Progression Score System) showed definite progression

  9. Registration of knee joint surfaces for the in vivo study of joint injuries based on magnetic resonance imaging

    Science.gov (United States)

    Cheng, Rita W. T.; Habib, Ayman F.; Frayne, Richard; Ronsky, Janet L.

    2006-03-01

    In-vivo quantitative assessments of joint conditions and health status can help to increase understanding of the pathology of osteoarthritis, a degenerative joint disease that affects a large population each year. Magnetic resonance imaging (MRI) provides a non-invasive and accurate means to assess and monitor joint properties, and has become widely used for diagnosis and biomechanics studies. Quantitative analyses and comparisons of MR datasets require accurate alignment of anatomical structures, thus image registration becomes a necessary procedure for these applications. This research focuses on developing a registration technique for MR knee joint surfaces to allow quantitative study of joint injuries and health status. It introduces a novel idea of translating techniques originally developed for geographic data in the field of photogrammetry and remote sensing to register 3D MR data. The proposed algorithm works with surfaces that are represented by randomly distributed points with no requirement of known correspondences. The algorithm performs matching locally by identifying corresponding surface elements, and solves for the transformation parameters relating the surfaces by minimizing normal distances between them. This technique was used in three applications to: 1) register temporal MR data to verify the feasibility of the algorithm to help monitor diseases, 2) quantify patellar movement with respect to the femur based on the transformation parameters, and 3) quantify changes in contact area locations between the patellar and femoral cartilage at different knee flexion angles. The results indicate accurate registration and the proposed algorithm can be applied for in-vivo study of joint injuries with MRI.

  10. Flexible Stabilisation of the Degenerative Lumbar Spine Using PEEK Rods

    Directory of Open Access Journals (Sweden)

    Jacques Benezech

    2016-01-01

    Full Text Available Posterior lumbar interbody fusion using cages, titanium rods, and pedicle screws is considered today as the gold standard of surgical treatment of lumbar degenerative disease and has produced satisfying long-term fusion rates. However this rigid material could change the physiological distribution of load at the instrumental and adjacent segments, a main cause of implant failure and adjacent segment disease, responsible for a high rate of further surgery in the following years. More recently, semirigid instrumentation systems using rods made of polyetheretherketone (PEEK have been introduced. This clinical study of 21 patients focuses on the clinical and radiological outcomes of patients with lumbar degenerative disease treated with Initial VEOS PEEK®-Optima system (Innov’Spine, France composed of rods made from PEEK-OPTIMA® polymer (Invibio Biomaterial Solutions, UK without arthrodesis. With an average follow-up of 2 years and half, the chances of reoperation were significantly reduced (4.8%, quality of life was improved (ODI = 16%, and the adjacent disc was preserved in more than 70% of cases. Based on these results, combined with the biomechanical and clinical data already published, PEEK rods systems can be considered as a safe and effective alternative solution to rigid ones.

  11. Flexible Stabilisation of the Degenerative Lumbar Spine Using PEEK Rods.

    Science.gov (United States)

    Benezech, Jacques; Garlenq, Bruno; Larroque, Gilles

    2016-01-01

    Posterior lumbar interbody fusion using cages, titanium rods, and pedicle screws is considered today as the gold standard of surgical treatment of lumbar degenerative disease and has produced satisfying long-term fusion rates. However this rigid material could change the physiological distribution of load at the instrumental and adjacent segments, a main cause of implant failure and adjacent segment disease, responsible for a high rate of further surgery in the following years. More recently, semirigid instrumentation systems using rods made of polyetheretherketone (PEEK) have been introduced. This clinical study of 21 patients focuses on the clinical and radiological outcomes of patients with lumbar degenerative disease treated with Initial VEOS PEEK(®)-Optima system (Innov'Spine, France) composed of rods made from PEEK-OPTIMA(®) polymer (Invibio Biomaterial Solutions, UK) without arthrodesis. With an average follow-up of 2 years and half, the chances of reoperation were significantly reduced (4.8%), quality of life was improved (ODI = 16%), and the adjacent disc was preserved in more than 70% of cases. Based on these results, combined with the biomechanical and clinical data already published, PEEK rods systems can be considered as a safe and effective alternative solution to rigid ones. PMID:26981285

  12. 减压结合动态稳定系统(Dynesys)治疗腰椎退行性病变的临床疗效观察%Efficacy of dynamic stabilization system(Dynesys)in addition to decompression for the treatment of lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    凌超; 关凯; 刘智

    2013-01-01

      背景:传统的脊柱融合术治疗腰椎退行性病变产生了越来越多的临床问题,在此背景下,多种非融合技术逐渐应用于临床。目的:评价减压结合动态稳定系统(dynamic neutralization system for the spine, Dynesys)治疗腰椎退行性病变的效果。方法:2008年7月至2011年8月应用后路减压术结合单节段Dynesys固定系统治疗腰椎退行性病变患者29例,评价指标包括VAS、ODI评分及椎间高度和椎间活动度。结果:27例患者获得随访,随访时间3~41个月,平均17.8个月。患者术后及末次随访VAS、ODI评分较术前评分均显著降低(P=0.001),术后及末次随访评分的差异无统计学意义(P>0.05)。术后手术节段(L4-L5和L5-S1)椎间隙高度较术前显著增大(P=0.009、P=0.001),术后各时间点差异无统计学意义(P>0.05)。术后椎间活动度较术前显著减小(P=0.001)。上下邻近节段椎间隙高度及椎间活动度术后较术前无明显变化(P>0.05)。结论:Dynesys后路动态稳定系统为腰椎退行性疾病治疗提供了更多的选择,其短期疗效满意,长期效果则需要大样本随机对照研究证实。%Background: More and more clinical affairs happened after traditional spinal fusion for lumbar degenerative diseases. So a variety of non-fusion technology has been applied gradually. Objective: To evaluate the clinical efficacy of the dynamic stabilization system (Dynesys) in the treatment of lumbar degen-erative diseases. Methods: From July 2008 toAugust 2011, 29 patients with lumbar degenerative diseases underwent decompression and dynam-ic stabilization with the Dynesys system. Clinical outcomes were evaluated by using ODI and VAS before and after surgery. Im-agingexaminations for intervertebralspace,surgicalsegmentalmovementandadjacentsegmentchangeswereobtained. Results: A total of 27 patients completed the final follow-up. The mean duration of

  13. Improved flow cytometric assessment reveals distinct microvesicle (cell-derived microparticle signatures in joint diseases.

    Directory of Open Access Journals (Sweden)

    Bence György

    Full Text Available INTRODUCTION: Microvesicles (MVs, earlier referred to as microparticles, represent a major type of extracellular vesicles currently considered as novel biomarkers in various clinical settings such as autoimmune disorders. However, the analysis of MVs in body fluids has not been fully standardized yet, and there are numerous pitfalls that hinder the correct assessment of these structures. METHODS: In this study, we analyzed synovial fluid (SF samples of patients with osteoarthritis (OA, rheumatoid arthritis (RA and juvenile idiopathic arthritis (JIA. To assess factors that may confound MV detection in joint diseases, we used electron microscopy (EM, Nanoparticle Tracking Analysis (NTA and mass spectrometry (MS. For flow cytometry, a method commonly used for phenotyping and enumeration of MVs, we combined recent advances in the field, and used a novel approach of differential detergent lysis for the exclusion of MV-mimicking non-vesicular signals. RESULTS: EM and NTA showed that substantial amounts of particles other than MVs were present in SF samples. Beyond known MV-associated proteins, MS analysis also revealed abundant plasma- and immune complex-related proteins in MV preparations. Applying improved flow cytometric analysis, we demonstrate for the first time that CD3(+ and CD8(+ T-cell derived SF MVs are highly elevated in patients with RA compared to OA patients (p=0.027 and p=0.009, respectively, after Bonferroni corrections. In JIA, we identified reduced numbers of B cell-derived MVs (p=0.009, after Bonferroni correction. CONCLUSIONS: Our results suggest that improved flow cytometric assessment of MVs facilitates the detection of previously unrecognized disease-associated vesicular signatures.

  14. (18)F Sodium Fluoride PET/CT in Patients with Prostate Cancer: Quantification of Normal Tissues, Benign Degenerative Lesions, and Malignant Lesions.

    Science.gov (United States)

    Oldan, Jorge D; Hawkins, A Stewart; Chin, Bennett B

    2016-01-01

    Understanding the range and variability of normal, benign degenerative, and malignant (18)F sodium fluoride ((18)F NaF) positron emission tomography/computed tomography (PET/CT) uptake is important in influencing clinical interpretation. Further, it is essential for the development of realistic semiautomated quantification techniques and simulation models. The purpose of this study is to determine the range of these values in a clinically relevant patient population with prostate cancer. (18)F NaF PET/CT scans were analyzed in patients with prostate cancer (n = 47) referred for evaluation of bone metastases. Mean and maximum standardized uptake values [SUVs (SUVmean and SUVmax)] were made in normal background regions (n = 470) including soft tissues (liver, aorta, bladder, adipose, brain, and paraspinal muscle) and osseous structures (T12 vertebral body, femoral diaphyseal cortex, femoral head medullary space, and ribs). Degenerative joint disease (DJD; n = 281) and bone metastases (n = 159) were identified and quantified by an experienced reader using all scan information including coregistered CT. For normal bone regions, the highest (18)F NaF PET SUVmean occurred in T12 (6.8 ± 1.4) and it also showed the lowest coefficient of variation (cv = 21%). For normal soft tissues, paraspinal muscles showed very low SUVmean (0.70 ± 0.11) and also showed the lowest variability (cv = 16%). Average SUVmean in metastatic lesions is higher than uptake in benign degenerative lesions but values showed a wide variance and overlapping values (16.3 ± 13 vs 11.1 ± 3.8; P disease, and osseous metastases are comparable to those reported for a general population with a wide variety of diagnoses. These normal ranges, specifically for prostate cancer patients, will aid in clinical interpretation and also help to establish the basis of normal limits in a semiautomated data analysis algorithm. PMID:27134560

  15. Polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw for lumbar degenerative disease accompanied with osteoporosis:strengthening technical points%骨水泥注入中空侧孔椎弓根螺钉内固定骨质疏松性腰椎退变:强化技术要点

    Institute of Scientific and Technical Information of China (English)

    荆丹峰; 许艺荠; 孙太存; 田进; 鲁彪; 崔学文

    2014-01-01

    BACKGROUND:Once lumbar degenerative diseases merge with lumbar spinal stenosis, lumbar instability and degenerative scoliosis, surgical therapy is required for corresponding clinical symptoms, and the usage of internal fixators cannot be inevitable. Osteoporosis is rather common in the elderly. Therefore, how to implant stable pedicle screw fixation system in serious osteoporosis patients wil be a big difficulty. In recent years, some studies have proven the biomechanical stability of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw in the vertebral body, so it becomes very hot in the spine surgery. OBJECTIVE: To explore the clinical efficacy of the use of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation for the treatment of lumbar degenerative disease accompanied with osteoporosis. METHODS:Thirty-one patients with lumbar degenerative disease accompanied with osteoporosis from Jun 2008 to Jan 2013 were selected, including 11 males and 20 females with an average age of 73.5 years (range, 65-86 years). There were 14 cases of lumbar degenerative stenosis, 9 of lumbar intervertebral disc herniation combined with segmental instability, 6 of lumbar degenerative spondylolisthesis, and 2 of lumbar degenerative scoliosis. The patients were treated with lumbar canal decompression, fusion and polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation according to their clinical features and imaging data. Visual analog scale for pain evaluation was used before and after fixation, the Japanese Orthopaedic Association (JOA) scale was used for assessment of neurological function and life skils before internal fixation and during folow-up. RESULTS AND CONCLUSION:Al cases were folowed up for 40 months (range, 36-48months). No screw breakage, rod breakage, screw extraction, loosening, pseudoarticulation formation, or incision infection was found. The postoperative visual

  16. Clinical Study on Arthroscopic Treatment of Hip Joint Disease%关节镜治疗髋关节疾病的临床研究

    Institute of Scientific and Technical Information of China (English)

    岳元辉; 龚庆国; 周刚; 向可; 税国俊; 龚万举; 卢静; 王卫国

    2016-01-01

    目的:研究髋关节镜治疗髋关节疾病的方法、疗效及适应证,探讨髋关节镜在髋关节疾病中的临床价值.方法:研究对象为86例有明显髋关节疼痛的患者,包括股骨头坏死(osteonecrosis,ON)(43%)、孟唇损伤(20%)、退行性关节病变(degenerative joint disease,DJD)(10%)、股骨头骨骺缺血性坏死(Legg-Calve’-Perthes,LCP)(1O%)、髋关节游离体(10%)、髋关节疼痛(100%)、机械性损伤(78%)、运动损伤(56%).对患者采用仰卧位进行髋关节镜检查,使用牵引床,300或700,前外侧入口.观察不同疾病在治疗后的预后结果.结果:所有患者均无并发症,平均随访时间30个月,有60%的患者疼痛症状得到缓解.盂唇(91%,P<0.003)或LCP(89%,P<0.05)患者疗效较好,而ON和DJD患者疼痛症状缓解较差,改善率仅为40%和44%.在吻合血管游离腓骨移植(free-vascularized fibular graft,FVEG)的患者中有34%在随访期间得到改善(P=0.003).其中18名患者(21%)进行了全髋关节置换术.结论:髋关节镜手术对于游离体、盂唇损伤、局灶性软骨病变、晚期LCP后遗症患者有良好的治疗效果;对股骨头坏死的治疗效果不佳.

  17. Partial antiviral activities detection of chicken Mx jointing with neuraminidase gene (NA against Newcastle disease virus.

    Directory of Open Access Journals (Sweden)

    Yani Zhang

    Full Text Available As an attempt to increase the resistance to Newcastle Disease Virus (NDV and so further reduction of its risk on the poultry industry. This work aimed to build the eukaryotic gene co-expression plasmid of neuraminidase (NA gene and myxo-virus resistance (Mx and detect the gene expression in transfected mouse fibroblasts (NIH-3T3 cells, it is most important to investigate the influence of the recombinant plasmid on the chicken embryonic fibroblasts (CEF cells. cDNA fragment of NA and mutant Mx gene were derived from pcDNA3.0-NA and pcDNA3.0-Mx plasmid via PCR, respectively, then NA and Mx cDNA fragment were inserted into the multiple cloning sites of pVITRO2 to generate the eukaryotic co-expression plasmid pVITRO2-Mx-NA. The recombinant plasmid was confirmed by restriction endonuclease treatment and sequencing, and it was transfected into the mouse fibroblasts (NIH-3T3 cells. The expression of genes in pVITRO2-Mx-NA were measured by RT-PCR and indirect immunofluorescence assay (IFA. The recombinant plasmid was transfected into CEF cells then RT-PCR and the micro-cell inhibition tests were used to test the antiviral activity for NDV. Our results showed that co-expression vector pVITRO2-Mx-NA was constructed successfully; the expression of Mx and NA could be detected in both NIH-3T3 and CEF cells. The recombinant proteins of Mx and NA protect CEF cells from NDV infection until after 72 h of incubation but the individually mutagenic Mx protein or NA protein protects CEF cells from NDV infection till 48 h post-infection, and co-transfection group decreased significantly NDV infection compared with single-gene transfection group (P<0. 05, indicating that Mx-NA jointing contributed to delaying the infection of NDV in single-cell level and the co-transfection of the jointed genes was more powerful than single one due to their synergistic effects.

  18. Analgesic effects of intra-articular botulinum toxin Type B in a murine model of chronic degenerative knee arthritis pain

    Directory of Open Access Journals (Sweden)

    Stephanie Anderson

    2010-09-01

    Full Text Available Stephanie Anderson1,2, Hollis Krug1,2, Christopher Dorman1, Pari McGarraugh1, Sandra Frizelle1, Maren Mahowald1,21Rheumatology Section, Veteran’s Affairs Medical Center, Minneapolis, Minnesota; 2Division of Rheumatology and Autoimmune Diseases, University of Minnesota Medical School, Minneapolis, Minnesota, USAObjective: To evaluate the analgesic effectiveness of intra-articular botulinum toxin Type B (BoNT/B in a murine model of chronic degenerative arthritis pain.Methods and materials: Chronic arthritis was produced in adult C57Bl6 mice by intra-articular injection of Type IV collagenase into the left knee. Following induction of arthritis, the treatment group received intra-articular BoNT/B. Arthritic control groups were treated with intra-articular normal saline or sham injections. Pain behavior testing was performed prior to arthritis, after induction of arthritis, and following treatments. Pain behavior measures included analysis of gait impairment (spontaneous pain behavior and joint tenderness evaluation (evoked pain response. Strength was measured as ability to grasp and cling.Results: Visual gait analysis showed significant impairment of gait in arthritic mice that improved 43% after intra-articular BoNT/B, demonstrating a substantial articular analgesic effect. Joint tenderness, measured with evoked pain response scores, increased with arthritis induction and decreased 49.5% after intra-articular BoNT/B treatment. No improvement in visual gait scores or decrease in evoked pain response scores were found in the control groups receiving intra-articular normal saline or sham injections. Intra-articular BoNT/B was safe, and no systemic effects or limb weakness was noted.Conclusions: This study is the first report of intra-articular BoNT/B for analgesia in a murine model of arthritis pain. The results of this study validate prior work using intra-articular neurotoxins in murine models. Our findings show chronic degenerative arthritis

  19. 腰椎间盘退变性疾病外科治疗的现状与展望%Present and perspective of surgery for degenerative diseases of lumbar disc

    Institute of Scientific and Technical Information of China (English)

    黄东生

    2004-01-01

    椎间盘退变性疾病(degenerative disc disease,DDD)是指椎间盘组织在多种原因综合作用下发生生物学变性进而引起椎间盘力学特性改变,使邻近的骨关节、韧带发生相应变化,造成脊柱不稳,甚至压迫脊髓、神经根、椎动脉,引起相应的临床症状和体征的综合征。应该重申,DDD并非单一的疾病,而是一组疾病的总称,包括了临床上

  20. Effect of community intervention on recovery of patients with lumbar degenerative disease%社区康复干预对腰椎退变性病变患者康复效果的影响

    Institute of Scientific and Technical Information of China (English)

    王飞; 孙丽; 钱佳成; 蒋行兰; 葛佳燕; 杨洁莎; 傅若蓝

    2013-01-01

    Objective To discuss the effect of community intervention on visual analogue scale ( VAS ) , Oswestry disability index ( ODI ) and frequency of drug use in patients with lumbar degenerative disease ( LDD) .Methods Forty-one patients with LDD were applied with 3 months of community intervention , self-made DV on health guide and handbook on rehabilitation training were handed out , community lecture was carried out and telephone interview was conducted .VAS and ODI were used to evaluate patients ’ pain and function of lumbar vertebra , and the frequency of drug use was collected 3 months before and after the intervention.Results The correct rate of training on lumbar posture and dorsal muscles was 92.68% after the intervention, higher than 17.07% before the intervention, and the difference was statistically significant (χ2 =47.33,P<0.001).The score of VAS on lumbar and VAS on lower limbs , the frequency of drug use and the score of ODI was respectively (2.65 ±0.82),(2.60 ±1.01),(1.51 ±0.71),(10.95 ±4.52) before intervention, and (2.05 ±0.69),(1.94 ±0.87),(0.98 ±0.57),(8.46 ±3.49)after the intervention, with statistically significant differences (t=6.82,7.07,6.81,9.87, respectively; P <0.00).Conclusions Community intervention can promote the improvement of symptoms and recovery of body function for patients with LDD .%目的:探讨社区康复干预对腰椎退变性病变患者视觉模拟评分( VAS)、Oswestry功能障碍评分及用药频度的影响。方法对41例腰椎退行性变者进行为期3个月社区康复干预,发放自制健康指导DV及配套《社区腰腿痛康复指导手册》,开展社区讲座,进行电话访视。分别在干预前及干预3个月后采用VAS、Oswestry功能障碍评分量表评价患者疼痛情况及腰椎功能,并统计患者的用药频度。结果干预后患者腰椎姿势纠正训练、腹背肌训练等项目的正确率(92.68%)明显高于干预前(17.07%),干预前后

  1. 全椎间盘置换术治疗腰椎间盘源性退行性疾病%Total lumbar disc replacement in treating degenerative disc disease

    Institute of Scientific and Technical Information of China (English)

    刘宝戈; Giovanni Alessi; Luc F. De Waele

    2008-01-01

    目的 评价腰椎全椎间盘置换治疗腰椎间盘源性退行性疾病的效果.方法 应用两种人工腰椎间盘移植物治疗90例108节段具有明确腰椎间盘源性退行性疾病且6个月保守治疗无效的患者,男28例,女62例;年龄25~54岁,平均39.2岁;单节段植入85例,双节段10例,三节段1例;L3-4节段6例,L4-5节段39例,L5S1A节段63例.使用Prodisc L人工腰椎间盘48节段,Maverick人工腰椎间盘60节段.手术均取腹膜后人路.术后采用改良Odom评估、Oswestry评分、VAS评分及影像学检查四种方法对症状及疼痛改善程度进行评价.结果 手术时间75~160min,平均115.5min.术中血管损伤1例.术后并发深静脉血栓1例.术后90例患者均随访12个月.随访时间分别为:术后4、6、26、52周.术后Odom评估显示:优76例,良10例,可4例,优良率95.55%.住院时间2.5~6d.平均3.4d.术后翻修2例.影像学检查:假体下沉2例,两种假体移植物均无明显向前或后迁移.结论 应用腰椎全椎间盘置换可恢复退变节段的间盘高度和神经根管的高度及前、后径,保留腰椎后柱结构的完整性和稳定性.%Objective To evaluate the effect of total lumbar disc replacement (TLDR) for treatment of lumbar degenerative disc disease (DDD). Methods The symptomatic 90 patients with DDD underwent single or multiple-level implantation of TLDR with Prodisc L prosthesis (48 levels) and Maverick prosthesis (60 levels). The conservative treatment failed to improve the symptoms in all patients after six months. The average age of the patients was 39.2 years (range 25-54 years). There were 62 females and 28 males. A total of 108 prostheses were implanted encompassing one and three levels. 85 patients were operated at one level, 10 patients at two levels, and 1 patient at three levels. Anterior retroperitoneal approach was performed at all cases. Subjective evaluation was performed according to Odom's criteria, Oswestry disability scale and visual

  2. MicroRNA Expression Signature in Degenerative Aortic Stenosis

    Science.gov (United States)

    2016-01-01

    Degenerative aortic stenosis, characterized by narrowing of the exit of the left ventricle of the heart, has become the most common valvular heart disease in the elderly. The aim of this study was to investigate the microRNA (miRNA) signature in degenerative AS. Through microarray analysis, we identified the miRNA expression signature in the tissue samples from healthy individuals (n = 4) and patients with degenerative AS (n = 4). Six miRNAs (hsa-miR-193a-3p, hsa-miR-29b-1-5p, hsa-miR-505-5p, hsa-miR-194-5p, hsa-miR-99b-3p, and hsa-miR-200b-3p) were overexpressed and 14 (hsa-miR-3663-3p, hsa-miR-513a-5p, hsa-miR-146b-5p, hsa-miR-1972, hsa-miR-718, hsa-miR-3138, hsa-miR-21-5p, hsa-miR-630, hsa-miR-575, hsa-miR-301a-3p, hsa-miR-636, hsa-miR-34a-3p, hsa-miR-21-3p, and hsa-miR-516a-5p) were downregulated in aortic tissue from AS patients. GeneSpring 13.1 was used to identify potential human miRNA target genes by comparing a 3-way comparison of predictions from TargetScan, PITA, and microRNAorg databases. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed to identify potential pathways and functional annotations associated with AS. Twenty miRNAs were significantly differentially expressed between patients with AS samples and normal controls and identified potential miRNA targets and molecular pathways associated with this morbidity. This study describes the miRNA expression signature in degenerative AS and provides an improved understanding of the molecular pathobiology of this disease.

  3. Conservative treatment of temporomandibular joint osteoarthrosis: intra-articular injection of sodium hyaluronate.

    Science.gov (United States)

    Guarda-Nardini, L; Masiero, S; Marioni, G

    2005-10-01

    Promising short-term results in the treatment of temporomandibular joint osteoarthrosis with intra-articular injections of sodium hyaluronate (SH) have been reported in preliminary studies. The present prospective study compared long-term outcomes of temporomandibular joint SH injections with those of a conventional non-surgical treatment (bite-plane). Data from three groups of 20 patients with degenerative temporomandibular joint disease were considered. Group A underwent one cycle of five injections of 1 mL SH. Group B underwent a bite-plane treatment for at least 6 months. We considered a control group of 20 patients who refused any treatments. The description of the outcomes was based on objective and subjective parameters after a 6-month follow-up. Sodium hyaluronate and bite-plane treatments significantly improved patients conditions in all considered parameters. No significant differences in outcomes were confirmed by the statistical analysis. The tolerability of SH treatment resulted to be significantly higher. The analysis of results of serial controls in the SH treated group disclosed a significant worsening in pain at rest by comparing 1 and 6 months follow-up. Sodium hyaluronate infiltration resulted a valid non-surgical treatment for temporomandibular joint degenerative disease. Five well-tolerated intra-articular SH injections achieved equivalent results to those of a 6 months bite-plane treatment. We did not diagnose any complications of SH intra-articular injections. Longer time follow-up is necessary to determine the stability of SH properties.

  4. Serum amyloid A isoforms in serum and synovial fluid from spontaneously diseased dogs with joint diseases or other conditions

    DEFF Research Database (Denmark)

    Kjelgaard-Hansen, Mads Jens; Christensen, Michelle B.; Lee, Marcel Huisung;

    2007-01-01

    in samples obtained from dogs (n = 16) suffering from different inflammatory or non-inflammatory conditions, which were either related or unrelated to joints. Expression of SAA isoforms was visualized by denaturing isoelectric focusing and Western blotting. Serum amyloid A was present in serum from all dogs...... with systemic inflammatory activity, and up to four major isoforms with apparent isoelectric points between 6.1 and 7.9 were identified. In synovial fluid from inflamed joints one or more highly alkaline SAA isoforms (with apparent isoelectric points above 9.3) were identified, with data suggesting local...... production of these isoforms in the canine inflamed joint....

  5. 微创经椎间孔椎间融合术治疗35例腰椎退行性疾病的疗效分析%Analysis of the Efficacy of Minimally Invasive Transforaminal Lumbar Interbody Fusion in the Treatment of 35 Cases of Lumbar Degenerative Disease

    Institute of Scientific and Technical Information of China (English)

    杨林; 廖绪强; 赵新建; 吴锐辉; 曾志超; 李世渊

    2014-01-01

    Objective To explore minimally invasive transforaminal lumbar interbody fusion (MiTLIF) treatment of 35 cases of lumbar degenerative disease effect. Methods 70 cases of lumbar degenerative disease patients according to surgical indications and patient willingness divided into study group and the control group, 35 cases in each group. Study Groups MiTLIF treatment, the control group received conventional transforaminal lumbar fusion between (TLIF) treatment. Results The study group blood loss, intraoperative blood transfusion, postoperative drainage was significantly lower than the control group (P0.05). Study group VAS scores, time in bed than the control group (P0.05). Conclusion MiTLIF treatment of lumbar degenerative disease a significant effect, can effectively reduce surgical blood loss, intraoperative blood transfusion and postoperative drainage, improve postoperative pain conditions, reducing time in bed, safe, reliable, and suitable for clinical application.%目的:探讨微创经椎间孔椎间融合术(MiTLIF)治疗35例腰椎退行性疾病的疗效。方法将70例腰椎退行性疾病患者根据手术指征及患者意愿分为研究组与对照组,每组各35例。研究组采取MiTLIF治疗,对照组采取常规椎间孔腰椎间融合术(TLIF)治疗。结果研究组手术出血量、术中输血量、术后引流量明显低于对照组(P<0.05);两组手术时间对比,差异无统计学意义(P>0.05)。研究组术后VAS评分、卧床时间均优于对照组(P<0.05);JOA评分差异无统计学意义(P>0.05)。结论 MiTLIF治疗腰椎退行性疾病疗效显著,可以有效降低手术出血量、术中输血量及术后引流量,改善术后疼痛情况,减少卧床时间,安全可靠,适于临床推广与应用。

  6. Effect comparison of minimally invasive and open transforaminal lumbar interbody fusion in the treatment of degenerative lumbar disease%微创和开放经椎间孔腰椎椎间融合术治疗腰椎退变性疾病的效果比较

    Institute of Scientific and Technical Information of China (English)

    陈文明; 黄华伟; 黄勇全

    2014-01-01

    Objective To compare the clinical effect of minimally invasive and open transforaminal lumbar interbody fusion in the treatment of degenerative lumbar disease. Methods 32 patients with degenerative lumbar disease in our hospital were selected as research subjects and randomly allocated to the research group and the control group,and there were 16 patients in each group.The control group received conventional open surgery,and the research group re-ceived minimally invasive transforaminal lumbar interbody fusion.Treatment effect between the two groups were com-pared. Results The total effective rate in the research group (93.75%) was obviously higher than that in the control group (68.75%) (P<0.05). Conclusion Minimally invasive transforaminal lumbar interbody fusion treating degenerative lumbar disease helps not only improve total curative effects,but also reduce postoperative complications,which is worthy of clinical promotion.%目的:比较微创和开放经椎间孔腰椎椎间融合术治疗腰椎退变性疾病的临床效果。方法选取本院收治的32例腰椎退变性疾病患者为研究对象,随机分为研究组与对照组,各16例,对照组给予传统开放手术治疗,研究组给予微创经椎间孔腰椎椎间融合术治疗,比较两组的治疗效果。结果研究组的总有效率为93.75%,明显高于对照组的68.75%(P<0.05)。结论采用微创经椎间孔腰椎椎间融合术治疗腰椎退变性疾病不仅可以提高整体治疗效果,还可以减少术后并发症的出现,值得临床推广。

  7. 后路椎间融合加椎弓根螺钉固定术治疗退行性腰椎间盘病变%Posterior lumbar interbody fusion combined with pedicle screw fixation in treatment of degenerative diseases of lumbar intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    黄占柱; 仇小华; 张如意

    2011-01-01

    Objective To investigate the clinical effect of treating the patients suffering from degenerative diseases of lumbar intervertebral disc with posterior lumbar interbody fusion (PLIF) combined with pedicle screw fixation.Methods This study was based on 100 cases suffering from degenerative diseases of lumbar intervertebral disc who underwent PLIF combined with pedicle screw fixation.All the patients were followed by 1 - 2 years.The shape and the function of spinal column were both estimated before and after the operation,and they were also estimated during the following of the patients after the operation.The datas in the formal 3 stages were multiply compared.Results Between the preoperative and postoperative datas,there were statistically significant differences in the JOA scores and the angle of scoliosis and kyphosis (P < 0.05 ).And so do the preoperative datas and the datas during the following (P <0.05).But no similar result was detected between the postoperative data and the data during the following (P > 0.05).Conclusions Posterior lumbar interbody fusion (PLIF) combined with pedicle screw fixation has a significant effect in treating degenerative diseases of lumbar intervertebral disc,deserving further study and clinical popularization.%目的 探讨后路椎间融合加椎弓根螺钉固定术治疗退行性腰椎间盘病变的临床疗效.方法 对100例退行性腰椎间盘病变患者采取后路椎间融合加椎弓根螺钉固定术,术后予1~2年随访,并比较术前、术后及随访时脊柱形态、功能恢复情况(JOA评分).结果 术后与术前患者脊柱后凸、侧凸角度和JOA评分比较差异均有统计学意义(P均<0.05),随访时与术前比较差异也有统计学意义(P<0.05),随访时与术后比较差异无统计学意义(P>0.05).结论 后路椎体间融合术治疗退行性腰椎间盘病变效果显著,有进一步研究和推广价值.

  8. Application of Zero-P interbody fusion in degenerative disease at the adjacent segments after anterior cervical fusion%Zero-P椎间融合术在治疗颈前路融合术后相邻节段退变性疾病中的应用

    Institute of Scientific and Technical Information of China (English)

    程彩霞; 卢旭华; 谢宁; 郭翔; 郭群峰; 倪斌

    2012-01-01

    Objective To investigate the clinical outcomes of Zero-P interbody fusion in the treatment of degenerative disease at the adjacent segments after anterior cervical decompression and fusion with internal fixation. Methods Sixteen patients with degenerative diseases at adjacent segments after anterior cervical decompression and fusion with internal fixation received Zero-P anterior cervical interbody fusion. Japanese Orthopaedic Association ( JOA) scores were compared before and after the operation. Postoperative dysphagia and intervertebral fusion were observed. Results Postoperative JOA score was significantly increased as compared with preoperative score (P<0.05). No dysphagia occurred and all the patients obtained solid fusion. Conclusion The mid- and short-term curative effect is satisfactory for the Zero-P intervertebral fusion in the treatment of cervical degenerative disease in the adjacent segments after anterior cervical fusion.%目的 探讨采用Zero-P椎间融合术治疗颈前路减压融合内固定术后相邻节段退变性疾病的疗效.方法 对16例颈前路减压融合内固定术后发生相邻节段退变性疾病的患者采用Zero-P行颈前路椎间融合术,比较患者手术前后日本骨科学会(Japanese Orthopaedic Association,JOA)评分,观察患者术后吞咽困难发生情况及椎间融合情况.结果 患者术后JOA评分较术前提高,差异有统计学意义(P<0.05),未发生吞咽困难,所有患者均获得牢固融合.结论 采用Zero-P椎间融合术治疗颈前路融合术后相邻节段退变性疾病中短期疗效较好.

  9. Development of Modulators Against Degenerative Aging Using Radiation Fusion Technology

    International Nuclear Information System (INIS)

    In this study, we selected final 20 biomarkers for the degenerative aging to develop radiation aging modeling, and validated a few of selected markers to utilize them in the screening of aging modulators. To select the biomarkers of the degenerative aging, 4 categories of aging-related markers (immune/hematopoiesis, oxidative damage, signaling molecule, lipid metabolism) were comparatively analyzed in irradiated and normally aged biosystems (cell lines or mice). In result, most of the biomarkers showed similar changes by irradiation and normal aging. Regarding the immune/hematopoiesis, the decline of immune cell functions (lymphocyte, NK cell) and Th1/Th2 imbalance, and decreased antigen-presenting of dendritic cells were observed and 10 biomarkers were selected in this category. mtDNA deletion was selected for the oxidative damage marker, 6 biomarkers including p21 and p-FOXO3a for signaling molecule biomarkers, and 3 biomarkers including the adipose tissue weight were selected for lipid metabolism. In addition, the various radiation application conditions by single/factionated irradiation and the periods after the irradiation were investigated for the optimal induction of changes of biomarker, which revealed that total 5Gy of 10 or more fractionated irradiations and 4 months or greather period were observed to be optimal. To found the basis for the screening of natural aging modulators, some selected aging biomarkers were validated by their inhibition by well-known natural agents (EGCG, HemoHIM, etc) in aged cell or mouse model. Additionally, by evaluating the reductive efficacy of 5 natural agents on the degeneration of skin and reproductive organs induced by radiation and chemicals (cyclophosphamide, etc), we established the base for the screening of degenerative diseases by various factors

  10. Development of Modulators Against Degenerative Aging Using Radiation Fusion Technology

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Sung Kee; Jung, U.; Park, H. R.

    2010-04-15

    In this study, we selected final 20 biomarkers for the degenerative aging to develop radiation aging modeling, and validated a few of selected markers to utilize them in the screening of aging modulators. To select the biomarkers of the degenerative aging, 4 categories of aging-related markers (immune/hematopoiesis, oxidative damage, signaling molecule, lipid metabolism) were comparatively analyzed in irradiated and normally aged biosystems (cell lines or mice). In result, most of the biomarkers showed similar changes by irradiation and normal aging. Regarding the immune/hematopoiesis, the decline of immune cell functions (lymphocyte, NK cell) and Th1/Th2 imbalance, and decreased antigen-presenting of dendritic cells were observed and 10 biomarkers were selected in this category. mtDNA deletion was selected for the oxidative damage marker, 6 biomarkers including p21 and p-FOXO3a for signaling molecule biomarkers, and 3 biomarkers including the adipose tissue weight were selected for lipid metabolism. In addition, the various radiation application conditions by single/factionated irradiation and the periods after the irradiation were investigated for the optimal induction of changes of biomarker, which revealed that total 5Gy of 10 or more fractionated irradiations and 4 months or greather period were observed to be optimal. To found the basis for the screening of natural aging modulators, some selected aging biomarkers were validated by their inhibition by well-known natural agents (EGCG, HemoHIM, etc) in aged cell or mouse model. Additionally, by evaluating the reductive efficacy of 5 natural agents on the degeneration of skin and reproductive organs induced by radiation and chemicals (cyclophosphamide, etc), we established the base for the screening of degenerative diseases by various factors

  11. Associations between APOE genotypes and disease susceptibility, joint damage and lipid levels in patients with rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Marthe T Maehlen

    Full Text Available OBJECTIVE: Apolipoprotein E (APOE genotypes are associated with cardiovascular disease (CVD and lipid levels. In rheumatoid arthritis (RA, an association has been found with disease activity. We examined the associations between APOE genotypes and disease susceptibility and markers of disease severity in RA, including radiographic joint damage, inflammatory markers, lipid levels and cardiovascular markers. METHOD: A Norwegian cohort of 945 RA patients and 988 controls were genotyped for two APOE polymorphisms. We examined longitudinal associations between APOE genotypes and C-reactive protein (CRP, erythrocyte sedimentation rate (ESR as well as hand radiographs (van der Heijde Sharp Score(SHS in 207 patients with 10 year longitudinal data. Lipid levels, cardiovascular markers and history of CVD were compared across genotypes in a cross sectional study of 136 patients. Longitudinal radiological data of cohorts from Lund and Leiden were available for replication. (N = 935, with 4799 radiographs. RESULTS: In the Norwegian cohort, associations between APOE genotypes and total cholesterol (TC and low-density lipoproteins (LDL were observed (ε2 < ε3/ε3 < ε4, p = 0.03 and p = 0.02, respectively. No association was present for acute phase reactant or CVD markers, but a longitudinal linear association between APOE genotypes and radiographic joint damage was observed (p = 0.007. No association between APOE genotypes and the severity of joint destruction was observed in the Lund and Leiden cohorts, and a meta- analysis combining all data was negative. CONCLUSION: APOE genotypes are associated with lipid levels in patients with RA, and may contribute to dyslipidemia in some patients. APOE genotypes are not consistently associated with markers of inflammation or joint destruction in RA.

  12. Associations between APOE Genotypes and Disease Susceptibility, Joint Damage and Lipid Levels in Patients with Rheumatoid Arthritis

    Science.gov (United States)

    Maehlen, Marthe T.; Provan, Sella A.; de Rooy, Diederik P. C.; van der Helm - van Mil, Annette H. M.; Krabben, Annemarie; Saxne, Tore; Lindqvist, Elisabet; Semb, Anne Grete; Uhlig, Till; van der Heijde, Désirée; Mero, Inger Lise; Olsen, Inge C.; Kvien, Tore K.; Lie, Benedicte A.

    2013-01-01

    Objective Apolipoprotein E (APOE) genotypes are associated with cardiovascular disease (CVD) and lipid levels. In rheumatoid arthritis (RA), an association has been found with disease activity. We examined the associations between APOE genotypes and disease susceptibility and markers of disease severity in RA, including radiographic joint damage, inflammatory markers, lipid levels and cardiovascular markers. Method A Norwegian cohort of 945 RA patients and 988 controls were genotyped for two APOE polymorphisms. We examined longitudinal associations between APOE genotypes and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) as well as hand radiographs (van der Heijde Sharp Score(SHS)) in 207 patients with 10 year longitudinal data. Lipid levels, cardiovascular markers and history of CVD were compared across genotypes in a cross sectional study of 136 patients. Longitudinal radiological data of cohorts from Lund and Leiden were available for replication. (N = 935, with 4799 radiographs). Results In the Norwegian cohort, associations between APOE genotypes and total cholesterol (TC) and low-density lipoproteins (LDL) were observed (ε2<ε3/ε3<ε4, p = 0.03 and p = 0.02, respectively). No association was present for acute phase reactant or CVD markers, but a longitudinal linear association between APOE genotypes and radiographic joint damage was observed (p = 0.007). No association between APOE genotypes and the severity of joint destruction was observed in the Lund and Leiden cohorts, and a meta- analysis combining all data was negative. Conclusion APOE genotypes are associated with lipid levels in patients with RA, and may contribute to dyslipidemia in some patients. APOE genotypes are not consistently associated with markers of inflammation or joint destruction in RA. PMID:23613766

  13. Failed Radiation Synovectomy in Diseased Knee Joint with Missed Tuberculous Synovitis

    Science.gov (United States)

    Sood, Ashwani; Sharma, Aman; Chouhan, Devendra Kumar; Gupta, Kirti; Parghane, Rahul; Shukla, Jaya; Mittal, Bhagwant Rai

    2016-01-01

    The authors in this case report highlight the poor outcome of radiation synovectomy (RSV) for repeated knee joint effusion in a patient with histopathologically proven nonspecific arthritis. There was partial response initially following RSV but later follow-up showed recurrence in joint effusion with limited and painful mobility of the knee joint. Subsequent surgical synovectomy and histopathological examination showed it to be tubercular in origin. Thus in a country endemic for tuberculosis, an alternative infective etiology should also be kept in mind before subjecting the patient to RSV. PMID:27651744

  14. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases.

    Science.gov (United States)

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint. PMID:27504021

  15. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases

    Science.gov (United States)

    Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint. PMID:27504021

  16. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases.

    Science.gov (United States)

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint.

  17. Joint space width in dysplasia of the hip

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, K;

    2005-01-01

    In a longitudinal case-control study, we followed 81 subjects with dysplasia of the hip and 136 control subjects without dysplasia for ten years assessing radiological evidence of degeneration of the hip at admission and follow-up. There were no cases of subluxation in the group with dysplasia....... Neither subjects with dysplasia nor controls had radiological signs of ongoing degenerative disease at admission. The primary radiological discriminator of degeneration of the hip was a change in the minimum joint space width over time. There were no significant differences between these with dysplasia...... and controls in regard to age, body mass index or occupational exposure to daily repeated lifting at admission.We found no significant differences in the reduction of the joint space width at follow-up between subjects with dysplasia and the control subjects nor in self-reported pain in the hip. The...

  18. Ultrasound colour Doppler measurements in a single joint as measure of disease activity in patients with rheumatoid arthritis--assessment of concurrent validity

    DEFF Research Database (Denmark)

    Ellegaard, K; Torp-Pedersen, S; Terslev, L;

    2009-01-01

    investigated if the amount of CDU activity in a single joint can be used to quantify disease activity in RA. METHODS: A total of 109 patients with RA and affection of the wrist joint underwent a standardized CDU examination assessing three positions in their most affected wrist at start up in biological...

  19. The early clinical observation about Dynesys and lumbar interbody fusion in treatment of lumbar degenerative diseases%非融合技术与腰椎融合术治疗腰椎退变性疾病的早期疗效观察

    Institute of Scientific and Technical Information of China (English)

    王孟; 李坤; 王飞; 张元豫

    2012-01-01

    Objective To investigate the difference of early clinical efficacy between Dynesys and lumbar interbody fusion in treatment of lumbar degenerative diseases. Methods Clinical data of 36 patients under two methods treatment of lumbar degenerative diseases with 18 examples in each were retrospectively analyzed. Patients were observed blood loss, VAS, ODI index, the rate for short-term excellent or good relief of symptoms and ROM. Results Two groups of VAS and ODI index had been significantly improved; Dynesys group maintained adjacent segment ROM to its original condition, while instrumented segment ROM decreased; In lumbar interbody fusion group, adjacent segment ROM increased, and instrumented segments fused. Conclusions Dynesys and the lumbar interbody fusion can all take the ideal early curative effect. Dynesys preserve partial ROM ,and prevent accelerated degeneration, which is a desirable method of treatment.%目的 探讨Dynesys和腰椎融合治疗腰椎退行性疾病早期临床疗效.方法 采用两种方法治疗36例腰椎退行性疾病患者,Dynesys组18例,腰椎融合组18例.观察两组手术时间、术中出血量、VAS评分、ODI指数、手术效果优良率及椎间活动度(ROM).结果 两组术后VAS及ODI都得到明显改善;Dynesys组邻近节段ROM维持在原来状态,手术节段ROM减小;腰椎融合组邻近节段ROM增大,手术节段融合.结论 Dynesys与腰椎融合术均可取的理想的早期疗效,Dynesys保持了部分椎间活动度,有利于防止退变加速.

  20. Common surgical complications in degenerative spinal surgery

    OpenAIRE

    Papadakis, Michael; Aggeliki, Lianou; Papadopoulos, Elias C.; Girardi, Federico P.

    2013-01-01

    The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the region of the spine involved (cervical and thoracolumbar) and the severity of the surgery. Several issues are becoming progressively clearer, such as complication rates in primary versus revision spinal surgery, complications in the elderly, the contribution of minimally invasive sur...

  1. 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...

  2. Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

    Energy Technology Data Exchange (ETDEWEB)

    Zilkens, Christoph; Krauspe, Ruediger; Bittersohl, Bernd [University of Duesseldorf, Medical Faculty, Department of Orthopedic Surgery, Duesseldorf (Germany); Tiderius, Carl Johann [Lund University Hospital, Department of Orthopedic Surgery, Lund (Sweden)

    2015-08-15

    Accurate assessment of early hip joint cartilage alterations may help optimize patient selection and follow-up of hip joint preservation surgery. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is sensitive to the glycosaminoglycan content in cartilage that is lost early in the development of osteoarthritis (OA). Hence, the dGEMRIC technique holds promise for the development of new diagnostic and therapeutic procedures. However, because of the location of the hip joint deep within the body and due to the fairly thin cartilage layers that require high spatial resolution, the diagnosis of early hip joint cartilage alterations may be problematic. The purpose of this review is to outline the current status of dGEMRIC in the assessment of hip joint cartilage. A literature search was performed with PubMed, using the terms ''cartilage, osteoarthritis, hip joint, MRI, and dGEMRIC'', considering all levels of studies. This review revealed that dGEMRIC can be reliably used in the evaluation of early stage cartilage pathology in various hip joint disorders. Modifications in the technique, such as the operation of three-dimensional imaging and dGEMRIC after intra-articular contrast medium administration, have expanded the range of application. Notably, the studies differ considerably in patient selection and technical prerequisites. Furthermore, there is a need for multicenter prospective studies with the required technical conditions in place to establish outcome based dGEMRIC data to obtain, in conjunction with clinical data, reliable threshold values for normal and abnormal cartilage, and for hips that may benefit from conservative or surgical treatment. (orig.)

  3. Analysis of the short-term surgical outcome of lumbar degenerative disease treated with dy-namic stabilization system%Dynesys动态稳定系统治疗腰椎退变性疾病的短期疗效分析

    Institute of Scientific and Technical Information of China (English)

    刘伟; 陈昌伟; 幸永明; 徐杏平

    2014-01-01

    Objective To analyze the short-term efficacy of the dynamic stabilization system in the treatment of lumbar degenerative disease. Methods We conducted posterior decompression and simultaneously internal fixation with dynamic stabilization system in 29 patients suffered from lumbar degenerative disease,and the curative effect was evaluated. Results The postoperative outcomes showed excellent in 23 cases (80%),good in 4 cases (14%)and fair in 2 cases (6%). VAS score was decreased from (7.14±1.29) points preoperation to (2.26±1.03)points at the last follow-up. The preoperative segmental range of motion (ROM) of the operative segments was (7.51±2.68)de-gree, and that was(4.22±1.47) degree at the last follow-up. There was no screw loose or rupture during the follow-up. Conclusion Dynamic stabilization system in the treatment of lumbar degen-erative disease has many advantages such as easy to operate, high safety,and so on,and it can reduce the destruction of the spine,maintain segmental stability,reduce long-term lumbar degenera-tion and the risk of reoperation. Dynamic stabilization system has good clinical application prospect.%目的:探讨Dynesys动态稳定系统在腰椎退变性疾病治疗中的短期临床疗效。方法29例腰椎退变性疾病患者在后路减压的同时行Dynesys动态稳定系统内固定术,评价术后疗效。结果术后临床疗效优23例(80%)、良4例(14%),可2例(6%)。 VAS疼痛评分(0~10分)术前7.14±1.29分,末次随访时2.26±1.03分。术前病变脊柱运动节段过伸过屈活动度(ROM)7.51±2.68度,术后末次随访时ROM为4.22±1.47度。随访期间未见内固定松动和螺钉断裂现象。结论 Dynesys动态稳定内固定系统治疗腰椎退变性疾患具有手术操作简便、安全性高等优点,可减少对脊柱生理结构的破坏,维持节段稳定,减少远期腰椎退变和再次手术的风险,有很好的临床应用前景。

  4. DEGRO guidelines for the radiotherapy of non-malignant disorders. Part II: Painful degenerative skeletal disorders

    Energy Technology Data Exchange (ETDEWEB)

    Ott, Oliver J. [University Hospitals Erlangen, Dept. of Radiation Oncology, Erlangen (Germany); Niewald, Marcus [Saarland University Medical School, Dept. of Radiotherapy and Radiation Oncology, Homburg/Saar (Germany); Weitmann, Hajo-Dirk [Fulda Hospital, Dept. of Radiooncology and Radiotherapy, Fulda (Germany); Jacob, Ingrid [Municipal Hospital Traunstein, Dept. of Radiotherapy, Traunstein (Germany); Adamietz, Irenaeus A. [Marien Hospital Herne/Ruhr University Bochum, Dept. of Radiotherapy and Radiation Oncology, Herne (Germany); Schaefer, Ulrich [Lippe Hospital, Dept. of Radiotherapy, Lemgo (Germany); Keilholz, Ludwig [Bayreuth Hospital, Dept. of Radiotherapy, Bayreuth (Germany); Heyd, Reinhard [Center for Radiosurgery, Frankfurt a. M. (Germany); Muecke, Ralph [Marien Hospital Herne/Ruhr University Bochum, Dept. of Radiotherapy and Radiation Oncology, Herne (Germany); Lippe Hospital, Dept. of Radiotherapy, Lemgo (Germany); Collaboration: German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD)

    2014-09-20

    The purpose of this article is to summarize the updated DEGRO consensus S2e guideline recommendations for the treatment of benign painful degenerative skeletal disorders with low-dose radiotherapy. This overview reports on the role of low-dose radiotherapy in the treatment of enthesiopathies (shoulder syndrome, trochanteric bursitis, plantar fasciitis, and elbow syndrome) and painful arthrosis (knee, hip, hand, and finger joints). The most relevant aspects of the DEGRO S2e Consensus Guideline Radiation Therapy of Benign Diseases 2014 regarding diagnostics, treatment decision, dose prescription as well as performance of radiotherapy and results are summarized. For all indications mentioned above, retrospective and some prospective analyses have shown remarkable effects in terms of pain relief. Nevertheless, the Level of Evidence (LoE) and the Grade of Recommendation (GR) vary: LoE 1b-4 and GR A-C. Low-dose radiotherapy for painful degenerative skeletal disorders is effective in the majority of the patients and therefore it may be a reasonable therapeutic alternative when simple and non-invasive methods have been used without persistent success. For all discussed entities, single fraction doses of 0.5-1.0 Gy and total doses of 3.0-6.0 Gy/series applied with 2-3 fractions per week are recommended. (orig.) [German] Zusammenfassung der Empfehlungen der DEGRO-S2e-Leitlinie zur Niedrigdosis-Radiotherapie von gutartigen schmerzhaften degenerativen Skeletterkrankungen. Die vorliegende Zusammenfassung berichtet ueber die Bedeutung der Niedrigdosis-Radiotherapie in der Behandlung von Enthesiopathien (Schultersyndrom, Ellenbogensyndrom, Bursitis trochanterica, Fasciitis plantaris) und schmerzhaften Arthrosen (Knie-, Hueft, Hand- und Fingergelenksarthrosen). Die wichtigsten Aspekte der aktuellen DEGRO-S2e-Konsensus-Leitlinie Strahlentherapie gutartiger Erkrankungen bezueglich Diagnostik, Therapieentscheidungen, Dosisempfehlungen und Durchfuehrung einer Radiotherapie werden

  5. Lumbar degenerative spinal deformity: Surgical options of PLIF, TLIF and MI-TLIF

    Directory of Open Access Journals (Sweden)

    Hey Hwee Weng

    2010-01-01

    Full Text Available Degenerative disease of the lumbar spine is common in ageing populations. It causes disturbing back pain, radicular symptoms and lowers the quality of life. We will focus our discussion on the surgical options of posterior lumbar interbody fusion (PLIF and transforaminal lumbar interbody fusion (TLIF and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF for lumbar degenerative spinal deformities, which include symptomatic spondylolisthesis and degenerative scoliosis. Through a description of each procedure, we hope to illustrate the potential benefits of TLIF over PLIF. In a retrospective study of 53 ALIF/PLIF patients and 111 TLIF patients we found reduced risk of vessel and nerve injury in TLIF patients due to less exposure of these structures, shortened operative time and reduced intra-operative bleeding. These advantages could be translated to shortened hospital stay, faster recovery period and earlier return to work. The disadvantages of TLIF such as incomplete intervertebral disc and vertebral end-plate removal and potential occult injury to exiting nerve root when under experienced hands are rare. Hence TLIF remains the mainstay of treatment in degenerative deformities of the lumbar spine. However, TLIF being a unilateral transforaminal approach, is unable to decompress the opposite nerve root. This may require contralateral laminotomy, which is a fairly simple procedure.The use of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF to treat degenerative lumbar spinal deformity is still in its early stages. Although the initial results appear promising, it remains a difficult operative procedure to master with a steep learning curve. In a recent study comparing 29 MI-TLIF patients and 29 open TLIF, MI-TLIF was associated with longer operative time, less blood loss, shorter hospital stay, with no difference in SF-36 scores at six months and two years. Whether it can replace traditional TLIF as the surgery of

  6. Assessment of disease activity in juvenile idiopathic arthritis. The number and the size of joints matter

    DEFF Research Database (Denmark)

    Berntson, Lillemor; Wernroth, Lisa; Fasth, Anders;

    2007-01-01

    Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA.......Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA....

  7. The use of compliant layer prosthetic components in orthopedic joint repair and replacement: a review.

    Science.gov (United States)

    St John, Kenneth R

    2014-08-01

    The surgical repair or treatment of degenerative joint disease has traditionally involved the substitution of synthetic materials for one or both surfaces of the joint. Engineering thermoplastics, metals, and ceramics have either been widely accepted or experimentally evaluated for use as bearing surfaces in these prostheses. When engineering thermoplastics are used, the opposing surface is a metal or a ceramic, but metal-on-metal, metal-on-ceramic, and ceramic-on-ceramic have also been used or tested. Researchers have sought the opportunity to utilize materials with compressive mechanical properties more closely matching those of the natural articular cartilage. This review discusses the theory, testing, and application of elastomers for one bearing component of articular joint prostheses.

  8. Polymethylmethacrylate-augmented transpedicular screw fixation for stabilization of the lumbar degenerative disease accompanied with osteoporosis%骨水泥加强椎弓根螺钉内固定治疗伴骨质疏松症的腰椎退行性病变

    Institute of Scientific and Technical Information of China (English)

    薛海滨; 马远征; 王亮; 李大伟; 顾苏熙

    2011-01-01

    Objective To explore the clinical efficacy of the use of polymethylmethacrylate (PMMA)-augmented transpedicular screw fixation for the treatment of lumbar degenerative disease accompanied with osteoporosis.Methods Thirty-eight patients of lumbar degenerative disease accompanied with osteoporosis from Jun 2004 to Jan 2009 were selected with intact follow-up data.They were 16 males and 22 females with average age of 62.5 years, including lumbar degenerative stenosis 16 cases, lumbar intervertebral disc herniation combined with segmental instability 12 cases, lumbar degenerative spondylolisthesis 6 cases, and lumbar degenerative scoliosis 4 cases.The patients were treated with lumbar canal decompression, or fusion,or transpedicular screw fixation by augmentation with PMMA in the screw tract, according to their clinical feature and imaging results.The postoperative outcomes were evaluated using Oswestry Disability Index (ODI) scale, visual analog scale (VAS), and radiological findings.Results All cases were followed up for 18-48months (36.5 months in average).Low back pain and leg pain were released apparently.There were no loosens and dislocations of the screw postoperatively according to X-ray scan.No bright lines appeared around the screws.Upon the last follow-up time, the VAS for low back pain decreased from 7.46 ± 2.24 preoperatively to 3.15 ± 1.47 postoperatively ( P < 0.01 ).The VAS for leg pain decreased from 7.24 ±2.32.preoperatively to 2.11 ±0.84 postoperatively (P <0.01 ).ODI score decreased from 43.15 ±5.72 preoperatively to 15.41 ± 6.42 postoperatively ( P < 0.01 ).The intraoperative and postoperative complications occurred in 16 cases.The complications did not cause any delayed damage.Conclusion For patients suffering from lumbar degenerative disease accompanied with osteoporosis, PMMA in the screw tract was helpful for increasing the stabilization of transpedicular screw and preventing from loosen and dislocation of the screws, therefore

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