BACKGROUND Although percutaneous vertebral augmentation(PVA)is a commonly used procedure for treating vertebral compression fracture(VCF),the risk of vertebral refracture should be considered.Chronic kidney disease-mi...BACKGROUND Although percutaneous vertebral augmentation(PVA)is a commonly used procedure for treating vertebral compression fracture(VCF),the risk of vertebral refracture should be considered.Chronic kidney disease-mineral and bone disorder(CKD-MBD)is a systemic disease of mineral and bone metabolism.It is associated with an increased risk of fracture.Few studies have reported the use of PVA in patients with CKD-MBD.We herein report a rare case wherein the cemented vertebra and the adjacent vertebra refractured simultaneously in a CKD-MBD patient after PVA.CASE SUMMARY A 74-year-old man suffered from low back pain after taking a fall about 3 wk ago.According to physical examination,imaging and laboratory findings,diagnoses of T12 VCF,CKD-MBD,and chronic kidney disease stage 5 were established.He then received percutaneous vertebroplasty at T12 vertebra.Fourteen weeks later,he presented with T12 and L1 vertebral refractures caused by lumbar sprain.Once again,he was given PVA which was optimized for the refractured vertebrae.Although the short-term postoperative effect was satisfactory,he reported chronic low back pain again at the 3-month follow-up.CONCLUSION It is necessary that patients with CKD-MBD who have received PVA are aware of the adverse effects of CKD-MBD.It may increase the risk of vertebral refracture.Furthermore,the PVA surgical technique needs to be optimized according to the condition of the patient.The medium-and long-term effects of PVA remain uncertain in patients with CKD-MBD.展开更多
Lower back pain is one of the most common medical problems in the world and it is experienced by a huge percentage of people everywhere.Due to its ability to produce a detailed view of the soft tissues,including the s...Lower back pain is one of the most common medical problems in the world and it is experienced by a huge percentage of people everywhere.Due to its ability to produce a detailed view of the soft tissues,including the spinal cord,nerves,intervertebral discs,and vertebrae,Magnetic Resonance Imaging is thought to be the most effective method for imaging the spine.The semantic segmentation of vertebrae plays a major role in the diagnostic process of lumbar diseases.It is difficult to semantically partition the vertebrae in Magnetic Resonance Images from the surrounding variety of tissues,including muscles,ligaments,and intervertebral discs.U-Net is a powerful deep-learning architecture to handle the challenges of medical image analysis tasks and achieves high segmentation accuracy.This work proposes a modified U-Net architecture namely MU-Net,consisting of the Meijering convolutional layer that incorporates the Meijering filter to perform the semantic segmentation of lumbar vertebrae L1 to L5 and sacral vertebra S1.Pseudo-colour mask images were generated and used as ground truth for training the model.The work has been carried out on 1312 images expanded from T1-weighted mid-sagittal MRI images of 515 patients in the Lumbar Spine MRI Dataset publicly available from Mendeley Data.The proposed MU-Net model for the semantic segmentation of the lumbar vertebrae gives better performance with 98.79%of pixel accuracy(PA),98.66%of dice similarity coefficient(DSC),97.36%of Jaccard coefficient,and 92.55%mean Intersection over Union(mean IoU)metrics using the mentioned dataset.展开更多
To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae...To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A （n=20） were rein-forced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B （n=50） did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B （group A： 6.4 degree; group B： 5.4 degree）/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B （P=0.0001）. Postoperatively, greater anterior height was achieved in group A than in group B （P〈0.01）. During follow-up study, anterior vertebral height was maintained only in Group A （P〈0.001）. Both group A and group B showed good Denis pain scores （P1 and P2） but group A outdid group B in terms of control of severe and constant pain （P4 and P5）. By Frankel criteria, the changes in neurological functions in group A was better than those of group B （P〈0.001）. It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures, decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.展开更多
BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is...BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is considered to be an effective,safe,and minimally invasive treatment for OVCFs.The recollapse of cemented vertebrae is one of the serious complications of PVP.However,the risk factors associated with recollapse after PVP remain controversial.AIM To identify risk factors for the recollapse of cemented vertebrae after PVP in patients with OVCFs.METHODS A systematic search in EMBASE,MEDLINE,the Cochrane Library,and PubMed was conducted for relevant studies from inception until March 2020.Studies investigating risk factors for the recollapse of cemented vertebrae after PVP without additional trauma were selected for analysis.Odds ratios(ORs)or standardized mean differences with 95%confidence interval(CI)were calculated and heterogeneity was assessed by both the chi-squared test and the I-squared test.The methodological quality of the included studies was assessed according to the Newcastle-Ottawa Scale.RESULTS A total of nine case-control studies were included in our meta-analysis comprising 300 cases and 2674 controls.The significant risk factors for the recollapse of cemented vertebrae after PVP in OVCF patients were fractures located at the thoracolumbar junction(OR=2.09;95%CI:1.30 to 3.38;P=0.002),preoperative intravertebral cleft(OR=2.97;95%CI:1.93 to 4.57;P<0.00001),and solid lump distribution pattern of the cement (OR = 3.11;95%CI: 1.91 to 5.07;P < 0.00001).The analysis did not support that age, gender, lumbar bone mineral density,preoperative visual analogue scale score, injected cement volume, intradiscalcement leakage, or vertebral height restoration could increase the risk forcemented vertebra recollapse after PVP in OVCFs.CONCLUSIONThis meta-analysis suggests that thoracolumbar junction fractures, preoperativeintravertebral cleft, and solid lump cement distribution pattern are associatedwith the recollapse of cemented vertebrae after PVP in OVCF patients.展开更多
Protrusion of the lumbar intervertebral disc is a common disorder frequently encountered in clinic. With TCM massage and the maneuver of manual reduction, we have treated 82 cases of protrusion of the lumbar inter... Protrusion of the lumbar intervertebral disc is a common disorder frequently encountered in clinic. With TCM massage and the maneuver of manual reduction, we have treated 82 cases of protrusion of the lumbar intervertebral disc, with satisfactory therapeutic results reported in the following.……展开更多
The authors treated 62 cases of protrusion oflumbar intervertebral disc by pulling and turningmanipulations from February 1993 to February 1998.Another 50 cases were treated by traction as controls.Statistical data sh...The authors treated 62 cases of protrusion oflumbar intervertebral disc by pulling and turningmanipulations from February 1993 to February 1998.Another 50 cases were treated by traction as controls.Statistical data showed that pulling and turningmanipulations had much better therapeuticeffectiveness than traction(P<0.05).展开更多
Clinically, there is a higher incidence of protrusion of the lumbar intervertebral disc. It can cause a terrible pain. The author has treated 66 cases by massotherapy, who were confirmatively diagnosed as having protr...Clinically, there is a higher incidence of protrusion of the lumbar intervertebral disc. It can cause a terrible pain. The author has treated 66 cases by massotherapy, who were confirmatively diagnosed as having protrusion of the lumbar intervertebral disc by X-ray film and computer-aided tomography, with satisfactory results as reported in the following.Clinical DataAmong the 66 cases in this series, 49 were male and 17 female, ranging in age from 26 to 59 years, averaging 36.2 years. All the patients had got lumbago and unilateral ischialgia, with the left side affected in 37 cases and the right side in 29 cases. The leg pain radiating to lateral malleolus was found in 28 cases, to dorsum of the foot in 24 cases, and to the toes in 14 cases. Intermittent claudication was present in 22 cases, numbness of the affected foot in 16 cases, pain exacerbated when coughing in 35 cases, scoliosis in 21 cases, and positive Lasegue's sign in 48 cases.展开更多
Fifty-six cases of the protrusion of the lumbar intervertebral disc in the treatment group were treated by drug-penetration and oral administration of traditional Chinese decoction plus traction, and the other 35 case...Fifty-six cases of the protrusion of the lumbar intervertebral disc in the treatment group were treated by drug-penetration and oral administration of traditional Chinese decoction plus traction, and the other 35 cases in the control group by oral administration of Chinese decoction and traction. The results showed that the cure rate in the treatment group was 83.9%, and that in the control group was 57.1%, with a statistically significant difference between the two groups (P<0.01), indicating that the former is a more effective therapy for protrusion of the lumbar intervertebral disc.展开更多
Since 1996,the author has treated 40 cases of protrusion of lumbar intervertebral disc with ultra short wave and the point injection,and obtained good therapeutic effects.This is reported as follows.
The vertebral-artery-type cervical spondylosis iscommonly encountered in the middle aged and oldpeople.The author has treated 21 cases of vertebral-artery-type cervical spondylosis by acupuncture andmoxibustion,with t...The vertebral-artery-type cervical spondylosis iscommonly encountered in the middle aged and oldpeople.The author has treated 21 cases of vertebral-artery-type cervical spondylosis by acupuncture andmoxibustion,with the other 19 cases treated only byacupuncture as the controls.The results are reportedas follows.Clinical展开更多
Although quantitative trait loci（QTLs） for number of thoracic-lumbar vertebrae have been identified on Sus scrofa chromosomes（SSCs） 1 and 7, the influence of these QTLs on the thoracic and lumbar vertebrae is not ...Although quantitative trait loci（QTLs） for number of thoracic-lumbar vertebrae have been identified on Sus scrofa chromosomes（SSCs） 1 and 7, the influence of these QTLs on the thoracic and lumbar vertebrae is not clear. The aim of this study was to identify single nucleotide polymorphisms（SNPs） associated with total number of thoracic-lumbar vertebrae and for each trait（number of thoracic and lumbar vertebrae） separately. A total of 581 individuals from an F2 Large White×Minzhu population were genotyped using an SNP60 K chip. Performing a genome-wide association study（GWAS） for total number of thoracic-lumbar vertebrae, 38 significant SNPs were identified in two QTL regions located on SSC1 and SSC7. Performing a GWAS for number of thoracic vertebrae only, 72 significant SNPs were located on SSC7. While performing a GWAS for number of lumbar vertebrae only, 17 significant SNPs were identified on SSC1. Gene mining suggested that the gene encoding orphan nuclear receptor, germ cell nuclear factor（NR6A1） on SSC1 was a strong candidate affecting the number of lumbar vertebrae in pigs. Additionally, genes encoding vertnin（VRTN）, prospero homeobox 2（PROX2）, Finkel-Biskis-Jinkins murine osteosarcoma viral oncogene homolog（FOS）, and transforming growth factor beta 3（TGFB3） may be important candidates affecting the number of thoracic vertebrae in pigs. QTLs on SSC1 and SSC7 independently influenced the numbers of thoracic and lumbar vertebrae. These results shed light on the complex genetic background of vertebrae development in pigs.展开更多
Numbers of vertebrae is an important economic trait associated with body size and meat productivity in animals.However,the genetic basis of vertebrae number in donkey remains to be well understood.The aim of this stud...Numbers of vertebrae is an important economic trait associated with body size and meat productivity in animals.However,the genetic basis of vertebrae number in donkey remains to be well understood.The aim of this study was to identify candidate genes affecting the number of thoracic(TVn)and the number of lumbar vertebrae(LVn)in Dezhou donkey.A genome-wide association study was conducted using whole genome sequence data imputed from low-coverage genome sequencing.For TVn,we identified 38 genome-wide significant and 64 suggestive SNPs,which relate to 7 genes(NLGN1,DCC,SLC26A7,TOX,WNT7A,LOC123286078,and LOC123280142).For LVn,we identified 9 genome-wide significant and 38 suggestive SNPs,which relate to 8 genes(GABBR2,FBXO4,LOC123277146,LOC123277359,BMP7,B3GAT1,EML2,and LRP5).The genes involve in the Wnt and TGF-βsignaling pathways and may play an important role in embryonic development or bone formation and could be good candidate genes for TVn and LVn.展开更多
To evaluate the therapeutic efficacy of Yinxing Damo （银杏达莫, YXDM） combined with Betahistine Hydrochloride Injection （BHI） on vertebra basilar artery ischemic vertigo （VBIV）. Methods： Ninety patients with VB...To evaluate the therapeutic efficacy of Yinxing Damo （银杏达莫, YXDM） combined with Betahistine Hydrochloride Injection （BHI） on vertebra basilar artery ischemic vertigo （VBIV）. Methods： Ninety patients with VBIV were randomly divided into two groups; 45 patients （the treated group） were treated with YXDM and BHI intravenous dripping, once a day for 14 days. Another 45 patients （control group） were treated with Xueshuantong （血栓通） and BHI intravenous dripping, once daily for 14 days. The clinical syndromes and the index of the transcranial Doppler （TCD） and hemorheology were observed. Results： The total effective rate was 100% in the treated group, which was better than that in the control group 90.5%, （P〈0. 05）. The indexes of TCD and hemorheology in the treated group were obviously improved after treatment, （P〈0.01）. Conclusion： YXDM combined with BHT injection had better effect in treating patients with VBIV is an ideal drug for VBIV.展开更多
Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related ost...Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. A rat vertebral body can be longitudinally divided into central portion, which contain more trabecular bone, and para-endplate portions which contain more compact bone. In matured male and female Wistar and Sprague-Dawley rat lumbar spines, we investigated baseline bone mineral density （BMD） characteristics and the differential segmental responses in bone loss within the lumbar vertebral body post gonadal surgery with clinical multidetector computed tomography. Results Para-endplate sections had a higher BMD than central sections. The cephalad para-endplate sections had a higher BMD than the caudad para-endplate sections. Eight weeks after gonadal removal, there was more bone loss in central sections than para-endplate sections. The relative difference of bone loss between para-endplate and central sections was more apparent in male rats than in female rats. There was more bone loss in caudad sections than cephalad sections; this lead to a further increase of BMD difference between caudad para-endplate sections and cephalad para-endplate sections post gonadal surgery. Conclusion The approach described in this study provided a consistent way to study BMD change within predominantly compact bone portion and trabecular bone portion of the vertebral body.展开更多
Thirty cases of vertebral-artery-type cervical spondylopathy were treated by Dr. Zhang Tao's technique. The cure rate was 50%, and the total effective rate was 100%.
Structure reconstruction of 3 D anatomy from biplanar X-ray images is a challenging topic. Traditionally, the elastic-model-based method was used to reconstruct 3 D shapes by deforming the control points on the elasti...Structure reconstruction of 3 D anatomy from biplanar X-ray images is a challenging topic. Traditionally, the elastic-model-based method was used to reconstruct 3 D shapes by deforming the control points on the elastic mesh. However, the reconstructed shape is not smooth because the limited control points are only distributed on the edge of the elastic mesh.Alternatively, statistical-model-based methods, which include shape-model-based and intensity-model-based methods, are introduced due to their smooth reconstruction. However, both suffer from limitations. With the shape-model-based method, only the boundary profile is considered, leading to the loss of valid intensity information. For the intensity-based-method, the computation speed is slow because it needs to calculate the intensity distribution in each iteration. To address these issues, we propose a new reconstruction method using X-ray images and a specimen’s CT data. Specifically, the CT data provides both the shape mesh and the intensity model of the vertebra. Intensity model is used to generate the deformation field from X-ray images, while the shape model is used to generate the patient specific model by applying the calculated deformation field.Experiments on the public synthetic dataset and clinical dataset show that the average reconstruction errors are 1.1 mm and1.2 mm, separately. The average reconstruction time is 3 minutes.展开更多
In the present study, 121 patients with lumbar vertebra hyperosteogeny were dividedinto following four groups for treatment and comparison: intense electro-acupuncture group (Group1), hydro-acupuncture group (Group 2)...In the present study, 121 patients with lumbar vertebra hyperosteogeny were dividedinto following four groups for treatment and comparison: intense electro-acupuncture group (Group1), hydro-acupuncture group (Group 2), electro-acupuncture plus hydro-acupuncture group (Group3) and analgesic liquid for spur group (Group 4). It is indicated that the effect of electro-acupunctureplus hydro-acupuncture is the best in the treatment of lumbar vertebra hyperosteogeny.展开更多
Introduction and Aims—The Growth stage of a patient can have considerable influence on diagnosis, treatment goals, timing and planning and the eventual outcome of orthodontic/orthopedic treatment. The purpose of this...Introduction and Aims—The Growth stage of a patient can have considerable influence on diagnosis, treatment goals, timing and planning and the eventual outcome of orthodontic/orthopedic treatment. The purpose of this study was to analyze associations between the cervical vertebrae maturation score (CVMS) and skeletal maturation index (SMI). The second objective was to determine the reproducibility of the measurements on lateral cephalograms and hand-wrist radiographs. Materials and Methods—Lateral cephalometric and left hand-wrist radiographs of 92 untreated subjects (44 females and 48 males) aged from 8 to 17 years were obtained from the files of the Columbia University, Division of Orthodontics and measured for growth stage using cervical vertebrae and hand-wrist methods. Results—A high correlation was revealed between the hand-wrist and cervical vertebrae measurements. The Spearman’s rho correlation coefficient was 0.925 and significant at the 0.01 level. The correlation between hand-wrist and age (0.665, p < 0.01) was slightly greater than that of the CVMS (0.611, p < 0.01). Intra rater reliability was high. When the three categorically modified methods of the Fishman’s 11 skeletal maturation stages in hand and wrist analysis were used to compare with CVMS, methods 2 and 3 were both statistically significantly different according to the Wilcoxon signed ranks test and the Sign test at a significance level of less than 0.05. However, for method 1, the tests showed probability scores of 0.028 and 0.151, respectively, showing no significant difference at the 0.01 level in the Wilcoxon Signed Ranks Test, and no significant difference in the 0.01 and 0.05 level in the Signed Test. Conclusions—The Fishman’s hand and wrist skeletal maturation index and Bacetti’s cervical vertebrae maturation stages are both useful tools in evaluating growth stages. Fishman’s hand-wrist method is slightly more accurate.展开更多
During spinal fusion surgery,angled screw insertion can provide a more favorable stress distribution reducing failure events(screw breakage and loosening).Finite element(FE)analysis can be employed for identifying the...During spinal fusion surgery,angled screw insertion can provide a more favorable stress distribution reducing failure events(screw breakage and loosening).Finite element(FE)analysis can be employed for identifying the optimal insertion path,preventing stress concentrations,and ensuring a lower failure incidence.In this work,a patient-specific FE model of L4 vertebra,virtually implanted with two pedicle screws,was obtained from diagnostic images and numerically investigated.Linearly elastic,inhomogeneous,and isotropic material properties were assigned to bone based on density distributions reconstructed from the medical images.The mechanical response of the screws-vertebra system was analyzed through a progressive damage procedure,considering a stress-based criterion.Different screws insertion angles were simulated,as well as physiological loading conditions.In each loading case,screw orientation influences the fracture mechanism(i.e.,brittle or ductile one),as well as the fracture pattern and load.Besides,stresses in trabecular bone and pedicle screws are significantly affected by the screw configuration.The caudomedial trajectory indicates the most safe case,significantly reducing the stress concentrations in both trabecular bone and screws.Our findings aim to furnish a useful indication to surgeons regarding the screws insertion angle,further reducing the failure risk and improving the clinical outcome of the fixation procedure.展开更多
Accurate placement of pedicle screw(PS)is crucial in spinal surgery.Developing new real-time intra-operative monitoring and navigation methods is an important direction of clinical appli-cation research.In this paper,...Accurate placement of pedicle screw(PS)is crucial in spinal surgery.Developing new real-time intra-operative monitoring and navigation methods is an important direction of clinical appli-cation research.In this paper,we studied the spectrum along the fixation trajectory of PS in frequency domain to tackle the accuracy problem.Fresh porcine vertebrae,bovine vertebrae and ovine vertebrae were measured with the near-infrared spectrum(NIR)device to obtain the reflected spectrum from the vertebrae.Along the fixation trajectory of PS,average energy from different groups was calculated and used for identifying different tissues and compared to achieve the optimal recognition factor.Compared with the time domain approach,the frequency domain method could divide the spectra measured at different tissue points into different groups more stably and accurately,which could serve as a new method to assist the PS insertion.The results gained from this study are significant to the development of hi-tech medical instruments with independent intellectual property rights.展开更多
文摘BACKGROUND Although percutaneous vertebral augmentation(PVA)is a commonly used procedure for treating vertebral compression fracture(VCF),the risk of vertebral refracture should be considered.Chronic kidney disease-mineral and bone disorder(CKD-MBD)is a systemic disease of mineral and bone metabolism.It is associated with an increased risk of fracture.Few studies have reported the use of PVA in patients with CKD-MBD.We herein report a rare case wherein the cemented vertebra and the adjacent vertebra refractured simultaneously in a CKD-MBD patient after PVA.CASE SUMMARY A 74-year-old man suffered from low back pain after taking a fall about 3 wk ago.According to physical examination,imaging and laboratory findings,diagnoses of T12 VCF,CKD-MBD,and chronic kidney disease stage 5 were established.He then received percutaneous vertebroplasty at T12 vertebra.Fourteen weeks later,he presented with T12 and L1 vertebral refractures caused by lumbar sprain.Once again,he was given PVA which was optimized for the refractured vertebrae.Although the short-term postoperative effect was satisfactory,he reported chronic low back pain again at the 3-month follow-up.CONCLUSION It is necessary that patients with CKD-MBD who have received PVA are aware of the adverse effects of CKD-MBD.It may increase the risk of vertebral refracture.Furthermore,the PVA surgical technique needs to be optimized according to the condition of the patient.The medium-and long-term effects of PVA remain uncertain in patients with CKD-MBD.
文摘Lower back pain is one of the most common medical problems in the world and it is experienced by a huge percentage of people everywhere.Due to its ability to produce a detailed view of the soft tissues,including the spinal cord,nerves,intervertebral discs,and vertebrae,Magnetic Resonance Imaging is thought to be the most effective method for imaging the spine.The semantic segmentation of vertebrae plays a major role in the diagnostic process of lumbar diseases.It is difficult to semantically partition the vertebrae in Magnetic Resonance Images from the surrounding variety of tissues,including muscles,ligaments,and intervertebral discs.U-Net is a powerful deep-learning architecture to handle the challenges of medical image analysis tasks and achieves high segmentation accuracy.This work proposes a modified U-Net architecture namely MU-Net,consisting of the Meijering convolutional layer that incorporates the Meijering filter to perform the semantic segmentation of lumbar vertebrae L1 to L5 and sacral vertebra S1.Pseudo-colour mask images were generated and used as ground truth for training the model.The work has been carried out on 1312 images expanded from T1-weighted mid-sagittal MRI images of 515 patients in the Lumbar Spine MRI Dataset publicly available from Mendeley Data.The proposed MU-Net model for the semantic segmentation of the lumbar vertebrae gives better performance with 98.79%of pixel accuracy(PA),98.66%of dice similarity coefficient(DSC),97.36%of Jaccard coefficient,and 92.55%mean Intersection over Union(mean IoU)metrics using the mentioned dataset.
文摘To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A （n=20） were rein-forced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B （n=50） did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B （group A： 6.4 degree; group B： 5.4 degree）/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B （P=0.0001）. Postoperatively, greater anterior height was achieved in group A than in group B （P〈0.01）. During follow-up study, anterior vertebral height was maintained only in Group A （P〈0.001）. Both group A and group B showed good Denis pain scores （P1 and P2） but group A outdid group B in terms of control of severe and constant pain （P4 and P5）. By Frankel criteria, the changes in neurological functions in group A was better than those of group B （P〈0.001）. It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures, decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.
文摘BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is considered to be an effective,safe,and minimally invasive treatment for OVCFs.The recollapse of cemented vertebrae is one of the serious complications of PVP.However,the risk factors associated with recollapse after PVP remain controversial.AIM To identify risk factors for the recollapse of cemented vertebrae after PVP in patients with OVCFs.METHODS A systematic search in EMBASE,MEDLINE,the Cochrane Library,and PubMed was conducted for relevant studies from inception until March 2020.Studies investigating risk factors for the recollapse of cemented vertebrae after PVP without additional trauma were selected for analysis.Odds ratios(ORs)or standardized mean differences with 95%confidence interval(CI)were calculated and heterogeneity was assessed by both the chi-squared test and the I-squared test.The methodological quality of the included studies was assessed according to the Newcastle-Ottawa Scale.RESULTS A total of nine case-control studies were included in our meta-analysis comprising 300 cases and 2674 controls.The significant risk factors for the recollapse of cemented vertebrae after PVP in OVCF patients were fractures located at the thoracolumbar junction(OR=2.09;95%CI:1.30 to 3.38;P=0.002),preoperative intravertebral cleft(OR=2.97;95%CI:1.93 to 4.57;P<0.00001),and solid lump distribution pattern of the cement (OR = 3.11;95%CI: 1.91 to 5.07;P < 0.00001).The analysis did not support that age, gender, lumbar bone mineral density,preoperative visual analogue scale score, injected cement volume, intradiscalcement leakage, or vertebral height restoration could increase the risk forcemented vertebra recollapse after PVP in OVCFs.CONCLUSIONThis meta-analysis suggests that thoracolumbar junction fractures, preoperativeintravertebral cleft, and solid lump cement distribution pattern are associatedwith the recollapse of cemented vertebrae after PVP in OVCF patients.
文摘 Protrusion of the lumbar intervertebral disc is a common disorder frequently encountered in clinic. With TCM massage and the maneuver of manual reduction, we have treated 82 cases of protrusion of the lumbar intervertebral disc, with satisfactory therapeutic results reported in the following.……
文摘The authors treated 62 cases of protrusion oflumbar intervertebral disc by pulling and turningmanipulations from February 1993 to February 1998.Another 50 cases were treated by traction as controls.Statistical data showed that pulling and turningmanipulations had much better therapeuticeffectiveness than traction(P<0.05).
文摘Clinically, there is a higher incidence of protrusion of the lumbar intervertebral disc. It can cause a terrible pain. The author has treated 66 cases by massotherapy, who were confirmatively diagnosed as having protrusion of the lumbar intervertebral disc by X-ray film and computer-aided tomography, with satisfactory results as reported in the following.Clinical DataAmong the 66 cases in this series, 49 were male and 17 female, ranging in age from 26 to 59 years, averaging 36.2 years. All the patients had got lumbago and unilateral ischialgia, with the left side affected in 37 cases and the right side in 29 cases. The leg pain radiating to lateral malleolus was found in 28 cases, to dorsum of the foot in 24 cases, and to the toes in 14 cases. Intermittent claudication was present in 22 cases, numbness of the affected foot in 16 cases, pain exacerbated when coughing in 35 cases, scoliosis in 21 cases, and positive Lasegue's sign in 48 cases.
文摘Fifty-six cases of the protrusion of the lumbar intervertebral disc in the treatment group were treated by drug-penetration and oral administration of traditional Chinese decoction plus traction, and the other 35 cases in the control group by oral administration of Chinese decoction and traction. The results showed that the cure rate in the treatment group was 83.9%, and that in the control group was 57.1%, with a statistically significant difference between the two groups (P<0.01), indicating that the former is a more effective therapy for protrusion of the lumbar intervertebral disc.
文摘Since 1996,the author has treated 40 cases of protrusion of lumbar intervertebral disc with ultra short wave and the point injection,and obtained good therapeutic effects.This is reported as follows.
文摘The vertebral-artery-type cervical spondylosis iscommonly encountered in the middle aged and oldpeople.The author has treated 21 cases of vertebral-artery-type cervical spondylosis by acupuncture andmoxibustion,with the other 19 cases treated only byacupuncture as the controls.The results are reportedas follows.Clinical
基金supported by the Agricultural Science and Technology Innovation Program, China (ASTIP-IAS02)the National Key Technology R&D Program of China (2011BAD28B01)+3 种基金the National Natural Science Foundation of China (31201781)the Earmarked Fund for Modern Agro-Industry Technology Research Systemthe National Key Technology R&D Program of China (2011ZX08006-003)the Chinese Academy of Agricultural Sciences Foundation (2014ZL006, 2011cj-5, 2012ZL069 and 2014ywf-yb-8)
文摘Although quantitative trait loci（QTLs） for number of thoracic-lumbar vertebrae have been identified on Sus scrofa chromosomes（SSCs） 1 and 7, the influence of these QTLs on the thoracic and lumbar vertebrae is not clear. The aim of this study was to identify single nucleotide polymorphisms（SNPs） associated with total number of thoracic-lumbar vertebrae and for each trait（number of thoracic and lumbar vertebrae） separately. A total of 581 individuals from an F2 Large White×Minzhu population were genotyped using an SNP60 K chip. Performing a genome-wide association study（GWAS） for total number of thoracic-lumbar vertebrae, 38 significant SNPs were identified in two QTL regions located on SSC1 and SSC7. Performing a GWAS for number of thoracic vertebrae only, 72 significant SNPs were located on SSC7. While performing a GWAS for number of lumbar vertebrae only, 17 significant SNPs were identified on SSC1. Gene mining suggested that the gene encoding orphan nuclear receptor, germ cell nuclear factor（NR6A1） on SSC1 was a strong candidate affecting the number of lumbar vertebrae in pigs. Additionally, genes encoding vertnin（VRTN）, prospero homeobox 2（PROX2）, Finkel-Biskis-Jinkins murine osteosarcoma viral oncogene homolog（FOS）, and transforming growth factor beta 3（TGFB3） may be important candidates affecting the number of thoracic vertebrae in pigs. QTLs on SSC1 and SSC7 independently influenced the numbers of thoracic and lumbar vertebrae. These results shed light on the complex genetic background of vertebrae development in pigs.
基金the Natural Science Foundation of Shandong Province,China(ZR2020MC168)。
文摘Numbers of vertebrae is an important economic trait associated with body size and meat productivity in animals.However,the genetic basis of vertebrae number in donkey remains to be well understood.The aim of this study was to identify candidate genes affecting the number of thoracic(TVn)and the number of lumbar vertebrae(LVn)in Dezhou donkey.A genome-wide association study was conducted using whole genome sequence data imputed from low-coverage genome sequencing.For TVn,we identified 38 genome-wide significant and 64 suggestive SNPs,which relate to 7 genes(NLGN1,DCC,SLC26A7,TOX,WNT7A,LOC123286078,and LOC123280142).For LVn,we identified 9 genome-wide significant and 38 suggestive SNPs,which relate to 8 genes(GABBR2,FBXO4,LOC123277146,LOC123277359,BMP7,B3GAT1,EML2,and LRP5).The genes involve in the Wnt and TGF-βsignaling pathways and may play an important role in embryonic development or bone formation and could be good candidate genes for TVn and LVn.
文摘To evaluate the therapeutic efficacy of Yinxing Damo （银杏达莫, YXDM） combined with Betahistine Hydrochloride Injection （BHI） on vertebra basilar artery ischemic vertigo （VBIV）. Methods： Ninety patients with VBIV were randomly divided into two groups; 45 patients （the treated group） were treated with YXDM and BHI intravenous dripping, once a day for 14 days. Another 45 patients （control group） were treated with Xueshuantong （血栓通） and BHI intravenous dripping, once daily for 14 days. The clinical syndromes and the index of the transcranial Doppler （TCD） and hemorheology were observed. Results： The total effective rate was 100% in the treated group, which was better than that in the control group 90.5%, （P〈0. 05）. The indexes of TCD and hemorheology in the treated group were obviously improved after treatment, （P〈0.01）. Conclusion： YXDM combined with BHT injection had better effect in treating patients with VBIV is an ideal drug for VBIV.
基金Supported by GRF of Hong Kong SAR (project no. 464508)a direct grant for research from the Chinese University of Hong Kong (project no.2041501)
文摘Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. A rat vertebral body can be longitudinally divided into central portion, which contain more trabecular bone, and para-endplate portions which contain more compact bone. In matured male and female Wistar and Sprague-Dawley rat lumbar spines, we investigated baseline bone mineral density （BMD） characteristics and the differential segmental responses in bone loss within the lumbar vertebral body post gonadal surgery with clinical multidetector computed tomography. Results Para-endplate sections had a higher BMD than central sections. The cephalad para-endplate sections had a higher BMD than the caudad para-endplate sections. Eight weeks after gonadal removal, there was more bone loss in central sections than para-endplate sections. The relative difference of bone loss between para-endplate and central sections was more apparent in male rats than in female rats. There was more bone loss in caudad sections than cephalad sections; this lead to a further increase of BMD difference between caudad para-endplate sections and cephalad para-endplate sections post gonadal surgery. Conclusion The approach described in this study provided a consistent way to study BMD change within predominantly compact bone portion and trabecular bone portion of the vertebral body.
文摘Thirty cases of vertebral-artery-type cervical spondylopathy were treated by Dr. Zhang Tao's technique. The cure rate was 50%, and the total effective rate was 100%.
基金supported in part by The National Key Research and Development Program of China(2018YFC2001302)the National Natural Science Foundation of China(61976209)+1 种基金CAS International Collaboration Key Project(173211KYSB20190024)Strategic Priority Research Program of CAS(XDB32040000)。
文摘Structure reconstruction of 3 D anatomy from biplanar X-ray images is a challenging topic. Traditionally, the elastic-model-based method was used to reconstruct 3 D shapes by deforming the control points on the elastic mesh. However, the reconstructed shape is not smooth because the limited control points are only distributed on the edge of the elastic mesh.Alternatively, statistical-model-based methods, which include shape-model-based and intensity-model-based methods, are introduced due to their smooth reconstruction. However, both suffer from limitations. With the shape-model-based method, only the boundary profile is considered, leading to the loss of valid intensity information. For the intensity-based-method, the computation speed is slow because it needs to calculate the intensity distribution in each iteration. To address these issues, we propose a new reconstruction method using X-ray images and a specimen’s CT data. Specifically, the CT data provides both the shape mesh and the intensity model of the vertebra. Intensity model is used to generate the deformation field from X-ray images, while the shape model is used to generate the patient specific model by applying the calculated deformation field.Experiments on the public synthetic dataset and clinical dataset show that the average reconstruction errors are 1.1 mm and1.2 mm, separately. The average reconstruction time is 3 minutes.
文摘In the present study, 121 patients with lumbar vertebra hyperosteogeny were dividedinto following four groups for treatment and comparison: intense electro-acupuncture group (Group1), hydro-acupuncture group (Group 2), electro-acupuncture plus hydro-acupuncture group (Group3) and analgesic liquid for spur group (Group 4). It is indicated that the effect of electro-acupunctureplus hydro-acupuncture is the best in the treatment of lumbar vertebra hyperosteogeny.
文摘Introduction and Aims—The Growth stage of a patient can have considerable influence on diagnosis, treatment goals, timing and planning and the eventual outcome of orthodontic/orthopedic treatment. The purpose of this study was to analyze associations between the cervical vertebrae maturation score (CVMS) and skeletal maturation index (SMI). The second objective was to determine the reproducibility of the measurements on lateral cephalograms and hand-wrist radiographs. Materials and Methods—Lateral cephalometric and left hand-wrist radiographs of 92 untreated subjects (44 females and 48 males) aged from 8 to 17 years were obtained from the files of the Columbia University, Division of Orthodontics and measured for growth stage using cervical vertebrae and hand-wrist methods. Results—A high correlation was revealed between the hand-wrist and cervical vertebrae measurements. The Spearman’s rho correlation coefficient was 0.925 and significant at the 0.01 level. The correlation between hand-wrist and age (0.665, p < 0.01) was slightly greater than that of the CVMS (0.611, p < 0.01). Intra rater reliability was high. When the three categorically modified methods of the Fishman’s 11 skeletal maturation stages in hand and wrist analysis were used to compare with CVMS, methods 2 and 3 were both statistically significantly different according to the Wilcoxon signed ranks test and the Sign test at a significance level of less than 0.05. However, for method 1, the tests showed probability scores of 0.028 and 0.151, respectively, showing no significant difference at the 0.01 level in the Wilcoxon Signed Ranks Test, and no significant difference in the 0.01 and 0.05 level in the Signed Test. Conclusions—The Fishman’s hand and wrist skeletal maturation index and Bacetti’s cervical vertebrae maturation stages are both useful tools in evaluating growth stages. Fishman’s hand-wrist method is slightly more accurate.
基金The authors acknowledge the support of the Italian National Group for Mathematical Physics(GNFM-INdAM).
文摘During spinal fusion surgery,angled screw insertion can provide a more favorable stress distribution reducing failure events(screw breakage and loosening).Finite element(FE)analysis can be employed for identifying the optimal insertion path,preventing stress concentrations,and ensuring a lower failure incidence.In this work,a patient-specific FE model of L4 vertebra,virtually implanted with two pedicle screws,was obtained from diagnostic images and numerically investigated.Linearly elastic,inhomogeneous,and isotropic material properties were assigned to bone based on density distributions reconstructed from the medical images.The mechanical response of the screws-vertebra system was analyzed through a progressive damage procedure,considering a stress-based criterion.Different screws insertion angles were simulated,as well as physiological loading conditions.In each loading case,screw orientation influences the fracture mechanism(i.e.,brittle or ductile one),as well as the fracture pattern and load.Besides,stresses in trabecular bone and pedicle screws are significantly affected by the screw configuration.The caudomedial trajectory indicates the most safe case,significantly reducing the stress concentrations in both trabecular bone and screws.Our findings aim to furnish a useful indication to surgeons regarding the screws insertion angle,further reducing the failure risk and improving the clinical outcome of the fixation procedure.
基金This work was supported by the Nanjing Institute of Technology high level introduction of talents Research Fund(YKJ201862)the National Major Scientific Instruments and Equipment Development Project Funded by the National Natural Science Foundation of China(Grant Nos.81827803 and 81727804)+1 种基金the National Natural Science Foundation of China(Grant Nos.61703201,61875085 and 81601532)Natural Science Foundation of Jiangsu Province(Grant Nos.BK20160814 and BK20170765).
文摘Accurate placement of pedicle screw(PS)is crucial in spinal surgery.Developing new real-time intra-operative monitoring and navigation methods is an important direction of clinical appli-cation research.In this paper,we studied the spectrum along the fixation trajectory of PS in frequency domain to tackle the accuracy problem.Fresh porcine vertebrae,bovine vertebrae and ovine vertebrae were measured with the near-infrared spectrum(NIR)device to obtain the reflected spectrum from the vertebrae.Along the fixation trajectory of PS,average energy from different groups was calculated and used for identifying different tissues and compared to achieve the optimal recognition factor.Compared with the time domain approach,the frequency domain method could divide the spectra measured at different tissue points into different groups more stably and accurately,which could serve as a new method to assist the PS insertion.The results gained from this study are significant to the development of hi-tech medical instruments with independent intellectual property rights.
