BACKGROUND Few reports have described lumbar foraminal stenosis-induced radiculopathy after treatment by full-endoscopic spine surgery(FESS)combined with percutaneous vertebroplasty(PVP)in patients with vertebral comp...BACKGROUND Few reports have described lumbar foraminal stenosis-induced radiculopathy after treatment by full-endoscopic spine surgery(FESS)combined with percutaneous vertebroplasty(PVP)in patients with vertebral compression fractures.We herein report such a case,including the patient’s treatment process and doctor’s surgical experience.CASE SUMMARY A 79-year-old man presented with symptoms of radiculopathy after sustaining L4 vertebral compression fractures.Imaging and physical examination revealed L4 vertebral compression fractures combined with L3/4 Lumbar foraminal stenosis(LFS).The patient’s symptoms were low back pain with pain in the lateral left leg.Although many reports have described radiculopathy induced by osteoporotic vertebral compression fractures,the use of FESS combined with PVP has rarely been reported.This case report indicates that the combination of FESS and PVP is a safe and effective approach for the treatment of LFS-induced radiculopathy after vertebral compression fractures.This minimally invasive technique has great potential to replace traditional lumbar fixation and decompression surgery.Thus,we suggest the continued accumulation of similar cases to discuss the wider application of FESS.CONCLUSION For patients with osteoporotic vertebral compression fracture(OVCF)and LFS,PVP and FESS can be used to restore the vertebral height and reduce the pressure around the intervertebral foramen.Additionally,the combination of FESS and PVP can treat the pain or numbness of the low back and lower limbs and allow for recovery in a short time with excellent postoperative effects.In general,FESS is a good treatment for radiculopathy caused by foraminal stenosis after OVCF.展开更多
Across many of the surgical specialties,the use of minimally invasive techniques that utilize indirect visualization has been increasingly replacing traditional techniques which utilize direct visualization.Arthroscop...Across many of the surgical specialties,the use of minimally invasive techniques that utilize indirect visualization has been increasingly replacing traditional techniques which utilize direct visualization.Arthroscopic surgery of the appendicular skeleton has evolved dramatically and become an integral part of musculoskeletal surgery over the last several decades,allowing surgeons to achieve similar or better outcomes,while reducing cost and recovery time.However,to date,the axial skeleton,with its close proximity to critical neural and vascular structures,has not adopted endoscopic techniques at as rapid of a rate.Over the past decade,increased patient demand for less invasive spine surgery combined with surgeon desire to meet these demands has driven significant evolution and innovation in endoscopic spine surgery.In addition,there has been an enormous advancement in technologies that assist in navigation and automation that help surgeons circumvent limitations of direct visualization inherent to less invasive techniques.There are currently a multitude of endoscopic techniques and approaches that can be utilized in the treatment of spine disorders,many of which are evolving rapidly.Here we present a review of the field of endoscopic spine surgery,including the background,techniques,applications,current trends,and future directions,to help providers gain a better understanding of this growing modality in spine surgery.展开更多
Bone morphogenetic proteins are osteoinductive factors which have gained popularity in orthopaedicsurgery and especially in spine surgery. The use of recombinant human bone morphogenetic protein-2 has been officially ...Bone morphogenetic proteins are osteoinductive factors which have gained popularity in orthopaedicsurgery and especially in spine surgery. The use of recombinant human bone morphogenetic protein-2 has been officially approved by the United States Food and Drug Administration only for single level anterior lumbar interbody fusion, nevertheless it is widely used by many surgeons with off-label indications. Despite advantages in bone formation, its use still remains a controversial issue and several complications have been described by authors who oppose their wide use.展开更多
Spine surgery is one of the fastest growing branches of orthopedic surgery. Patients often present with a relatively high acuity and, depending on surgical approach, morbidity and mortality can be comparatively high. ...Spine surgery is one of the fastest growing branches of orthopedic surgery. Patients often present with a relatively high acuity and, depending on surgical approach, morbidity and mortality can be comparatively high. Among the most prevalent and most frequently fatalitybound perioperative complications are those affecting the pulmonary system; evidence of clinical or subclinical lung injury triggered by spine surgical procedures is emerging. Increasing burden of comorbidity among the patient population further increases the likelihood of adverse outcome. This review is intended to give an overview over some of the most important causes of pulmonary complications after spine surgery, their pathophysiology and possible ways to reduce harm associated with those conditions. We discuss factors surrounding surgical trauma, timing of surgery, bone marrow and debris embolization, transfusion associated lung injury, and ventilator associated lung injury.展开更多
Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common spine diseases which are mainly due to age related Spine degeneration. Diagnosis of both Lumbar Disc Herniation and Lumbar Spine Stenosis depends on...Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common spine diseases which are mainly due to age related Spine degeneration. Diagnosis of both Lumbar Disc Herniation and Lumbar Spine Stenosis depends on clinical findings as well as radiological investigations. Treatment of choice of these conditions is on the basis of the patient conditions. Surgical treatment is the option only when the conservative treatment does not improve the patient’s clinical condition. Advancement and improvement of the technology have resulted in the traditional open surgical treatment into minimal invasive surgery. Intervention of the different surgical instruments with expert spinal surgeons had made percutaneous endoscopic lumbar Spine surgery as one of the preferred choices of surgery for treating Lumbar Disc Herniation and Lumbar Spine Stenosis. The concept of percutaneous endoscopic surgery for lumbar region is to provide surgical options without producing iatrogenic morbidity associated with the open surgical procedures. Conventionally, there are different approaches/techniques for Percutaneous Endoscopic Lumbar Spine Surgery, but in this review we are mainly focusing on the Transforaminal Technique. Regarding the Lumbar Disc Herniation treatment with transforaminal approach, a number of articles have been published due to which we mainly focused on those articles which were published after 2009 onwards. While fewer articles related to Lumbar Spine Stenosis treatment with Transforaminal approach were found, we tried to brief out all those articles. On the basis of comparative study of different surgeries done for Lumbar Disc Herniation and Lumbar Spine Stenosis, Percutaneous Transforaminal endoscopic Lumbar Surgery provides a substantial benefit. Transforaminal approach for treating Lumbar Disc Herniation and Lumbar Spine Stenosis is safe and effective. The Percutaneous Transforaminal Endoscopic Lumbar Surgery has advantage as it is performed under local anesthesia with shorter length of hospitalization and early return to normal life. The clinical outcome of the patient that underwent Percutaneous Transforaminal Endoscopic Lumbar Surgery for Lumbar Disc Herniation and Lumbar Spine Stenosis is quite good in regard of its fewer complication and more benefits.展开更多
In the past few years, stem cells have become the focus of research by regenerative medicine professionals and tissue engineers. Embryonic stem cells, although capable of differentiating into cell lineages of all thre...In the past few years, stem cells have become the focus of research by regenerative medicine professionals and tissue engineers. Embryonic stem cells, although capable of differentiating into cell lineages of all three germ layers, are limited in their utilization due to ethical issues. In contrast, the autologous harvest and subsequent transplantation of adult stem cells from bone marrow, adipose tissue or blood have been experimentally utilized in the treatment of a wide variety of diseases ranging from myocardial infarction to Alzheimer's disease. The physiologic consequences of stem cell transplantation and its impact on functional recovery have been studied in countless animal models and select clinical trials. Unfortunately, the bench to bedside translation of this research has been slow. Nonetheless, stem cell therapy has received the attention of spinal surgeons due to its potential benefits in the treatment of neural damage, muscle trauma, disk degeneration and its potential contribution to bone fusion.展开更多
Spine surgery is typically having a relationship to high degrees of pain and immobility.It is a known fact that the implementation of an enhanced recovery after surgery(ERAS)approach has led to a paradigm shift in var...Spine surgery is typically having a relationship to high degrees of pain and immobility.It is a known fact that the implementation of an enhanced recovery after surgery(ERAS)approach has led to a paradigm shift in various surgical specialties.These protocols require doctors,nurses,anesthesiologists,patients,and their families to agree to strengthen communication with each other,and involve a long timeline and teamwork from start to finish.To our knowledge,the role of nursing in the ERAS of spine surgery has not been reported before.The purpose of this study is to summarize the role of nursing in ERAS programs in accordance with surgical periods.The methods applied for this review include literature review of the world’s acknowledged databases such as Springer Link,PubMed,Embase,and Wanfang,especially in the period of 2000-2015.A total of 9 studies fulfilled the eligibility criteria and were included in the review.The findings confirm that the nursing work continued throughout the perioperative procedure,which plays a key role in the successful ERAS pathway.According to different nursing measures,ERAS nursing can effectively promote the postoperative recovery of spine surgical patients,with fewer postoperative complications and increased patient satisfaction.展开更多
Background Ossification of the ligamentum flavum （OLF） has been widely recognized as one of the main causes of thoracic spinal canal stenosis and thoracic myelopathy.Decompression is the only effective strategy for ...Background Ossification of the ligamentum flavum （OLF） has been widely recognized as one of the main causes of thoracic spinal canal stenosis and thoracic myelopathy.Decompression is the only effective strategy for treating thoracic myelopathy caused by OLF.The purpose of this study was to describe the clinical outcomes of computer-assisted minimally invasive spine surgery （CAMISS） for posterior decompression in patients with thoracic myelopathy caused by OLF.Methods In all cases,the surgical procedure was performed with the assistance of an intraoperative three-dimensional navigation system.Decompression of the spinal cord was performed with a high-speed drill; the supraspinal ligaments and spinous process were partially preserved.The outcomes were evaluated by a modified Japanese Orthopedic Association （JOA） scoring system and recovery rates.Results The mean duration of follow-up for the 14 cases was 3.9 years.All patients experienced neurological recovery,the mean JOA score improving from 6.1 points preoperatively to 8.6 points at final follow-up and the mean rate of recovery being 52.7% （excellent in two cases,good in eight,fair in three,and unchanged in one）.Conclusion CAMISS is a safe and effective procedure for resection of the OLF in the thoracic spine.展开更多
Spinal surgery is a technically demanding and challenging procedure because of the complicated anatomical structures of the spine and its proximity to several important tissues.Surgical landmarks and fluoroscopy have ...Spinal surgery is a technically demanding and challenging procedure because of the complicated anatomical structures of the spine and its proximity to several important tissues.Surgical landmarks and fluoroscopy have been used for pedicle screw insertion but are found to produce inaccuracies in placement.Improving the safety and accuracy of spinal surgery has increasingly become a clinical concern.Computerassisted navigation is an extension and application of precision medicine in orthopaedic surgery and has significantly improved the accuracy of spinal surgery.However,no clinical guidelines have been published for this relatively new and fast-growing technique,thus potentially limiting its adoption.In accordance with the consensus of consultant specialists,literature reviews,and our local experience,these guidelines include the basic concepts of the navigation system,workflow of navigation-assisted spinal surgery,some common pitfalls,and recommended solutions.This work helps to standardize navigation-assisted spinal surgery,improve its clinical efficiency and precision,and shorten the clinical learning curve.展开更多
Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid （CSF） leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new tre...Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid （CSF） leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new treatment strategies have shown a promising effect that is listed as follows： 1） creating watertight dural closure to stop CSF leak with the help of dural substitute material; and 2） retarding CSF leak by changing pressure difference, including reducing the subarachnoid fluid pressure, increasing the epidural space pressure and both. In fact several methods mentioned above are usually combined to treat CSF leak. However, no update review summarized the relevant studies implemented in recent years. In this re- view, the authors would compare the effects of different dural closure techniques, and introduce the latest treatment methods and mechanisms.展开更多
Purpose： Up to date, some approaches retarding the flow of cerebrospinal fluid （CSF） could be regarded as direct applications of the fluid mechanics （Poiseuille＇s law）. However, there is a lack of the research o...Purpose： Up to date, some approaches retarding the flow of cerebrospinal fluid （CSF） could be regarded as direct applications of the fluid mechanics （Poiseuille＇s law）. However, there is a lack of the research on the efficacy of subfascial drainage for management of CSF leak after spine surgery based on the law. This is a prospective and comparative study on suhfascial drainage for CSE Methods： Every four months in the three years from January 2010 to December 2012, the patients were enrolled respectively in Group A, Group B and Group C, in which, the drainage tube was discontinued within postoperative 3-4 days, 5-6 days, 7-10 days. Results and complications of postoperative CSF leak were investigated, and mean wound healing time （MWHT） of the three groups was compared. Results： A total of 108 cases （Group A/B/C：35/32/41） of CSF leak following posterior spine surgery were admitted to Tianjin Union Medicine Center, and 92 cases have been followed up for more than 1 year （follow-up rate of 85.2%）. Preoperative demographics were similar among the 3 groups. In Group A, 7 patients developed CSI： leak through the wound （CSFLW）, of which 5 cases had to undergo reoperation. One case in Group A was confirmed to have pseudomeningocele at the 1st month after surgery. The MWHT was （16.6 ± 3.6） days. In Group B, 3 patients developed CSFLW and cured by reoperation, in which 1 case of superficial infection recovered well after reoperation. MWHT was （11.4 ± 2.2） days. In Group C, CSFLW was not found and MWHT was （10.1 ± 2.9） days. The differences of MWHT among Groups A, B and C were statistically significant.Conclusion： Postoperative subfascial drainage, which is used to decrease the subfascial space pressure （P2）, would help wound healing. When it is placed for more than 7 days, the wound resistance （Rw） would be strong enough to withstand the suharachnoid pressure （P1）. Meanwhile, the power trans- duction in a sequence of Rw 〉 P2〉P1 will indirectly retard CSF leak at the durotomy site and accordingly facilitate the healing of damaged spinal dura mater.展开更多
Objective:To observe and study the actual effects of percutaneous pedicle screw minimally invasive surgery in the treatment of spinal fractures and its impact on spinal function.Methods:This study included 48 patients...Objective:To observe and study the actual effects of percutaneous pedicle screw minimally invasive surgery in the treatment of spinal fractures and its impact on spinal function.Methods:This study included 48 patients with spinal fractures admitted between May 2023 and May 2024.The patients were divided into a control group and an experimental group based on treatment differences,with 24 patients in each group.The control group underwent open internal fixation surgery,while the experimental group received percutaneous pedicle screw minimally invasive surgery.Clinical index improvements,cervical dysfunction index,Japanese Orthopaedic Association scores,and pain level improvements were compared between the two groups.Results:The intraoperative blood loss,incision length,operation time,and hospitalization duration in the experimental group were(88.63±18.85),(6.32±1.05),(73.42±4.05),and(12.58±2.56),respectively,compared to(279.95±17.32),(12.89±1.36),(89.93±4.79),and(22.41±2.87)in the control group.Significant differences were observed between the groups,with the experimental group showing superior improvements across all metrics(P<0.05).Conclusion:Percutaneous pedicle screw minimally invasive surgery shows more significant effects in treating spinal fractures,particularly in improving cervical and lumbar spine function,enhancing treatment efficacy and safety,reducing pain levels,and shortening recovery time.Clinical application and promotion are recommended.展开更多
BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is ...BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.展开更多
BACKGROUND The combined anterior/posterior approach appears to be capable of reconstructing spinal stability,correcting thoracolumbar deformity,and promoting neural recovery in severe thoracolumbar fracture dislocatio...BACKGROUND The combined anterior/posterior approach appears to be capable of reconstructing spinal stability,correcting thoracolumbar deformity,and promoting neural recovery in severe thoracolumbar fracture dislocation.However,this type of operation requires changing the body position during the procedure,resulting in a lengthy operation time.As a universal surgical robot,TINAVI robot has achieved good surgical results in clinical surgery.But to our knowledge,no reports describing TINAVI robot-assisted single lateral position anteroposterior surgery for thoracolumbar fracture dislocation.CASE SUMMARY We describe a case of a 16-year-old female patient with severe thoracolumbar fracture and dislocation underwent surgery assisted by the TINAVI robot.A onestage combined anterior and posterior operation was performed on a severe thoracolumbar fracture dislocation using the TINAVI robot,and the operation was completed in right lateral position.CONCLUSION The TINAVI robot-assisted one-stage anterior and posterior surgery in right lateral position for severe thoracolumbar fracture and dislocation is both safe and effective.展开更多
Spinal cord injury is a severe neurological condition with limited neuronal regeneration and functional recovery.Currently,no effective treatments exist to improve spinal cord injury prognosis.Neuronal guidance protei...Spinal cord injury is a severe neurological condition with limited neuronal regeneration and functional recovery.Currently,no effective treatments exist to improve spinal cord injury prognosis.Neuronal guidance proteins are a diverse group of molecules that play crucial roles in axon and dendrite growth during nervous system development.Increasing evidence highlights their regulatory functions in spinal cord injury.This review provides a brief overview of the modulation patterns of key neuronal guidance proteins in neuronal axon growth during nervous system formation and subsequently focuses on their roles in neuronal regeneration and functional recovery following spinal cord injury.Neuronal guidance proteins include,but are not limited to,semaphorins and their receptors,plexins;netrins and their receptors,deleted in colorectal cancer and UNC5;Eph receptors and their ligands,ephrins;Slit and its receptor,Robo;repulsive guidance molecules and their receptor,neogenin;Wnt proteins and their receptor,Frizzled;and protocadherins.Localized Netrin-1 at the injury site inhibits motor axon regeneration after adult spinal cord injury while promoting oligodendrocyte growth.Slit2 enhances synapse formation in the injured spinal cord of rats.EphA7 regulates acute apoptosis in the early pathophysiological stages of spinal cord injury,while ephrinA1 plays a role in the nervous system’s injury response,with its reduced expression leading to impaired motor function in rats.EphA3 is upregulated following spinal cord injury,promoting an inhibitory environment for axonal regeneration.After spinal cord injury,bidirectional activation of ephrinB2 and EphB2 in astrocytes and fibroblasts results in the formation of a dense astrocyte-meningeal fibroblast scar.EphB1/ephrinB1 signaling mediates pain processing in spinal cord injury by regulating calpain-1 and caspase-3 in neurons.EphB3 expression increases in white matter after spinal cord injury,further inhibiting axon regeneration.Sema3A,expressed by neurons and fibroblasts in the scar surrounding the injury,inhibits motor neuron and sensory nerve growth after spinal cord injury.Sema4D suppresses neuronal axon myelination and axon regeneration,while its inhibition significantly enhances axon regeneration and motor recovery.Sema7A is involved in glial scar formation and may influence serotonin channel remodeling,thereby affecting motor coordination.Given these findings,the local or systemic application of neuronal guidance proteins represents a promising avenue for spinal cord injury treatment.展开更多
Disulfidptosis is a newly identified form of regulated cell death(RCD)first described in 2023,representing a significant advance in understanding programmed cell death pathways.This unique cell death modality is chara...Disulfidptosis is a newly identified form of regulated cell death(RCD)first described in 2023,representing a significant advance in understanding programmed cell death pathways.This unique cell death modality is characterized by abnormal intracellular accumulation of disulfide bonds and disruption of redox homeostasis,leading to cytoskeletal collapse without caspase activation.Disulfidptosis is primarily triggered by glucose deprivation in cells with high expression of solute carrier family 7 member 11(SLC7A11).Under these conditions,insufficient NADPH supply prevents the effective reduction of accumulated cystine to cysteine,thereby inducing disulfide stress.Distinct from apoptosis,ferroptosis,cuproptosis,or pyroptosis,disulfidptosis exhibits unique metabolic dependencies and a hallmark feature of cytoskeletal disintegration.Current evidence indicates that this mechanism is operative in various tumor types,including hepatocellular carcinoma,colorectal cancer,and lung adenocarcinoma,suggesting its potential therapeutic relevance.Therapeutic strategies targeting disulfidptosis include modulation of metabolic pathways—such as the use of GLUT1 or G6PD inhibitors—to selectively induce this form of cell death in cancer cells.This review systematically summarizes current understanding,aiming to elucidate the unique mechanisms and therapeutic potential of disulfidptosis,and provides a foundational framework for future studies and the development of innovative strategies targeting tumor metabolic vulnerabilities.展开更多
BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
Rat nerve growth factor and total flavonoids from hawthorn leaf contribute to the recovery of neurological function after spinal cord injury,including traumatic,non-traumatic spinal cord injuries.However,it remains ch...Rat nerve growth factor and total flavonoids from hawthorn leaf contribute to the recovery of neurological function after spinal cord injury,including traumatic,non-traumatic spinal cord injuries.However,it remains challenging to efficiently deliver nerve growth factor and total flavonoids from hawthorn leaf to spinal cord injury sites,ensure their sustained release,and minimize further damage.In the present study,we chose a biocompatible and biodegradable gelatin as the substrate,which was crosslinked with the natural biological crosslinker genipin to form a gelatin-genipin hydrogel carrier for the slow release of nerve growth factor and total flavonoids from hawthorn leaf in spinal cord injury sites.The prepared gelatin-genipin hydrogel had good injectable properties and photothermal effects.Furthermore,when the hydrogel with 2%genipin,200 ng/mL nerve growth factor,and 320μg/mL total flavonoids from hawthorn leaf was combined with near infrared irradiation,there was a slow release of total flavonoids from hawthorn leaf and nerve growth factor,reduced oxidative stress,an improved inflammatory microenvironment,and accelerated angiogenesis and axonal regeneration via inhibition of the nuclear factor kappa-B signaling pathway,thereby promoting recovery from spinal cord injury.Collectively,our results indicate that this new hydrogel may improve the prognosis of spinal cord injury,and may represent a new strategy for treating spinal cord injury.展开更多
Ferroptosis constitutes a pivotal pathological event following spinal cord injury and presents substantial challenges to the restoration of neurological function.Cystine-glutamate transporter SLC7A11 is essential for ...Ferroptosis constitutes a pivotal pathological event following spinal cord injury and presents substantial challenges to the restoration of neurological function.Cystine-glutamate transporter SLC7A11 is essential for maintaining cellular redox homeostasis and resisting ferroptosis.However,the mechanisms underlying neuronal ferroptosis caused by SLC7A11 downregulation following spinal cord injury remain unclear.Herein,we provide evidence that tumor protein 53,a negative regulator of SLC7A11,was significantly upregulated post-spinal cord injury.Transcriptomic analysis indicated that tumor protein 53 was associated with injury severity.We subsequently confirmed that tumor protein 53 inhibition restored the expressions of SLC7A11 and glutathione peroxidase 4,alleviated neuronal ferroptosis,and improved neurological function in a contusion spinal cord injury rat model.The regulatory effects of tumor protein 53 on the transcription and ubiquitination of SLC7A11 were further elucidated using chromatin immunoprecipitation polymerase chain reaction and cleavage under targets and tagmentation techniques.Additionally,Kelch-like protein 4,an E3 ubiquitin ligase adaptor,was demonstrated to play an important role in the tumor protein 53-mediated ubiquitination of SLC7A11.In summary,the present study elucidated the possible mechanisms of tumor protein 53-mediated neuronal ferroptosis in spinal cord injury,thereby providing potential targets and insights for clinical translation.展开更多
Unlike mammals,zebrafish possess a remarkable ability to regenerate their spinal cord after injury,making them an ideal vertebrate model for studying regeneration.While previous research has identified key cell types ...Unlike mammals,zebrafish possess a remarkable ability to regenerate their spinal cord after injury,making them an ideal vertebrate model for studying regeneration.While previous research has identified key cell types involved in this process,the underlying molecular and cellular mechanisms remain largely unexplored.In this study,we used single-cell RNA sequencing to profile distinct cell populations at different stages of spinal cord injury in zebrafish.Our analysis revealed that multiple subpopulations of neurons showed persistent activation of genes associated with axonal regeneration post injury,while molecular signals promoting growth cone collapse were inhibited.Radial glial cells exhibited significant proliferation and differentiation potential post injury,indicating their intrinsic roles in promoting neurogenesis and axonal regeneration,respectively.Additionally,we found that inflammatory factors rapidly decreased in the early stages following spinal cord injury,creating a microenvironment permissive for tissue repair and regeneration.Furthermore,oligodendrocytes lost maturity markers while exhibiting increased proliferation following injury.These findings demonstrated that the rapid and orderly regulation of inflammation,as well as the efficient proliferation and redifferentiation of new neurons and glial cells,enabled zebrafish to reconstruct the spinal cord.This research provides new insights into the cellular transitions and molecular programs that drive spinal cord regeneration,offering promising avenues for future research and therapeutic strategies.展开更多
基金Supported by National Natural Science Foundation of China,No.81972108.
文摘BACKGROUND Few reports have described lumbar foraminal stenosis-induced radiculopathy after treatment by full-endoscopic spine surgery(FESS)combined with percutaneous vertebroplasty(PVP)in patients with vertebral compression fractures.We herein report such a case,including the patient’s treatment process and doctor’s surgical experience.CASE SUMMARY A 79-year-old man presented with symptoms of radiculopathy after sustaining L4 vertebral compression fractures.Imaging and physical examination revealed L4 vertebral compression fractures combined with L3/4 Lumbar foraminal stenosis(LFS).The patient’s symptoms were low back pain with pain in the lateral left leg.Although many reports have described radiculopathy induced by osteoporotic vertebral compression fractures,the use of FESS combined with PVP has rarely been reported.This case report indicates that the combination of FESS and PVP is a safe and effective approach for the treatment of LFS-induced radiculopathy after vertebral compression fractures.This minimally invasive technique has great potential to replace traditional lumbar fixation and decompression surgery.Thus,we suggest the continued accumulation of similar cases to discuss the wider application of FESS.CONCLUSION For patients with osteoporotic vertebral compression fracture(OVCF)and LFS,PVP and FESS can be used to restore the vertebral height and reduce the pressure around the intervertebral foramen.Additionally,the combination of FESS and PVP can treat the pain or numbness of the low back and lower limbs and allow for recovery in a short time with excellent postoperative effects.In general,FESS is a good treatment for radiculopathy caused by foraminal stenosis after OVCF.
文摘Across many of the surgical specialties,the use of minimally invasive techniques that utilize indirect visualization has been increasingly replacing traditional techniques which utilize direct visualization.Arthroscopic surgery of the appendicular skeleton has evolved dramatically and become an integral part of musculoskeletal surgery over the last several decades,allowing surgeons to achieve similar or better outcomes,while reducing cost and recovery time.However,to date,the axial skeleton,with its close proximity to critical neural and vascular structures,has not adopted endoscopic techniques at as rapid of a rate.Over the past decade,increased patient demand for less invasive spine surgery combined with surgeon desire to meet these demands has driven significant evolution and innovation in endoscopic spine surgery.In addition,there has been an enormous advancement in technologies that assist in navigation and automation that help surgeons circumvent limitations of direct visualization inherent to less invasive techniques.There are currently a multitude of endoscopic techniques and approaches that can be utilized in the treatment of spine disorders,many of which are evolving rapidly.Here we present a review of the field of endoscopic spine surgery,including the background,techniques,applications,current trends,and future directions,to help providers gain a better understanding of this growing modality in spine surgery.
文摘Bone morphogenetic proteins are osteoinductive factors which have gained popularity in orthopaedicsurgery and especially in spine surgery. The use of recombinant human bone morphogenetic protein-2 has been officially approved by the United States Food and Drug Administration only for single level anterior lumbar interbody fusion, nevertheless it is widely used by many surgeons with off-label indications. Despite advantages in bone formation, its use still remains a controversial issue and several complications have been described by authors who oppose their wide use.
文摘Spine surgery is one of the fastest growing branches of orthopedic surgery. Patients often present with a relatively high acuity and, depending on surgical approach, morbidity and mortality can be comparatively high. Among the most prevalent and most frequently fatalitybound perioperative complications are those affecting the pulmonary system; evidence of clinical or subclinical lung injury triggered by spine surgical procedures is emerging. Increasing burden of comorbidity among the patient population further increases the likelihood of adverse outcome. This review is intended to give an overview over some of the most important causes of pulmonary complications after spine surgery, their pathophysiology and possible ways to reduce harm associated with those conditions. We discuss factors surrounding surgical trauma, timing of surgery, bone marrow and debris embolization, transfusion associated lung injury, and ventilator associated lung injury.
文摘Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common spine diseases which are mainly due to age related Spine degeneration. Diagnosis of both Lumbar Disc Herniation and Lumbar Spine Stenosis depends on clinical findings as well as radiological investigations. Treatment of choice of these conditions is on the basis of the patient conditions. Surgical treatment is the option only when the conservative treatment does not improve the patient’s clinical condition. Advancement and improvement of the technology have resulted in the traditional open surgical treatment into minimal invasive surgery. Intervention of the different surgical instruments with expert spinal surgeons had made percutaneous endoscopic lumbar Spine surgery as one of the preferred choices of surgery for treating Lumbar Disc Herniation and Lumbar Spine Stenosis. The concept of percutaneous endoscopic surgery for lumbar region is to provide surgical options without producing iatrogenic morbidity associated with the open surgical procedures. Conventionally, there are different approaches/techniques for Percutaneous Endoscopic Lumbar Spine Surgery, but in this review we are mainly focusing on the Transforaminal Technique. Regarding the Lumbar Disc Herniation treatment with transforaminal approach, a number of articles have been published due to which we mainly focused on those articles which were published after 2009 onwards. While fewer articles related to Lumbar Spine Stenosis treatment with Transforaminal approach were found, we tried to brief out all those articles. On the basis of comparative study of different surgeries done for Lumbar Disc Herniation and Lumbar Spine Stenosis, Percutaneous Transforaminal endoscopic Lumbar Surgery provides a substantial benefit. Transforaminal approach for treating Lumbar Disc Herniation and Lumbar Spine Stenosis is safe and effective. The Percutaneous Transforaminal Endoscopic Lumbar Surgery has advantage as it is performed under local anesthesia with shorter length of hospitalization and early return to normal life. The clinical outcome of the patient that underwent Percutaneous Transforaminal Endoscopic Lumbar Surgery for Lumbar Disc Herniation and Lumbar Spine Stenosis is quite good in regard of its fewer complication and more benefits.
文摘In the past few years, stem cells have become the focus of research by regenerative medicine professionals and tissue engineers. Embryonic stem cells, although capable of differentiating into cell lineages of all three germ layers, are limited in their utilization due to ethical issues. In contrast, the autologous harvest and subsequent transplantation of adult stem cells from bone marrow, adipose tissue or blood have been experimentally utilized in the treatment of a wide variety of diseases ranging from myocardial infarction to Alzheimer's disease. The physiologic consequences of stem cell transplantation and its impact on functional recovery have been studied in countless animal models and select clinical trials. Unfortunately, the bench to bedside translation of this research has been slow. Nonetheless, stem cell therapy has received the attention of spinal surgeons due to its potential benefits in the treatment of neural damage, muscle trauma, disk degeneration and its potential contribution to bone fusion.
基金sponsored by the scientific research and technology development plan of Nanning(20193100,Z20191065,Z20190446)Nanning Excellent Young Scientist Program RC20200102.
文摘Spine surgery is typically having a relationship to high degrees of pain and immobility.It is a known fact that the implementation of an enhanced recovery after surgery(ERAS)approach has led to a paradigm shift in various surgical specialties.These protocols require doctors,nurses,anesthesiologists,patients,and their families to agree to strengthen communication with each other,and involve a long timeline and teamwork from start to finish.To our knowledge,the role of nursing in the ERAS of spine surgery has not been reported before.The purpose of this study is to summarize the role of nursing in ERAS programs in accordance with surgical periods.The methods applied for this review include literature review of the world’s acknowledged databases such as Springer Link,PubMed,Embase,and Wanfang,especially in the period of 2000-2015.A total of 9 studies fulfilled the eligibility criteria and were included in the review.The findings confirm that the nursing work continued throughout the perioperative procedure,which plays a key role in the successful ERAS pathway.According to different nursing measures,ERAS nursing can effectively promote the postoperative recovery of spine surgical patients,with fewer postoperative complications and increased patient satisfaction.
文摘Background Ossification of the ligamentum flavum （OLF） has been widely recognized as one of the main causes of thoracic spinal canal stenosis and thoracic myelopathy.Decompression is the only effective strategy for treating thoracic myelopathy caused by OLF.The purpose of this study was to describe the clinical outcomes of computer-assisted minimally invasive spine surgery （CAMISS） for posterior decompression in patients with thoracic myelopathy caused by OLF.Methods In all cases,the surgical procedure was performed with the assistance of an intraoperative three-dimensional navigation system.Decompression of the spinal cord was performed with a high-speed drill; the supraspinal ligaments and spinous process were partially preserved.The outcomes were evaluated by a modified Japanese Orthopedic Association （JOA） scoring system and recovery rates.Results The mean duration of follow-up for the 14 cases was 3.9 years.All patients experienced neurological recovery,the mean JOA score improving from 6.1 points preoperatively to 8.6 points at final follow-up and the mean rate of recovery being 52.7% （excellent in two cases,good in eight,fair in three,and unchanged in one）.Conclusion CAMISS is a safe and effective procedure for resection of the OLF in the thoracic spine.
文摘Spinal surgery is a technically demanding and challenging procedure because of the complicated anatomical structures of the spine and its proximity to several important tissues.Surgical landmarks and fluoroscopy have been used for pedicle screw insertion but are found to produce inaccuracies in placement.Improving the safety and accuracy of spinal surgery has increasingly become a clinical concern.Computerassisted navigation is an extension and application of precision medicine in orthopaedic surgery and has significantly improved the accuracy of spinal surgery.However,no clinical guidelines have been published for this relatively new and fast-growing technique,thus potentially limiting its adoption.In accordance with the consensus of consultant specialists,literature reviews,and our local experience,these guidelines include the basic concepts of the navigation system,workflow of navigation-assisted spinal surgery,some common pitfalls,and recommended solutions.This work helps to standardize navigation-assisted spinal surgery,improve its clinical efficiency and precision,and shorten the clinical learning curve.
文摘Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid （CSF） leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new treatment strategies have shown a promising effect that is listed as follows： 1） creating watertight dural closure to stop CSF leak with the help of dural substitute material; and 2） retarding CSF leak by changing pressure difference, including reducing the subarachnoid fluid pressure, increasing the epidural space pressure and both. In fact several methods mentioned above are usually combined to treat CSF leak. However, no update review summarized the relevant studies implemented in recent years. In this re- view, the authors would compare the effects of different dural closure techniques, and introduce the latest treatment methods and mechanisms.
文摘Purpose： Up to date, some approaches retarding the flow of cerebrospinal fluid （CSF） could be regarded as direct applications of the fluid mechanics （Poiseuille＇s law）. However, there is a lack of the research on the efficacy of subfascial drainage for management of CSF leak after spine surgery based on the law. This is a prospective and comparative study on suhfascial drainage for CSE Methods： Every four months in the three years from January 2010 to December 2012, the patients were enrolled respectively in Group A, Group B and Group C, in which, the drainage tube was discontinued within postoperative 3-4 days, 5-6 days, 7-10 days. Results and complications of postoperative CSF leak were investigated, and mean wound healing time （MWHT） of the three groups was compared. Results： A total of 108 cases （Group A/B/C：35/32/41） of CSF leak following posterior spine surgery were admitted to Tianjin Union Medicine Center, and 92 cases have been followed up for more than 1 year （follow-up rate of 85.2%）. Preoperative demographics were similar among the 3 groups. In Group A, 7 patients developed CSI： leak through the wound （CSFLW）, of which 5 cases had to undergo reoperation. One case in Group A was confirmed to have pseudomeningocele at the 1st month after surgery. The MWHT was （16.6 ± 3.6） days. In Group B, 3 patients developed CSFLW and cured by reoperation, in which 1 case of superficial infection recovered well after reoperation. MWHT was （11.4 ± 2.2） days. In Group C, CSFLW was not found and MWHT was （10.1 ± 2.9） days. The differences of MWHT among Groups A, B and C were statistically significant.Conclusion： Postoperative subfascial drainage, which is used to decrease the subfascial space pressure （P2）, would help wound healing. When it is placed for more than 7 days, the wound resistance （Rw） would be strong enough to withstand the suharachnoid pressure （P1）. Meanwhile, the power trans- duction in a sequence of Rw 〉 P2〉P1 will indirectly retard CSF leak at the durotomy site and accordingly facilitate the healing of damaged spinal dura mater.
文摘Objective:To observe and study the actual effects of percutaneous pedicle screw minimally invasive surgery in the treatment of spinal fractures and its impact on spinal function.Methods:This study included 48 patients with spinal fractures admitted between May 2023 and May 2024.The patients were divided into a control group and an experimental group based on treatment differences,with 24 patients in each group.The control group underwent open internal fixation surgery,while the experimental group received percutaneous pedicle screw minimally invasive surgery.Clinical index improvements,cervical dysfunction index,Japanese Orthopaedic Association scores,and pain level improvements were compared between the two groups.Results:The intraoperative blood loss,incision length,operation time,and hospitalization duration in the experimental group were(88.63±18.85),(6.32±1.05),(73.42±4.05),and(12.58±2.56),respectively,compared to(279.95±17.32),(12.89±1.36),(89.93±4.79),and(22.41±2.87)in the control group.Significant differences were observed between the groups,with the experimental group showing superior improvements across all metrics(P<0.05).Conclusion:Percutaneous pedicle screw minimally invasive surgery shows more significant effects in treating spinal fractures,particularly in improving cervical and lumbar spine function,enhancing treatment efficacy and safety,reducing pain levels,and shortening recovery time.Clinical application and promotion are recommended.
文摘BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.
文摘BACKGROUND The combined anterior/posterior approach appears to be capable of reconstructing spinal stability,correcting thoracolumbar deformity,and promoting neural recovery in severe thoracolumbar fracture dislocation.However,this type of operation requires changing the body position during the procedure,resulting in a lengthy operation time.As a universal surgical robot,TINAVI robot has achieved good surgical results in clinical surgery.But to our knowledge,no reports describing TINAVI robot-assisted single lateral position anteroposterior surgery for thoracolumbar fracture dislocation.CASE SUMMARY We describe a case of a 16-year-old female patient with severe thoracolumbar fracture and dislocation underwent surgery assisted by the TINAVI robot.A onestage combined anterior and posterior operation was performed on a severe thoracolumbar fracture dislocation using the TINAVI robot,and the operation was completed in right lateral position.CONCLUSION The TINAVI robot-assisted one-stage anterior and posterior surgery in right lateral position for severe thoracolumbar fracture and dislocation is both safe and effective.
基金supported by Shenzhen University General Hospital Scientific Research Project,No.SUGH2019QD002Shenzhen Science and Technology Development Foundation,No.20220810173216001(both to ZS).
文摘Spinal cord injury is a severe neurological condition with limited neuronal regeneration and functional recovery.Currently,no effective treatments exist to improve spinal cord injury prognosis.Neuronal guidance proteins are a diverse group of molecules that play crucial roles in axon and dendrite growth during nervous system development.Increasing evidence highlights their regulatory functions in spinal cord injury.This review provides a brief overview of the modulation patterns of key neuronal guidance proteins in neuronal axon growth during nervous system formation and subsequently focuses on their roles in neuronal regeneration and functional recovery following spinal cord injury.Neuronal guidance proteins include,but are not limited to,semaphorins and their receptors,plexins;netrins and their receptors,deleted in colorectal cancer and UNC5;Eph receptors and their ligands,ephrins;Slit and its receptor,Robo;repulsive guidance molecules and their receptor,neogenin;Wnt proteins and their receptor,Frizzled;and protocadherins.Localized Netrin-1 at the injury site inhibits motor axon regeneration after adult spinal cord injury while promoting oligodendrocyte growth.Slit2 enhances synapse formation in the injured spinal cord of rats.EphA7 regulates acute apoptosis in the early pathophysiological stages of spinal cord injury,while ephrinA1 plays a role in the nervous system’s injury response,with its reduced expression leading to impaired motor function in rats.EphA3 is upregulated following spinal cord injury,promoting an inhibitory environment for axonal regeneration.After spinal cord injury,bidirectional activation of ephrinB2 and EphB2 in astrocytes and fibroblasts results in the formation of a dense astrocyte-meningeal fibroblast scar.EphB1/ephrinB1 signaling mediates pain processing in spinal cord injury by regulating calpain-1 and caspase-3 in neurons.EphB3 expression increases in white matter after spinal cord injury,further inhibiting axon regeneration.Sema3A,expressed by neurons and fibroblasts in the scar surrounding the injury,inhibits motor neuron and sensory nerve growth after spinal cord injury.Sema4D suppresses neuronal axon myelination and axon regeneration,while its inhibition significantly enhances axon regeneration and motor recovery.Sema7A is involved in glial scar formation and may influence serotonin channel remodeling,thereby affecting motor coordination.Given these findings,the local or systemic application of neuronal guidance proteins represents a promising avenue for spinal cord injury treatment.
文摘Disulfidptosis is a newly identified form of regulated cell death(RCD)first described in 2023,representing a significant advance in understanding programmed cell death pathways.This unique cell death modality is characterized by abnormal intracellular accumulation of disulfide bonds and disruption of redox homeostasis,leading to cytoskeletal collapse without caspase activation.Disulfidptosis is primarily triggered by glucose deprivation in cells with high expression of solute carrier family 7 member 11(SLC7A11).Under these conditions,insufficient NADPH supply prevents the effective reduction of accumulated cystine to cysteine,thereby inducing disulfide stress.Distinct from apoptosis,ferroptosis,cuproptosis,or pyroptosis,disulfidptosis exhibits unique metabolic dependencies and a hallmark feature of cytoskeletal disintegration.Current evidence indicates that this mechanism is operative in various tumor types,including hepatocellular carcinoma,colorectal cancer,and lung adenocarcinoma,suggesting its potential therapeutic relevance.Therapeutic strategies targeting disulfidptosis include modulation of metabolic pathways—such as the use of GLUT1 or G6PD inhibitors—to selectively induce this form of cell death in cancer cells.This review systematically summarizes current understanding,aiming to elucidate the unique mechanisms and therapeutic potential of disulfidptosis,and provides a foundational framework for future studies and the development of innovative strategies targeting tumor metabolic vulnerabilities.
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
基金Guangxi Science and Technology Base and Talent Special Project,No.GuiKeAD24010037(to SZ)Guangxi Health Commission Self-Funded Research Project,No.Z-A20241029(to YL).
文摘Rat nerve growth factor and total flavonoids from hawthorn leaf contribute to the recovery of neurological function after spinal cord injury,including traumatic,non-traumatic spinal cord injuries.However,it remains challenging to efficiently deliver nerve growth factor and total flavonoids from hawthorn leaf to spinal cord injury sites,ensure their sustained release,and minimize further damage.In the present study,we chose a biocompatible and biodegradable gelatin as the substrate,which was crosslinked with the natural biological crosslinker genipin to form a gelatin-genipin hydrogel carrier for the slow release of nerve growth factor and total flavonoids from hawthorn leaf in spinal cord injury sites.The prepared gelatin-genipin hydrogel had good injectable properties and photothermal effects.Furthermore,when the hydrogel with 2%genipin,200 ng/mL nerve growth factor,and 320μg/mL total flavonoids from hawthorn leaf was combined with near infrared irradiation,there was a slow release of total flavonoids from hawthorn leaf and nerve growth factor,reduced oxidative stress,an improved inflammatory microenvironment,and accelerated angiogenesis and axonal regeneration via inhibition of the nuclear factor kappa-B signaling pathway,thereby promoting recovery from spinal cord injury.Collectively,our results indicate that this new hydrogel may improve the prognosis of spinal cord injury,and may represent a new strategy for treating spinal cord injury.
基金supported by the National Natural Science Foundation of China,Nos.81672161,81871785,82372411(to ZY)the Health Research Project of Health Commission of Anhui Province,No.AHWJ2023A30106(to YX).
文摘Ferroptosis constitutes a pivotal pathological event following spinal cord injury and presents substantial challenges to the restoration of neurological function.Cystine-glutamate transporter SLC7A11 is essential for maintaining cellular redox homeostasis and resisting ferroptosis.However,the mechanisms underlying neuronal ferroptosis caused by SLC7A11 downregulation following spinal cord injury remain unclear.Herein,we provide evidence that tumor protein 53,a negative regulator of SLC7A11,was significantly upregulated post-spinal cord injury.Transcriptomic analysis indicated that tumor protein 53 was associated with injury severity.We subsequently confirmed that tumor protein 53 inhibition restored the expressions of SLC7A11 and glutathione peroxidase 4,alleviated neuronal ferroptosis,and improved neurological function in a contusion spinal cord injury rat model.The regulatory effects of tumor protein 53 on the transcription and ubiquitination of SLC7A11 were further elucidated using chromatin immunoprecipitation polymerase chain reaction and cleavage under targets and tagmentation techniques.Additionally,Kelch-like protein 4,an E3 ubiquitin ligase adaptor,was demonstrated to play an important role in the tumor protein 53-mediated ubiquitination of SLC7A11.In summary,the present study elucidated the possible mechanisms of tumor protein 53-mediated neuronal ferroptosis in spinal cord injury,thereby providing potential targets and insights for clinical translation.
基金supported by the Jiangsu Province Traditional Chinese Medicine Technology Development Plan Project,Nos.MS2023113(to JC),MS2022090Young and Middle-aged Academic Leaders of Jiangsu Qing-Lan Project(to GL).
文摘Unlike mammals,zebrafish possess a remarkable ability to regenerate their spinal cord after injury,making them an ideal vertebrate model for studying regeneration.While previous research has identified key cell types involved in this process,the underlying molecular and cellular mechanisms remain largely unexplored.In this study,we used single-cell RNA sequencing to profile distinct cell populations at different stages of spinal cord injury in zebrafish.Our analysis revealed that multiple subpopulations of neurons showed persistent activation of genes associated with axonal regeneration post injury,while molecular signals promoting growth cone collapse were inhibited.Radial glial cells exhibited significant proliferation and differentiation potential post injury,indicating their intrinsic roles in promoting neurogenesis and axonal regeneration,respectively.Additionally,we found that inflammatory factors rapidly decreased in the early stages following spinal cord injury,creating a microenvironment permissive for tissue repair and regeneration.Furthermore,oligodendrocytes lost maturity markers while exhibiting increased proliferation following injury.These findings demonstrated that the rapid and orderly regulation of inflammation,as well as the efficient proliferation and redifferentiation of new neurons and glial cells,enabled zebrafish to reconstruct the spinal cord.This research provides new insights into the cellular transitions and molecular programs that drive spinal cord regeneration,offering promising avenues for future research and therapeutic strategies.
