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Objective: To compare therapeutic effects between surgical and conservative treatment for postoperative lumbar discitis., Methods: From January 2004 to January 2009, 41 patients (17 males and 24 females ranging the age from 37 to 68 years with an average of 53.6 years) with postoperative lumbar discitis were retrospectively studied and divided into two groups. There were 19 patients in operation group, 22 patients in conservative group. Clinical data and features,image data, laboratory examinations, antibiotics utilization, hospital stays and sequelae were recorded and analyzed. Visual analogue scales system (VAS) and Oswestry disability index (ODI) were applied to evaluate therapeutic effects., Results: All patients were followed up over 2 years. Imaging revealed good bone fusion and no occurrence of discitis. VAS score and ODI at 1 month, 1 year and 2 years were significantly improved after treatment (P < 0.01). While VAS and ODI in operation group at 1 month were improved more than that of conservative group (P < 0.01), and there was no significant difference between two groups at 1 year and 2 years (P > 0.01)., Conclusion: Surgical and conservative treatment for postoperative lumbar discitis is effective. Surgical treatment is superior to conservative treatment in a short time, while conservative treatment can achieve long-term satisfactory curative effects.

Objective: To identify the initial effect of dynamic interspinous implant of Coflex on the treatment of lumbar spinal stenosis., Methods: A retrospective study of 18 patients who underwent posterior lumbar decompression and fixation with interspinous implant of Coflex between March 2008 and October 2009 was taken to compare the Cobb angel of nature and dynamic position on the segment of Coflex fixation at the time of before and after operation and following time,including 10 males and 8 females with average age of 62.2 years old (54 to 71 years). The symptoms of patients included chronic lower back pain and intermittent claudication and lower extremity numbness. All cases including 17 cases of L4,5 and 1 case of L3,4 were central canal stenosis without obviously segmental instability. Clinical outcomes were evaluated with VAS and ODI., Results: All patients were followed up from 10 to 18 months with an average of 14.4 months. There did not about internal fixation failure. It was found that postoperative Cobb angel of fixation segment [(12.1 +/- 2.6) degrees] was significantly decreased than preoperative [(14.8 +/- 3.2) degrees] (t = 2.61, P = 0.03). But the Cobb angel [(14.9 +/- 4.1) degrees] increased at final follow-up, even reached the level of before operation (t = 1.39, P = 0.65). The Cobb angle of upper adjacent segment did not obviously change in preoperation, postoperation and final follow-up [(12.1 +/- 2.3) degrees, (12.3 +/- 3.2) degrees, (11.9 +/- 3.0) degrees, respectively]. Dynamic measure showed that Coflex can adequately limit the ROM of extension (t = 4.01, P = 0.001), but the ROM of flexion increased (t = 2.57, P = 0.02). The VAS score in follow-up (2.2 +/- 0.7) was significantly decreased than before operation (4.9 +/- 1.1, t = 2.95, P = 0.02). The ODI score in follow-up [(29.1 +/- 9.0)%] was significantly decreased than before operation [(56.5 +/- 14.2)%, (t = 3.02, P = 0.02)]., Conclusion: The Coflex implanting combined with decompression can get good result clinically, but imaging showed that Coflex can not maintain the relatively kyphosis gained after operation except for extension limitation.

Background Context: Different animal models are being used in disc degenerative disease (DDD) research; most of these models are induced invasively rather than noninvasively. Computed tomography (CT)-guided percutaneous biopsy, widely used in clinical malignant pathology diagnosis, is a safe, useful, and highly accurate procedure. However, this process was not carried out in animal model preparation of intervertebral disc degeneration.Purpose: To apply a minimally invasive method in DDD animal model preparation with a biopsy gun guided by CT scan and evaluate the accuracy and efficiency of this process with radiology and histology analyses. The relationship between the weight of removed nucleus pulposus (NP) and the degenerative process was also explored preliminarily.Methods: The canine intervertebral discs L1-L2, L3-L4, and L5-L6 were divided into three groups randomly: Group A: 18G biopsy gun; Group B: 20G biopsy gun; and Group C: 24G biopsy gun. After the lumbar spine was scanned with CT and the depth and angle of the centesis operation sites ascertained, biopsy gun was stabbed percutaneously through the annulus into the NP. A certain volume of NP tissue was removed by the biopsy gun. Radiology examination, including digital radiography (DR) and magnetic resonance imaging (MRI), was carried out preoperatively and at first and third months postoperatively. Each sample was harvested at the 3rd month postoperation for histology evaluation.Results: Computed tomography-guided percutaneous biopsy with 18G, 20G, and 24G biopsy guns was carried out for six discs, respectively. In the procedure, the weight of the NP tissue was removed: 3.0±0.53mg in Group A, 2.01±0.34 mg in Group B, and 0.99±0.12 mg in Group C. Significant differences of the weight of the removed NP tissue were calculated between groups (p<.05). During the observation period, although the disc height of Group A and B was reduced, no significant differences in the disc height comparison were found between groups at each time point and within groups at different time points in DR analysis. However, the signal intensity of MRI was reduced significantly (p<.05) in Group A when compared with Group C at third month, whereas the signal intensity was decrease mildly (p>.05) in Group B when compared with Group C at third month. The decreased content of NP, the number of NP cells, and the loose annulus fibrosus at the inner area was observed in both hematoxylin-eosin and Safranin-O staining in Group A at the 3rd month postoperation.Conclusions: Computed tomography-guided percutaneous biopsy could be applied in intervertebral disc degeneration preparation of canine model, and the 20G biopsy gun would be the optimal choice in this procedure. The intervertebral disc degenerative process could be forecasted approximately on an account of the negative association between the degeneration process and the weight of the removed NP tissue. [ABSTRACT FROM AUTHOR]