Search

Purpose The aim of the study was to explore surgical strategies for effectively treating spine fractures in patients with ankylosing spondylitis (AS) and investigate the postoperative outcomes. Methods We retrospectively analyzed 9 patients with AS that was complicated by spine fractures, who underwent surgery at our spine and spinal cord clinic between 2005 and 2012. The surgical methods included posterior instrumentation and bone grafting, with or without decompression. Fracture healing and neurological function recovery were observed postoperatively. The average follow-up period was 45.1 months (range: 24-60). Results The 9 patients included 7 men and 2 women. Eight patients were treated with long posterior fixation. One patient underwent combined long posterior fixation and anterior bone grafting. The neurological function of these patients improved significantly to varying degrees after surgery, and fracture union and segmental instability of the lumbar vertebrae were radiologically confirmed at the 1-month and 2-year follow-up intervals. Severe surgery-related complications were not observed. Conclusions Posterior instrumentation with bone grafting was a satisfying method for treating spine fractures in patients with AS.

The present study used a spinal cord injury (SCI) model to evaluate whether sparstolonin B was able to prevent SCI, and to investigate the underlying signaling mechanism. Sparstolonin B attenuated the SCI‑induced Batto, Beattie and Bresnahan score and water content in rats. Sparstolonin B attenuated the mRNA expression of proinflammatory cytokines interleukin (IL)‑18, IL‑6, IL‑1β, and IL‑23, decreased the levels of tumor necrosis factor‑α and interferon‑γ, and decreased caspase‑3 activity and apoptosis regulator Bax protein expression in SCI rats. Similarly, sparstolonin B inhibited monocyte chemoattractant protein‑1 mRNA levels, and Toll‑like receptor (TLR) 4, myeloid differentiation primary response protein MyD88 (MyD88) and nuclear factor (NF)‑κB protein levels in SCI rats. The present results suggested that sparstolonin B may attenuate SCI‑induced inflammation and apoptosis in rats by modulating the TLR4/MyD88/NF‑κB signaling pathway.

Lumbar disc herniation (LDH) is a common disease and lumbar discectomy is the most common surgical procedure carried out for patients with low back pain and leg symptoms. Although most researchers are focusing on the surgical techniques during operation, the aim of this study is to evaluate the effect of local intervertebral lavage during microdiscectomy.In this retrospective study, 410 patients were operated on by microdiscectomy for LDH during 2011 to 2014. Retrospectively, 213 of them (group A) accepted local intervertebral irrigation with saline water before wound closure and 197 patients (group B) only had their operative field irrigated with saline water. Systematic records of visual analog scores (VAS), Oswestry disability Index (ODI) questionnaire scale scores, use of analgesia, and hospital length of stay were done after hospitalization.The majority (80.49%) of the cases were diagnosed with lumber herniation at the levels of L4/5 and L5/S1. Fifty-one patients had herniations at 2 levels. There were significant decreases of VAS scores and ODI in both groups between preoperation and postoperation of different time points. VAS scores decreased more in group A than group B at early stage of postoperation follow-up. However, there were no statistically significant differences between 2 groups in using analgesia, VAS and ODI up to 1 month of follow-up.Microdiscectomy for LDH offers a marked improvement in back and radicular pain. Local irrigation of herniated lumber disc area could relief dick herniation-derived low back pain and leg radicular pain at early stage of post-operation. However, the pain relief of this intervention was not noticeable for a long period.

To summarize the experience in diagnosis and surgery of lumbar disc herniation sequestrating to upper spinal canal.Seventeen patients, 9 males and 8 females, aged 41 (27-54), with the diseased intervertebral discs herniated and upward sequestrated that were confirmed by lumbar MRI, all with definite clinical manifestations of nerve root compression, underwent operation, including 14 cases undergoing semi-laminectomy and discectomy and 3 cases undergoing laminectomy, discectomy, and fusion. Japanese Orthopedic Association (JOA) (29 scores) evaluation standard was used to before the operation and 14 days and 3 months after the operation to evaluate the curative effects.The average operation time was 80 min 50-180 min), and the average blood loss was 170 ml (20-350 ml). Cerebrospinal fluid leakage occurred after operation in 2 cases. The JOA score was 6.7 pre-operationally, and then rose to 24.214 days and 26.53 months post-operationally. The clinical effect was satisfied.Lumbar disc herniation sequestrating to upper spinal canal is often misdiagnosed as intraspinal tumor. Confirmed diagnosis depends on the operators' experience and intensive MRI. Operation is necessary for this type of lumbar disc herniation. Lumbar stability must be considered during decompression and discectomy.