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[PMID]:29200854
[Au] Autor:Qu Y; Wang Z; Zhou H; Kang M; Dong R; Zhao J
[Ad] Endereço:Department of Orthopedics, The Second Hospital of Jilin University, Changchun, People's Republic of China.
[Ti] Título:Oligosaccharide nanomedicine of alginate sodium improves therapeutic results of posterior lumbar interbody fusion with cages for degenerative lumbar disease in osteoporosis patients by downregulating serum miR-155.
[So] Source:Int J Nanomedicine;12:8459-8469, 2017.
[Is] ISSN:1178-2013
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:Degenerative lumbar disease (DLD) is a significant issue for public health. Posterior lumbar intervertebral fusion with cages (PLIFC) has high-level fusion rate and realignment on DLD. However, there are some complications following the surgery. Alginate oligosaccharides (AOS) have antioxidant and anti-inflammatory activities and may be suitable for infection therapy. MiR-155 is a biomarker associated with inflammatory and oxidative stress. AOS may promote PLIFC therapy by regulating miR-155. Pluronic nanoparticles and oligosaccharide nanomedicine of alginate sodium (ONAS) were prepared with ampicillin at size <200 nm. Ninety-six DLD osteoporosis patients received PLIFC and were evenly assigned into ONAS group (OG, oral administration of 100 mg ONAS daily) and control group (PG, 100 mg pluronic nanoparticles). Serum miR-155 level was measured by real-time quantitative PCR. The levels of superoxide dismutase (SOD), glutathione (GSH), aspartate aminotransaminase (AST), alanine aminotransferase (ALT), interleukin-1ß (IL-1ß), and interleukin-1 receptor antagonist (IL-1ra) were measured. Weighted mean difference (WMD), relative risk (RR), complications, surgery infection rate, fusion rate, and Japanese Orthopaedic Association (JOA) scores were used to evaluate therapeutic efficacy. After 1-month therapy, infection rates and side effects were lower in OG than those in PG (RR =0.64, 95% confidence interval [CI] [0.48, 0.84], =0.001). The fusion rates were higher in OG than in PG (WMD =21.96, 95% CI [-0.24, 37.62], =0.021). The JOA scores were higher in OG than in PG (RR =0.52, 95% CI [0.33, 0.84], =0.007), and no significant difference was found for the visual analog scale and Oswestry Disability Index. Serum levels of miR-155, ALT, AST, and IL-1ß were lower while SOD, GSH, and IL-1ra were higher in OG than in PG. MiR-155 mimic increased the levels of ALT, AST, and IL-1ß and reduced the levels of SOD, GSH, and IL-1ra. In contrast, miR-155 inhibitor had reverse results. Therefore, ONAS has better improvement in complications and therapeutic effects on DLD by regulating serum miR-155.
[Mh] Termos MeSH primário: Alginatos/farmacologia
Degeneração do Disco Intervertebral/terapia
Vértebras Lombares/patologia
MicroRNAs/sangue
Nanomedicina/métodos
Oligossacarídeos/farmacologia
Osteoporose/complicações
Fusão Vertebral
[Mh] Termos MeSH secundário: Idoso
Antioxidantes/farmacologia
Linhagem Celular Tumoral
Citocinas/metabolismo
Regulação para Baixo/efeitos dos fármacos
Regulação para Baixo/genética
Feminino
Ácido Glucurônico/farmacologia
Ácidos Hexurônicos/farmacologia
Seres Humanos
Degeneração do Disco Intervertebral/sangue
Degeneração do Disco Intervertebral/genética
Masculino
MicroRNAs/genética
Nanopartículas/ultraestrutura
Estresse Oxidativo/efeitos dos fármacos
Garantia da Qualidade dos Cuidados de Saúde
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Alginates); 0 (Antioxidants); 0 (Cytokines); 0 (Hexuronic Acids); 0 (MIRN155 microRNA, human); 0 (MicroRNAs); 0 (Oligosaccharides); 8A5D83Q4RW (Glucuronic Acid); 8C3Z4148WZ (alginic acid)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.2147/IJN.S143824


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[PMID]:28471737
[Au] Autor:Walter BA; Mageswaran P; Mo X; Boulter DJ; Mashaly H; Nguyen XV; Prevedello LM; Thoman W; Raterman BD; Kalra P; Mendel E; Marras WS; Kolipaka A
[Ad] Endereço:From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Ra
[Ti] Título:MR Elastography-derived Stiffness: A Biomarker for Intervertebral Disc Degeneration.
[So] Source:Radiology;285(1):167-175, 2017 Oct.
[Is] ISSN:1527-1315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose To determine the repeatability of magnetic resonance (MR) elastography-derived shear stiffness measurements of the intervertebral disc (IVD) taken throughout the day and their relationship with IVD degeneration and subject age. Materials and Methods In a cross-sectional study, in vivo lumbar MR elastography was performed once in the morning and once in the afternoon in 47 subjects without current low back pain (IVDs = 230; age range, 20-71 years) after obtaining written consent under approval of the institutional review board. The Pfirrmann degeneration grade and MR elastography-derived shear stiffness of the nucleus pulposus and annulus fibrosus regions of all lumbar IVDs were assessed by means of principal frequency analysis. One-way analysis of variance, paired t tests, concordance and Bland-Altman tests, and Pearson correlations were used to evaluate degeneration, diurnal changes, repeatability, and age effects, respectively. Results There were no significant differences between morning and afternoon shear stiffness across all levels and there was very good technical repeatability between the morning and afternoon imaging results for both nucleus pulposus (R = 0.92) and annulus fibrosus (R = 0.83) regions. There was a significant increase in both nucleus pulposus and annulus fibrosus MR elastography-derived shear stiffness with increasing Pfirrmann degeneration grade (nucleus pulposus grade 1, 12.5 kPa ± 1.3; grade 5, 16.5 kPa ± 2.1; annulus fibrosus grade 1, 90.4 kPa ± 9.3; grade 5, 120.1 kPa ± 15.4), and there were weak correlations between shear stiffness and age across all levels (R ≤ 0.32). Conclusion Our results demonstrate that MR elastography-derived shear stiffness measurements are highly repeatable, weakly correlate with age, and increase with advancing IVD degeneration. These results suggest that MR elastography-derived shear stiffness may provide an objective biomarker of the IVD degeneration process. RSNA, 2017 Online supplemental material is available for this article.
[Mh] Termos MeSH primário: Técnicas de Imagem por Elasticidade/métodos
Degeneração do Disco Intervertebral/diagnóstico por imagem
Disco Intervertebral/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Biomarcadores
Estudos Transversais
Seres Humanos
Interpretação de Imagem Assistida por Computador
Disco Intervertebral/fisiopatologia
Degeneração do Disco Intervertebral/fisiopatologia
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1148/radiol.2017162287


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[PMID]:29205004
[Au] Autor:Chen F; Cheng YB; Fan LH
[Ad] Endereço:Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R.China, Shanghai 200063, China.
[Ti] Título:[Analysis of Relationship between Injury and Disease in 17 Cases of Cervical Trauma with Cervical Vertebra Degeneration].
[So] Source:Fa Yi Xue Za Zhi;32(5):350-352, 2016 Oct.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVES: To study the characteristics of the relationship between injury and disease in forensic identification cases of cervical trauma with cervical vertebra degeneration, and to explore the problems about how to identify the participation rates of injury and disease using the clinical information, forensic examination and imaging examination. METHODS: Seventeen forensic identification cases of cervical trauma with cervical vertebra degeneration were collected. The age distributions, injury formations, injury severities and imaging findings of these cases were analyzed and the relationship between injury and disease was evaluated comprehensively. RESULTS: Middle-aged and elderly were common in 17 cases and every case was involved with intervertebral disc herniation. The main reasons of injuries were hyperextension. The degree of injury severity and vertebra degeneration were graded according to the imaging findings. The participation rates of injury and disease were also calculated comprehensively. CONCLUSIONS: The forensic identification cases of cervical trauma with cervical vertebra degeneration should be evaluated with clinical information, forensic examination and imaging finding.
[Mh] Termos MeSH primário: Vértebras Cervicais/lesões
Vértebras Cervicais/patologia
Degeneração do Disco Intervertebral/patologia
Deslocamento do Disco Intervertebral/patologia
[Mh] Termos MeSH secundário: Adulto
Distribuição por Idade
Idoso
Seres Humanos
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2016.05.008


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[PMID]:29480873
[Au] Autor:Makino T; Honda H; Fujiwara H; Yoshikawa H; Yonenobu K; Kaito T
[Ad] Endereço:Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita.
[Ti] Título:Low incidence of adjacent segment disease after posterior lumbar interbody fusion with minimum disc distraction: A preliminary report.
[So] Source:Medicine (Baltimore);97(2):e9631, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY DESIGN: A retrospective review of prospectively collected data. OBJECTIVE: To investigate the incidence of radiographic and symptomatic adjacent segment disease (ASD) and identify possible risk factors for ASD after posterior lumbar interbody fusion (PLIF) with minimum disc distraction by selecting low-height interbody cages. SUMMARY OF BACKGROUND DATA: Excessive disc space distraction is reportedly 1 of the risk factors for ASD after PLIF; however, the incidence and other risk factors of ASD after PLIF with minimum disc distraction remain unclear. METHODS: Forty-one consecutive patients who underwent PLIF at L4-L5 and were postoperatively followed up for a minimum of 2 years were included. The height and shape (box or bullet shape) of interbody cages was determined according to the disc height and morphology of the intervertebral space assessed on preoperative computed tomography scans to avoid excessive distraction. The incidence of radiographic and symptomatic ASD was evaluated and all demographic and radiographic parameters were compared between patients with and without ASD. Multivariate logistic regression analysis was performed to identify risk factors for ASD among the variables with P < .20 in univariate analysis. RESULTS: The overall incidence of ASD was 12.2% (5/41 patients): radiographic ASD, 7.3% (3 patients); symptomatic ASD, 4.9% (2 patients). Multivariate analysis revealed preoperative retrolisthesis of L3 on extension as the sole risk factor for ASD after PLIF with minimum disc distraction (odds ratio, 2.13; 95% confidence interval, 1.00-4.05; P = .049). CONCLUSIONS: The incidence of ASD in this study was lower than that of ASD in our previous study about PLIF with distraction of disc space (12.2% vs. 31.8%). Minimum disc distraction by selection of low-height interbody cages is a simple and effective method to prevent ASD at the surgeons' discretion, although preexisting retrolisthesis at the adjacent upper segment should be taken into consideration.
[Mh] Termos MeSH primário: Degeneração do Disco Intervertebral/epidemiologia
Degeneração do Disco Intervertebral/etiologia
Vértebras Lombares/cirurgia
Complicações Pós-Operatórias/epidemiologia
Fusão Vertebral
Estenose Espinal/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Seres Humanos
Incidência
Degeneração do Disco Intervertebral/diagnóstico por imagem
Vértebras Lombares/diagnóstico por imagem
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Complicações Pós-Operatórias/diagnóstico por imagem
Dados Preliminares
Estudos Prospectivos
Estudos Retrospectivos
Fatores de Risco
Estenose Espinal/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009631


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[PMID]:29480856
[Au] Autor:Yuan B; Ji W; Fan B; Zhang B; Zhao Y; Li J
[Ad] Endereço:Department of Orthopaedics.
[Ti] Título:Association analysis between thrombospondin-2 gene polymorphisms and intervertebral disc degeneration in a Chinese Han population.
[So] Source:Medicine (Baltimore);97(2):e9586, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study is to determine the contribution of 2 single nucleotide polymorphisms (SNPs) in thrombospondin 2 (THBS2) gene to the development of intervertebral disc degeneration (IDD) in a Chinese Han population.We studied 138 patients with radiographically proven IDD and 136 healthy volunteers with no history of back problems. Magnetic resonance images (MRIs) were obtained for all the patients and controls. Image evaluation for IDD was performed to evaluate the severity of IDD. All patients and controls were genotyped for rs6422747 and rs6422748. Associations between genotypes and development of IDD were analyzed.We found that 2 SNPs in the intron region of THBS2 gene (rs6422747 and rs6422748) were associated with susceptibility of IDD. However, they were not related with severity of IDD, including the total number of degenerative disc and level of IDD. G allele in both SNPs was associated with a higher risk of IDD.The 2 SNPs (rs6422747 and rs6422748) in the THBS2 gene were associated with susceptibility of IDD but not severity of IDD in a Chinese Han population. Our results indicated that THBS2 gene polymorphisms might be the risk factors for IDD. More studies with larger sample size need to be perfected to make sure the functions of THBS2 gene polymorphisms in IDD development.
[Mh] Termos MeSH primário: Predisposição Genética para Doença
Degeneração do Disco Intervertebral/genética
Polimorfismo de Nucleotídeo Único
Trombospondinas/genética
[Mh] Termos MeSH secundário: Grupo com Ancestrais do Continente Asiático/genética
China
Feminino
Técnicas de Genotipagem
Seres Humanos
Degeneração do Disco Intervertebral/diagnóstico por imagem
Íntrons
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Índice de Gravidade de Doença
Coluna Vertebral/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Thrombospondins); 0 (thrombospondin 2)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009586


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[PMID]:29390319
[Au] Autor:Wang Y; Yi XD; Li CD
[Ad] Endereço:Department of Orthopedics, Peking University First Hospital, Beijing, China.
[Ti] Título:The influence of artificial nucleus pulposus replacement on stress distribution in the cartilaginous endplate in a 3-dimensional finite element model of the lumbar intervertebral disc.
[So] Source:Medicine (Baltimore);96(50):e9149, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This study aimed to investigate the effects involved with the artificial nucleus pulposus (NP) replacement on stress distribution of the cartilaginous endplate (CEP) in a 3-dimensional lumbar intervertebral disc (IVD) model using a finite element (FE) analysis. METHODS: A healthy male volunteer was recruited for the purposes of the study and a spiral computed tomography scan was subsequently conducted to obtain the data information in relation to the L4/5 motion segment. An FE model of the L4/5 motion segment constructed, on the basis of which degenerative IVD, IVD with NP removal, and IVD with NP replacement were in turn built. The stress distribution of the CEP and bulging of IVD were estimated using various motion states, including axial loading, forward flexion, backward extension, left axial rotation, and right axial rotation. RESULTS: Under different motion states, the vertebral stress was higher in the degenerative IVD, the IVD with NP removal, and the IVD with NP replacement, in comparison to that of the normal IVD. Furthermore, a higher vertebral stress was detected in the degenerative IVD than the IVD with NP removal and the IVD with NP replacement. An even distribution of vertebral stress was observed in the IVD model with an artificial NP replacement, while the vertebral stress and bulging displacement were lower than after NP removal. Our findings provided confirmation that stress of the CEP was consistent with the vertebral stress. CONCLUSION: This study provided evidence suggesting that NP replacement, vertebral stress, and bulging displacement are lower than that of degenerative IVD and IVD with NP removal under different motion states.
[Mh] Termos MeSH primário: Degeneração do Disco Intervertebral/cirurgia
Núcleo Pulposo/cirurgia
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Simulação por Computador
Discotomia
Análise de Elementos Finitos
Voluntários Saudáveis
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Modelos Anatômicos
Estresse Mecânico
Tomografia Computadorizada Espiral
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009149


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[PMID]:29381716
[Au] Autor:Paul CPL; Smit TH; de Graaf M; Holewijn RM; Bisschop A; van de Ven PM; Mullender MG; Helder MN; Strijkers GJ
[Ad] Endereço:Department of Orthopedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
[Ti] Título:Quantitative MRI in early intervertebral disc degeneration: T1rho correlates better than T2 and ADC with biomechanics, histology and matrix content.
[So] Source:PLoS One;13(1):e0191442, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Low-back pain (LBP) has been correlated to the presence of intervertebral disc (IVD) degeneration on T2-weighted (T2w) MRI. It remains challenging, however, to accurately stage degenerative disc disease (DDD) based on T2w MRI and measurements of IVD height, particularly for early DDD. Several quantitative MRI techniques have been introduced to detect changes in matrix composition signifying early DDD. In this study, we correlated quantitative T2, T1rho and Apparent Diffusion Coefficient (ADC) values to disc mechanical behavior and gold standard early DDD markers in a graded degenerated lumbar IVD caprine model, to assess their potential for early DDD detection. METHODS: Lumbar caprine IVDs were injected with either 0.25 U/ml or 0.5 U/ml Chondroïtinase ABC (Cabc) to trigger early DDD-like degeneration. Injection with phosphate-buffered saline (PBS) served as control. IVDs were cultured in a bioreactor for 20 days under axial physiological loading. High-resolution 9.4 T MR images were obtained prior to intervention and after culture. Quantitative MR results were correlated to recovery behavior, histological degeneration grading, and the content of glycosaminoglycans (GAGs) and water. RESULTS: Cabc-injected IVDs showed aberrancies in biomechanics and loss of GAGs without changes in water-content. All MR sequences detected changes in matrix composition, with T1rho showing largest changes pre-to-post in the nucleus, and significantly more than T2 and ADC. Histologically, degeneration due to Cabc injection was mild. T1rho nucleus values correlated strongest with altered biomechanics, histological degeneration score, and loss of GAGs. CONCLUSIONS: T2- and T1rho quantitative MR-mapping detected early DDD changes. T1rho nucleus values correlated better than T2 and ADC with biomechanical, histological, and GAG changes. Clinical implementation of quantitative MRI, T1rho particularly, could aid in distinguishing DDD more reliably at an earlier stage in the degenerative process.
[Mh] Termos MeSH primário: Degeneração do Disco Intervertebral/diagnóstico por imagem
Degeneração do Disco Intervertebral/patologia
Imagem por Ressonância Magnética
Fenômenos Mecânicos
[Mh] Termos MeSH secundário: Animais
Fenômenos Biomecânicos
Progressão da Doença
Feminino
Glicosaminoglicanos/metabolismo
Cabras
Degeneração do Disco Intervertebral/metabolismo
Degeneração do Disco Intervertebral/fisiopatologia
Razão Sinal-Ruído
Fatores de Tempo
Água/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Glycosaminoglycans); 059QF0KO0R (Water)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191442


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[PMID]:29192043
[Au] Autor:Beltran E
[Ad] Endereço:Department of Clinical Science & Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
[Ti] Título:Acute hydrated non-compressive nucleus pulposus extrusion: what do we know so far?
[So] Source:Vet Rec;181(22):591-593, 2017 12.
[Is] ISSN:2042-7670
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Deslocamento do Disco Intervertebral
Núcleo Pulposo
[Mh] Termos MeSH secundário: Animais
Disco Intervertebral
Degeneração do Disco Intervertebral
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1136/vr.j5494


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[PMID]:29384883
[Au] Autor:Lu Y; Bao W; Wang Z; Zhou F; Zou J; Jiang W; Yang H; Zhang Z; Zhu X
[Ad] Endereço:Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou.
[Ti] Título:Comparison of the clinical effects of zero-profile anchored spacer (ROI-C) and conventional cage-plate construct for the treatment of noncontiguous bilevel of cervical degenerative disc disease (CDDD): A minimum 2-year follow-up.
[So] Source:Medicine (Baltimore);97(5):e9808, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Comparing the clinical and radiographic outcomes in anterior cervical discectomy and fusion (ACDF) using a zero-profile anchored spacer (ROI-C) or a conventional cage-plate construct (CPC) for treating noncontiguous bilevel of cervical degenerative disc disease (CDDD).Overall, 46 patients with 2 noncontiguous segments of CDDD, treated with ACDF from January 2011 to October 2015, were included in this study. ROI-C was used in 22 patients (group A) and CPC in 24 patients (group B). The clinical and radiographic outcomes and complications were compared pre- and postoperatively. All patients were followed up for at least 24 months after surgery.No significant difference was found in fusion rate, cervical curvature, height of fused segment (FSDH), intraoperative blood loss, and Japanese Orthopaedic Association (JOA), and Neck Disability Index (NDI) scores between the 2 groups. Group A had a shorter operation time and significantly lower incidence of dysphagia (3 and 24 months postoperatively) than group B (P < .001 and P < .05, respectively). Moreover, group A had a higher loss of FSDH than group B, but with no difference between the 2 groups (P > .05). Two cages developed subsidence in group A (4.5%) and 2 adjacent levels developed degeneration in group B (2,8%).ACDF with ROI-C device was superior to CPC for noncontiguous bilevel of CDDD because it avoided postoperative dysphagia and required a shorter operation time. Moreover, the clinical outcomes were comparable. Prospective trials with larger samples and longer follow-up are required to confirm the results.
[Mh] Termos MeSH primário: Vértebras Cervicais
Fixadores Internos
Degeneração do Disco Intervertebral/cirurgia
Fusão Vertebral/instrumentação
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Degeneração do Disco Intervertebral/diagnóstico por imagem
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009808


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[PMID]:29381927
[Au] Autor:Sun D; Li Q; Tang Y; Gong W; He L; Dou Z; Ni J
[Ad] Endereço:Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China.
[Ti] Título:Comparison of coblation annuloplasty and radiofrequency thermocoagulation for treatment of lumbar discogenic pain.
[So] Source:Medicine (Baltimore);96(47):e8538, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to compare the effectiveness and safety of coblation annuloplasty and radiofrequency thermocoagulation for lumbar discogenic pain.Patients who suffered from lumbar discogenic pain and underwent coblation annuloplasty and radiofrequency thermocoagulation surgery were included. A questionnaire, including the visual analo scale (VAS), MacNab criteria, pain relief rate, and any complications due to surgery, was completed by the patients with the help of a trained volunteer who was blinded to the study. Data were collected at 1 week, and 1, 3, 6, and 12 months after surgery. Significant pain relief was defined as postoperative pain relief ≥50% compared with the preoperative state. Any complications during or after surgery were also recorded.A total of 122 patients were included; 37 patients were lost in the follow-up and 85 were evaluated. Among these, 45 patients underwent coblation annuloplasty (CA group, n = 45) and 40 underwent radiofrequency thermocoagulation procedures (RF group, n = 40).VAS pain scores were decreased at 1 week and 1, 3, 6, and 12 months postoperatively compared with preoperation in both groups (P < .05). The CA group had significantly lower VAS scores at 6 and 12 months of follow-up than did the RF group (P < .05). According to the modified MacNab criteria, the proportions of patients with excellent and/or good results at 3, 6, and 12 months of follow-up were significantly higher in the CA group compared with the RF group (P < .05).Only 2 patients reported soreness at the needle insertion site in the CA group. However, 3 patients had soreness at the needle insertion site, 3 had increased intensity of low back pain, 1 had intracranial hypotension, and 2 had new numbness in the leg and foot in the RF group. At the 1-year follow-up, this numbness was present all of the time. No major complications occurred in the CA group.Our study suggests that CA is a more effective and safe minimally invasive procedure than RF for treating lumbar discogenic pain.
[Mh] Termos MeSH primário: Técnicas de Ablação/métodos
Degeneração do Disco Intervertebral/cirurgia
Vértebras Lombares
Procedimentos Ortopédicos/métodos
[Mh] Termos MeSH secundário: Técnicas de Ablação/efeitos adversos
Adulto
Idoso
Eletrocoagulação/efeitos adversos
Eletrocoagulação/métodos
Feminino
Seres Humanos
Degeneração do Disco Intervertebral/complicações
Dor Lombar/etiologia
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos
Procedimentos Ortopédicos/efeitos adversos
Medição da Dor
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008538



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