Guixing Qiu

Peking Union Medical College Hospital, Peping, Beijing, China

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Publications (78)150.29 Total impact

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    ABSTRACT: The aim of the present study was to summarize and analyze the complications of posterior vertebral column resection in patients with spinal tumors. The complications of 40 patients following surgery were recorded, and surgery-related parameters including segments, bleeding volume and surgical duration were recorded and analyzed. SPSS 12.0 software was used to analyze the correlation between the complications and these parameters retrospectively. A total of 36 complications were reported. The median follow-up duration of the patients was 14 months (range, 4-78 months). Transient late tracheal extubation was associated with higher intraoperative bleeding volume, lower preoperative forced vital capacity and forced expiratory volume in 1 sec. Replaced spinal segment subsidence was associated with increased duration of surgery, higher intraoperative bleeding volume and higher total blood transfusion volume. Thrombocytopenia was associated with increased duration of surgery and higher total blood transfusion volume. The majority of the complications were minor and did not affect the recovery of the patients. Active prevention is necessary to reduce the incidence of complications, in particular, major ones.
    Experimental and therapeutic medicine 11/2014; 8(5):1539-1544. · 0.34 Impact Factor
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    ABSTRACT: Study Design. A retrospective radiographic analysis.Objective. To assess the effect of unfused segments in the reconstitution of coronal balance after posterior selective thoracolumbar/lumbar (TL/L) curve fusion for adolescent idiopathic scoliosis.Summary of Background Data. Current literature suggests that compensatory changes occur after selective TL/L curve fusion surgery. Hitherto the roles of the unfused levels in coronal balance reconstitution have not fully understood.Methods. Radiographic data of idiopathic scoliosis patients that underwent selective posterior TL/L curve fusion at our hospital before October 2011 with a minimum of 2 years follow-up period was retrospectively analyzed. Changes of coronal trunk shift during the follow-up period were studied and multiple linear regression analysis was performed to determine its correlation with changes of upper and lower curve of unfused thoracic segments, instrumented segments angle, distal unfused segments angle and coronal sacral inclination.Results. A total of 43 patients were included in this study. Pre-operative and first erect radiographs demonstrated trunk shifts of 21.1mm and 18.7mm respectively, showing no significant differences (P = 0.205). At the last follow-up, it compensated to 9mm, which showed significant differences (P<0.01). Regression analysis of all patients showed that coronal trunk shift changes only correlated with distal unfused segments angle changes. Subgroup analysis based on the magnitude of preoperative thoracic curve found that only distal unfused segments had an impact on coronal balance reconstitution. However, subgroup analysis based on the flexibility of preoperative thoracic curve showed that both proximal unfused thoracic segments and distal unfused lumbar segments contributed to coronal balance compensation in patients with a thoracic curve flexibility rate of more than 70%.Conclusions. The reconstitution of coronal balance was mainly compensated by distal unfused segments after selective posterior fusion of TL/L idiopathic scoliosis. The effect of unfused thoracic segments in coronal balance reconstitution mainly depended on its flexibility.
    Spine 09/2014; · 2.16 Impact Factor
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    ABSTRACT: Study Design. Retrospective Case SeriesObjective. The objectives of this study were to 1) determine the rate of POUR in a series of patients undergoing lumbar spine surgery 2) compare length of stay between patients who developed POUR and patients who did not, and 3) identify the patient and surgical factors associated with the development of POUR.Summary of Background Data. Although post-operative urinary retention (POUR) is a common complication in many surgical subspecialties, sparse literature is present regarding development of POUR after posterior lumbar surgical procedures.Methods. A retrospective review was conducted of all posterior lumbar surgery cases performed at single institute from July 2008 to July 2012. Data collected included demographic variables (age, sex, BMI), length of stay, comorbid medical conditions, and surgical data. Wilcoxon rank sum test with continuity correction was used to compare length of stay between patients who developed POUR and patients who did not. A multivariate logistic regression model was created using all patient and surgical factors and systematically pruned of variables not improving overall predictive power.Results. 647 patients (291 decompression, 356 decompression and fusion) were included in the study. 36 of 647 patients had urinary retention after lumbar spine surgery (5.6%). Patients who developed POUR had a longer length of stay compared to patients who did not develop POUR (3.94 days vs. 2.34 days, p = 0.005). Male gender, BPH, age, diabetes, and depression were significantly associated with development of POUR (OR: 3.05, 9.82, 1.04, 3.32, and 2.51, respectively). Smoking was inversely associated with the development of POUR (OR: 0.45).Conclusions. The risk of developing POUR following posterior lumbar spine surgery is approximately 5%. Male gender, BPH, age, diabetes, and depression were significantly associated with the POUR group. Patients who developed POUR had a greater length of stay.
    Spine 09/2014; · 2.16 Impact Factor
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    ABSTRACT: Cartilage-derived mesenchymal stem cells (MSCs) have been isolated with different methods. In this study lateral and medial femoral condyles were respectively collected from patients with late-stage osteoarthritis during the total knee arthroplasty. After digestion of the cartilage tissues with type II collagenase and analysis by fluorescence-activated cell sorting (FACS) with CD146, a chondroprogenitor cell sub-population were isolated and purified. The expression of other MSC-associated markers in the CD146+ chondroprogenitors was analyzed by flow cytometry. Multi-lineage differentiation capacity of CD146+ chondroprogenitors was compared with that of unsorted chondrocytes and adipose-derived MSCs (ADMSCs). Higher percentage of CD146+ chondroprogenitors isolated from the medial femoral condyles was observed than that from the lateral. CD146+ chondroprogenitors expressed high levels of MSC-specific surface antigens, and showed higher chondrogenesis capacity than ADMSCs and unsorted chondrocytes in a 3D cell pellet culture model. Thus CD146 might be a new cell surface marker for cartilage progenitor cell population in the late-stage osteoarthritis. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res
    Journal of Orthopaedic Research 09/2014; · 2.88 Impact Factor
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    ABSTRACT: Study Design. A genetic association study of single nucleotide polymorphisms (SNPs) for LMX1A gene with congenital scoliosis (CS) in a Chinese Han populationObjective. To determine whether LMX1A genetic polymorphisms are associated with susceptibility to CS.Summary of Background Data. CS is a lateral curvature of the spine due to congenital vertebral defects, whose exact genetic etiology has not been well established. LMX1A gene was suggested as a potential human candidate gene for CS. However, no genetic study of LMX1A in CS has ever been reported.Methods. We genotyped thirteen SNPs of LMX1A gene in 154 CS patients and 144 controls with matched sex and age. After Hardy-Weinberg Equilibrium test, the data of thirteen SNPs were analyzed by the allelic and genotypic association with logistic regression analysis. Furthermore, the genotype-phenotype association and haplotype association analysis were also performed.Results. The thirteen SNPs of LMX1A gene met Hardy-Weinberg equilibrium in the controls, which was not in the cases. None of the allelic and genotypic frequencies of these SNPs showed significant difference between case and control group (P0.05). However, the genotypic frequencies of rs1354510 and rs16841013 in LMX1A gene were associated with CS predisposition (P=0.02 and 0.018 respectively). Genotypic frequencies of 3 SNPs at rs6671290, rs1354510, and rs16841013 were found to exhibit significant differences between CS patients with failure of formation and the healthy controls (P=0.019, 0.007 and 0.006 respectively). Besides, in the model analysis by using unconditional logistic regression analysis, the optimized model for the three genotypic positive SNPs with failure of formation were rs6671290 (codominant, P=0.025, AIC=316.6, BIC=333.9), rs1354510 (overdominant, P=0.0017, AIC=312.1, BIC=325.9) and rsl6841013 (overdominant, P=0.0016, AIC=311.1, BIC=325) respectively. However, the haplotype distributions in the case group were not significantly different from those of control group in the three haplotypic blocks.Conclusion. To our knowledge, this is the first study identifying the SNPs of LMX1A gene might be associated with the susceptibility to CS and different clinical phenotypes of CS in Chinese Han population.
    Spine 08/2014; · 2.16 Impact Factor
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    ABSTRACT: Object There are limited published data about the risk factors for the development of delayed infections after spinal fusion and instrumentation in the population with scoliosis. The objective of this study was to evaluate the predictive factors of development of delayed infections in patients with scoliosis who underwent surgical treatment. Methods A total of 17 patients with scoliosis and delayed infections were identified from 3463 patients with scoliosis who received surgical treatment. The control group was composed of 85 patients with scoliosis without infections, matched for sex, age, approximate date of surgery, and diagnosis. These 2 groups were compared for demographic distribution and clinical data to investigate the predictive factors of delayed infections. Results The overall incidence rate of delayed infections was 0.49%. The variables of age, body mass index, and number of levels fused were similar between the 2 groups. The average primary curve magnitude for the delayed infection and control (uninfected) groups was 80.4° ± 27.0° (range 47°-135°) and 66.3° ± 11.6° (range 42°-95°), respectively (p = 0.001). Operation time in the group with delayed infections was 384.7 ± 115.9 minutes versus 254.4 ± 79.2 minutes in the control group (p = 0.000), and estimated blood loss was 1342.2 ± 707.2 ml versus 833.9 ± 235.6 ml (p = 0.000) in these 2 groups, respectively. The perioperative mean red blood cell transfusion requirement in the delayed infection group was significantly higher than that found in patients without infections (2.8 ± 2.3 units/patient versus 1.1 ± 1.6 units/patient, respectively; p = 0.000). Logistic regression analysis showed that operation time and allogenic blood transfusion were the 2 independent predictors of delayed infections (odds ratio [OR] 1.021, 95% confidence interval [CI] 1.010-1.033, and OR 1.546, 95% CI 1.048-2.278, respectively). Conclusions The occurrence of a delayed infection in patients with scoliosis who undergo surgical treatment is most likely multifactorial and is related to surgical time and the use of allogenic blood transfusion.
    Journal of neurosurgery. Spine. 07/2014;
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    ABSTRACT: To evaluate the biocompatibility of SLS-produced titanium alloy scaffold in vitro and investigate the therapeutic effects in repairing segmental bone defects.
    Zhonghua yi xue za zhi. 05/2014; 94(19):1499-502.
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    ABSTRACT: To determine: (1) the relationship of thoracic cage parameters and preoperative pulmonary function tests (PFTs) in congenital scoliosis (CS) patients. (2) if patients with rib deformity have greater impairment of PFTs than those without rib deformity. A total of 218 patients with CS and pulmonary dysfunction (FVC < 80 %) were conducted in one spine center between Jan 2009 and Mar 2013. The demographic distribution, medical records, PFTs and radiographs of all patients were collected. The association of PFTs and thoracic cage deformities was analyzed. In total, 143 patients (65.6 %) had a clinically relevant impairment of pulmonary function. They had smaller BMI, larger thoracic transverse and anteroposterior diameter, more thorax height, scoliotic angle and number of involved vertebra than no clinically impairment. PFTs were negative correlation significantly with scoliotic angle, number of involved vertebra and thoracic sagittal diameter, while thorax height is significant positive. The T1-12 height was significant positive correlation with age, stature, weight, thoracic transverse and sagittal longitudinal diameter, while negative correlation with scoliotic curve, number of involved vertebra, as well as kyphotic angle. PFTs do not correlate with T1-12 height, but significantly associated with the rib anomalies. The FVC and FEV1 were significantly lower in patients with rib anomalies than without rib anomalies. There was no association between the pulmonary function and the location of rib deformities. PFTs correlate significantly with scoliotic angle, number of involved vertebra, thoracic sagittal diameter, and thorax height. PFTs were significantly lower in patients with rib anomalies, particular to the patients with fused rib.
    European Spine Journal 05/2014; · 2.47 Impact Factor
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    ABSTRACT: To determine fusion necessity to one level below lower-end vertebra (LEV+1) in selective posterior fusion of moderate thoracolumbar/lumbar (TL/L) idiopathic scoliosis. A total of 37 patients with moderate TL/L idiopathic scoliosis (Cobb angle of TL/L curve between 30° and 60°) were identified and three patients with TL/L curve Cobb angle more than 60° were excluded. And the follow-up period was at least 2 years. Lowest instrumented vertebra (LIV) was one level proximal to LEV in three patients, LEV in 22 patients and LEV+1 in 12 patients. The three patients with TL/L Cobb angle more than 60° were all fused to LEV+1. Clinical and various radiographic measurements were collected before surgery, post-surgery and during last follow-up, and analytical comparisons were made between LIV = LEV patients and LIV = LEV+1 patients. No significant difference was observed regarding clinical and radiographic parameters between LEV group and LEV+1 group preoperatively except LIV disc angle and LIV translation. The correction rate of unfused thoracic curve and TL/L curve was 52.7 and 79.9 % in LEV group and 52.5 and 83.7 % in LEV+1 group at the last follow-up, indicating no significant difference (P = 0.976 and P = 0.415, respectively). Coronal balance and sagittal alignments were also comparable between the two groups. LIV translation was slightly less in LEV+1 group (P = 0.028) at the last follow-up on the basis that LEV+1 was less translated than LEV preoperatively. Our analysis almost showed no benefit for fusing to LEV+1 in moderate TL/L idiopathic scoliosis patients undergoing posterior selective fusion with pedicle screws. For patients with TL/L Cobb angle more than 60°, the distal fusion level probably needs to be LEV+1.
    European Spine Journal 03/2014; · 2.47 Impact Factor
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    ABSTRACT: Retrospective case control study. To assess patient quality of life with different fusion levels in posterior pedicle screw correction of idiopathic scoliosis. No previous study has been demonstrated differences of health-related quality of life (HRQoL) between patients fused to L3 versus L4. A retrospective study was conducted on 30 scoliotic patients fused to L3 using a complete pedicle screw instruments. 30 age- and gender-matched scoliotic patients fused to L4 as the control group. Radiologic parameters were assessed before surgery and at latest follow-up between the two groups. These two groups were compared for the SRS-22, ODI, VAS and SF-36 questionnaires which were administered preoperatively and at final follow-up. There were no significant differences in gender, age, follow-up duration, the distribution of curve patterns, the postoperative residual Cobb angle of the main curve, complications, or surgical method between the L3 group and the L4 group (P>0.05). Preoperative scores were statistically similar in the L3 and L4 groups for all domains of all questionnaires. There was no difference between L3 and L4 group for ODI (P=0.527) and VAS (P=0.518). There were no significant differences in the scores on function/activity, self-image/appearance, pain, mental health or satisfaction with treatment domains between the two groups. No significant differences between two groups were found at final follow-up in the SF-36 subscales/domain scores. This study attempted to elucidate the correlation between the length of fusion and functional outcome; however, could not identify any difference between different fusion levels. On the basis of short-term results, there were no significant differences in the Questionnaire scores between the two groups.
    Journal of spinal disorders & techniques 02/2014; · 1.21 Impact Factor
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    ABSTRACT: Purpose: Low back pain is a global health problem in which more than 40% is caused by lumbar intervertebral disc degeneration (LDD). ADAMTS-5 (A disintegrin and metalloproteinase with thrombospondin motifs-5) was shown to be involved in LDD by functional analyses. To identify whether there is an association between ADAMTS-5 and LDD, and what is the contribution of ADAMTS-5 genetic polymorphisms to MD (Mean diffusivity) changes in lumbar IVD (Intervertebral disc). We firstly genotyped selected ADAMTS-5 SNPs (Single nucleotide polymorphisms) in a Chinese Han population. After the primary analyses of allelic, genotypic, and haplotypic association, we performed SNP-SNP interaction analysis. We subsequently genotyped another 50 participants and acquired the corresponding MD values from individual lumbar IVDs. The association analysis between the genotypic groups divided by the above positive SNPs and the corresponding MD values were also performed. Significant associations were identified in rs151058, rs229052, and rs162502. None of the 2-SNP haplotypic analysis survived the 10,000 permutation test. The following interaction analysis demonstrated that rs151058 was strong associated with LDD when conditioning on rs162502. Significant difference of MD values between AA and G+ carriers was identified in rs162502. This is the first study indicating that the SNPs of ADAMTS-5 may contribute to predisposition of LDD. An interaction between rs151058 and rs229052 may exist in ADAMTS-5 with LDD. The rs162502 might be associated with altered MD values. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
    Journal of Orthopaedic Research 01/2014; · 2.88 Impact Factor
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    ABSTRACT: Bacterial cellulose (BC) has been proposed as a biomaterial applied in biomedical scope due to its good biocompatibility. Recent reports showed that human adipose-derived stem cells (HASCs) have become a new choice to be used as seeding cells in tissue engineering. The objective of this study is to explore the potential of using BC and HASCs as scaffold and seeding cells in bone tissue engineering. The osteogenic differentiation was investigated by Von Kossa, Alizarin Red, ALP cellular staining and RT-PCR. The results showed that HASCs took a successful osteogenic differentiation on BC. Moreover, the in vivo animal test also provided the confirmation of the repair ability of BC on damaged bone. In conclusion, the author demonstrates the osteogenic differentiation of HASCs on BC and the feasibility of using BC and HASCs as scaffold and seeding cells in bone tissue engineering.
    Carbohydrate Polymers 01/2014; 104:158–165. · 3.48 Impact Factor
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    ABSTRACT: No recent studies have analyzed the rates of or reasons for unanticipated revision surgery within 30 days of primary surgery in spinal deformity patients. Our aim was to examine the incidence, characteristics, reasons, and risk factors for unplanned revision surgery in spinal deformity patients treated at one institution. All patients with a diagnosis of spinal deformity presenting for primary instrumented spinal fusion at a single institution from 1998 to 2012 were reviewed. All unplanned reoperations performed within 30 days after primary surgery were analyzed in terms of demographics, surgical data, and complications. Statistical analyses were performed to obtain correlations and risk factors for anticipated revision. Of 2758 patients [aged 16.07 years (range, 2-71), 69.8% female] who underwent spinal fusion surgery, 59 (2.1%) required reoperation within 30 days after primary surgery. The length of follow up for each patient was more than 30 days. Of those that required reoperation, 87.0% had posterior surgery only, 5.7% had anterior surgery, and 7.3% underwent an anteroposterior approach. The reasons for reoperation included implant failure (n = 20), wound infection (n = 12), neurologic deficit (n = 9), pulmonary complications (n = 17), and coronal plane imbalance (n = 1). The risk factors for reoperation were age, diagnosis, and surgical procedure with osteotomy.
    PLoS ONE 01/2014; 9(3):e87172. · 3.53 Impact Factor
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    ABSTRACT: Erythropoietin (EPO)/erythropoietin receptor (EPOR) signaling is involved in the development and regeneration of several non-hematopoietic tissues including the skeleton. EPO is identified as a downstream target of the hypoxia inducible factor-α (HIF-α) pathway. It is shown that EPO exerts a positive role in bone repair, however, the underlying cellular and molecular mechanisms remain unclear. In the present study we show that EPO and EPOR are expressed in the proliferating, pre-hypertrophic and hypertrophic zone of the developing mouse growth plates as well as in the cartilaginous callus of the healing bone. The proliferation rate of chondrocytes is increased under EPO treatment, while this effect is decreased following siRNA mediated knockdown of EPOR in chondrocytes. EPO treatment increases biosynthesis of proteoglycan, accompanied by up-regulation of chondrogenic marker genes including SOX9, SOX5, SOX6, collagen type 2, and aggrecan. The effects are inhibited by knockdown of EPOR. Blockage of the endogenous EPO in chondrocytes also impaired the chondrogenic differentiation. In addition, EPO promotes metatarsal endothelial sprouting in vitro. This coincides with the in vivo data that local delivery of EPO increases vascularity at the mid-stage of bone healing (day 14). In a mouse femoral fracture model, EPO promotes cartilaginous callus formation at days 7 and 14, and enhances bone healing at day 28 indexed by improved X-ray score and micro-CT analysis of microstructure of new bone regenerates, which results in improved biomechanical properties. Our results indicate that EPO enhances chondrogenic and angiogenic responses during bone repair. EPO's function on chondrocyte proliferation and differentiation is at least partially mediated by its receptor EPOR. EPO may serve as a therapeutic agent to facilitate skeletal regeneration.
    PLoS ONE 01/2014; 9(7):e102010. · 3.53 Impact Factor
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    ABSTRACT: Background Total knee arthroplasty (TKA) is commonly performed using a tourniquet. However, some studies have reported that several complications were associated with the use of a tourniquet in TKA. In this study we investigate whether the limited use of a tourniquet in TKA would reduce complications and facilitate postoperative recovery. Methods Sixty patients were randomly divided into two groups (30 cases/group): group A using the tourniquet throughout the surgical procedure, and group B using the tourniquet starting from the cementation to the completion of the procedure. Operation time, total measured blood loss, and incidence of complications were all recorded. Results There was no significant difference in operation time, total measured blood loss, and hemoglobin concentration between the two groups. Incidence of postoperative complications in group B was significantly decreased in comparison to that in group A. The limb circumference at 10 cm above the superior patellar pole or below the inferior patellar pole and the pain score in group B were significantly decreased compared with that in group A at any time point. Range of motion in group B was significantly increased at three and 5 days postoperatively in comparison to that in group A. Conclusions The limited use of a tourniquet in TKA provides the benefit of decreased limb swelling and knee joint pain while not compromising the operation time or blood loss and recovery. Level of evidence Level I (Therapeutic). Trial registration number NCT02102581.
    The Knee 01/2014; · 2.01 Impact Factor
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    ABSTRACT: Retrospective review. To identify the incidence and characteristics of rib anomalies in patients with congenital scoliosis (CS) in a Chinese population. Rib deformities and intraspinal anomalies often coexist in individuals with CS. Rib deformities may assist in diagnosing occult anomalies in these patients. The incidence of rib anomalies and the relationship between rib and vertebral abnormalities in Chinese patients with CS have not been reported. A total of 382 patients operated on at Peking Union Medical College Hospital during January 2010 to October 2012 were identified from a single institutional database. The demographic distribution, clinical and radiographical data were collected to investigate the incidence of rib anomalies, and the vertebral and intraspinal abnormalities associated with it. A total of 192 patients (50.3%) were documented with rib anomalies including numerical variation (46.4%) and structural changes (72.4%). Missing ribs was the most commonly seen anomaly in these patients, accounting for 43.8% of the rib anomalies. Of the patients with rib anomalies, a slightly higher proportion of patients had simple anomalies, 106 (55.2%) versus 86 (44.8%). Rib changes were most common in patients with thoracic or thoracolumbar vertebral anomalies, and occurred most frequently on the concave side (65.5%) or in the lower thoracic spine (36.5%). The overall incidence rate of intraspinal anomalies was 40.1% (153/382), and these were most commonly seen in patients with thoracic vertebral anomalies or with upper and middle thoracic rib anomalies. The incidence of rib anomalies was 50.3% in surgical patients with CS. The rib anomalies vary with the location and type of vertebral anomalies. The incidence of intraspinal anomalies was significantly higher in patients with rib anomalies than in those without rib anomalies.Level of Evidence: 4.
    Spine 12/2013; 38(26):E1656-61. · 2.16 Impact Factor
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    ABSTRACT: Retrospectively study. To analyze whether there were differences of mental health scores of Scoliosis Research Society-22(SRS-22) questionnaire and Short Form-36(SF-36) questionnaire between adolescent idiopathic scoliosis (AIS) patients with/without preoperative brace treatment. Mental health is an important domain of SRS-22 and SF-36 questionnaire. There are few studies focused on the effect of preoperative brace treatment on the mental health in surgically treated AIS patients. The SRS-22 and SF-36 questionnaires of 211 AIS patients who underwent posterior correction surgery were retrospectively reviewed. The average age of the patients was 14.4 years old (range, 11 to 18), and the patients were classified into 2 groups: with preoperative brace treatment (group BS-32 cases, 5 males and 27 females) and without preoperative brace treatment (group S-179 cases, 23 males and 156 females). Compare the radiographic data and mental health scores of SRS-22 and SF-36 questionnaires between the 2 groups. There was no significant difference in terms of height, rib hump, the mean preoperative coronal Cobb angle or apical vertebral translation of the major curve, sagittal thoracic kyphosis or coronal trunk balance between group BS and group S (all P>0.05). The average and total mental health scores of SRS-22 between group BS and group S were 3.6±0.7 and 3.7±0.5, and 18.1±3.5 and 18.3±2.6, respectively. The total mental health scores of SF-36 between group BS and group S were 71.1±8.7 and 68.7±11.5, respectively. There was none significant difference of the mental health scores of SRS-22 and SF-36 questionnaires between group BS and group S (all P>0.05). Preoperative brace treatment didn't have obvious influence on the mental health scores of SRS-22 and SF-36 questionnaires in surgically treated AIS patients.
    Journal of spinal disorders & techniques 11/2013; · 1.21 Impact Factor
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    ABSTRACT: Study Design. Retrospective studyObjectives. To evaluate the clinical outcomes of the hybrid technique of one stage posterior osteotomy with short segmental fusion and dual growing rod technique for severe rigid congenital scoliosis.Summary of Background Data. As some types of congenital scoliosis consist of long curve including sharp deformities producing enormous asymmetric growth at apex, they can't be well corrected with osteotomy and short segmental fusion. Growing rod technique may be the best option. However, enormous asymmetric growth potential due to the sharp deformities at apex will increase risk of complications, especially implants failures.Methods. 7 patients (2males, 5 females) undergoing this hybrid technique for severe rigid congenital scoliosis were retrospectively reviewed. The patients' charts were reviewed. The Analysis included age at initial surgery and the latest follow-up, number and frequency of lengthening, and complications. Radiographic evaluation included measured changes in scoliosis Cobb angle, thoracic kyphosis, lumber lordosis, trunk shift, length of T1-S1 and instrumentation.Results. The mean follow up was 53.3 (30-77) months. The mean age at the initial is 5.9 (2-10) years. The averaged lengthenings were of 5.3 per patient. The mean scoliosis improved from81.4° to 40.1° after initial surgery and was 41.0° at the latest follow-up. The average T1-S1 length was of 1.23cm per year. The SAL increased from 0.86 to 0.96.Conclusion. Osteotomy with short fusion could help to improve the correction of the growing rod and eliminate the large asymmetric growth potential around the apex, with little influence to the length of the spine. Dual growing rod technique could maintain correction achieved at initial surgery while allowing spinal growth to continue. This hybrid technique may be an option for young patients who present sharp deformities with large asymmetric growth potential in a long congenital spinal deformity.
    Spine 11/2013; · 2.16 Impact Factor
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    ABSTRACT: Study Design. A retrospective study.Objective. To analysis the cerebrospinal fluid (CSF) leak during the thoracic pedicle screw fixation in spinal deformities, the relative intraoperative neuromonitoring changes and the strategy for managementSummary and Background Date. Cerebrospinal fluid leak may occurred during the preparation of trajectory of thoracic pedicle screws in scoliosis surgery. The strategy for management of such situation is controversial. There is limited literature about the CSF leak and concomitant neuromonitoring change.Methods. A total of 695 patients with spinal deformity subjected to correction by posterior instrumentation using thoracic pedicle screw fixation from 2008 January to 2010 December and followed up for more than 2 years were retrospectively analyzed for CSF leak during pedicle screw placement and the concomitant neuromonitoring changes. The cases with CSF leak and with complete information about neuromonitoring were reviewed.Results. A total of 7284 thoracic pedicle screws were inserted in the thoracic level (10.4 screws/patient). All the procedures were performed under the intraoperative neuromonitoring. There were eight cases of CSF leak with the rate of 0.11% during the screw trajectory preparation. Seven of the screws located at the concave side. Five cases presented with concomitant positive intraoperative neuromonitoring changes. The holes were sealed for three of them, and patients presented with reversible monitoring changes and intact neurologic function. Negligence of the CSF leak and screw insertion caused the deterioration of neuromonitoring even neurologic deficit which needed revision surgery. Three cases presented without intraoperative monitoring changes and woke up without neurologic deficit.Conclusion. The factors impacting the safety of screw placement for CSF leak included screw position, segment of vertebra and concomitant neuromonitoring changes. Commonly, it was not necessary to repair the dural tear and sealing the pedicle hole with bone wax for the case with reversible neuromonitoring changes was all that needed. A lateral entry point to the initial one could be used and to continue the screw placement when neuromonitoring demonstrate reversible positive changes.
    Spine 10/2013; · 2.16 Impact Factor
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    ABSTRACT: To determine the reliability of pedicle screws placed in children younger than 7 years of age, and to evaluate the effect of pedicle screw insertion on further growth of the vertebra and spinal canal. A retrospective study of 35 consecutive patients through Jan 2003-Dec 2010 for congenital scoliosis in <7 years children was performed at one spine center. Patients undergoing pedicle screw instrumentation of at least two levels, which had been followed-up for at least 24 months were included. Measurements were performed in instrumented and adjacent non-instrumented levels. The effect of pedicle screw insertion on further growth was evaluated. The average age at surgery was 4.4 year (53 months, range, 23-84 months). 190 segments in 35 patients met the inclusion criteria. 77 segments had no screws and 113 had at least one screw. There was a significant difference between the pre-operative and final follow-up values of the measurement of spinal canal and vertebral body parameters (P < 0.001). No significant difference existed between growth rates of vertebral bodies and the sagittal diameters of spinal canal with or without screws. The growth rates of vertebral bodies in lumbar spine were higher than in thoracic spine in both instrumented and adjacent groups. Pedicle screw instrumentation does not cause a retardation effect on the development of vertebral bodies and the spinal canal in children at an early age. It is a safe and reliable procedure to achieve a stable fixation.
    European Spine Journal 09/2013; · 2.47 Impact Factor

Publication Stats

276 Citations
150.29 Total Impact Points

Institutions

  • 2002–2014
    • Peking Union Medical College Hospital
      Peping, Beijing, China
  • 2013
    • University of Jinan (Jinan, China)
      Chi-nan-shih, Shandong Sheng, China
  • 2002–2013
    • Peking Union Medical University
      Peping, Beijing, China
  • 2011
    • University of Maryland, Baltimore
      • Center for Vascular and Inflammatory Diseases
      Baltimore, MD, United States
  • 2010
    • Capital Medical University
      Peping, Beijing, China
  • 2009
    • Icahn School of Medicine at Mount Sinai
      Manhattan, New York, United States