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ABSTRACT: Study Design. follow-up of animals after surgically initiated scoliosisObjective. To develop quantitatively asymmetric loads on rat lumbar to create scoliosisSummary of Background Data. Current animal models for scoliosis use mostly rigid or flexible posterior asymmetric tethers. The curve progression can only be expected for the growth potential, leading to insufficient growth potential for validation of corrective techniques.Methods. Scoliosis was induced in fifty-five 5-week-old female SD rats using a nickel-titanium (NT) coil spring. The experimental rats were randomly divided into two groups: In Group A (n = 15), the NT coil spring was not removed until these rats reached physical maturity (age, 12 weeks). Group B (n = 40) was further randomly subdivided into five subgroups (n = 8 for each subgroup): removal of the spring after 1 week (Group B1), 2 weeks (Group B2), 3 weeks (Group B3), 4 weeks (Group B4), and 5 weeks (Group B5). All rats were followed for a 7-week period with serial radiographs to document change of the deformity.Results. All experimental animals of Group A developed progressive, structural scoliotic curves convex to the left in the lumbar segment. In Group B, the deformity of the lumbar progressed after the spring load was applied and regressed after the spring was removed. The scoliosis in Group B1-B3 (the spring removed before sexual maturity) regressed after spring removal until the rats reached sexual maturity (4 weeks after spring implant surgery). The scoliosis in Group B4-B5 (the spring removed after sexual maturity) regressed only during the first week after spring removal surgery. The average coronal Cobb angle was 7.8 ± 1.3˚ (range: 6.0-10.2˚) in Group B1 at the final follow-up and there was only one experimental rat that maintained a curve >10˚. The models of Group B2-B5 maintained stable scoliotic curves (coronal Cobb angle of L2-L5 > 10˚) convex to the left in the lumbar segment at the final follow-up.Conclusions. This study establishes a rat lumbar scoliosis model via asymmetric load. This method develops lumbar scoliosis in a short time and maintains the essential elements along the curve. It is suitable for the investigation of scoliosis.
Spine 05/2013; · 2.08 Impact Factor
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ABSTRACT: STUDY DESIGN:: Retrospectively study. OBJECTIVES:: To analyze the influence of preoperative brace treatment on the pulmonary function tests (PFTs) in female adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND:: Brace is a selection of conservative treatment for some AIS patients. Some authors reported that wearing brace could impair the PFTs, while there is no report that analyze the related factors. METHODS:: Preoperative PFTs were evaluated in 270 female patients with AIS. The patients were classified into two groups: group A-with preoperative brace treatment, 70 cases; group B-without preoperative brace treatment, 200 cases. Compare the differences of the PFTs between the 2 groups. RESULTS:: The predicted values of forced vital capacity (FVC) and forced expiratory volume in one second(FEV1) in group A and B were 3.26L and 3.20L, 2.78L and 2.73L, respectively(both P>0.05). The actual values of FVC and FEV1 in group A and B were 2.61L and 2.72L, 2.37L and 2.48L, respectively(both P>0.05). The percentage of actual value and predicted value of FVC(FVC%) and FEV1(FEV1%) in group A and B were 80.6% and 85.2%, 85.7% and 91.1%, respectively, and group A had significant lower values than those of group B(both P<0.05). This difference was significant in patients with a primary thoracic curve (166 cases) (P<0.05), while not in patients with a primary thoracolumbar/lumbar curve(104 cases) (P>0.05). In group A, there were significant correlations between the sagittal Cobb angle of the thoracic curve and the actual values of FVC and FEV1, and FVC% and FEV1%(both P<0.05). CONCLUSIONS:: Preoperative brace treatment can reduce the FVC% and FEV1% in thoracic AIS. The sagittal Cobb angle of the thoracic curve may be the influential factors.
Journal of spinal disorders & techniques 02/2013; · 1.21 Impact Factor
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ABSTRACT: To explore perioperative management and postoperative effectiveness of hemophilia induced lesions of the foot and ankle.
Between June 1998 and February 2012, 10 cases (12 feet) of hemophilia induced lesions of the foot and ankle were treated with surgery, including 9 cases (11 feet) of hemophilia A and 1 case (1 foot) of hemophilia B. Single foot was involved in 8 cases and both feet in 2 cases, including 3 left feet and 9 right feet. All were males, aged from 13-41 years (mean, 22.6 years). Disease duration was 5-84 months (mean, 32.2 months). Preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was 43.2 +/- 21.1. Short Form 36 Health Survey Scale (SF-36) score was 45.4 +/- 20.0. All patients were given clotting factors (2 000-3 500 U) for pre-experiment and clotting factors substitution therapy was performed perioperatively. Four cases (4 feet) underwent arthrodesis, and 7 cases (8 feet) underwent Achilles tendon lengthening/tendon transposition (1 patient underwent tendon lengthening on the left foot and arthrodesis on the right foot).
The operation time was 65-265 minutes (mean, 141.1 minutes); 1 case had 400 mL blood loss and 200 mL autogenous blood transfusion, the other cases had less than 50 mL blood loss and no blood transfusion. Wounds healed by first intention in all patients, no postoperative infection, deep vein thrombosis, or other complications occurred. All cases were followed up 6 months to 14 years and 3 months (median, 22 months). The X-ray films at last follow-up showed the patients undergoing arthrodesis obtained complete joint fusion. AOFAS scores at postoperative 6 months and last follow-up were 78.8 +/- 14.7 and 75.8 +/- 14.5, respectively; SF-36 scores were 76.6 +/- 13.1 and 75.5 +/- 13.2, respectively; and significant differences were found when compared with preoperative scores (P < 0.05), but no significant difference between postoperative 6 months and last follow-up (P > 0.05).
For patients with hemophilia induced lesions of the foot and ankle, surgical treatment could relieve foot and ankle pain and improve the function. Clotting factors pre-experiment at preoperation and substitution therapy at perioperation can reduce the risk of severe postoperative hemorrhage.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 02/2013; 27(2):160-3.
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ABSTRACT: The pure motor peripheral nerves animal model, obtained by ablating the dorsal root ganglions (DRGs), was used to investigate the accuracy of peripheral nerve selective regeneration using small gap sleeve bridging compared to epineurium neurorrhaphy. The results showed that the number of improperly regenerated motor axons in the distal stump and the misrouting ratio were significantly lower when the nerve transection was treated by small gap sleeve bridging. This suggests that more accurate reinnervation may be achieved by small gap sleeve bridging than by traditional epineurium neurorrhaphy.
Artificial cells, nanomedicine, and biotechnology (Print). 01/2013;
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ABSTRACT: Obesity is an important risk factor for intervertebral disc degeneration and leptin is a biomarker of obesity. However, the expression of leptin receptors has not been determined in disc tissue. It is not known whether leptin has a direct effect on the nucleus pulposus (NP) cells. To determine whether the NP tissues and cells express leptin receptors (OBRa and OBRb) and whether leptin affects the organization and the expression of major cytoskeletal elements in NP cells. Messenger RNA (mRNA) and protein levels of OBRa and OBRb were measured by real-time PCR and Western blot, respectively, in NP tissues and cells. Immunofluorescence and real-time PCR and Western blot were performed to investigate the effect of leptin on cytoskeleton reorganization and expression. Results show that mRNA and proteins of OBRa and OBRb were expressed in all NP tissues and cells, and that OBRb expression was correlated with patients' body weight. Increased expression of β-actin and reorganization of F-actin were evident in leptin-stimulated NP cells. Leptin also induced vimentin expression but had no effect on β-tubulin in NP cells. These findings provide novel evidence supporting the possible involvement of leptin in the pathogenesis of intervertebral disc degeneration. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
Journal of Orthopaedic Research 01/2013; · 2.81 Impact Factor
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ABSTRACT: Study Design. Retrospective study of a series of 226 consecutive Chinese patients with congenital scoliosis.Objective. To identify the incidence of intraspinal abnormalities and other organ defects in surgical patients with congenital scoliosis in Chinese population.Summary of Background Data. Previous studies have revealed high rates of intraspinal anomalies and other organ defects in patients with congenital scoliosis. The incidence of abnormalities in patients with congenital scoliosis in Chinese population has not been reported.Methods. A total of 226 patients with congenital scoliosis underwent surgical treatment in our hospital between January 2005 and March 2011 were identified. All patients were definite diagnosis of congenital scoliosis. Complete data were reviewed, including medical records, plain radiograph, magnetic resonance imaging (MRI) screening of the whole spine, echocardiography, and renal ultrasound. The incidence of intraspinal abnormalities and other organ defects were analyzed.Results. Intraspinal abnormalities were found in 99 (43%) patients. Diastematomyelia was identified to be the most common intraspinal pathologic anomaly, which was different from the previous reports. The incidence of intraspinal anomaly in patients with failures of segmentation and mixed defects were significantly higher than those with failures of formation. Patients with thoracic hemivertebrae were found to have a higher incidence of intraspinal abnormalities than patients with lumbar hemivertebrae. Patients with intraspinal abnormality had a higher incidence of positive clinical findings than those with a normal MRI. However, the difference between the two groups was not statistically significant. Other organic defects were found in 91(40%) patients. Cardiac defects were detected in 18%, urogenital anomalies in 12% and gastrointestinal anomalies in 5% of the patients in this study.Conclusion. Diastematomyelia was found to be the most common intraspinal pathologic anomaly and cardiac defects were the most common extraspinal anomaly in surgical patients with congenital scoliosis in this study. MRI, echocardiography and ultrasound should be part of routine evaluation in all congenital cases before surgery, no matter positive clinical findings were found or not.
Spine 11/2012; · 2.08 Impact Factor
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ABSTRACT: PURPOSE: Until now there have been many reports on hemivertebra resection. But there were no large series on the posterior hemivertebra resection with bisegmental fusion. This is a retrospective study to evaluate the surgical outcomes of posterior hemivertebra resection only with bisegmental fusion for congenital scoliosis caused by fully segmented non-incarcerated hemivertebra. METHODS: In our study, 36 consecutive cases (19 males, 17 females) diagnosed with congenital scoliosis, resulting from fully segmented non-incarcerated hemivertebra, treated by posterior hemivertebra resection with bisegmental fusion were investigated retrospectively, with at least a 3 year follow-up period (36-106 months). RESULTS: The total number of resected hemivertebra was 36. Mean operation time was 188.6 min with average blood loss of 364.2 ml. The segmental scoliosis was corrected from 36.6° to 5.1° with a correction rate of 86.1 %, and segmental kyphosis(difference to normal segmental alignment) from 21.2° to 5.8° at the latest follow-up. The correction rate of the compensatory cranial and caudal curve is 76.4 and 75.1 %. Unanticipated surgeries were performed on eight patients, including one delayed wound healing, two pedicle fractures, one progressive deformity and four implants removals. CONCLUSIONS: Posterior hemivertebra resection with bisegmental fusion allows for early intervention in very young children. Excellent correction can be obtained while the growth potential of the unaffected spine could be preserved well. However, it is not indicated for the hemivertebra between L5 and S1. The most common complication of this procedure is implant failure. Furthermore, in the very young children we noted that although solid fusion could be observed in the fusion level, implants migration may still happen during the time of adolescence, when the height of the body developed rapidly. So a close follow-up is necessary.
European Spine Journal 11/2012; · 1.97 Impact Factor
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ABSTRACT: Study Design. Retrospective studyObjectives. To evaluate clinical outcomes of dual growing rod technique in treating children with congenital scoliosisSummary of Background Data. Published reports on dual growing rod technique results for early onset scoliosis demonstrate it to be safe and effective. However, the use of growing rod in congenital spinal deformities is controversial and there has been no reports on the results and complications of dual growing rod technique for congenital scoliosis with large series of patients.Methods. From 2004 to 2009, 30 patients with congenital scoliosis underwent dual growing rod procedures. Of 159 total procedures within the treatment period, 125 were lengthenings with an average of 4.2 lengthenings per patient. 5 patients with severe rigid deformity or kyphosis had an osteotomy at apex vertebra with short segmental fusion. The Analysis included age at initial surgery and final fusion (if applicable), number and frequency of lengthenings, and complications. Radiographic evaluation was conducted.Results. The mean scoliosis improved from72.3° to 34.9° after initial surgery and was 35.2°at the last follow-up or post-final fusion. T1-S1 length increased from 25.42 to 29.03cm after initial surgery and to 33.32 cm at last follow-up or post-final fusion with an average T1-S1 length increase of 1.49 cm per year. The space available for lung ratio in patients with thoracic curves improved from 0.84 to 0.96 at the latest follow-up.3 patients reached final fusion. Complications occurred in 7 of the 30 patients, and they had a total of 13 complications.Conclusion. The dual growing rod technique is safe and effective in the treatment of selected cases of long, complex congenital scoliosis. It maintains correction achieved at initial surgery while allowing spinal growth to continue. And it has an acceptable rate of complications. The osteotomy at the apex vertebra with short segmental fusion of the severe rigid scoliosis or the patients with kyphosis could help to improve the correction and decrease the implants failures, with little influence to the length of the spine.
Spine 09/2012; · 2.08 Impact Factor
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ABSTRACT: Retrospective review.
To evaluate the efficacy of multimodal intraoperative neuromonitoring for predicting iatrogenic neurological injury during surgical correction of a spine deformity and evaluate the potential risk factors for neurological monitoring changes.
Single modal intraoperative neuromonitoring is insufficient to predict neurological injury during surgical correction of spine deformity. Multimodal monitoring can provide more accuracy. Some risk factors were reported to be correlated with high rates of neurological deficits during scoliosis correction. But few studies have reported on the risk factors for neurological monitoring changes (NMCs).
The records of 176 consecutive patients who underwent surgery for the treatment of spinal deformities were reviewed. The patients were monitored using transcranial electric motor-evoked potential (MEP) and/or somatosensory-evoked potential (SEP). Alterations with the MEP wave amplitude decreasing more than 75% and SEP amplitude decreasing more than 50%, as compared with the baseline, were diagnosed as positive changes. Risk factors related to NMCs were evaluated, in light of preoperative neurological deficits, comorbidity of spinal cord deformity, procedure of osteotomy, main curve Cobb angle, and a diagnosis of kyphosis.
Combined MEP/SEP monitoring was successfully achieved in 175 of 176 cases. Eleven cases were presented with true NMCs according to MEPs. One patient had an irreversible neurological deficit and 4 patients had transient neurological deficits after waking up from the operation. SEP lagged MEP for an average of 15 minutes when both were presented with positive changes. The sensitivity and specificity of MEP were 91.7% and 98.8%, respectively. Solo SEP were 50% and 95.2%. Combined MEP and SEP were 92.9% and 99.4%. The procedure of osteotomy, curve Cobb angle more than 90 degrees, and preoperative kyphosis were correlated with a higher incidence of NMCs.
Multimodal intraoperative monitoring provides higher sensitivity for monitoring during spine deformity surgery and can predict events of neurological injury. The detection of NMCs and adjustment of surgical strategy may prevent irreversible neurological deficits. The possible risk factors for NMCs during spine deformity surgery include an osteotomy procedure, kyphosis correction, and preoperative Cobb angle more than 90 degrees.
Journal of spinal disorders & techniques 02/2012; 25(4):E108-14. · 1.21 Impact Factor
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ABSTRACT: An analysis of computed tomography (CT) images of patients with adolescent thoracic idiopathic scoliosis for posterior pedicle screw placement.
To evaluate the relative position of the aorta to the spine by the axial CT scans in patients with right thoracic idiopathic scoliosis, and to discuss the safe trajectory and screw length for posterior pedicle screw placement.
Posterior pedicle screw instrumentation and fusion are widely used in the correction of scoliosis. Pedicle screw placement in the thoracic spine implies risk of injuring the aorta. Literatures on the relative position of the aorta to the spine are mostly focused on the anterior surgery. However, few are reported about the posterior surgery.
A total of 47 patients with adolescent right thoracic idiopathic scoliosis who underwent CT scan of total spine before surgery were included in this study. Transverse plane including bilateral pedicles, lamina, and transverse process was selected for measurement from T4 to T12. We defined a new coordinate system, and 5 parameters were measured in each vertebral body from T4 to T12 of the patients. The point where the left pedicle axial line and the base of the left transverse process intersected was defined as the origin of the coordinate system. A line connecting bilateral intersection was defined as x-axis. y-axis perpendicular to the x-axis is drawn ventrally from the origin. The left pedicle-aorta angle (α), the left aorta angle (β), the left pedicle-aorta distance (PAD), the aorta-x-axis distance (AXD), and the vertebral rotation angle (γ) were measured.
The values of angles α and β had a tendency of first increasing and then decreasing, and increasing again from T4 to T12. The lowest value of angle α occurred at T10 (7.45±6.10 degrees), followed by T4 (8.89±6.49 degrees), T11 (9.13±7.59 degrees), and T9 (9.74±6.11 degrees). PAD and AXD values had a tendency of decreasing first and then increasing from T4 to T12. The lowest values of PAD and AXD occurred at T6; 25.94±5.33 and 23.64±6.53 mm, respectively. From the cephalad to the caudal spine, angle γ increased first and then decreased. The highest value occurred at T7 (2.32±6.83 degrees), which rotated to the right side. The second largest value occurred at T8 (2.23±7.76 degrees). Statistical analysis indicated that the apical vertebral translation and vertebral rotation angle were significantly positively correlated to angles α and β (P<0.05).
The highest risk of injuring the aorta when placing pedicle screw during posterior scoliosis surgery was at T10, followed by T4, T11, and T9 in right thoracic idiopathic scoliosis. Taking a spine CT scan and evaluating the relative position of the aorta to the thoracic spine before surgery are significant in precise and safe pedicle screw placement.
Journal of spinal disorders & techniques 02/2012; 25(4):E103-7. · 1.21 Impact Factor
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ABSTRACT: Increasing evidence suggests that obesity and aberrant proliferation of nucleus pulposus (NP) cells are associated with intervertebral disc degeneration. Leptin, a hormone with increased circulating level in obesity, has been shown to stimulate cell proliferation in a tissue-dependent manner. Nevertheless, the effect of leptin on the proliferation of human NP cells has not yet been demonstrated. Here, we show that leptin induced the proliferation of primary cultured human NP cells, which expressed the leptin receptors OBRa and OBRb. Induction of NP cell proliferation was confirmed by CCK8 assay and immunocytochemistry and Real-time PCR for PCNA and Ki-67. Mechanistically, leptin induced the phosphorylation of STAT3, Akt and ERK1/2 accompanied by the upregulation of cyclin D1. Pharmacological inhibition of JAK/STAT3, PI3K/Akt or MEK/ERK signaling by AG490, Wortmannin or U0126, respectively, reduced leptin-induced cyclin D1 expression and NP cell proliferation. These experiments also revealed an intricate crosstalk among these signaling pathways in mediating the action of leptin. Taken together, we show that leptin induces human NP cell cyclin D1 expression and proliferation via activation of JAK/STAT3, PI3K/Akt or MEK/ERK signaling. Our findings may provide a novel molecular mechanism that explains the association between obesity and intervertebral disc degeneration.
PLoS ONE 01/2012; 7(12):e53176. · 4.09 Impact Factor
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ABSTRACT: Most cases of congenital spinal deformities were sporadic and without strong evidence of heritability. The etiology of congenital spinal deformities is still elusive and assumed to be multi-factorial. The current study seeks to elucidate the effect of maternal vitamin A deficiency and the production of congenital spinal deformities in the offsping. Thirty two female rats were randomized into two groups: control group, which was fed a normal diet; vitamin A deficient group, which were given vitamin A-deficient diet from at least 2 weeks before mating till delivery. Three random neonatal rats from each group were killed the next day of parturition. Female rats were fed an AIN-93G diet sufficient in vitamin A to feed the rest of neonates for two weeks until euthanasia. Serum levels of vitamin A were assessed in the adult and filial rats. Anteroposterior (AP) spine radiographs were obtained at week 2 after delivery to evaluate the presence of the skeletal abnormalities especially of spinal deformities. Liver and vertebral body expression of retinaldehyde dehydrogenase (RALDHs) and RARs mRNA was assessed by reverse transcription-real time PCR. VAD neonates displayed many skeletal malformations in the cervical, thoracic, the pelvic and sacral and limbs regions. The incidence of congenital scoliosis was 13.79% (8/58) in the filial rats of vitamin A deficiency group and 0% in the control group. Furthermore, vitamin A deficiency negatively regulate the liver and verterbral body mRNA levels of RALDH1, RALDH2, RALDH3, RAR-α, RAR-β and RAR-γ. Vitamin A deficiency in pregnancy may induce congenital spinal deformities in the postnatal rats. The decreases of RALDHs and RARs mRNA expression induced by vitamin A deprivation suggest that vertebral birth defects may be caused by a defect in RA signaling pathway during somitogenesis.
PLoS ONE 01/2012; 7(10):e46565. · 4.09 Impact Factor
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ABSTRACT: STUDY DESIGN:: Prospective, randomized controlled clinical study. OBJECTIVE:: To evaluate the efficacy of subcutaneous closed-suction drainage in reducing blood loss as compared with conventional closed-suction drainage in adolescent idiopathic scoliosis cases undergoing posterior instrumented spinal fusion. BACKGROUND:: Subcutaneous closed-suction drainage is reported to be a reasonable alternative to intra-articular indwelling closed-suction drainage and to that of no usage of any drainage system in knee arthroplasty. However, little is reported about the use of subcutaneous closed-suction drainage in adolescents idiopathic scoliosis patients undergoing posterior instrumented spinal fusion. METHODS:: A total of 105 adolescent idiopathic scoliosis patients undergoing posterior instrumented spinal fusion were randomized into 2 groups of either a subcutaneous drainage or a conventional closed-wound suction drainage system. These 2 groups were compared for demographic distribution, blood loss (hemoglobin/hematocrit changes, transfusion requirements), and incidence of wound problems (requirements for dressing reinforcement, oozing, subcutaneous hematoma, ecchymosis, infection). RESULTS:: Mean drainage volume was less (P=0.000) in the subcutaneous closed-wound suction drainage group compared with the conventional closed-wound suction drainage group (42 vs. 631 mL). The groups were statistically similar in terms of hemoglobin and hematocrit values obtained on the third postoperative day (10.60 vs. 9.52 g/dL, P=0.110; 30.85% vs. 27.82%, P=0.226), on discharge (10.90 vs. 9.75 g/dL, P=0.114; 31.10% vs. 28.13%, P=0.147), transfusion requirements (31.2% vs. 45.6%, P=0.133), and incidence of wound problems. However, the core temperature values were higher in subcutaneous closed-wound suction drainage group compared with the conventional closed-wound suction drainage group (P=0.001), and the duration of fever was longer in the former compared with the latter (P=0.008). CONCLUSIONS:: The data suggest that subcutaneous closed-suction drainage offers a reasonable alternative to closed-wound suction drainage in adolescents idiopathic scoliosis patients undergoing posterior instrumented spinal fusion.
Journal of spinal disorders & techniques 11/2011; · 1.21 Impact Factor
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ABSTRACT: In this study, the effect of calcitonin on lumbar spinal fusion was studied in a New Zealand rabbit model.
To investigate whether calcitonin can enhance lumbar spinal fusion in a New Zealand rabbit model and whether calcitonin can enhance expression genes involved in osteogenesis and angiogenesis.
Calcitonin is used to treat osteoporosis and diseases involving accelerated bone turnover. Studies have shown that calcitonin might also promote bone cell proliferation and bone formation, suggesting its possible role in promoting spinal fusion, but few data are available.
The effect of calcitonin on lumbar spinal fusion was analyzed in 32 New Zealand rabbits. Each rabbit received 2 autologous iliac bone grafts (one between L4-L5 without fixation, one between L6-L7 with fixation). Sixteen rabbits received calcitonin (calcitonin group, 1 U/kg daily from day 1 to the day of sacrifice), whereas the other 16 did not (control). At weeks 1, 2, 4, and 8, after examination for spinal fusion with radiography, 4 rabbits from each group were sacrificed. Each graft was histologically scored under light microscopy. In addition, we analyzed the messenger RNA (mRNA) levels of collagen I (Col I), bone morphometric protein 2 (BMP-2), insulinlike growth factor-1 (IGF-1), and vascular endothelial growth factor (VEGF), genes known to be involved in osteogenesis and angiogenesis, in each graft.
With both fixation and without fixation, the bone grafts in rabbits receiving calcitonin showed a higher spinal fusion rate and higher histologic scores from week 2 to week 8, and had higher mRNA levels of Col I, BMP-2, IGF-1, and VEGF at all time points except BMP-2 and IGF-1 at week 1, than grafts in rabbits without receiving calcitonin.
Calcitonin can enhance lumbar spinal fusion. One mechanism might be through upregulating genes involved in osteogenesis and angiogenesis.
Spine 07/2011; 37(3):E139-46. · 2.08 Impact Factor
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ABSTRACT: Degenerative scoliosis (DS) is an important degenerative lumbar disease causing spinal dysfunction and affecting the quality of life of the elderly, and is associated not only with severe back or leg pain but also with complicated surgical outcomes. The pathogenesis of DS is still unknown. Therefore, it is very important to ascertain the etiology of degenerative scoliosis and establish related molecular markers predicting and controlling the scoliosis. For the first time, we used two-dimensional fluorescence DIGE to compare the serum proteome profiles of 12 DS patients and controls. Proteins found to be differentially expressed were identified by MALDI-TOF mass spectrometric analysis, coupled with database interrogation. Eleven spots that were differentially expressed in the sera of DS patients were found, and eight gene products were identified among these spots. Clusterin, CLU cDNA FLJ57622, ALB cDNA FLJ50830, Hypothetical short protein, HLA-A MHC class 1 antigen. (Fragment), ALB 23 kDa protein, Isoform 1 of G protein-regulated inducer of neurite outgrowth 1 (GPRIN I)and Ficolin-3 were down-regulated in the sera of DS patients. The decreased levels of Clusterin and Ficolin-3 were confirmed by Western blot. The information obtained with this proteomic analysis will be very useful in understanding the pathophysiology of DS as well as in finding candidates as drug targets of DS. These results may provide a novel approach for the pathogenesis study of DS.
Journal of Orthopaedic Research 06/2011; 29(12):1896-903. · 2.81 Impact Factor
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ABSTRACT: Th17 play a central role in autoimmune inflammatory responses. Th1 are also necessary for autoimmune disease development. The interplay of Th1 signals and how they coordinate with Th17 during inflammatory disease pathogenesis are incompletely understood. In this study, by adding Stat4 deficiency to Stat6/T-bet double knockout, we further dissected the role of Stat4 in Th1 development and colitis induction. We showed that in the absence of the strong Th2 mediator Stat6, neither Stat4 nor T-bet is required for IFN-γ production and Th1 development. However, addition of Stat4 deficiency abolished colitis induced by Stat6/T-bet double-knockout cells, despite Th1 and Th17 responses. The failure of colitis induction by Stat4/Stat6/T-bet triple-knockout cells is largely due to elevated Foxp3(+) regulatory T cell (Treg) development. These results highlight the critical role of Stat4 Th1 signals in autoimmune responses in suppressing Foxp3(+) Treg responses and altering the balance between Th17 and Tregs to favor autoimmune disease.
The Journal of Immunology 06/2011; 186(11):6597-606. · 5.79 Impact Factor
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ABSTRACT: To investigate apoptosis of osteoarthritic (OA) chondrocytes stimulated with different inhibitors targeting tumor necrosis factor-alpha (TNFα) pathway, we isolated first passage chondrocytes from OA patients and then treated them with the inhibitors in combination with TNFα, and then collected the stimulated chondrocytes for Western blotting. Chondrocytes from OA patients expressed cleaved caspase-3 and PARP, suggesting apoptotic background. We here, validated that 10 ng/ml of TNFα couldn't induce more chondrocytes apoptosis. PI3K inhibitor LY294002 or NF-κB inhibitor CAPE, but not mTOR inhibitor rapamycin and MEK1/2 inhibitor U0126 in combination with TNFα could facilitate apoptosis. CAPE-induced more apoptosis could be explained by c-FLIP downregulation more than cIAP1 upregulation. And, we showed the first time that PI3K-NF-κB pathway, but not mTOR pathway could prevent chondrocytes apoptosis induced by a pro-apoptotic factor TNFα and call for attention while trying to inhibit NF-κB as a therapeutic target.
Rheumatology International 04/2011; 32(7):2017-22. · 1.88 Impact Factor
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ABSTRACT: Thymic carcinomas (TC) are rare tumors, representing 0.2% to 1.5% of all malignancies, with extrathoracic metastases to liver, kidney and bone occurring in 1% to 15% of patients. Although TC exhibit highly aggressive biological behavior, spinal metastasis with cord compression is rare. We describe a 57-year-old man with a 2-month history of cervicodorsal pain diagnosed with TC with primary spinal metastasis. We conclude that TC should be considered in the differential diagnosis in patients who have developed spine metastatic tumors. Early detection and appropriate surgical treatment can lead to preservation of spinal stability and neurologic improvement.
Journal of Clinical Neuroscience 03/2011; 18(6):840-2. · 1.25 Impact Factor
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ABSTRACT: Kaposiform hemangioendothelioma (KHE) is a rare locally aggressive vascular tumor that usually presents as a superficial or deep soft tissue mass with associated cutaneous lesions. We report a unique spinal KHE with painless thoracic scoliosis in a 14-year-old girl. She underwent simultaneous tumor biopsy, spinal deformity correction and fusion. At 3 years follow-up, the patient's MRI showed no significant deterioration of process without any therapy. KHE presenting as scoliosis is rare and to our knowledge this is the first recognized case in the reported world literature.
European Spine Journal 03/2011; 20 Suppl 2:S309-13. · 1.97 Impact Factor
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ABSTRACT: There have been several reports on hemivertebra resection via a posterior-only procedure. However, the number of reported cases is small, and various types of instrumentation have been used. In our study, we retrospectively investigated 56 consecutive cases of congenital scoliosis that were treated by posterior hemivertebra resection with transpedicular instrumentation. Radiographs were reviewed to determine the type and location of the hemivertebra, the coronal curve magnitude and the sagittal alignment pre-operatively, post-operatively and at the latest follow-up. Radiographs were also used to assess implant failure and inter-body fusion. Surgical reports and patient charts were reviewed to record any peri-operative complications. Fifty-eight posterior hemivertebrae resections from 56 patients aged 1.5-17 years with fully segmented non-incarcerated hemivertebra were evaluated. The average age at surgery was 9.9 years (1.5-17 years). The average follow-up was 32.9 months (24-58 months). The mean fusion level was 5.0 segments (2-11 segments). There was a mean improvement of 72.9% in the segmental scoliosis, from 42.4° before surgery to 12.3° at the time of the latest follow-up, and there was a mean improvement of 70% in segmental kyphosis from 42.0° to 14.5° over the same time period. The thoracic kyphosis (T5-T12) averaged 10.8° before surgery and 23.9° at the latest follow-up. The lumbar lordosis (L1-S1) averaged -52.8° before surgery and -51.6° at the latest follow-up. Two cases with neurological claudications had complete recovery immediately after the surgery. There was one case of delayed wound healing, two fractures of the pedicle at the instrumented level, two rod breakages and one proximal junction kyphosis that required revision. There were no neurological complications. Radiolucent gaps were found in the residual space after resection on the lateral view in five cases, without any sign of implant failure or correction loss. Our results show that one-stage posterior hemivertebra resection with transpedicular instrumentation can achieve excellent correction, 360° decompression and short fusion without neurological complications. Pedicle cutting still remains a challenge in younger children when using bisegmental instrumentation. In addition, the radiolucent gaps in the residual space require further investigation.
European Spine Journal 02/2011; 20(10):1692-702. · 1.97 Impact Factor
