Weishi Li

Peking University Third Hospital, Peping, Beijing, China

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Publications (18)24.04 Total impact

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    ABSTRACT: Scheuermann's disease (SD) is a spinal disorder and includes both a classic form and an atypical form. Interestingly, its existence among the general population as well as the disc disease patients is common. One of our previous studies showed that about 18% of the hospital staff members meet the SD criteria. On the other hand, another study has demonstrated that 95.2% of the symptomatic thoracolumbar disc herniation (STLDH) patients meet the SD criteria, which suggests that STLDH is very likely a special form of SD. The purpose of this study was to discriminate the factors contributing to the development of STLDH by comparing STLDH patients with the healthy SD-like hospital staff members. This is a retrospective study including 33 STLDH patients who met the SD criteria and 30 SD-like hospital staff members. The STLDH group was chosen from a group of patients who underwent surgery after a diagnosis of STLDH (T10/11-L1/2) at our hospital between June 2007 and June 2010. SD-like hospital staff members were chosen from a database created in 2007, which contained a lumbar MR and low back pain (LBP) questionnaire of 188 hospital staff members. The demographic and radiologic characteristics were compared between groups. There was no statistical difference in sex, age, and height between the two groups. The STLDH patients had higher body weight, boby mass index, and thoracolumbar kyphotic angle than SD-like hospital staff members. In addition, STLDH patients had more levels of Schmorl's nodes (3.5±1.7 vs. 2.0±1.9, t = 3.364, P = 0.001) and irregular endplateson (4.0±1.9 vs. 2.7±1.9, t = 2.667, P = 0.010) compared to the SD-like hospital staff members. Higher body weight, higher body mass index, larger thoracolumbar kyphosis, and more Schmorl's nodes and irregular endplates on MR may be associated with the development of STLDH in "SD-like people."
    Chinese medical journal. 11/2014; 127(22):3862-6.
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    ABSTRACT: Study Design. A clinical study.Objective. To measure the changes in pulmonary function and thoracic volume associated with surgical correction of kyphotic deformities.Summary of Background Data. No prior study has focused on the pulmonary function and thoracic cavity volume before and after corrective surgery for kyphosis.Methods. Thirty-four patients with kyphosis underwent posterior deformity correction with instrumented fusion. Preoperative and postoperative pulmonary function was measured, and pulmonary function grade was evaluated as mild, significant, or severe. The change in preoperative to postoperative pulmonary function was analyzed, using six comparative sub-groupings of patients based on: age, severity of kyphosis, location of kyphosis apex, length of follow up time after surgery, degree of kyphosis correction, and number of segments fused. A second group of nineteen patients also underwent posterior surgical correction of kyphosis, which had thoracic volume measured preoperatively and postoperatively with CT scanning.Results. All of the pulmonary impairments were found to be restrictive. After surgery, most of the patients had improvement of the pulmonary function. Before surgery, the pulmonary function differences were found to be significant, both based on severity of preoperative kyphosis (less than 60 degrees vs. more than 60 degrees), and based on the location of the kyphosis apex (above T10 vs. below T10). Younger patients (below 35 years old) were more likely to exhibit statistically significant improvements in pulmonary function after surgery. However, thoracic volume was not significantly related to pulmonary function parameters. After surgery, average thoracic volume had no significant change.Conclusion. The major pulmonary impairment caused by kyphosis was found to be restrictive. Patients with kyphosis angle≥60° or with kyphosis apex above T10 had more severe pulmonary dysfunction. Patient age was significantly related to change in pulmonary function after surgery. However, the average thoracic volume had no significant change after surgery.
    Spine 07/2014; · 2.16 Impact Factor
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    ABSTRACT: To analyze the clinical characteristics of focal kyphosis in upper thoracic spine, and observe the outcome of the posterior corrective surgical procedures.
    06/2014;
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    ABSTRACT: Study Design. Retrospective cohort studyObjective. To investigate the relationship between radiological signs of Scheuermann's disease (SD) and low back pain (LBP) in a local population using lumbar magnetic resonance (MR) images.Summary of Background Data. SD is a spinal disorder, and both its classic and atypical (lumbar) forms are associated with LBP. However, radiological signs of SD are present in 18-40% of the general population, in whom the clinical significance of 'SD-like' spine remains largely unknown.Methods. This retrospective cohort study included 188 staff members from a single hospital. Participants' lumbar MR images and self-administered questionnaires concerning demographic information, LBP status, consequences, and functional limitations were collected. Participants were classified into two groups according to whether lumbar MR images met SD diagnostic criteria, and LBP status, consequences, and functional limitation were compared. Follow-up interviews were conducted after 6 years to compare LBP progression.Results. Thirty-four participants (18.1%) had SD-like spine. Rates of life-time, previous 1-year, and point LBP did not significantly differ between groups. However, among participants who had ever had LBP, SD-like spine was associated with higher rates of work absence (42.1% vs. 9.5%, χ = 9.620, P = 0.002) and seeking medical care (68.4% vs. 39.2%, χ = 5.216, P = 0.022) due to LBP, as well as significantly greater intensity of the most severe LBP episode in the past 2 years (6.4±2.5 vs. 4.1±2.5, t = 3.564, P = 0.001). Among 159 participants who completed the 6-year follow-up, a significantly higher proportion of people with SD-like spine reported aggravated LBP during the follow-up.Conclusion. Our results suggest that in the general population, lumbar MR images of many people meet SD diagnostic criteria, and having 'SD-like' spine appeared to be associated with the severity and progressive nature of LBP. Our findings should inspire further research in this field.
    Spine 06/2014; · 2.16 Impact Factor
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    ABSTRACT: For young patients, the surgical method for lumbar disc herniation remains controversial. The aim of this study was to prospectively determine the short-term clinical outcome after surgery for young patients with lumbar disc herniation.
    Chinese medical journal. 06/2014; 127(11):2037-42.
  • Journal of Spinal Disorders & Techniques 05/2014; · 1.77 Impact Factor
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    ABSTRACT: There have been several surgical approaches used in the treatment of thoracolumbar disc herniation (TLDH) from T10/11 to L1/2. However, central calcified TLDH cases are still challenging to spine surgeons. The anterior transthoracic approaches and lateral/posterolateral approaches are all essentially performed from one side; thus, the compressive lesion and the dura matter on the other side of the spinal canal are not clearly visualized, predisposing the procedure to incomplete decompression or inadvertent cord manipulation. Moreover, a number of these approaches are technically demanding and require entry into the chest. The purpose of this study was to introduce a new surgical procedure-circumspinal decompression and fusion through a posterior midline incision-for the treatment of central calcified TLDH and to evaluate its surgical outcome. In this study, 22 patients (15 males and 7 females; mean age 49 years) with central calcified TLDH underwent this procedure between April 2008 and April 2011. Altogether, 26 discs were excised, with two discs at T10/11, eight discs at T11/12, nine discs at T12/L1 and seven discs at L1/2. Of these patients, 16 returned for final follow-up, with a mean follow-up period of 41 months (range 24-57 months). Clinical outcomes, including operative time, blood loss, perioperative complications, post-operative time of hospitalization, neurological status improvement, extent of decompression, back pain, local spinal curvature and fusion, were investigated. The patients' neurological status was evaluated by a modified Japanese Orthopedic Association scoring system of 11 points. Fusion and the extent of decompression were evaluated by reconstruction CT at final follow-up. The mean operative time was 185 min, the mean blood loss was 896 ml and the mean post-operative hospitalization time was 8 days. Four patients suffered perioperative complications, but only two were related to dura violation and none involved the respiratory system. All of the 16 patients who returned for the final follow-up showed improvement, and evidence of improvement was found in five of the other six patients who did not return for final follow-up through telephone interview or earlier follow-up evaluations. Complete decompression was achieved in 12 of the 16 patients who returned for final follow-up. In the 16 patients who returned for final follow-up, back pain was significantly reduced and local spinal curvature remained unaltered. In addition, based on reconstruction CT images, solid fusion was observed in 15 of the 16 patients who returned for final follow-up. The circumspinal decompression and fusion through a posterior midline incision procedure can be used to treat central calcified TLDH patients with neurological deficits. This method's greatest advantage is that it is a highly effective and safe procedure for decompression. Although it is a major and destructive procedure, spinal stability was well maintained in most of the cases. In this era when minimally invasive spine surgeries like thoracoscopy have been in an upward trajectory, spine surgeons still should be made aware of this procedure.
    European Spine Journal 10/2013; · 2.47 Impact Factor
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    ABSTRACT: Study Design. Retrospective and radiological analysis of spino-pelvic sagittal alignment in Chinese patients with thoracic and thoracolumbar kyphosis.Objective. To determine the impact of thoracic and thoracolumbar kyphosis on pelvic sagittal morphology and the mechanisms of adjusting trunk sagittal balance.Summary of Background Data. Previous studies have reported the normative values of pelvic sagittal parameters and classification of normal patterns of sagittal curvature, but no study has analyzed the impact of thoracic and thoracolumbar kyphosis on pelvic sagittal morphology and the mechanisms of maintaining the sagittal balance.Methods. Whole spine and standing lateral radiographs of 49 Chinese patients with thoracic and thoracolumbar kyphosis were taken before surgery, immediately after surgery and in the final follow-up. The pelvic and spinal parameters were measured and the correlations of all parameters were analyzed. A descriptive analysis characterizing these parameters and a multivariate analysis were performed.Results. The patients had a mean age of 30.3 years, while the mean age at which the patients developed kyphosis was 7.1 years. Preoperative pelvic incidence was significantly less than that of normal subjects, and there was no difference in the preoperative, in the immediate postoperative and in the final follow-up radiographs. The magnitude of kyphosis and the levels involved were independent factors of pelvic incidence. Pelvis anteversion and lumbar hyperlordosis were the mechanisms of adjusting the trunk sagittal balance. Although kyphosis and sagittal imbalance was corrected by surgery, pelvic sagittal morphology remained unchanged.Conclusion. Thoracic and thoracolumbar angular kyphosis occurring during the growth period will lead to abnormal pelvic morphology. Greater the kyphotic angle and lower the kyphotic levels, greater impact it will have on the pelvic morphology during skeletal maturation. The mechanisms of adjusting the trunk sagittal balance include not only pelvis anteverting, but also lumbar hyperlordosis. The latter serves as the main mechanism once skeletal maturation has been established. After skeletal maturation, surgery can reestablish the spinal sagittal balance but not the pelvis morphology.
    Spine 03/2013; · 2.16 Impact Factor
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    ABSTRACT: PURPOSE: The purpose of this study is to review our operative experience of congenital kyphosis or kyphoscoliosis undergoing either pedicle subtraction osteotomy (PSO) or posterior vertebral column resection (pVCR) according to certain criteria we have established. METHODS: From December 2003 to 2009, 23 consecutive patients of congenital kyphosis or kyphoscoliosis were treated by means of PSO or pVCR procedure in a single institution. The average preoperative kyphosis angle was 74.3º. The C7 plumb line was 12.6 mm posterior to the posterior-superior corner of S1 on average, showing negative imbalance. In the 11 cases who had accompanied scoliosis, the average preoperative scoliosis angle was 42.6º. The average Oswestry Deficiency Index (ODI) for back pain was 14.6 before surgery. Eleven patients had compromise of neurological functions. RESULTS: After PSO or pVCR procedure, the average kyphosis angle decreased to 20.0º, and the accompanied scoliosis also decreased to 15.8º. The average follow-up time after surgery was 34.3 months. At the last follow-up, the average kyphosis corrective rate was 73.7 %, and the average scoliosis corrective rate was 61.7 %. The negative imbalance improved, with the C7 plumb line being 1.5 mm posterior to the posterior-superior corner of S1 on average. After surgery, the average ODI for back pain had 40.6 % improvement, and most patients who had neurological symptoms before surgery had varying degrees of relief. The total satisfactory rate to corrective surgery was 91.3 %. No permanent neurological damage was observed. CONCLUSIONS: If selected appropriately, both PSO and pVCR procedures can achieve compatible and satisfactory correction results in the surgical treatment of congenital kyphosis or kyphoscoliosis.
    European Spine Journal 08/2012; · 2.47 Impact Factor
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    ABSTRACT: Milling operations in spinal surgery demand much experience and skill for the surgeon to perform the procedure safely. A 3D navigation method is introduced aiming at providing a monitoring system with enhanced safety and minimal intraoperative interaction. An automatic registration method is presented to establish the 3D-3D transformation between the preoperative CT images and a common reference system in the surgical space, and an intensity-based similarity metric adapted for the multi-planar configuration is introduced in the registration procedure. A critical region is defined for real-time monitoring in order to prevent penetration of the lamina and avoid violation of nerve structures. The contour of the spinal canal is reconstructed as the critical region, and different levels of warning limits are defined. During the milling procedure, the position of the surgical instrument relative to the critical region is provided with augmented display and audio warnings. Timely alarm is provided for surgeons to prevent surgical failure when the mill approaches the critical region. Our validation experiment shows that real-time 3D navigation and monitoring is advantageous for improving the safety of the milling operation.
    Computer methods and programs in biomedicine 04/2012; 108(1):151-7. · 1.56 Impact Factor
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    ABSTRACT: STUDY DESIGN:: A clinical retrospective study. OBJECTIVE:: To analyze the complications and relevant management of the correction procedure for focal kyphosis. SUMMARY OF BACKGROUND DATA:: The treatment of focal kyphosis is a difficult problem in spine surgery. The potential complications of surgery should be considered cautiously and managed positively. METHODS:: Eighty-one patients with focal kyphosis were treated by posterior osteotomy and correction. The etiology was posttraumatic in 31 cases, healed tuberculosis in 31 cases, congenital in 17 cases, and iatrogenic in 2 cases. The surgical procedures were pedicle subtraction osteotomy in 19 cases, posterior osteotomy with anterior opening-posterior closing correction in 23 cases, and posterior vertebral column resection with dual axial rotation correction in 39 cases. The intraoperative and postoperative complications were summarized, and the corresponding management was described in detail. RESULTS:: The average follow-up time was 31 months. Among patients who underwent pedicle subtraction osteotomy, the intraoperative and postoperative complications included 3 cases of dural tear and 1 case of wound infection. For posterior osteotomy with anterior opening-posterior closing correction, the complications included 4 cases of dural tear, 1 case of wound infection, and 1 case of instrumentation loosening and recurrence of kyphosis . For posterior vertebral column resection with dual axial rotation correction, the complications included 3 cases of dural tear, 5 cases of nerve root injury, 1 case of titanium mesh loosening, 1 case of osteotomy segment migration, 2 cases of transient neurological compromise, and 1 case of instrumentation loosening and kyphosis recurrence. All the complications were treated positively and pertinently. CONCLUSIONS:: During the posterior osteotomy and correction of focal kyphosis, the risk of surgery increases along with the more severe deformity and the more complicated surgical procedure. However, most complications do not significantly affect the outcome if treated appropriately.
    Journal of spinal disorders & techniques 02/2012; · 1.21 Impact Factor
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    ABSTRACT: The object of this study was to compare the clinical and radiographic outcomes of 36 patients with posttuberculosis kyphosis who underwent one of two types of osteotomy. Each patient underwent single-stage correction via a posterior surgical approach. A modified pedicle subtraction osteotomy (mPSO) was performed when the kyphotic deformity was less than 70° (7 cases), whereas a posterior vertebral column resection (VCR) was performed when the kyphotic deformity exceeded 70° (29 cases). Full-length standing radiographs were obtained before surgery and at follow-up visits. These images were used to measure the kyphosis angle; sagittal alignment of the lumbar, thoracic, and cervical regions; and sagittal balance of the spine. Back pain was rated using the visual analog scale (VAS), and neurological function was classified based on the American Spinal Injury Association (ASIA) grading system. Each patient's overall satisfaction with surgical treatment was measured with the Patient Satisfaction Index. For purposes of comparison, patients were studied in 2 groups based on the region of their kyphotic apex. Half of the cohort had apical kyphosis in the lower thoracic spine or thoracolumbar junction (TL group). Using both radiographic and clinical assessments, the authors compared this group with the other half of the patients who had apical kyphosis in the upper to mid thoracic spine (MT group). The cohort included 15 males and 21 females, with an average age of 34 years at the time of surgery. The minimum follow-up was 24 months, and the mean follow-up was 31 months. Following surgery, kyphosis across the treated segments was reduced by an average of 60°. Lumbar lordosis also improved by an average of 24°, and thoracic kyphosis improved by an average of 20°. Both back pain and neurological function improved after surgical treatment. There was a 67% improvement in VAS scores, and 13 of the 36 patients had improvement in their ASIA grade. The 2 surgical procedures used for deformity correction (mPSO and VCR) demonstrated comparable radiographic and clinical results. Note, however, that differences were found in both radiographic and clinical outcomes in comparing patients who had lower thoracic or thoracolumbar (TL group) versus upper to midthoracic (MT group) apical kyphosis. Posterior tubercular kyphosis can be effectively improved through corrective surgery, and deformity correction can be accompanied by improvement in clinical symptoms. When appropriately selected, both the mPSO and the VCR can be expected to yield satisfactory reduction of post-tuberculosis kyphotic deformities. Differences in radiographic and clinical outcomes should be anticipated, however, when treating such deformities in different regions of the spine.
    Journal of neurosurgery. Spine 01/2012; 16(4):351-8. · 1.61 Impact Factor
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    ABSTRACT: OBJECTIVES:: To analyze the clinical characteristics and surgical results of posttraumatic kyphosis of the thoracolumbar segment. METHODS:: Thirty-four patients with posttraumatic kyphosis of the thoracolumbar segment underwent posterior osteotomy, kyphosis correction, and fixation at our hospital. The kyphosis apex was from T10 to L2. There were 15 male and 19 female patients. The mean age was 48.9 years. Full-spine standing radiographs were obtained before surgery, after surgery, and at follow-up. The sagittal spine balance status was evaluated, and the kyphotic angle, the lumbar lordotic angle, and the thoracic kyphotic angle were measured. The Frankel grading system for neurological functions and the Visual Analogue Scale for back pain were evaluated before surgery and at follow-up. The Oswestry Disability Index was applied for assessment of life quality and surgical results of patients. The Patient Satisfied Index (PSI) was also used for determination of surgical results. Patients were grouped according to the extent of kyphotic angle and the surgical technique. The difference in kyphosis correction and back pain between groups was observed before and after surgery. Relief from neurological symptoms was also observed. RESULTS:: The average kyphotic angle was 48.5 degrees, the average lumbar lordotic angle was 57.9 degrees, and the average thoracic kyphotic angle was 11.4 degrees before surgery. The sagittal spine balance was well maintained in 14 cases, and negative imbalance and positive imbalance were seen in 13 cases and 7 cases, respectively. There was significant difference in back pain between patients in the abnormal and normal groups of the lumbar lordotic angle. The average follow-up time after surgery was 32.1 months. The average kyphotic angle correction rate was 90.4% after surgery and 87.2% at follow-up. The average Oswestry Disability Index was 50.4% before surgery, which improved to 29.4% at follow-up, with an improvement rate of 41.5%. The Patient Satisfied Index result showed a total satisfactory rate of 94.1%. There were 16 cases of neurological deficit before surgery; 8 of them achieved various degrees of improvement after surgery. CONCLUSIONS:: Surgical correction of posttraumatic kyphosis of the thoracolumbar segment can show good radiologic and clinical results with the appropriate procedure according to the extent of the kyphosis angle. Some patients with neurological deficit are still worthy of surgical treatment.
    Journal of spinal disorders & techniques 09/2011; · 1.21 Impact Factor
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    ABSTRACT: in this paper, the authors' goal was to evaluate the feasibility, safety, and efficacy of apical segment resection osteotomy with dual axial rotation correction for severe focal kyphosis by examining outcomes. between May 2004 and December 2006, the authors treated 23 patients with severe focal kyphosis (average Cobb angle 86.9°, range 50°-130°) using apical segmental resection osteotomy with dual axial rotation correction and instrumented anterior column reconstruction and fusion. Radiographic assessment of sagittal plane balance and kyphotic Cobb angle (including a scoliosis Cobb angle in 9 cases) was performed in each patient before and immediately after surgery and at the last follow-up (minimum 2 years). The Frankel grading system for neurological function and Oswestry Disability Index for quality of life were evaluated before surgery and at the last follow-up. The patient satisfaction index was also used for clinical evaluation at the last follow-up. the mean surgical time was 6.7 hours. The average blood loss was 2960 ml. All patients underwent follow-up for 2 or more years after surgery. The fusion rate was 95.65%. The average kyphotic angle improved from 86.9° preoperatively to 25.6° immediately postoperatively, with an average correction rate of 72.17%. At the last follow-up, the average kyphotic angle was 27.4°, making the final correction rate 69.87%. The sagittal plane balance was significantly improved at the last follow-up. Preoperatively, 15 patients had neurological deficits, and the Frankel grade was E in 8 cases, D in 8 cases, C in 6 cases, and B in 1 case. At the last follow-up, 15 cases were Grade E, 5 were Grade D, and 3 were Grade C. The average improvement in the Oswestry Disability Index score was 43.30%. The patient satisfaction index result showed a total satisfaction rate of 91.30%. Complications included 1 case of late neurological deficit due to shifting of an expandable artificial vertebra, 5 cases of nerve root injury, 3 cases of dural tear, and 1 case of transient lower-extremity weakness due to insufficient blood supply to the spinal cord during surgery. apical segmental resection osteotomy with dual axial rotation correction and instrumented fusion is an effective and safe way to treat severe focal kyphosis of the thoracolumbar spine.
    Journal of neurosurgery. Spine 01/2011; 14(1):106-13. · 1.61 Impact Factor
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    ABSTRACT: Spine-milling operation during laminectomy surgery requires steady manipulation and intraoperative monitoring. A spinal milling robot with force-based control is introduced to improve the operation safety. The robot is designed with compact structure and simple configuration. Real-time thrust force is measured and three stages corresponding to the anatomical structures of the vertebra are identified, based on the analysis of typical characteristic parameters of the force profiles. The cross-correlation to the standard profiles are adopted to judge the milling status. A 1 mm margin is prescribed to stop the procedure before the lamina is thoroughly milled through. Automatic robot-milling experiments on porcine vertebrae are conducted, based on the force-based control method, and the procedure is stopped when the critical condition is met. The average thickness of the milled part is 1.1 mm, and no penetration occurs. The spinal milling robot could provide steady manipulation, facilitate the surgeon's labour with an automatic feeding process and improve the safety of the operation with enhanced monitoring.
    International Journal of Medical Robotics and Computer Assisted Surgery 03/2010; 6(2):178-85. · 1.49 Impact Factor
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    ABSTRACT: A case-control association study was conducted to investigate the genetic etiology for ossification of the ligamentum flavum (OLF) and ossification of the posterior longitudinal ligament of the spine (OPLL). To determine whether COL6A1 polymorphisms are associated with susceptibility to OLF and OPLL in Chinese Han population. The COL6A1 has been identified as a susceptibility gene for OPLL in Japanese. The susceptibility gene for OPLL may be different among various populations, so we investigated whether COL6A1 polymorphisms are also associated with OPLL in Chinese Han population. OLF and OPLL are similar in epidemiology, etiology, and pathology, and common coexist. Hereditary factors may be implicated in OLF and COL6A1 may be a potential susceptibility gene for OLF, so we investigated the relations between COL6A1 polymorphisms and OLF. Four known single nucleotide polymorphisms (SNPs) of COL6A1 were genotyped among 338 Chinese Han subjects by high throughput GenomeLab SNPstream genotyping system. Allele frequency and genotype distribution of each polymorphism were compared using a contingency chi2 test between 183 cases (90 OPLL, 61 OLF, and 32 OPLL coexisting with OLF) and 155 controls. Among 4 studied SNPs, allele frequency of promoter (-572T) SNP demonstrated the most significant difference not only between OPLL cases and controls (P = 2.65E-4), but also between OLF cases and controls (P =7.38E-4). Moreover, the overall frequency of haplotypes constructed from promoter (-572), intron 32 (-29), and intron 33 (+20) SNPs showed significant difference not only between the patients with OPLL and controls, but also between the patients with OLF and controls (P = 5.86E-3, P = 1.5E-8, respectively). This is the first report on SNPs of COL6A1 in OLF that suggests polymorphisms may be a risk factor for OLF. Our findings indicate that COL6A1 may be a common susceptibility gene for OLF and OPLL in Chinese Han population.
    Spine 01/2008; 32(25):2834-8. · 2.16 Impact Factor
  • Spine Journal - SPINE J. 01/2003; 3(5):148-149.
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    ABSTRACT: To provide reference for correct clinical treatment by summarizing the characteristics and surgical experience in spinal deformity of the upper thoracic (T(1)-T(4)) short angular kyphosis. Medical history was taken in 15 cases are reviewed. The results of X-ray and MRI examinations were analyzed. The kyphotic angles were measured using the Cobb technique. All cases underwent the anterior spinal cord decompression, by posterolateral approach in 4 cases and posterior in 11 cases. Kyphosis was congenital in 7 cases and due to tuberculosis approach in 8 was. The average age at deformity was first noted was 3.6 years in 7 congenital cases and 9.0 years in 8 tuberculosis cases. All cases had neurologic deficits. The mean kyphosis was 86.5 degrees (range, 45 - 100 degrees). The delay between first observation of the deformity and subsequent neurologic loss was 16.5 years and 18.1 years respectively. The operation failed in 1 case. 13 cases were followed up, with an average 42 months. Seven cases showed improvement, 2 no change and 4 deterioration in neurologic deficit. In cases of or tuberculosis kyphosis, the usual time for kyphosis to occur is during the preadolescent growth spurt. Neurologic deficits may occur without treatment and will be always progressive. The result of operation is not satisfactory. Early diagnosis and adequate management of kyphosis will prevent progression and thus any possible spinal cord compression. Early fusion is usually necessary to control the kyphosis.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 02/2002; 40(1):52-4.