Chang-Jung Chiang

Taipei Medical University | TMU · Department of Orthopedics

Lumbar disc herniation (LDH) is a common condition which can lead to back pain. Although surgical treatments for LDH are well established, complications such as spinal instability and narrowing of adjacent facet joints are still frequently reported. The purpose of this study was to use finite element models to evaluate the stability of the L3–L4 se...

Background and Objectives: Using an appropriate torque to tighten set screws ensures the long-term stability of spinal posterior fixation devices. However, the recommended torque often varies between different devices and some devices do not state a recommended torque level. The purpose of this study is to evaluate the effect of set screw torque on...

Self-tapping screws are commonly used in trauma and maxillofacial surgery and are increasingly used for pedicle screw insertions. In order to evaluate how the quantity and length of cutting flutes on self-tapping pedicle screws affect the insertion torque and pullout strength, eight different self-tapping pedicle screw designs were evaluated. All s...

Suture anchor fixation is a common method for securing bone and soft tissue in the body, with proven applications in the hip, elbow, hand, knee and foot. A critical limiting factor of suture anchors is the pull-out strength, particularly in suboptimal bone. This study introduces a novel 3D printed threadless suture anchor with a rectangular cross-s...

This study proposed a pedicle screw design where the proximal 1/3 of the screw is unthreaded to improve fixation in posterior spinal surgery. This design was also expected to reduce the incidence of mechanical failure often observed when an unsupported screw length is exposed outside the vertebra in deformed or degenerated segments. The aim of this...

A hybrid fixation method, using a combination of vertebroplasty and cement-augmented screws, has been demonstrated as a useful technique for securing osteoporotic burst fractures. The purpose of this study was to assess changes in the range of motion (ROM) and stress in the spine after treating a lumbar burst fracture with this hybrid method. Five...

Background: Lumbar spinal fusion with rigid spinal fixators as one of the high risk factors related to adjacent-segment failure. The purpose of this study is to investigate how the material properties of spinal fixation rods influence the biomechanical behavior at the instrumented and adjacent levels through the use of the finite element method....

Pedicle screws are commonly used for posterior stabilization of the spine. When used in deformed or degenerated segments, the pedicle screws are often not fully inserted into the bone, but instead the threaded portion is exposed by 1 or 2 threads to accommodate rod placement and ensure alignment between the tulip of the screw and the rod. However,...

Background: Effective treatment of low back pain (LBP) originating in the lumbar and sacroiliac joints is difficult to achieve. The objective of the current study was to compare the clinical effectiveness of radiofrequency (RF) neurotomy versus conservative nonsurgical approaches for the management of chronic lumbar and sacroiliac joint pain. Met...

The majority of compressive vertebral fractures in osteoporotic bone occur at the level of the thoracolumbar junction. Immediate decompression is often required in order to reduce the extent of neurological damage. This study evaluated four fixation methods for decompression in patients with thoracolumbar burst fractures, and presented the most sui...

Background and objectives: This study is a meta-analysis of randomized controlled trials comparing the efficacy of transcutaneous electrical nerve stimulation (TENS) to a control and to other nerve stimulation therapies (NSTs) for the treatment of chronic back pain. Methods: Citations were identified in MEDLINE, the Cochrane Library, Google Scho...

Interbody fusion with posterior instrumentation is a common method for treating lumbar degenerative disc diseases. However, the high rigidity of the fusion construct may produce abnormal stresses at the adjacent segment and lead to adjacent segment degeneration (ASD). As such, biodegradable implants are becoming more popular for use in orthopaedic...

Recent advances in tissue engineering have led to potential new strategies, especially decellularization protocols from natural tissues, for the repair, replacement, and regeneration of intervertebral discs. This study aimed to validate our previously reported method for the decellularization of annulus fibrosus (AF) tissue and to quantify potentia...

Background context: Minimally invasive spine surgery has become increasingly popular in clinical practice, and it offers patients the potential benefits of reduced blood loss, wound pain, and infection risk, and it also diminishes the loss of working time and length of hospital stay. However, surgeons require more intraoperative fluoroscopy and io...

Background data: Combined usage of posterior lumbar interbody fusion and transpedicular fixation has been extensively used to treat the various lumbar degenerative disc diseases. The transpedicular fixator aims to increase stability and enhance the fusion rate. However, how the fused disc and bridged vertebrae respectively affect adjacent-segment...

Background: Failure of pedicle screw is a major concern in spinal surgery. The threaded and unthreaded portions of the pedicle screw provide the ability to anchor and squeeze the surrounding bone, respectively. This study aimed to investigate the anchoring and squeezing effects of different design of the threaded/unthreaded portions of a pedicle s...

Aims: Intervertebral disc (IVD) degeneration was believed to contribute to lower back pain. The aim of the study was to investigate the pathogenesis and regulatory mechanism of puncture-induced IVD degeneration. Main methods: We established a rat-tail puncture model using Kirschner wire and a homemade stopper. The progress of disc degeneration w...

Purpose The purpose was to quantify the structural integrity of annulus fibrosis (AF) after injuries with repair. Methods Punctures in the AF of 6-month-old porcine spine specimens were made with 18-, 20-, 22-, 24-, and 26-gauge needles. Leakage testing was performed immediately after needle puncture (Group 1), after the puncture was repaired with...

Honokiol is a potential candidate for the treatment of intervertebral disc (IVD) degeneration. In this study, we develop in vitro and in vivo methods to detect the distribution of honokiol in intervertebral discs using high-performance liquid chromatography. A rat tail disc was used for both experimental models. For the in vivo animal experiment, b...

Vertebroplasty is commonly used to treat vertebral wedge fractures (VWFs). However, differing degrees of vertebral height restoration (VHR) have been reported after vertebroplasty, and little is known about how grades (steepness) of VWF deformities affect loadings on the fractured and adjacent unfractured vertebrae. Therefore, the goal of this stud...

Background Over the last few years, new treatments for a damaged intervertebral disc (IVD) have included strategies to repair, replace, or regenerate the degenerative disc. However, these techniques are likely to have limited success, due to insufficiently effective means to address the damaged anulus fibrosus (AF). Here, we try to develop a biopro...

Background: The treatment of adhesive capsulitis is a dilemma for orthopaedic rehabilitation specialists. In this study, we assessed whether extracorporeal shockwave therapy (ESWT) improves the functional outcome of primary shoulder adhesive capsulitis. Methods: In this prospective, randomized, controlled, single-blind clinical trial, we enrolle...

An apparatus for anulus fibrosus repair includes a shaft, a pair of curved suturing needles mounted in parallel on the shaft, and a rotational driving mechanism connected to the shaft, which is configured to rotate the shaft and the pair of needles about a rotation axis of the shaft. Each needle includes a substantially semi-annular body having a p...

Femoral nerve palsy due to iliacus hematoma has been reported previously1-4. Its incidence has increased because of the widespread use of anticoagulants and revision hip surgery. Surgical hematoma evacuation has been highly recommended in patients with coagulopathy5. In healthy patients with posttraumatic iliacus hematoma, previous case reports hav...

Various designs of cervical total disc replacement (CTDR) have been introduced and employed in an attempt to avoid disadvantages of the fusion surgery. The purposes of this study were to evaluate the effects of the range of motion (ROM), the instantaneous center of rotation (ICR) and the facet joint force (FJF) with different constrained types of C...

This article describes two case studies involving lumbar facet joint synovial cyst causing acute sciatica and progressive neurological deficit. The cases involve women, 57 and 69 years old, respectively. The first patient was presented with left buttock and lower leg pain, numbness and paresthesia, while the second one had progressive right lower l...

Di-isononyl phthalate (DINP) is a general-purpose plasticizer for polyvinyl chloride. However, this industrial chemical plasticizer used as a clouding agent has recently contaminated food and beverages that had been inspected by Taiwan Food and Drug Administration. This study develops a sensitive and specific method combining ultra-performance liqu...

Calcium phosphate ceramic has been known for its properties of bioactivity and osteoconductivity and has been widely used in orthopedic, plastic and craniofacial surgeries. The biocompatibility, unlimited availability, lower morbidity for the patient and cost-effectiveness of calcium phosphate ceramics represent important advantages over other biol...

The adverse effects of annulotomy during lumbar discectomy have been increasingly recognized, and methods are developing to repair the annular defect. Biomechanically, the repair should retain the intra-nuclear pressure, which is doubtful using the current suture techniques. Therefore, a new suture technique was designed and tested to close a simpl...

In vitro and in vivo studies to assess the effect of direct anular repair on subsequent degeneration of intervertebral discs (IVDs). To assess whether a new suturing method could provide sealing effect on IVD after discectomy, and influence degenerative process of IVD. Recurrent disc herniation and subsequent disc degeneration are major problems af...

IntroductionStandard techniques for lumbar decompression, fusion, and pedicle screw fixation involve open exposures, extensive muscle dissection, and posterior element destruction. The purpose of this study was to report the initial clinical experience with minimally invasive decompression, transforaminal interbody fusion, and percutaneous pedicle...

To characterize the pathway of ceftriaxone penetration into intervertebral discs, rat-tail discs were collected and immersed in a ceftriaxone solution for an in vitro study. For this in vivo experiment, plasma and tail discs were collected 30 min after ceftriaxone administration (463.2 mg/kg, equal to 500 mg/kg disodium salt, iv). The ceftriaxone l...

Retrospective review of an anterior polyetheretherketone (PEEK) cage incorporated with a bovine xenograft to treat disorders of the cervical disc. To assess the achievement of fusion by PEEK cage with xenograft radiographically and clinically when used to perform ACDF. Anterior cervical discectomy and fusion is the therapy of choice for degenerativ...

Soy protein, a rich source of phytoestrogens, exhibit estrogen-type bioactivity. The purpose of this study was to determine if ingestion of isoflavones before ovariectomy can prevent bone loss following ovariectomy. Twenty-four nulliparous Wistar rats were randomly divided into four groups. In the normal diet groups, a sham operation was performed...

We report a young man with gouty discitis of the cervical spine. To our knowledge, our patient is the youngest patient with cervical gouty discitis reported in the literature. The clinical manifestation was similar to that of cervical spondylosis with radiculopathy. Gouty discitis was diagnosed only when tophi in the disc were found during surgery...

Intensive eccentric exercise can cause muscle damage. We simulated an animal model of isokinetic eccentric exercise by repetitively stretching stimulated triceps surae muscle-tendon units to determine if such exercise affects the mechanical properties of the unit within its physiologic excursion. Biomechanical parameters of the muscle-tendon unit w...