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Rehabilitation Protocol for spondylolisthesis Patients: A Treatment Protocol 脊柱滑脱患者的康复治疗方案:一种治疗方案
Pub Date : 2023-01-01 DOI: 10.26502/fjsrs0055
Md. Majidur Rahman, Md.Zahid Hasan, A. Islam, S. Afridi, Mayesa Nujhat
Background: Spondylolisthesis refers to the anterior slippage of one vertebra upon another. Objectives: To assist physiotherapists in decision-making during intervention for patients with spondylolisthesis grades I and II. Methodology: Evidence-based physiotherapy treatment protocol for spondylolisthesis. RCT study was used to develop this evidence. Results: This study was found evidence-based physiotherapy treatment on spondylolisthesis. There are very few RCT studies is found during searching. This study found that lumbar flexion exercise, as well as stretching of hip flexors, hamstring, piriformis, thoracic mobilization
背景:椎体滑脱是指一个椎体在另一个椎体上的前滑脱。目的:帮助物理治疗师在I级和II级滑脱患者的干预过程中做出决策。方法:脊椎滑脱的循证理疗治疗方案。我们采用了随机对照试验来证明这一点。结果:本研究发现以证据为基础的物理疗法治疗脊柱滑脱。在检索过程中发现的RCT研究很少。本研究发现,腰屈运动,以及拉伸髋屈肌、腘绳肌、梨状肌、胸椎的活动
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引用次数: 0
Analysing the clinical relevance and impact of subsidence seen with standalone cages for cervical disc surgeries – A study of fusion rates in 118 patients 分析独立椎弓根固定架在颈椎间盘手术中下沉的临床意义和影响——对118例患者融合率的研究
Pub Date : 2023-01-01 DOI: 10.26502/fjsrs0058
Vishnu Vikraman Nair, Vishal G. Kundnani, Mukul Jain, Sunil Shamjibhai Chodavadiya, A. Shetty, Jenil R. Patel, Nikhil Dewnany
Background and Aim: The objective of this study is to examine the short and long term impact of subsidence after anterior cervical discectomy and fusion for compressive cervical disc disease, utilizing solely non-locking stand-alone titanium cage and to analyze the fusion rates. Methods: The single-center retrospective study included one and two-level Anterior cervical discectomy and fusion (ACDF) cases from July 2014 to June 2019. Minimum 2-year follow-up was included and titanium cage with autologous bone graft was used. Interbody height (IBH), subsidence and fusion rates were analysed at follow up. Clinically, VAS score for neck and arm, mJOA score for myelopathy, C2-C7 cobb angle for lordosis improvement were analyzed. Results: A sample of 118 patients, was subjected to analysis. The fusion rate was observed to be 96.6%. Eleven instances of subsidence were observed at the 3-month follow-up (p= 0.89). All 11 patients with subsidence had excellent/good functional outcomes on analyzing Odom’s criteria. The study observed a noteworthy enhancement in the (VAS) for neck and arm pain, as well as in the (mJOA) score among patients with myelopathy, with a statistical significance of p<0.05. There was significant reduction in IBH in the subsidence group in comparison to non-subsidence group. Segmental kyphosis angles were also seen to be higher in the subsidence group(p<0.05) Conclusion: According to our study, the subsidence observed did not have a significant clinical impact on outcome scores or patient satisfaction. The utilisation of a stand-alone cage devoid of screw or plate instrumentation
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引用次数: 0
Advances in Extracellular Vesicles in the Treatment of Osteosarcoma 细胞外囊泡治疗骨肉瘤的研究进展
Pub Date : 2023-01-01 DOI: 10.26502/fjsrs0064
Zhefei Du, Lixin Xie, Daihan Xie, Kesheng Wang, Qiuxia Peng, Chao Fang
Osteosarcoma, a prevalent primary malignant bone tumor, presents a pressing challenge in terms of improving patient prognosis effectively. Extracellular vesicles, encompassing vesicular structure with a bilayered biomembrane released by cells, have been shown to play a significant role in the pathogenesis and progression of osteosarcoma. This mini-review provides an overview of the fundamental biological characteristics of extracellular vesicles and their therapeutic implications in osteosarcoma. Furthermore, it presents an outlook on the current limitations of extracellular vesicles and their potential future applications.
骨肉瘤是一种常见的原发性骨恶性肿瘤,在有效改善患者预后方面面临着紧迫的挑战。细胞外囊泡是一种由细胞释放的双层生物膜包裹的囊泡结构,已被证明在骨肉瘤的发病和进展中起重要作用。这篇综述综述了细胞外囊泡的基本生物学特性及其在骨肉瘤中的治疗意义。此外,还对目前细胞外囊泡的局限性及其潜在的应用前景进行了展望。
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引用次数: 0
Anterior Lumbar Interbody Fusion (ALIF): Complications and radiological outcomes 腰椎前路椎体间融合术(ALIF):并发症和放射学结果
Pub Date : 2023-01-01 DOI: 10.26502/fjsrs0059
A. Demirel, Renata Terzic, J. Kaspersen, E. Aras, Søren Peter Eiskjær
Introduction: Anterior lumbar interbody fusion (ALIF) is a well-established treatment. Using poly-ether-ether-ketone (PEEK) cages for ALIF procedure take advantage of the relative radiolucency of PEEK cages .The goal of this study was to determine the radiological outcomes and complications after ALIF surgery. Materials & Methods: Retrospective review of patients with ALIF (PEEK cage) surgery. Complications were noted. Bone union determined with Bridwell classification. Pre and post-operative X-rays, X-rays at the last follow-up reviewed. Anterior-posterior disc space height, segmental lordosis at the ALIF levels and global lumbar lordosis were measured. Results: 56 patients (M:25, F:31) and 80 ALIF cages were reviewed. The respective median age of surgery and follow-up duration (months) for the 3 subgroups were as follows: 47(37-54) /14(12-24) (disc degeneration), 45(40-52) /22(14-27) (listhesis), 57(51-62) /17(16-25) (non-union). Number of complications associated with the anterior approach was 9/56 or 16%. Bridwell fusion status was classified as 1 in 72 cages, 2 in 6 cages and 4 in 2 cages. The anterior disc space height and posterior disc space height L3/L4, L4/L5, L5/S1 significantly increased from preoperatively to immediately postoperatively and compared to the distance at last follow up. The anterior disc space height and posterior disc space height L4/L5, L5/S1 decreased significantly from immediately postoperatively to last follow-up. Only for the L5/S1 level did the segmental lordosis increase significantly from preoperatively to immediately postoperatively and compared to the angle at last follow-up. Conclusions: The use of ALIF (PEEK cage) with posterior fixation resulted in very low non-union rate (2.5%). The approach related complications are comparable to the literature.
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引用次数: 0
Traumatic Spondylolisthesis of the Axis without Fracture: Case Report and Literature Review 外伤性脊柱滑脱无骨折:1例报告及文献复习
Pub Date : 2023-01-01 DOI: 10.26502/fjsrs0063
Lívio Pereira de Macêdo, MD, João Batista Monte Freire, MD
Traumatic spondylolisthesis of the axis is a recurrent up-per cervical spine injury. Axis spondylolisthesis is a broader term, related to when one vertebra slips forward on another, which may in-clude fractures of other vertebral elements and even dislocations not associated with fractures.
外伤性椎体滑脱是一种复发性颈椎上段损伤。椎体滑脱是一个更广泛的术语,涉及到一个椎体在另一个椎体上向前滑动,这可能包括其他椎体元件的骨折,甚至与骨折无关的脱位。
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引用次数: 0
Outcome of Surgical Management in Lumber Disc Prolapse: A Study in Dhaka Medical College Hospital, Dhaka, Bangladesh 腰椎间盘脱垂的外科治疗效果:孟加拉国达卡医学院医院的一项研究
Pub Date : 2022-01-01 DOI: 10.26502/fjsrs0038
S. Islam, M. Shahiduzzaman, Ferdous Ara Banu, M. Hasan, Shamiul Alam Siddique, Fatema Sultana Sumi, T. Akhter, Abu Hena Md Atiquzzaman
Professor and Head, Department of Orthopedics and Spine Surgery,Addin womens medical college hospital, Dhaka, Bangladesh Professor and Head, Department of Orthopedics, Dhaka Medical College Hospital, Dhaka, Bangladesh Junior consultant, DGHS, Mohakhali, Deputation in BSMMU, Dhaka, Bangladesh Assistant professor, Department of Orthopedics, Holy Family Red Cresent Medical College Hospital, Dhaka, Bangladesh Assistant Professor, Department of Neurosurgery, Mymensingh Medical College, Dhaka, Bangladesh Medical officer, Department of Orthopedics and Spine Surgery, Addin Medical College Hospital, Dhaka, Bangladesh Medical officer, Department of Orthopedics and Spine Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh
孟加拉国达卡阿丁女子医学院医院骨科和脊柱外科教授兼主任,孟加拉国达卡医学院医院骨科教授兼主任,孟加拉国达卡BSMMU代表团初级顾问,DGHS, Mohakhali,孟加拉国达卡圣家红新月医学院医院骨科助理教授,孟加拉国达卡迈门辛格医学院神经外科助理教授,孟加拉国达卡孟加拉国,孟加拉国,达卡,阿丁医学院医院骨科和脊柱外科医生,孟加拉国,达卡,国立创伤学和骨科康复研究所骨科和脊柱外科医生
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引用次数: 0
ImPACT® Assessment of Photobiomodulation Therapy for Post-Concussion Syndrome 脑震荡后综合征光生物调节治疗的ImPACT®评估
Pub Date : 2022-01-01 DOI: 10.26502/fjsrs0037
Ronaldo Santiago, J. Ozsarfati, H. Shulman, R. Valenzuela, Michael Zitney
Background: Several studies have detailed the efficacy of Photobiomodulation Therapy (PBMT) as a treatment for concussions [1]. As there are no widely accepted imaging or laboratory modalities that document concussive injuries, monitoring improvement objectively proves difficult. ImPACT® is a computer based neurocognitive assessment tool meant to measure cognitive performance and subjective symptoms for concussion injuries. This study uses ImPACT® as a means to document an improvement in symptomatology for patients with persistent post-concussion symptoms pre and post-treatment with PBMT [2]. Methods: This retrospective study reviews patient performance in the ImPACT® test in a cohort of 35 patients who are diagnosed with mild Traumatic Brain Injuries (mTBI) and experiencing persistent post-concussive symptoms. Patients initially took the Post Injury 1 test then underwent PBMT therapy using the BIOFLEX DUO+ system three times a week for 4 weeks using approved parameters for treatment of the cervical spine soft tissue injuries. Journal Surgery After the 4 week treatment, patients took the Post Injury 2 test and the results were compared. Results: All patients improved clinically after PBMT and their Post injury 2 ImPACT® test results were significantly better compared to their Post injury 1 ImPACT® test results. Conclusion: PBMT may provide neurological rehabilitation in patients with persistent post-concussion symptoms and ImPACT® is an appropriate and objective measure to monitor and assess improvement.
背景:一些研究已经详细介绍了光生物调节疗法(PBMT)治疗脑震荡的疗效。由于没有广泛接受的影像学或实验室模式来记录脑震荡损伤,客观地监测改善证明是困难的。ImPACT®是一种基于计算机的神经认知评估工具,旨在测量脑震荡损伤的认知表现和主观症状。本研究使用ImPACT®作为记录持续脑震荡后症状患者在PBMT[2]治疗前后的症状改善的手段。方法:本回顾性研究回顾了35名诊断为轻度创伤性脑损伤(mTBI)并经历持续脑震荡后症状的患者在ImPACT®测试中的表现。患者最初接受损伤后1测试,然后使用BIOFLEX DUO+系统进行PBMT治疗,每周3次,持续4周,使用批准的参数治疗颈椎软组织损伤。治疗4周后,对患者进行损伤后2测试并比较结果。结果:所有患者在PBMT后均有临床改善,损伤后2期ImPACT®测试结果明显优于损伤后1期ImPACT®测试结果。结论:PBMT可为持续性脑震荡后症状患者提供神经康复治疗,ImPACT®是监测和评估改善的适当和客观的措施。
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引用次数: 1
Late onset posttraumatic vascular myelopathy without spinal chord injury – a case report 无脊髓损伤的迟发性创伤后血管性脊髓病1例报告
Pub Date : 2022-01-01 DOI: 10.26502/fjsrs0049
Maria Erika Hevia Vaca, M. Frink, Maximilian Schulze, S. Ruchholtz, M. Bäumlein
Background: Yet, we couldn´t find any reported case of a trauma patient, that describes a late onset complete paraplegia of the lower limbs caused by spinal chord ischaemia without a spinal (chord) injury. Leading causes are dissections of the aorta and their reconstructions. Case presentation: Here, we present a case of a 43 year old male patient with traumatic dissection of the external iliac artery and demolition of the iliac vein on the left side . Moreover, he was in hypovolemic shock. Injuries of the spine or the spinal chord were not apparent. He was able to move both legs on demand. After performance of damage control surgery at the day of the accident, the patient presented a complete sensoric and motoric deficit 7 days after surgery, the MRI showed a vascular myelopathy. Conclusion: The myelopathy could be caused by impaired arterial perfusion due to hypovolaemia and disrupted arterial flow on the Adamkiewicz artery. A venious congestion as well as fibrocartilary embolisation are causes that also need to be dicussed.
背景:然而,我们没有发现任何外伤患者的报告病例,描述了由脊髓缺血引起的迟发性下肢完全截瘫,而没有脊髓损伤。主要原因是主动脉夹层和主动脉重建。病例介绍:在这里,我们报告了一例43岁男性患者,外伤性髂外动脉夹层和左侧髂静脉破裂。此外,他处于低血容量性休克状态。脊柱或脊髓损伤不明显。他可以根据需要移动双腿。在事故当天进行损伤控制手术后,患者在手术后7天出现完全的感觉和运动障碍,MRI显示血管性脊髓病。结论:Adamkiewicz动脉低血容量和血流中断可能是引起脊髓病的主要原因。静脉充血和纤维软骨栓塞也是需要讨论的原因。
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引用次数: 0
Minimally Invasive Approach of Lumbar Plasmacytoma: Case Report 腰椎浆细胞瘤的微创入路1例
Pub Date : 2022-01-01 DOI: 10.26502/fjsrs0046
A. Guimarães, R. Sousa, S. Neves, P. Gomes, L. Castelo
Solitary Bone Plasmacytoma is a subtype of Solitary Plasmacytoma characterized by a mass of monoclonal plasma cells with involvement of bony structures. This pathology presents a high risk of progression to Multiple Myeloma with systemic involvement. In vertebral involvement it can lead to lytic lesions with progression to vertebral collapse and instability. The clinical case is a female patient with no medical history, with a clinic of low back pain with evolution for more than 1 month, radiography showed wedge of L4 and computed tomography a lytic lesion of that level, was hospitalized for pain control and study. The Magnetic Resonance came to discard the compression of noble parts. She was admitted for surgery due to vertebral instability and minimally invasive L2-L3-L5 posterolateral fixation was performed with transpedicular bars and screws, tissue biopsy and decompression with L4 partial facetectomy laminectomy. Surgery was uneventful and the patient was discharged 3 days after a complementary study of the disease. After 1 month, the patient showed clear improvement in pain and after half a year, the fixation was stable without instability or deformities. The patient was followed up by Orthopedics and Hematology. Plasmacytoma is an uncommon neoplasm and the main symptoms are low back pain, as in the case described. Radiotherapy is the treatment of choice, however surgery has been growing as an adjuvant and clinical improvement. This case demonstrates a unique treatment, not previously described with a percutaneous fixation with good results. plasmacytoma: Case Report.
孤立性骨浆细胞瘤是孤立性浆细胞瘤的一种亚型,其特征是大量单克隆浆细胞累及骨结构。这种病理表现为进展为全身累及多发性骨髓瘤的高风险。在椎体受累时,可导致溶解性病变进展为椎体塌陷和不稳定。临床病例为女性,无病史,临床表现为腰痛演变1个多月,x线片示腰4楔状,ct示腰4段溶解性病变,住院控制疼痛并进行研究。磁共振技术摒弃了对高贵部分的压缩。由于椎体不稳定,患者接受手术治疗,采用经椎弓根棒和螺钉进行微创L2-L3-L5后外侧固定,组织活检和L4部分椎板切除术减压。手术顺利,患者在对疾病进行补充研究3天后出院。1个月后,患者疼痛明显改善,半年后固定稳定,无不稳定和畸形。对患者进行骨科和血液学随访。浆细胞瘤是一种罕见的肿瘤,其主要症状为腰痛,如病例所述。放疗是首选的治疗方法,但是手术作为辅助治疗和临床改善手段也越来越多。本病例展示了一种独特的治疗方法,以前没有报道过经皮内固定的良好效果。浆细胞瘤1例报告。
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引用次数: 0
CHL1-Deficient and Wild-Type Male Mice do Not Differ in Locomotor Recovery from Spinal Cord Injury. chl1缺失和野生型雄性小鼠在脊髓损伤后的运动恢复方面没有差异。
Pub Date : 2022-01-01 Epub Date: 2022-09-20 DOI: 10.26502/fjsrs0047
Thomas Theis, Carlos Ayala, Monica Tschang, Michele Philip, Vini Nagaraj, Anil Shrirao, Gregory Voronin, Wise Young, Melitta Schachner

CHL1 is a close homolog of L1, a cell adhesion molecule that plays major roles in neural and tumor cell functions. We had found that young adult female mice deficient in CHL1 recovered better than their wild-type female littermates after thoracic Spinal Cord Injury (SCI). This observation was surprising, because CHL1 increases neurite outgrowth in vitro. Injury of adult mouse central and peripheral nervous systems upregulate CHL1 expression in neurons and astrocytes, consistent with CHL1's pro-active, homophilic interaction between CHL1 surface molecules in wild-type mice. After SCI, CHL1 expression was observed to increase in the glial scar, areas of axonal regrowth and remodeling of neural circuits. These observations were made only in females, and we therefore sought to analyze SCI in CHL1-deficient male mice. We now show that CHL1-deficient males did not recover better or worse than their male wild-type littermates. Primary and secondary lesion volumes were similar in the two genotypes, as seen in female mice which were studied in parallel with male mice. Assessment of peripheral leukocytes showed a significant increase in numbers of blood neutrophils at 24 h after SCI in males, but not in females. Lymphocyte numbers in mutant males increased slightly, but numbers of lymphocytes or monocytes did not differ significantly between males or females. These results indicate that CHL1-deficient males and females differ in the number of neutrophils but not lymphocytes or monocytes, suggesting that the difference between males and females is unlikely due to differences in leukocytes.

CHL1是L1的同源基因,L1是一种细胞粘附分子,在神经和肿瘤细胞功能中起重要作用。我们发现,在胸椎脊髓损伤(SCI)后,缺乏CHL1的年轻成年雌鼠比野生型雌鼠恢复得更好。这一观察结果令人惊讶,因为CHL1增加了体外神经突的生长。成年小鼠中枢和周围神经系统损伤可上调神经元和星形胶质细胞中CHL1的表达,这与野生型小鼠CHL1表面分子之间的主动、亲同性相互作用一致。脊髓损伤后,在神经胶质瘢痕、轴突再生区和神经回路重塑区观察到CHL1表达增加。这些观察结果仅在雌性小鼠中进行,因此我们试图分析chl1缺陷雄性小鼠的SCI。我们现在表明,与野生型雄鼠相比,缺乏chl1的雄鼠没有更好或更差的恢复。两种基因型的原发性和继发性病变体积相似,这在雌性小鼠和雄性小鼠的平行研究中可见。外周白细胞的评估显示,在脊髓损伤后24小时,男性的血液中性粒细胞数量显著增加,而女性则没有。突变雄性的淋巴细胞数量略有增加,但淋巴细胞和单核细胞的数量在雌雄之间没有显著差异。这些结果表明,缺乏chl1的男性和女性在中性粒细胞数量上存在差异,但在淋巴细胞或单核细胞数量上没有差异,这表明男性和女性之间的差异不太可能是由于白细胞的差异。
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引用次数: 1
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Journal of spine research and surgery
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