BACKGROUND Due to mechanical imbalance in the spine,elderly scoliosis patients tend to develop vertebral fracture nonunion,i.e.,Kümmell disease,when osteoporotic vertebral compression fractures occur.However,acco...BACKGROUND Due to mechanical imbalance in the spine,elderly scoliosis patients tend to develop vertebral fracture nonunion,i.e.,Kümmell disease,when osteoporotic vertebral compression fractures occur.However,accompanying vertebral rotational deformities make surgical procedures challenging risky.Such patients are usually compelled to undergo conservative treatment and there are very few reports on minimally invasive surgeries for them.We first-time report a patient with Kümmell disease and lumbar scoliosis treated with percutaneous kyphoplasty(PKP)under O-arm guidance.CASE SUMMARY An 89-year-old female was admitted to the hospital due to delayed low back pain after a fall.She was diagnosed with Kümmell disease based on physical and radiologic examinations.The patient experienced severe scoliosis and subsequently underwent O-arm-guided kyphoplasty,resulting in a significant alleviation of low back pain.CONCLUSION PKP has good efficacy in treating Kümmell disease.However,surgical risks are elevated in scoliosis patients with Kümmell disease due to the abnormal anatomical structure of the spine.O-arm assisted operations play a crucial role in decreasing surgical risks.展开更多
Axonal regeneration plays an important role in functional recovery after nervous system damage.However,after axonal injury in mammals,regeneration is often poor.The deletion of Krüppel-like factor-4(Klf4)has been...Axonal regeneration plays an important role in functional recovery after nervous system damage.However,after axonal injury in mammals,regeneration is often poor.The deletion of Krüppel-like factor-4(Klf4)has been shown to promote axonal regeneration in retinal ganglion cells.However,the effects of Klf4 deletion on the corticospinal tract and peripheral nervous system are unknown.In this study,using a mouse model of sciatic nerve injury,we show that the expression of Klf4 in dorsal root ganglion sensory neurons was significantly reduced after peripheral axotomy,suggesting that the regeneration of the sciatic nerve is associated with Klf4.In vitro,dorsal root ganglion sensory neurons with Klf4 knockout exhibited significantly enhanced axonal regeneration.Furthermore,the regeneration of the sciatic nerve was enhanced in vivo following Klf4 knockout.Finally,AAV-Cre virus was used to knockout the Klf4 gene in the cortex.The deletion of Klf4 enhanced regeneration of the corticospinal tract in mice with spinal cord injury.Together,our findings suggest that regulating KLF4 activity in neurons is a potential strategy for promoting axonal regeneration and functional recovery after nervous system injury.This study was approved by the Animal Ethics Committee at Soochow University,China(approval No.SUDA20200316A01).展开更多
基金Supported by The Innovation and Entrepreneurship Program of Jiangsu Province,No.(2015)-159。
文摘BACKGROUND Due to mechanical imbalance in the spine,elderly scoliosis patients tend to develop vertebral fracture nonunion,i.e.,Kümmell disease,when osteoporotic vertebral compression fractures occur.However,accompanying vertebral rotational deformities make surgical procedures challenging risky.Such patients are usually compelled to undergo conservative treatment and there are very few reports on minimally invasive surgeries for them.We first-time report a patient with Kümmell disease and lumbar scoliosis treated with percutaneous kyphoplasty(PKP)under O-arm guidance.CASE SUMMARY An 89-year-old female was admitted to the hospital due to delayed low back pain after a fall.She was diagnosed with Kümmell disease based on physical and radiologic examinations.The patient experienced severe scoliosis and subsequently underwent O-arm-guided kyphoplasty,resulting in a significant alleviation of low back pain.CONCLUSION PKP has good efficacy in treating Kümmell disease.However,surgical risks are elevated in scoliosis patients with Kümmell disease due to the abnormal anatomical structure of the spine.O-arm assisted operations play a crucial role in decreasing surgical risks.
基金This study was supported by the National Natural Science Foundation of China,Nos.81571189,81772353(to Saijilafu).
文摘Axonal regeneration plays an important role in functional recovery after nervous system damage.However,after axonal injury in mammals,regeneration is often poor.The deletion of Krüppel-like factor-4(Klf4)has been shown to promote axonal regeneration in retinal ganglion cells.However,the effects of Klf4 deletion on the corticospinal tract and peripheral nervous system are unknown.In this study,using a mouse model of sciatic nerve injury,we show that the expression of Klf4 in dorsal root ganglion sensory neurons was significantly reduced after peripheral axotomy,suggesting that the regeneration of the sciatic nerve is associated with Klf4.In vitro,dorsal root ganglion sensory neurons with Klf4 knockout exhibited significantly enhanced axonal regeneration.Furthermore,the regeneration of the sciatic nerve was enhanced in vivo following Klf4 knockout.Finally,AAV-Cre virus was used to knockout the Klf4 gene in the cortex.The deletion of Klf4 enhanced regeneration of the corticospinal tract in mice with spinal cord injury.Together,our findings suggest that regulating KLF4 activity in neurons is a potential strategy for promoting axonal regeneration and functional recovery after nervous system injury.This study was approved by the Animal Ethics Committee at Soochow University,China(approval No.SUDA20200316A01).
