The clinical rehabilitation of spine and spinal cord disorders: detection and evaluation using SPECT/CT

Spine-related disorders are caused by several factors including （1） spinal nerve/visceral nerve stimulation by perivertebral aseptic inflammation, （2） spinal nerve/visceral nerve compression by injured periverterbal soft tissue, dislocated perivertebral small joint, and proliferative/degenerative tissue and, （3） secondary damage to the spinal cord, peripheral nerve, vessels and autonomic nerve, which further stimulate nerve root sheath and surround- ing pain-carrying nerve fibers. In many cases, the source of pain cannot be detected by standard image modalities. Particularly in anatomically complex regions like the spine, SPECT/CT can be helpful for some aspects by intro- ducing a metabolical dimension to the classical way of morphology-based diagnostic. The aim of the present review was to give an overview of the adoption of SPECT/CT in a clinical spine-focused setting.

Traditional Chinese spinal orthopedic manipulation

Traditional Chinese spinal orthopedic manipulation(TCSOM)is an external therapeutic method of traumatology and orthopedics of traditional Chinese medicine to treat trauma and set bone.The doctor exerts his force through thumb or bilateral upper extremities on the spine or acupoints of the patient,applying various manipulatory techniques according to the conditions.Correcting the abnormal position or state of the spine serve as the most important theoretical foundation for TCSOM to treat spinal disorders and spinogenic disorders.This paper presented the definition and function of the TCSOM,with a special focus on how to make a preliminary diagnosis of spinal segments disorders,and the indications of TCSOM in different spinal segments.

Spinal Cord Stimulation Frequency Influences the Hemodynamic Response in Patients with Disorders of Consciousness

Spinal cord stimulation （SCS） is a promising technique for treating disorders of consciousness （DOCs）. However, differences in the spatio-temporal responsiveness of the brain under varied SCS parameters remain unclear. In this pilot study, functional near-infrared spectroscopy was used to measure the hemodynamic responses of 10 DOC patients to different SCS frequencies （5 Hz, 10 Hz, 50 Hz, 70 Hz, and 100 Hz）. In the prefrontal cortex, a key area in consciousness circuits, we found significantly increased hemodynamic responses at 70 Hz and 100 Hz, and significantly different hemodynamic responses between 50 Hz and 70 Hz/100 Hz. In addition, the functional connectivity between prefrontal and occipital areas was significantly improved with SCS at 70 Hz. These results demonstrated that SCS modulates the hemodynamic responses and long-range connectivity in a frequency-specific manner （with 70 Hz apparently better）, perhaps by improving the cerebral blood volume and information transmission through the reticular formation-thalamus-cortex pathway.

Probable lumbar acute noncompressive nucleus pulposus extrusion: a case report of acute pain caused by a hydrated nucleus pulposus and review of the literature

Acute noncompressive nucleus pulposus(NP)extrusion has been widely described in veterinary medicine,especially in dogs and cats;however,caseshave rarely been reported in humans.We report a rare case of acute pain caused by a hydrated NP.Magnetic resonance imaging revealed an obvious hyperintense signal on T2-weighted images at the L5/S1 segments,while computed tomography imaging and radiography revealed amildly herniated discat the L4/5 level and slightlumbar spondylo listhesis at the L5/S1 segments.The operation was performed to confirm the presence of ared and swollen nerve root on the right side of the hydrated L5/S1 segment.The patient’s severe pain disappeared,and full recovery was achieved months after surgery.Thus,our case demonstrated a probable lumbar acute noncompressive NP extrusion in humans and reported associated symptoms and imaging characteristics.In such circumstances,surgical management is indicated and may be associated with a good outcome.