Intervertebral disk degeneration （IDD） is strongly associated with genetic predisposition and environmental susceptibility. Several studies been conducted to investigate the potential asso- ciation between IDD and F...Intervertebral disk degeneration （IDD） is strongly associated with genetic predisposition and environmental susceptibility. Several studies been conducted to investigate the potential asso- ciation between IDD and FokI polymorphism located in the gene encoding the vitamin D receptor （VDR）, and inconsistent conclusions had been reached among different ethnic populations. In order to assess the association between the FokI polymorphism and the risk of IDD, we performed a comprehensive and systematic meta-analysis. Candidate articles were retrieved from PubMed, EMBASE, China National Knowledge Infrastructure （CNKI）, and China Biology Medical （CBM） with strict inclusion criteria in January 2015. Among the 54 articles that were retrieved, only eight studies met the inclusion criteria. The pooled data analysis based on allele contrast, homozy- gore, heterozygote, dominant, and recessive models revealed no significant correlation between the FokI polymorphism and the risk of IDD. However, when stratified by ethnicity, significant associ- ations were detected for Hispanics based on allele contrast （OR = 1.395, 95% CI = 1.059-1.836, P = 0.018）, homozygote （OR = 1.849, 95% CI = 1.001-3.416, P = 0.049）, heterozygote （OR = 1.254, 95% CI = 1.049-1.498, P = 0.013）, and dominant （OR = 1.742, 95% CI = 1.174-2.583, P = 0.006） models, and for Asians using the dominant model （OR = 1.293, 95% CI = 1.025-1.632, P --- 0.030）, whereas there is no significant association detected for Caucasians. In conclusion, FokI polymorpbism is not generally associated with IDD, but there is increased risk for IDD in Hispanics and Asians carrying FokI allele T.展开更多
Background This study was to investigate the safety of two types of commercially available lumbar artificial discs （CHARITE and PRODISC-L） during a magnetic resonance imaging （MRI） procedure in a 1.5-Tesla MR syst...Background This study was to investigate the safety of two types of commercially available lumbar artificial discs （CHARITE and PRODISC-L） during a magnetic resonance imaging （MRI） procedure in a 1.5-Tesla MR system, and to evaluate the size of metal artifacts on the MR image for different sequences. Methods A 1.5-Tesla clinical MR imaging system was used. The degree of deflection of the endplates of two artificial discs was evaluated by an angle-measurement instrument at the portals of the MRI scanner. The heating effect of the radio frequency （RF） magnetic field was evaluated by using ＂worst-case＂ imaging sequences on a human cadaver implanted with an artificial lumbar disc at the L5/S1 intervertebral disc location. The temperatures of the tissue adjacent to the implant, and of the L4/L5 intervertebral disc （used as a control） were measured, respectively, using a digital probe thermometer before and after the MRI scan sequence. A rectangular water phantom was designed to evaluate the metal artifacts of these two artificial discs under different MR imaging sequences. Results The maximal deflection angle of the endplate of the implants under a static MR field was 7.5 and 6.0 degrees, for the CHARITE and PRODISC-L, respectively. The difference between temperature rise of tissue adjacent to the two types of artificial discs and the temperature rise of the L4/L5 control location was 0.4 and 0.6℃, respectively. The size of metal artifacts on images of TSE （T1/T2 -weighted）, STIR and Turbo Dark Fluid sequences were relatively less than those of TSE fat saturation, Flash and SE （Tl-weighted） sequences. Conclusions The CHARITE and the PRODISC-L artificial disc do not present an additional hazard or risk to a patient undergoing an MRI procedure using a scanner operating with a static magnetic field of 1.5T or lower. Image artifacts from the implants may present problems if the anatomical region of interest is in or near the area where these implants are located （e.g., vertebral canal at affected segment）.展开更多
Background Spinal pain is a serious health and social-economic problem.Endoscopic spine surgery as a treatment option for spinal pain has gained tremendous attention and growth in the past 2 decades,and a variety of e...Background Spinal pain is a serious health and social-economic problem.Endoscopic spine surgery as a treatment option for spinal pain has gained tremendous attention and growth in the past 2 decades,and a variety of endoscopic techniques have been invented to treat a wide range of spinal conditions.Purposes The purposes of this 2-part review article are to 1) overview the published techniques of endoscopic spine surgery,2) summarize the applications of these techniques in treating various spinal conditions,and 3) evaluate the clinical evidence of the safety and effectiveness of these endoscopic techniques in treating some of the most common spinal conditions.The first part of the review article provides an overview of currently most commonly used techniques.Methods We searched the PubMed database for publications concerning endoscopic spine surgery and reviewed the relevant articles published in the English language.Results Discectomy and foraminotomy are the most common types of spine surgery that can currently be done endoscopically.Endoscopic techniques have been used to treat a wide range of spinal disorders located in the lumbar,cervical,as well as the thoracic regions of the spine.展开更多
基金supported by the Science & Technology Commission of Shanghai Municipality, China (Grant No. 11DZ191109)the National Natural Science Foundation of China (Grant No. 30872611)
文摘Intervertebral disk degeneration （IDD） is strongly associated with genetic predisposition and environmental susceptibility. Several studies been conducted to investigate the potential asso- ciation between IDD and FokI polymorphism located in the gene encoding the vitamin D receptor （VDR）, and inconsistent conclusions had been reached among different ethnic populations. In order to assess the association between the FokI polymorphism and the risk of IDD, we performed a comprehensive and systematic meta-analysis. Candidate articles were retrieved from PubMed, EMBASE, China National Knowledge Infrastructure （CNKI）, and China Biology Medical （CBM） with strict inclusion criteria in January 2015. Among the 54 articles that were retrieved, only eight studies met the inclusion criteria. The pooled data analysis based on allele contrast, homozy- gore, heterozygote, dominant, and recessive models revealed no significant correlation between the FokI polymorphism and the risk of IDD. However, when stratified by ethnicity, significant associ- ations were detected for Hispanics based on allele contrast （OR = 1.395, 95% CI = 1.059-1.836, P = 0.018）, homozygote （OR = 1.849, 95% CI = 1.001-3.416, P = 0.049）, heterozygote （OR = 1.254, 95% CI = 1.049-1.498, P = 0.013）, and dominant （OR = 1.742, 95% CI = 1.174-2.583, P = 0.006） models, and for Asians using the dominant model （OR = 1.293, 95% CI = 1.025-1.632, P --- 0.030）, whereas there is no significant association detected for Caucasians. In conclusion, FokI polymorpbism is not generally associated with IDD, but there is increased risk for IDD in Hispanics and Asians carrying FokI allele T.
基金This project was supported by the grants from the National Natural Science Foundation of China （No. 30700849） and Science Foundation of Shanghai Municipal Commission of Sciences and Technology （No. 07JC14069）.
文摘Background This study was to investigate the safety of two types of commercially available lumbar artificial discs （CHARITE and PRODISC-L） during a magnetic resonance imaging （MRI） procedure in a 1.5-Tesla MR system, and to evaluate the size of metal artifacts on the MR image for different sequences. Methods A 1.5-Tesla clinical MR imaging system was used. The degree of deflection of the endplates of two artificial discs was evaluated by an angle-measurement instrument at the portals of the MRI scanner. The heating effect of the radio frequency （RF） magnetic field was evaluated by using ＂worst-case＂ imaging sequences on a human cadaver implanted with an artificial lumbar disc at the L5/S1 intervertebral disc location. The temperatures of the tissue adjacent to the implant, and of the L4/L5 intervertebral disc （used as a control） were measured, respectively, using a digital probe thermometer before and after the MRI scan sequence. A rectangular water phantom was designed to evaluate the metal artifacts of these two artificial discs under different MR imaging sequences. Results The maximal deflection angle of the endplate of the implants under a static MR field was 7.5 and 6.0 degrees, for the CHARITE and PRODISC-L, respectively. The difference between temperature rise of tissue adjacent to the two types of artificial discs and the temperature rise of the L4/L5 control location was 0.4 and 0.6℃, respectively. The size of metal artifacts on images of TSE （T1/T2 -weighted）, STIR and Turbo Dark Fluid sequences were relatively less than those of TSE fat saturation, Flash and SE （Tl-weighted） sequences. Conclusions The CHARITE and the PRODISC-L artificial disc do not present an additional hazard or risk to a patient undergoing an MRI procedure using a scanner operating with a static magnetic field of 1.5T or lower. Image artifacts from the implants may present problems if the anatomical region of interest is in or near the area where these implants are located （e.g., vertebral canal at affected segment）.
文摘Background Spinal pain is a serious health and social-economic problem.Endoscopic spine surgery as a treatment option for spinal pain has gained tremendous attention and growth in the past 2 decades,and a variety of endoscopic techniques have been invented to treat a wide range of spinal conditions.Purposes The purposes of this 2-part review article are to 1) overview the published techniques of endoscopic spine surgery,2) summarize the applications of these techniques in treating various spinal conditions,and 3) evaluate the clinical evidence of the safety and effectiveness of these endoscopic techniques in treating some of the most common spinal conditions.The first part of the review article provides an overview of currently most commonly used techniques.Methods We searched the PubMed database for publications concerning endoscopic spine surgery and reviewed the relevant articles published in the English language.Results Discectomy and foraminotomy are the most common types of spine surgery that can currently be done endoscopically.Endoscopic techniques have been used to treat a wide range of spinal disorders located in the lumbar,cervical,as well as the thoracic regions of the spine.
