[目的]探讨颈椎前路经椎间隙截骨融合术(anterior intervertebral osteotomy and fusion,AIOF)治疗严重颈椎病的临床疗效。[方法]回顾性分析2015年5月~2017年6月采用AIOF治疗的严重颈椎病患者37例的临床资料。其中男性25例,女性12例,年...[目的]探讨颈椎前路经椎间隙截骨融合术(anterior intervertebral osteotomy and fusion,AIOF)治疗严重颈椎病的临床疗效。[方法]回顾性分析2015年5月~2017年6月采用AIOF治疗的严重颈椎病患者37例的临床资料。其中男性25例,女性12例,年龄30~68岁;单节段11例,双节段15例,三节段8例,四节段3例。总结患者围手术期、随访与影像资料。[结果]37例患者均顺利完成手术,无血管、神经和脏器损伤等严重并并发症。随访13~26个月,平均(15.32±2.55)个月。随时间推移,患者VAS评分显著减少(P<0.05),JOA评分显著增加(P<0.05),肌力和深反射评级显著改善(P<0.05)。影像方面,术后各时间点颈椎前凸角较术前显著增加(P<0.05),术后各时间点间相比颈椎前凸角无显著变化(P>0.05)。术后颈椎CT显示钩椎关节、椎间隙后方、椎体后下方及后上方的增生骨赘被彻底切除;术后颈椎MRI显示神经减压彻底,脊髓形态、曲度恢复良好。至末次随访时,椎间植骨融合良好,未出现内置物松动、断裂。[结论]颈椎前路经椎间隙截骨融合术治疗严重颈椎病安全可行、减压充分,特别适应于椎间隙狭窄、椎体后方骨赘增生严重的颈椎病患者。展开更多
Nerve conduit is one of strategies for spine cord injury(SCI)treatment.Recently,studies showed that biomaterials could guide the neurite growth and promote axon regeneration at the injury site.However,the scaffold by ...Nerve conduit is one of strategies for spine cord injury(SCI)treatment.Recently,studies showed that biomaterials could guide the neurite growth and promote axon regeneration at the injury site.However,the scaffold by itself was difficult to meet the need of SCI functional recovery.The basic fibroblast growth factor(bFGF)administration significantly promotes functional recovery after organ injuries.Here,using a rat model of T9 hemisected SCI,we aimed at assessing the repair capacity of implantation of collagen scaffold(CS)modified by collagen binding bFGF(CBD-bFGF).The results showed that CS combined with CBD-bFGF treatment improved survival rates after the lateral hemisection SCI.The CS/CBD-bFGF group showed more significant improvements in motor than the simply CS-implanted and untreated control group,when evaluated by the 21-point Basso-Beattie-Bresnahan(BBB)score and footprint analysis.Both hematoxylin and eosin(H&E)and immunohistochemical staining of neurofilament(NF)and glial fibrillary acidic protein(GFAP)demonstrated that fibers were guided to grow through the implants.These findings indicated that administration of CS modified with CBD-bFGF could promote spinal cord regeneration and functional recovery.展开更多
文摘[目的]探讨颈椎前路经椎间隙截骨融合术(anterior intervertebral osteotomy and fusion,AIOF)治疗严重颈椎病的临床疗效。[方法]回顾性分析2015年5月~2017年6月采用AIOF治疗的严重颈椎病患者37例的临床资料。其中男性25例,女性12例,年龄30~68岁;单节段11例,双节段15例,三节段8例,四节段3例。总结患者围手术期、随访与影像资料。[结果]37例患者均顺利完成手术,无血管、神经和脏器损伤等严重并并发症。随访13~26个月,平均(15.32±2.55)个月。随时间推移,患者VAS评分显著减少(P<0.05),JOA评分显著增加(P<0.05),肌力和深反射评级显著改善(P<0.05)。影像方面,术后各时间点颈椎前凸角较术前显著增加(P<0.05),术后各时间点间相比颈椎前凸角无显著变化(P>0.05)。术后颈椎CT显示钩椎关节、椎间隙后方、椎体后下方及后上方的增生骨赘被彻底切除;术后颈椎MRI显示神经减压彻底,脊髓形态、曲度恢复良好。至末次随访时,椎间植骨融合良好,未出现内置物松动、断裂。[结论]颈椎前路经椎间隙截骨融合术治疗严重颈椎病安全可行、减压充分,特别适应于椎间隙狭窄、椎体后方骨赘增生严重的颈椎病患者。
基金supported by National Natural Science Foundation of China(81101369,81071450)the Scientific Research Foundation for the Returned Overseas Chinese Scholars,Ministry of Education of China(to Shi Qin),Ph.D.Programs Foundation of State Education Ministry(20113201110013)+1 种基金Jiangsu Provincial Special Program of Medical Science(BL2012004,BK2011264)Jiangsu Province’s Key Provincial Talents Program(RC2011102)
文摘Nerve conduit is one of strategies for spine cord injury(SCI)treatment.Recently,studies showed that biomaterials could guide the neurite growth and promote axon regeneration at the injury site.However,the scaffold by itself was difficult to meet the need of SCI functional recovery.The basic fibroblast growth factor(bFGF)administration significantly promotes functional recovery after organ injuries.Here,using a rat model of T9 hemisected SCI,we aimed at assessing the repair capacity of implantation of collagen scaffold(CS)modified by collagen binding bFGF(CBD-bFGF).The results showed that CS combined with CBD-bFGF treatment improved survival rates after the lateral hemisection SCI.The CS/CBD-bFGF group showed more significant improvements in motor than the simply CS-implanted and untreated control group,when evaluated by the 21-point Basso-Beattie-Bresnahan(BBB)score and footprint analysis.Both hematoxylin and eosin(H&E)and immunohistochemical staining of neurofilament(NF)and glial fibrillary acidic protein(GFAP)demonstrated that fibers were guided to grow through the implants.These findings indicated that administration of CS modified with CBD-bFGF could promote spinal cord regeneration and functional recovery.
