BACKGROUND Ligamentum flavum cysts,which are most common in mobile junctional levels of the spine,can be a rare cause of spinal stenosis.There have been several case reports of ligamentum flavum cysts.However,there is...BACKGROUND Ligamentum flavum cysts,which are most common in mobile junctional levels of the spine,can be a rare cause of spinal stenosis.There have been several case reports of ligamentum flavum cysts.However,there is yet to be a documented case report of a calcified ligamentum flavum cyst.Herein,we report the first case of a calcified ligamentum flavum cyst causing ankle and toe weakness.CASE SUMMARY A 66-year-old male visited our hospital complaining of claudication as well as thigh and calf pain in his left leg,all beginning two weeks prior.Physical examination revealed motor weakness of the left ankle dorsiflexion and great toe dorsiflexion.Lumbar spinal computed tomography scans showed spinal stenosis combined with a calcified mass at the left side of the L4-5 level.Magnetic reso-nance imaging showed dural sac compression caused by the calcified mass at the left ligamentum flavum of the L4-5 level.We performed decompressive laminectomy and excision of the calcified mass combined with posterior lumbar interbody fusion at the L4-5 level.Intra-operatively,we found a firm and nodule like mass originating from the ventral surface of ligamentum flavum.Pathological examination suggested a calcified pseudocyst without a capsular lining.After the operation,the patient’s motor weakness in the ankle and great toe improved gradually.CONCLUSION The patient’s ankle and great toe weakness were improved successfully after surgical removal of the calcified cyst.展开更多
BACKGROUND Ligamentum flavum hematoma(LFH)can cause compression of the spinal cord or nerve root,which results in neurological symptoms.We report a case of lumbar radicular pain due to LFH following a traffic accident...BACKGROUND Ligamentum flavum hematoma(LFH)can cause compression of the spinal cord or nerve root,which results in neurological symptoms.We report a case of lumbar radicular pain due to LFH following a traffic accident.CASE SUMMARY A 59-year-old man complained of left buttock and lateral thigh pain that was dull in nature after a traffic accident 18 d prior to presentation.Magnetic resonance imaging(MRI),taken 17 d after the traffic accident,revealed a mass lesion at the L4-5 Level.These MRI findings suggested subacute LFH.The patient’s pain was not alleviated with conservative treatment,including oral medication and epidural steroid injection.After a partial-hemilaminectomy and removal of LFH,the patient’s pain completely disappeared.CONCLUSION Because early operation for decompression is important for a good outcome,clinicians should be able to determine LFH from MRI results and be aware of the possibility of LFH,especially in patients with a history of trauma.展开更多
Sixteen diterpenoid alkaloids(DAs),including six aconitine-type alkaloids(5 and 9−13),seven 7,17-seco-aconitine-type alkaloids(1−4,6−8),two napelline-type alkaloids(14 and 15)as well as one veatchine-type alkaloid(16)...Sixteen diterpenoid alkaloids(DAs),including six aconitine-type alkaloids(5 and 9−13),seven 7,17-seco-aconitine-type alkaloids(1−4,6−8),two napelline-type alkaloids(14 and 15)as well as one veatchine-type alkaloid(16),were isolated from the aerial parts of Aconitum flavum Hand.-Mazz.In which,flavumolines A−D(1−4)were four new ones,and flavu-moline E(5)was reported as natural compound for the first time.Their chemical structures were elucidated by the analysis of extensive spectroscopic data.The inhibitory activities of these isolates on Cav3.1 low voltage-gated Ca^(2+)channel,NO production in LPS-activated RAW264.7cells,five human tumor cell lines,as well as acetylcholinesterase(AChE)were tested.展开更多
BACKGROUND Ligament flavum(LF)hypertropy is the main etiopathogenesis of lumbar canal stenosis(LCS).The purely elastic LF undergoes a morphological adaptation including a reduction in the elastic fibers and a conseque...BACKGROUND Ligament flavum(LF)hypertropy is the main etiopathogenesis of lumbar canal stenosis(LCS).The purely elastic LF undergoes a morphological adaptation including a reduction in the elastic fibers and a consequent increase in the collagen content,fibrosis,cicatrization,and calcification.However,the morphometric analysis can delineate the LF in patients with LCS from those without LCS,which would help in better understanding LCS pathogenesis.AIM To compare the histopathological changes in LF between the degenerative LCS and non-stenotic(non-LCS)group.METHODS The present prospective study was conducted in 82 patients who were divided into two groups,namely LCS and non-LCS.Demographic details of the patients such as duration of symptoms,level of involvement,and number of segments were recorded.The LF obtained from both groups was histopathologically examined for the fibrosis score,elastic fiber degeneration,calcification,and chondroid metaplasia.Morphometrical details included a change in elastin and collagen percentages,elastin/collagen ratio,elastic fiber fragmentation,and ligamentocyte numbers.All parameters were compared between the two groups by using the independent t test,Chi-square test,and Pearson’s correlation test.RESULTS Out of 82 cases,74 were analysed,34 in LCS and 40 in non-LCS group.The mean±SD age of presentation in LCS and non-LCS group was 49.2±8.9 and 43.1±14.3 respectively.The LCS group(n=34)exhibited significant differences in fibrosis(P=0.002),elastic fiber degeneration(P=0.01),%elastic fragmentation(66.5±16.3 vs 29.5±16.9),%elastic,content(26.9±6.7 vs 34.7±8.4),%collagen content(63.6±10.4 vs 54.9±6.4),reduction of elastic/collagen(0.4±0.1 vs 0.6±0.1),and ligamentocyte number(39.1±19.1 vs 53.5±26.9)as compared to non-LCS group(n=40).The calcification(P=0.08)and Pearson’s correlation between duration and loss of elastin was not significant.The difference in LF morphology is consistent in patient’s≥40 years of age among the groups as found in subgroup analysis.Similarly in the patents<40 and>40 in the non-LCS group.CONCLUSION LF is vital in the pathogenesis of LCS.The purely elastic LF undergoes a morphological adaptation that includes a reduction in the elastic fibers with a consequent increase in the collagen content,fibrosis,cicatrization,and calcification.The present study provides a detailed morphometric analysis to semiquantitatively delineate the LF changes in patients with LCS from those in patients without LCS.展开更多
Objective To study the clinical epidemiology of ossification of ligamentum flavum(OLF)and evaluate its characteristics of prevalence, morphology, and distribution in a common population.Some factors associated with it...Objective To study the clinical epidemiology of ossification of ligamentum flavum(OLF)and evaluate its characteristics of prevalence, morphology, and distribution in a common population.Some factors associated with its occurrence were analyzed展开更多
Objective To describe the pathological unit and octagonal en bloc resection for the treatment of ossification ligamentum flavum(OLF)in thoracic spine with spondylotic myelopathy.Methods Ninety-five patients from Janua...Objective To describe the pathological unit and octagonal en bloc resection for the treatment of ossification ligamentum flavum(OLF)in thoracic spine with spondylotic myelopathy.Methods Ninety-five patients from January 2002 to January展开更多
Objective To investigate the difference between different surgical methods for thoracic ossification of ligamentum flavum(OLF) combined with cervical spondylotic myelopathy(CSM) . Methods From January 1991 to January ...Objective To investigate the difference between different surgical methods for thoracic ossification of ligamentum flavum(OLF) combined with cervical spondylotic myelopathy(CSM) . Methods From January 1991 to January 2003,56 cases展开更多
Objective To study the diagnosis and treatment of lower thoracic ossification of ligamentum flavum(OLF) combined with lumbar spinal stenosis.Methods Retrospective analysis was carried out on 11 cases of lower thoracic...Objective To study the diagnosis and treatment of lower thoracic ossification of ligamentum flavum(OLF) combined with lumbar spinal stenosis.Methods Retrospective analysis was carried out on 11 cases of lower thoracic OLF combined with展开更多
Objective To evaluate the effects of the laminar thinned-segmented decompression technique in the treatment of thoracic ossification of ligamentum flavum with spondylotic myelopathy.Methods From January 1999 to Januar...Objective To evaluate the effects of the laminar thinned-segmented decompression technique in the treatment of thoracic ossification of ligamentum flavum with spondylotic myelopathy.Methods From January 1999 to January 2009,126 cases展开更多
Objective To explore the strategy and outcomes of surgical treatment of thoracic ossification of ligamentum flavum(OLF),especially combined with ossification of posterior longitudinal ligament,thoracic kyphosis and ep...Objective To explore the strategy and outcomes of surgical treatment of thoracic ossification of ligamentum flavum(OLF),especially combined with ossification of posterior longitudinal ligament,thoracic kyphosis and epidural展开更多
Objective To investigate different surgical procedures for treatment of thoracic ossification of ligamentum flavum.Methods From January 1994 to June 2008,56 cases of thoracic ossification of ligamentum flavum underwent
Objective To analyze the surgical treatment options and its results for thoracic and thoracolumbar disc herniation.Methods From June 2004 to December 2009,thirty-one patients of thoracic and thoracolumbar disc herniat...Objective To analyze the surgical treatment options and its results for thoracic and thoracolumbar disc herniation.Methods From June 2004 to December 2009,thirty-one patients of thoracic and thoracolumbar disc herniation with展开更多
Ligamentum flavum(LF)hypertrophy(LFH)has been recognised as one of the key contributors to lumbar spinal stenosis.Currently,no effective methods are available to ameliorate this hypertrophy.In this study,human umbilic...Ligamentum flavum(LF)hypertrophy(LFH)has been recognised as one of the key contributors to lumbar spinal stenosis.Currently,no effective methods are available to ameliorate this hypertrophy.In this study,human umbilical cord mesenchymal stromal cell-derived extracellular vesicles(hUCMSC-EVs)were introduced for the first time as promising vehicles for drug delivery to treat LFH.The downregulation of miR-146a-5p and miR-221-3p expressions in human LF tissues negatively correlated with increased LF thickness.The hUCMSC-EVs enriched with these two miRNAs significantly suppressed LFH in vivo and notably ameliorated the progression of transforming growth factorβ1(TGF-β1)-induced fibrosis in vitro after delivering these two miRNAs to mouse LF cells.The results further demonstrated that miR-146a-5p and miR-221-3p directly bonded to the 3′-UTR regions of SMAD4 mRNA,thereby inhibiting the TGF-β/SMAD4 signalling pathway.Therefore,this translational study determined the effectiveness of a hUCMSC-EVs-based approach for the treatment of LFH and revealed the critical target of miR-146a-5p and miR-221-3p.Our findings provide new insights into promising therapeutics using a hUCMSC-EVs-based delivery system for patients with lumbar spinal stenosis.展开更多
背景:既往认为黄韧带骨化在人群中罕见发生,随着研究深入,发现其发病率逐渐上升,这引起大量学者的研究兴趣。目的:通过检索科学引文索引数据库核心集自1999年以来的有关黄韧带骨化的研究成果,使用文献计量学方法对数据进行可视化分析,...背景:既往认为黄韧带骨化在人群中罕见发生,随着研究深入,发现其发病率逐渐上升,这引起大量学者的研究兴趣。目的:通过检索科学引文索引数据库核心集自1999年以来的有关黄韧带骨化的研究成果,使用文献计量学方法对数据进行可视化分析,回顾黄韧带骨化的研究历史,指示重要文献,梳理研究热点,为学者寻找研究方向提供思路。方法:以Web of Science核心集数据库为主,搜索并筛选黄韧带骨化相关论文,使用VOSviewer 1.6.19和CiteSpace 6.2.R6软件对年度发文量、研究国家、机构、被引文献、期刊、作者和关键词等进行可视化分析。结果与结论:①共纳入347篇文献,自1999年发文量呈螺旋上升,中国研究较日本起步晚,但是发文量后来居上,北京大学是发文量最多的机构,北京大学的陈仲强教授是发文量最多的学者。②被引用最多的10篇文献中5篇都与黄韧带骨化的手术治疗有关。③去除与研究主题直接相关的关键词,综合词频和中介中心性的结果发现,“胸椎脊髓病”“硬膜骨化”“微创手术”“后纵韧带骨化”处于领域研究的核心地位。④关键词聚类分析显示,黄韧带骨化的临床表现和手术治疗在疾病的研究中占比较大。⑤关键词时间线图及关键词突现分析显示,“微创手术”作为关键词出现在2015年前后,是突现强度最高的关键词,也是突现开始时间最晚的关键词,2019年开始受到学者广泛关注,关键词“硬膜骨化”的突现尚未结束。⑥黄韧带骨化的手术治疗一直处于研究前沿,微创手术方式的开发和研究、黄韧带骨化继发硬膜骨化的研究是该领域的研究热点。展开更多
文摘BACKGROUND Ligamentum flavum cysts,which are most common in mobile junctional levels of the spine,can be a rare cause of spinal stenosis.There have been several case reports of ligamentum flavum cysts.However,there is yet to be a documented case report of a calcified ligamentum flavum cyst.Herein,we report the first case of a calcified ligamentum flavum cyst causing ankle and toe weakness.CASE SUMMARY A 66-year-old male visited our hospital complaining of claudication as well as thigh and calf pain in his left leg,all beginning two weeks prior.Physical examination revealed motor weakness of the left ankle dorsiflexion and great toe dorsiflexion.Lumbar spinal computed tomography scans showed spinal stenosis combined with a calcified mass at the left side of the L4-5 level.Magnetic reso-nance imaging showed dural sac compression caused by the calcified mass at the left ligamentum flavum of the L4-5 level.We performed decompressive laminectomy and excision of the calcified mass combined with posterior lumbar interbody fusion at the L4-5 level.Intra-operatively,we found a firm and nodule like mass originating from the ventral surface of ligamentum flavum.Pathological examination suggested a calcified pseudocyst without a capsular lining.After the operation,the patient’s motor weakness in the ankle and great toe improved gradually.CONCLUSION The patient’s ankle and great toe weakness were improved successfully after surgical removal of the calcified cyst.
基金Supported by the National Research Foundation of Korea Grant funded by the Korean government,No.NRF-2021R1A2C1013073.
文摘BACKGROUND Ligamentum flavum hematoma(LFH)can cause compression of the spinal cord or nerve root,which results in neurological symptoms.We report a case of lumbar radicular pain due to LFH following a traffic accident.CASE SUMMARY A 59-year-old man complained of left buttock and lateral thigh pain that was dull in nature after a traffic accident 18 d prior to presentation.Magnetic resonance imaging(MRI),taken 17 d after the traffic accident,revealed a mass lesion at the L4-5 Level.These MRI findings suggested subacute LFH.The patient’s pain was not alleviated with conservative treatment,including oral medication and epidural steroid injection.After a partial-hemilaminectomy and removal of LFH,the patient’s pain completely disappeared.CONCLUSION Because early operation for decompression is important for a good outcome,clinicians should be able to determine LFH from MRI results and be aware of the possibility of LFH,especially in patients with a history of trauma.
基金the Second Tibetan Plateau Scientific Expedition and Research(STEP)program(2019QZKK0502)State Key Laboratory of Phytochemistry and Plant Resources in West China(P2017-KF02 and P2019-ZZ05)the Natural Sciences Foundation of Yunnan Province(2019FA003).
文摘Sixteen diterpenoid alkaloids(DAs),including six aconitine-type alkaloids(5 and 9−13),seven 7,17-seco-aconitine-type alkaloids(1−4,6−8),two napelline-type alkaloids(14 and 15)as well as one veatchine-type alkaloid(16),were isolated from the aerial parts of Aconitum flavum Hand.-Mazz.In which,flavumolines A−D(1−4)were four new ones,and flavu-moline E(5)was reported as natural compound for the first time.Their chemical structures were elucidated by the analysis of extensive spectroscopic data.The inhibitory activities of these isolates on Cav3.1 low voltage-gated Ca^(2+)channel,NO production in LPS-activated RAW264.7cells,five human tumor cell lines,as well as acetylcholinesterase(AChE)were tested.
基金Institutional research grant(AIIMS Bhubaneswar).
文摘BACKGROUND Ligament flavum(LF)hypertropy is the main etiopathogenesis of lumbar canal stenosis(LCS).The purely elastic LF undergoes a morphological adaptation including a reduction in the elastic fibers and a consequent increase in the collagen content,fibrosis,cicatrization,and calcification.However,the morphometric analysis can delineate the LF in patients with LCS from those without LCS,which would help in better understanding LCS pathogenesis.AIM To compare the histopathological changes in LF between the degenerative LCS and non-stenotic(non-LCS)group.METHODS The present prospective study was conducted in 82 patients who were divided into two groups,namely LCS and non-LCS.Demographic details of the patients such as duration of symptoms,level of involvement,and number of segments were recorded.The LF obtained from both groups was histopathologically examined for the fibrosis score,elastic fiber degeneration,calcification,and chondroid metaplasia.Morphometrical details included a change in elastin and collagen percentages,elastin/collagen ratio,elastic fiber fragmentation,and ligamentocyte numbers.All parameters were compared between the two groups by using the independent t test,Chi-square test,and Pearson’s correlation test.RESULTS Out of 82 cases,74 were analysed,34 in LCS and 40 in non-LCS group.The mean±SD age of presentation in LCS and non-LCS group was 49.2±8.9 and 43.1±14.3 respectively.The LCS group(n=34)exhibited significant differences in fibrosis(P=0.002),elastic fiber degeneration(P=0.01),%elastic fragmentation(66.5±16.3 vs 29.5±16.9),%elastic,content(26.9±6.7 vs 34.7±8.4),%collagen content(63.6±10.4 vs 54.9±6.4),reduction of elastic/collagen(0.4±0.1 vs 0.6±0.1),and ligamentocyte number(39.1±19.1 vs 53.5±26.9)as compared to non-LCS group(n=40).The calcification(P=0.08)and Pearson’s correlation between duration and loss of elastin was not significant.The difference in LF morphology is consistent in patient’s≥40 years of age among the groups as found in subgroup analysis.Similarly in the patents<40 and>40 in the non-LCS group.CONCLUSION LF is vital in the pathogenesis of LCS.The purely elastic LF undergoes a morphological adaptation that includes a reduction in the elastic fibers with a consequent increase in the collagen content,fibrosis,cicatrization,and calcification.The present study provides a detailed morphometric analysis to semiquantitatively delineate the LF changes in patients with LCS from those in patients without LCS.
文摘Objective To study the clinical epidemiology of ossification of ligamentum flavum(OLF)and evaluate its characteristics of prevalence, morphology, and distribution in a common population.Some factors associated with its occurrence were analyzed
文摘Objective To describe the pathological unit and octagonal en bloc resection for the treatment of ossification ligamentum flavum(OLF)in thoracic spine with spondylotic myelopathy.Methods Ninety-five patients from January 2002 to January
文摘Objective To investigate the difference between different surgical methods for thoracic ossification of ligamentum flavum(OLF) combined with cervical spondylotic myelopathy(CSM) . Methods From January 1991 to January 2003,56 cases
文摘Objective To study the diagnosis and treatment of lower thoracic ossification of ligamentum flavum(OLF) combined with lumbar spinal stenosis.Methods Retrospective analysis was carried out on 11 cases of lower thoracic OLF combined with
文摘Objective To evaluate the effects of the laminar thinned-segmented decompression technique in the treatment of thoracic ossification of ligamentum flavum with spondylotic myelopathy.Methods From January 1999 to January 2009,126 cases
文摘Objective To explore the strategy and outcomes of surgical treatment of thoracic ossification of ligamentum flavum(OLF),especially combined with ossification of posterior longitudinal ligament,thoracic kyphosis and epidural
文摘Objective To investigate different surgical procedures for treatment of thoracic ossification of ligamentum flavum.Methods From January 1994 to June 2008,56 cases of thoracic ossification of ligamentum flavum underwent
文摘Objective To analyze the surgical treatment options and its results for thoracic and thoracolumbar disc herniation.Methods From June 2004 to December 2009,thirty-one patients of thoracic and thoracolumbar disc herniation with
基金supported by the National Natural Science Foundation of China(81572149,81600697)Guangdong Basic and Applied Basic Research Foundation(2021A1515220086)+1 种基金Basic Research Program of Jiangsu Province(Natural Science Foundation,K20201487)Jiangsu Province"333"Project(LGY2016001)and Sino-German Mobility programme of the Chinese-German Research Center of the National Science Foundation of China(NSFC)and the German Research Council(DFG),Grant Number M-0332.
文摘Ligamentum flavum(LF)hypertrophy(LFH)has been recognised as one of the key contributors to lumbar spinal stenosis.Currently,no effective methods are available to ameliorate this hypertrophy.In this study,human umbilical cord mesenchymal stromal cell-derived extracellular vesicles(hUCMSC-EVs)were introduced for the first time as promising vehicles for drug delivery to treat LFH.The downregulation of miR-146a-5p and miR-221-3p expressions in human LF tissues negatively correlated with increased LF thickness.The hUCMSC-EVs enriched with these two miRNAs significantly suppressed LFH in vivo and notably ameliorated the progression of transforming growth factorβ1(TGF-β1)-induced fibrosis in vitro after delivering these two miRNAs to mouse LF cells.The results further demonstrated that miR-146a-5p and miR-221-3p directly bonded to the 3′-UTR regions of SMAD4 mRNA,thereby inhibiting the TGF-β/SMAD4 signalling pathway.Therefore,this translational study determined the effectiveness of a hUCMSC-EVs-based approach for the treatment of LFH and revealed the critical target of miR-146a-5p and miR-221-3p.Our findings provide new insights into promising therapeutics using a hUCMSC-EVs-based delivery system for patients with lumbar spinal stenosis.
文摘背景:既往认为黄韧带骨化在人群中罕见发生,随着研究深入,发现其发病率逐渐上升,这引起大量学者的研究兴趣。目的:通过检索科学引文索引数据库核心集自1999年以来的有关黄韧带骨化的研究成果,使用文献计量学方法对数据进行可视化分析,回顾黄韧带骨化的研究历史,指示重要文献,梳理研究热点,为学者寻找研究方向提供思路。方法:以Web of Science核心集数据库为主,搜索并筛选黄韧带骨化相关论文,使用VOSviewer 1.6.19和CiteSpace 6.2.R6软件对年度发文量、研究国家、机构、被引文献、期刊、作者和关键词等进行可视化分析。结果与结论:①共纳入347篇文献,自1999年发文量呈螺旋上升,中国研究较日本起步晚,但是发文量后来居上,北京大学是发文量最多的机构,北京大学的陈仲强教授是发文量最多的学者。②被引用最多的10篇文献中5篇都与黄韧带骨化的手术治疗有关。③去除与研究主题直接相关的关键词,综合词频和中介中心性的结果发现,“胸椎脊髓病”“硬膜骨化”“微创手术”“后纵韧带骨化”处于领域研究的核心地位。④关键词聚类分析显示,黄韧带骨化的临床表现和手术治疗在疾病的研究中占比较大。⑤关键词时间线图及关键词突现分析显示,“微创手术”作为关键词出现在2015年前后,是突现强度最高的关键词,也是突现开始时间最晚的关键词,2019年开始受到学者广泛关注,关键词“硬膜骨化”的突现尚未结束。⑥黄韧带骨化的手术治疗一直处于研究前沿,微创手术方式的开发和研究、黄韧带骨化继发硬膜骨化的研究是该领域的研究热点。
