Baastrup's disease: The kissing spine

A 67-year-old male presented with a gradually progressive low back pain of 2 years duration. The patient was leading a retired life and there was no history of chronic fever or significant trauma. There was no radiation of pain or any features suggestive of claudication. There was no history of any comorbidity. The pain was aggravated with extension of the spine and relieved with flexion. There was no swelling or neurological deficit, but muscle spasm was present. Radiographs of the spine revealed degenerative changes in the lumbosacral spine, along with articulation of spinous processes at in lumbar spine at all levels level suggestive of Baastrup's disease, commonly known as "kissing spine". Routine blood investigations were within normal limits. The patient was managed conservatively. He was given a week's course of analgesics and muscle relaxants and then started on spinal flexion exercises, with significant improvement being noted at 6 months follow up.

Neurotrophic fragments as therapeutic alternatives to ameliorate brain aging

Aging is a global phenomenon and a complex biological process of all living beings that introduces various changes.During this physiological process,the brain is the most affected organ due to changes in its structural and chemical functions,such as changes in plasticity and decrease in the number,diameter,length,and branching of dendrites and dendritic spines.Likewise,it presents a great reduction in volume resulting from the contraction of the gray matter.Consequently,aging can affect not only cognitive functions,including learning and memory,but also the quality of life of older people.As a result of the phenomena,various molecules with notable neuroprotective capacity have been proposed,which provide a therapeutic alternative for people under conditions of aging or some neurodegenerative diseases.It is important to indicate that in recent years the use of molecules with neurotrophic activity has shown interesting results when evaluated in in vivo models.This review aims to describe the neurotrophic potential of molecules such as resveratrol(3,5,4′-trihydroxystilbene),neurotrophins(brain-derived neurotrophic factor),and neurotrophic-type compounds such as the terminal carboxyl domain of the heavy chain of tetanus toxin,cerebrolysin,neuropeptide-12,and rapamycin.Most of these molecules have been evaluated by our research group.Studies suggest that these molecules exert an important therapeutic potential,restoring brain function in aging conditions or models of neurodegenerative diseases.Hence,our interest is in describing the current scientific evidence that supports the therapeutic potential of these molecules with active neurotrophic.

Blunt dopamine transmission due to decreased GDNF in the PFC evokes cognitive impairment in Parkinson’s disease

Studies have found that the absence of glial cell line-derived neurotrophic factor may be the primary risk factor for Parkinson’s disease. However, there have not been any studies conducted on the potential relationship between glial cell line-derived neurotrophic factor and cognitive performance in Parkinson’s disease. We first performed a retrospective case-control study at the Affiliated Hospital of Xuzhou Medical University between September 2018 and January 2020 and found that a decreased serum level of glial cell line-derived neurotrophic factor was a risk factor for cognitive disorders in patients with Parkinson’s disease. We then established a mouse model of Parkinson’s disease induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and analyzed the potential relationships among glial cell line-derived neurotrophic factor in the prefrontal cortex, dopamine transmission, and cognitive function. Our results showed that decreased glial cell line-derived neurotrophic factor in the prefrontal cortex weakened dopamine release and transmission by upregulating the presynaptic membrane expression of the dopamine transporter, which led to the loss and primitivization of dendritic spines of pyramidal neurons and cognitive impairment. In addition, magnetic resonance imaging data showed that the long-term lack of glial cell line-derived neurotrophic factor reduced the connectivity between the prefrontal cortex and other brain regions, and exogenous glial cell line-derived neurotrophic factor significantly improved this connectivity. These findings suggested that decreased glial cell line-derived neurotrophic factor in the prefrontal cortex leads to neuroplastic degeneration at the level of synaptic connections and circuits, which results in cognitive impairment in patients with Parkinson’s disease.

Isolation of <em>Mycobacterium celatum</em>from a Case of Koch’s Spine

Mycobacterium celatum is a newly discovered micro-organism causing disseminated infections in immuno compromised patients. Here we report a case of Mycobacterium celatum in an apparently immuno competent young patient with Koch’s spine, the organism was confirmed at tuberculosis research centre, Chennai. The patient was started with clarithromycin and ciprofloxin along with category-I ATT.

Induced Electromagnetic Fields Estimation in Spine Examinations of MRI Patients: A Re-Evaluation of Existing Clinical Protocols at a Hospital in Accra, Ghana

Patients undergoing Magnetic Resonance Imaging (MRI) are exposed to strong, non-uniform static magnetic fields outside of the central imaging region, in which the movement of the body may induce electric currents in tissues which could possibly be harmful. The purpose of this study was to re-evaluate existing clinical protocols by determining the induced electromagnetic (EM) fields in MRI spine examinations. The study covered 120 MRI spine examinations at the MRI Unit of a hospital in Accra, Ghana. A numerical model based on Faraday’s equation was developed using the finite difference method (FDM) and MATLAB software to compute, first, a test simulation of induced EM field intensities and then actual measurements of induced fields on the spine. The simulation results were peak induced electric field, 0.39 V/m and current density, 0.039 A/m2. Patient results were;calculated maximum velocity, 0.29 m/s;peak induced electric field strength, 0.44 V/m, and current density, 0.043 A/m2. The levels of induced EM-fields were such that they would not pose any potential health hazards to the patients as these values were well below the recommended guidance levels set by the Directive IEC 60601-2-33 of the European Parliament.

C1-C2 Pott’s Disease, a Rare Location of Spine Tuberculosis

The authors report a new case of spine tuberculosis of C1-C2 occurred in a 58-year-old negative HIV patient that was responsible of inflammatory cervical pain with multidirectional stiffness and complicated by spastic quadriplegia. The diagnosis was made on the basis of presumptive elements, including cervical spinal CT scan, which showed atlan-to-axial subluxation (C1-C2) with destruction of the odontoid apophysis and lateral mass of the atlas and favorable evolution under specific antibiotic treatment with ethambutol, isoniazid, rifampicin, pyrazinamide and immobilization with brace cast, despite the absence of bacteriological and anatomo-pathological evidence of certainty. The evolution has been favorable, with the disappearance of cervical pain, progressive motor recovery and resumption of autonomy of walking.

郑氏手法结合针刺治疗中老年神经根型颈椎病对其颈椎生理曲度影响的临床观察

目的观察郑氏手法结合针刺治疗中老年神经根型颈椎病的临床疗效及对其颈椎生理曲度的影响。方法将该院2021年6月—2022年5月收治的63例符合神经根型颈椎病急性期诊断标准的患者分为治疗组和对照组,其中治疗组在治疗中脱离2例,完成治疗30例,对照组在治疗中脱离1例,完成治疗30例。治疗组采用郑氏手法结合普通针刺治疗,对照组采用普通手法结合针刺治疗。1周治疗5次,两组均治疗2周。比较两组总体疗效,比较两组治疗前后视觉模拟评分法(visual analogue scale,VAS)、颈椎功能障碍指数(neck disability index,NDI)和颈椎病临床评价量表(clinical evaluation scale of cervical spondylosis,CASCS)评分变化;比较两组治疗前后颈椎生理曲度变化。结果治疗组治疗总有效率为86.67%(26/30),对照组治疗总有效率为63.33%(19/30)。治疗组总体疗效优于对照组(P<0.05);治疗组治疗后VAS评分、NDI评分低于对照组,CASCS评分高于对照组(P<0.05);治疗组治疗后颈椎生理弧度高于对照组(P<0.05)。结论郑氏手法结合针刺是治疗神经根型颈椎病的有效方案,值得临床进一步研究。

温针灸项四穴联合郑氏手法治疗颈源性头痛对颈椎功能、疼痛程度的影响

目的:探究温针灸项四穴联合郑氏手法治疗颈源性头痛(CEH)对颈椎功能、疼痛程度的影响。方法:将2022年1月—2023年12月本院收治的90例CEH患者随机分为对照组与观察组,各45例。对照组使用常规手法进行治疗,观察组使用温针灸项四穴联合郑氏手法进行治疗,观察两组治疗后的疗效,两组治疗前后的头痛程度、头痛频率、颈部的活动功能和血液流变学[红细胞压积(HCT)、纤维蛋白原(FIB)],观察治疗期间两组的不良反应。结果:治疗后,观察组总有效率为95.56%(43/45),对照组为82.22%(37/45),观察组高于对照组,差异具有统计学意义(P<0.05);与治疗前比较,两组治疗后头痛持续时间、每周头痛发作频率、颈痛视觉模拟评分(VAS)、颈椎功能障碍指数量表评分(NDI)、颈部功能活动度评分(ROM)、HCT和FIB水平均大幅下降,且观察组上述指标均低于对照组,差异具有统计学意义(P<0.05)。治疗期间两组均未出现明显不良反应。结论:温针灸项四穴联合郑氏手法治疗CEH,能有效缓解患者疼痛症状,改善颈部功能,调节颈部血流,且安全性良好。

Use of calcein and alizarin red S for immersion marking of black rockfish Sebastes schlegelii juveniles

Black rockfish Sebastes schlegelii juveniles （30-40 mm total length） were immersed in a range of calcein （CAL） solutions at concentrations ranging from 50 to 250 mg/L and alizarin red S （ARS） solutions at concentrations ranging from 100 to 500 mg/L in filtered seawater （salinity 30） for 24 h. Fluorescent marks were detected in otoliths （sagittae, asteriscus）, scales, fin rays （dorsal, pectoral, ventral, anal, and caudal fin rays）, and fin spines （dorsal, ventral, and anal fin spines） after a 60-d growth experiment. With the exception of 50-100 rng/L CAL, acceptable marks were produced in the otoliths and fin spines by all concentrations of CAL and ARS. In particular, marks were clearly visible under normal light in the sagittae, asteriscus, and fin spines offish immersed in 200 500 mg/L, 300-500 rag/L, and 200-500 mg/LARS, respectively. Scales and fin rays had acceptable marks at much higher concentrations （≥50 mg/L CAL, ≥300 mg/L ARS for scales and ≥50 mg/L CAL,≥200 mg/L ARS for fin rays）. The mark quality was highest （i.e., acceptable marks were observed in all sampled structures after immersion marking） in fish immersed in 150-250 mg/L CAL or 300-500 mg/LARS. In addition, there was no significant difference in survival and growth of marked fish compared with controls 60 d post-marking （P〉0.05）.

Activities of nicotinic acetylcholine receptors modulate neurotransmission and synaptic architecture

The cholinergic system is involved in a broad spectrum of brain function, and its failure has been implicated in Alzheimer＇s disease. Acetylcholine transduces signals through muscarinic and nicotinic acetylcholine receptors, both of which influence synaptic plasticity and cognition. However, the mechanisms that relate the rapid gating of nicotinic acetylcholine receptors to persistent changes in brain function have remained elusive. Recent evidence indicates that nicotinic acetylcholine receptors activities affect synaptic morphology and density, which result in persistent rearrangements of neural connectivity. Further investigations of the relationships between nicotinic acetylcholine receptors and rearrangements of neural circuitry in the central nervous system may help understand the pathogenesis of Alzheimer＇s disease.

Atypical Presentation of Cervical Pott’s Disease: A Case Report

Tuberculous spondylitis, also known as Pott’s disease, is due to infection of the spine by mycobacterium tuberculosis (MTB) leading to vertebral body and inter-vertebral disc destruction. It is the most common form of musculoskeletal tuberculosis most frequently affecting the thoracolumbar spine and is commoner in young people. Onset of this condition is insidious and its clinical presentation is non specific. However, Pott’s disease may be complicated by neurologic deficits including paraplegia or even quadriplegia, with huge health, economic and psychological burden. Following is a case report of Pott’s disease involving the cervical spine in a 33-year old farmer presenting unusually with paraplegia and a negative Mantoux test. It is reported because this very uncommon condition is highly treatable, and there is need for a raised index of suspicion in order to diagnose this condition early, thus limiting its complications. The role of MRI in diagnosis of Pott’s disease is also highlighted.

经皮穿刺球囊扩张椎体成形术治疗老年胸腰椎骨折患者的临床效果

目的分析经皮穿刺球囊扩张椎体成形术对老年胸腰椎骨折患者的治疗效果。方法纳入2019年1月—2022年1月就诊于南京南钢医院骨科的老年胸腰椎骨折患者48例,将患者按照入院顺序均分,对照组24例,接受切开复位经椎弓根螺钉内固定术,观察组24例,接受经皮穿刺球囊扩张椎体成形术。对比围术期指标、手术前后疼痛程度、障碍程度和功能,以及手术前后影像学指标。结果与对照组相比,观察组手术时间、下床活动时间和住院时间更短,出血量更少,差异有统计学意义(P<0.05);术前两组疼痛程度、障碍程度、胸腰椎功能和影像学指标比较,差异无统计学意义(P>0.05),术后观察组疼痛评分为(1.80±0.32)分、ODI评分为(13.27±2.18)分,Cobb角为(7.56±1.32)°,明显低于对照组,JOA评分和椎骨高度分别为(22.18±1.78)分和(25.12±1.96)mm,明显高于对照组,差异有统计学意义(t=14.583、7.581、8.843、8.699、9.318,P<0.001)。结论经皮穿刺球囊扩张椎体成形术可促进老年胸腰椎骨折患者术后恢复,可缓解疼痛感,对腰椎功能和影像学指标有改善作用,有应用价值。

腰椎椎体后缘骨软骨病的临床特点与手术治疗

[目的]探讨腰椎椎体后缘骨软骨病（osteochondrosis oflumbar posterior vertebral edge，OLPV）的临床特点、手术方法及疗效。[方法]回顾分析2000年8月-2003年8月间接受手术治疗并获随访的OLPV患者41例，所有患者均在后路充分减压基础上选择性行间盘、后突骨块或问盘＋骨块切除，1例伴腰椎失稳且减压范围较大者行椎弓根内固定并椎间植骨。[结果]41例患者术后腰腿痛症状均完全或明显改善，仅4例部分残留下肢感觉、运动障碍，术后病理均提示符合骨软骨病特点；随访5～8年（平均6．8年），6例诉偶有腰痛但程度多较轻未影响日常生活；全部病例未见腰椎失稳表现；内固定组未出现螺钉松动、拔出。患者术前JOA腰痛疾患疗效评分为（14．73±2．06）分，术后3个月时评分（27．144-4．13）分，两者间存在显著性差异（P〈0．05）；终末随访时为（26．584-2．23）分，与术后3个月时相比差异无显著性（P〉0．05）。终末随访时手术满意程度：优35例，良3例，可3例，差0例，优良率为92．7％。[结论]OLPV主要表现类似腰椎间盘突出及腰椎管狭窄症但又有其自身特点；影像学特别是CT检查在诊断及指导治疗中具有重要意义；神经压迫严重或伴有髓核疝出时需尽早手术治疗；术中需在充分显露并尽可能保证脊柱稳定性基础上根据具体情况选择性切除致压物，通常无需内固定或植骨融合。

青海湖裸鲤不同年龄鉴定材料的年轮特征

通过各种年龄鉴定材料比较研究了青海湖裸鲤的年轮特征。微耳石和星耳石可用于鉴定年龄,而矢耳石易碎,不适合鉴定年龄。4种年龄鉴定材料对青海湖裸鲤年龄的判别能力为:背鳍条>微耳石>臀鳞>脊椎骨。对8龄以下个体,用背鳍条磨片鉴定年龄效果较佳;对8龄以上个体,臀鳞、背鳍条磨片和脊椎骨上的年轮计数明显低于微耳石磨片,微耳石磨片是高龄青海湖裸鲤较为可靠的年龄鉴定材料。

小针刀、银质针、整脊复位联合治疗顽固性腰椎间盘突出症的临床效果观察

目的探讨小针刀、银质针、整脊复位联合治疗顽固性腰椎间盘突出症的临床效果。方法选取60例顽固性腰椎间盘突出症患者作为研究对象,随机分为治疗组和对照组,各30例。治疗组采用针刀、银质针、整脊复位联合疗法进行治疗,对照组采用牵引、整脊复位联合疗法治疗。比较两组的ODI分级及临床效果。结果两组治疗后腰痛ODI分级为Ⅴ级的患者显著多于治疗前,差异有统计学意义(P<0.05);治疗组治疗后腰痛ODI分级为Ⅴ级的患者显著多于对照组治疗后,差异有统计学意义(P<0.05);治疗组1个疗程后的总有效率为96.7%,显著高于对照组的73.3%,差异有统计学意义(P<0.05);治疗组1年后的总有效率为96.7%,显著高于对照组的83.8%,差异有统计学意义,(P<0.05)。结论小针刀、银质针、整脊复位联合疗法治疗顽固性腰椎间盘突出症的效果优于牵引、整脊复位联合疗法。

CT监测下经皮脊柱穿刺活检352例分析

目的:探讨术前CT监测下经皮穿刺活检的穿刺路径及器械选择的方法,分析其在脊柱疾患诊疗中的作用。方法:352例脊柱病变患者,包括颈椎155例(寰枢椎39例)、胸椎101例、腰椎81例、骶椎15例,采用CT监测下经皮穿刺活检的方法获得病理诊断。依病变的部位设计穿刺路径,根据病变内骨性成分多少选用穿刺器械取材。结果:352例中333例获得明确病理诊断,活检阳性率94.60%。手术137例,手术与穿刺标本的病理检查结果符合率95.62%。平均随访27个月,证实活检准确率为93.75%(330/352),无并发症发生。结论:CT监测下经皮穿刺活检是脊柱病变术前明确诊断的有效方法,其安全、准确率高、费用低,对制定脊柱病变的综合治疗方案起重要的作用。

螺旋CT三维测量在腰椎椎弓根置钉中的应用研究

目的:探索螺旋CT三维测量(SCT-3DM)引导腰椎椎弓根螺钉置入的有效方法。方法:取成人腰椎干骨标本(L1～L5)5具,各沿棘突髓腔插入钛合金定位针(针尾外露);行螺旋CT连续容积扫描,资源图像输入AW4.0工作站作多平面重组(MPR)、最大密度投影(MIP)及表面遮盖显示(SSD)等重建,并测量根针距(PND)、根轴距(PAD)及矫正角(PRA)、根轴角(PAA);并将5具标本作实体解剖测量,对照分析两种测量结果的统计学差异。结果:三维测量结果与实体解剖测量比较呈高相关性(均为γ>0.99)。临床应用此方法经腰椎椎弓根置钉30例,有效性为100%。结论:一针法定位及SCT-3DM对腰椎椎弓根螺钉的置入有重要实用价值。

同种异体骨笼在颈椎前路融合的应用观察

目的:探讨应用同种异体骨笼行颈椎前路融合的效果.方法:对287例颈椎疾患采用颈椎前路减压、同种异体骨笼植入椎体间融合术,随访观察神经功能恢复、植骨融合情况、椎间隙高度和颈椎生理曲度变化及内置物并发症等.结果:全组手术历时平均50min,术中出血量平均11Oml.228例获平均14个月随访.骨融合时间为3～5个月,平均4个月;单节段骨融合率为98.3%,双节段为94.4%,三节段为86.9%,平均93.3%.椎体间高度术后即时略有增高,术后3～5个月内有丢失,之后稳定.颈椎生理曲度恢复并维持,仅1例向后成角畸形;3例出现骨笼崩裂.无植骨排斥反应.结论:用同种异体骨笼行颈椎体间融合的融合率达90%以上;可缩短手术时间,减少并发症,能替代自体髂骨移植.

可吸收钉板在颈椎前路椎体次全切除术中的应用研究

目的探讨颈前路椎体次全切手术应用Inion S-1TM生物型可吸收钉板对比传统钛质钉板治疗颈椎病的疗效分析。方法 2010年1月~2014年4月,收治患者33例行颈椎前路手术,其中A组12例,采用Inion S-1TM生物型可吸收钉板固定,B组21例采用钛质钉板固定。比较两组患者术后1周、3个月、1年VAS疼痛评分、JOA评分、颈椎功能障碍指数（NDI）,以及两种钉板对于影像成像的影响、相邻节段退变情况,植骨融合率,并发症。结果 33例患者均获随访,随访时间10~25个月,平均16.2个月。A、B两组在术后1周、3个月、1年VAS疼痛评分、JOA评分和NDI评分比较差异无统计学意义（P〉0.05）。两组椎体间均获得骨性融合,融合率100%。B组3例出现相邻节段退变。无内固定失效、失败、脱落、松动、折断等并发症,远期均无迟发型食道瘘出现。两组术后1年融合上位相邻节段活动度比较差异具有统计学意义。结论颈前路椎体次全切术中应用Inion S-1TM生物型可吸收钉板能取得和钛质钉板相同的近期疗效。可在一定程度上避免应用传统钛质钉板术后内植物松动、融合过程中的应力遮挡、影像干扰等常见缺点。

枕颈融合角度与颅颈交界区畸形患者下颈椎退变的关系

背景:枕颈融合是颅颈交界区畸形的主要治疗方法。对于非骨质疏松症患者,颈椎的退变主要表现在椎间盘,而椎体的高度基本保持恒定不变,所以可用颈椎间盘高度和与颈椎体高度和的比值(S值)衡量颈椎的退变,S值越小则颈椎退变越严重。目的:测量颅颈畸形枕颈融合内固定患者的颈椎侧位X射线片,分析融合过程中枕颈固定角度和融合后下颈椎退变的关系,确定最佳枕颈融合角度范围。方法:纳入因颅颈畸形行枕颈融合患者21例,根据融合后即刻枕颈角度(0c-C2角度),将颅颈畸形枕颈融合患者分为3组,即枕颈角9°-22°组、枕颈角<9°组、枕颈角>22°组,其中融合后即刻0c-C2角度在9°-22°属于正常范围。测量融合前及融合后终末随访时各组S值及JOA评分,并进行统计学比较。结果与结论:融合前枕颈角9°-22°组、枕颈角<9°组、枕颈角>22°组JOA评分分别为(7.3±1.7)分、(7.2±1.6)分、(7.3±1.5)分,融合后随访分别为(14.2±1.5)分、(13.5±1.6)分、(13.3±1.5)分,3组JOA评分均有明显改善,枕颈角9°-22°组JOA改善程度明显较枕颈角<9°组、枕颈角>22°组好。融合前S值枕颈角9°-22°组、枕颈角<9°组、枕颈角>22°组分别为0.440±0.017,0.441±0.016,0.440±0.018,3组间差异无显著性意义。枕颈角9°-22°组融合后终末随访S值与融合前S值差异无显著性意义,枕颈角<9°组、枕颈角>22°组融合后终末随访S值均较其融合前S值明显减小。提示枕颈融合内固定时枕颈角应尽量在正常范围内,超过或小于正常范围均会加速下颈椎的退变进程。