International orthopaedics
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Aged patients represent a high risk group for acquiring spinal tuberculosis, and it still remains a leading cause of kyphosis and paraplegia in developing nations. Aged patients often combined with cardiovascular and respiratory disease and single lung ventilation via anterior approach surgery could result in more post-operative complications. We aimed to analyze the efficacy and feasibility of surgical management of aged patients with lumbo-sacral spine tuberculosis using one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation, and fusion. ⋯ Our results showed that one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation, and fusion was an effective treatment for aged patients with lumbo-sacral spinal tuberculosis. It is characterized with minimum surgical trauma, good pain relief, good neurological recovery, and good reconstruction of the spinal stability.
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Our aim was to investigate the biological effects of bone morphogenic protein 2 (BMP2) on the differentiation of bone marrow mesenchymal stem cells (BMSCs) into chondrocyte-like cells in platelet-rich plasma (PRP) gel in vitro. In addition, the effectiveness of BMP2-transduced BMSCs in combined with PRP gel to repair the degenerated intervertebral disc in a rabbit model was also evaluated. Previous studies have shown that tissue engineering provides many promising advantages to treating disc degeneration and may reverse the pathological process of disc degeneration. ⋯ BMP2-transduced BMSCs can maintain the chondrocyte-like phenotype in PRP gel in vitro, and the combined use of these two agents can significantly promote repair of the degenerated discs in vivo.
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Comparative Study
Clinical and radiological analysis of Bryan cervical disc arthroplasty: eight-year follow-up results compared with anterior cervical discectomy and fusion.
Bryan cervical disc arthroplasty has been reported with satisfactory short- and medium-term clinical results. However, the long-term clinical and radiographic outcomes are seldom reported. The purpose of this study was to compare the eight-year follow-up results in patients who underwent Bryan disc arthroplasty with patients received ACDF, and assess the incidence of heterotopic ossification (HO) and its effect on clinical outcome and mobility of the device. ⋯ At eight year follow-up, the clinical and radiographic outcomes of Bryan cervical disc arthroplasty compared favorably to those of ACDF. It avoided accelerated adjacent segment degeneration by preserving motion. However, severe HO restricted the ROM of the index levels and maybe associated with post-operative axial pain.
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Comparative Study
Comparing the early efficacies of autologous bone grafting and interbody fusion cages for treating degenerative lumbar instability in patients of different ages.
The aim of this study was to compare the early efficacies of interbody fusion using autologous bone graft or an interbody fusion cage in a modified transforaminal lumbar interbody fusion (TLIF) in patients of different ages with degenerative lumbar instability. ⋯ At different ages, the interbody fusion cages can better preserve the intervertebral space and the intervertebral foramen height. However, autologous bone graft can rapidly achieve a bony fusion. Interbody fusion cages are therefore ideal for young adults, while autologous bone grafting is ideal for middle-aged and elderly patients who receive a modified TLIF.