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spine system changes in soldiers after load carriage training in a plateau environment: A prediction model research

Military Medical Research 2021年第3期8卷 373-383页

作者： Hao Qu Ling-Jia Yu Ju-Tai Wu Gang Liu Sheng-Hui Liu Peng Teng Li Ding Yu Zhao Department of Orthopaedics Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Orthopaedics Beijing Friendship HospitalBeijing 100050China Department of Orthopaedics the Affiliated Hospital of Xuzhou Medical UniversityXuzhou 221006JiangsuChina Department of Radiology Qinghai Red Cross HospitalXining 810000QinghaiChina School of Biological Science and Medical Engineering Beihang UniversityBeijing 100191China National Laboratory of Human Factors Engineering China Astronaut Research and Training CenterBeijing 100094China

Background: Low back pain is the most common spinal disorder among soldiers, and load carriage training(LCT) is considered the main cause. We aimed to investigate changes in the spine system of soldiers after LCT at high altitudes and the change trend of the lumbar spine and surrounding soft tissues under different load conditions.Methods: Magnetic resonance imaging scans of the lumbar spines of nine soldiers from plateau troops were collected and processed. We used ImageJ and Surgimap software to analyze changes in the lumbar paraspinal muscles, intervertebral discs(IVDs), intervertebral foramina, and curvature. Furthermore, the multiple linear regression equation for spine injury owing to LCT at high altitudes was established as the mathematical prediction model using SPSS Statistics version 23.0 software.Results: In the paraspinal muscles, the cross-sectional area(CSA) increased significantly from(9126.4±691.6) mm~2 to(9862.7±456.4) mm~2, and the functional CSA(FCSA) increased significantly from(8089.6±707.7) mm~2 to(8747.9±426.2) mm~2 after LCT(Pspine showed a decreasing trend after LCT with a significant difference(P<0.05). Regarding the lumbar intervertebral foramen, the percentage of the effective intervertebral foraminal area of L3/4 significantly decreased from 91.6%±2.0% to 88.1%±2.9%(P<0.05). For curvature, the lumbosacral angle after LCT(32.4°±6.8°) was significantly higher(P<0.05) than that before LCT(26.6°±5.3°), while the lumbar lordosis angle increased significantly from(24.0°±7.1°) to(30.6°±7.4°)(P<0.05). The linear regression equation of the change rate, ΔFCSA%=–0.718+23.085×load weight, was successfully established as a prediction model of spinal injury after LCT at high altitudes.Conclusion: The spinal system encountered increased muscle volume, muscle congestion, tissue edema, IVD compression, decreased effective intervertebral foramen area, and increased lumbar curvature after LCT, which revealed im

关键词： spine Load carriage Paraspinal muscle Intervertebral disc Prediction model

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Deleterious effects of whole-body vibration on the spine:A review of in vivo,ex vivo,and in vitro models

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Animal Models and Experimental Medicine 2021年第2期4卷 77-86页

作者： Folly Patterson Raheleh Miralami Keith E.Tansey Raj K.Prabhu Lauren B.Priddy Department of Agricultural and Biological Engineering Mississippi State UniversityMississippi StateMSUSA Center for Advanced Vehicular Systems Mississippi State UniversityStarkvilleMSUSA Department of Neurosurgery and Neurobiology University of Mississippi Medical CenterJacksonMSUSA Center for Neuroscience and Neurological Recovery Methodist Rehabilitation CenterJacksonMSUSA Spinal Cord Injury Medicine and Research Services G.V.(Sonny)Montgomery VA Medical CenterJacksonMSUSA

Occupational exposure to whole-body vibration is associated with the develop-ment of musculoskeletal,neurological,and other ailments.Low back pain and other spine disorders are prevalent among those exposed to whole-body vibration in occupational and military settings.Although standards for limiting exposure to whole-body vibration have been in place for decades,there is a lack of understanding of whole-body vibration-associated risks among safety and healthcare profession-als.Consequently,disorders associated with whole-body vibration exposure remain prevalent in the workforce and military.The relationship between whole-body vibra-tion and low back pain in humans has been established largely through cohort stud-ies,for which vibration inputs that lead to symptoms are rarely,if ever,quantified.This gap in knowledge highlights the need for the development of relevant in vivo,ex vivo,and in vitro models to study such pathologies.The parameters of vibrational stimuli(eg,frequency and direction)play critical roles in such pathologies,but the specific cause-and-effect relationships between whole-body vibration and spinal pa-thologies remain mostly unknown.This paper provides a summary of whole-body vibration parameters;reviews in vivo,ex vivo,and in vitro models for spinal patholo-gies resulting from whole-body vibration;and offers suggestions to address the gaps in translating injury biomechanics data to inform clinical practice.

关键词： adverse effects animal models intervertebral disc spine translational research vibration

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Comparative Study of ROCK1 and ROCK2 in Hippocampal spine Formation and Synaptic Function

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Neuroscience Bulletin 2019年第4期35卷 649-660页

作者： Jinglan Yan Youcan Pan Xiaoyan Zheng Chuanan Zhu Yu Zhang Guoqi Shi Lin Yao Yongjun Chen Nenggui Xu South China Research Center for Acupuncture and Moxibustion Medical College of Acu-Moxi and Rehabilitation Guangzhou University of Chinese Medicine Guangzhou 510006 China School of Pharmaceutical Sciences Guangzhou University of Chinese Medicine Guangzhou 510006 China Guangdong Provincial Hospital of Chinese Medicine Guangzhou 510006 China Guangdong Province Key Laboratory of Psychiatric Disorders Southern Medical University Guangzhou 510515 China

Rho-associated kinases(ROCKs)are serinethreonine protein kinases that act downstream of small Rho GTPases to regulate the dynamics of the actin cytoskeleton.Two ROCK isoforms(ROCK1 and ROCK2)are expressed in the mammalian central nervous system.Although ROCK activity has been implicated in synapse formation,whether the distinct ROCK isoforms have different roles in synapse formation and function in vivo is not clear.Here,we used a genetic approach to address this long-standing question.Both Rock1^+/- and Rock2^+/- mice had impaired glutamatergic transmission,reduced spine density,and fewer excitatory synapses in hippocampal CA1 pyramidal neurons.In addition,both Rockl^+/- and Rock2^+/- mice showed deficits in long-term potentiation at hippocampal CA1 synapses and were impaired in spatial learning and memory based on the water maze and contextual fear conditioning tests.However,the spine morphology of CA1 pyramidal neurons was altered only in Rock2^+/- but not Rock1^+/- mice.In this study we compared the roles of ROCK1 and ROCK2 in synapse formation and function in vivo for the first time.Our results provide a better understanding of the functions of distinct ROCK isoforms in synapse formation and function.

关键词： Rho-associated kinases spine Hippocampus STP LTP Spatial learning and memory

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French spine Surgery Society guidelines for management of spinal surgeries during COVID-19 pandemic

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World Journal of Clinical Cases 2020年第10期8卷 1756-1762页

作者： Solène Prost Yann Philippe Charles Jérome Allain Jean-Luc Barat Henri d'Astorg Manuel Delhaye Chistophe Eap Fahed Zairi Pierre Guigui Brice Ilharreborde Jean Meyblum Jean-Charles Le Huec Nicolas Lonjon Guillaume Lot Olivier Hamel Guillaume Riouallon Stéphane Litrico Patrick Tropiano Benjamin Blondel Aix-Marseille Université APHMCNRSISMCHU TimoneUnitéde Chirurgie RachidienneMarseille 13005France Service de Chirurgie du Rachis Hopitaux Universitaires de StrasbourgStrasbourg 67200France Institut Parisien du dos Paris 75005France Service de Neurochirurgie Hopital privéClairval-Ramsay santéMarseille 13009France Unitéde Chirurgie du Rachis Centre Orthopédique SantyLyon 69008France Centre Francilien du dos Versailles 78000France CHU Reims Hopital Maison BlancheNeurochirurgieReims 51100France Hopital PrivéLe Bois Ramsay Santé Lille 59000France Hopital Européen Georges-Pompidou HEGP Paris 75015France Service de Chirurgie Orthopédique Pédiatrique CHU Robert DebréAPHPUniversitéde ParisParis 75019France Service de Chirurgie Orthopédique Groupe Hospitalier Paris Saint-JosephParis 75014France Polyclinique Bordeaux Nord Aquitaine Bordeaux 33300France Service de Neurochirurgie Hopital Gui de ChauliacMontpellier 34090France Hopital-Fondation Rothschild Service de NeurochirurgieParis 75019France Clinique Des Cèdres Service de Neurochirurgie Chateau D’AlliezCornebarrieu 31700France Hopital Paris Saint-Joseph Paris 75014France Unitéde Chirurgie Rachidienne Hopital Pasteur 2CHU de NiceNice 06001France

Since the outbreak of coronavirus disease 2019(COVID-19)in December 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the population.With regard to spine surgery,French physicians are devoted to take place in the national plan against COVID-19,the French spine Surgery Society therefore decided to elaborate specific guidelines for management of spinal disorders during COVID-19 pandemic in order to prioritize management of patients.A three levels stratification was elaborated with Level I:Urgent surgical indications,Level II:Surgical indications associated to a potential loss of chance for the patient and Level III:Non-urgent surgical indications.We also report French experience in a COVID-19 cluster region illustrated by two clinical cases.We hope that the guidelines formulated by the French spine Surgery Society and the experience of spine surgeons from a cluster region will be helpful in order optimizing the management of patients with urgent spinal conditions during the pandemic.

关键词： COVID-19 spine Surgery Guidelines Organization Cluster region

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ALK-positive anaplastic large cell lymphoma of the thoracic spine occurring in pregnancy: A case report

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World Journal of Clinical Cases 2019年第18期7卷 2857-2863页

作者： Sen Yang Wei-Min Jiang Hui-Lin Yang Department of Orthopedics The First Affiliated Hospital of Soochow University

BACKGROUND Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin’s lymphoma (NHL). ALCL is rare as a bone lesion and in pregnancy. CASE SUMMARY We present the first case of anaplastic lymphoma kinase (ALK)+ ALCL of the thoracic spine during pregnancy. A 25-year-old pregnant woman was presented to us at 24 wk’ gestation with severe back pain and weakness in the left lower limb. Imaging examination showed lesions at T10 and T11. She underwent posterior pedicle screw fixation and vertebroplasty. Pathological examination showed ALK+ ALCL. The patient chose to have therapeutic abortion after surgery and received chemotherapy in the hematology department. She now remains disease free with no neurological deficit after 30 mo’ follow-up. CONCLUSION ALK+ ALCL with the thoracic spine involvement is uncommon, especially in pregnancy. Many symptoms can be misunderstood during pregnancy;therefore, when a pregnant patient has persistent back pain or lower limb neurological symptoms, imaging examinations should be performed.

关键词： Anaplastic large cell lymphoma Pregnancy Thoracic spine Surgical treatment Chemotherapy Case report

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Surgical treatment of a cervical spine fracture in an ankylosing spondylitis patient with severe global spine kyphosis and chin-on-chest deformity

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Chinese Medical Journal 2019年第21期132卷 2644-2646页

作者： Xin-Hu Guo Hong-Quan Ji Department of Orthopedics Peking University Third HospitalBeijing 100191China.

To the Editor:Kyphotic deformity is one of the main manifestations of ankylosing spondylitis(AS).Usually,the hyperkyphosis is distributed along the lumbar,thoracolumbar,and thoracic spine,since the ossification of the spinal column mainly starts at the sacroiliac joint and then progresses towards the head.111 Occasionally,the kyphotic deformity occurs in the cervicothoracic spine,resulting in the chin resting on the chest,called chin-on-chest deformity?Patients with chin-on-chest deformity may have problems with horizontal gaze,chewing and swallowing,maintaining and performing proper personal hygiene,and they may suffer from neck pain and myelopathy.[1]However,severe global spine kyphosis in AS,resulting in a curvature of the upper body resembling the letter C,is an extremely rare condition with a simultaneous lumbar,thoracic,and cervicothoracic kyphosis.When cervical spine fractures happen in these patients,it is very challenging to deal with them,because of the severity of the deformity and the instability of the fracture.In this study,we report our experience in the treatment of a patient reporting these problems.

关键词： treatment spine curvature

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Treatment of cerebrospinal fluid leak after spine surgery

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Chinese Journal of Traumatology 2017年第2期20卷 81-83页

作者： Zhao Fang Rong Tian Yu-Tao Jia Tian-Tong Xu Yang Liu Department of spine Surgery Tianjin Union Medical Centre Tianjin 300121 China

Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid (CSF) leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new treatment strategies have shown a promising effect that is listed as follows: 1) creating watertight dural closure to stop CSF leak with the help of dural substitute material; and 2) retarding CSF leak by changing pressure difference, including reducing the subarachnoid fluid pressure, increasing the epidural space pressure and both. In fact several methods mentioned above are usually combined to treat CSF leak. However, no update review summarized the relevant studies implemented in recent years. In this review, the authors would compare the effects of different dural closure techniques, and introduce the latest treatment methods and mechanisms.

关键词： spine Cerebralspinal fluid leak Therapeutics

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Subfascial drainage for management of cerebrospinal fluid leakage after posterior spine surgery--A prospective study based on Poiseuille＇s law

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Chinese Journal of Traumatology 2016年第1期19卷 35-38页

作者： Zhao Fang Yu-Tao Jia Rong Tian Yang Liu Department of spine Surgery Tianjin Union Medicine Center Tianjin Institute of Spine Tianjin 300121 China

Purpose: Up to date, some approaches retarding the flow of cerebrospinal fluid (CSF) could be regarded as direct applications of the fluid mechanics (Poiseuille's law). However, there is a lack of the research on the efficacy of subfascial drainage for management of CSF leak after spine surgery based on the law. This is a prospective and comparative study on subfascial drainage for CSF. Methods: Every four months in the three years from January 2010 to December 2012, the patients were enrolled respectively in Group A, Group B and Group C, in which, the drainage tube was discontinued within postoperative 3-4 days, 5-6 days, 7-10 days. Results and complications of postoperative CSF leak were investigated, and mean wound healing time (MWHT) of the three groups was compared. Results: A total of 108 cases (Group A/B/C:35/32/41) of CSF leak following posterior spine surgery were admitted to Tianjin Union Medicine Center, and 92 cases have been followed up for more than 1 year (follow-up rate of 85.2%). Preoperative demographics were similar among the 3 groups. In Group A, 7 patients developed CSF leak through the wound (CSFLW), of which 5 cases had to undergo reoperation. One case in Group A was confirmed to have pseudomeningocele at the 1st month after surgery. The MWHT was (16.6 ± 3.6) days. In Group B, 3 patients developed CSFLW and cured by reoperation, in which 1 case of superficial infection recovered well after reoperation. MWHT was (11.4 ± 2.2) days. In Group C, CSFLW was not found and MWHT was (10.1 ± 2.9) days. The differences of MWHT among Groups A, B and C were statistically significant. Conclusion: Postoperative subfascial drainage, which is used to decrease the subfascial space pressure (P 2 ), would help wound healing. When it is placed for more than 7 days, the wound resistance (Rw) would be strong enough to withstand the subarachnoid pressure (P 1 ). Meanwhile, the power transduction in a sequence of Rw > P 2 >P 1 will indirectly retard CSF leak at the durotomy site and accordingly facilitate the heal

关键词： spine Cerebrospinal fluid leak Drainage

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Growing spine deformities: Are magnetic rods the final answer?

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世界骨科杂志：英文版 2017年第4期8卷 295-300页

作者： Ashok N Johari Amit S Nemade Enable International Center for Paediatric Musculoskeletal Care

Treatment paradigms for Early Onset Scoliosis have changed from fusion to fusionless methods as the harmful effects of early fusion on the growing spine and thorax were realized. Magnetic rods are a recent addition to fusionless technology for controlling scoliosis in a growing spine. The clinical evidence base on magnet driven growth rods(MDGR) has accumulated over the last 4 years. It has implications for reduction in the number of repeat surgeries required with similar complications as the traditional growth rods(TGR) and at a higher initial cost. However in terms of patient psyche and avoidance of repeat surgeries which are necessary with the TGR, MDGR treatment works out less expensive in the long run with definitely better patient comfort. The authors look at the available literature coupled with their own experience to discuss the current status, limitations and future prospects for this type of technology.

关键词： Growing spine Magnet driven growth rods Magnetic growth rods Growth rods Early Onset Scoliosis

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Microvascular response to transfusion in elective spine surgery

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世界骨科杂志：英文版 2017年第1期8卷 49-56页

作者： J Matthias Walz Ottokar Stundner Federico P Girardi Bruce A Barton Aimee R Koll-Desrosiers Stephen O Heard Stavros G Memtsoudis Department of Anesthesi-ology and Perioperative Medicine UMass Memorial Healthcare Department of Anesthesiology Hospital for Special SurgeryWeill Cornell Medical Center Department of Anesthesiology PerioperativeMedicine and Intensive Care MedicineParacelsus Medical University Department of Orthopedic Surgery Hospital for Special SurgeryWeill Cornell Medical Center Department of Quantitative Health Sciences University of Massachusetts Medical School

AIM To investigate the microvascular(skeletal muscle tissue oxygenation; SmO_2) response to transfusion in patients undergoing elective complex spine surgery.METHODS After IRB approval and written informed consent, 20 patients aged 18 to 85 years of age undergoing > 3level anterior and posterior spine fusion surgery were enrolled in the study. Patients were followed throughout the operative procedure, and for 12 h postoperatively. In addition to standard American Society of Anesthesiologists monitors, invasive measurements including central venous pressure, continual analysis of stroke volume(SV), cardiac output(CO), cardiac index(CI), and stroke volume variability(SVV) was performed. To measure skeletal muscle oxygen saturation(SmO_2) during the study period, a non-invasive adhesive skin sensor based on Near Infrared Spectroscopy was placed over the deltoid muscle for continuous recording of optical spectra. All administration of fluids and blood products followed standard procedures at the Hospital for Special Surgery, without deviation from usual standards of care at the discretion of the Attending Anesthesiologist based on individual patient comorbidities, hemodynamic status, and laboratory data. Time stamps were collected for administration of colloids and blood products, to allow for analysis of SmO_2 immediately before, during, and after administration of these fluids, and to allow for analysis of hemodynamic data around the same time points. Hemodynamic and oxygenation variables were collected continuously throughout the surgery, including heart rate, blood pressure, mean arterial pressure, SV, CO, CI, SVV, and SmO_2. Bivariate analyses were conducted to examine the potential associations between the outcome of interest, SmO_2, and each hemodynamic parameter measured using Pearson's correlation coeffi-cient, both for the overall cohort and within-patients individually. The association between receipt of packed red blood cells and SmO_2 was performed by running an interrupted time series model, with SmO_2

关键词： Transfusion Complex spine surgery Near infrared spectroscopy Microvascular blood flow Hemodynamic monitoring

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