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Spinous process plate fixation for cervical spinal fusion after spinal trauma:two case reports

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第9期14卷 855-858页

作者： Hiroki HIRABAYASHI Jun TAKAHASHI Hiroyuki HASHIDATE Nobuhide OGIHARA Keijiro MUKAIYAMA Shugo KURAISHI Masayuki SHIMIZU Hiroyuki NAKAGAWA Renzo MATSUE Hiroyuki KATO department of orthopedic Surgery Shinshu University School of Medicine

Posterior cervical fixation with various forms of instrumentation has been used for reconstruction in cases of traumatic disorders and degenerative or tumor-related dysfunction of the cervical spine. Recently, posterior plate and rod techniques using lateral mass screws or pedicle screws have been reported to show excellent fusion rates (Xu et al.,2010).

关键词：病例报告脊柱融合脊髓损伤颈椎椎弓根螺钉钢板功能障碍外伤性

Effects of poly lactic-co-glycolic acid-Nogo A antibody delayed-release microspheres on regeneration of injured spinal cord in rats

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Neural Regeneration Research 2009年第5期4卷 358-364页

作者： Hai Lan Yueming Song department of orthopedic Surgery West China Hospital Sichuan University Chengdu 610041 Sichuan Province China department of orthopedic Surgery Chengdu Railway Center Hospital Chengdu 610081 Sichuan Province China

BACKGROUND： Nogo A antigen is the major inhibiting factor blocking regeneration of the injured spinal cord. Neutralizing Nogo A antigens using Nogo A antibodies may help promote neurite regeneration and nervous function recovery. For successful regeneration, sustained release of the antibody from a biodegradable material loaded with Nogo A antibodies to the injury site is required. OBJECTIVE： To compare the therapeutic effects of poly lactic-co-glycolic acid （PLGA）-Nogo A antibody delayed-release microspheres and Nogo A antibody alone on spinal regeneration in Sprague-Dawley rats with complete transverse injury to the spinal cord. DESIGN, TIME AND SETTING： A randomized, controlled animal trial was performed at the Pharmacological Laboratory of West China Center of Medical Sciences, Sichuan University, between October 2007 and January 2008. MATERIALS： Goat anti-rat Nogo A monoclonal antibody was purchased from Santa, American; goat anti-rat neurofilament 200 monoclonal antibody was from Zhongshan Goldenbridge, Beijing, China; PLGA-Nogo A antibody delayed-release microspheres were provided by the College of Pharmacy, Sichuan University. METHODS： A total of 36 adult female Sprague Dawley rats were used to establish models of completely transected spinal cord injury, at T10. Animals were randomly divided into three groups （n=12）： model, Nogo A antibody alone, and Nogo A antibody delayed-release microsphere groups. After transverse injury of the spinal cord, 50 μ L normal saline solution, 50 μL normal saline solution containing 50μL g Nogo A antibody, and 50 μL normal saline solution containing 50 μg Nogo A antibody microspheres were administered to the respective groups at the injury site. MAIN OUTCOME MEASURES： The expression of Nogo A and neurofilament 200 in injured spinal cord was tested immunohistochemically, and motor function of rats was assessed by Basso-Beattie-Bresnahan （BBB） locomotor rating scale. RESULTS： Four weeks after injury, expression of Nogo A in mic

关键词： Nogo A antibody microspheres poly lactic-co-glycolic acid spinal cord injury neural regeneration

Differential gene and protein expression between rat tibial nerve and common peroneal nerve during wallerian degeneration

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Neural Regeneration Research 2019年第12期14卷 2183-2191页

作者： Yao-Fa Lin Zheng Xie Jun Zhou Gang Yin Hao-Dong Lin department of orthopedic Surgery Changzheng Hospital the Second Military Medical University Shanghai China department of orthopedic Surgery Shanghai General Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

Wallerian degeneration and nerve regeneration after injury are complex processes involving many genes, proteins and cytokines. After different peripheral nerve injuries the regeneration rate can differ. Whether this is caused by differential expression of genes and proteins during Wallerian degeneration remains unclear. The right tibial nerve and the common peroneal nerve of the same rat were exposed and completely cut through and then sutured in the same horizontal plane. On days 1, 7, 14, and 21 after surgery, 1–2 cm of nerve tissue distal to the suture site was dissected out from the tibial and common peroneal nerves. The differences in gene and protein expression during Wallerian degeneration of the injured nerves were then studied by RNA sequencing and proteomic techniques. In the tibial and common peroneal nerves, there were 1718, 1374, 1187, and 2195 differentially expressed genes, and 477, 447, 619, and 495 differentially expressed proteins on days 1, 7, 14, and 21 after surgery, respectively. Forty-seven pathways were activated during Wallerian degeneration. Three genes showing significant differential expression by RNA sequencing (Hoxd4, Lpcat4 and Tbx1) were assayed by real-time quantitative polymerase chain reaction. RNA sequencing and real-time quantitative polymerase chain reaction results were consistent. Our findings showed that expression of genes and proteins in injured tibial and the common peroneal nerves were significantly different during Wallerian degeneration at different time points. This suggests that the biological processes during Wallerian degeneration are different in different peripheral nerves after injury. The procedure was approved by the Animal Experimental Ethics Committee of the Second Military Medical University, China (approval No. CZ20160218) on February 18, 2016.

关键词： nerve regeneration peripheral nerves peripheral nerve injuries Wallerian degeneration tibial nerve common peroneal nerve RNA sequencing proteomic real-time quantitative polymerase chain reaction neural regeneration

Contralateral C7 transfer combined with acellular nerve allografts seeded with differentiated adipose stem cells for repairing upper brachial plexus injury in rats

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Neural Regeneration Research 2019年第11期14卷 1932-1940页

作者： Jian-Tao Yang Jin-Tao Fang Liang Li Gang Chen Ben-Gang Qin Li-Qiang Gu department of Microsurgery & orthopedic Trauma the First Affiliated Hospital of Sun Yat-sen University

Nerve grafting has always been necessary when the contralateral C7 nerve root is transferred to treat brachial plexus injury. Acellular nerve allograft is a promising alternative for the treatment of nerve defects, and results were improved by grafts laden with differentiated adipose stem cells. However, use of these tissue-engineered nerve grafts has not been reported for the treatment of brachial plexus injury. The aim of the present study was to evaluate the outcome of acellular nerve allografts seeded with differentiated adipose stem cells to improve nerve regeneration in a rat model in which the contralateral C7 nerve was transferred to repair an upper brachial plexus injury. Differentiated adipose stem cells were obtained from Sprague-Dawley rats and transdifferentiated into a Schwann cell-like phenotype. Acellular nerve allografts were prepared from 15-mm bilateral sections of rat sciatic nerves. Rats were randomly divided into three groups: acellular nerve allograft, acellular nerve allograft + differentiated adipose stem cells, and autograft. The upper brachial plexus injury model was established by traction applied away from the intervertebral foramen with micro-hemostat forceps. Acellular nerve allografts with or without seeded cells were used to bridge the gap between the contralateral C7 nerve root and C5–6 nerve. Histological staining, electrophysiology, and neurological function tests were used to evaluate the effect of nerve repair 16 weeks after surgery. Results showed that the onset of discernible functional recovery occurred earlier in the autograft group first, followed by the acellular nerve allograft + differentiated adipose stem cells group, and then the acellular nerve allograft group;moreover, there was a significant difference between autograft and acellular nerve allograft groups. Compared with the acellular nerve allograft group, compound muscle action potential, motor conduction velocity, positivity for neurofilament and S100, diameter o

关键词： nerve regeneration peripheral nerve injury brachial plexus injury contralateral C7 nerve root acellular nerve adipose stem cells Schwann cells tissue engineering nerve nerve grafting nerve defect neural regeneration

Surgical treatment of Lenke 5 adolescent idiopathic scoliosis: Comparison of anterior vs posterior approach

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World Journal of orthopedics 2016年第9期7卷 553-560页

作者： Mark F Abel Anuj Singla Mark A Feger Lindsay D Sauer Wendy Novicoff department of orthopedic Surgery University of Virginia

AIM To compare the posterior vs anterior approaches for fusion of Lenke 5 adolescent idiopathic scoliosis curves,matched for curve magnitude and for the distal level of fixation(dLOF) standardized to the third lumbar vertebrae(L3).METHODS A prospectively collected multicenter database was used for this retrospective comparative study. Our dependent variables included sagittal and coronal radiographic measurements, number of fused vertebrae, estimated blood loss, length of hospitalization and SRS total and individual domain scores at the two-year follow-up. Subject demographics were similar for all group *** t-test was used to compare groups for all analyses at P < *** For all matched cases of Lenke 5 curves, a selective approach was used only 50% of the time in cases undergoing a posterior fusion. When comparing a posterior selective approach to an anterior selective approach,surgeons utilizing a posterior approach fused significantly more levels than surgeons using an anterior approach with no other significant differences in radiographic or SRS outcomes(Ant = 4.8 ± 1.0 levels vs post = 6.1 ± 1.0 levels, P < 0.0001). When the dLOF was standardized to L3, the anterior approached provided significantly greater lumbar Cobb percent correction than the posterior approach(Ant = 69.1% ± 12.6% vs post =54.6% ± 16.4%, P = 0.004), with no other significant radiographic or SRS score differences between *** Surgeons treating Lenke 5c curves with a posterior instrumentation and fusion vs an anterior approach include more motion segments, even with a selective fusion. When controlled for the distal level of fixation,the anterior approach provides greater correction of the thoracolumbar curve.

关键词： Instrumentation Thoracolumbar curve Selective fusion

Effect of opioid dependence or abuse on opioid utilization after shoulder arthroplasty

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World Journal of orthopedics 2018年第8期9卷 105-111页

作者： Derek D Berglund Samuel Rosas Jennifer Kurowicki Dragomir Mijic Jonathan C Levy department of orthopedic Surgery Holy Cross Orthopedic Institute department of orthopedic Surgery Wake Forest School of Medicine department of Orthopaedic Surgery Seton Hall University School of Health and Medical Sciences

AIM To examine whether opioid dependence or abuse has an effect on opioid utilization after anatomic or reverse total shoulder arthroplasty(TSA).METHODS All anatomic TSA(ICD-9 81.80) and reverse shoulder arthroplasty(RSA)(ICD-9 81.88) procedures from 2007 to 2015 were queried from within the Humana claims database utilizing the Pearl Diver supercomputer(Colorado Springs, CO). Study groups were formed based on the presence or absence of a previous history of opioid dependence(ICD-9 304.00 and 304.03) or abuse(ICD-9 305.50 and 305.53). Opioid utilization among the groups was tracked monthly up to 1 year post-operatively utilizing National Drug Codes. A secondary analysis was performed to determine risk factors for pre-operative opioid dependence or *** Two percent of TSA(157 out of 7838) and 3% of RSA(206 out of 6920) patients had a history of opioid dependence or abuse. For both TSA and RSA, opioid utilization was significantly higher in opioid dependent patients at all post-operative intervals(P < 0.01) although the incidence of opioid use among groups was similar within the first post-operative month. After TSA, opioid dependent patients were over twice as likely to fill opioid prescriptions during the post-operative months 1-12. Following RSA, opioid dependent patients were over 3 times as likely to utilize opioids from months 3-12. Age less than 65 years, history of mood disorder, and history of chronic pain were significant risk factors for pre-operative opioid dependence/abuse in patients who underwent TSA or *** Following shoulder arthroplasty, opioid use between opioid-dependent and non-dependent patients is similar within the first post-operative month but is greater among opioid-dependent patients from months 2-12.

关键词： Opioid Narcotic Abuse Dependence Anatomic total shoulder arthroplasty Reverse shoulder arthroplasty Chronic pain Mood disorder

Cell cycle and complement inhibitors may be specific for treatment of spinal cord injury in aged and young mice: transcriptomic analyses

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Neural Regeneration Research 2018年第3期13卷 518-527页

作者： Ming Hao Xin-ran Ji Hua Chen Wei Zhang Li-cheng Zhang Li-hai Zhang Pei-fu Tang Ning Lu department of orthopedic Surgery General Hospital of People’s Liberation Army (301 Hospital)

Previous studies have reported age-specific pathological and functional outcomes in young and aged patients suffering spinal cord injury,but the mechanisms remain poorly understood. In this study, we examined mice with spinal cord injury. Gene expression profiles from the Gene Expression Omnibus database （accession number GSE93561） were used, including spinal cord samples from 3 young injured mice （2–3-months old, induced by Impactor at Th9 level） and 3 control mice （2–3-months old, no treatment）, as well as 2 aged injured mice （15–18-months old, induced by Impactor at Th9 level） and 2 control mice （15–18-months old, no treatment）. Differentially expressed genes （DEGs） in spinal cord tissue from injured and control mice were identified using the Linear Models for Microarray data method,with a threshold of adjusted P 〈 0.05 and ｜logFC（fold change）｜〉 1.5. Protein–protein interaction networks were constructed using data from the STRING database, followed by module analysis by Cytoscape software to screen crucial genes. Kyoto encyclopedia of genes and genomes pathway and Gene Ontology enrichment analyses were performed to investigate the underlying functions of DEGs using Database for Annotation, Visualization and Integrated Discovery. Consequently, 1,604 and 1,153 DEGs were identified between injured and normal control mice in spinal cord tissue of aged and young mice, respectively. Furthermore, a Venn diagram showed that 960 DEGs were shared among aged and young mice, while 644 and 193 DEGs were specific to aged and young mice, respectively. Functional enrichment indicates that shared DEGs are involved in osteoclast differentiation, extracellular matrix–receptor interaction, nuclear factor-kappa B signaling pathway, and focal adhesion. Unique genes for aged and young injured groups were involved in the cell cycle （upregulation of PLK1） and complement （upregulation of C3） activation, respectively. These findings were confirmed by functional analysis of genes in module

关键词： nerve regeneration spinal cord injury aged young transcriptome differentially expressed genes protein-protein interaction network function enrichment inflammation cell cycle complement neural regeneration

Aldehyde dehydrogenase 2 overexpression inhibits neuronal apoptosis after spinal cord ischemia/reperfusion injury

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Neural Regeneration Research 2017年第7期12卷 1166-1171页

作者： Xing-zhen Liu Xin Sun Kang-ping Shen Wen-jie Jin Zhi-yi Fu Hai-rong Tao Zhi-xing Xu Shanghai Key Laboratory of orthopedic Implants Department of Orthopedic surgery Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

Aldehyde dehydrogenase 2（ALDH2）is an important factor in inhibiting oxidative stress and has been shown to protect against renal ischemia/reperfusion ***,we hypothesized that ALDH_2 could reduce spinal cord ischemia/reperfusion *** cord ischemia/reperfusion injury was induced in rats using the modified Zivin＇s method of clamping the abdominal *** successful model establishment,the agonist group was administered a daily consumption of 2.5%*** 7 days post-surgery,the Basso,Beattie,and Bresnahan score significantly increased in the agonist group compared with the spinal cord ischemia/reperfusion injury ***_2expression also significantly increased and the number of apoptotic cells significantly decreased in the agonist group than in the spinal cord ischemia/reperfusion injury *** analysis revealed that ALDH_2 expression negatively correlated with the percentage of TUNEL-positive cells（r=-0.485,P〈0.01）.In summary,increased ALDH_2 expression protected the rat spinal cord against ischemia/reperfusion injury by inhibiting apoptosis.

关键词： nerve regeneration spinal cord ischemia/reperfusion injury aldehyde dehydrogenase 2 alcohol apoptosis oxidative stress terminaldeoxynucleotidyl transferase dUTP nick-end labeling neural regeneration

Comparison between direct repair and humana cellular nerve allografting during contralateral C7 transfer to the upper trunk for restoration of shoulder abduction and elbow flexion

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Neural Regeneration Research 2019年第12期14卷 2132-2140页

作者： Liang Li Wen-Ting He Ben-Gang Qin Xiao-Lin Liu Jian-Tao Yang Li-Qiang Gu department of orthopedic Trauma and Microsurgery the First Affiliated Hospital of Sun Yat-sen University

Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct repair can only be performed in some selected cases, and partial procedures still require autografts, which are the gold standard for repairing neurologic defects. As symptoms often occur after autografting, human acellular nerve allografts have been used to avoid concomitant symptoms. This study investigated the quality of shoulder abduction and elbow flexion following direct repair and acellular allografting to evaluate issues requiring attention for brachial plexus injury repair. Fifty-one brachial plexus injury patients in the surgical database were eligible for this retrospective study. Patients were divided into two groups according to different surgical methods. Direct repair was performed in 27 patients, while acellular nerve allografts were used to bridge the gap between the contralateral C7 nerve root and upper trunk in 24 patients. The length of the harvested contralateral C7 nerve root was measured intraoperatively. Deltoid and biceps muscle strength, and degrees of shoulder abduction and elbow flexion were examined according to the British Medical Research Council scoring system;meaningful recovery was defined as M3–M5. Lengths of anterior and posterior divisions of the contralateral C7 in the direct repair group were 7.64 ± 0.69 mm and 7.55 ± 0.69 mm, respectively, and in the acellular nerve allografts group were 6.46 ± 0.58 mm and 6.43 ± 0.59 mm, respectively. After a minimum of 4-year follow-up, meaningful recoveries of deltoid and biceps muscles in the direct repair group were 88.89% and 85.19%, respectively, while they were 70.83% and 66.67% in the acellular nerve allografts group. Time to C5/C6 reinnervation was shorter in the direct repair group compared with the acellular nerve allografts group. Direct repair facilitated the restorati

关键词： nerve regeneration contralateral C7 nerve root transfer nerve graft brachial plexus avulsion injury direct repair human acellular nerve allograft shoulder function elbow function nerve transfer phrenic nerve accessary nerve neural regeneration