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  • 1
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    Epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China: a hospital-based retrospective study
    Medknow ; 2024
    In:  Neural Regeneration Research Vol. 19, No. 5 ( 2024-05), p. 1126-1132
    Details
    In: Neural Regeneration Research, Medknow, Vol. 19, No. 5 ( 2024-05), p. 1126-1132
    Abstract: JOURNAL/nrgr/04.03/01300535-202405000-00044/inline-graphic1/v/2023-09-28T063346Z/r/image-tiff Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death. China has the largest population of patients with traumatic spinal cord injury. Previous studies of traumatic spinal cord injury in China have mostly been regional in scope; national-level studies have been rare. To the best of our knowledge, no national-level study of treatment status and economic burden has been performed. This retrospective study aimed to examine the epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China at the national level. We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China. Patient epidemiological and clinical features, treatment status, and total and daily costs were recorded. Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program. The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall (annual percentage change, –0.5% and 2.1%, respectively). A total of 10,053 (74.7%) patients underwent surgery. Only 2.8% of patients who underwent surgery did so within 24 hours of injury. A total of 2005 (14.9%) patients were treated with high-dose (≥ 500 mg) methylprednisolone sodium succinate/methylprednisolone (MPSS/MP); 615 (4.6%) received it within 8 hours. The total cost for acute traumatic spinal cord injury decreased over the study period (–4.7%), while daily cost did not significantly change (1.0% increase). Our findings indicate that public health initiatives should aim at improving hospitals’ ability to complete early surgery within 24 hours, which is associated with improved sensorimotor recovery, increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.
    Type of Medium: Online Resource
    ISSN: 1673-5374 , 1876-7958
    URL: Article
    DOI: 10.4103/1673-5374.382257
    Language: English
    Publisher: Medknow
    Publication Date: 2024
    detail.hit.zdb_id: 2388460-5
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  • 2
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    Preoperative cervical range of motion in flexion as a risk factor for postoperative cervical sagittal imbalance after laminoplasty
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Spine
    Details
    In: Spine, Ovid Technologies (Wolters Kluwer Health)
    Abstract: Retrospective study. Objective: To investigate factors associated with cervical sagittal imbalance after cervical laminoplasty (LMP) Summary of Background Data: Preoperative dynamic cervical sagittal alignment is an important predictor for changes in cervical sagittal alignment and clinical outcomes after LMP. However, the impact of preoperative dynamic cervical sagittal alignment on postoperative changes in the cervical sagittal vertical axis (cSVA) after LMP remains unclear. We hypothesized that preoperative cervical flexion and extension function are associated with the changes in cSVA and clinical outcomes and found potential risk factors for post-LMP cervical sagittal imbalance (CSI). Methods: Patients undergoing LMP at a single institution between January 2019 and December 2021 were retrospectively reviewed. The average follow-up period was 19 months. The parameters were collected before the surgery and at the final follow-up. We defined the changes in cSVA (△cSVA) ≤ -10 mm as the improvement group, -10 mm 〈 △cSVA ≤ 10 mm as the stable group, and △cSVA 〉 10 mm as the deterioration group. Multivariate logistic regression was used to evaluate factors associated with postoperative CSI. The chi-square test was used to compare categorical data between groups. T-tests, ANOVA, Kruskal-Wallis tests, and Mann-Withney-Wilcoxon tests were used to assess the differences between radiographic and clinical parameters among groups. A receiver-operating characteristic curve (ROC) analysis was used to identify optimal cutoff values. Results: The study comprised 102 patients with cervical spondylotic myelopathy. The Japanese Orthopedic Association (JOA) recovery rate was better in the improvement group and a significant aggravation in neck pain was observed in the deterioration group after surgery. Cervical Flex ROM (spine range of flexion) was significantly higher in the deterioration group. The multivariate logistic regression model suggested that greater Flex ROM and starting LMP at C3 were significant risk factors for postoperative deterioration of cervical sagittal balance. Receiver operating characteristic curves showed that the cut-off value for preoperative Flex ROM was 34.10°. Conclusion: Preoperative dynamic cervical sagittal alignment influences postoperative cervical sagittal balance after LMP. Cervical LMP should be carefully considered for patients with a preoperative high Flex ROM, as cervical sagittal imbalance is likely to occur after surgery. Level of Evidence: 3
    Type of Medium: Online Resource
    ISSN: 0362-2436
    URL: Article
    DOI: 10.1097/BRS.0000000000004844
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2002195-1
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  • 3
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    Different acute behaviors of pelvic incidence after long fusion to sacrum between elderly patients with severe and minor sagittal deformity: a retrospective radiographic study on 102 cases
    Springer Science and Business Media LLC ; 2020
    In:  European Spine Journal Vol. 29, No. 6 ( 2020-06), p. 1379-1387
    Details
    In: European Spine Journal, Springer Science and Business Media LLC, Vol. 29, No. 6 ( 2020-06), p. 1379-1387
    Type of Medium: Online Resource
    ISSN: 0940-6719 , 1432-0932
    URL: Article
    DOI: 10.1007/s00586-020-06395-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 1472721-3
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  • 4
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    Biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters: An in vitro study
    Frontiers Media SA ; 2022
    In:  Frontiers in Bioengineering and Biotechnology Vol. 10 ( 2022-8-19)
    Details
    In: Frontiers in Bioengineering and Biotechnology, Frontiers Media SA, Vol. 10 ( 2022-8-19)
    Abstract: Background: Although the management of the lumbar disease is highly dependent on the severity of the patient’s condition, optimal surgical techniques to reduce the risk of adjacent degeneration disease (ADS) remain elusive. Based on in vitro biomechanical tests of the cadaver spine, this study aimed to comparatively analyze the kinematic responses of the spine with dynamic and rigid fixations (i.e., Coflex fixation and posterolateral fusion) after single-or double-level lumbar fusion in daily activities. Methods: Six human lumbar specimens (L1-S1) were selected for this experiment, and the sagittal parameters of each lumbar specimen were measured in the 3D model. The specimens were successively reconstructed into five groups of models: intact model, single-level L4-5 Coflex fixation model, single-level L4-5 Fusion (posterior pedicle screw fixation) model, double-level L4-5 Coflex + L5-S1 Fusion model; and double-level L4-5 Fusion + L5-S1 Fusion model. The pure moment was applied to the specimen model to simulate physiological activities in daily life through a custom-built robot testing device with an optical tracking system. Results: For single-level lumbar fusion, compared to the traditional Fusion fixation, the Coflex dynamic fixation mainly restricted the extension of L4-L5, partially retained the range of motion (ROM) of the L4-L5 segment, and reduced the motion compensation of the upper adjacent segment. For the double-level lumbar fixation, the ROM of adjacent segments in the Coflex + Fusion was significantly decreased compared to the Fusion + Fusion fixation, but there was no significant difference. In addition, PT was the only sagittal parameter of the preoperative lumbar associated with the ROM under extension loading. The Coflex fixation had little effect on the original sagittal alignment of the lumbar spine. Conclusion: The Coflex was an effective lumbar surgical technique with a less altering kinematic motion of the lumbar both at the index segment and adjacent segments. However, when the Coflex was combined with the fusion fixation, this ability to protect adjacent segments remained elusive in slowing the accelerated degradation of adjacent segments.
    Type of Medium: Online Resource
    ISSN: 2296-4185
    URL: Article
    DOI: 10.3389/fbioe.2022.943092
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2719493-0
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  • 5
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    Biomechanical effects of over lordotic curvature after spinal fusion on adjacent intervertebral discs under continuous compressive load
    Elsevier BV ; 2020
    In:  Clinical Biomechanics Vol. 73 ( 2020-03), p. 149-156
    Details
    In: Clinical Biomechanics, Elsevier BV, Vol. 73 ( 2020-03), p. 149-156
    Type of Medium: Online Resource
    ISSN: 0268-0033
    URL: Article
    DOI: 10.1016/j.clinbiomech.2020.01.002
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2004518-9
    SSG: 31
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  • 6
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    Dynamic Stabilization Adjacent to Fusion versus Posterior Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Disease: A Meta-Analysis
    Hindawi Limited ; 2020
    In:  BioMed Research International Vol. 2020 ( 2020-05-20), p. 1-19
    Details
    In: BioMed Research International, Hindawi Limited, Vol. 2020 ( 2020-05-20), p. 1-19
    Abstract: This study evaluated differences in outcome variables between dynamic stabilization adjacent to fusion (DATF) and posterior lumbar interbody fusion (PLIF) for the treatment of lumbar degenerative disease. A systematic review of PubMed, EMBASE, and Cochrane was performed. The variables of interest included clinical adjacent segment pathologies (CASPs), radiological adjacent segment pathologies (RASPs), lumbar lordosis (LL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery (DS), estimated blood loss (EBL), complications, and reoperation rate. Nine articles identified as meeting all of the inclusion criteria. DATF was better than PLIF in proximal RASP, CASP, and ODI during 3 months follow-up, VAS-L. However, no significant difference between DATF and PLIF was found in distal RASP, LL, JOA score, VAS-B, ODI after 3 months follow-up, complication rates, and reoperation rate. These further confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The differences between hybrid surgery and topping-off technique were located in DS and EBL in comparison with PLIF. Our study confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to the fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The difference between hybrid surgery and topping-off technique was not significant in treatment outcomes.
    Type of Medium: Online Resource
    ISSN: 2314-6133 , 2314-6141
    URL: Article
    DOI: 10.1155/2020/9309134
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2020
    detail.hit.zdb_id: 2698540-8
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  • 7
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    Topping-Off Technology versus Posterior Lumbar Interbody Fusion in the Treatment of Lumbar Disc Herniation: A Meta-Analysis
    Hindawi Limited ; 2020
    In:  BioMed Research International Vol. 2020 ( 2020-01-13), p. 1-10
    Details
    In: BioMed Research International, Hindawi Limited, Vol. 2020 ( 2020-01-13), p. 1-10
    Abstract: The treatment effects of topping-off technique were still controversial. This study compared all available data on postoperative clinical and radiographic outcomes of topping-off technique and posterior lumbar interbody fusion (PLIF). PubMed, EMBASE, and Cochrane were systematically reviewed. Variations included radiographical adjacent segment disease (RASD), clinical adjacent segment disease (CASD), global lumbar lordosis (GLL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery, estimated blood loss (EBL), reoperation rates, and complication rates. Sixteen studies, including 1372 cases, were selected for the analysis. Rates of proximal RASD ( P = 0.0004 ), distal RASD ( P = 0.03 ), postoperative VAS-B ( P = 0.0001 ), postoperative VAS-L ( P = 0.02 ), EBL ( P = 0.007 ), and duration of surgery ( P = 0.02 ) were significantly lower in topping-off group than those in PLIF group. Postoperative ODI after 3 years ( P = 0.04 ) in the topping-off group was significantly less than that in the PLIF group. There was no significant difference in the rates of CASD ( P = 0.06 ), postoperative GLL ( P = 0.14 ), postoperative ODI within 3 years ( P = 0.24 ), and postoperative JOA ( P = 0.70 ) and in reoperation rates ( P = 0.32 ) and complication rates ( P = 0.27 ) between topping-off group and PLIF. The results confirmed that topping-off technique could effectively prevent ASDs after lumbar internal fixation. However, this effect is effective in preventing RASD. Topping-off technique is more effective in improving the subjective feelings of patients rather than objective motor functions compared with PLIF. With the development of surgical techniques, both topping-off technique and PLIF are safe.
    Type of Medium: Online Resource
    ISSN: 2314-6133 , 2314-6141
    URL: Article
    DOI: 10.1155/2020/2953128
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2020
    detail.hit.zdb_id: 2698540-8
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  • 8
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    Selecting proper distal fusion level in severe thoracolumbar kyphosis secondary to late osteoporotic vertebral compression fracture to limit distal complications
    Elsevier BV ; 2022
    In:  Journal of Orthopaedic Science Vol. 27, No. 6 ( 2022-11), p. 1177-1184
    Details
    In: Journal of Orthopaedic Science, Elsevier BV, Vol. 27, No. 6 ( 2022-11), p. 1177-1184
    Type of Medium: Online Resource
    ISSN: 0949-2658
    URL: Article
    DOI: 10.1016/j.jos.2021.07.025
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 1481657-X
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  • 9
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    Correlation between inflammatory cytokine expression in paraspinal tissues and severity of disc degeneration in individuals with lumbar disc herniation
    Springer Science and Business Media LLC ; 2023
    In:  BMC Musculoskeletal Disorders Vol. 24, No. 1 ( 2023-03-14)
    Details
    In: BMC Musculoskeletal Disorders, Springer Science and Business Media LLC, Vol. 24, No. 1 ( 2023-03-14)
    Abstract: Previous animal studies have discovered dysregulation of the local inflammatory state as a novel mechanism to explain structural changes in paraspinal muscles in association with disc degeneration. This study aimed to determine whether the expression of inflammatory genes in the multifidus muscle (MM) differs between individuals with disc degeneration and non-degeneration, which may cause changes in the cross-sectional area (CSA) of paraspinal muscles and clinical outcomes. Methods Muscles were procured from 60 individuals undergoing percutaneous endoscopic lumbar discectomy for lumbar disc herniation (LDH). Total and functional CSAs and fatty degeneration of paraspinal muscles on ipsilateral and unilateral sides were measured. Gene expression was quantified using qPCR assays. Paired t-test and Pearson’s correlation analysis were used to compare the mean difference and associations, respectively. Results There were significant differences in total CSAs of paraspinal muscles and functional CSA and fatty degeneration of MM between ipsilateral and unilateral sides. Participants in the disc degeneration group displayed higher fat infiltration in MM. The expression of TNF was moderately correlated with total CSAs of paraspinal muscles and functional CSA and fatty degeneration of MM. The expression of IL-1β was strongly correlated with the total and functional CSA of MM. The expression of TGF-β1 was moderately correlated with the functional CSA of MM. The expression of TNF, IL-1β, and TGF-β1 was moderate to strongly correlated with clinical outcomes. Conclusion The results show that there were differences in the characteristics of paraspinal muscles between the ipsilateral and unilateral sides, which were affected by disc degeneration and the degree of fat infiltration. High-fat filtration and reduction of CSA of MM are associated with inflammatory dysfunction. There was evidence of a dysregulated inflammatory profile in MM in individuals with poor clinical outcomes.
    Type of Medium: Online Resource
    ISSN: 1471-2474
    URL: Article
    DOI: 10.1186/s12891-023-06295-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041355-5
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  • 10
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    A new lever reduction technique for the surgical treatment of elderly patients with lumbar degenerative Spondylolisthesis
    Springer Science and Business Media LLC ; 2020
    In:  BMC Musculoskeletal Disorders Vol. 21, No. 1 ( 2020-12)
    Details
    In: BMC Musculoskeletal Disorders, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: Proper reduction method for Lumbar degenerative spondylolisthesis (LDS) is still controversial. The aim of this study was to determine the safety and effectiveness of lever reduction combined with traditional elevating-pull reduction technique for the treatment of elderly patients with LDS. Methods From May 2015 to December 2017, 142 elderly patients (≥65 years) diagnosed with LDS were enrolled in this study with a mean follow-up of 25.42 ± 8.31 months. All patients were operated using lever reduction combined with traditional elevating-pull reduction technique. Patient age, sex, body mass index, bone mineral density, preoperative comorbidities, surgical duration, blood loss, and surgical complications were collected form patient charts. Clinical data as visual analog scale (VAS), Oswestry Disability Index (ODI), and 36-Item Short Form Health Survey (SF-36) were collected preoperatively, 1 month postoperatively, and at the final follow-up. Radiographic evaluation included slip percentage, slip angle (SA), lumbar lordosis (LL), and fusion status. Results The clinical parameters of VAS back , VAS leg , ODI, and SF-36 had significantly improved at both follow-ups after surgery. A significant improvement was indicated for slippage reduction at both follow-ups, showing no significant correction loss after surgery. SA significantly increased after surgery and was well maintained at the final follow-up. LL was not affected by the surgery. At the final follow-up, complete fusion was obtained in 121 patients (85.2%) and partial fusion in 21 (14.8%). Revision surgery was performed for one patient. Screw loosening was observed in 3 (2.11%) cases. No nerve root injury or adjacent segment disease was observed. Conclusions This new lever reduction combined with traditional elevating-pull reduction technique for the surgical treatment of elderly patients with LDS is both safe and effective. Satisfactory correction and fusion rates were achieved with acceptable correction loss and reduction-related complications.
    Type of Medium: Online Resource
    ISSN: 1471-2474
    URL: Article
    DOI: 10.1186/s12891-019-3028-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2041355-5
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