Three-dimensional finite element analysis of ligaments of lumbar spine

The lumbar ligaments play an important role in spinal biomechanics.The results ofthree-dimensional finite dement analysis showed that one of the functions of lumbar ligaments istransmission of the tensile load between the lumbar vertebrae.The anterior longitudinal ligament isloaded in extension of lumbar spine and the resistance to the tensile load in flexion is providedby other ligaments.These ligaments are subject to much more tension with degeneration of theintervertebral disc so that a series of pathological changes occur.Relevant significance in clinical as-pect is also discussed.     

A Combined Treatment of Scalp Acupuncture and Traction in 108 Cases of Prolapse of the Lumbar Intervertebral Disc

Prolapse of the lumbar intervertebral disc is a syndrome commonly seen in clinic. The main manifestation is pain in the lumbar region radiating to the lower limbs. In the treatment of this disease, the author has employed traction together with scalp needling, and obtained quite good therapeutic effects. A report follows.     

Treatment of Protrusion of the Lumbar Intervertebral Disc by TCM Massage

Protrusion of the lumbar intervertebral disc is acommon disorder frequently encountered in clinic.With TCM massage and the maneuver of manualreduction,we have treated 82 cases of protrusion ofthe lumbar intervertebral disc,with satisfactorytherapeutic results reported in the following.     

Cervical disc arthroplasty with ProDisc-C artificial disc: 5-year radiographic follow-up results

Background Cervical disc arthroplasty is an alternative surgery to standard cervical decompression and fusion for disc degeneration. Different types of cervical disc prosthesis are used in China. The aim of this study was to evaluate the radiographic outcomes of cervical arthroplasty using the ProDisc-C prosthesis.     

Effects of discectomy on the stress distribution in the lumbar spine.

The change of the stress distribution of the lumbar spine after discectomy was analysed by the three-dimensional finite element method. It was shown that the stress level in the posterior element was higher, but that in the anterior element was lower than before disc excision. The most significant change of the stress distribution was found in the trabecular bone of the vertebral body. It is considered that in discectomy the normal disc tissue should be preserved as much as possible to maintain good function of the spine.

     

The effects of a new shape-memory alloy interspinous process device on the distribution of intervertebral disc pressures in vitro

This study was designed to measure the pressure distribution of the intervertebral disc under different degrees of distraction of the interspinous process, because of a suspicion that the degree of distraction of the spinous process may have a close relationship with the disc load share. Six human cadaver lumbar spine L2-L5 segments were loaded in flexion, neutral position, and extension. The L3-L4 disc load was measured at each position using pressure measuring films. Shape-memory interspinous process implants （SMID） with different spacer heights, ranging in size from 10 to 20 mm at 2 mm increments, were used. It was found that a SMID with a spacer height equal to the distance of the interspinous process in the neutral position can share the biomechanical disc load without a significant change of load in the anterior annulus. An interspinous process stabilizing device （IPD） would not be appropriate to use in those cases with serious spinal stenosis because the over-distraction of the interspinous process by the SMID would lead to overloading the anterior annulus which is a recognized cause of disc degeneration.     

Evaluation of the disc diffusion method with a comparison study for fluconazole susceptibility of Candida strains

Objective To performance susceptibility testing of antifungal agents. Due to the increasing number of resistant strains, susceptibility testing of antifungal agents is gaining importance.Methods We compared the results of standard macrotube dilution reference method with two different microdilution methods, as well as the disc diffusion method in order to test the susceptibility of 150 Candida strains to fluconazole.Results Overall correlation between microdilution and macrodilution methods was 86%. It was 91% between the Minimal Inhibitory Concentrations obtained from macrodUution and disc diffusion zone diameters.Conclusion The disc diffusion test was evaluated as a low-cost, reproducible, and efficient way of assessing the in vitro susceptibility of Candida strains to fluconazole.     

Extracts of Monascusus Purpureus beyond Statins——Profile of Efficacy and Safety of the Use of Extracts of Monascus Purpureus

Monascus purpureus is a fungus that has been tradi-tionally used in China for thousands of years to produce ricewine . Traditionally the fungus is used to ferment non-gluti-nous cooking of rice ,to produce a kind of famous red ricewine .Its main traditional indications consist of disordersdue to the accumulation of fats (nosologically linked withthe problems of stasis of circulation in traditional Chinesemedicine) ,liver disorders and some forms of tumor as ithelps i mprove the circulation of …     

Treatment of Motor Neuron Disease with Qi-invigorating Herbs——A Report of 31 Cases

The motor neuron disease (MND) refers to agroup of progressive diseases with unknown reasons,which attacks the cells of the anterior horn of thespinal cord,the motor nuclei of the brain stem cranialnerves and the pyramidal cells of the cerebral motorcortex.It is characterized in clinic by atrophy of themuscles,myasthenia and even death due to paralysisof the respiratory muscle.Currently,there is still noany effective cure for this illness.50-70% of thevictims will die in 3 to 5 years,and the survival timefor those with brain stem injuries is no more than two     

Treatment of Protrusion of Lumbar Intervertebral Disc by Massotherapy under Anesthesia—A Report of 64 Cases

Sixty-four cases of protrusion of lumbarintervertebral disc were treated by massotherapy withheavy manipulations plus blocking therapy underanesthesia from August,1997 to July,1998,withsatisfactory therapeutic results as reported in thefollowing.Clinical DataNinety-four cases in the series were randomlydivided into two groups.All the 94 cases satisfied thecriteria for diagnosis of the disorder,and thediagnosis was confirmed by computer-aided     

LUMBAR SPINAL STENOSIS. A REVIEW OF BIOMECHANICAL STUDIES

ObjectS. To investigate the biomechanical aspects of etiology, pathology, clinical manifestation, diagnosis and surgical treatment of the lumbar spinal stenosis. Methods. A series of biomechanical methods, such as three-dimensional finite element models, threedimensional kinematic measurement, cadeveric evaluation, and imaging assessment was applied to correlate lumbar biomechanics and lumber spinal stenosls. Surgery of lumber spinal stenosis has been improved. Results.The stresses significantly concentrate on the posterolateral part of the annulus fibrcsms of disc, the posterior surface of vertebral body, the pedlcle, the interarticularis and the beet joints. This trend is intensified by disc degeneration and lumber backward extension. Posterior elcxnent resection has a definite effect upon the biomechanical behavior of lumbar vertebrae. The improved operations proved satisfactory. Conclusion. Stress concentration in the lumber vertebrae is of importance to the etiology of degenerative lumbar spinal stenosls, and disc degeneratkm is the initial key of this process. Than these will be aggravatnd by backward extension. Functloval radiography and myelography are of assistance to the diagnosis of the lumhar spinal stenosls. For the surgcal treatment of the lumber spinal stenosis, destruction of the posterior element should be avoid as far as possible based upon the thorough decmnpression. Maintaining the lumbar spine in flexion by fusion after decorapression has been proved a useftd method. When developmental spinal stenoals is combined with disc herniation, discectoray through laminotomy is recommend for decompression.     

Epidural fat distribution patterns in patients with lumbar intervertebral disc protrusion

Objective： To investigate epidural fat distribution patterns in patients with lumbar intervertebral disc protrusion. Methods： Medical records were selected randomly from 30 patients whose diagnoses were consistent with the inclusion criteria of the study. Thickness of bilateral fat, the longest length of posterior fat, thickness of bilateral yellow ligament and the hernial distance of lumbar discs were measured by MRI at L3/L4, L4/L5 and L5/S 1 levels. According to clinical symptoms of lumbar intervertebral disc protrusion, the patients were divided into two groups at all space levels. All data were analyzed by statistical software. Results： The longest length of posterior epidural fat at the symptomatic levels was shorter than that at the non-symptomatic levels in each disc space. The symptomatic levels had no effect on the whole thickness of the lateral fat and lateral yellow ligaments. Conclusion： Epidural fat distribution in patients with lumbar intcrvertebral disc protrusion is different from that in normal adults. It is affected by the hernial distance of lumbar discs. The diagnostic criteria for spinal epidural lipomatosis in normal adults may therefore prove to be inappropriate for patients with lumbar intervertebral disc protrusion.     

Morphogenetic Action of Neurotransmitters on Regenerating Planarians—A Review

Planarians can be used as invertebrate bioassays to evaluate the role of neurotransmitters on regenerating cells.The influence of the nervous system is crucial to regenerate a normal complete animal.The neurotrophic action of the nervous system has been attributed to the major neurohormones present throughout the animal kingdom.The same type of transmitters found in mammals have been extensively found in many invertebrates,including planarians,but their tole in regeneration is unclear.Neurotransmitters and drugs which act on neurohumoral transmission have been used to determine the role of each neurohormone on regenerating planarians.Biochemical and pharmacological mechanisms of neurohormones on regenerative planarians are reviewed,as is their putative role on regeneration.Correlation with the roles of neurotransmitters in the central nervous system of higher organisms are also addressed.     

Imaging study of lumbar posterior marginal intraosseous node. An analysis of 36 cases.

Clinical, radiological and CT manifestations of 36 patients with lumbar posterior marginal intraosseous cartilaginous node (LPMN) were analysed. Of the 36 patients, 27 were male and 9 female, most of them were young adults. The posteroinferior margin of L4 was the commonest site and the posterosuperior margin might also be involved. Two patients had multiple lesions. Typical radiological findings included a defect in the posteroinferior (or posterosuperior) margin of the affected vertebral body and behind the defect a bony ridge protruding into the spinal canal. CT scan showed a cartilaginous node in the posterior zone of the vertebral plate. It is suggested that LPMN was the result of disc material herniating into the posterior aspect of vertebral body through ruptured cartilaginous end-plate during the adolescence, similar to that of the limbus vertebra. Hyperflexion and hyperextension of the spine probably play an important role in the pathogenesis. The existence of LPMN favours posterior disc herniation in the same disco-vertebral junction.

     

Spinal cord——Interlaminar micro-neurosurgical discectomy in lumbar disk hermiation

Objective To investigate the surgical results of interlaminar microsurgical discectomy in lumbar disk herniation. Methods A study of 36 consecutive patients undergoing microsurgical lumbar discectomy was conducted. The extend of anular deficiency and the presence of disc fragment were determined. The clinical raiological parameters, type of surgery performed, follow-up, were assessed. Results We found that interlaminar disectomy without laminotomy was adequate in 28 cases （78 % ）. Seletive foraminotomy in addition to diseectomy was performed in 17 cases （47 % ）. Patients in the Fragment-Fissure and Fragment-Contained group had the best clinical outcomes, and lower rates of reherniation. Conclusion Interlaminar discectomy without laminotomy is a safe,     

TREATMENT OF BONY GONARTHRITIS WITH HERBAL MEDICINE AND BY MASSOTHERAPY——Analysis of 121 Cases

Bony arthritis of the knee is mostly encountered in the aged and middle-aged. It is manifested mainly by pain, swelling, dysfunction, and deformity of the knee, belonging to the category of Bi Syndrome in TCM. From January 1988 to July 1990, the authors had treated this disease with herbal     

Magnetic resonance imaging of disc space infection revisited: temporal changes

Background Magnetic resonance imaging （MRI） has advantages in showing pathologic changes of disc space infection,which is important in clinical treatment.The purpose of this study was to describe the MRI findings of disc space infections in relation to chronicity.Methods MRI of 60 patients from January 1,2002 to April 30,2012 in Ottawa Hospital were retrospectively evaluated by two radiologists blindly.All patients had histological confirmation,with 55 having microbiological confirmation as well.These patients were divided into acute （n=18）,subacute （n=21） and chronic （n=21） based on histological findings.The following potential signs of MRI finding were assessed：marrow edema,endplate erosions,disk fluid and height change,paraspinal mass,epidural collection,facet fluid and enhancement in the marrow,disc,paraspinal mass,and epidural involvement.Statistical analysis consisted of t-or F-tests and chi-square test.Results In the 60 patients,83 infected discs （single disc in 45 patients,2-4 discs in 15 patients） were found,including 22 discs in the acute group,30 discs in the subacute group,and 31 discs in the chronic group.There was a significant difference in the extent of marrow edema between the acute,subacute and chronic groups （P ＜0.05）,with a gradually increasing extent from acute to chronic.The extent of endplate erosions increased with chronicity,but was not statistically significant.There were significant differences in the disc fluid,epidural collection,and disc enhancement among the acute,subacute and chronic groups,as well as the facet fluid between acute and chronic groups （P ＜0.05）.There were no significant differences in the present probability of disc height loss,paraspinal mass,and marrow enhancement among the three groups （P ＞0.05）.Conclusions From acute to chronic infections,the extent of marrow edema and endplate erosions appeared to gradually increase.Epidural collections and facet fluid are most frequently found in the acute group,while disc fluid and disc     

General Situation on the Study of Inspection of Sublingual Veins

The inspection of sublingual veins is an important component of the tongue diagnose. This method is mainly to observe change in sublingual vein in order to find out whether there is stagnation of qi and blood, According to traditional method of inspection of the tongue, observation is mainly given to colour and form of the tongue proper.     

The Research of Artificial Cervical Disc Replacement

Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. It develops quickly during recent years. Currently there are several cervical arthroplasty devices. Each device varies in terms of materials, range of motion and constraint. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses as well as discussing issues regarding indications and technique. It is hoped that an improvement of cervical arthroplasty occurs in terms of materials and design as spinal surgeons enter a new times of the management of cervical spine disease.     

The Clinical Characteristics and Imaging Findings of Morning Glory Syndrome

To investigate the features of CT, ultrasonography and fundus fluorescein angiography （FFA） of morning glory syndrome, the data on CT, A/B-scan ultrasonography and fundus fluorescein angiography （FFA） were retrospectively analyzed in 8 cases of morning glory syndrome （MGS）. Among those cases, 6 were examined with CT, 4 with FFA and 8 with A/B-scan ultrasonography. Results showed that the characteristics of CT, A/B-scan ultrasonography and FFA in MGS included： （1） The attachment spot of optic nerve became thin and vitreous body protruded to the posterior wall of eyeball with a spherical shape on CT image; （2） in the early period of FFA, hypofluorescence appeared on the optic, the abnormal arteriae and veins around the optic papilla were displayed clearly and in the late period, optic disc was stained with fluorescein; （3） on B-scan ultrasonogram, the vitreous cavity extended to the posterior pole and optic papilla, and projected to the basal part of muscle cones and thus the posterior part of vitreous cavity looked like an upside-down bottleneck. Sometimes the echogenic band of retinal detachment could also be seen. On A-scan ultrasonogram, both vitreous cavity and bottleneck showed no ultrasonic echoes and presented a base line without any evident wave crest. It is concluded that CT, A /B-scan ultrasonography and FFA could show the imageological features of MGS from different aspects, which helps clinicians to differentiate it from other diseases such as optic disc coloboma. CT and A /B-scan ultrasonography, in particular, are considered to be reliable imageological methods for the accurate diagnosis of MGS and are superior to the traditional techniques.