椎弓根螺钉PEEK棒动态稳定内固定系统治疗腰椎退行性疾病

目的:探讨椎弓根螺钉PEEK棒动态稳定内固定系统治疗退变性腰椎疾病的临床疗效及对植骨融合时间的影响.方法:退变性腰椎疾病患者40例,随机分为PEEK动态内固定组(A组)20例和坚强内固定组(B组)20例.两组患者均行后路减压椎间植骨融合内固定术,A组用PEEK棒安装于椎弓根螺钉钉尾予以动态稳定内固定,B组以钛棒安装于钉尾进行坚强内固定.比较两组患者的治疗效果及同期椎间植骨融合率等.治疗效果评价采用 Oswestry 功能障碍指数(ODI)评分,同期椎间植骨融合率根据X线片和CT平扫检查结果进行评价.结果:所有患者术后均随访7～16个月,平均12个月.两组患者术后症状均有明显改善,ODI评分与术前相比差异有统计学意义(P＜0.01);A组治疗效果优于B组(P＜0.01).术后3个月A组植骨融合率明显高于B组(P＜0.05),末次随访两组植骨融合率差异无统计学意义(P＞0.05).两组均未出现内固定相关并发症.结论:坚强内固定和椎弓根螺钉PEEK棒动态稳定内固定治疗腰椎退变性疾病均可取得较为满意的短期临床疗效,其中椎弓根螺钉PEEK棒动态稳定内固定术后椎间融合时间更短,治疗效果更优,因此更值得推荐,但其长期疗效仍需要进一步观察.     

AMP活化蛋白激酶在终板软骨细胞体外传代培养中的表达及意义

BACKGROUND: Endplate cartilage degeneration initiates intervertebral disc degeneration. AMP-activated protein kinase (AMPK) regulates the formation and degradation of cartilage. OBJECTIVE: To explore the role of AMPK in an in vitro natural degeneration model of chondrocytes derived from endplate of rat intervertebral discs. METHODS: Morphology of in vitro subcultured endplate chondrocytes of rat intervertebral discs at passages 0, 2, and 5 were observed under an inverted microscope following cytoskeleton staining. Chondrocyte phenotype, proliferation, and the cartilage marker genes (type II collagen, proteoglycan, SOX-9, matrix metalloproteinase-3 and -13), and AMPK phosphorylation were determined by toluidine blue staining, MTT assay, real-time PCR analysis, and western blot assay, respectively. RESULTS AND CONCLUSION: The altered morphology, decreased proliferation ability, and phenotype loss were observed in chondrocytes with increased passage number. Gene expression of type II collagen, proteoglycan, SOX-9 was significantly decreased; while gene expression of matrix metalloproteinase-3 and -13 was significantly increased in endplate chondrocytes at passage 5 compared with those at passages 0 and 2. AMPK phosphorylation in endplate chondrocytes at passage 5 was significantly decreased. These findings indicate that AMPK phosphorylation is involved in in vitro natural degeneration of chondrocytes derived from the endplate of rat intervertebral discs, and the degeneration of endplate chondrocytes and intervertebral discs can be inhibited through the regulation of AMPK activity. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

颈椎间盘置换术治疗颈椎病的短期疗效观察

目的:探讨颈椎间盘置换术治疗颈椎病的临床疗效。方法:观察2010年3月～2011年1月期间皖南医学院附属弋矶山医院脊柱外科采用颈椎间盘置换术治疗颈椎病患者20例;记录并比较术前、术后3个月及末次随访患者的颈椎JOA评分、椎间高度、颈椎活动度和脊柱功能单位活动度。结果:平均随访(18.9±7.23)个月。患者临床症状明显缓解。JOA评分、椎间高度术前与术后、末次随访差异有统计学意义(P<0.05)。颈椎活动度和脊柱功能单位活动度术后及末次随访数据与术前比较差异均无统计学意义(P>0.05)。结论:在严格把握手术适应证和禁忌症的情况下,颈椎间盘置换术可取得满意的临床疗效,同时可预防和减少邻近节段退变的发生,值得临床推广应用。