Chunyue Duan

3D visualization of the lumbar facet joint after degeneration using propagation phase contrast micro-tomography.

Lumbar facet joint (LFJ) degeneration is believed to be an important cause of low back pain (LBP). Identifying the morphological changes of the LFJ in the degeneration process at a high-resolution level could be meaningful for our better understanding of the possible mechanisms underlying this process. In the present study, we determined the 3D morphology of the LFJ using propagation phase contrast micro-tomography (PPCT) in rats to assess the subtle changes that occur during the degeneration process. PPCT provides vivid 3D images of micromorphological changes in the LFJ during its degeneration process, and the changes in the subchondral bone occurred earlier than in the cartilage during the early stage of degeneration of the LFJ. The delineation of this alteration was similar to that with the histological method. Our findings demonstrated that PPCT could serve as a valuable tool for 3D visualization of the morphology of the LFJ by providing comprehensive information about the cartilage and the underlying subchondral bone and their changes during degeneration processes. It might also have great potential for providing effective diagnostic tools to track changes in the cartilage and to evaluate the effects of therapeutic interventions for LFJ degeneration in preclinical studies.

3D characterization of morphological changes in the intervertebral disc and endplate during aging: A propagation phase contrast synchrotron micro-tomography study

A better understanding of functional changes in the intervertebral disc (IVD) and interaction with endplate is essential to elucidate the pathogenesis of IVD degeneration disease (IDDD). To date, the simultaneous depiction of 3D micro-architectural changes of endplate with aging and interaction with IVD remains a technical challenge. We aim to characterize the 3D morphology changes of endplate and IVD during aging using PPCST. The lumbar vertebral level 4/5 IVDs harvested from 15-day-, 4- and 24-month-old mice were initially evaluated by PPCST with histological sections subsequently analyzed to confirm the imaging efficiency. Quantitative assessments of age-related trends after aging, including mean diameter, volume fraction and connectivity of the canals, and endplate porosity and thickness, reached a peak at 4 months and significantly decreased at 24 months. The IVD volume consistently exhibited same trend of variation with the endplate after aging. In this study, PPCST simultaneously provided comprehensive details of 3D morphological changes of the IVD and canal network in the endplate and the interaction after aging. The results suggest that PPCST has the potential to provide a new platform for attaining a deeper insight into the pathogenesis of IDDD, providing potential therapeutic targets.

One-stage posterior debridement and fusion combined with irrigation and drainage for the treatment of postoperative lumbar spondylodiscitis

Objective The aim of this study was to evaluate the clinical outcomes of one-stage posterior debridement, interbody fusion, and instrumentation, combined with irrigation and drainage, for treating lumbar spondylodiscitis. Methods The study included 23 patients (13 male and 10 female, mean age: 45 years) who had posterior debridement, interbody fusion, and instrumentation, followed by continuous closed irrigation and drainage for lumbar postoperative spondylodiscitis. The visual analog scale, Oswestry disability index, and lumbar lordosis angle were assessed before and after surgery to evaluate the clinical outcome. Results The mean follow-up time was 27 (24–36) months. All patients tolerated the procedure well, and there were no instances of spondylodiscitis recurrence, though a dorsal dermal sinus developed in one patient after surgery. Infection was eliminated, as evidenced by the normalization of the erythrocyte sedimentation rates and C-reactive protein levels. The mean visual analog scale scores were significantly decreased after the operation. The mean lumbar lordosis angle before surgery was 21.61 ± 6.88° and the angle at the final follow-up was 31.61 ± 4.24°. The mean Oswestry disability index scores improved significantly both after the operation and at the follow-up visits (p < 0.05). Bone union was confirmed in all patients at a mean of 8.6 months post-operation, though this was not achieved until 2 years post-operation in one patient. All 3 patients who had neurological deficits showed great improvement at the last follow-up. Conclusion Surgical management using one-stage posterior debridement, interbody fusion, and instrumentation, followed by continuous closed irrigation and drainage, might be an effective treatment option for lumbar postoperative spondylodiscitis. Level of evidence Level IV, Therapeutic study.

TEMPORARY REMOVAL: 3D visualization and pathological characteristics of cartilage and subchondral bone changes in the lumbar facet joint of an Ovariectomized mouse model

The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.spinee.2017.11.009. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Three-dimensional visualization and pathologic characteristics of cartilage and subchondral bone changes in the lumbar facet joint of an ovariectomized mouse model

BACKGROUND CONTEXT Low back pain (LBP) is more prevalent among postmenopausal women than men. Ovariectomy (OVX) is an established animal model that mimics the estrogen deficiency of postmenopausal women. Little is known about the three-dimensional (3D) morphologic properties of cartilage and subchondral bone changes in the lumbar facet joint (LFJ) of an OVX mouse model. PURPOSE The purpose of this study was to characterize the 3D morphologic change of cartilage and subchondral bone in the LFJ of an OVX mouse model. STUDY DESIGN Three-dimensional visualization and a histologic study on degenerative changes in cartilage and subchondral bone in the LFJ of an OVX mouse model were conducted. MATERIALS AND METHODS Ovariectomy is performed to mimic postmenopausal changes in adult female mice. We present an imaging tool for 3D visualization of the pathologic characteristics of cartilage and subchondral bone changes LFJ degradation using propagation-based phase-contrast computed tomography (PPCT). The samples were further dissected, fixed, and stained for histologic examination. RESULTS Propagation-based phase-contrast computed tomography imaging provides a 3D visualization of altered cartilage with a simultaneous high detail of the subchondral bone abnormalities in an OVX LFJ model. A quantitative analysis demonstrated that the cartilage volume, the surface area, and thickness were decreased in the OVX group compared with the control group (p<.05). Meanwhile, these decreases were accompanied by an obvious destruction of the subchondral bone surface and a loss of trabecular bone in the OVX group (p<.05). The delineation of the 3D pathologic changes in the PPCT imaging was confirmed by a histopathologic method with Safranin-O staining. Tartrate-resistant acid phosphatase staining revealed an increased number of osteoclasts in the subchondral bone of the OVX mice compared with that of the control group. CONCLUSIONS These results demonstrated that a mouse model of OVX-induced LFJ osteoarthritis (OA)-like changes was successfully established and showed a good resemblance to the human OA pathology. Propagation-based phase-contrast computed tomography has great potential to becomea powerful 3D imaging method to comprehensively characterize LFJ OA and to effectively monitor therapeutics. Moreover, degenerative LFJ possesses a severe morphologic change in the subchondral bone, may be the source of postmenopausal LBP, and has the potential to be a novel therapeutic target for LBP treatment.

Feasibility study for evaluating early lumbar facet joint degeneration using axial T 1ρ, T 2, and T2* mapping in cartilage: Evaluating Early LFJ Degeneration

To assess the feasibility of axial T2, T2* , and T1ρ mapping of lumbar facet joint (LFJ) cartilage for evaluation of early degeneration.

Genetic factors of cervical spondylotic myelopathy-a systemic review

BACKGROUND Cervical spondylotic myelopathy (CSM) is a degenerative disorder of the neck. Recent studies have reported the roles of single nucleotide polymorphisms and abnormal gene expression in the etiology and development of CSM. However, a systemic review of these findings is currently unavailable. METHODS A systemic review of genetic factors of CSM was conducted through searching PubMed and EMbase databases. A total of 9 studies were included in this study, which included 8 genes: brain derived neurotrophic factor (BDNF), osteopontin (OPN), bone morphogenic protein (BMP) 4, collagen IX, vitamin D receptor (VDR), apolipoprotein E (ApoE), hypoxia-inducible factor α (HIF-1α), and cyclooxygenase 2 (COX-2). RESULTS The polymorphisms of 6 genes (OPN, BMP-4, collagen IX, VDR, HIF-1α) showed significant association with the susceptibility to or risk of CSM. The polymorphisms of 3 genes (BMP-4, ApoE4, HIF-1α) were significantly associated with the postoperative outcome. The polymorphism of BDNF, VDR, and expression of COX-2 were associated with the severity of disease. CONCLUSION This review demonstrates that 8 genes were associated with CSM although there is no repeated study. This review also suggests that large scale and high quality studies are needed to provide more reliable evidence for future evaluation.

Erratum: Corrigendum: 3D visualization of the lumbar facet joint after degeneration using propagation phase contrast micro-tomography

Scientific Reports 6: Article number: 21838; Published online: 24 February 2016; updated: 09 May 2016 The original version of this Article contained a typographical error in the spelling of the author Xianzhen Yin, which was incorrectly given as Xianzheng Yin. This has now been corrected in the PDF and HTML versions of the Article.

[Early and one-stage posterior-anterior surgery for fresh and severe lower cervical spine fracture and dislocation].

OBJECTIVE To explore the clinical value of early and one-stage posterior laminectomy decompression, fracture reconstruction and lateral mess screw fixation combined with anterior cervical corpectomy or discectomy for the treatment of fresh and severe lower cervical spine fracture and dislocation.
 METHODS A total of 156 consecutive cases of severe fracture and dislocation of lower cervical spine were reviewed from January 2008 to January 2015. Skull traction was installed when the patients were enrolled in the hospital, so the operation was performed as early as possible. Firstly, the posterior procedure was applied to the patients prone on a frame. A standard posterior laminectomy, fixation and fusion were performed with lateral mass screws and rods. The cervical spine reconstruction was achieved by laminecomy, partially facetectomy, leverage and distraction. The technique of rotating rod was applied to recover the sequence of the cervical and keep or increase the zygopophysis and lordosis of the cervical on the sagittal plane. After the skull traction removed, a standard anterior approach to the cervical spine was initiated as the second stage of the procedure. Anterior cervical corpectomy or discectomy, spinal cord decompression, antograft and cervical spine auto-locking plate fixation were carried out. The stability, the fusion rate of the injured segments and spinal cord decompression were observed on the regular postoperative X-ray film and CT scan. The function of the spinal cord was evaluated by American Spinal Injury Association (ASIA) classification.
 RESULTS A total of 137 cases were followed-up, 19 failed to follow-up and 8 of them were due to death. The follow-up time was from 9.0 months to 35.0 months (mean: 13.7 months). All patients got completely reduction of the cervical spine. The injured segments were stable. There was no patient of bone graft no-fusion. The cervical intervertebral height and lordosis were reconstructed and maintained and all grafts were fused at the end of follow-up period. There was no complication related to internal fixation breakage, loosening or displacement. There was also no neurovascular and esophagus complications during the operation. Twelve patients complained neck pain at the final follow-up. There were 12 cases of wound infection and 12 cases of neck inflammatory. They were healed after anti-inflammatory therapy. There were 13 cases of cerebrospinal fluid leakage, and they were healed after the symptomatic treatment. The neuro-function of most patients was improved, and ASIA classification was improved by 1 to 2 grade.
 CONCLUSION Early and one-stage posterior-anterior decompression and reconstruction for the patients with fresh and severe lower cervical spine fracture and dislocation can achieve good reduction and cervical alignment of cervical spine. The injured segments can gain postoperative immediate stability. It also gives a completely decompression, which is benefit to the patients for nursing, functional exercise, and the functional recovery of the spinal cord.

[Treatment of multi-segmental cervical spondylosis by long or segmented anterior cervical decompression and fixation surgery].

OBJECTIVE To investigate the clinical efficacy of two different anterior cervical surgeries in treatment of multi-segmental cervical spondylosis. METHODS A total of 86 patients with multi-segmental cervical spondylosis were treated by anterior cervical surgery procedure. Among them, 62 and 24 cases were involved in three and four gap, respectively. Each patient underwent the surgery of long or segmented anterior cervical decompression and fixation. Preoperative and postoperative cervical curvature change, internal fixation stability, fusion rate and nerve function were evaluated. RESULTS All patients were successfully completed the operation, segmented surgery showed better cervical lordosis recovery, but there were no significant difference between long and segmented anterior cervical surgery in blood loss and recovery of neurological function (P> 0.05). CONCLUSION The segmented anterior cervical surgery has advantages in the treatment of multisegmental cervical spondylosis.