Xuqiang Liu

Correlation between facet tropism and lumbar degenerative disease: a retrospective analysis

BackgroundThe aim of this study was to investigate the correlation between facet tropism and spinal degenerative diseases, such as degenerative lumbar spondylolisthesis, degenerative lumbar scoliosis, and lumbar disc herniation.MethodsThis study retrospectively analysed clinical data from the Department of Orthopaedics at The First Affiliated Hospital of Nanchang University. Ninety-two patients were diagnosed with lumbar spondylolisthesis, 64 patients with degenerative scoliosis, and 86 patients with lumbar disc herniation between 1 October 2014 and 1 October 2016. All patients were diagnosed using 3.0xa0T magnetic resonance imaging and underwent conservative or operative treatment. Facet tropism was defined as greater than a ten degree between the facet joint angles on both sides.ResultsFor L3-L4 degenerative lumbar spondylolisthesis, one out of six cases had tropism compared to seven out of the 86 controls (pu2009=u20090.474). At the L4-L5 level, 17/50 cases had tropism compared to 4/42 cases in the control group (pu2009=u20090.013). At the L5-S1 level, 18/36 cases had tropism compared to 7/56 controls (pu2009=u20090.000). For degenerative lumbar scoliosis at the L1-L5 level, 83/256 cases had tropism as compared to 36/256 controls (pu2009=u20090.000). For L3-L4 lumbar disc herniation two out of eight cases had tropism compared to 14/78 controls (pu2009=u20090.625). At the L4-L5 level, 19/44 cases had tropism compared to four out of 42 controls (pu2009=u20090.001). At the L5-S1 level, 24/34 cases had tropism compared to 10/52 controls (pu2009=u20090.000).ConclusionAt the L4–5 and L5-S1 levels, facet tropism is associated with degenerative spondylolisthesis. In the degenerative lumbar scoliosis group, the number of case with facet tropism was significantly higher than that of the control group. Facet tropism was associated with lumbar disc herniation at the L4–5 and L5-S1 levels. Overall, in these three lumbar degenerative diseases, facet tropism is a common phenomenon.

ABT-737 potentiates cisplatin-induced apoptosis in human osteosarcoma cells via the mitochondrial apoptotic pathway

ABT-737 is a BH-3 mimetic that inhibits Bcl-2 and induces apoptosis of cancer cells, which has potential for anticancer therapies. Studies have shown that Bcl-2 expression in human osteosarcoma (OS) cells plays a significant role in tumor progression; however, its effects on OS cell apoptosis are still unknown. Therefore, we examined whether ABT-737 was effective in eliminating human U-2OS cells, either alone or in combination with the chemotherapy drug cisplatin [cis-diamminedichloroplatinumxa0(II); DDP]. Furthermore, we studied the molecular mechanisms of ABT-737 in combination with DDP to induce apoptosis. To analyze the role of ABT-737 and/or DDP on osteosarcoma progression, CCK-8 viability assay, flow cytometry, Hoechstxa033258 staining, and western blots were performed. Combined use of ABT-737 and DDP synergistically suppressed cell viability and induced apoptosis in human U-2OS cells when compared with either compound treated alone at low doses. We found that the combination of ABT-737 and DDP upregulated the expression of the pro-apoptotic protein Bax and downregulated the expression of the pro-survival protein Bcl-2, resulting in a change in the Bax/Bcl-2 ratio, release of cytochromexa0c, and activation of the mitochondrial apoptotic pathway, which resulted in caspase-9 and caspase-3 activation and PARP cleavage. Our results demonstrated that ABT-737 alone has a nominal influence on human U-2OS cells when treated within the clinically administered range, but when combined with DDP, it can inhibit the proliferation of human U-2OS cells by inducing apoptosis via the mitochondrial apoptotic pathway.

Risk factors for acute surgical site infections after lumbar surgery: a retrospective study

BackgroundCurrently, many scholars are concerned about the treatment of postoperative infection; however, few have completed multivariate analyses to determine factors that contribute to the risk of infection. Therefore, we conducted a multivariate analysis of a retrospectively collected database to analyze the risk factors for acute surgical site infection following lumbar surgery, including fracture fixation, lumbar fusion, and minimally invasive lumbar surgery.MethodsWe retrospectively reviewed data from patients who underwent lumbar surgery between 2014 and 2016, including lumbar fusion, internal fracture fixation, and minimally invasive surgery in our hospital’s spinal surgery unit. Patient demographics, procedures, and wound infection rates were analyzed using descriptive statistics, and risk factors were analyzed using logistic regression analyses.ResultsTwenty-six patients (2.81%) experienced acute surgical site infection following lumbar surgery in our study. The patients’ mean body mass index, smoking history, operative time, blood loss, draining time, and drainage volume in the acute surgical site infection group were significantly different from those in the non-acute surgical site infection group (pu2009<u20090.05). Additionally, diabetes mellitus, chronic obstructive pulmonary disease, osteoporosis, preoperative antibiotics, type of disease, and operative type in the acute surgical site infection group were significantly different than those in the non-acute surgical site infection group (pu2009<u20090.05). Using binary logistic regression analyses, body mass index, smoking, diabetes mellitus, osteoporosis, preoperative antibiotics, fracture, operative type, operative time, blood loss, and drainage time were independent predictors of acute surgical site infection following lumbar surgery.ConclusionsIn order to reduce the risk of infection following lumbar surgery, patients should be evaluated for the risk factors noted above.

Key Triggers of Osteoclast-Related Diseases and Available Strategies for Targeted Therapies: A Review

Osteoclasts, the only cells with bone resorption functions in vivo, maintain the balance of bone metabolism by cooperating with osteoblasts, which are responsible for bone formation. Excessive activity of osteoclasts causes many diseases such as osteoporosis, periprosthetic osteolysis, bone tumors, and Paget’s disease. In contrast, osteopetrosis results from osteoclast deficiency. Available strategies for combating over-activated osteoclasts and the subsequently induced diseases can be categorized into three approaches: facilitating osteoclast apoptosis, inhibiting osteoclastogenesis, and impairing bone resorption. Bisphosphonates are representative molecules that function by triggering osteoclast apoptosis. New drugs, such as tumor necrosis factor and receptor activator of nuclear factor kappa-B ligand (RANKL) inhibitors (e.g., denosumab) have been developed for targeting the receptor activator of nuclear factor kappa-B /RANKL/osteoprotegerin system or CSF-1/CSF-1R axis, which play critical roles in osteoclast formation. Furthermore, vacuolar (H+)-ATPase inhibitors, cathepsin K inhibitors, and glucagon-like peptide 2 impair different stages of the bone resorption process. Recently, significant achievements have been made in this field. The aim of this review is to provide an updated summary of the current progress in research involving osteoclast-related diseases and of the development of targeted inhibitors of osteoclast formation.

Unilateral versus Bilateral Pedicle Screw Fixation Combined with Transforaminal Lumbar Interbody Fusion for the Treatment of Low Lumbar Degenerative Disc Diseases: Analysis of Clinical and Radiographic Results

OBJECTIVEnTo compare the clinical and radiographic results of unilateral pedicle screw fixation (UPSF) and bilateral pedicle screw fixation (BPSF) after unilateral transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degenerative disc diseases (DDDs).nnnMETHODSnA total of 63 patients who underwent UPSF or BPSF combined with unilateral TLIF at L4-L5 or L5-S1 in our hospital between 2014 and 2016 were included in this analysis. The perioperative outcomes and radiographic results were recorded at preoperative and postoperative follow-up. Fusion rates were determined according to the Bridwell-Lenke grading system. Clinical outcomes were evaluated using the visual analog scale, Oswestry Disability Index, and lumbar Japanese Orthopedic Association score.nnnRESULTSnAccording to the perioperative assessment, the duration of operation, intraoperative and postoperative blood loss, duration of pain medication use, and hospital costs were significantly (P < 0.0001) lower in the UPSF group compared with the BPSF group. After a mean follow-up of 24 months, both the UPSF and BPSF groups showed significantly (P < 0.05) maintained disc height and segmental lordosis of the surgical segment and achieved similar clinical outcomes at the final postoperative follow-up. The impact on the cranial adjacent vertebral level was significantly (P < 0.05) less in the UPSF group than the BPSF group in the short term.nnnCONCLUSIONSnUPSF techniques with TLIF can attain similar clinical efficiency as BPSF techniques in treating single-level low lumbar DDD, but with fewer surgical injuries and at lower cost. BPSF with TLIF likely causes more degeneration at the cranial adjacent segment compared with UPSF techniques. The long-term results require more study.

A rare case of giant osteoblastoma of the sacrum

BackgroundAn osteoblastoma is axa0rare benign bone tumor characterized by formation of osteoid tissue and primitive bone and occurs more often in men than in women. They are often secondary to an osteoid osteoma and can be located at any site on the skeleton. Lesions generally involve the posterior elements of the spine, such as the pedicle and the lamina.Case presentationThis study reports the case of axa025-year-old female who suffered from an osteoblastoma of the right sacrum with repeated swelling and pain in the right lumbosacral region for approximately 6xa0months. Computed tomography (CT) and magnetic resonance imaging (MRI) of the pelvis revealed axa0segmented, expansive, multiseptate lesion. Resection with wide margins was performed and axa0huge cavity of approximately 15u202f×u20098u202f×u20094.4u202fcm in the right sacrum and pelvis was formed after complete curettage of the tumor. The pathological analysis of the resected tissue was consistent with axa0benign osteoblastoma. Axa0follow-up was performed 2xa0years later and the patient was eventually relieved of the pain, the mobility of the right leg was improved and the CT scan demonstrated no evidence of recurrence.ConclusionOsteoblastomas most commonly occur in the spine but rarely also in the sacrum. Large core needle biopsies play an important role in the diagnostics. Intralesional surgery can be performed for treatment of osteoblastomas.ZusammenfassungHintergrundDas Osteoblastom ist ein seltener benigner Knochentumor, der durch die Bildung von Osteoidgewebe und primitivem Knochen gekennzeichnet ist. Er ist bei Männern häufiger als bei Frauen. Osteoblastome treten oft sekundär zu einem Osteoidosteom auf und können sich an jeder Stelle im Skelett befinden. Die Läsionen betreffen i.u202fd.u202fR. die hinteren Elemente der Wirbelsäule, beispielsweise die Pedikel und die Lamina.KasuistikWir präsentieren den Fall einer 25-jährigen Frau, die etwa 6xa0Monate lang an einem Osteoblastom des rechten Kreuzbeins mit wiederkehrenden Schwellungen und Schmerzen in der rechten Lumbosakralregion litt. Die Computer- und die Magnetresonanztomographie (CT, MRT) des Beckens zeigten eine segmentierte, expansive, vielfach septierte Läsion. Nach großzügiger Resektion und vollständiger Kürettage des Tumors war eine sehr große Kavität von etwa 15u202f×u20098u202f×u20094,4xa0u202fcm im rechten Os sacrum und im Becken entstanden. Die histopathologische Befundung war vereinbar mit einem gutartigen Osteoblastom. Ein Follow-up wurde 2xa0Jahre später durchgeführt. Schließlich litt die Patientin nicht mehr unter Schmerzen, die Beweglichkeit des rechten Beins war verbessert und in der Kontroll-CT zeigten sich keine Hinweise für ein Rezidiv.SchlussfolgerungOsteoblastome treten am häufigsten in der Wirbelsäule auf, selten auch im Os sacrum. Von Relevanz für die Diagnose ist eine Kernbiopsie mit einer großlumigen Nadel. Intraläsionale Operationen sind eine Option zur Behandlung von Osteoblastomen.

miR-30d inhibits cell biological progression of Ewing's sarcoma by suppressing the MEK/ERK and PI3K/Akt pathways in vitro

MicroRNAs (miRNAs) are small, single-stranded, non-coding RNA molecules involved in cancer initiation and progression. The present study aimed to determine the effect of miRNA-30d (miR-30d) on the growth, malignant phenotype, and apoptosis of Ewings sarcoma (ES) SK-ES-1 cells, and to elucidate the underlying molecular mechanism and signaling pathway involved. Cell proliferation, invasion, migration, morphological changes, cell cycle distribution and apoptosis were investigated. Furthermore, the expression of matrix metalloproteinase (MMP)-2, MMP-9, B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax), caspase-3 and poly (ADP-ribose) polymerase (PARP) were examined, as was the activity of the mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase (ERK) and phosphoinositide 3-kinase (PI3K)/Akt pathways. It was found that the overexpression of miR-30d repressed the proliferation, migration and invasion, and promoted morphological changes, S-phase arrest and apoptosis of SK-ES-1 cells. Additionally, it was observed that increased miR-30d levels inhibited the expression of MMP-2 and MMP-9, and inhibited the activity of the MEK/ERK and PI3K/Akt pathways, but elevated the ratio of Bax/Bcl-2 and the cleavage of caspase-3 and PARP. Taken together, the results demonstrated that miR-30d suppressed the biological progression of SK-ES-1 cells by targeting MMP-2 and MMP9, the Bax/Bcl-2 and caspase-3 cascade, and the MEK/ERK and PI3K/Akt signaling pathways. Therefore, miR-30d is a promising target in the treatment of ES. However, further investigations are urgently required to investigate the underlying molecular mechanisms of the effects of miR-30d on ES for a comprehensive understanding of the tumorigenesis and progression of this cancer.

Double-level lumbar spondylolysis and spondylolisthesis: A retrospective study

BackgroundLumbar spondylolysis and isthmic spondylolisthesis are common conditions. However, double-level lumbar spondylolysis and spondylolisthesis are rare. We report 24 cases of it along with a review of literature and a briefly description of the clinical and radiological features and integrated management of patients with this condition.MethodsOf 1700 inpatients diagnosed with lumbar spondylolisthesis at our hospital between January 2008 and September 2015, we selected those with a diagnosis of double-level spondylolisthesis who underwent surgery. We analyzed the data regarding age, sex, and heavy physical labour. Japanese Orthopaedic Association (JOA) and Visual Analog Scale (VAS) scores were used to evaluate preoperative and postoperative neurological function and back pain. All patients underwent decompression, reduction, and posterior lumbar interbody fusion (PLIF) with autogenous bone chips from posterior decompression or with a cage. After the operation, we were followed up for more than 2xa0years to observe the effect of the operation. In the meantime, the height of the intervertebral discs was measured at follow-up, and all data are analyzed in SPSS stastic.ResultsDouble-level spondylolisthesis occurred at the L2/L3 and L3/L4 levels in one patient, L3/4 and L4/L5 levels in 11 patients, and L4/L5 and L5/S1 levels in 12 patients. Nine patients also had spondylolysis. Twenty patients underwent posterior lumbar interbody fusion and internal fixation with autologous bone chip, and 4 of them underwent cage and autogenous bone graft fixation. Postoperatively, the major symptoms (neurological dysfunction and low-back pain) improved significantly. Comparison of JOA and VAS scores indicated effective recovery of neurological function (pu2009<u20090.05). Postoperative follow-up demonstrated satisfactory interbody fusion and pars interarticularis healing.ConclusionsDouble-level lumbar spondylolysis and spondylolisthesis occurred more often in women. Most common site of double lumbar spondylolisthesis was L3–L5. The treatment principle was the same as that for single-level spondylolisthesis, but the reset order is questionable. Both, posterior lumbar interbody fusion (PLIF) with autogenous bone chips from posterior decompression or with cage can relieve discomfort in most patients. In our follow-up, we found that there was a high degree of loss in disk height when autogenous bone was used. Therefore, we suggest the use of a cage.

Adiponectin inhibits osteoclastogenesis by suppressing NF-κB and p38 signaling pathways

Adiponectin (APN) has been shown to play a key role in regulating bone mineral density (BMD). Nevertheless, the effects of APN on receptor activator of NF-κB ligand (RANKL)-induced osteoclast formation and mechanism of regulation are not entirely clear. The study, therefore, aimed to evaluate the effect of APN on osteoclastogenesis. Our results showed that APN inhibits osteoclastogenesis and resorption function inxa0vitro by suppressing nuclear factor-κB (NF-κB) and p38 signaling pathways, which is essential for osteoclast formation. Moreover, APN blocked the formation of F-actin rings and attenuated osteoclast-mediated bone resorptive function. Therefore, we concluded that APN may provide a potential treatment for osteoclast-related diseases, such as osteoporosis.

Correlation between the sagittal spinopelvic alignment and degenerative lumbar spondylolisthesis: a retrospective study

BackgroundPain and disability associated with degenerative lumbar spondylolisthesis (DLS) results in significant burden on both the patients’ quality of life and healthcare costs. Currently, there is controversy regarding the specificity of spinopelvic measures of sagittal plane alignment with respect to DLS. Moreover, the correlation among spinopelvic parameters of sagittal plane alignment remains to be clarified. Our aim in this study was to compare these measurements between patients with single-segment DLS at L5 and a control group with no history of DLS.MethodsOur study group was formed of 132 patients who underwent full length lateral view radiographs of the spine in a relaxed standing posture. Among these, DLS at L5 was identified in 72 patients, forming the DLS group, with no radiographic evidence of lumbar spine disease in the remaining 60 patients, forming the control group. The patient and control groups were balanced with regard to age and sex distribution. The following spinopelvic parameters of sagittal plane alignment were measured: angle of incidence (PI) and tilt (PT) of the pelvis; sacral slope (SS); thoracic kyphosis (TK); lumbar lordosis (LL); and the spinal sagittal vertical axis (SVA). The Meyerding grade of L5 slippage was quantified for each patient in the DLS group.ResultsMeasures of TK, PI, SS, and LL were significantly greater in the DLS than control group (Pu2009<u2009xa00.05), with no between-group difference in SVA and PT. In the DLS group, the grade of L5 slippage correlated with SS (ru2009=u20090.873, Pu2009<u2009xa00.0001), PI (ru2009=u20090.791, Pu2009<u2009xa00.0001) and LL (ru2009=u20090.790, Pu2009<u2009xa00.0001). Moreover, the measurement for SS correlated more strongly with the PI (ru2009=u20090.94, Pu2009<u2009xa00.01) than the LL (ru2009=u20090.69, Pu2009<u2009xa00.01).ConclusionMeasurements of SS, PI, and LL were specifically associated with DLS, with measurements correlating positively with the grade of slippage.