What are the optimal image magnification ratios for EBQ score measurement and the accuracy of this score in predicting titanium mesh cage (TMC) subsidence in patients with cervical ossification of the posterior longitudinal ligament (OPLL) after anterior cervical corpectomy and fusion (ACCF)? 107 cervical OPLL patients who had undergone single-level ACCF were included. Patients were stratified into subsidence and non-subsidence groups, paired by propensity score matching, and the predictive values of EBQ and VBQ scores for TMC subsidence were evaluated via receiver operating curve (ROC) and the area under the curve (AUC). On radiographs, 75

Background: Spinal cord injury (SCI) leads to significant brain alterations, the vital factors affecting functional recovery. Accumulating evidence demonstrated the neuroprotective effect of Puerarin (Pur), a natural extract, in a rat model of SCI. The study is designed to explore the role and mechanism of Pur on SCI. Methods: A total of 24 rats were divided into 2 groups: sham group and SCI group. 9 rats were used for in vitro experiments, where NG2 cells were extracted from both groups, and NG2 cells from the SCI group were treated with Pur. EdU, western blotting, and ELISA were utilized to detect effects of Pur on NG2 cell proliferation, differentiation and inflammation after SCI. Another 15 rats were utilized for in vivo experiment and the SCI group was given Pur treatment for subsequent assays. Locomotor function was evaluated using the BBB test. The histological changes in the spinal cord were observed by HE and Nissl staining. Neuron survival and glial cell activation were evaluated by western blotting and ELISA. Based on network pharmacology, the corresponding targets of Pur and SCI were collected from TCMSP, SwissTargetPrediction Database, GeneCards Database. The protein-protein interaction (PPI) networks of intersected targets were constructed by using the STRING database and visualized using Cytoscape. GO enrichment and KEGG pathway enrichment analyses were conducted to assess the function of the intersection target. AutoDockTools and PyMOL were used for molecular docking to recognize the association between the core ingredients of Pur and the core target of SCI. Casp3, Bcl2, and Pparg mRNA levels were detected using real-time quantitative polymerase chain reaction (RT-qPCR). Results: Pur ameliorated SCI-induced NG2 cell proliferation and inflammation in vitro. Moreover, Pur increased BBB score in SCI rats, relieved histological injury, decreased neuron loss, repressed glial cell activation, and alleviated inflammation in the injured spinal cords. From 33 candidate target genes of Pur and SCI, the PPI network identified ten hub genes. GO and KEGG analysis indicated that the target genes Casp3, Bcl2, and Pparg were mostly enriched in SCI. The molecular docking results displayed that the core ingredients of Pur had good binding ability with Casp3, Bcl2, and Pparg. Casp3, Bcl2 mRNA levels were decreased in the SCI group, and Pparg was increased. Conclusion: Pur could abolish SCI by regulating Casp3, Bcl2, and Pparg, which might provide novel ideas for the therapy of SCI.

The proliferation, migration, and osteogenic differentiation of bone mesenchymal stem cells (BMSCs) play vital roles in maintaining bone mass and metabolism. BMSC base cell therapy has become a competitive treatment option for osteoporosis. PIWI-interacting RNAs (piRNAs) are critical regulators of cellular processes. Small RNA sequencing and qPCR were used to detect piRNA expression during BMSC proliferation. CCK-8, clone formation, and EdU assays were used to detect the effect of piRNA DQ690018 on BMSC proliferation. Wound healing and Transwell assays were used to assess the effect of piRNA DQ690018 on the migration of BMSCs. RNA sequencing was performed to identify DQ690018. Alkaline phosphatase and alizarin red staining were used to evaluate the effect of DQ690018 on osteogenic differentiation.The glucocorticoid-induced osteoporosis animal model was used to assess the impact of DQ690018 on bone mass. Micro-CT and hematoxylin and eosin staining of tibia were used to measure bone mass. Fifteen piRNAs were upregulated, and 81 piRNAs were downregulated during BMSC proliferation. DQ690018 promotes BMSC proliferation by downregulating p21 expression and BMSC migration by upregulating vinculin (Vcl) expression. Furthermore, it improved the osteogenic differentiation of BMSCs and promoted the effect of BMSC base cell therapy in maintaining bone mass. DQ690018 is a novel target for increasing the proliferation, migration, and osteogenic differentiation of BMSCs.

To develop a rapid CT soft tissue window-based visual scoring system, the vertebral low-attenuation area (VLAA) score, for initial assessment of bone density, and to evaluate its correlation with established densitometric measures. Each cervical vertebra (C3–C7) was scored based on the presence and continuity of low-attenuation areas (0–3 points per vertebral body), and a composite VLAA score was calculated. Correlations between VLAA scores and T-scores, Hounsfield unit (HU) values, and vertebral bone quality (VBQ) scores were assessed using Pearson’s correlation. Multiple linear regression was performed to evaluate the independent predictive value of the VLAA score for the lowest T-score. Receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) were used to assess the performance of the VLAA score in predicting bone density and titanium mesh cage (TMC) subsidence. Cohort A included 292 patients. VLAA scores correlated significantly with T-scores (r = − 0.647 to − 0.676), HU values (r = − 0.823), and VBQ scores (r = 0.492). Multiple regression models confirmed the independent predictive role of the VLAA score for the lowest T-score (p < 0.001). The optimal VLAA cutoff for diagnosing osteopenia was 8 (sensitivity = 0.88, specificity = 0.63, AUC = 0.83), and for osteoporosis was 11 (sensitivity = 0.71, specificity = 0.88, AUC = 0.89). Cohort B included 41 patients. Regression analysis revealed a significant correlation between VLAA scores and TMC subsidence (OR = 1.78, 95

Spinal cord injury (SCI) is a devastating disorder and a leading cause of disability in adults worldwide. Multiple studies have reported the upregulation of programmed cell death 1 (PD-1) following SCI. However, the underlying mechanism of PD-1 deficiency in SCI is not well established. Therefore, we aimed to investigate the role and potential mechanism of PD-1 in SCI pathogenesis. PD-1 Knockout (KO) SCI mouse model was established, and PD-1 expression was evaluated in tissue samples by western blot assay. We then used a series of function gain-and-loss assays to determine the role of PD-1 in SCI pathogenesis. Moreover, mechanistic assays were performed to explore the association between PD-1, neuron-glia antigen-2 (NG2) glia cells, and miR-23b-5p and then investigated the involved signaling pathway. Results illustrated that PD-1 deficiency enhanced the inflammatory response, neuron loss, and functional impairment induced by SCI. We found that NG2 glia depletion aggravated inflammation, reduced neural survival, and suppressed locomotor recovery in murine SCI model. Further analysis indicated that NG2+ cells were increased in the spinal cord of SCI mice, and PD-1 deficiency increased the number of NG2+ cells by activating the Nogo receptor/ras homolog family member A/Rho kinase (NgR/RhoA/ROCK) signaling. Mechanistically, miR-23b-5p was identified as the negative regulator of PD-1 in NG2 glia. MiR-23b-5p deficiency reduced the expression of inflammatory cytokines, enhanced neural survival, and promoted locomotor recovery in SCI mice, which was counteracted by PD-1 deficiency. In conclusion, PD-1 deficiency exacerbates SCI in vivo by regulating reprogramming of NG2 glia and activating the NgR/RhoA/ROCK signaling.

Purpose: To analyze the significance of ossification index of cervical posterior longitudinal ligament as a risk factor for thoracic OPLL (ossification of the posterior longitudinal ligament) in patients with cervical OPLL. Methods: We retrospectively analyzed the clinical data of cervical OPLL patients in Changzheng hospital, who received chest CT scans for screening of COVID-19, and included 87 patients into this study. According to the radiographic evidence, 87 patients were divided into CT group(cervical OPLL combined with thoracic OPLL) and C group(cervical OPLL group). We measured the cervical OS index (ossification index), and analyzed the relationship between thoracic OPLL and cervical OS index. Results: There was no difference of age?sex?duration of symptoms?comorbidity between the 2 groups(P > 0.05). The mean cervical OS index was higher in the CT group than in the C group (8 +/- 2 VS 3 +/- 2,P < 0.001). Conclusions: Patients with cervical OS index > 8 was considered as "high risk " of tandem OPLL, while with value <= 4 was considered as "low risk ". Index between 5 and 8 were considered as "middle risk ". This study demonstrated that the cervical OS index may be used as an indicator of thoracic OPLL in patients with cervical OPLL, with a high diagnostic accuracy.

Study Design. Western blot, reverse transcription-polymerase chain reaction (RT-PCR), radiological, and histological analyses of the rat ossification of ligamentum flavum (OLF) induced by cyclic tensile stress. Objective. The aim of this study was to induce the OLF using cyclic tensile stress to rat thoracolumbar ligamentum flavum, and to investigate the possible molecular mechanism of tension-induced OLF. Summary of Background Data. Tensile stress has been considered as an important factor leading to the OLF. So far, however, no OLF induced by tension has been reported. Methods. Forty rats were randomly divided into five equal groups. For control groups, the blank and anesthesia groups were not subjected to tension. For experimental groups, the 4-, 8-, and 12-week groups were subjected to cyclic tensile stress of ligamentum flavum after abdominal anesthesia for 4weeks, 8 weeks, and 12 weeks, respectively, using an original stress apparatus for rats. The radiological and morphological changes of rat spine, as well as the protein and mRNA expressions of CD44, bone morphogenetic protein-2 (BMP-2), integrin beta 3, collagen protein type I (COL1), osteopontin (OPN), runt-related transcription factor 2 (RUNX-2), and vascular endothelial growth factor (VEGF), were concerned. Results. The micro-CT showed OLF in the 4-, 8-, and 12-week group. The axial maximum occupied area of ossifications was 1.42 mm(2), 3.35 mm(2), and 7.28 mm(2), respectively. In histopathology, chondrocytes proliferated in the experimental model; woven bone arose in the 8- and 12-week groups, and was more noticeable in the 12-week group. According to western blot and RT-PCR, the expressions of seven osteogenesis-related molecules were all increased in three experimental groups. Conclusion. Cyclic tensile stress to the ligamentum flavum in rats can induce the OLF, and the longer the duration, the more visible the osteogenesis. The upregulation and synergism of osteogenesis-related molecules may contribute to the OLF induced by tensile stress.

Introduction Osthole has a potential therapeutic application for anti-osteoporosis. The present study verified whether osthole downregulates osteoclastogenesis via targeting OPG. Methods In vivo, 12-month-old male mice were utilized to evaluate the effect of osthole on bone mass. In vitro, bone marrow stem cells (BMSCs) were isolated and extracted from 3-month-old OPG -/- mice and the littermates of OPG +/+ mice. calvaria osteoblasts were extracted from 3-day-old C57BL/6J mice or 3-day-old OPG -/- mice and the littermates of OPG +/+ mice. Results Osthole significantly increased the gene and protein levels of OPG in primary BMSCs in a dose-dependent manner. The deletion of the OPG gene did not affect β-catenin expression. The deletion of the β-catenin gene inhibited OPG expression in BMSCs, indicating that osthole stimulates the expression of OPG via activation of β-catenin signaling. Conclusion Osthole attenuates osteoclast formation by stimulating the activation of β-catenin-OPG signaling and could be a potential drug for the senile osteoporosis.

Summary Osthole has potential therapeutic applications due to its antiosteoporotic. Our study suggested that osthole attenuates osteoclast formation by stimulating the activation of β -catenin-OPG signaling and could be a potential agent to inhibit bone resorption. Introduction Osthole has potential therapeutic applications due to its antiosteoporotic. we performed study to test if OPG is the target gene of osthole-attenuated osteoclastogenesis. Methods In vivo, using 12-month-old male mice to evaluate the effect of osthole on bone mass. In vitro, Bone marrow stem cells (BMSCs) were isolated, extracted from 3-month-old C57BL/6J mice, 3-month-old β -catenin fx/fx mice, or 3-month-old OPG −/− mice and its littermates of OPG +/+ mice. Results we found that osthole significantly increased the gene and protein levels of OPG expression in primary BMSCs dose-dependently. The deletion of the OPG gene did not affect β -catenin expression and the deletion of the β -catenin gene inhibited OPG expression in BMSCs, which indicated that osthole stimulated the expression of OPG through activation of β -catenin signaling. Conclusion Osthole attenuates osteoclast formation by stimulating the activation of β -catenin-OPG signaling and could be a potential agent to inhibit bone resorption.

Study Design. A cross-sectional study. Objective. The aim of this study was to investigate the prevalence of ossification of posterior longitudinal ligament (OPLL) in patients with degenerative cervical myelopathy (DCM). Summary of Background Data. OPLL of the cervical spine is one of the main entities of DCM in Asian populations. However, few studies have reported the prevalence of cervical OPLL in DCM patients. Methods. A total of 7210 DCM patients (4546 males and 2664 females; mean age: 54 years) who underwent cervical spine three-dimensional computed tomography (3D-CT) at the Shanghai Changzheng Hospital between January 2012 and December 2016 were included in this study. Demographic data including age, sex, height, body weight, body mass index (BMI), concomitant diabetes mellitus (DM), and hypertension were recorded. The imaging diagnosis criterion for OPLL was thickness >2 mm on axial imaging. Results. The overall prevalence of OPLL in the 7210 DCM patients was 18.22%, including 19.73% in males and 15.65% in females, with a significant difference between the two groups (P < 0.001). The prevalence of OPLL in DM and hypertensive patients was significantly higher than that in non-DM and normotensive patients (24.16% vs. 18.76% and 22.26% vs. 17.91%, both P < 0.001). Comparison by age and BMI showed that the prevalence of OPLL was the highest in the 70- to 79-year age group (21.91%) and obesity group (26.51%), respectively. Conclusion. This CT-based study revealed that the overall prevalence of OPLL in DCM patients was 18.22%. Furthermore, old age, male sex, comorbid hypertension or DM, and high BMI were risk factors for cervical OPLL. Given its high prevalence, CT examination is suggested to identify possible OPLL in DCM patients. Level of Evidence: 2

Long non-coding RNAs (lncRNAs) play an important role in the development of bone-related diseases. This study was conducted to investigate the role and mechanism of lncRNA X inactive specific transcript (XIST) in the occurrence of cervical ossification of the posterior longitudinal ligament (OPLL). Here, primary human ligament fibroblasts cells (LFCs) were isolated from 30 cases of OPLL and 30 normal cervical posterior longitudinal ligament (non-OPLL) tissues to perform the qPCR and Western blot assay. We found that the mRNA level of lncRNA XIST was significantly increased in OPLL LFCs compared to non-OPLL LFCs. By bioinformatics analysis, we found that lncRNA XIST has four binding sites for miR-17-5p and found that the mRNA level of miR-17-5p was also significantly decreased in OPLL LFCs compared to non-OPLL LFCs. Since AHNAK is the target gene of miR-17-5p, we further found that the expression of AHNAK was significantly reduced in non-OPLL LFCs after being transfected with miR-17-5p mimic. The qPCR results showed that the mRNA expressions of BMP2 and Runx2 were significantly decreased. After being transfected with lncRNA XIST siRNA in the non-OPLL LFCs, the mRNA levels of lncRNA XIST, AHNAK, BMP2, and Runx2 were significantly decreased and the phosphorylated protein of Smad1/5/8 was reduced. After being cultured by mechanical vibration, the mRNA levels of lncRNA XIST, AHNAK, BMP2, Runx2, COL1, OC, OPN, and Phospho1 were significantly increased, but the mRNA expression of miR-17-5p was significantly decreased. The expression of phosphorylated Smad1/5/8 protein was also significantly increased. Together, this study was the first to determine that XIST gene inhibition plays an important role in the occurrence of cervical OPLL, through the mechanism of regulation of miR-17-5P/AHNAK/BMP2 signaling pathway. Thus, XIST may be a potential target that could be modulated for the treatment of cervical OPLL.

[目的]总结伴颈性眩晕颈椎病患者手术疗效,探索该类患者手术治疗指征及手术要点.[方法]收集本院2010年1月～2014年12月伴颈性眩晕颈椎病患者127例,并根据性别、年龄、手术入路、手术节段、术前眩晕评分及术后颈椎前凸角进行分组,统计并比较各组患者改善率及改善度差异.[结果]女性、前路手术及术前评分超过3分患者改善率及改善度明显提高.长节段(＞2个)、术后颈椎前凸角超过10°患者改善率显著提高,但改善度差异无统计学意义.年龄超过60岁患者改善度显著低于年龄低于60岁患者.[结论]保守治疗无效、女性患者、年龄不超过60岁及眩晕评分超过3分可作为重要的手术指征.尽量选择前路手术,长节段固定不稳定的椎体,重建颈椎曲度有助于提高患者的改善率及改善程度.

Objective To investigate the pathogen distribution and risk factors of pulmonary infection after acute cervical spinal cord injury (ACSCI) in an attempt to offer reference for early antiinfection therapy.Methods The study comprised 223 cases who were admitted from October 2011 to October 2014.There were 149 males and 74 females,at (43.3 ± 13.5) years of age.Species of pathogens identified were gram-positive,gram-negative and mixed.Effects of age,gender,injury types and tracheotomy on pathogen distribution were analyzed.Results Gram-negative infection was found in 114 cases (51.1％),with tracheotomy accounting for 7.0％ of the cases and death accounting for 1.8％ of the cases,and the main causative pathogens were Klebsiella pneumonia,Escherichia coli,Pseudomonas aeruginosa and Acinetobacter baumannii.Gram-positive infection was found in 41 cases (18.4％),with tracheotomy accounting for 12.2％ of the cases and death accounting for 7.3％ of the cases,and the main causative pathogens were Staphylococcus aureus and Streptococcus pneumonia.Mixed infection was found in 68 cases (30.5％),with tracheotomy accounting for 22.1％ of the cases and death accounting for 13.2％ of the cases.Gender had no significant correlation with pathogen distribution.For the cases of complete spinal cord injury and tracheotomy,the ratio of mixed infection increased significantly (P ＜ 0.05).For the cases younger than 30 years,the pathogens were mainly gram-positive bacteria (P ＜ 0.05).Conclusions Main pathogens of pulmonary infection after ACSCI are gram-negative bacteria.The cases younger than 30 years are associated with higher risk of grampositive infection,while the cases with complete injury or tracheotomy are associated with higher risk of mixed infection.

[目的]比较颈后路单开门椎管扩大成形术(One-door open Laminoplasty,Lam组)和颈后路椎板切除减压内固定术(lamninectomy with implant fixation,LIF组)术后轴性疼痛发生情况.[方法]回顾性纳入接受Lam(n=74)和LIF术式(n=51)的病例,比较两组病例轴性疼痛发生情况、神经功能改善率(improvement rate of neurological function,IR)及颈部功能障碍指数(neck dysfunction index,NDI)改善率的差异,分析轴性疼痛对神经功能、颈部功能障碍的影响.[结果] Lam组病例的轴性疼痛发生率、疼痛视觉模拟评分(visual analogue scale,VAS)和疼痛完全缓解所需时间均明显低于LIF组病例(P＜0.05).两组病例术前神经功能和NDI均无明显差别(P＞0.05),分别随访29.4个月和33.1个月后(P＞0.05),两组病例IR无明显差别(P＞0.05),LIF组NDI改善率显著低于Lam组(P＜0.05).相关性分析提示轴性疼痛的发生与否和IR、NDI改善率均无明显相关性(P＞0.05).[结论]接受Lam术式的病例轴性疼痛发生率、疼痛评分和完全缓解所需时间均明显低于接受LIF术式的病例,且颈部功能障碍恢复情况优于后者.

Study Design:A retrospective clinical study.Objective:To analyze and evaluate the clinical outcomes of cerebrospinal fluid (CSF) leak after anterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL) with or without dural ossification (DO).Summary of Background Data:Anterior decompression can be highly efficacious in the treatment of OPLL. However, in some cases of OPLL, there often exists DO and fusion with the posterior longitudinal ligament, which may increase the chance for CSF leak during an anterior decompression surgery.Materials and Methods:A retrospective analysis was performed on 126 OPLL patients (89 men and 37 women) treated with anterior decompression surgery between January 2008 and January 2012. The mean age at operation was 61 years (ranging from 46 to 72 y) and the average duration of diagnosis was 4.2 years (ranging from 3 d to 7 y). DO was present in 11 patients, of whom 7 developed dural tear or defect. Among the 115 patients without DO, only 4 developed dural tear. Intraoperative dural repair was performed with gelatin foam onlay and fibrin glue seal. Postoperative care for CSF leak involved bed rest, CSF drainage, nutritional support, and antibiotics.Results:A total of 11 cases associated with dural tear or defect developed postoperative CSF leak (an overall incidence of 8.7%). There was a statistically significant difference (P<0.001) in the incidence of CSF leak between the DO group (63.6%) and the non-DO group (3.5%). While leakage in 3 patients resolved spontaneously within 5 days of surgery, intermittent CSF cysts developed in 8 patients. These were treated with circular pressure bandages, repeated aspiration, and lumbar drainage. All 8 cases resolved 14-30 days after surgery. These 11 patients were followed up for an average of 12.8 months (range of 1 to 36 mo) with an average Japanese Orthopedic Association score of 51.2% and no significant neurological deficit or persistent headaches were recorded.Conclusions:Patients with DO are at increased risk for dural injury while undergoing anterior decompression for the treatment of OPLL. This is associated with a high incidence of CSF leak. However, the majority of patients with CSF leak could be managed conservatively.

Objective To obtain the morphology and three-dimensional structure characteristics of goat spinal dural and provide information for reconstructing artificial spinal dural. Methods The specimens of spinal dural were obtained to observe the microstructure, surface morphology, histology, collagen fiber diameter, distribution and distribution model through naked eyes, light microscope, scanning electron microscope (SEM) and transmission electron microscope (TEM). Results The spinal dura looked like a milky white, translucent, flexible and elastic membrane. It was mainly composed of oriented collagen fibers while fibroblasts line sparsely along those fibers. Its inner and outer surfaces looked like mountain peaks through SEM observation. It was revealed by TEM that collagen fibers distribute orderly with an average diameter of (627±60) nm. The diameters of collagen fibers exhibited a bimodal distribution. Conclusion The goat spinal dura is a translucent membrane which is mainly composed of nanoscale oriented collagen fibers and sparsely scattered fibroblasts.

Many neuro- and spinal surgeries involving access to the underlying nervous tissue will cause defect of spinal dural mater, further resulting in cerebrospinal fluid leakage. The current work was thus aimed to develop a package which included two layers of novel electrospun membranes, dermal fibroblasts and mussel adhesive protein for repairing spinal dural defect. The inner layer is electrospun fibrous poly(lactide-co-glycolide) membrane with oriented microstructure (O-poly(lactide-co-glycolide)), which was used as a substrate to anchor dermal fibroblasts as seed cells to reconstitute dura-like tissue via tissue engineering technique. The outer layer is chitosan-coated electrospun nonwoven poly(lactide-co-glycolide) membrane (poly(lactide-co-glycolide)-chitosan). During surgery, the inner reconstituted tissue layer was first used to directly cover dura defects, while the outer layer was placed onwards with its marginal area tightly immobilized to the surrounding normal spinal dura aided by mussel adhesive protein. Efficacy of the current design was verified in goats with spinal dural defects (0.6 cm × 0.5 cm) in lumbar. It was shown that seamless and quick sealing of the defect area with the implants was realized by mussel adhesive protein. Guided tissue growth and regeneration in the defects of goats were observed when they were repaired by the current package. Effective cerebrospinal fluid containment and anti-adhesion of the regenerated tissue to the surrounding tissue could be achieved in the current animal model. Hence, it could be ascertained that the current package could be a favorite choice for surgeries involving spinal dural defects.

目的 探讨退变性腰椎侧凸的后路手术方法和手术疗效.方法 回顾性分析2007～2012年本院手术治疗并获得随访的32例退变性腰椎侧凸患者的手术方法及疗效.患者均接受腰椎后路减压椎间融合器植骨融合内固定术,术后随访6个月～6年.采用下腰痛Oswestry功能障碍指数(Oswestry disability index,ODI)对患者手术前后的临床症状进行评分和疗效评价;通过手术前后冠状位和矢状位Cobb角度的比较,了解患者手术治疗的侧凸矫正率和腰椎前凸的恢复情况.结果 患者ODI术前(52.30±13.65)％、术后(9.62±6.41)％,术前术后比较差异有统计学意义(P＜0.05),术后疼痛改善率为81.6％.32例患者中,24例疗效为优,6例疗效为良,2例疗效为可,术后疗效评价的优良率为93.8％.患者冠状位Cobb角术前21.99°±8.97°、术后6.84°±5.32°,术前术后比较差异有统计学意义(P＜0.05),侧凸矫正率为69.0％.患者腰椎前凸Cobb角术前13.80°±15.99°、术后24.95°±12.86°,术前术后比较差异有统计学意义(P＜0.05).结论 退变性腰椎侧凸采用腰椎后路减压椎间融合器植骨融合椎弓根螺钉内固定术治疗效果较理想,术后疗效满意.手术的关键是彻底减压、正确选择融合节段、重建退变节段椎间高度、矫正前凸减少和后凸畸形、纠正椎体侧方移位和侧凸畸形以稳定椎体.

目的 探讨一期联合手术治疗颈胸椎韧带串联骨化症的疗效.方法 回顾性分析本院2005年1月～2010年1月,一期联合手术治疗的颈胸椎韧带串联骨化症患者14例.术前及术后6个月、末次随访时行日本骨科学会(Japanese Orthopaedic Association,JOA)评分、Nurick分级法评价,分析比较术前、术后6个月及末次随访评分,并计算改善率.末次随访时行患者满意度评分.结果 所有患者均获得2～5年随访,出血量1 550.3±740.7 mL,手术时间278.5±54.6 min.1例患者出现血肿,2例患者术后出现C5神经根麻痹,1例患者术后神经功能加重.术后6个月JOA评分明显较术前提高(P＜0.01),与末次随访相比,差异无统计学意义(P＞0.05).Nurick分级法术前3.6±0.7,术后6个月时明显提高到2.6±1.0(P＜0.01),末次随访时为2.3±1.1 (P ＞0.05).满意度评分为1.8±1.1,Pearson相关分析显示患者满意度评分与JOA评分有明显的正相关性(r=0.649 3,P＜0.01),而与Nurick分级法呈负相关(r=-0.594 1,P＜0.05).结论 一期联合手术减压可达到良好的神经功能恢复效果.患者满意度与术后神经功能改善明显相关,围手术期的并发症及术后因串联骨化症进展而导致再手术会明显降低患者的满意度评分.