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Liu Z, Yang T, Li J, Chen D. Comparative clinical efficacy of percutaneous coaxial large-channel endoscopic lumbar interbody fusion and transforaminal lumbar interbody fusion for degenerative lumbar spinal stenosis: a retrospective study. BMC Musculoskelet Disord 2024; 25:496. [PMID: 38926851 PMCID: PMC11202381 DOI: 10.1186/s12891-024-07608-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
This study aimed to evaluate the clinical efficacy of percutaneous coaxial large-channel endoscopic lumbar interbody fusion (PCLE-LIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of degenerative lumbar spinal stenosis. The clinical data of patients with degenerative lumbar spinal stenosis who underwent PCLE-LIF (experimental group) and TLIF (control group) surgery from September 2019 to September 2021 were retrospectively analyzed. We collected clinical data and compared the two groups in terms of perioperative parameters, treatment response rate, inflammatory response markers, postoperative complications, postoperative pain, and functional recovery. The results showed that the treatment outcomes in the experimental group were significantly better than those in the control group. Specifically, perioperative parameters and inflammatory response markers in the experimental group were significantly better than those in the control group, with statistically significant differences (P < 0.05). The overall treatment response rate in the experimental group was significantly higher than that in the control group (P < 0.05). Meanwhile, the incidence of postoperative complications in the experimental group was lower than that in the control group, postoperative VAS pain scores and ODI functional scores were lower, and postoperative JOA functional scores were higher than those in the control group, with statistically significant differences (P < 0.05). In conclusion, PCLE-LIF appears to be a promising technique with better clinical outcomes in the treatment of degenerative lumbar spinal stenosis.
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Affiliation(s)
- Zige Liu
- School of Clinical Medicine, Guangxi Medical University, Nanning, 530000, China
| | - Tianxiang Yang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, 750000, China
| | - Jun Li
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, 750000, China
| | - Desheng Chen
- Department of Orthopedic Surgery, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, 750000, China.
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Zhang H, Hong Z, Jiang Z, Hu W, Hu J, Zhu R. miR-29b-3p Affects the Hypertrophy of Ligamentum Flavum in Lumbar Spinal Stenosis and its Mechanism. Biochem Genet 2024:10.1007/s10528-024-10811-8. [PMID: 38625592 DOI: 10.1007/s10528-024-10811-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
To explore the effect of miR-29b-3p on fibrosis and hypertrophy of ligamentum flavum (LF) in lumbar spinal stenosis (LSS) and its underlying mechanism. Patients with LSS and lumbar disc herniation (LDH) (control) undergoing posterior lumbar laminectomy were included in this study. Human LF samples were obtained for LF cell isolation, RNA, and protein extraction. Histomorphological analysis of LF was performed using hematoxylin-eosin (HE) staining. After isolation, culture, and transfection of primary LF cells, different transfection groups were constructed: NC-mimic, miR-29b-3p-mimic, NC-inhibitor, and miR-29b-3p-inhibitor. Quantitative real time polymerase chain reaction (qRT-PCR) was performed to detect the expression of miR-29b-3p in LF and LF cells. Western blot analysis detected the protein expressions of P16 and CyclinD1. ELISA detected the protein expressions of TGF-β1, Smad2, Smad3, TLR4, Type I collagen, and Type III collagen. Finally, LF cell viability was detected using the Cell Counting Kit-8 (CCK8) assay. The thickness of LF was significantly thicker in the LSS group compared to the LDH group (p < 0.05), accompanied by a higher calcification degree, more fibroblasts, and a larger area of collagen fiber proliferation. miR-29b-3p expression was significantly lower in LSS-derived LF tissues and cells than in LDH-derived tissues and cells (both p < 0.05). Compared to the NC-mimic group, the miR-29b-3p-mimic group exhibited significantly higher miR-29b-3p expression, decreased protein expressions of Type I collagen, Type III collagen, TGF-β1, Smad2, Smad3, TLR4, P16, and CyclinD1, and inhibited LF cell proliferation (all p < 0.05). As expected, the miR-29b-3p-inhibitor group displayed contrasting expression patterns (all p < 0.05). Compared to the phosphate buffer saline (PBS) group, the Trimethylamine-N-Oxide (TMAO) group showed significantly increased expressions of TGF-β1, Smad2, Smad3, TLR4, Type I collagen, Type III collagen, P16, and CyclinD1, as well as enhanced LF cell proliferation (all p < 0.05). However, there was no significant difference between the TMAO group and the Ang II group (all p > 0.05). Upregulation of miR-29b-3p expression may play a role in improving LF fibrosis and hypertrophy in LSS by inhibiting P16 expression and suppressing the activation of the TGF-β/Smad signaling pathway. This finding offers new insights into future gene modification therapy for this patient population.
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Affiliation(s)
- Hongjie Zhang
- Department of Orthopedics, Dehong People's Hospital, Kunming Medical University Affiliated Dehong Hospital, Dehong, No.13 Yonghan Road, Mangshi District, 678400, China
- College of Integrative Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, No.10, Poyang Lake Road, Jinghai District, Tianjin, 301617, China
| | - Zhixiong Hong
- Department of Orthopedics, Dehong People's Hospital, Kunming Medical University Affiliated Dehong Hospital, Dehong, No.13 Yonghan Road, Mangshi District, 678400, China
| | - Zehua Jiang
- Department of Spine Surgery, Tianjin Union Medical Center, No.190 Jieyuan Road, Hongqiao District, Tianjin, 300122, China
| | - Wei Hu
- Department of Spine Surgery, Tianjin Union Medical Center, No.190 Jieyuan Road, Hongqiao District, Tianjin, 300122, China
| | - Jiashao Hu
- Department of Orthopedics, Dehong People's Hospital, Kunming Medical University Affiliated Dehong Hospital, Dehong, No.13 Yonghan Road, Mangshi District, 678400, China
| | - Rusen Zhu
- Department of Spine Surgery, Tianjin Union Medical Center, No.190 Jieyuan Road, Hongqiao District, Tianjin, 300122, China.
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Sobański D, Staszkiewicz R, Filipowicz M, Holiński M, Jędrocha M, Migdał M, Grabarek BO. Evaluation of the Concentration of Selected Elements in the Serum of Patients with Degenerative Stenosis of the Lumbosacral Spine. Biol Trace Elem Res 2024:10.1007/s12011-024-04083-x. [PMID: 38321303 DOI: 10.1007/s12011-024-04083-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/27/2024] [Indexed: 02/08/2024]
Abstract
In humans, 23 elements have been shown to have biological activity. The purpose of this study was to evaluate the concentrations of iron (Fe), zinc (Zn), sodium (Na), potassium (K), magnesium (Mg), phosphorus (P), and calcium (Ca) in the serum of patients diagnosed with lumbar degenerative stenosis when compared to the concentrations of those elements in the serum of healthy volunteers. The study group consisted of 60 patients who were diagnosed with degenerative stenosis of the lumbosacral spine and who qualified for hemilaminectomy. The control group included 60 healthy volunteers without degenerative spinal stenosis. The clinical specimens studied had sera collected from both groups. The quantitative analysis of the selected elements revealed statistically significant (p < 0.05) lower concentrations of Zn (740 ± 110 µg/L vs. 880 ± 160 µg/L) and Mg (22,091 ± 4256 µg/L vs. 24,100 ± 4210 µg/L) in the serum of the patients from the study group when compared to the controls. By contrast, K (16,230 µg/L ± 1210 µg/L vs. 13,210 µg/L ± 1060 µg/L) and Fe (141.87 µg/L ± 11.22 µg/L vs. 109.1 µg/L ± 26.43 µg/L) levels were significantly higher in the study group compared to the controls (p < 0.05). No statistically significant changes were detected in the concentrations of the assessed micronutrients and macronutrients in both sexes in either the study group, the control group, or those based on body mass index (p > 0.05). In the serum samples from the study group, the strongest correlations were noted between the concentrations. In the study group, we showed a significant relationship between the levels of Fe/Zn (r = 0.41), Fe/Na (r = 0.41), Fe/P (r = 0.55), Zn/P (r = 0.68), Zn/K (r = 0.48), Zn/Ca (r = 0.94), Mg/Ca (r = 0.79), and Na/K (r = 0.67). We showed that only Mg concentration varied statistically significantly with the severity of pain (p < 0.05). These findings suggest that the assessment of Fe, Zn, Mg, and K concentrations can be helpful in predicting the onset of degenerative changes in the spine.
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Affiliation(s)
- Dawid Sobański
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland.
- Collegium Medicum, WSB University, 41-300, Dabrowa Gornicza, Poland.
| | - Rafał Staszkiewicz
- Collegium Medicum, WSB University, 41-300, Dabrowa Gornicza, Poland
- Department of Neurosurgery, 5th Military Clinical Hospital with the SP ZOZ Polyclinic in Krakow, 30-901, Krakow, Poland
- Department of Neurosurgery, Faculty of Medicine in Zabrze, Academy of Silesia, 40-555, Katowice, Poland
| | - Michał Filipowicz
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland
| | - Mateusz Holiński
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland
| | - Maciej Jędrocha
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland
| | - Marek Migdał
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland
| | - Beniamin Oskar Grabarek
- Collegium Medicum, WSB University, 41-300, Dabrowa Gornicza, Poland
- Gyncentrum, Laboratory of Molecular Biology and Virology, 40-851, Katowice, Poland
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Canós-Verdecho Á, Robledo R, Izquierdo RM, Bermejo A, Gallach E, Abejón D, Argente-Navarro MP, Peraita-Costa I, Morales-Suárez-Varela M. Quantum Molecular Resonance Radiofrequency Disc Decompression and Percutaneous Microdiscectomy for Lumbar Radiculopathy. J Clin Med 2023; 13:234. [PMID: 38202241 PMCID: PMC10779544 DOI: 10.3390/jcm13010234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Within the practice of pain management, one of the most commonly encountered events is low back pain. Lumbar radiculopathy (LR) is a pain syndrome caused by the compression or irritation of the nerve roots in the lower back due to lumbar disc herniation, vertebra degeneration, or foramen narrowing. Symptoms of LR include low back pain that propagates toward the legs, numbness, weakness, and loss of reflexes. The aim of this study is to assess the long-term effectiveness of quantum molecular resonance disc decompression and its combination with a percutaneous microdiscectomy using Grasper© forceps (QMRG) in patients with persistent lumbar radiculopathy (LR) in relation to patient physical stress status. The main outcome measures of this prospective observational study were DN4, NRS, ODI, SF12, PGI, CGI, and MOS Sleep Scale. An improvement 12 months post-intervention was observed in patients without physical stress, presenting better overall results. The mean change was over the minimal clinically important difference in 64.3% of outcome measures studied for the whole sample. QMRG appears to be an effective treatment option for LR, but a reduction in physical stress is needed to ensure long-term effectiveness.
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Affiliation(s)
- Ángeles Canós-Verdecho
- Multidisciplinary Pain Management Unit, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain (R.R.)
- Anaesthesiology Department, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - Ruth Robledo
- Multidisciplinary Pain Management Unit, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain (R.R.)
- Anaesthesiology Department, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - Rosa M. Izquierdo
- Multidisciplinary Pain Management Unit, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain (R.R.)
- Anaesthesiology Department, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - Ara Bermejo
- Multidisciplinary Pain Management Unit, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain (R.R.)
| | - Elisa Gallach
- Multidisciplinary Pain Management Unit, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain (R.R.)
- Psychiatry Department, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - David Abejón
- Multidisciplinary Pain Management Unit, Hospital Universitario Quirónsalud, Calle Diego de Velázquez, 1, 28223 Pozuelo de Alarcón, Spain
| | - María Pilar Argente-Navarro
- Anaesthesiology Department, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain
- Surgical Specialties Department, Hospital Universitari i Politècnic La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - Isabel Peraita-Costa
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - María Morales-Suárez-Varela
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
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Filippiadis DK, Masala S, Lucatelli P, Kelekis A. Update on Interventional Radiology of the Spine. Semin Musculoskelet Radiol 2022; 26:412-423. [PMID: 36103884 DOI: 10.1055/s-0042-1748913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Interventional radiologists now perform spinal interventions routinely for diagnostic and therapeutic purposes. New technologies for the management of spine pathologies have emerged with promising results in terms of safety and efficacy. Interventional radiology techniques in the spine include percutaneous biopsy and therapies for intervertebral disk herniation or spinal stenosis, facet and sacroiliac joint pathologies, vertebral and sacral fractures, and metastases. These techniques can also be easily combined one with the other or to further therapeutic approaches including systemic therapies, surgical approaches, and radiotherapy. This review provides a comprehensive overview of current percutaneous imaging-guided interventional radiology techniques in the spine. It will help readers become familiar with the most common indications, learn about different technical considerations during performance, and review the available evidence. Controversies concerning new products and technical approaches are also addressed.
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Affiliation(s)
- Dimitrios K Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON," Medical School, National and Kapodistrian University of Athens, Haidari/Athens, Greece
| | - Salvatore Masala
- Diagnostic Imaging and Interventional Radiology, University of Rome Tor Vergata, Rome, Italy
| | - Pierleone Lucatelli
- Diagnostic Imaging and Interventional Radiology, Vascular and Interventional Radiology Unit, Sapienza University of Rome, Rome, Italy
| | - Alexis Kelekis
- 2nd Department of Radiology, University General Hospital "ATTIKON," Medical School, National and Kapodistrian University of Athens, Haidari/Athens, Greece
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Splendiani A, Bruno F. MR-guided spine interventions: time to get off the ground? ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1609. [PMID: 34926653 PMCID: PMC8640907 DOI: 10.21037/atm-21-5167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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