Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging,which has been found to be a contributing factor for low back pain and might cause radiculopathy,myelopath...Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging,which has been found to be a contributing factor for low back pain and might cause radiculopathy,myelopathy,spinal stenosis,degenerative spondylolisthesis,and herniations.Its etiology is complex and multifactorial.Although genetics influence more dominant,the occupational and mechanical influences still persist as a major risk factor.This review emphasizes up-to-date knowledge regarding etiology of disc degeneration with special consideration on occupational,lifestyle factors,and genetic polymorphisms.展开更多
This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients＇ ability to perform daily activities, reducing pain, and maintainin...This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients＇ ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months （with a mean of 5.2 months）. Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130±50 rain and the time of two-level surgery was 165±53 min on average （from skin incision to skin suturing）. Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores （JOA scores） increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68° （3.6°-6.1°） in flexion and extension position and 3.51 ° （2.5°-4.6°）, 3.42° （2.6°-4.3°） in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm） in 2 of 14 levels and between 1.5 mm and 3 mm） in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.展开更多
Lumbar degenerative disc disease(DDD)in the elderly population remains a global health problem,especially in patients with osteoporosis.Osteoporosis in the elderly can cause failure of internal fixation.Cortical bone ...Lumbar degenerative disc disease(DDD)in the elderly population remains a global health problem,especially in patients with osteoporosis.Osteoporosis in the elderly can cause failure of internal fixation.Cortical bone trajectory(CBT)is an effective,safe and minimally invasive technique for the treatment of lumbar DDD in patients with osteoporosis.In this review,we analyzed the anatomy,biomechanics,and advantages of the CBT technique in lumbar DDD and revision surgery.Additionally,the clinical trials and case reports,indications,advancements and limitations of this technique were further discussed and reviewed.Finally,we concluded that the CBT technique can be a practical,effective and safe alternative to traditional pedicle screw fixation,especially in DDD patients with osteoporosis.展开更多
BACKGROUND Cervical degenerative disc(CDD)disease is a common type of spondylosis.Although anterior cervical discectomy and fusion(ACDF)is the preferred treatment for CDD disease,internal fixation with a titanium plat...BACKGROUND Cervical degenerative disc(CDD)disease is a common type of spondylosis.Although anterior cervical discectomy and fusion(ACDF)is the preferred treatment for CDD disease,internal fixation with a titanium plate may cause various complications.The invention of the ACDF with a self-locking fusion cage(ROI-C)has effectively decreased the incidence of postoperative complications.AIM To observe the outcomes of CDD disease treated by ACDF with a ROI-C.METHODS Ninety patients with CDD disease treated at our hospital from March 2019 to March 2021 were included.They were divided into two groups(control group and observation group,n=45 in each)using a random number table.Patients in the control group received ACDF plus internal fixation with a titanium plate.Those in the observation group received ACDF+ROI-C placement.The two groups of patients were compared in terms of surgical parameters,pain,cervical spine function,range of motion,and complications.RESULTS The two groups of patients showed no significant differences in surgical time,blood loss,drainage volume,and length of hospital stay(P>0.05).No significant differences in the visual analogue scale(VAS),Japanese Orthopedic Association(JOA),and neck disability index(NDI)scores were observed between the two groups before surgery(P>0.05).The VAS and NDI scores in the observation group were considerably lower than those in the control group after surgery;however,the JOA scores in the observation group were significantly higher than those in the control group(P<0.05).No significant differences were observed in cervical disc height and the range of motion of the superior or inferior adjacent vertebrae between the two groups before surgery(P>0.05).The disc height in the observation group was larger than that in the control group after surgery.The range of motion of both the superior and inferior adjacent vertebrae was significantly smaller in the observation group than in the control group(P<0.05).The incidence of complications was only 2.22% in the observation group compared to 15.56% in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Cervical spine function restoration was better with ROI-C with internal fixation in ACDF than with conventional titanium plates in ACDF for CDD disease.展开更多
The degenerative disease of the intervertebral disc is nowadays an important health problem,which has still not been understood and solved adequately.The vertebral endplate is regarded as one of the vital elements in ...The degenerative disease of the intervertebral disc is nowadays an important health problem,which has still not been understood and solved adequately.The vertebral endplate is regarded as one of the vital elements in the structure of the intervertebral disc.Its constituent cells,the chondrocytes in the endplate,may also be involved in the process of the intervertebral disc degeneration and their role is central both under physiological and pathological conditions.They main functions include a role in homeostasis of the extracellular environment of the intervertebral disc,metabolic support and nutrition of the discal nucleus and annulus beneath and the preservation of the extracellular matrix.Therefore,it is understandable that the cells in the endplate have been in the centre of research from several viewpoints,such as development,degeneration and growth,reparation and remodelling,as well as treatment strategies.In this article,we briefly review the importance of vertebral endplate,which are often overlooked,in the intervertebral disc degeneration.展开更多
Study Design: Prospective analytical study. Objectives: The aim was to determine the association between mental depression and symptomatic Lumbar Degenerative Disc Disease (LDDD) in patients with no previous backgroun...Study Design: Prospective analytical study. Objectives: The aim was to determine the association between mental depression and symptomatic Lumbar Degenerative Disc Disease (LDDD) in patients with no previous background of mental disorder. We also aimed at determining the incidence of mental depressions in patients with LDDD and the effects of the treatment on the mental depression. Methodology: One hundred and sixty patients with no prior history of mental or behavioral disorders who presented with low back pains arising from LDDD and met inclusion criteria were studied. The clinical findings and Depression Screening Test pro-forma were completed for each. The extracted information was analyzed using Statistical Package for Social Science (SPSS) version 24.0. The statistical significance was set at P Results: One hundred and fifty-three patients completed the study, with a male to female ratio of 1:1.5 and the mean age of the patients was 48.5 years. The marital status was 4.4% single, 86.9% married, 3.8% divorce/separate and 5% widow/widower. Their levels of education were: no formal education (10.00%), primary school level (8.10%), secondary level (27.50%) and Tertiary level (54.40%). Conclusions: This study showed the incidence of mental depression in 32% of the patients with LDDD. We also noted a statistically significant relationship between symptomatic LDDD and level of mental depression with significant improvement in the level of depression at 6th month after treatment. Hence, assessment of the patients’ mental health is important in the management of LDDD.展开更多
As a minimally invasive surgery,percutaneous cement discoplasty(PCD)is now contemplated to treat lumbar disc degeneration disease in elder population.Here,we investigated whether the osteogenic mineralized collagen(MC...As a minimally invasive surgery,percutaneous cement discoplasty(PCD)is now contemplated to treat lumbar disc degeneration disease in elder population.Here,we investigated whether the osteogenic mineralized collagen(MC)modified polymethylmethacrylate(PMMA)cement could be a suitable material in PCD surgery.Injectability,hydrophilicity and mechanical properties of the MC-modified PMMA(PMMA-MC)was characterized.The introduction of MC did not change the application and setting time of PMMA and was easy to be handled in minimally invasive operation.Hydrophilicity of PMMA-MC was greatly improved and its elastic modulus was tailored to complement mechanical performance of bone under dynamic stress.Then,PCD surgery in a goat model with induced disc degeneration was performed with implantation of PMMA-MC or PMMA.Three months after implantation,micro-computed tomography analysis revealed a 36.4%higher circumferential contact index between PMMA-MC and bone,as compared to PMMA alone.Histological staining confirmed that the surface of PMMA-MC was in direct contact with new bone,while the PMMA was covered by fibrous tissue.The observed gathering of macrophages around the implant was suspected to be the cause of fibrous encapsulation.Therefore,the interactions of PMMA and PMMA-MC with macrophages were investigated in vitro.We discovered that the addition of MC could hinder the proliferation and fusion of the macrophages.Moreover,expressions of fibroblaststimulating growth factors,insulin-like growth factor,basic fibroblast growth factor and tumor necrosis factor-b were significantly down-regulated in the macrophages cocultured with PMMA-MC.Together,the promoted osteointegration and reduced fibrous tissue formation observed with PMMA-MC material makes it a promising candidate for PCD surgery.展开更多
The human spine carries the weight of the trunk, upper extremities, and head, and provides an extensiverange of motion. Due to heavy use and lack of vasculature, the intervertebral discs degenerate much more rapidly t...The human spine carries the weight of the trunk, upper extremities, and head, and provides an extensiverange of motion. Due to heavy use and lack of vasculature, the intervertebral discs degenerate much more rapidly than other structures of the human body.1 Intervertebral disc degeneration is mostly age-related, 2 and spinal disorders associated with disc degeneration have a significant impact on society.3,4 Indeed, low back展开更多
Innovative and astonishing developments in the field of spine analysis can commence with this manuscript.The lumbar disks(L1−L2 to L5−S1)are most commonly impaired by degeneration due to their long-standing degenerati...Innovative and astonishing developments in the field of spine analysis can commence with this manuscript.The lumbar disks(L1−L2 to L5−S1)are most commonly impaired by degeneration due to their long-standing degeneration and associated strain.We investigate the indications,purposes,risk factors,and therapies of lumbar degenerated disc disease(L-DDD).We assume that the degeneration of five discs creates many effects,making it difficult to differentiate between the different types of degenerated discs and their seriousness.Since the indeterminacy and falsity portions of science or clinical diagnosis are often ignored.Due to this complexity,the reliability of the patient’s progress report cannot be calculated,nor can the period of therapy be measured.The revolutionary concept of interval-valued m-polar neutrosophic Choquet integral aggregation operator(IVmPNCIAO)is proposed to eliminate these problems.We associate generalized interval-valued m-polar neutrosophic Choquet integral aggregation operator(GIVmPNCIAO)with the statistical formulation of L^(p)-spaces and use it to identify the actual kind of degenerative disc in the lumbar spine.For the classification of interval-valued m-polar neutrosophic numbers(IVMPNNs),we set the ranking index and score function.These concepts are appropriate and necessary in order to better diagnose degeneration by associating it with mathematical modeling.We construct a pre-diagnosis map based on the fuzzy interval[0,1]to classify the types of degenerative discs.We develop an algorithm by using GIVmPNCIAO based on interval-valued m-polar neutrosophic sets(IVMPNNs)to identify the degenerative disc appropriately and to choose the most exquisite treatment for the corresponding degeneration of every patient.Furthermore,we discuss the sensitivity analysis with parameter p in GIVmPNCIAO to investigate the patient’s improvement record.展开更多
背景:腰椎间盘退行性疾病是导致腰痛和下肢神经症状的常见疾病。胶原代谢的平衡在维持椎间盘的稳定中发挥着重要的作用。目的:对椎间盘退变中胶原蛋白代谢失衡的研究进展作一综述。方法:由第一作者在中国知网、PubMed、Web of Science...背景:腰椎间盘退行性疾病是导致腰痛和下肢神经症状的常见疾病。胶原代谢的平衡在维持椎间盘的稳定中发挥着重要的作用。目的:对椎间盘退变中胶原蛋白代谢失衡的研究进展作一综述。方法:由第一作者在中国知网、PubMed、Web of Science数据库中检索2024年5月之前发表的相关文章,中文检索词为“椎间盘退变疾病”“胶原代谢”“胶原酶家族”“胶原合成相关因子”“细胞因子”,英文检索词为“degenerative disc disease”“Collagen metabolism”“Collagenase family”“Collagen synthesis related factors”“Collagen breakdown related factors”。最终纳入76篇文献进行综述。结果与结论:在椎间盘退变的过程中,胶原蛋白代谢的平衡在维持正常椎间盘的稳定中起到至关重要的作用。当椎间盘发生退变时,椎间盘内分泌大量促炎因子、胶原酶,并发生氧化应激反应等,使椎间盘内胶原蛋白分解增加,同时抑制生长因子、胶原蛋白合成酶、胶原蛋合成相关因子的生成,使椎间盘内胶原蛋白合成减少。上述两种情况共同作用使椎间盘内胶原蛋白的代谢平衡被打破,进一步加剧了椎间盘退变的进程。展开更多
BACKGROUND In recent years,the mechanical concept of intervertebral disc regeneration has become more and more popular due to the increasing awareness of the importance of preservation of spine movement.Interestingly,...BACKGROUND In recent years,the mechanical concept of intervertebral disc regeneration has become more and more popular due to the increasing awareness of the importance of preservation of spine movement.Interestingly,there is increasing evidence,however,that dynamic stabilization systems may compensate nonphysiological loads,limit pathological movement,normalize disc height and intradiscal pressure,and provide an adaptive environment for disc regeneration.CASE SUMMARY The patient was a 54-year-old man,who presented with a 10-year history of mechanical back pain,which had become progressively serious and radiated into the left lower limb with numbness 3 mo prior.He had decreased muscle strength(class IV)of the left dorsal extensor and plantar flexor.Magnetic resonance imaging scans showed L3-S1 disc degeneration and L4-L5 disc herniation.Because the patient did not respond to various conservative treatments,he underwent a posterior L4-5 discectomy with fixation of the BioFlex dynamic stabilization system(Bio-Spine,Seoul,Korea).Preoperative symptoms were relieved and lumbar function was markedly improved after the operation.L4-L5 disc rehydration of instrumented segment was noted on magnetic resonance imaging at the 2-year follow-up.CONCLUSION Rehydration of the degenerated disc in our patient indicates that the BioFlex dynamic stabilization system may promote disc regeneration.Further research is needed to provide more evidence to support lumbar disc rehydration in the bridged segment using this system.展开更多
文摘Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging,which has been found to be a contributing factor for low back pain and might cause radiculopathy,myelopathy,spinal stenosis,degenerative spondylolisthesis,and herniations.Its etiology is complex and multifactorial.Although genetics influence more dominant,the occupational and mechanical influences still persist as a major risk factor.This review emphasizes up-to-date knowledge regarding etiology of disc degeneration with special consideration on occupational,lifestyle factors,and genetic polymorphisms.
文摘This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients＇ ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months （with a mean of 5.2 months）. Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130±50 rain and the time of two-level surgery was 165±53 min on average （from skin incision to skin suturing）. Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores （JOA scores） increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68° （3.6°-6.1°） in flexion and extension position and 3.51 ° （2.5°-4.6°）, 3.42° （2.6°-4.3°） in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm） in 2 of 14 levels and between 1.5 mm and 3 mm） in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.
基金Supported by National Natural Science Foundation of China,No.82202694。
文摘Lumbar degenerative disc disease(DDD)in the elderly population remains a global health problem,especially in patients with osteoporosis.Osteoporosis in the elderly can cause failure of internal fixation.Cortical bone trajectory(CBT)is an effective,safe and minimally invasive technique for the treatment of lumbar DDD in patients with osteoporosis.In this review,we analyzed the anatomy,biomechanics,and advantages of the CBT technique in lumbar DDD and revision surgery.Additionally,the clinical trials and case reports,indications,advancements and limitations of this technique were further discussed and reviewed.Finally,we concluded that the CBT technique can be a practical,effective and safe alternative to traditional pedicle screw fixation,especially in DDD patients with osteoporosis.
文摘BACKGROUND Cervical degenerative disc(CDD)disease is a common type of spondylosis.Although anterior cervical discectomy and fusion(ACDF)is the preferred treatment for CDD disease,internal fixation with a titanium plate may cause various complications.The invention of the ACDF with a self-locking fusion cage(ROI-C)has effectively decreased the incidence of postoperative complications.AIM To observe the outcomes of CDD disease treated by ACDF with a ROI-C.METHODS Ninety patients with CDD disease treated at our hospital from March 2019 to March 2021 were included.They were divided into two groups(control group and observation group,n=45 in each)using a random number table.Patients in the control group received ACDF plus internal fixation with a titanium plate.Those in the observation group received ACDF+ROI-C placement.The two groups of patients were compared in terms of surgical parameters,pain,cervical spine function,range of motion,and complications.RESULTS The two groups of patients showed no significant differences in surgical time,blood loss,drainage volume,and length of hospital stay(P>0.05).No significant differences in the visual analogue scale(VAS),Japanese Orthopedic Association(JOA),and neck disability index(NDI)scores were observed between the two groups before surgery(P>0.05).The VAS and NDI scores in the observation group were considerably lower than those in the control group after surgery;however,the JOA scores in the observation group were significantly higher than those in the control group(P<0.05).No significant differences were observed in cervical disc height and the range of motion of the superior or inferior adjacent vertebrae between the two groups before surgery(P>0.05).The disc height in the observation group was larger than that in the control group after surgery.The range of motion of both the superior and inferior adjacent vertebrae was significantly smaller in the observation group than in the control group(P<0.05).The incidence of complications was only 2.22% in the observation group compared to 15.56% in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Cervical spine function restoration was better with ROI-C with internal fixation in ACDF than with conventional titanium plates in ACDF for CDD disease.
文摘The degenerative disease of the intervertebral disc is nowadays an important health problem,which has still not been understood and solved adequately.The vertebral endplate is regarded as one of the vital elements in the structure of the intervertebral disc.Its constituent cells,the chondrocytes in the endplate,may also be involved in the process of the intervertebral disc degeneration and their role is central both under physiological and pathological conditions.They main functions include a role in homeostasis of the extracellular environment of the intervertebral disc,metabolic support and nutrition of the discal nucleus and annulus beneath and the preservation of the extracellular matrix.Therefore,it is understandable that the cells in the endplate have been in the centre of research from several viewpoints,such as development,degeneration and growth,reparation and remodelling,as well as treatment strategies.In this article,we briefly review the importance of vertebral endplate,which are often overlooked,in the intervertebral disc degeneration.
文摘Study Design: Prospective analytical study. Objectives: The aim was to determine the association between mental depression and symptomatic Lumbar Degenerative Disc Disease (LDDD) in patients with no previous background of mental disorder. We also aimed at determining the incidence of mental depressions in patients with LDDD and the effects of the treatment on the mental depression. Methodology: One hundred and sixty patients with no prior history of mental or behavioral disorders who presented with low back pains arising from LDDD and met inclusion criteria were studied. The clinical findings and Depression Screening Test pro-forma were completed for each. The extracted information was analyzed using Statistical Package for Social Science (SPSS) version 24.0. The statistical significance was set at P Results: One hundred and fifty-three patients completed the study, with a male to female ratio of 1:1.5 and the mean age of the patients was 48.5 years. The marital status was 4.4% single, 86.9% married, 3.8% divorce/separate and 5% widow/widower. Their levels of education were: no formal education (10.00%), primary school level (8.10%), secondary level (27.50%) and Tertiary level (54.40%). Conclusions: This study showed the incidence of mental depression in 32% of the patients with LDDD. We also noted a statistically significant relationship between symptomatic LDDD and level of mental depression with significant improvement in the level of depression at 6th month after treatment. Hence, assessment of the patients’ mental health is important in the management of LDDD.
基金supported by National Natural Science Foundation of China(grant no.81971755)Sichuan Science and Technology Innovation Team of China(2019JDTD0008)+4 种基金Young Elite Scientist Sponsorship Program by CAST(2019QNRC001)Fundamental Research Funds for the Central Universities,“111”Project of China(B16033)Key Research and Development Project of Heibei Province(182777172)Provincial Key Technology Support Program of Sichuan(grant no.2015SZ0027)Graduate Student’s Research and Innovation Fund of Sichuan University(Grant No.2018YJSY067).
文摘As a minimally invasive surgery,percutaneous cement discoplasty(PCD)is now contemplated to treat lumbar disc degeneration disease in elder population.Here,we investigated whether the osteogenic mineralized collagen(MC)modified polymethylmethacrylate(PMMA)cement could be a suitable material in PCD surgery.Injectability,hydrophilicity and mechanical properties of the MC-modified PMMA(PMMA-MC)was characterized.The introduction of MC did not change the application and setting time of PMMA and was easy to be handled in minimally invasive operation.Hydrophilicity of PMMA-MC was greatly improved and its elastic modulus was tailored to complement mechanical performance of bone under dynamic stress.Then,PCD surgery in a goat model with induced disc degeneration was performed with implantation of PMMA-MC or PMMA.Three months after implantation,micro-computed tomography analysis revealed a 36.4%higher circumferential contact index between PMMA-MC and bone,as compared to PMMA alone.Histological staining confirmed that the surface of PMMA-MC was in direct contact with new bone,while the PMMA was covered by fibrous tissue.The observed gathering of macrophages around the implant was suspected to be the cause of fibrous encapsulation.Therefore,the interactions of PMMA and PMMA-MC with macrophages were investigated in vitro.We discovered that the addition of MC could hinder the proliferation and fusion of the macrophages.Moreover,expressions of fibroblaststimulating growth factors,insulin-like growth factor,basic fibroblast growth factor and tumor necrosis factor-b were significantly down-regulated in the macrophages cocultured with PMMA-MC.Together,the promoted osteointegration and reduced fibrous tissue formation observed with PMMA-MC material makes it a promising candidate for PCD surgery.
基金This work was supported by a grant from the National Natural Science Foundation of China （No. 30973037）.
文摘The human spine carries the weight of the trunk, upper extremities, and head, and provides an extensiverange of motion. Due to heavy use and lack of vasculature, the intervertebral discs degenerate much more rapidly than other structures of the human body.1 Intervertebral disc degeneration is mostly age-related, 2 and spinal disorders associated with disc degeneration have a significant impact on society.3,4 Indeed, low back
文摘Innovative and astonishing developments in the field of spine analysis can commence with this manuscript.The lumbar disks(L1−L2 to L5−S1)are most commonly impaired by degeneration due to their long-standing degeneration and associated strain.We investigate the indications,purposes,risk factors,and therapies of lumbar degenerated disc disease(L-DDD).We assume that the degeneration of five discs creates many effects,making it difficult to differentiate between the different types of degenerated discs and their seriousness.Since the indeterminacy and falsity portions of science or clinical diagnosis are often ignored.Due to this complexity,the reliability of the patient’s progress report cannot be calculated,nor can the period of therapy be measured.The revolutionary concept of interval-valued m-polar neutrosophic Choquet integral aggregation operator(IVmPNCIAO)is proposed to eliminate these problems.We associate generalized interval-valued m-polar neutrosophic Choquet integral aggregation operator(GIVmPNCIAO)with the statistical formulation of L^(p)-spaces and use it to identify the actual kind of degenerative disc in the lumbar spine.For the classification of interval-valued m-polar neutrosophic numbers(IVMPNNs),we set the ranking index and score function.These concepts are appropriate and necessary in order to better diagnose degeneration by associating it with mathematical modeling.We construct a pre-diagnosis map based on the fuzzy interval[0,1]to classify the types of degenerative discs.We develop an algorithm by using GIVmPNCIAO based on interval-valued m-polar neutrosophic sets(IVMPNNs)to identify the degenerative disc appropriately and to choose the most exquisite treatment for the corresponding degeneration of every patient.Furthermore,we discuss the sensitivity analysis with parameter p in GIVmPNCIAO to investigate the patient’s improvement record.
文摘背景:腰椎间盘退行性疾病是导致腰痛和下肢神经症状的常见疾病。胶原代谢的平衡在维持椎间盘的稳定中发挥着重要的作用。目的:对椎间盘退变中胶原蛋白代谢失衡的研究进展作一综述。方法:由第一作者在中国知网、PubMed、Web of Science数据库中检索2024年5月之前发表的相关文章,中文检索词为“椎间盘退变疾病”“胶原代谢”“胶原酶家族”“胶原合成相关因子”“细胞因子”,英文检索词为“degenerative disc disease”“Collagen metabolism”“Collagenase family”“Collagen synthesis related factors”“Collagen breakdown related factors”。最终纳入76篇文献进行综述。结果与结论:在椎间盘退变的过程中,胶原蛋白代谢的平衡在维持正常椎间盘的稳定中起到至关重要的作用。当椎间盘发生退变时,椎间盘内分泌大量促炎因子、胶原酶,并发生氧化应激反应等,使椎间盘内胶原蛋白分解增加,同时抑制生长因子、胶原蛋白合成酶、胶原蛋合成相关因子的生成,使椎间盘内胶原蛋白合成减少。上述两种情况共同作用使椎间盘内胶原蛋白的代谢平衡被打破,进一步加剧了椎间盘退变的进程。
基金Supported by Foundation of Capital Medical Development,Beijing,China,No.2010026.
文摘BACKGROUND In recent years,the mechanical concept of intervertebral disc regeneration has become more and more popular due to the increasing awareness of the importance of preservation of spine movement.Interestingly,there is increasing evidence,however,that dynamic stabilization systems may compensate nonphysiological loads,limit pathological movement,normalize disc height and intradiscal pressure,and provide an adaptive environment for disc regeneration.CASE SUMMARY The patient was a 54-year-old man,who presented with a 10-year history of mechanical back pain,which had become progressively serious and radiated into the left lower limb with numbness 3 mo prior.He had decreased muscle strength(class IV)of the left dorsal extensor and plantar flexor.Magnetic resonance imaging scans showed L3-S1 disc degeneration and L4-L5 disc herniation.Because the patient did not respond to various conservative treatments,he underwent a posterior L4-5 discectomy with fixation of the BioFlex dynamic stabilization system(Bio-Spine,Seoul,Korea).Preoperative symptoms were relieved and lumbar function was markedly improved after the operation.L4-L5 disc rehydration of instrumented segment was noted on magnetic resonance imaging at the 2-year follow-up.CONCLUSION Rehydration of the degenerated disc in our patient indicates that the BioFlex dynamic stabilization system may promote disc regeneration.Further research is needed to provide more evidence to support lumbar disc rehydration in the bridged segment using this system.
