Osteosarcoma (OS) is the most common primary malignancy of the bone in teenagers and accounts for 20‑35% of all malignant primary bone tumors. Increasing evidence shows that microRNAs (miRNAs) are abnormally expressed in several types of human cancer. miRNAs are necessary to maintain the malignant phenotype of cancer cells and can function as either tumor suppressors or oncogenes. The present study aimed to measure the expression of miRNA‑129‑5p (miR‑129‑5p) in OS, determine the effects of miR‑129‑5p on the malignant behaviors of OS cells, and elucidate the molecular mechanism underlying the oncogenesis and progression of OS. The expression levels of miR‑129‑5p in OS tissues and cell lines were measured using reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) analysis. SAOS‑2 and U2OS cells were then transfected with miR‑129‑5p mimics or miR‑negative control. The effects of miR‑129‑5p on the proliferation, migration and invasion of SAOS‑2 and U2OS cells in vitro were then evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, Transwell migration assay and invasion assays, respectively. In addition, bioinformatics analysis, a luciferase reporter assay, and RT‑qPCR and western blot analyses were used to examine whether Rho‑associated protein kinase 1 (ROCK1) was a direct target of miR‑129‑5p. The mRNA expression of ROCK1 in OS tissues was detected using RT‑qPCR analysis, and the biological roles of ROCK1 in OS cells were also evaluated. The results showed that miR‑129‑5p was significantly downregulated in the OS tissues and cell lines. The re‑expression of miR‑129‑5p suppressed the cell proliferation, migration and invasion of OS cells. In addition, ROCK1 was confirmed as a direct target of miR‑129‑5p. The mRNA expression of ROCK1 was high in OS tissues and inversely correlated with the expression of miR‑129‑5p. The downregulation of ROCK1 inhibited the proliferation, migration and invasion of OS cells. These findings suggested that miR‑129‑5p inhibited cell proliferation, migration and invasion in the development of OS via the negative regulation of ROCK1. The miR‑129‑5p/ROCK1 axis may serve as an efficient target in cancer therapy.
Background The objective of the study was to explore the feasibility and efficacy of computer-assisted screw inserting planning (CASIP) in the surgical treatment for severe spinal deformity. Methods A total of 50 patients participated in this prospective cohort study. 25 patients were allocated into CASIP group and 25 patients were in Non-CASIP group. The demographic data, radiological spinal parameters were documented and analyzed. Each pedicle screw insertion was classified as satisfactory insertion or unsatisfactory insertion based on Gertzbein-Robbins classification. The primary outcome was the accuracy of pedicle screw placement. The secondary outcomes were the rate of puncturing screws, estimated blood loss, surgical time, correction rate and other radiological parameters. Results A total of 45 eligible patients completed the study. 20 patients were in CASIP group and 25 patients were in Non- CASIP group. The accuracy of pedicle screw placement in CASIP Group and Non-CASIP Group were (92.0 ± 5.5) % and (82.6 ± 8.3) % (P < 0.05), and the rate of puncturing screws were (0 (0–0)) % and (0 (0-6.25)) % (P < 0.05). The median surgical time were 280.0 (IQR: 260.0–300.0) min and 310 (IQR: 267.5–390.0) min in two group and showed significant statistic difference (P < 0.05). Conclusions CASIP has good feasibility and can gain a more accurate and reliable instruments fixation, with which spine surgeons can make a detailed and personalized screw planning preoperatively to achieve satisfying screw placement.
(1) Background: The three-dimensional printing (3DP) technique has been reported to be of great utility in spine surgery. The purpose of this study is to report the clinical application of personalized preoperative digital planning and a 3DP guidance template in the treatment of severe and complex adult spinal deformity. (2) Methods: eight adult patients with severe rigid kyphoscoliosis were given personalized surgical simulation based on the preoperative radiological data. Guidance templates for screw insertion and osteotomy were designed and manufactured according to the planning protocol and used during the correction surgery. The perioperative, and radiological parameters and complications, including surgery duration, estimated blood loss, pre- and post-operative cobb angle, trunk balance, and precision of osteotomy operation with screw implantation were collected retrospectively and analyzed to evaluate the clinical efficacy and safety of this technique. (3) Results: Of the eight patients, the primary pathology of scoliosis included two adult idiopathic scoliosis (ADIS), four congenital scoliosis (CS), one ankylosing spondylitis (AS), and one tuberculosis (TB). Two patients had a previous history of spinal surgery. Three pedicle subtraction osteotomies (PSOs) and five vertebral column resection (VCR) osteotomies were successfully performed with the application of the guide templates. The main cobb angle was corrected from 99.33° to 34.17°, and the kyphosis was corrected from 110.00° to 42.00°. The ratio of osteotomy execution and simulation was 97.02%. In the cohort, the average screw accuracy was 93.04%. (4) Conclusions: The clinical application of personalized digital surgical planning and precise execution via 3D printing guidance templates in the treatment of severe adult rigid deformity is feasible, effective, and easily generalizable. The preoperative osteotomy simulation was executed with high precision, utilizing personalized designed guidance templates. This technique can be used to reduce the surgical risk and difficulty of screw placement and high-level osteotomy.
Objective To determine the three‐dimensional (3D) changes of the spinal canal length (SCL) after corrective surgeries and their association with the radiographic and clinical outcomes of idiopathic scoliosis patients. The length of the spinal cord has been demonstrated to be strongly correlated with the SCL. Understanding the changes in SCL could help determine the morphologic changes in the spinal cord to prevent spinal cord injury. Methods Twenty‐seven scoliotic patients' 3D spinal canal were investigated using computed tomography images. The SCL between the upper and lower end vertebrae (U/L‐EV) was measured at five locations. The radiographic parameters of each patient and the patient‐reported outcomes (PROs) scores were also collected. The correlations of the changes of the SCLs with the other factors were analyzed. Results The SCL between the U/L‐EV changed non‐uniformly at different locations. The post‐operative SCLs were significantly elongated by 7.5 ± 3.5 mm (6.0 ± 2.5%, P < .001) at the concave side and compressed by −2.6 ± 2.6 mm (−1.9 ± 1.9%, P < .001) at the convex side. The elongations of the SCL at the concave and posterior locations were correlated with the radiographic parameters including the pre‐operative main Cobb angles (r = .511, P = .006; r = .613, P = .001) and apical vertebral translation (AVT) (r = .481, P = .011; r = .684, P = .000). No PRO scores were found to correlate with the SCL changes. Conclusion The corrective surgeries elongated the spinal canal mainly at the concave side and compressed at the convex side. The main thoracic Cobb angle, the changes of AVT, and Cobb angles were moderately associated with the changes of the SCLs, but no PRO score was found to associate with the changes of the SCLs. The data could be instrumental for the improvement of corrective surgeries that are aimed to maximize the correction of scoliosis and minimize the negative effect on the spinal cord to prevent neurological complications.
Objectives. The study was aimed at investigating the reliability of computer-assisted three-dimensional surgical simulation (CA3DSS) of posterior osteotomies in thoracolumbar kyphosis secondary to ankylosing spondylitis (TLKAS) patients. Methods. Eligible TLKAS patients who underwent posterior correction surgery with posterior osteotomies were consecutively included. Simulated posterior osteotomies were performed in Mimics and 3-Matic Medical software. Coronal and sagittal angle and alignment parameters were measured in preoperative full-length X-ray, preoperative original 3D spine (Pre-OS), simulated 3D spine (SS), and postoperative original 3D spine (Post-OS). Reliability was tested by both intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Results. A total of 30 TLKAS patients were included. Excellent consistency of radiological parameters was shown between preoperative X-ray and Pre-OS model. In SS and Post-OS models, excellent reliabilities were shown in global kyphosis (ICC 0.832, 95% CI 0.677-0.916), thoracic kyphosis (ICC 0.773, 95% CI 0.577-0.885), and lumbar lordosis (ICC 0.896, 95% CI 0.794-0.949) and good reliabilities were exhibited in the main curve (ICC 0.680, 95% CI 0.428-0.834) and sagittal vertical axis (ICC 0.619, 95% CI 0.338-0.798). ICCs of correction angle achieved by pedicle subtraction osteotomy (PSO) was 0.754 (95% CI 0.487-0.892), and that of posterior column osteotomies (PCO) was 0.703 (95% CI 0.511-0.829). Bland-Altman analysis also showed good agreement for both Cobb angle and distance measurements in Pre-OS and SS models, and good reliabilities were shown in PCO and PSO in real spine and SS models. Conclusions. CA3DSS can provide an accurate measurement, and it is a reliable and effective method to conduct proper simulation for correction surgery with posterior osteotomies in TLKAS patients. This trial is registered with Chinese Clinical Trial Registry ChiCTR2100053808.
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