Objective: We create a new S1 cortical screw trajectory technique using 3D reconstruction and the finite element (FE) method to provide a more reliable theoretical basis for clinical practices and to advance internal fixation technology for treatment of lumbosacral degenerative diseases.Methods: This retrospective study included patients (aged from 40 to 70 years) who needed intervertebral fusion surgery between August 2016 and August 2017. Data of patients with lumbosacral lesions was scanned and measured by 64-row spiral CT, and were then transmitted to the GE-AW4.3 post-processing system for 3D reconstruction. The trajectories of the three different screws were simulated by FE software and processed by mimics software to simulate the screw path: traditional PS fixation (Model A); traditional cortical screw (Model B); and new cortical screw (Model C). The CT value of the bone around the screw canal was recorded. Biomechanical effects of the three screws were analyzed and compared.Results: The displacement of flexion and extension, the vertebral body stress of right torsion, and the cage stress of flexion showed no significant differences among the three models (P > 0.05). The results demonstrated that cortical screws exceeded pedicle screws in stability and pullout force. Models B and C showed higher vertebral displacement in left bending (0.41 and 0.31 mm) and right bending (0.58 and 0.40 mm), lower vertebral body stress on extension (48.37 and 38.92 MPa), left bending (0.76 and 0.74 mm) and right bending (0.50 and 0.53 mm), and higher cage stress on left bending (162.19 and 160.63 MPa), right bending (150.02 and 150.05 MPa), left torsion (158.45 and 146.27 MPa) and right torsion (167.33 and 171.15 MPa) (all P < 0.05) compared to model A. Compared to Model B, Model C had higher displacement of left and right torsion, lower pressure in extension and flexion, and lower stress on cages in extension (P < 0.05). Conclusion:The new cortical screw insertion method has similar effects to traditional cortical screw fixation. However, it demonstrated advantages in promoting lumbosacral interbody fusion, which protects vessels and nerves.
Introduction Osteoporosis is related to lncRNA‐neighboring enhancer of FOXA2 (NEF) and inversely correlated to ankylosing spondylitis (AS), implying that lncRNA‐NEF might also relate to AS. Thus, the study was carried out to investigate the involvement of lncRNA‐NEF in AS. Methods The study included 60 AS patients and 60 healthy controls. LncRNA‐NEF expression in synovial fluid samples was analyzed by reverse transcription quantitative real‐time polymerase chain reaction. Disease activity of the 60 AS patients was determined using the Ankylosing Spondylitis Disease Activity Score (ASDAS) 1–4 and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Western blot was carried out to investigate the effects of lncRNA‐NEF on inflammatory factors in human fibroblast‐like synovial (HFLS) cells. A 3‐year follow‐up was performed to analyze the role of lncRNA‐NEF in the prediction of the recurrence of AS. Results Our study observed that lncRNA‐NEF expression was upregulated in synovial fluid of AS patients and significantly correlated with the ASDAS 1–4, BASDAI, erythrocyte sedimentation rate (ESR), and C‐reactive protein level (p < .05). Treatment with nonsteroidal anti‐inflammatory drugs significantly downregulated lncRNA‐NEF expression (p < .01). A 3‐year follow‐up showed that patients with high lncRNA‐NEF levels had a high recurrence rate (hazard ratio = 2.266). In addition, lncRNA‐NEF was found to regulate the expression of inflammatory factors in HFLS cells. Conclusions Therefore, lncRNA‐NEF upregulation can predict recurrence and poor treatment outcomes of AS and has a great potential to serve as a predictive biomarker factor for the recurrent AS.
Tuina combined with Shuxuetong injection treatment can prevent deep venous thrombosis in patients with rheumatoid arthritis after total knee arthroplasty.
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