Background Transforaminal endoscopic discectomy was popular in the treatment of lumbar disc herniation. Previous study focuses on the leg pain of disc herniation, and little study concern the residual leg numbness after surgery. The purposes of this study were to evaluate the clinical outcomes of transforaminal endoscopic discectomy in the treatment of lumbar disc herniation with leg pain and numbness. Methods Patients with one level lumbar disc herniation who had transforaminal endoscopic lumbar discectomy from June 2016 to July 2019 were categorized into two groups according to the leg numbness. 293 patients initially fulfilled the study criteria, and 27 patients were lost to follow-up. Of the remaining 266 patients available for analysis, 81 cases with leg numbness and pain (A group), and 185 cases with leg pain (B). Endoscopic transforaminal lumbar discectomy was performed, and the clinical outcomes of blood loss, operation times, hospital stay days, pain (Visual Analog Scale, VAS-pain), numbness (VAS-numbness), functional disability (Oswestry Disability Index, ODI), and the disk height and intervertebral foramen height were recorded. Results All patients with pain and numbness pre-operation in group A, complain of leg numbness during or just after walking or standing not diminished after surgery in group A, and no one complain numbness after surgery in group B. The pain index and ODI score were better than preoperational in all patients (P < 0.01), and no significant difference between two groups (P > 0.05). The postoperative disk and foramen height were no significant difference compare to preoperative in all patients (P > 0.05), and no significant difference between two groups (P > 0.05). The leg numbness symptoms last longer in central disc herniation patients (10.4 ± 2.2 months) than in paracentral (6.3 ± 2.1 months) and foraminal disc herniation patients (5.6 ± 2.3 months) after surgery (P < 0.01). Conclusions Based on the results of this study, transforaminal endoscopic lumbar discectomy was effective and safe procedures in the treatment of disc herniation with leg pain and numbness. The leg numbness symptoms last longer in central disc herniation patients than in paracentral and foraminal disc herniation patients after surgery.
The expression of microRNA-206 (miR-206) is aberrantly induced in steroid-induced avascular necrosis of femoral head (SANFH). Therefore, investigating the function of miR-206 in SANFH and uncovering the functional mechanism associated with the condition will promote the understanding and treatment of the disease. The purpose of the present study was to investigate the pro-osteoclasteogenic effect of miR-206 that occurs through regulation of programmed cell death 4 (PDCD4). The expression of miR-206 and PDCD4 was analyzed in the clinical SANFH specimens. The level of miR-206 and PDCD4 was regulated in human osteoblast lineage hFOB1.19 and the effect of different treatments on cell viability, proliferation, apoptosis and differentiation potential of osteoblasts were analyzed with a Cell Counting kit-8, 5-ethynyl-2′-deoxyuridine staining, flow cytometry and Hoechst staining. The expression of miR-206 was upregulated while PDCD4 was downregulated in the SANFH specimens. Induced expression of miR-206 decreased cell viability and proliferation, while apoptosis was induced. At the molecular level, overexpression of miR-206 inhibited the expression of PDCD4, alkaline phosphatase (ALP) and B-cell lymphoma 2 (Bcl-2), and increased the expression of apoptosis regulator Bcl2-X-associated protein (Bax). Inhibiting the expression of miR-206 increased cell viability and proliferation but had no effect on cell apoptosis, as detected by flow cytometry and Hoechst staining. However, at the molecular level, inhibiting the expression of miR-206 induced expression of PDCD4, ALP and Bcl-2, while it decreased the expression of Bax. Additionally, knockdown of PDCD4 blocked the effect of miR-206 inhibition on hFOB1.19 cells, representing a PDCD4-dependent manner of miR-206 in inducing apoptosis of osteoblasts. Therefore, miR-206 promoted the onset of SANFH by inducing apoptosis and suppressed the proliferation of osteoblasts, which was dependent on the inhibition of PDCD4.
The antibiotics of cephazolin, ceftazidime, and ceftriaxone had concentration in the NP tissue, which was higher than the stated MIC. Ceftazidime had highest penetration in to NP tissue, and ceftriaxone had the lowest penetration in to NP tissue.
Background There were no studies in literature of lumbar spondylolisthesis treated by endoscopic surgery. The purpose of this study was to evaluate the efficacy of endoscopic transforaminal lumbar interbody fusion (ELIF) in the treatment of degenerative lumbar spondylolisthesis by compare to the standard transforaminal lumbar interbody fusion (TLIF).Methods A total of 93 patients with lumbar spondylolisthesis who had surgery from February 2017 to January 2018 were categorized into different groups depending on the procedure by ELIF or TLIF. The ELIF and TLIF procedures was performed, and the clinical outcomes of blood loss, operation times, hospital stay days, pain index, ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were recorded.Results There was no intraoperative death in this series. In ends 86 cases had follow-up at least one year and 7 cases lost, and the follow-up rate and followed time were no difference between two groups (P > 0.05). The operational time was longer in ELIF than TLIF (P < 0.01).The hospital days and blood loss were significant less in endoscopic group than TLIF (P < 0.01). The pain index and ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were better than preoperational (P < 0.01), and there were no difference between two groups (P > 0.05). All patients achieved spinal fusion with no cases of cage extrusion, and no infection, and no dural tear of cerebrospinal fluid leakage complication. There were one case of radiculitis (man) at endoscopic group. CT-myelogram revealed the radiculitis patients had normal radiologic findings, and the patient was recovered by neurotrophy drugs and functional exercises after 3 months.Conclusions Endoscopic lumbar decompression and interbody fusion procedures was effective and safe measure in the treatment of the lumbar spondylolisthesis. Compare to open interbody fusion techniques, endoscopic lumbar interbody fusion was minimally invasive surgery with less bold loss and earlier postoperative recovery.
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