Spine杂志201701上半期摘要翻译

,index,Basic ScienceEffect of Polyether Ether Ketone on Therapeutic Radiation to the Spine: A Pilot Study聚醚醚酮树脂PEEK对脊柱放射治疗的影响：初步研究Deletion of Opg Leads to Increased Neovascularization and Expression of Inflammatory Cytokines in the Lumbar Intervertebral Disc of Mice敲除小鼠Opg基因导致腰椎间盘中炎症细胞因子的表达和新生血管形成的增加,index,Cervical SpineComplication and Reoperation Rates Following Surgical Management of Cervical Spondylotic Myelopathy in Medicare Beneficiaries医疗保险受益人髓性颈椎病手术治疗后的并发症和再手术率Efficacy of Diffusion Tensor Imaging Indices in Assessing Postoperative Neural Recovery in Cervical Spondylotic Myelopathy扩散张量成像指数在评估颈椎脊髓病性脊髓病术后神经恢复的功效Routine Use of Intraoperative Neuromonitoring During ACDFs for the Treatment of Spondylotic Myelopathy and Radiculopathy Is Questionable: A Review of 15,395 Cases在ACDF治疗髓性或根性颈椎病术中常规使用神经监护是可疑的：回顾15,395例,index,Clinical Case SeriesRoutine Use of Intraoperative Neuromonitoring During ACDFs for the Treatment of Spondylotic Myelopathy and Radiculopathy Is Questionable: A Review of 15,395 Cases在ACDF治疗髓性或根性颈椎病术中常规使用神经监护是可疑的：回顾15,395例Dermal Discolorations and Burns at Neuromonitoring Electrodes in Pediatric Spine Surgery儿科脊柱手术使用神经电极导致皮肤色素沉着和烧伤Preventive Effect of Dynamic Stabilization Against Adjacent Segment Degeneration After Posterior Lumbar Interbody Fusion动态稳定对后路腰椎间融合后相邻节段退变的预防效果Lumbar Degenerative Spondylolisthesis: Changes in Surgical Indications and Comparison of Instrumented Fusion With Two Surgical Decompression Procedures腰椎退行性脊椎滑脱：手术适应症的变化和两种减压手术的比较,INDEX,DeformityDiscrepancy Between Standing Posture and Sagittal Balance During Walking in Adult Spinal Deformity Patients成年脊柱畸形患者行走和站立姿势矢状平衡之间的差异Function and Clinical Symptoms are the Main Factors that Motivate Thoracolumbar Adult Scoliosis Patients to Pursue Surgery功能和临床症状是促使成人胸腰椎脊柱侧凸患者进行手术的主要因素,INDEX,EpidemiologyFrequency and Risk Factors for Additional Lesions in the Axial Spine in Subjects With Chordoma:Indications for Screening脊柱脊索瘤患者脊柱轴向其他病变的频率和危险因素Health Services ResearchThe Influence of Race on Short-term Outcomes After Laminectomy and/or Fusion Spine Surgery种族对椎板切除和/或融合脊柱手术后短期结果的影响,INDEX,Literature ReviewA Systematic Review of the Soft-Tissue Connections Between Neck Muscles and Dura Mater: The Myodural Bridge连接颈部肌肉和硬脑膜之间的软组织的系统评价：肌肉桥OutcomesComparison of Outcomes of Single-Level Anterior Cervical Discectomy With Fusion and Single-Level Artificial Cervical Disc Replacement for Single-Level Cervical Degenerative Disc Disease单节段前路颈椎椎间盘切除融合术和单节段颈椎椎间盘置换术对单节段颈椎退行性椎间盘疾病的预后比较,INDEX,Perioperative Complications in 155 Patients Who Underwent Oblique Lateral Interbody Fusion Surgery: Perspectives and Indications From a Retrospective, Multicenter Survey155例OLIF患者的围手术期并发症Surgical Site Infections in Posterior Lumbar Surgery: A Controlled-Cohort Study of Epidural Steroid Paste后路腰椎手术切口感染：控制性队列研究硬膜外类固醇使用Canadian Consensus for the Prevention of Blood Loss in Spine Surgery加拿大对预防脊柱手术出血的共识Metallosis Presenting as a Progressive Neurologic Deficit Four Years After a Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: A Case Report金属沉着导致青少年特发性脊柱侧凸后路脊柱融合术四年后渐进性的神经功能障碍：病例报告,TITLE,Effect of Polyether Ether Ketone on Therapeutic Radiation to the Spine: A Pilot Study聚醚醚酮树脂PEEK对脊柱放射治疗的影响：初步研究Study Design. Cadaveric model.研究设计：尸体模型。,ABSTRACT,Objectives. To compare the effect of PEEKversusconventional implants on scatter radiation to a simulated tumor bed in the spine目的：比较PEEK与传统植入物对脊柱模拟放射治疗的影响,ABSTRACT,Summary of Background Data. Given the highly vasculature nature of the spine, it is the most common place for bony metastases. After surgical treatment of a spinal metastasis, adjuvant radiation therapy is typically administered. Radiation dosing is primarily limited by toxicity to the spinal cord. The scatter effect caused by metallic implants decreases the accuracy of dosing and can unintentionally increase the effective dose seen by the spinal cord. This represents a dose-limiting factor for therapeutic radiation postoperatively.背景资料概述：由于椎体的血运丰富，所以是骨转移最常发生的部位。脊柱转移癌的外科治疗后，通常需要辅助放射治疗。辐射剂量主要受脊髓毒性的限制。金属植入物引起的散射效应降低剂量的准确性，并可以无意中增加脊髓的有效剂量。这代表术后放射治疗的剂量限制因素。,ABSTRACT,Methods. A cadaveric thorax specimen was utilized as a metastatic tumor model with two separate three-level spine constructs (one upper thoracic and one lower thoracic). Each construct was examined independently. All four groups compared included identical posterior instrumentation. The anterior constructs consisted of either: an anterior polyether ether ketone (PEEK) cage, an anterior titanium cage, an anterior bone cement cage (polymethyl methacrylate), or a control group with posterior instrumentation alone. Each construct had six thermoluminescent detectors to measure the radiation dose.方法：使用尸体胸部标本作为具有两个完整脊柱三柱构造（一个上胸椎和一个下胸椎）的转移性肿瘤模型。独立地检测每个构建体。所有四组比较包括相同的后路内固定物。前柱固定使用：前聚醚醚酮（PEEK），钛笼，骨水泥笼（聚甲基丙烯酸甲酯）或仅有后路内固定的对照组。每个构建体用六个热释光检测器以测量辐射剂量。,ABSTRACT,Results. The mean dose was similar across all constructs and locations. There was more variability in the upper thoracic spine irrespective of the construct type. The PEEK construct had a more uniform dose distribution with a standard deviation of 9.76. The standard deviation of the others constructs was 14.26 for the control group, 19.31 for the titanium cage, and 21.57 for the cement (polymethyl methacrylate) construct.结果：所有构建体和位置的平均剂量相似。无论内固定类型如何，上胸椎存在更多的变异性。 PEEK构建体具有更均匀的剂量分布，标准偏差为9.76。其他构建体的标准偏差：对照组为14.26，钛笼为19.31，骨水泥（聚甲基丙烯酸甲酯）构建体为21.57。,ABSTRACT,Conclusion. The PEEK inter-body cage resulted in a significantly more uniform distribution of therapeutic radiation in the spine when compared with the other constructs. This may allow for the application of higher effective dosing to the tumor bed for spinal metastases without increasing spinal cord toxicity with either fractionated or hypofractionated radiotherapy.结论：与其他构建体相比，PEEK笼手术后放射治疗的辐射在脊柱中有更显着均匀的分布。 这可以允许对脊柱转移肿瘤施加更高的有效剂量，而不增加放疗的脊髓毒性。,Sample radiation planning model created from a planning CT scan for one of our cadaveric specimens. The separate iso-dense lines can be seen with the percentage of the total dose administered. The yellow area is the spinal cord that has been selected during the radiation planning as an area to protect. Note the red iso-dense lines, representing 100% dose, lack of uniform distribution in the PMMA construct and its overlap with the spinal cord.,A clinical photograph of a representative construct with the posterior spinal rods (blue arrow), the circumferentially decompressed spinal cord (white arrow), and the PMMA anterior construct (yellow arrow).B, A clinical photograph after the sensors were placed in their respective trocar and then placed in the back. The trocars were placed through the skin to allow for more secure positioning. Each trocar was labeled for accurate recovery of the sensor from its corresponding location.,. A carton representation of the TLD sensor placement location. Each TLD sensor placement was confirmed visually before closing the incision and filling it with the phantom material.,Representative images from a complete planning CT scan with beam angles and iso-dense lines illustrated. Coronal, sagittal, axial, and 3D images are included. The phantom can be seeing filling the lungs. The lower construct dosing was planned separately.,A representative T2 sagittal MRI of a patient after posterior instrumentation and anterior reconstruction with a PEEK cage. Note the scatter with the pedicles screws (red arrows). The PEEK cage has minimal scatter affecting the imaging sequence (yellow arrow).,Representative axial CT scan images demonstrating the difference in scatter effect from a metal anterior construct (A)versusa PEEK anterior construct (B).,* Despite advances, metastatic disease continues to affect the spine and it can cause symptoms from pain and weakness to complete paralysis leading to significant morbidity and disability*尽管取得进展，但转移性疾病任然影响脊柱，并且可引起疼痛和无力，甚至完全瘫痪* The PEEK interbody cage resulted in a significantly more uniform distribution of therapeutic radiation in the spine when compared with the other constructs in a cadaveric spine model.*与尸体脊柱模型中的其他内固定构造相比，PEEK椎间融合器的治疗辐射在脊柱中有更加显着均匀的分布。* This knowledge may allow for the application of higher effective dosing to the tumor bed for spinal metastases without increasing spinal cord toxicity with either fractionated or hypofractionated radiotherapy.*这种知识可以对脊柱转移的肿瘤应用更高的有效剂量，而不增加放疗的脊髓毒性。,TITLE,Deletion of Opg Leads to Increased Neovascularization and Expression of Inflammatory Cytokines in the Lumbar Intervertebral Disc of Mice敲除小鼠Opg基因导致腰椎间盘中炎症细胞因子的表达和新生血管形成的增加Study Design. Neovascularization and expression of inflammatory cytokines were examined in Osteoprotegerin (Opg) knockout (KO) mice that show intervertebral disc (IVD) degeneration.研究设计：研究骨保护素（Opg）敲除（KO）小鼠的椎间盘（IVD）变性模型中炎症细胞因子的表达和新血管的形成。,ABSTRACT,Objective. The aim of this study was to clarify the pathological changes in lumbar IVD degeneration in Opg KO mice.目的：本研究的目的是阐明Opg KO小鼠腰椎IVD变性的病理变化。,ABSTRACT,Summary of Background Data. Osteoporosis is a controversial risk factor for IVD degeneration. Deletion of Opg resulted in IVD degeneration in mice. Neovascularization and inflammatory cytokines are key factors in IVD degeneration.背景数据概述：骨质疏松是IVD变性的有争议的风险因素。敲除Opg导致小鼠中的IVD变性。新血管形成和炎症细胞因子是IVD变性的关键因素。,ABSTRACT,Methods. Opg KO mice and their wild-type (WT) littermates were euthanized. Lumbar IVDs were harvested. Safranin O/Fast Green staining was performed to examine the pathological changes. Microcomputed tomographic (micro-CT) analysis was performed to determine the structural changes at the junction of lumbar IVD cartilage and vertebrae. Tartrate-resistant acid phosphatase (TRAP) staining was performed to evaluate osteoclast formation. Protein expression of vascular endothelial growth factor A (VEGF-A), CD31, VE-cadherin, CD 34, interleukin-1 (IL-1), and tumor necrosis factors (TNF-) were analyzed by immunohistochemistry (IHC) assays. Gene expressions of IL-1, IL-6, and TNF- were analyzed by real-time polymerase chain reaction (RT-PCR).方法：将Opg KO小鼠及其野生型（WT）同窝小鼠安乐死。 获取腰部IVD。 进行Safranin O / Fast Green染色以检查病理变化。 进行微计算机断层扫描（micro-CT）分析以确定腰椎IVD软骨和椎骨的连接处的结构变化。 进行酒石酸盐抗性酸性磷酸酶（TRAP）染色以评价破骨细胞形成。 通过免疫组织化学（IHC）测定分析血管内皮生长因子A（VEGF-A），CD31，VE-钙粘蛋白，CD34，白细胞介素-1（IL-1）和肿瘤坏死因子 。 通过实时聚合酶链反应（RT-PCR）分析IL-1，IL-6和TNF-的基因表达。,ABSTRACT,Results. In 12-week-old Opg KO mice, new bone was formed in the endplate cartilage of lumbar IVDs and this became more obvious in 24-week-old Opg KO mice. Three-dimensional (3D) CT reconstruction analyses showed that the edges of the L4 and L5 vertebrae were rugged with bone marrow cavities in it. Protein expression of VEGF-A, CD31, VE-cadherin, and CD34 was increased in the endplate and growth plate of lumbar IVDs of Opg KO mice. Gene expression of IL-1, IL-6, and TNF- as well as protein expression of IL-1 and TNF- were highly expressed in the lumbar IVDs of Opg KO mice.结果：在12周龄的Opg KO小鼠中，腰椎IVD的终板软骨中形成新骨，这在24周龄的Opg KO小鼠中变得更明显。 三维（3D）CT重建分析显示，L4和L5椎骨的边缘与骨髓腔骨质增生。 在Opg KO小鼠的腰椎IVD的终板和生长板中VEGF-A，CD31，VE-钙粘着蛋白和CD34的蛋白表达增加。 IL-1，IL-6和TNF-的基因表达以及IL-1和TNF-的蛋白表达在Opg KO小鼠的腰部IVD中高度表达。,ABSTRACT,Conclusion. Deletion of Opg leads to increased neovascularization and expression of inflammatory cytokines in the lumbar disc in Opg KO mice, which may play important roles in IVD degeneration.结论：Opg的缺失导致Opg KO小鼠腰椎间盘的新血管形成和炎症细胞因子的表达增加，这可能在IVD变性中起重要作用。,New bone was formed in the endplate cartilage of the lumbar 4/5 IVDs inOpgKO mice.(A)Safranin O and Fast Green staining showed that the new bone was found at the edge of the endplate cartilage in 12-week-oldOpgKO IVDs (arrow, middle panel), and was developed throughout the endplate cartilage in 24-week-oldOpgKO IVDs (arrow heads, right panel). The growth plate became thinner (arrow, right panel).(B)New bone formation was quantified by the ratio of new bone area and endplate cartilage area in lumbar 4/5 IVDs. In both 12-week-old and 24-week-old mice, new bone formation in endplate cartilage ofOpgKO IVDs was significantly increased than that of WT IVDs (P 0.01). n = 3.(C)3D reconstruction analysis from the transverse position showed that in 12-week-oldOpgKO mice, new cavities appeared on the edges of the L4 and L5 vertebrae. In 24-week-oldOpgKO mice, the vertebrae became even rugged with a lot of cavities in it (pixel size: 906 x 906).,* Deletion of Opg leads to increased neovascularization in lumbar intervertebral disc of mice.* Deletion of Opg leads to increased expression of inflammatory cytokines in lumbar intervertebral disc of mice.* Lumbar IVD degeneration in Opg KO mice could be accelerated by the interactions among osteoclast formation, inflammatory cytokines, and neovascularization.*敲除Opg导致小鼠腰椎间盘增加新血管形成。*敲除Opg导致小鼠腰椎间盘中炎症细胞因子的表达增加。* Opg KO小鼠的腰椎IVD变性可以通过破骨细胞形成，炎症细胞因子和新血管形成之间的相互作用而加速。,Title,Complication and Reoperation Rates Following Surgical Management of Cervical Spondylotic Myelopathy in Medicare BeneficiariesDepartment of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, MD医疗保险受益人髓性颈椎病手术治疗后的并发症和再手术率Study Design. Retrospective database review.研究设计：回顾性数据库审查。,ABSTRACT,Objective. To compare complication and reoperation rates after anterior cervical discectomy and fusion (ACDF), posterior cervical fusion (PCFs), and anterior cervical corpectomy and fusion (ACCF) for cervical spondylotic myelopathy (CSM) using a large national database of Medicare beneficiaries.目的：使用国家医疗保险受益人的大型国家数据库，比较颈椎前路椎间盘切除融合术和颈椎后路融合术（PCF），颈椎前路椎体融合术（ACCF）治疗颈椎髓性颈椎病（CSF）的并发症和再手术率。,ABSTRACT,Summary of Background Data. CSM is the most common cause of myelopathy in patients over 55 years and is considered the most common cause of spinal cord dysfunction in the world. Surgical treatment includes ACDF, PCF, or ACCF procedures.背景资料概述：CSM是55岁以上患者中脊髓压迫最常见的原因，并且被认为是世界上导致脊髓功能障碍的最常见原因。 手术治疗包括ACDF，PCF或ACCF。,ABSTRACT,Methods. The PearlDiver database (20052012) was utilized to determine revision rates after surgical treatment of CSM by one of the aforementioned surgical treatments. Specifically, 1 to 2 level ACDF, ACCF, and PCF and 3+ level PCF cohorts were included. Each cohort was stratified by the age of 65 years. Survivorship curves were graphed and compared.方法：使用PearlDiver数据库（2005-2012）确定上述手术治疗的CSM患者的返修率。 具体来说，包括1至2阶段ACDF，ACCF和PCF和3+PCF队列。每个队列按65岁分层。绘制并比较存活曲线。,ABSTRACT,Results. Of the patients younger than 65 years of age, there were 10,557 patients treated with 1 to 2 level ACDF procedures, 1319 patients with 1 to 2 level PCF procedures, 1203 patients with 1 to 2 level ACCF procedures, and 2312 patients treated with 3+ level PCF procedures. Of the elderly patients, 24,310 patients were treated with 1 to 2 level ACDFs, 4776 with 1 to 2 level PCF procedures, 3109 with 1 to 2 level ACCFs, and 7760 with 3+ level PCFs. Patients younger than 65 years of age were significantly more likely to have a reoperation procedure, than those 65 years or older when analyzing ACCF, ACDF, and 3+ level PCF procedures. ACCFs were significantly more likely than ACDFs to require reoperation. Patients treated with PCF were consistently more likely to have nondysphagia-related complications than those treated with ACDF. Rates of transfusion, dysphagia, and hematoma/seroma formation were significantly increased with ACCF compared with ACDF within the elderly population.结果：在65岁以下的患者中，有10,557例患者接受12阶段的ACDF手术，1319例患者接受12阶段的PCF手术，1203例患者接受12阶段的ACCF手术，2312例患者接受 3+级PCF程序。 在老年患者中，24,310例患者接受12阶段的ACDF治疗，4776例接受12阶段的PCF手术，3109例接受12阶段的ACCF，7760例接受34阶段的PCF。 65岁以下的患者ACCF，ACDF和3+级PCF比65岁或更大的患者明显更有可能进行再次手术。 ACCF明显比ACDF更可能需要再次手术。PCF治疗的患者比用ACDF治疗的患者更可能患有非吞咽困难相关的并发症。 输血，吞咽困难和血肿形成率在老年人口中的ACDF组显着增加。,ABSTRACT,Conclusion. The elderly are significantly less likely to have a revision surgery after surgical treatment for CSM. Patients treated with ACCF are more likely to need a revision than those treated with ACDF.结论：老年人在CSM手术治疗后进行返修手术的可能性显着降低。用ACCF治疗的患者比用ACDF治疗的患者更可能需要翻修。,* Patients treated with ACCF are more likely to need revision surgery than those treated with ACDF or PCF.* There is no significant difference in revision rate when comparing ACDF and PCF procedures.* The elderly were significantly less likely than younger patients to have a revision surgery when considering all surgeries.* PCF is associated with greater complication rates, though lower dysphagia rates.*ACCF治疗的患者比ACDF或PCF治疗的患者更可能需要翻修手术。*当比较ACDF和PCF程序时，翻修率没有显着差异。*在考虑所有手术时，老年人比年轻患者进行翻修手术的可能性显着降低。* PCF与较高的并发症发生率相关，但吞咽困难率较低。,TITLE,Efficacy of Diffusion Tensor Imaging Indices in Assessing Postoperative Neural Recovery in Cervical Spondylotic MyelopathyDepartment of spine surgery, Ganga Hospital, Coimbatore, India.扩散张量成像指数在评估颈椎脊髓病性脊髓病术后神经恢复的功效Study Design. Prospective observational cohort study.研究设计：前瞻性观察性队列研究。,ABSTRACT,Objective. The aim of this study was to analyze the efficacy of diffusion tensor imaging (DTI) anisotropy indices in predicting the postoperative recovery in cervical spondylotic myelopathy (CSM) patients and to describe postoperative changes in the DTI indices based on neurological recovery after surgery.目的：本研究的目的是分析扩散张量成像（DTI）各向异性指数在预测颈髓性脊髓病（CSM）患者的术后恢复的效果，并描述手术后神经恢复的DTI指数的术后变化。,ABSTRACT,Summary of Background Data. Surgical results of CSM are unpredictable and cannot be estimated based on preoperative MRI. DTI indices were found to have good sensitivity to detect changes in CSM, but their efficacy in predicting postoperative recovery and postoperative changes in DTI indices has not been studied before.背景资料总结：CSM的手术结果是不可预测的，不能基于术前MRI进行估计。 DTI指数具有良好的敏感性以检测CSM的变化，但DTI指数术后变化在预测术后恢复的功效尚未进行过研究。,ABSTRACT,Methods. Thirty-five patients who underwent surgical decompression for cervical spondylotic myelopathy underwent DTI evaluation preoperatively and postoperatively at 12 months. DTI indicesfractional anisotropy, apparent diffusion coefficient (ADC), relative anisotropy, volume ratio, and eigen vectors (E1, E2, and E3)were obtained and clinical evaluations were made preoperatively and 12 months postoperatively.方法：35例颈椎病接受手术减压的患者术前和术后12个月进行DTI评估。 获得DTI指数 - 分数各向异性，表观扩散系数（ADC），相对各向异性，体积比和特征向量（E1，E2和E3），并在术前和术后12个月进行临床评价。,ABSTRACT,Results. Twenty-six patients were available for final follow-up at 12 months. Twenty patients showed improvement by at least 1 Nurick grade, five maintained the preoperative Nurick grade status and one patient was noted to have det