RESUMEN
OBJECTIVE: To evaluate the therapeutic efficacies and surgical procedures of anterior approach for cervical spinal canal stenosis. METHODS: A total of 162 cases of cervical spinal canal stenosis underwent anterior surgical procedure from March 2007 to March 2010. The operative duration, the volume of blood loss and the days of postoperative hospital stay were recorded and analyzed. The Cobb angle and canal sagittal diameter were measured. The bone graft fusion and nerve functions were evaluated postoperatively. RESULTS: The average operative duration was 86.4 minutes with an intraoperative blood loss of 80.2 ml and a postoperative hospital stay of 5.3 days. A follow-up visit of 9-18 months (average: 12.8) showed that bone graft fusion was achieved in all cases and Cobb angle increased by an average of 7.2 degree. The spinal canal sagittal diameter increased by 4.23 mm. And the JOA (Japanese Orthopedic Association) score increased by an average of 6.1 points at 3 Month post-operation. CONCLUSION: For cervical spinal canal stenosis, the pressure comes mostly from the front part. The anterior surgical procedure can decompress directly with a shorter operative duration, a smaller volume of blood loss, a shorter hospitalization stay and an effective recovery of cervical curvature and canal volume.
Asunto(s)
Vértebras Cervicales , Descompresión Quirúrgica/métodos , Estenosis Espinal/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the effects of lentiviral vector-mediated RNA interfere gene Nogo receptor (NgR) of rat cortical neurons in repairing spinal cord injury. METHODS: The recombinant-lentiviral vector with small inferring RNA siNgR199 which had been constructed was transfected into rat cortical neuron cells in vitro in 3 multiplicity of infection (MOI). The infection rate was determined with fluorescent microscope, and the target gene was detected by PCR analysis. Then, the recombinant was injected into the cortical motor area of the rats with severe spinal cord injury, and the saline was also injected into other rats with severe spinal cord injury as a match control. The functional recovery of the rats' hindlimb was assessed using BBB score and the nerve fiber of the injured region was observed by nerve tracing. RESULTS: The rate of recombinant infecting rat cortical neuron in vitro exceeded 99%. PCR analysis confirmed that the effect of lentiviral vector-mediated RNA interfering gene NgR of rat cortical neurons in vitro was 61%. Although all rats with spinal cord injury were observed to have the hindlimb functional recovery, these rats injected with recombinant had better hindlimb functional recovery than others showing by more BBB score (P < 0.01). Moreover, it was found that some nerve fiber passed the injured spinal cord region of the rats which were injected with recombinant. CONCLUSION: The recombinant lentiviral vector with siNgR199 which had been constructed is able to promote the growth of nerve fiber and the functional recovery of the rats' hindlimb.