Objectives There is a high risk of nerve root injury during endoscopic‐assisted transforaminal lumbar interbody fusion (Endo‐TLIF). This study used computed tomography (CT) imaging to assess the relationship between the exiting nerve root and its surroundings, and the corresponding intervertebral disc. We also measured the approximate position and angle for the placement of the working cannula to reduce the risk of nerve root injury during Endo‐TLIF procedures in the Chinese population. Methods This retrospective study was conducted at our institution between December 2021 and December 2022. A total of 115 patients suffering from low back pain were recruited for the study. For each participant, three‐dimensional (3D) vertebral models of the lumbar segments from L3 to S1 were constructed based on their CT images. The nerve root–disc distance, cannula insertion bypass distance and angle, foraminal height and width, exiting nerve root height, and nerve root–pedicle distance were measured. A paired t‐test was used to compare measurements between the left and right sides, while inter‐ and intraobserver reproducibility was assessed using the intraclass correlation coefficient (ICC). Results From L3/4 to L5/S1 segments, the ideal cannula insertion distance range was 37.51 ± 4.91–120.38 ± 37.71 mm at L3/4; 42.38 ± 5.29–116.25 ± 27.22 mm at L4/5; and 37.78 ± 4.86–69.26 ± 12.64 mm at L5/S1. The appropriate cannula insertion angle range was 30.86° ± 5.05°–62.59° ± 6.66° at L3/4; 34.30° ± 4.73°–60.88° ± 7.34° at L4/5; and 35.89° ± 4.18°–47.65° ± 7.38° at L5/S1. The height of the intervertebral foramen (IVF) gradually decreased, and the width steadily increased. The exiting nerve root height and the nerve root–pedicle distance slightly decreased caudally. Conclusion From L3/4 to L5/S1, the range of working cannula insertion distance and angle gradually decreased, and the exiting nerve root height occupying the IVF gradually increased. Our measurement can reduce the risk of nerve root injury caused by inserting the working cannula during Endo‐TLIF.
Central nervous system (CNS) trauma, including traumatic brain injury (TBI) and traumatic spinal cord injury (SCI), is characterized by high morbidity, disability, and mortality. TBI and SCI have similar pathophysiological mechanisms and are often accompanied by serious inflammatory responses. Pyroptosis, an inflammation-dependent programmed cell death, is becoming a major problem in CNS post-traumatic injury. Notably, the pyrin domain containing 3 (NLRP3) inflammasome is a key protein in the pyroptosis signaling pathway. Therefore, underlying mechanism of the NLRP3 inflammasome in the development of CNS trauma has attracted much attention. In this review, we briefly summarize the molecular mechanisms of NLRP3 inflammasome in pyroptosis signaling pathway, including its prime and activation. Moreover, the dynamic expression pattern, and roles of the NLRP3 inflammasome in CNS post-traumatic injury are summarized. The therapeutic applications of NLRP3 inflammasome activation inhibitors are also discussed.
Polyploidization often leads to "transcriptome shock," and is considered an important factor in evolution of species. Analysis of the cell cycle, which is associated with survival in polyploidy, has proved useful in investigating polyploidization. Here, we used mRNA sequencing to investigate global expression in vitro (in cultured cells) and in vivo (in fin and liver tissues) in both the diploid and tetraploid Carassius auratus red var.. Differential expression (DE) of genes in diploid (7482, 36.0%) and tetraploid (3787, 18.2%) states suggested that in vitro and in vivo conditions dramatically change mRNA expression levels. However, of the 20,771 total shared expressed genes, 18,050 (87.0%), including 17,905 (86.2%) non-differentially expressed genes (DEGs) and 145 (0.7%) DEGs between diploids and tetraploids, showed the same expression trends in both cultured cells and liver tissues. Of the DEGs, four of seven genes in the cell cycle pathway had the same expression trends (upregulated in diploids and tetraploids) in both cultured cells and liver tissues. Quantitative PCR analysis confirmed the same expression trends in the nine DEGs associated with regulation of the cell cycle. This research on common characteristics between diploids and tetraploids provides insights into the potential molecular regulatory mechanisms of polyploidization. The steady changes that occur between diploids and tetraploids in vitro and in vivo show the potential value of studying polyploidy processes using cultured cell lines, especially with respect to cell cycle regulation.
Lumbar degenerative disease (LDD) is a very common disease. And decompression alone, posterior lumbar interbody fusion (PLIF), and interspinous device (Coflex) are generally accepted surgical techniques. However, the effectiveness and safety of the above techniques are still not clear. Network meta-analysis a comprehensive technique can compare multiple treatments based on indirect dates and all interventions are evaluated and ranked simultaneously. To figure out this problem and offer a better choice for LDD, we performed this network meta-analysis.PubMed and WanFang databases were searched based on the following key words, "Coflex," "decompression," "PLIF," "Posterior Lumbar Interbody Fusion," "Coflex" "Lumbar interbody Fusion." Then the studies were sorted out on the basis of inclusion criteria and exclusion criteria. A network meta-analysis was performed using The University of Auckland, Auckland city, New Zealand R 3.5.3 software.A total of 10 eligible literatures were finally screened, including 946 patients. All studies were randomized controlled trials (RCTs). Compared with decompression alone group, there were no significant differences of Oswestry Disability Index (ODI) in Coflex and lumbar interbody fusion groups after surgery. However, Coflex and PLIF were better in decreasing Visual Analogue Scale (VAS) score compared with decompression alone. Furthermore, we found Coflex have a less complication incidence rate.Compared with decompression alone, Coflex and lumbar interbody fusion had the similar effectiveness in improving lumbar function and quality of life. However, the latter 2 techniques were better in relieving pain. Furthermore, Coflex included a lower complication incidence rate. So we suggested that Coflex technique was a better choice to cue lumbar spinal stenosis (LSS).Systematic review and meta-analysis, level I.
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