This study investigated the molecular mechanism by which acetylshikonin inhibits SOX4 expression via the PI3K/Akt pathway to delay intervertebral disc degeneration (IVDD) and low back pain (LBP). Bulk RNA-seq, RT-qPCR, Western blot analysis, immunohistochemical staining, small interfering RNA (siSOX4), lentivirus (lentiv-SOX4
To investigate the relationships between sagittal parameters and health-related quality of life (HRQOL) scores following anterior cervical hybrid decompression and fusion (ACHDF) of multilevel cervical spondylotic myelopathy (CSM) and to study the impact of the T1 slope (T1 s).In total, 42 patients with complete radiographic measurements following ACHDF in the Spine Surgery Department of the First Affiliated Hospital of Fujian Medical University from August 2014 to January 2017 were retrospectively analysed. Radiographic measurements included C2-7 lordosis, T1 s, C2-7 sagittal vertical axis (SVA), cervical tilting and cranial tilting. The neck disability index (NDI) was used to evaluate the HRQOL. Spearman's correlation coefficients were calculated between pairs of cervical sagittal parameters and NDI scores.Preoperative NDI scores were correlated with preoperative T1 s (r = 0.413); follow-up NDI scores were correlated with follow-up T1 s (r = 0.534). The regression analysis indicated that a preoperative T1 s value of 42.36° corresponded to a preoperative NDI score of 25 (r2 = 0.171, P < 0.001). A follow-up T1 s value of 48.61° corresponded to a follow-up NDI score of 25 (r2 = 0.421, P < 0.01). The differences in C2-7 SVA and cranial tilting before and after the operation were statistically significant (P < 0.05).This study showed that the sagittal balance of the cervical vertebrae changed significantly after ACHDF, showing a forward trend. The sagittal parameters after ACHDF were related to clinical prognosis. An excessive T1 s can be considered a risk factor. The T1 s could provide a reference value to determine the correction of the sagittal balance of the cervical spine.
Abstract Background An experimental study was performed to improve the anterior approach model of intervertebral disc degeneration (IVDD). Objective The aims of this study were to investigate the anterior approach model of IVDD for the cause of death, phenotypes, and underlying mechanisms of low back pain in mice. Method In this study, we conducted an anterior puncture procedure on a cohort of 300 C57BL/6J mice that were 8 weeks old. Our investigation focused on exploring the causes of death in the study population ( n = 300) and assessing the time‐course changes in various parameters, including radiographical, histological, immunofluorescence, and immunohistochemistry analyses ( n = 10). Additionally, we conducted behavioral assessments on a subset of the animals ( n = 30). Results Transverse vertebral artery rupture is a major factor in surgical death. Radiographical analyses showed that the hydration of the nucleus pulposus began to decrease at 2 weeks after puncture and obviously disappeared over 4 weeks. 3D‐CT showed that disc height was significantly decreased at 4 weeks. Osteophyte at the anterior vertebral rims was observed at 2 weeks after the puncture. As the time course increased, histological analyses showed progressive disruption of the destruction of the extracellular matrix and increased secretion of inflammatory cytokines and apoptosis. Behavioral signs of low back pain were increased between the puncture and sham groups at 4 weeks. Conclusion The improvement of anterior intervertebral disc approach model in mice will be useful to investigate underlying mechanisms and potential therapeutic strategies for behavior and phenotypes. Furthermore, the application of vibrational pre‐treatment can be used to increase the sensitivity of axial back pain in the model, thereby providing researchers with a reliable method for measuring this critical phenotype.
Abstract Background T1s, C2-7 lordosis, and C2-7 sagittal vertical axis (SVA) are the three most important sagittal parameters in the cervical spine. This study was conducted to investigate the relationships between classical sagittal alignment parameters and a new parameter, K-line tilt, and to study the impact of K-line tilt. Material and methods A total of 72 patients who underwent adjacent two-level anterior cervical discectomy and fusion (ACDF) were retrospectively analyzed. Radiographic measurements included T1 slope (T1s), C2-7 lordosis, segment angle (SA), C2-7 SVA, and K-line tilt. The Neck Disability Index (NDI) scores were used to evaluate the clinical prognosis. Pearson correlation coefficients were calculated between radiographic measures. Linear regression analysis was used to analyze the relationship between follow-up K-line tilt and NDI. Results ΔNDI was positively correlated with ΔT1s ( r = 0.620, p < 0.05), ΔC2-7 SVA ( r = 0.645, p < 0.05), and ΔK-line tilt ( r = 0.702, p < 0.01); ΔK-line tilt was positively correlated with ΔT1s ( r = 0.650, p < 0.05), ΔSA ( r = 0.269, p < 0.05), and ΔC2-7 SVA ( r = 0.293, p < 0.05); ΔT1s was positively correlated with ΔC2-7 lordosis ( r = 0.428, p < 0.05), ΔSA ( r = 0.631, p < 0.01), and ΔC2-7 SVA ( r = 0.235, p < 0.05); ΔC2-7 lordosis was positively correlated with ΔSA ( r = 0.666, p < 0.05) and negatively correlated with ΔC2-7 SVA ( r = − 0.467, p < 0.01). The preoperative and postoperative K-line tilt values were statistically significant ( p < 0.01), increasing from (7.50 ± 6.48)° to (9.95 ± 5.09)°. Preoperative NDI was positively correlated with preoperative C2-7 SVA ( r = 0.639, p = 0.011) and K-line tilt ( r = 0.516, p = 0.026); follow-up NDI was positively correlated with follow-up T1s ( r = 0.664, p = 0.038), C2-7 SVA ( r = 0.756, p = 0.004), and K-line tilt ( r = 0.832, p = 0.006). The linear regression model showed that when the follow-up K-lint tilt was > 23.75°, NDI scores were > 25 ( R 2 = 0.737, p = 0.000). Conclusion This study showed that the K-line tilt was strongly correlated with the C2-C7 SVA, indicating that the K-line tilt can be used as another cervical parameter to evaluate cervical alignment in adjacent two-level ACDF. K-line tilt is an important parameter similar to the classical parameter C2–C7 SVA. In particular, a K-line tilt greater than 23.75 corresponded to a worse clinical prognosis, which was defined as an NDI score greater than 25.
Abstract Intervertebral disc degeneration is a natural process during aging and a leading cause of lower back pain. Here, we generate a comprehensive atlas of nucleus pulposus cells using single-cell RNA-seq analysis of human nucleus pulposus tissues (three males and four females, age 41.14 ± 18.01 years). We identify fibrotic late-stage nucleus pulposus cells characterized by upregulation of serglycin expression which facilitate the local inflammatory response by promoting the infiltration of inflammatory cytokines and macrophages. Finally, we discover that daphnetin, a potential serglycin ligand, substantially mitigates the local inflammatory response by downregulating serglycin expression in an in vivo mouse model, thus alleviating intervertebral disc degeneration. Taken together, we identify late-stage nucleus pulposus cells and confirm the potential mechanism by which serglycin regulates intervertebral disc degeneration. Our findings indicate that serglycin is a latent biomarker of intervertebral disc degeneration and may contribute to development of diagnostic and therapeutic strategies.
Objective:To investigate the diagnosis and treatment of canal conversion during canalith repositioning procedure for benign paroxysmal positional vertigo.Method:The clinic features, nystagmus characteristics, diagnosis and treatment of the patients with benign paroxysmal positional vertigo who suffered from canal conversion during canalith repositioning procedure were analyzed retrospectively.All patients'positioning test and canalith repositioning procedure were done with the aid of videonystagmography.Result:A total of 186 patients with benign paroxysmal positional vertigo were diagnosed and performed canalith repositioning procedure.Eight patients (4.3%) developed canal conversion after canalith repositioning procedure.Of these 8 patients,5 cases with posterior canal canalolithiasis converted to lateral canal canalolithiasis,2 cases with lateral canal canalolithiasis converted to posterior canal canalolithiasis,and 1 case with posterior canal canalolithiasis converted to anterior canal canalolithiasis. All cases recovered well under the corresponding repositioning procedure.Conclusion:The change of the characteristics of positioning nystagmus is the major diagnostic feature of canal conversion. Accurate diagnosis and targeted repositioning procedure are the key to the success of canal conversion treatment.
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