application-cortical-bone-trajectory-screw-for-treating-thoracolumbar

Application of Cortical Bone Trajectory Screw for Treating Thoracolumbar and Lumbar Tuberculosis

The common form of extrapulmonary tuberculosis is spinal tuberculosis (TB). Spinal TB can lead to vertebral damage, resulting in kyphosis and neurological ...

Hangzhou Red Cross Hospital

To date, there is no consensus on the best technique to repair injured posterolateral structures of the knee. We evaluated the effects of a fibular head based isometric reconstruction of the posterolateral knee corner with a double bundle semitendinosus tendon. From February 2001 to February 2005, 18 isometric reconstructions of a chronic posterolateral corner (PLC) injury of the knee were performed using the semitendinosus tendon. The average age of the patients was 39 years, ranging from 19 to 52 years. Twelve were male and 6 female. The time interval between injury and treatment ranged from 1.5 to 14 months. Three patients had simple PLC injuries, 10 had combined PLC-posterior cruciate ligament (PCL) injuries and two of them had undergone a PCL reconstruction elsewhere 6.5 months prior to referral. Three other patients had an associated anterior cruciate ligament (ACL) injury and two had a combination of PLC with ACL and PCL injury. A doubled semitendinosus tendon was threaded through bony tunnels in the fibular head running from the insertion of the lateral collateral ligament (LCL) to the fibular insertion of the popliteo-fibular ligament and both ends were fixed proximally into bony tunnels of the lateral femoral condyle at their respective isometric point. The varus stress test and the posterolateral rotation test were used to evaluate stability of the posterolateral structures. Isometry was optimal between the femoral attachment site of the popliteal tendon to the anatomical insertion of the popliteofibular ligament at the fibular head. The fibular insertion of the LCL is isometric to the anterior or antero-inferior 8-10 mm of the femoral insertion of the LCL. The average follow-up period was 32 months (30-42 months). There was no varus knee instability in full extension. At 30 degrees of flexion two cases demonstrated a grade I varus instability. A fibular head based isometric reconstruction is a reproducible and reliable technique for reconstruction of the posterolateral corner of the knee.

Isometric reconstruction of the posterolateral corner of the knee.

In this study, we propose a finite element analysis of the complete cervical spine with straightened and normal physiological curvature by using a specially designed modelling system. An accurate finite element model is established to recommend plausible approaches to treatment of cervical spondylosis through the finite element analysis results. There are few reports of biomechanics influence of the straightened cervical curve. It is difficult to measure internal responses of cervical spine directly. However, the finite element method has been reported to have the capability to quantify both external and internal responses to mechanical loading, such as the strain and stress distribution of spinal components. We choose a subject with a straightened cervical spine from whom to collect the CT scan data, which formed the basis of the finite element analysis. By using a specially designed modelling system, a high quality finite element model of the complete cervical spine with straightened curvature was generated, which was then mapped to reconstruct a normal physiological curvature model by a volumetric mesh deformation method based on discrete differential properties. Then, the same boundary conditions were applied to do a comparison. The result demonstrated that the active movement range of straightened cervical spine decreased by 24-33 %, but the stress increased by 5-95 %. The stress was concentrated at the facet joint cartilage, uncovertebral joint and the disk. The results suggest that cervical lordosis may have a direct impact on cervical spondylosis treatment. These results may be useful for clinical treatment of cervical spondylosis with straightened curvature.

Straightened cervical lordosis causes stress concentration: a finite element model study.

Osteoarthritis (OA) is a complex disease that is induced by many genetic risk variants and other factors. To examine the role of toll-like receptor 9 (TLR-9) in OA patients, we conducted a case-control study involving 215 knee OA (KOA) patients and 215 controls in a Chinese population. Genotyping with a custom-by-design 48-Plex single nucleotide polymorphism Scan™ Kit showed the -9 gene rs187084 polymorphism was associated with an increased risk of KOA. Stratification analyses further validated this finding among old people (age ≥ 55 years). In conclusion, -9 gene rs187084 polymorphism is positively correlated with susceptibility to KOA, especially among old people. Nevertheless, this finding should be confirmed by larger size studies with more ethnic populations.

Association between -9 gene rs187084 polymorphism and knee osteoarthritis in a Chinese population.

The present study investigated the clinical significance of mannose-binding lectin 2 (MBL2), cluster of differentiation 14 (CD14) and tumour necrosis factor-α (TNF-α) gene polymorphisms in patients with spinal tuberculosis (TB) in Chinese population.

Correlation between MBL2/CD14/TNF-α gene polymorphisms and susceptibility to spinal tuberculosis in Chinese population.

To evaluate the clinical value of percutaneous endoscopic focal cleaning and drainage in the treatment of single-level suppurative spondylitis.

[Eearly clinical effects of percutaneous endoscopic focal cleaning and drainage in the treatment of single-level suppurative spondylitis].

BACKGROUND Spinal tuberculosis (STB) is the main cause of bone and joint tuberculosis. This study aimed to screen and analyze the susceptibility genes for STB using whole-exome sequencing (WES). MATERIAL AND METHODS All exon regions of peripheral blood DNA from 6 STB patients were captured and sequenced using WES and the sequencing data were analyzed by modern bioinformatics methods to identify disease-causing mutations. Sanger sequencing was then used to validate the mutation sites in normal controls (207) and STB patients (193). The mRNA expression of the mutant gene and the serum levels of IL-6 and TNF-α were detected using qPCR or ELISA assay, respectively. RESULTS A nonsynonymous single-nucleotide polymorphism (SNP) in the gene HLA-DQA1 (rs796778515, c.592delCinsG, CAG to GAG, p.Q198E) was identified and further validated by Sanger sequencing. The percentage of the 3 genotypes C/C, C/G and G/G in STB patients and normal controls were 37.3%, 32.1%, and 30.6% and 47.8%, 33.8%, and 18.4%, respectively. Furthermore, the C>G mutation was significantly associated with the occurrence of STB. In addition, the levels of HLA-DQA1 mRNA were significantly lower in blood cells from STB patients compared with normal controls, while the serum levels of IL-6 and TNF-α were significantly higher. CONCLUSIONS The C>G mutation in the HLA-DQA1 gene was associated with the occurrence of STB. This variation may result in the decreased level of HLA-DQA1 mRNA and increased serum levels of IL-6 and TNF-α, which finally led the STB susceptibility.

Identification of HLA-DQA1 as a Susceptibility Gene for Spinal Tuberculosis by Exome Sequencing.

To investigate the clinical efficacy of cortical bone trajectory (CBT) screws in the treatment of elderly patients with lumbar spinal tuberculosis.

Application of Cortical Bone Trajectory Screws in Elderly Patients with Lumbar Spinal Tuberculosis.

To explore the accuracy and security of 3-dimensional (3D) printing technology combined with guide plates in the preoperative planning of thoracic tuberculosis and the auxiliary placement of pedicle screws during the operation.

Application of 3-dimensional printing technology combined with guide plates for thoracic spinal tuberculosis.

The burden of spinal tuberculosis (STB) in China remains substantial, with the country ranking third in the number of tuberculosis cases globally in 2022, among the 30 countries with a high tuberculosis burden. In East China, few large-scale studies have been conducted on STB.

Article	Year
Isometric reconstruction of the posterolateral corner of the knee. Acta orthopaedica Belgica\| PubMed ID: 19774818	2009
Straightened cervical lordosis causes stress concentration: a finite element model study. Australasian physical & engineering sciences in medicine\| PubMed ID: 23355324	2013
Association between -9 gene rs187084 polymorphism and knee osteoarthritis in a Chinese population. Bioscience reports\| PubMed ID: 28916728	2017
Correlation between MBL2/CD14/TNF-α gene polymorphisms and susceptibility to spinal tuberculosis in Chinese population. Bioscience reports\| PubMed ID: 29298876	2018
[Eearly clinical effects of percutaneous endoscopic focal cleaning and drainage in the treatment of single-level suppurative spondylitis]. Zhongguo gu shang = China journal of orthopaedics and traumatology\| PubMed ID: 29772863	2018
Identification of HLA-DQA1 as a Susceptibility Gene for Spinal Tuberculosis by Exome Sequencing. Medical science monitor : international medical journal of experimental and clinical research\| PubMed ID: 29795056	2018
Application of Cortical Bone Trajectory Screws in Elderly Patients with Lumbar Spinal Tuberculosis. World neurosurgery\| PubMed ID: 29864561	2018
Application of 3-dimensional printing technology combined with guide plates for thoracic spinal tuberculosis. Medicine\| PubMed ID: 33578582	2021
Clinical and epidemiological analysis of 893 patients with spinal tuberculosis: an 11-Year investigation of a general hospital in East China. BMC musculoskeletal disorders\| PubMed ID: 40890663	2025

Shiyuan Shi

Biography

JoVE Journal Publications

Other Publications