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BackgroundCervical ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. Posterior decompression surgery is reported to be an effective and comparatively safe procedure with few complications for treatment of patients with myelopathy caused by OPLL. However, some patients require revision surgery because of late neurological deterioration due to OPLL progression or kyphotic changes in cervical alignment. This study reports preliminary clinical results of anterior controllable antidisplacement and fusion (ACAF), a novel revision surgery after initial posterior surgery for OPLL.MethodsFrom January 2017 to June 2018, ten patients with cervical OPLL who underwent ACAF revision surgery after initial posterior surgery were included in this study. The mean age was 62.1 ± 8.0 years (52–78), and the mean interval between initial posterior surgery and revision was 78.0 ± 48.2 months (5–180). The Japanese Orthopaedic Association (JOA) scales, Neck Disability Index (NDI), visual analog scale (VAS), and surgical complications were recorded.ResultsThe mean surgery time was 179.3 ± 41.8 min (120–240), and the mean blood loss was 432.5 ± 198.3 ml (225–850). The patients were followed up for at least 12 months. The JOA scores improved from 8.7 ± 2.8 to 13.4 ± 2.4; the mean improvement rate was 59.9% ± 16.1%. Postoperative NDI and VAS scores were 13.3 ± 3.7 and 2.0 ± 1.6, respectively, and were significantly improved compared to those before the procedure (P < 0.05). Cervical lordosis improved from 3.8 ± 4.3° to 17 ± 4.6° after revision surgery. There was only one instance of cerebrospinal fluid (CSF) leakage; no instances of postoperative hematoma, C5 root palsy, or hoarseness occurred.ConclusionsThe present study demonstrates that excellent postoperative outcomes can be achieved with the ACAF technique for revision treatment of OPLL. Though further study is required to confirm the conclusion, this novel technique has the potential to serve as an alternative surgical technique for revision treatment of OPLL.

Taking all these data together, it is suggested that the increased neuroglobin expression could improve the locomotor function.

The menopausal hormone abnormal changes such as estrogen deficiency and increased FSH secretion in female patients in old age may cause osteoporosis which is plagued by patients. The pathogenesis of osteoporosis is not yet fully understood. BMP in the transforming growth factor-β superfamily is a key member in the process of bone growth and development, among which BMP-2 exerts critical roles. Impaired osteogenic differentiation of bone marrow mesenchymal stem cells (BMSC) contributes to the progress of osteoporosis. BMSC plays an indispensable role in treating osteoporosis and can develop into different directions through induction. As the regenerative medicine nanotechnology has become a new medical method, it is believed that BMSC can be used to treat osteoporosis and other related diseases. Our study analyzed the effects of BMP-2/estrogen composite nanoparticles on the proliferation and differentiation of osteoporotic BMSC cells to provide a reliable reference for the future treatment. Our results showed that BMP-2/estrogen composite nanoparticles promoted BMSC cell proliferation, increased ALP activity, decreased apoptosis rate, increased the expression of Col-1, Runx2 and Osterix, upregulated the osteogenic marker BMP-2. As confirmed by Alizarin Red staining, it could differentiate into osteoblasts and the content of Trap was decreased. In conclusion, our study confirms that BMP-2/estrogen composite nanoparticles can promote BMSC cell proliferation, osteogenic differentiation, and inhibit osteoclast differentiation, thereby providing new treatments and theoretical reference basis for treating osteoporosis.

Background: The 3D-print technology has been widely used in the medical field. The purpose of this study is to investigate the advantages of 3D-print model pre-operation for percutaneous kyphoplasty (PKP).Methods: Before the operations of 25 Osteoporotic vertebral body compression fractures (OVCF) cases as the experimental group, and 35 cases of the same disease in the same period were retrospectively selected as the control group without pre-operation. The 3D-print model was made by CT imagine. The puncture point and insertion angle were determined by the pre-operation on that model. The data recorded included data about operation time/fluoroscopy times/Changing channel times and preoperative and postoperative VAS(Visual Analogue Score), JOA(Japanese Orthopedic Association) score, Cobb’s angles.Results: There are significant advantages in the 3D printing group compared with the control group in the time of operation, the number of tunnel changes and the number of perspectives (p<0.05). The postoperative Cobbs angle is significantly improved (p<0.05) in both the short and long term compared with the control group. The recent postoperative VAS score is significantly lower than that in the control group (p<0.05), and there is no significant difference in the long-term postoperative VAS score. There is no significant difference between the two groups of JOA functional score and improvement index.Conclusions: preoperation with 3D-print model can significantly improve the accuracy, reduce the change times of tunnels, shorten the operation time and reduce the number of fluoroscopy. Postoperative pain can be better relieved.