Objective. The purpose of this study is to make a systematic review of the therapeutic effect of stem cells in animal models of disc degeneration from an imaging point of view. Methods. Data were extracted by searching electronic databases for RCTs that met the inclusion criteria. Data analysis was performed using RevMan 5.3 and STATA 15.1 software. This meta-analysis was registered with INPLASY, registration number INPLASY202240148. Results. A total of 34 studies were included, covering four species of animals, rabbits, sheep, rats, and mice, with a total of 1163 intervertebral discs. In terms of DHI, the efficacy of stem cell group in rabbits ( P < 0.001 ), mice ( P < 0.001 ), sheep ( P < 0.001 ), and rats ( P = 0.001 ) was better than that in control group. In terms of disc height, the efficacy of stem cell group in rats ( P < 0.001 ) was better than that in control group, while in sheep ( P = 0.355 ), there was no statistical difference between two groups. In terms of MRI index, the efficacy of stem cell group in rats ( P < 0.001 ), mice ( P < 0.001 ), and rabbits ( P = 0.016 ) was better than that in control group. In terms of MRI signal score, the efficacy of stem cell group in rabbits ( P < 0.001 ) was better than that of control group. In terms of T2 signal intensity, stem cell group was more effective than control group in rabbits ( P < 0.001 ), mice ( P < 0.001 ), and rats ( P = 0.003 ).Conclusion. Stem cell therapy can improve intervertebral disc-related imaging parameters in animal models of disc degeneration, indicating that stem cell therapy has a repairing effect on intervertebral discs. However, given the heterogeneity and limitations of this study, this conclusion still needs to be tested by a large number of studies.
Background Rigid fixation, represented by titanium rods, is a widely used fixation technique for lumbar fusion. However, this technique carries the risk of degeneration of adjacent segments. In recent years, the semi-rigid fixation technique represented by PEEK rods has gradually matured, and its effectiveness has been verified by numerous studies. The aim of this study was to systematically evaluate the effectiveness of these two fixation modalities in posterior lumbar fusion surgery. Methods Studies meeting the inclusion criteria were searched in PubMed, Cochrane Library, ScienceDirect, Embase, CNKI, and Wanfang databases. After data extraction and quality assessment of included studies, meta-analysis was performed using STATA 15.1 software. The protocol for this systematic review was registered on INPLASY (2021110049) and is available in full on the inplasy.com (https://inplasy.com/inplasy-2021-11-0049/). Results Fifteen relevant studies were finally included, including eight prospective studies and seven retrospective studies. The results of meta-analysis showed that in ODI (P = 0.000), JOA score (P = 0.017), VAS score for lower limb pain (P = 0.027), fusion rate of bone graft at week 12 (P = 0.001), fusion rate of bone graft at last follow-up (P = 0.028), there was a statistical difference between the two groups. The PEEK rod group was superior to the titanium rod group in the above aspects. While in VAS score for LBP (P = 0.396), there was no statistical difference between the two groups. Conclusion Both PEEK rods and titanium rods are effective fixation materials in lumbar fusion surgery. PEEK rods may be superior to titanium rods in improving postoperative function and improving bone graft fusion rates. However, given the limitations of this study, whether these conclusions are applicable needs further research.
Background Degenerative lumbar scoliosis (DLS) is a common degenerative disease of the spine, that predominates in the elderly, and causes spinal deformities along with severe pain and reduced quality of life. The relationship between DLS and degenerated discs is now a new direction of research. Our study aimed to the relationship between the imaging parameters of coronal imbalance and the number of degenerated discs in patients with degenerative lumbar scoliosis and analyzed the segmental distribution of the degenerated discs in patients with DLS. Methods We performed a retrospective analysis of the imaging of 40 patients who met the inclusion criteria who attended our outpatient clinic between April 2021 and July 2021, measuring the intervertebral space height of the AV (high side and low side), Cobb angle, and AVT (Apical vertebral translation) from coronal X-ray. Degenerated discs were evaluated by the Pfirrmann score based on T2-weighted magnetic resonance images. We record the number of degenerated discs (Graded as Grade III, Grade IV or Grade V by the Pfirrmann score) and the segments in which they are located. Finally, we explore the relationship between the imaging parameters of coronal imbalance and the number of degenerated discs in patients with DLS. Result Among the 40 patients with DLS in our study, all patients had degenerated discs in the lumbar spine, 95% of patients had degenerated discs(Pfirrmann score Grade III, Grade IV or Grade V) in 2 or more segments, with the L4-L5 segment being the most involved segment with the most degenerated discs, followed by the L3-L4 segment and the L5-S1 segment. There was no statistically significant relationship between the number of degenerated discs and the coronal imbalance in patients with DLS. Conclusion Our results showed an association between DLS and degenerated discs, but there was no statistically significant relationship between imbalance in the coronal plane of the lumbar spine and the number of degenerated discs in patients with DLS. The distribution of degenerated disc segments in patients with DLS showed a higher likelihood of disc degeneration in 2 or more segments, and a higher frequency of disc degeneration in the inferior disc and in the adjacent segments of the AV.
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