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Expression of CPLX1 in Different Degrees of Spinal Cord Injury in Subacute Stage
Xinhua Xi,
Zhisheng Ji,
Yongzheng Bao,
Xueren Zhong,
Junjian Liao,
Qiang Wu,
Hongsheng Lin
Issue:
Volume 4, Issue 2, December 2020
Pages:
18-21
Received:
18 June 2020
Accepted:
2 July 2020
Published:
6 July 2020
Abstract: This study is to explore the expression of CPLX1 (Complexin 1) in spinal cord tissues with different degrees of injury in the subacute phase of spinal cord injury. Twenty-four SD rats were randomly divided into three experimental groups (light, medium and severe injury) and a sham-operated control group. The experimental group made acute spinal cord injury models according to the lisa method, and the spinal cord tissue were collected 72 hours after injury. The tissues of rats were taken for transcriptome high-throughput sequencing and proteomic analysis experiments to observe the expression of CPLX1 in the different degrees during the subacute phase of spinal cord injury. The mRNA and protein of CPLX1 were detect in rat spinal cord tissue, and they were expressed high in the sham operation group. The protein expression in the light injury group began to decrease, and with the increase of the degree of injury, the transcription level of CPLX1 and the amount of protein expression also gradually decreased. The change trend of mRNA transcription level and protein expression level was basically the same. When the spinal cord injury heavier, the less CPLX1 was expressed, the two showed a significant negative correlation. In the subacute stage of spinal cord injury, the translation and protein levels of CPLX1 decreased significantly. The more severe the injury, the lower the transcription level and protein expression level. CPLX1 may be used as a marker gene for the severity of spinal injury.
Abstract: This study is to explore the expression of CPLX1 (Complexin 1) in spinal cord tissues with different degrees of injury in the subacute phase of spinal cord injury. Twenty-four SD rats were randomly divided into three experimental groups (light, medium and severe injury) and a sham-operated control group. The experimental group made acute spinal cor...
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Treatment Options in Drug Recalcitrant Epilepsy for Physicians: A Brief Introduction to Epilepsy Surgery
Sibhi Ganapathy,
Rajesh Nair
Issue:
Volume 4, Issue 2, December 2020
Pages:
22-33
Received:
13 May 2020
Accepted:
22 June 2020
Published:
28 July 2020
Abstract: Epilepsy surgery has been rapidly progressing over the last decade or so, with many previously untreatable conditions now satisfactorily managed to allow improved quality of life and seizure control without excessive medication and debilitating neurological deficits. We present a brief recap on accepted axioms of epilepsy surgery with a look at the future with a short summary of seizure disorder itself and the various management options. The article is directed at general physicians and Internalists who deal with epilepsy on a daily basis. Many have been exasperated by drug recalcitrant epilepsy and have tried with limited success to manage the condition medically. Many are not aware of the speciality of epilepsy surgery, which as mentioned above has made great strides in seizure control over the last decade. The piece also adds emphasis on diagnosis, seizure semiology and detection along with post procedure analysis and evaluation of efficacy. This has been added to assist the general physician in assessing the disease appropriately and referring the disease correctly to ensure proper diagnosis and treatment early. The authors hope that this piece helps sensitise the physicians to the existence of epilepsy surgery, so that they will refer their patient more and more to neurosurgeons for better care and results to their patients.
Abstract: Epilepsy surgery has been rapidly progressing over the last decade or so, with many previously untreatable conditions now satisfactorily managed to allow improved quality of life and seizure control without excessive medication and debilitating neurological deficits. We present a brief recap on accepted axioms of epilepsy surgery with a look at the...
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Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)
Shafik Tahseen El Molla,
Hisham Anwer,
Hatem Sabry
Issue:
Volume 4, Issue 2, December 2020
Pages:
34-40
Received:
22 June 2020
Accepted:
25 July 2020
Published:
10 August 2020
Abstract: Introduction: Lumbar degenerative diseases (LDD) is considered a common disease. Lumbar pedicular screw fixation and interbody fusion is one of the com¬monly used and effective surgical method in management of single-level lumbar degenerative diseases. Although bilateral pedicular screw (PS) fixation after lumbar interbody fusion is accepted as a standard surgical procedure providing rigid fixation with a great biomechanical stability and clinical benefits, the rigidity of bilateral (PS) fixation can cause device-related osteoporosis of the vertebrae which makes the adjacent segment prone to load and motion-induced degeneration. Therefore, the concept of using less rigid systems of fixation has been advocated. Aim of study: To evaluate effectiveness of unilateral pedicular screws fixation and interbody fusion in unilateral degenerative spine pathology. Patients and methods: This study included 34 patients with single level degenerative lumbar spine disease who were subjected to transforaminal interbody lumbar fusion (TILF) and unilateral transpedicular screws fixation between July 2017 and March 2019 in Ain Shams University hospitals. Results: The study was conducted on 34 patients with age ranging between 32-56 years (mean 45.12±7.80 years). There were 17 male and 17 female in this study. When comparing VAS back pain preoperatively and at postoperative intervals of 1,6 and 12 months, it showed highly significant improvement (P-value 0.000). Also when comparing VAS of leg pain preoperatively and at postoperative intervals of 1,6 and 12 months duration, it showed highly significant improvement (P-value 0.000). ODI preoperatively and at postoperative intervals of 1,6 and 12 months showed also highly significant improvement (P-value 0.000). Regarding the fusion rate, at 6 months postoperative 61.8% (21) of the patients had fusion grade 1,26.5% (9) of the patients had fusion grade 2 and 11.8% (4) of the patients had fusion grade 3. While at 12 months postoperative the percent of grade 1 fusion increased to become 85.3% (29 patients) and the rest were grade 2 fusions (14.7%) with no patients with grade 3 fusion. Conclusion: Unilateral pedicular screws and interbody fusion is a good modality of treatment for unilateral degenerative spine pathology.
Abstract: Introduction: Lumbar degenerative diseases (LDD) is considered a common disease. Lumbar pedicular screw fixation and interbody fusion is one of the com¬monly used and effective surgical method in management of single-level lumbar degenerative diseases. Although bilateral pedicular screw (PS) fixation after lumbar interbody fusion is accepted as a s...
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Direct Thrombin Inhibitors as the Primary Treatment Modality for Cerebral Venous Sinus Thrombosis (CVST)
Abhishek Chaturbedi,
Jitendra Thakur
Issue:
Volume 4, Issue 2, December 2020
Pages:
41-45
Received:
20 July 2020
Accepted:
6 August 2020
Published:
13 August 2020
Abstract: Background: Cerebral venous sinus thrombosis (CVST) is an uncommon entity with improved clinical outcome over time due to utilization of advanced diagnostic tools and effective treatment modalities. Previous treatment regimen pertained to primarily medical therapies, with use of anticoagulants like Coumadin and Heparin. However the advent of Direct Thrombin Inhibitors (DTI) which do not need regular monitoring of blood coagulation panel and has better safety profile than Coumadin, has been suggested as a treatment modality for CVST in recent literature. Case Description: It is a case series of 3 adult patients presenting with intracerebral hemorrhage secondary to CVST from occlusion of dural venous sinuses. Dabigatran, a DTI was used as the primary treatment modality for a period of 6 months for 2 patients who had identifiable underlying cause and lifelong for 1 patient who had no identifiable underlying cause for dural sinus thrombosis. Patients has been followed for a total period of six months while on DTI treatment, with Magnetic Resonance Venography (MRV) of the brain performed at 6 months follow up visit to assess recanalization of the obstructed dural sinuses. All the 3 patients had improved clinical outcome at 6 months follow up visit with no added morbidity upon using DTI. Two patients had complete recanalization of obstructed venous sinuses, while 1 patient had partial recanalization at 6 months follow-up visit. No patient had increased hematoma volume while on treatment with DTI. Conclusion: This case series suggests DTI are probably effective primary treatment modality for patients with CVST with good safety profile.
Abstract: Background: Cerebral venous sinus thrombosis (CVST) is an uncommon entity with improved clinical outcome over time due to utilization of advanced diagnostic tools and effective treatment modalities. Previous treatment regimen pertained to primarily medical therapies, with use of anticoagulants like Coumadin and Heparin. However the advent of Direct...
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Radiological Imaging Analysis of Cervical Expansive Open-door Laminoplasty Causing C5 Palsy
Luo Jianxian,
Liu Dongming,
Chen Tianjun,
Zhang Guowei,
Yang Hua,
Ji Zhisheng,
Lin Hongsheng
Issue:
Volume 4, Issue 2, December 2020
Pages:
46-49
Received:
2 September 2020
Accepted:
11 September 2020
Published:
19 September 2020
Abstract: The aim of this research is to explore the difference of imaging parameters in patients with C5 palsy after cervical expansive open-door laminoplasty. A retrospective analysis was made on the clinical data of 62 patients who were diagnosed as multiple cervical spondylotic myelopathy and operated with cervical expansive open-door laminoplasty using Centerpiece titanium miniplate fixation. According to weather C5 nerve root palsy occurred after surgery, the patients were divided into normal group (group A with 8 cases) and paralysis group (group B with 54 cases). The preoperative and postoperative cervical spine angle (C2–7) enlargement rate of spinal canal, distance of spine cord shifting and cervical curvature between two groups were measured. Compare with group A (27.38±1.99°), the average lamina open angle of group B (34.56±5.55°) was larger, which were found statistically significant difference (P<0.05). In addition, there were no significant differences between two groups in C3 or C7 lamina open angle. However, significant differences were found between two groups in C4, C5 and C6 lamina open angle. The average enlargement rate of spinal canal and distance of spine cord shifting of group B were larger than group A, which was statistically differences (P<0.05). The opening angle of the lamina, the expansion rate of the spinal canal, and the distance of the spinal cord may prevent the occurrence of cervical 5 nerve root palsy in cervical expansive open-door laminoplasty.
Abstract: The aim of this research is to explore the difference of imaging parameters in patients with C5 palsy after cervical expansive open-door laminoplasty. A retrospective analysis was made on the clinical data of 62 patients who were diagnosed as multiple cervical spondylotic myelopathy and operated with cervical expansive open-door laminoplasty using ...
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Minimally Invasive Versus Open TLIF in the Management of Lumbar Spondylolisthesis
Ahmed Nagaty,
Ashraf Yassin Amer,
Ahmed Gamil Hassan,
Ahmed Samir Rady,
Hatem Sabry
Issue:
Volume 4, Issue 2, December 2020
Pages:
50-58
Received:
29 August 2020
Accepted:
28 September 2020
Published:
7 October 2020
Abstract: This study aims to assess the difference between minimal invasive TLIF surgery and conventional TLIF surgery in cases of lytic spondylolisthesis, as regards pain, disability, hospital stay and complications. Lytic Spondylolisthesis patients may require fusion of one or more spinal segments to treat their condition adequately. The chances of achieving a successful lumbar spinal fusion has increased. TLIF technique is gradually being accepted in these cases and widely used by most spine surgeons. Minimal invasive TLIF is a recent trend for spinal fusion. This is a prospective randomized comparative study conducted from March 2016 to December 2018 included forty patients with low grade lytic spondylolisthesis that underwent surgeries. Twenty patients underwent MI-TLIF through percutaneous posterior lumbar pedicular screw fixation, microscopic minimally invasive transformational discectomy and interbody cage fusion (patients group “A”) and another twenty patients underwent traditional open posterior lumbar pedicular screw fixation and TLIF (control group “B”). In our results, both surgical techniques showed improvement in pain and function within 12 months (follow up period), but group A showed statistically significant improvement in pain and function in the 1st three months. Regarding blood loss, need for transfusion and hospital stay, group A showed statistically significant better results. As a conclusion, minimally invasive TLIF is a better option in surgical management of spondylolisthesis especially in the early postoperative period.
Abstract: This study aims to assess the difference between minimal invasive TLIF surgery and conventional TLIF surgery in cases of lytic spondylolisthesis, as regards pain, disability, hospital stay and complications. Lytic Spondylolisthesis patients may require fusion of one or more spinal segments to treat their condition adequately. The chances of achievi...
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Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report
Basavaraj Tulajappa Badadal,
Viraja Nimmagadda,
Mallanna Mulimani,
Mamatha Karigar,
Savitri Nerune,
Firos Khan
Issue:
Volume 4, Issue 2, December 2020
Pages:
59-62
Received:
29 August 2020
Accepted:
24 October 2020
Published:
23 November 2020
Abstract: Mucormycosis is an invasive fungal infection caused by fungi of Mucoraceae family in immunocompromised individuals. CNS (Central Nervous System) Mucormycosis commonly arises from an adjacent para nasal sinus infection (Rhino cerebral), but isolated CNS Mucormycosis is a rare presentation as in our case. Presented as raised intra cranial pressure and no focal neurological deficit on evaluation found to have left temporal space occupying lesion with significant mass effect looking like high grade glioma. Operated on emergency basis, histopathology suggestive of invasive fungal infection managed accordingly. Results: As per literature primary CNS Mucormycosis has high mortality and morbidity even after best possible management. Our case was managed as per treatment protocol and after discharge patient got readmitted with surgical site infection and uncontrolled blood sugars and worsened medical condition, and finally died due to cardiac event after 28 days of diagnosis. Conclusion: Mucormycosis is an aggressive infection which can cause significant morbidity and mortality, thus needs high index of suspicion for early diagnosis and treatment.
Abstract: Mucormycosis is an invasive fungal infection caused by fungi of Mucoraceae family in immunocompromised individuals. CNS (Central Nervous System) Mucormycosis commonly arises from an adjacent para nasal sinus infection (Rhino cerebral), but isolated CNS Mucormycosis is a rare presentation as in our case. Presented as raised intra cranial pressure an...
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Scoliosis Correction Surgery for a Patient with Marfan Syndrome with Severe Scoliosis and Restricted Lung Ventilation
Liu Dongming,
Xiong Tingliang,
Zhang Ziqi,
Wang Xiaochen,
Zhang Guowei,
Yang Hua,
Ji Zhisheng,
Lin Hongsheng
Issue:
Volume 4, Issue 2, December 2020
Pages:
63-67
Received:
1 December 2020
Accepted:
14 December 2020
Published:
25 December 2020
Abstract: Objective: Marfan syndrome is a multi-system disease caused by genetic mutations that can cause damage to multiple systems in the body. With the development of the disease, the scoliosis of patients with Marfan syndrome will be further aggravated, which will eventually seriously affect the patient's cardiopulmonary function and lead to a serious decline in the patient's quality of life. The aim is to summarize the experience of spinal orthopedic surgery in a patient with Marfan syndrome and severe scoliosis with limited pulmonary ventilation. Method: In November 2019, a 13-year-old male with Marfan syndrome with severe scoliosis and restricted lung ventilation was admitted. The full-length positive and lateral X-rays of the spine before the operation showed that the spine was S-shaped scoliosis, double thoracic curve (thoracic curve + lumbar curve), upper vertebrae T4, lower vertebrae T11, thoracic T4-T11 structural curve, thoracic Cobb angle of bend is 42.4°, the lumbar bend is compensatory, Cobb angle of lumbar bend is 33.2° The lung function indicates that the forced end-expiratory volume/forced vital capacity (FEV1/FVC) in the first second is 70%. "Scoliosis correction + interlaminar bone graft fusion + posterior T4-T11 pedicle screw fixation" was performed on the patient under general anesthesia with tracheal intubation. Result: The full-length positive and lateral X-rays of the spine at 1 week, 1 month, 3 months, and 1 year after surgery showed that the internal fixation position was good, and the Cobb angle remained basically unchanged. There was basically no change in the Cobb angle of the thoracic curve (10.2°, 10.8°, 10.9°, 10.5°, respectively) and the Cobb angle of the lumbar curve (13.1°, 13.6°, 13.8°, 13.9, respectively) at each follow-up time point after surgery. The lung function at 1 year after surgery suggested that FEV1/FVC was 80%. No sensorimotor abnormalities and other complications occurred during the follow-up. Conclusion: Scoliosis correction surgery is feasible and safe for patients with Marfan syndrome combined with severe scoliosis deformity and restricted lung ventilation. It can improve the patient's appearance, at the same time improve the patient's cardiopulmonary function, and solve the problem of the continued increase in the number of cobb angles of scoliosis. Surgery improves the quality of life of patients as a whole.
Abstract: Objective: Marfan syndrome is a multi-system disease caused by genetic mutations that can cause damage to multiple systems in the body. With the development of the disease, the scoliosis of patients with Marfan syndrome will be further aggravated, which will eventually seriously affect the patient's cardiopulmonary function and lead to a serious de...
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