Anterior cervical plating has been widely used to treat cervical spine trauma, degeneration, deformity and tumor due to the advantages such as augmentation of cervical stability and promotion of bone graft fusion. This paper introduced the classification and evolution of plate-screw internal fixation system, analyzed the biomechanics of anterior cervical plate, and discussed its clinical application. Although the therapeutic effect of anterior cervical plating is favorable, there are still various complications postoperatively. Therefore, it is necessary to improve the anterior cervical plate from different aspects to expand its clinical application.

Objective To quantify the morphometric characteristics of the pedicles of the infantile thoracolumbar spine and to determine the feasibility and safety of pedicle screw fixation in very young children. Methods A total of 52 patients younger than three years of age underwent standard spiral computed tomography (CT) were enrolled in this study. The patients were grouped according to age, group 1 (0 ～ 18months of age) and group 2 (18 ～ 36 months of age). Images were reformatted, and multiplanar reconstructions were used to attain images of thoracic and lumbar pedicles on sagittal, coronal and transverse planes.The measurements included the inner and outer pedicle diameters on the transverse plane, pedicle sagittal diameter, pedicle length and the pedicle angle on the transverse. Characteristics of the pedicles of the immature thoracic and lumbar spine were studied. Results Pedicle diameters on the transverse plane decreased gradually from T1 to T5 and increased gradually from T6 to L5. The shortest transverse diameter of the thoracic pedicle was T5 or T6. The inner diameter of the segment of L4 in infant (younger than eighteen months) was less than 3.0 mm and the external diameter less than 3.5 mm from T3 to T9. The inner diameter of the segment from T5 to T8 in infant (more than eighteen months) was less than 3.0 mm and the external diameter from T4 to T7 was less than 3.5 mm. The sagittal diameter was significantly more than the transverse diameter. Pedicle diameters on the transverse plane, the sagittal diameter, and the length of the pedicle changed significantly with age, but the pedicle angle did not changed significantly with age. Conclusions The pedicles in the segment from T3 to T9 of less than eighteen months and from T4 to T7 of more than eighteen months were too small, there was no feasibility and safety of pedicle screw fixation. So pedicle screw fixation was feasible and safe for below T9 segment in the infants who are younger than three years old.

OBJECTIVE: To investigate the clinical characteristics, diagnostic foundation and treatment of vertebral sarcoidosis. METHODS: The clinical data of 13 patients with vertebral sarcoidosis who received anterior debridement and instrumentation were retrospectively analyzed. RESULTS: The onset of progressive pain in the pathological region was common in the 13 patients. Neurologic deficit existed in 4 cases. Radiographic study showed multiple vertebral bone destructions, and no other systemic lesions were found. Surgical indications were progressive vertebral destruction, spinal instability or neurological deficit. Anterior vertebra resection, and autologous bone grafts fusion with internal fixation were done. No operative mortality and major complications occurred. Diagnosis was confirmed in all patients by pathological exam. After the surgery, metacortandracin treatment was given routinely for 1 year. Patients were followed up for 12-52 (median 26) months, and pain and neurological symptoms were alleviated. Visual analog scale (VAS) score was 7-10 (median 8) points preoperatively, which dropped to 0-4 (median 2) points postoperatively. All patients showed successful bone fusion with no recurrence. CONCLUSION For vertebral sarcoidosis associated with progressive instability and/or neurological symptoms, surgical intervention combined with steroid therapy is safe and effective.
Adolescent ; Adult ; Female ; Humans ; Ilium ; transplantation ; Infusions, Spinal ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Retrospective Studies ; Sarcoidosis ; surgery ; Spinal Diseases ; surgery ; Young Adult

OBJECTIVE: To establish a proper animal model of pyogenic spondylitis, to evaluate the efficacy of silver nanoparticles for treatment of spinal pyogenic infections, and to explore the distribution of the particles in the body of the animals. METHODS: Staphylococcus aureus was inoculated into intervertebral discs of rabbits to establish a spinal pyogenic infection model. These rabbits were divided into Group A [0.1 mg/(kg.d)], Group B [1 mg/(kg.d)], and a Control group. Groups A and B were injected with different doses of silver nanoparticles solution daily at locally infected side. Two weeks later, bacterial cultures, radiographic outcomes, histopathology were analyzed. Atomic absorption spectrometry was utilized to measure silver contents in some vital organs of the rabbits to detect the distribution and accumulation of silver particles. RESULTS: Staphylococcus aureus (100 CFU/mL), induced 100% pyogenic spondylitis. 1 mg/kg dose of silver nanoparticles solution could effectively inhibit the occurrence of spinal pyogenic infection with the effective rate of 75%. While the effect of 0.1 mg/kg dose of silver nanoparticles solution was less obvious, the efficiency was only 25%. Significant numbers of silver nanoparticles were observed to accumulate in the animal. In the 1 mg/kg group silver was deposited mainly in the spinal cord, liver, kidneys, spleen, and testicles, while in the 0.1 mg/kg group it accumulated only in the spinal cord. CONCLUSION Local administration of silver nanoparticles can effectively prevent and treat pyogenic spondylitis; the particles accumulate in the body commensurate with the administered drug concentration.
Animals ; Infusions, Intralesional ; Lumbar Vertebrae ; Male ; Metal Nanoparticles ; administration & dosage ; Rabbits ; Silver ; administration & dosage ; pharmacology ; Spondylitis ; drug therapy ; microbiology ; Staphylococcal Infections ; drug therapy