OBJECTIVETo observe the effect of Chinese herbal medicine Qianggu drink ([Chinese characters: see text]) on bone histomorphometry of lumbar vertebrae in ovariectomized rats and to explore its mechanism.

METHODSSixty female SD rats (weight 230 to 280 gram) were randomized into three groups: Qianggu drink ([Chinese characters: see text]) group (treatment group), Miacalcic group (control group) and blank group. The osteoporosis model was established successfully after all rats were ovariectomized for 10 weeks. The treatment group was used intragastric infusion with Qianggu drink ([Chinese characters: see text]) 0.001 ml/kg once a day. The control group was used hypodermic injection once a day with Miacalcic 0.72 U/kg. Five rats were killed respectively and the lumbar specimens were taken and cut for bone histomorphometric analysis at 45, 90, 135 and 180 days after the treatment.

RESULTSThe thickness of trabecular bone in treatment group had the statistical significance with control group at 135 days after ovariectomized rats were given the medicine. The data of BV/TV and the thickness and space of trabecular bone had statistical significance compared with control group and blank group 180 days later.

CONCLUSIONQianggu drink ([Chinese characters: see text]) could effectively improve the histomorphometry indexes. The mechanism probably plays by stimulating osteogenesis and inhibiting the cytoactive of osteoclast and the trend of bone transform.

Animals ; Female ; Humans ; Lumbar Vertebrae ; drug effects ; pathology ; Osteoporosis, Postmenopausal ; drug therapy ; Ovariectomy ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the clinical effects of Simo Decoction Oral Liquid for the treatment of gastrointestinal dysfunction after stable thoracolumbar fractures.

METHODSFrom May 2005 to July 2008, 81 patients with stable thoracolumbar fractures were randomly divided into treatment group (41 cases) and control group (40 cases) according to a random digits table. The treatment group included 32 males and 9 females with an average age of (47.19 +/- 5.18) years old ranging from 21 to 55 years, and the course was from 1 to 45 hours with an average of (7.83 +/- 1.29) hours. The control group included 30 males and 10 females with an average age of (46.31 +/- 3.72) years ranging from 20 to 54 years,and the course was from 1.5 to 43 hours with an average of (8.15 +/- 1.63) hours. The treatment group were dealed with Simo Decoction Oral Liquid,and the control group with neostigmine for acupoint block in bilateral Foot-Three-Li. The recovery of gastrointestinal function and the first passage of gas by anus were compared.

RESULTSThe time of recovery of gastrointestinal function in treatment group (7.27 +/- 3.14) h was shorter than that in control group (10.12 +/- 3.62) h. The time of first passage of gas by anus in treatment group (15.39 +/- 13.70) h was significantly shorter than that in contral group (24.02 +/- 18.11) h. The total effective rate in treatment group was higher than that in control group.

CONCLUSIONBoth the treatment group and the control group have clinical effects in treatment of the restoration of gastrointestinal dysfunction after the stable thoracolumbar fractures, but the treatment group has more remarkable therapeutic effect and less side effects.

Adult ; Female ; Gastrointestinal Diseases ; drug therapy ; Gastrointestinal Motility ; drug effects ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Spinal Fractures ; complications ; Thoracic Vertebrae ; injuries

OBJECTIVETo investigate sex hormone deficiency related osteoporosis and efficacy of different therapies.

METHODSOrchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. A rat vertebral body can be longitudinally divided into central portion, which contain more trabecular bone, and para-endplate portions which contain more compact bone. In matured male and female Wistar and Sprague-Dawley rat lumbar spines, we investigated baseline bone mineral density (BMD) characteristics and the differential segmental responses in bone loss within the lumbar vertebral body post gonadal surgery with clinical multidetector computed tomography.

RESULTSPara-endplate sections had a higher BMD than central sections. The cephalad para-endplate sections had a higher BMD than the caudad para-endplate sections. Eight weeks after gonadal removal, there was more bone loss in central sections than para-endplate sections. The relative difference of bone loss between para-endplate and central sections was more apparent in male rats than in female rats. There was more bone loss in caudad sections than cephalad sections; this lead to a further increase of BMD difference between caudad para-endplate sections and cephalad para-endplate sections post gonadal surgery.

CONCLUSIONThe approach described in this study provided a consistent way to study BMD change within predominantly compact bone portion and trabecular bone portion of the vertebral body.

Animals ; Bone Density ; drug effects ; Female ; Gonadal Steroid Hormones ; deficiency ; metabolism ; Lumbar Vertebrae ; physiology ; Male ; Orchiectomy ; Ovariectomy ; Rats ; Sex Factors

PURPOSE: Changes in human body composition can affect the accuracy of spine bone mineral density (BMD) measurements. The purpose of this study was to evaluate whether fat and water in the soft tissue of the abdomen influence lumbar spine BMD measurements obtained using dual energy X-ray absorptiometry (DXA). MATERIALS AND METHODS: Duplicate BMD measurements were carried out on healthy volunteers (10 men and 10 women) and the Hologic anthropomorphic spine phantom had on the same day before and after placement of following 3 materials in the abdominal area: lard 900 g, 1.5 cm thick; oil 1.4 liters in a vinyl bag; and water 1.2 liters in a vinyl bag. RESULTS: In the case of human participants, following the placement of exogenous water to mimic extracellular fluid (ECF), there was a significant decrease in lumbar spine BMD (-0.012 g/cm2, p=0.006), whereas the placement of exogenous lard and oil to mimic abdominal fat produced a slight increase in lumbar spine BMD (0.006 g/cm2, p=0.301; 0.008 g/cm2, p=0.250, respectively). The average percentage of lumbar spine BMD change with and without exogenous lard, oil, and water showed increase of 0.51%, and 0.67%, and decrease of 1.02%, respectively. Using the phantom, BMD decreased with the placement of both lard (-0.002 g/cm2, p=0.699) and water (-0.006 g/cm2, p=0.153); however, there was no difference in BMD after oil placement. CONCLUSION: These results suggest that in cases where changes in fat and ECF volume are similar, ECF exerts a greater influence than fat on DXA lumbar BMD measurements.
Absorptiometry, Photon ; Adult ; Bone Density/*drug effects ; Dietary Fats/pharmacology ; Fats/*pharmacology ; Female ; Humans ; Lumbar Vertebrae/*drug effects/*metabolism ; Male ; Water/*pharmacology

OBJECTIVETo evaluate the effects of alendronate on the structural properties of trabecular bone.

METHODSAlendronate was administered at a daily p.o. dose of 0.5 mg/kg over a 12-week period in hound dogs (n = 8 for both the control and treated group), and the structural indices of the lumbar vertebral (L1 and L2) trabecular bone were assessed directly from 3-D images.

RESULTSTreatment with alendronate increased bone volume fraction by 9.5% and 7.7% in L1 and L2 respectively. Trabecular thickness significantly increased after alendronate treatment, whereas trabecular separation remained constant. The degree of anisotropy for the alendronate-treated group was decreased compared with that of the control group. Bone surface to volume ratio declined significantly in the alendronate-treated group, whereas alendronate induced a higher bone surface density.

CONCLUSIONAlendronate increased the structural properties of canine trabecular bone after short-term treatment at a dose of 0.5 mg x k(-1) x day(-1).

Alendronate ; pharmacology ; Animals ; Anisotropy ; Biometry ; methods ; Bone Density ; Bone and Bones ; anatomy & histology ; drug effects ; Dogs ; Female ; Lumbar Vertebrae ; anatomy & histology ; drug effects

OBJECTIVETo evaluate the influence and safety of denosumab on bone mineral density (BMD) of lumbar spine in women with low bone mass.

METHODSThe clinical literatures concerning denosumab for the treatment of osteopenia or osteoporosis in women were searched from Medline, Embase, Cochrane Central Register of Controlled Trials, Wanfang database, China National Knowledge Infrastructure database, Chinese Biomedical Database. Randomized controlled trials (RCT) were selected by the inclusive and exclusive criteria. The jadad scale was used in the quality assessment of included studies. Meta-analysis of valid data picked from included studies was performed by RevMan 5.0.24 software.

RESULTS5 RCT were included in this meta-analysis. The results of meta-analysis using the fixed effects model showed that, the increase level of lumbar BMD after 12 month was 5.45% (95% CI, 5.05%~5.84%) higher in denosumab group than in placebo control group (P<0.00001). The serious adverse event, serious infection event and pack pain occurred during the followed-up were analysed using fixed effects model. The results showed no significant difference between two groups.

CONCLUSIONCompared with placebo control group, denosumab can significant increase the BMD of lumbar spine, and the safety of two groups is similar.

Antibodies, Monoclonal, Humanized ; adverse effects ; pharmacology ; Bone Density ; drug effects ; Bone Density Conservation Agents ; adverse effects ; pharmacology ; Denosumab ; Female ; Humans ; Lumbar Vertebrae ; Randomized Controlled Trials as Topic

OBJECTIVETo explore the differences between conservative and surgical treatment for thoracic and lumbar spine tuberculosis on indications and clinical results.

METHODSFrom May 2000 to June 2008, 162 cases of thoracic spinal tuberculosis patients were studied retrospectively, including 89 males and 73 females, aged from 4 to 71 years (means 43.6 years). Among them, 38 cases of onset time was short, X-ray showed a narrow cone gap and MRI showed vertebral body signal changes, the ones who had better general condition were applicated of anti-TB drugs [6HREZ (S)/6-9HRE] and traditional Chinese medicine dialectical; 51 cases with thick swollen and vertebral body marginal damage but not affect the stability of spine, were treated with spinal tuberculosis debridement surgery; 73 cases with abscess, vertebral destruction of center, spinal instability or spinal cord function associated with damage to persons, were treated with surgical debridement and interbody bone grafting and fixation. Clinical observation were evaluated according to the standard cure for bone tuberculosis.

RESULTSThirty-eight cases by conservative treatment, had been cured in 1 to 2 years. Focus of infection cleared in 51 cases, 3 cases occurrenced the sinus next to incision, 4 cases of kyphosis angle (Cobb) lost 5 degrees-10 degrees compared with that before treatment (means 4.5 degrees). Seventy-three cases by internal fixation obtained neurological deficiency symptoms recovery; 2 occurenced the sinus next to the incision, 3 cases appeared subcutaneous emphysema of iliac area and local pain, but need no special treatment. A total of 136 patients were followed-up from 12 to 60 months with an average of 32.8 months, and had been all clinically cured.

CONCLUSIONPatients with early detection only on the imaging showing vertebral lesions, without obvious sequestrum, abscesses, can be selected for conservative anti-tuberculosis treatment. Patients combined with abscess, vertebral destruction on light degree and not affected the stability of the spine, can be removed by simple surgery to obtain better efficacy. Patients with abscesses, sequestrum, spinal vertebral instability leading to heavy damage associated with spinal cord or nerve function impairment,will need surgical removal of lesions of tuberculosis, give graft and spinal fixation at the same time.

Adolescent ; Adult ; Aged ; Antitubercular Agents ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Lumbar Vertebrae ; drug effects ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Thoracic Vertebrae ; drug effects ; surgery ; Treatment Outcome ; Tuberculosis, Spinal ; drug therapy ; surgery ; Young Adult

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Injections ; Intervertebral Disc Displacement ; drug therapy ; Lumbar Vertebrae ; drug effects ; Male ; Middle Aged ; Ozone ; administration & dosage

Glucocorticosteroid-induced osteoporosis is the most frequent of all secondary types of osteoporosis, and can increase the risk of vertebral compression fractures (VCFs). There are promising additions to current medical treatment for appropriately selected osteoporotic patients. Few studies have reported on the efficiency of percutaneous vertebroplasty (PVP) or kyphoplasty for whole thoracic and lumbar glucocorticosteroid-induced osteoporotic vertebral compression fractures. We report a case of a 67-year-old man with intractable pain caused by successional VCFs treated by PVP.
Aged ; Arthritis, Rheumatoid/drug therapy ; Fractures, Compression/*radiography ; Glucocorticoids/*adverse effects/therapeutic use ; Humans ; Kyphoplasty ; Lumbar Vertebrae/radiography/surgery ; Male ; Osteoporosis/*chemically induced/radiography/surgery ; Pulmonary Fibrosis/drug therapy ; Thoracic Vertebrae/radiography/surgery ; Vertebroplasty

OBJECTIVETo explore the surgical measurements and principles in the treatment of thoracic and thoracolumbar spinal tuberculosis.

METHODSFrom 2001 to 2008, 232 cases of thoracic or thoracolumbar spinal tuberculosis were treated by operations in the study, including 148 males and 84 females with an average age of 37.8 years ranging from 20 to 76 years. Preoperative assessment displayed as follow: Cobb angles of kyphosis < 30 degrees in 65 cases, 30 degrees to 60 degrees in 147 cases, > 60 degrees in 20 cases; Frankel B grade in 13 cases, C in 12 cases, D in 41 cases, E in 166 cases. Among them, 48 cases were performed with one-stage transpedicular screw system and anterolateral debridement by single incision, 184 cases with one-stage anterior approach (debridement, fusion, and plate-screw fixation) routinely. The tissues and liquor puris debrided from focus were sent for pathological examination, Bacillus tuberculosis detection and culture, and drug sensitivity test. The patients were given anti-tuberculosis therapy according the results of drug sensitivity test for 1 to 1.5 years. The followed-up included relapse rate, fusion of the bone graft, the status of neurological restoring, kyphosis correction etc.

RESULTSAll 232 cases recovered from perioperation and 230 cases got primary wound healing, only 2 cases performed with single incision one-stage posterior instrumentation and anterolateral debridement got complications of wound healing problems and the sinus formation,which delayed healed by changing dressings. The complications included intercostals neuralgia in 135 cases and pneumothorax or hydrothorax in 13 cases, which needed not special handling. All the patients in this series got the followed-up ranging from 1.0 to 4.5 years (means 2.6 years). No recurrence within followed-up period and bone union was found in all cases. All 66 cases with the neurological deficits recovered partially or totally. Kyphosis correction were achieved by 27.5 degrees on average postoperatively and showed a mild loss of 4.2 degrees on average during followed-up period. All cases were confirmed with Bacillus tuberculosis infection by pathology. Bacillus tuberculosis was detected and culture successfully in 107 cases (46.1%), 40 strains (37.4%) were drug resistant and in which 8 strains (7.5%) were multi-drug resistant.

CONCLUSIONFor the treatment of thoracic and thoracolumbar spinal tuberculosis, the best treatment include directional chemotherapy, one-stage anterior approach with thorough debridement, auto-rib or Ti-mesh fusion, and plate-screw fixation.

Adult ; Aged ; Antitubercular Agents ; therapeutic use ; Female ; Humans ; Lumbar Vertebrae ; microbiology ; surgery ; Male ; Middle Aged ; Mycobacterium ; drug effects ; genetics ; isolation & purification ; Thoracic Vertebrae ; microbiology ; surgery ; Tuberculosis, Spinal ; drug therapy ; microbiology ; surgery ; Young Adult