The population aging and the coming of the information era are accompanied with the growing incidence of spinal degenerative diseases, which result in heavy social and economic burdens. Under the guidance of the tendon-bone theory, rich experience has been accumulated in the prevention and diagnosis of spinal degenerative diseases with traditional Chinese medicine(TCM), which demonstrates unique advantages. China's government has placed people's health in the strategic position of development, providing a favorable environment for the realization of healthy aging. The Healthy China 2030 advocates special actions for healthy bones. As China is facing an important period of demographic transition, the Traditional Chinese Medicine for Bone Health Program has emerged, combining the needs of the national health strategy and the advantages of TCM. This paper discusses the background and significance of the program. According to the theory of five body constituents and the characteristics of musculoskeletal system diseases, this paper constructs a theoretical system of "tendon-meridian-muscle-bone-marrow" to explain the structure and function of the musculoskeletal system. From the holistic view of TCM, this system shows not only the structure and function of the musculoskeletal system but also the patterns of disease development and the mechanism of TCM treatment. The system facilitates the research on not only the comorbidities related to bone health but also the occurrence, development, and outcome of diseases. In the management of chronic degenerative diseases, attention should be paid to the establishment and improvement of the disease prevention and control system in addition to the disease treatment alone. Finally, this paper introduces the characteristic advantages of TCM in the whole process of prevention, diagnosis, treatment, rehabilitation, and health maintenance of spinal degenerative diseases, aiming to enrich the connotation of the tendon-bone theory, provide ideas and implementation strategies for TCM clinical practice, and ultimately achieve the effective management of the diagnosis and treatment of spinal degenerative diseases.
Humans ; Medicine, Chinese Traditional ; Spinal Diseases/prevention & control* ; Drugs, Chinese Herbal/therapeutic use* ; China ; Bone and Bones/drug effects*

OBJECTIVE: To review the application status, clinical advantages, and complications of unilateral biportal endoscopy (UBE) technique and explore its future development direction. METHODS: By reviewing recent domestic and international literature, the evolution history of UBE technique, its surgical advantages, and its application effectiveness in various spinal diseases were analyzed, providing a comprehensive review. RESULTS: UBE technique, with its unique dual-channel design, provides a clearer surgical field and more flexible operating space, significantly reduces surgical trauma and postoperative recovery time. UBE technique has demonstrated high safety and effectiveness in the treatment of lumbar disc herniation, spinal stenosis, lumbar instability, and cervical spondylosis. Additionally, the complication incidence of UBE surgery is lower than that of traditional open surgery. CONCLUSION In recent years, UBE technique has shown good clinical application prospects and efficacy, but further technical optimization and large-scale clinical research are still needed to ensure the safety and effectiveness. In the future, the combination of UBE technique and intelligent medical and surgical robotics technology is expected to promote the further development of spinal surgery.
Humans ; Endoscopy/methods* ; Spinal Stenosis/surgery* ; Intervertebral Disc Displacement/surgery* ; Spinal Diseases/surgery* ; Postoperative Complications/prevention & control* ; Lumbar Vertebrae/surgery* ; Treatment Outcome ; Spondylosis/surgery* ; Laparoscopy/methods*

In this article, the annual reports of the Korean Nosocomial Infections Surveillance System (KONIS) were referred for the description of the current status of healthcare-associated infections (HAI) in Korea. KONIS has been established with the cooperation of the Korean Society for Nosocomial Infection Control and the Korea Centers for Disease Control and Prevention since 2006. The KONIS surveillance of healthcare-associated infections at intensive care units (ICU) and surgical site infections was performed by 116 ICUs of 63 hospitals in 2009. According to the 2010 report of KONIS, the infection rate per 1,000 patient-days in ICU is 7.65. The device-associated infection rates of bloodstream infection, urinary tract infection, and pneumonia are 3.27, 4.80, and 1.86, respectively. Surgical site infection (SSI) rates of gastric surgery, colon surgery, rectal surgery, craniotomy, ventricular shunt and spinal fusion are 3.3%, 4.7%, 5.8%, 3.6%, 5.1% and 3.9%, respectively. The SSI rates of gastrectomy and knee prosthesis are over 90 percentiles of the data of National Healthcare Safety Network, USA. In conclusion, the current healthcare-associated infection rates are higher than those of other developed countries. Through the harmonized communication of various specialists such as infectious diseases physicians, clinical microbiologists, and infection control nurses, the HAI should be monitored and prevented.
Centers for Disease Control and Prevention (U.S.) ; Colon ; Communicable Diseases ; Craniotomy ; Cross Infection ; Delivery of Health Care ; Developed Countries ; Gastrectomy ; Infection Control ; Intensive Care Units ; Knee Prosthesis ; Korea ; Pneumonia ; Specialization ; Spinal Fusion ; Surgical Wound Infection ; Urinary Tract Infections

OBJECTIVETo investigate the effects of sufentanil pretreatment on acute gastric mucosal lesion and its impact on the expression of acid-sensing ion channel 3 (ASIC3) in thoracic dorsal root ganglia (DRG) neurons in rats with water immersion-restraint stress (WIRS).

METHODSTwenty-four Wistar rats were randomly assigned into 3 groups, namely the normal control group (n=6), WIRS group (n=12) and sufentanil pretreatment group (n=6). Gastric mucosal lesion was induced by WIRS, and after 6 h of WIRS, the gastric tissues were excised and observed under microscope, with the ulcer index (UI) calculated. The expression of ASIC3 in the DRG neurons was detected by immunofluorescence assay, and the ASIC3 mRNA expression by quantitative real-time RT-PCR.

RESULTSCompared with the normal control group, the rats in the WIRS group showed obvious gastric injury with increased UI and extensive expression of ASIC3 in the DRG neurons. Sufentanil pretreatment of the rats subjected to WIRS significantly alleviated the gastric mucosal injury, lowered the UI, and reduced ASIC3 mRNA expression in thoracic DRG neurons.

CONCLUSIONASIC3 is involved in the development of acute gastric mucosal lesion, and sufentanil pretreatment offers protection of gastric mucosa by inhibiting the expression of ASIC3.

Acid Sensing Ion Channels ; Animals ; Ganglia, Spinal ; metabolism ; Male ; Nerve Tissue Proteins ; metabolism ; Protective Agents ; pharmacology ; Random Allocation ; Rats ; Rats, Wistar ; Restraint, Physical ; adverse effects ; Sodium Channels ; metabolism ; Stomach Diseases ; etiology ; prevention & control ; Stress, Physiological ; Sufentanil ; pharmacology

Spinal instrumentation is a common method for the treatment of spinal disorders, but it can lead to the changes of spine biomechanics. Because of the stress changes, accelerated degeneration of the adjacent segment may occur as time goes by, namely adjacent segment disease. The accelerated degeneration can lead to secondary spinal stenosis, articulated joint degeneration, acquired spondylolisthesis, and spine instability, and some patients may have to receive surgery again. In recent years, the researchers gradually recognized the importance of this disease, and began to investigate its pathogenesis and management.
Humans ; Joint Instability ; etiology ; prevention & control ; Postoperative Complications ; diagnosis ; prevention & control ; Spinal Diseases ; surgery ; Spinal Fusion ; adverse effects ; instrumentation ; Spinal Stenosis ; etiology ; prevention & control ; Spondylolisthesis ; etiology ; prevention & control

OBJECTIVETo evaluate the ability of a polycaprolactone/polylactic acid (PCL/PLA) membrane to inhibit epidural scar adhesion after laminectomy, and observe the responsive changes of the pain media in the spinal cord.

METHODSL(1), L(3) laminectomies were performed on 96 Wistar rats. The rats were divided into 3 groups: None-implant Control Group (NC), Autologous free fat graft group (AFFG) and PCL/PLA membrane group (PCL/PLAm). The rats were killed at 1, 3, 6, and 12 weeks postoperatively. Epidural scar formation and adhesion were observed grossly and histologically. Reverse transcription polymerase chain reaction (RT-PCR) were used to analyses the expression of Transforming growth factor beta (TGF-beta) in the epidural scar. Immunohistochemistry stain and RT-PCR were performed to evaluate the expression of the substance P and the c-fos gene in the relevant spinal cord, and the results were analyzed statistically.

RESULTSGross evaluation and histological evaluation showed that in the NC lamina defect site had much scar tissue and had wide and tight adhesions to the dura; in the AFFG, with the fat degrading gradually, the adhesions were increased; whereas in the PCL/PLAm group, there were slightly adhesions to the dura. RT-PCR showed that the expression of the TGF-beta was much less in the PCL/PLAm group than in the NC group. The insertion of the PCL/PLA membrane and the fat patch reduced the expression of the substance P and the c-fos gene in the spinal cord.

CONCLUSIONThe insertion of the PCL/PLA membrane reduces scar formation and separates fibrosis tissue from the dura, the results indicate that PCL/PLA membrane is an effective way of reducing peridural scar formation and preventing the failed back surgery syndrome.

Animals ; Biocompatible Materials ; Cicatrix ; prevention & control ; Female ; Lactic Acid ; Laminectomy ; adverse effects ; Membranes, Artificial ; Polyesters ; Polymers ; Postoperative Complications ; prevention & control ; Prosthesis Implantation ; Proto-Oncogene Proteins c-fos ; biosynthesis ; Rats ; Rats, Wistar ; Spinal Cord ; metabolism ; Spinal Diseases ; prevention & control ; Substance P ; biosynthesis ; Tissue Adhesions ; prevention & control

OBJECTIVESTo evaluate the incidence of immediate postoperative pulmonary complications and their correlation to preoperative pulmonary function tests (PFTs), preoperative pulmonary symptoms and surgical approaches.

METHODSThe case records of 298 patients, who underwent anterior or posterior fusion, were reviewed. Preoperative PFTs were recorded and abnormal PFTs were defined as forced vital capacity (FVC) is less than 80% of FVC predicted. Preoperative pulmonary symptoms (breathless on exertion) were noted, and postoperative pulmonary complications were defined when the presence of atelectasis, infiltrates, pneumothorax, hemothorax, pneumonia or requirement of postoperative ventilatory support was noted.

RESULTSThe mean age of this group was 16.4 years (range from 6-62 years). The average coronal Cobb angle was 73.26 degrees (range from 45 degrees-141 degrees ). Of all the patients, 115 patients had normal preoperative PFTs, the other 183 cases had abnormal PFTs. Nineteen cases of all the patients were found with postoperative pulmonary complications including postoperative ventilatory support in 6 cases, atelectasis in 4 cases, infiltration in 2 cases, pneumothorax in 3 cases, pneumonia in 3 cases and hypoxemia in 1 case. The incidence of postoperative pulmonary complication was 6.4% in all the patients, while 18.99% in the 79 patients with thoracotomy and 1.85% in the 216 patients without. The correlation between postoperative pulmonary complications and the surgical approach was statistically significant (P=0.0000). When the patients were classified into 3 groups: 60%< FVCR <80%, 40%< FVCR <60%, FVCR <40%, the incidence of postoperative pulmonary complications were 2.72% (3/110), 7.40% (4/54) and 31.6% (6/19) respectively, which showed an increasing complication incidence. In the 115 patients with normal PFTs, 3 patients had preoperative pulmonary symptoms (2.68%), while 14 of the 183 patients with abnormal PFTs had preoperative pulmonary symptoms (7.65%). The correlation between presence of preoperative respiratory symptoms and abnormal results on PFTs was statistically significant (P=0.01). No significant correlation was found between preoperative respiratory symptoms and postoperative pulmonary complications (P=0.52).

CONCLUSIONSThe incidence of postoperative pulmonary complications increases with the deterioration of PFTs. The posterior procedure has a very low incidence of postoperative pulmonary possibility of complications, but a transthoracic procedure increases the complications significantly. Preoperative respiratory symptoms usually predict abnormal results of PFTs but have no correlation with postoperative pulmonary complication.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Lung Diseases ; etiology ; prevention & control ; Male ; Middle Aged ; Postoperative Complications ; Preoperative Care ; Respiratory Function Tests ; Retrospective Studies ; Scoliosis ; surgery ; Spinal Fusion ; adverse effects

We report a case of progressive myelopathy following herpes zoster skin eruption In adult. Varicella-zoster virus (VZV) myelopathy was diagnosed based on the close temporal relationship between rash and onset of myelopathy, and confirmed by demonstrating the presence of varicella-zoster virus DNA in the cerebral spinal fluid (CSF) by amplification using the polymerase chain reaction (PCR). The patient was treated with intravenous acyclovir, and strength, sensation, sphincter function improved within 2 weeks. Detection of VZV DNA in CSF was useful for diagnosis and a role of virus In the pathogenesis of myelopathy. The clinical Improvement suggests that early therapy with an effective antiviral drug was beneficial.
Acyclovir ; Adult ; Diagnosis ; DNA* ; Exanthema ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Myelitis* ; Polymerase Chain Reaction* ; Secondary Prevention ; Sensation ; Skin ; Spinal Cord Diseases

We report a case of progressive myelopathy following herpes zoster skin eruption In adult. Varicella-zoster virus (VZV) myelopathy was diagnosed based on the close temporal relationship between rash and onset of myelopathy, and confirmed by demonstrating the presence of varicella-zoster virus DNA in the cerebral spinal fluid (CSF) by amplification using the polymerase chain reaction (PCR). The patient was treated with intravenous acyclovir, and strength, sensation, sphincter function improved within 2 weeks. Detection of VZV DNA in CSF was useful for diagnosis and a role of virus In the pathogenesis of myelopathy. The clinical Improvement suggests that early therapy with an effective antiviral drug was beneficial.
Acyclovir ; Adult ; Diagnosis ; DNA* ; Exanthema ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Myelitis* ; Polymerase Chain Reaction* ; Secondary Prevention ; Sensation ; Skin ; Spinal Cord Diseases