scholarly journals Treatment of Degenerative Disc Disease associated with Modic changes, with ozone therapy. A new therapeutic proposal.

2021 ◽  
Vol 4 (5) ◽  
pp. 13
Author(s):  
Anibal Martin Grangeat ◽  
Angeles Erario
Keyword(s):  
Oxygen Metabolism ◽  
Blood Stream ◽  
Substantial Improvement ◽  
Magnetic Resonance Images ◽  
Modic Changes ◽  
Ozone Therapy ◽  
Disc Disease ◽  
Significant Difference ◽  
Scientific Papers ◽  
Amoxicillin Clavulanate

Introduction. Modic Changes (MCs) represent signal changes in the vertebral endplate and subchondral bone region visualized on T1 and T2 weighted magnetic resonance images (MRI). Three types of MCs It have been identified (Types 1 to 3). Modic changes are commonly associated with low-back pain (LBP). In the last few years scientific papers have shown that one of the causes of MCs (fundamentally, the MCs type 1) is the infection caused by an anaerobic bacterium of very low virulence: Propionibacterium acnes (P. acnes). This bacterium resides on the human skin, oral cavity, intestinal tract, and external ear canal as normal flora. As a consequence of tooth brushing and endodontic-therapy, could invade the blood stream leading to transient bacteremia. The authors propose a treatment which consists of Amoxicillin-clavulanate (500 mg/125 mg) three times a day, at 8-hour intervals, for 90 days/100 days. Objectives. Ozone therapy could be the gold standard therapy for MC1 because ozone is a powerful anti-microbial, anti-inflammatory and analgesic agent, which regulates oxidative stress, immune system and oxygen metabolism. Materials and Methods Patients with LBP lasting 6 months or more and MC1 confirmed by MRI of lumbar spine L3/L4 or L4/L5 or L5/S1 and who responded with 5 or more points on the VAS scale were treated with three intradiscal sessions of ozone therapy and ten paravertebral sessions. Results. Patients who were treated with ozone therapy according to our treatment proposal showed a substantial improvement on VAS comparing the beginning and the end of the treatment. They show a significant difference in pain, and general condition. However, these results were not reflected on ODI scale, neither on the MRI but we could notice certain improvements.

Association between lumbar sacralization and increased degree of vertebral slippage and disc degeneration in patients with L4 spondylolysis

2019 ◽  
Vol 30 (6) ◽  
pp. 767-771
Author(s):  
Xinqiang Yao ◽  
Ruoting Ding ◽  
Junhao Liu ◽  
Siyuan Zhu ◽  
Jingshen Zhuang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Disc Degeneration ◽  
Transverse Process ◽  
Modic Changes ◽  
Bony Fusion ◽  
Transitional Vertebra ◽  
Type Iiia ◽  
Type Iiib ◽  
Significant Difference ◽  
Lumbosacral Transitional Vertebra

OBJECTIVEThe aim of this study was to evaluate the effect of lumbar sacralization on the level of vertebral slip and disc degeneration in patients with L4 spondylolysis.METHODSThe authors analyzed data from 102 cases in which patients underwent surgical treatment for L4 spondylolysis and spondylolisthesis at their institution between March 2007 and September 2016. Lumbar sacralization was characterized by the presence of pseudarthrosis and/or bony fusion between the L5 transverse process and sacrum, and the type of lumbosacral transitional vertebra (LSTV) was evaluated with the Castellvi classification. The amount of vertebral slippage was measured using the Taillard technique and Meyerding grade. Degeneration of the L4–5 segment was quantified using the Pfirrmann and Modic classifications. Patients were divided into 2 groups based on the presence or absence of sacralization, and the amount of vertebral slip and degeneration of the L4–5 segment was compared between groups.RESULTSLumbar sacralization was present in 37 (36%) of 102 patients with L4 spondylolysis. The LSTV was type IIa in 10 cases, type IIb in 7, type IIIa in 2, and type IIIb in 18. The levels of vertebral slip and disc degeneration in the group of patients with sacralization were significantly greater than in the group without sacralization. No significant difference was found between the 2 groups with respect to Modic changes.CONCLUSIONSThe increased stability between a sacralized L5 and the sacrum may predispose the L4–5 segment to greater instability and disc degeneration in patients with L4 spondylolysis.

scholarly journals The radiological outcome in lumbar interbody fusion among rheumatoid arthritis patients: a 20-year retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kuan-Kai Tung ◽  
Yun-Che Wu ◽  
Kun-Hui Chen ◽  
Chien-Chou Pan ◽  
Wen-Xian Lu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interbody Fusion ◽  
Fusion Rate ◽  
Substantial Improvement ◽  
Lumbar Interbody Fusion ◽  
Subsidence Rate ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Cage Subsidence

Abstract Background Clinical outcomes amongst Rheumatoid Arthritis (RA) patients have shown satisfactory results being reported after lumbar surgery. The increased adoption of the interbody fusion technique has been due to a high fusion rate and less invasive procedures. However, the radiographic outcome for RA patients after receiving interbody fusion has scarcely been addressed in the available literature. Methods Patients receiving interbody fusion including ALIF, OLIF, and TLIF were examined for implant cage motion and fusion status at two-year follow-up. Parameters for the index correction level including ADH, PDH, WI, SL, FW, and FH were measured and compared at pre-OP, post-OP, and two-year follow-up. Results We enrolled 64 RA patients at 104 levels (mean 64.0 years old, 85.9% female) received lumbar interbody fusion. There were substantial improvement in ADH, PDH, WI, SL, FW, and FH after surgery, with both ADH and PDH having significantly dropped at two-year follow up. The OLIF group suffered from a higher subsidence rate with no significant difference in fusion rate when compared to TLIF. The fusion rate and subsidence rate for all RA patients was 90.4 and 28.8%, respectively. Conclusions We revealed the radiographic outcomes of lumbar interbody fusions towards symptomatic lumbar disease in RA patients with good fusion outcome despite the relative high subsidence rate amongst the OLIF group. Those responsible for intra-operative endplate management should be more cautious to avoid post-OP cage subsidence.

What is the Role of the Bacterium Propionibacterium acnes in Type 1 Modic Changes? A Review of the Literature

2017 ◽  
Vol 68 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Mark Georgy ◽  
Mark Stern ◽  
Kieran Murphy
Keyword(s):  
Randomized Controlled Trial ◽  
Propionibacterium Acnes ◽  
Controlled Trial ◽  
Modic Changes ◽  
Low Back ◽  
Review Of The Literature ◽  
Disc Disease ◽  
Randomized Controlled

This review presents a summary of the pathology and epidemiology of Modic changes and the possible role of Propionibacterium acnes. This information is followed by a synthesis of the most recent clinical research involved in culturing the discs of patients with degenerative disc disease for the presence of bacteria. We also discuss a randomized controlled trial that investigates the effects of antibiotics on patients with chronic low back pain and type 1 Modic changes. We conclude with a brief discussion of the difficulties involved in this research and the significance of the findings.

673 Effect of Subcutaneous Topical Ozone Therapy on Second Degree Burn Wounds in Rats: An Experimental Study

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S193-S193
Author(s):  
Emre Karakaya ◽  
Aydincan Akdur ◽  
H Ebru ◽  
Ayvazoglu Soy ◽  
Alev Ok Atilgan ◽  
...  
Keyword(s):  
Wound Healing ◽  
Healing Process ◽  
Silver Sulfadiazine ◽  
Male Rats ◽  
Control Group ◽  
Ozone Therapy ◽  
Burn Wounds ◽  
Degree Burn ◽  
Significant Difference ◽  
Second Degree

Abstract Introduction Burn is one of the most severe traumas that causes coagulative destruction of the skin. The use of various products that accelerate wound healing in patients with burn may affect the patient’s survival and reduce the complications that may be seen. In the present study we aimed effects of subcutaneous ozone injection on second degree burn wound. Methods A total of 72 Sprague-Dawley male rats included in the study were divided randomly into three groups (control group (CG), silver sulfadiazine group (SG), ozone group (OG)) and each group was divided randomly two subgroups (as sacrificed on d7 and on d14).A deep second degree scald burns were created on the lower back. In CG subcutaneous 0.9% serum saline was injected daily into the burn area. In SG, burns were dressed with silver sulfadiazine daily and in OG subcutaneous ozone was injected daily into the burn area. Tissue hydroxyproline level measurement and histopathological evaluation were done. Results When the groups were compared in terms of weight change, no significant difference was found on the 7th and 14th days. In the evaluation made in terms of tissue hydroxyproline, tissue hydroxyproline level in OG was found to be significantly higher on both the 7th and 14th days (p < 0.001). In histopathological evaluations, it was determined that wound healing in OG was significantly higher than in the other groups. Conclusions According to the results, subcutaneous ozone therapy is more effective than silver sulphadiazine in the healing process of second-degree burn wounds and it can be safely used in the treatment of burn wounds.

Pituitary volume in children with growth hormone deficiency, idiopathic short stature and controls

2016 ◽  
Vol 29 (10) ◽  
Author(s):  
Marion Kessler ◽  
Michael Tenner ◽  
Michael Frey ◽  
Richard Noto
Keyword(s):  
Growth Hormone ◽  
Magnetic Resonance ◽  
Growth Hormone Deficiency ◽  
Short Stature ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Magnetic Resonance Images ◽  
Idiopathic Short Stature ◽  
Hormone Deficiency ◽  
Significant Difference

AbstractBackground:The objective of the study was to describe the pituitary volume (PV) in pediatric patients with isolated growth hormone deficiency (IGHD), idiopathic short stature (ISS) and normal controls.Methods:Sixty-nine patients (57 male, 12 female), with a mean age of 11.9 (±2.0), were determined to have IGHD. ISS was identified in 29 patients (20 male, 9 female), with a mean age of 12.7 (±3.7). Sixty-six controls (28 female, 38 male), mean age 9.8 (±4.7) were also included. Three-dimensional (3D) magnetic resonance images with contrast were obtained to accurately measure PV.Results:There was a significant difference in the mean PV among the three groups. The IGHD patients had a mean PV 230.8 (±89.6), for ISS patients it was 286.8 (±108.2) and for controls it was 343.7 (±145.9) (p<0.001). There was a normal increase in PV with age in the ISS patients and controls, but a minimal increase in the IGHD patients.Conclusions:Those patients with isolated GHD have the greatest reduction in PV compared to controls and the patients with ISS fall in between. We speculate that a possible cause for the slowed growth in some ISS patients might be related to diminished chronic secretion of growth hormone over time, albeit having adequate pituitary reserves to respond acutely to GH stimulation. Thus, what was called neurosecretory GHD in the past, might, in some patients, be relative pituitary hypoplasia and resultant diminished growth hormone secretion. Thus, PV determinations by magnetic resonance imaging (MRI) could assist in the diagnostic evaluation of the slowly growing child.

scholarly journals 15O Radioactivity Clearance is Faster after Intracarotid Bolus Injection of 15O-Labeled Oxyhemoglobin than after 15O-Water Injection

2003 ◽  
Vol 23 (7) ◽  
pp. 838-844 ◽  
Author(s):  
Chie Seki ◽  
Jeff Kershaw ◽  
Paule-Joanne Toussaint ◽  
Kenichi Kashikura ◽  
Tetsuya Matsuura ◽  
...  
Keyword(s):  
Brain Tissue ◽  
Bolus Injection ◽  
Water Injection ◽  
Oxygen Metabolism ◽  
Blood Stream ◽  
Time Range ◽  
Cerebral Oxygen ◽  
Cerebral Oxygen Metabolism ◽  
Finite Period ◽  
The Brain

The authors tested the hypothesis that the oxygen content of brain tissue is negligible by injecting an intracarotid bolus of 15O-labeled tracer into rats. Under the hypothesis, the clearance rates of 15O radioactivity from the brain after injections of both 15O-labeled water (H215O) and 15O-labeled oxyhemoglobin (HbO15O) should be identical. However, the logarithmic slope of the 15O radioactivity curve after HbO15O injection (0.494 ± 0.071 min-1) was steeper than that after H215O injection (0.406 ± 0.038 min−1) ( P<0.001, n = 13), where the time range used in the comparison was between 60 and 120 seconds after the injection. A possible interpretation of this result is that nonmetabolized O15O may dwell in the brain tissue for a finite period of time before it is eventually metabolized or returned to the blood stream unaltered. These findings contradict assumptions made by models currently used to measure cerebral oxygen metabolism.

scholarly journals Mathematical Models for Tumor Growth and the Reduction of Overtreatment

2018 ◽  
Vol 80 (01) ◽  
pp. 072-078 ◽  
Author(s):  
Berdine Heesterman ◽  
John-Melle Bokhorst ◽  
Lisa de Pont ◽  
Berit Verbist ◽  
Jean-Pierre Bayley ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Mathematical Models ◽  
Goodness Of Fit ◽  
Mean Squared Error ◽  
Age At Onset ◽  
Growth Curves ◽  
Magnetic Resonance Images ◽  
Coefficient Of Determination ◽  
Growth Data ◽  
Significant Difference

Background To improve our understanding of the natural course of head and neck paragangliomas (HNPGL) and ultimately differentiate between cases that benefit from early treatment and those that are best left untreated, we studied the growth dynamics of 77 HNPGL managed with primary observation. Methods Using digitally available magnetic resonance images, tumor volume was estimated at three time points. Subsequently, nonlinear least squares regression was used to fit seven mathematical models to the observed growth data. Goodness of fit was assessed with the coefficient of determination (R 2) and root-mean-squared error. The models were compared with Kruskal–Wallis one-way analysis of variance and subsequent post-hoc tests. In addition, the credibility of predictions (age at onset of neoplastic growth and estimated volume at age 90) was evaluated. Results Equations generating sigmoidal-shaped growth curves (Gompertz, logistic, Spratt and Bertalanffy) provided a good fit (median R 2: 0.996–1.00) and better described the observed data compared with the linear, exponential, and Mendelsohn equations (p < 0.001). Although there was no statistically significant difference between the sigmoidal-shaped growth curves regarding the goodness of fit, a realistic age at onset and estimated volume at age 90 were most often predicted by the Bertalanffy model. Conclusions Growth of HNPGL is best described by decelerating tumor growth laws, with a preference for the Bertalanffy model. To the best of our knowledge, this is the first time that this often-neglected model has been successfully fitted to clinically obtained growth data.

Rate of carbon clearance in three strains of germfree mice

1962 ◽  
Vol 203 (2) ◽  
pp. 291-295 ◽  
Author(s):  
James P. Doll
Keyword(s):  
Reticuloendothelial System ◽  
Blood Stream ◽  
Spleen Weight ◽  
Infectious Agents ◽  
Clearance Rates ◽  
Colloidal Carbon ◽  
Significant Difference ◽  
Carbon Clearance

Three strains of germfree mice (ND-1, ND-2, C57), along with conventional controls, were compared in terms of their ability to rid the blood stream, via the reticuloendothelial system, of intravenously injected colloidal carbon. K values of ND-1 germfree mice were lower than values for their conventional controls, but there was no difference between ND-2 and C57 germfree and their controls. Germfree ND-1 mice had lower K values than germfree ND-2 or C57. Clearance rates were correlated to relative combined weights of liver and spleen. There was no significant difference in α values among these animals, indicating that although the liver + spleen weights of ND-1 were lower, these organs were not atrophied or nonfunctional. When the germfree mice with smaller liver + spleen weights were "conventionalized," relative liver + spleen weight increased as did their K values. No such increase was noted with conventionalized ND-2 mice. In other laboratories, ND-1 mice were found to be more susceptible to infectious agents than ND-2.

CLINICAL AND RADIOLOGIC OUTCOMES OF TWO TYPES OF CAGES USED IN THE TREATMENT OF DEGENERATIVE LUMBAR DISEASES: NOVEL TITANIUM CAGES VERSUS PEEK CAGES

2020 ◽  
Vol 23 (01) ◽  
pp. 2050004
Author(s):  
Meng-Yin Yang ◽  
Hsin-Huan Chang ◽  
Shao-Ching Chao
Keyword(s):  
Transforaminal Lumbar Interbody Fusion ◽  
Neurological Status ◽  
Clinical Effects ◽  
Disc Disease ◽  
Degenerative Lumbar Diseases ◽  
Intervertebral Disc Height ◽  
Significant Difference ◽  
Vas Scores ◽  
Titanium Cages

Purpose: This study reports the clinical effects of [Formula: see text]-shaped titanium cages (ReBorn Essence Z-Brace cages) and compares the clinical outcomes between [Formula: see text]-shaped titanium cages (ZTC group) and polyetheretherketone cages (PEEK cages, PK group) for the application in transforaminal lumbar interbody fusion (TLIF). Methods: A retrospective and case control study with six patients using PEEK cages and four patients using ZTC was conducted. All patients underwent TLIF and had a 3-month follow-up. The Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) were selected to assess the pain of low back and neurological status. The intervertebral disc height (DH) and segmental angle (SA) were also measured to estimate the radiological changes. At the 3-month follow-up, the fusion and subsidence rates were evaluated. Results: There was no significant difference between the two groups regarding the ODI and VAS scores. At the 3-month follow-up, the subsidence rates were 42% and 0% for the PK and ZTC groups, respectively; the bony fusion rates were 67% and 100% for the PK and ZTC groups, respectively. Conclusion: The study has indicated that both PEEK and [Formula: see text]-shaped titanium cages can be effective options used to treat degenerative disc disease (DDD). Moreover, the higher fusion and lower subsidence rates have revealed that [Formula: see text]-shaped titanium cages may be a better choice compared to PEEK cages for lumbar reconstruction after TLIF.

scholarly journals Anatomical Feasibility Study of Flexor Hallucis Longus Transfer in Treatment of Achilles Tendon and Posterior Ankle Arthroscopy

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0033
Author(s):  
Haijiao Mao
Keyword(s):  
Achilles Tendon ◽  
Magnetic Resonance Images ◽  
Neurovascular Bundle ◽  
Flexor Hallucis Longus ◽  
Muscle Morphology ◽  
Musculotendinous Junction ◽  
Muscle Belly ◽  
Lateral Muscle ◽  
Significant Difference ◽  
The Relationship

Category: Hindfoot Introduction/Purpose: The aim of this study was to evaluate the occurrence of anatomical variations of the musculotendinous junction of the flexor hallucis longus (FHL) muscle, the relationship between FHL tendon or muscle and the tibial neurovascular bundle at the level of the posterior ankle joint in human cadavers. Methods: Seventy embalmed feet from 20 male and 15female cadavers, the cadavers’ mean age was 65.4 (range from 14 to 82) years, were dissected and anatomically classified to observe FHL muscle morphology define the relationship between FHL tendon or muscle and the tibial neurovascular bundle . The distance between the musculotendinous junction and thehe relationship between FHL tendon or muscle and the tibial neurovascular bundle was determined. Results: The three morphology types of FHL muscle were identified: a long lateral and shorter medial muscle belly, which was observed in 63 specimens (90%).; equal length medial and lateral muscle bellies, this variant was only observed in 5 specimens (7.1%); a lateral and no medial muscle belly, which was observed in 2 specimens (2.9%). No statistically significant difference was observed according to gender or side (p > 0.05). Two patterns were identified and described between FHL tendon or muscle and the tibial neurovascular bundle. Pattern 1, the distance between the neurovascular bundle and FHL tendon was 3.46 mm (range, 2.34 to 8.84, SD = 2.12) which was observed in 66 specimens (94.3%); Pattern 2, there was no distance which was observed in 4 specimens (5.7%). Conclusion: Knowing FHL muscle morphology variations provide new important insights into secure planning and execution of a FHL transfer for Achilles tendon defect as well as for the interpretation of ultrasound and magnetic resonance images. During posterior arthroscopic, posteriormedial portal may be introduced into the posterior aspect of the ankle without gross injury to the tibial neurovascular structures.

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