这项研究是由美国波士顿科学神经调节。

1。简介： 脊髓刺激，或公务员事务局局长，已被临床应用，自1967年以来，诺曼Shealy博士首次植入刺激电极，企图为缓解患者的慢性，顽固性疼痛（Shealy等，1967）背列。公务员事务局局长断定，大型髓传入神经的激活调解触摸和压力的感觉门理论，临床实施，能抑制，或“关闭门”疼痛信号传输到大脑中的高中心（Melzack和墙，1965）。为公务员事务局局长的技术提高了几十年来，与刺激，更可靠的设备更好地刺激背列已发展成。 这些改进的关键，已增加相关临床电刺激脊髓神经解剖学和神经生理学的理解。这种认识已提前由公务员事务局局长的计算模型。神经元的计算模型已被用于以来首次描述了霍奇金淋巴瘤和赫胥黎的数学模型（霍奇金，赫胥黎，1952年），以了解神经刺激的基本机制。神经活动是由电流注入细胞内和细胞外的潜在领域应用的电场调制。 Ranck定性地讨论了如何在附近的一个轴突外的电压变化引起的轴突膜的一些地区去极化和超极化（Ranck，1975年）。 一个为公务员事务局局长的计算模型最初是由Coburn和仙（科伯恩，1980年），并显着促进Holsheimer和他的同事们，开始与Struijk和Holsheimer三南海三维场模型“（Holsheimer和Struijk，1988年）的发展。他们的计算模型估计的解剖参数背柱纤维（Struijk等，1992）的阈值的影响，预测可能的位置在背根纤维（Struijk等人，1993年b）激发，并分析脑脊液的影响厚度（Struijk 等 ，1993）与临床验证（他等，1994; Holsheimer 等人 ，1995年;。Holsheimer等 ，1994）。模型的刺激导致设计的设计作出了重大贡献，建议触点的尺寸和间距（Holsheimer和Struijk，1992年; Holsheimer和韦塞林克，1997年）的最佳参数，有利于根纤维（Holsheimer等优惠政策刺激背柱纤维 ，。 1995年b）。 2。方法： 数学模型的定义低胸段脊髓和周围的环境创造了一个有限元数学（FEM）模型。有限元模型包括脊髓灰白质，脑脊液，硬膜，硬膜外腔组织，椎体骨，和两个圆柱形的多触点信息。包括8个圆柱铂铱接触（域进行，3mm长度和直径为1.25 mm）1毫米绝缘聚合物（非导电域，1mm，长）的长度分隔，每根引线。线索定位背部，顶部硬脑膜，并对称，1mm至脊髓中线两侧。在模型中，脑脊液层之间的接触和脊髓的背水面（DCSF）的“厚度”是指定要3.2毫米。几何模型是在图1A所示，我在表中给出电阻率，主要来自文献（Holsheimer，2002年;韦塞林克等 ，1999）的值。体积超过1万个节点，与在该地区靠近电极位于如图1B所示的高密度网状网状。 <img src="/files/ftp_upload/2443/2443fig1.jpg" alt="图1" /> 图1。脊髓和多触点导致的有限元网格的描写。 （一）组件和模型结构。 （b）示范网 - 只有高密度的一部分显示。网格分割成变量节点密度部分：附近的联系人（≤300微米）;绝缘体，硬膜和脊髓（≤750微米）;硬膜外腔（≤3000微米）;和椎体骨（≤5000微米）。 <img src="/files/ftp_upload/2443/2443table1.jpg" alt="表1" /> 表1：电阻值的有限元法域（Holsheimer，2002年;。韦塞林克等 ，1999）和修改（硬膜外腔），以配合临床资料。 脊髓几何（图2）从相关文献的来源是使用功能的组合。电源线的截面是来自龟山​​等 ，并通过Struijk 等背根（DR）的轨迹（龟山等，1996;。。Struijk等，1993年b）。背柱（DC）的纤维被放置在规则格网（200um mediolateral方向和100um的背腹方向;见图2a），并预计在rostrocaudal方向。每个DR被建模为一个直径较大的“母亲”光纤连接岔&#39;女儿&#39;纤维直径较小（图2B）。 <img src="/files/ftp_upload/2443/2443fig2.jpg" alt="图2" /> 图2。脊髓模型的结构。 （一）事务的观点，脊髓和背柱纤维的位置。 （二）神经根的母亲纤维和分叉的女儿纤维组成。数字化从1993年Struijk母亲纤维的轨迹。 （三）三维视图脊髓和DR纤维。 模型研究一旦导致定位模型内，刺激的两种类型的定义为两条平行的接触电流的实施。对于单源系统中，有三种可能的方法来提供电流：A.最左边的接触，所有的电流;两个触点都提供了目前的50％; C.最右边的接触提供了所有的电流。在这里，我们注意到两个触点的阻抗是假设平等的，虽然这是不可能的，在临床应用中的真实。 对于多源系统，每个联系人定义在1％的增量之间的接触电流的变化有自身的电流源的可控性。换句话说，如果交付的两个触点的总电流为10mA，在多源系统，目前每个联系人指定任何总数的一小部分，因此只要通过平等10毫安每个接触的电流的总和。例如，最左边的接触可能会提供6.8 mA的最右边的接触，然后将提供3.2毫安。对于多源系统，100分数分割目前的这种方式编程。 要计算的激活区域内每个系统的背列，激活功能分析。激活功能是近似的跨膜电位时，细胞外的刺激电流应用于一个给定的电极和纤维的几何形状的神经组织的变化。激活区域被定义为模型中的纤维，激活功能（或简单的第二个沿轴突的电压差异）超过预定阈值（例如0.1mV/mm2）的轨迹。刺激的中心点是定义和计算几何形心作为3维区域的激活。 要确定刺激幅度，两个触点被指定为单极配置中的阴极（50％和50％的两个触点的负电位）（来源电流与等效电流密度模型边界）。然后反复刺激幅度增加，直到第一个纤维激活（这是永远背柱纤维）。这首先激活被假定为与感觉异常的病人在临床上的第一感知。目前在该模型中，当时增加1.4 *（MA激活第一个光纤）和激活导致区域的质心计算。所有转向步骤（100:0至0:100）的重心在上一步确定的幅度计算。质心变化的平均决议除以当前步骤的质心位置，范围。 3。结果： 当转向双导线之间的刺激mediolaterally，计算模型的预测，为每个联系人的独立电流源的设备可以针对更多的中央背柱的刺激点，比单一来源系统（3）VS 100。由于这一结果，调整中央的刺激点的分辨率为30微米多源系统，约50倍的增加相比，单一来源系统（见图3）。 <img src="/files/ftp_upload/2443/2443fig3.jpg" alt="图3" /> 图3。计算模型，使下面的预测。 A.双铅配置：2.0毫米之间单极刺激导致分离。 B.单源设备可以提供一个单一的，所有联系人的共享电源的目标刺激的三个中央点，换挡时的刺激mediolaterally（步上平均1毫米2毫米的铅分离的大小）。 C：与设备专用电源，为每个联系人可以横向目标100中央点背柱时fractionalizing目前在增量为1％，或10个中央点时，10％的增量（为1％的步长0.02毫米fractionalizing步骤和平均10％的步长为0.2毫米）。

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作者是波士顿科学神经调节员工。

在高分辨率的背柱的中心刺激区域的能力，以便更好地优化患者的感觉异常疼痛重叠。也就是说，在一个给定的病人，在背列激活的区域可能会集中到痛苦的地区的覆盖面最大化，最大限度地减少副作用（因刺激不受欢迎的纤维，这可能会产生undesireable位置感觉异常或建立电机或自主影响）。

<ul><li>神经元（ <a href="http://www.neuron.yale.edu">http://www.neuron.yale.edu</a> ） </li><li> ANSYS（匹斯堡，PA， <a href="http://www.ansys.com">http://www.ansys.com</a> ） </li><li> MATLAB（Natick郡，马， <a href="http://www.mathworks.com">http://www.mathworks.com</a> ） </li></ul>

dorsal column steerability with dual parallel leads using dedicated power sources:  a computational model

脊髓刺激（SCS），一致的刺激引起的感觉异常痛苦的身体部位，是一种疗效的必要条件。由于病人疼痛的模式可以是唯一的的，一个共同的刺激配置放置在背侧硬膜外腔平行的两个线索。这个构造在指导当前的刺激，mediolaterally在背柱，以达到更好的疼痛，感觉异常重叠提供了灵活性。使用一个准确的纤维直径分布的数学模型，我们研究了双并行的能力，导致转向双平行相邻触点之间的刺激导致使用（1）单一来源系统，及（2）多源系统，以专门为每个联系人的电流源。容积导体低胸段脊髓硬膜外定位的双平行模式（2毫米分离）经皮导致最初创建和电场计算采用ANSYS，有限元建模工具。计算的第二个区别Ranvier节点沿背柱神经纤维外的潜力为10微米的纤维激活功能。激活（美国之音）和美国之音中心点量计算使用了激活功能的预定阈值。模型相比，现场督导结果与双8接触刺激信息的来源与专用电源系统的单一来源。该模型预测，多源系统，可以针对更为重要的刺激点，比单一来源系统（100比3）和平均mediolateral转向转向一步背列多源系统和1毫米，0.02毫米单一来源系统，改善了50倍。在高分辨率的背柱的中心刺激区域的能力，以便更好地优化患者的感觉异常疼痛重叠。

Watch this Scientific Journal Video about Dorsal Column Steerability with Dual Parallel Leads using Dedicated Power Sources:  A Computational Model at JoVE.com

Dorsal Column Steerability with Dual Parallel Leads using Dedicated Power Sources:  A Computational Model

使用一个数学模型脊髓刺激，我们发现，一个独立的电力来源多源系统为每个联系人可以针对更多的中央点上刺激背柱（100比3）和50倍更多的领域转向决议（ 0.02毫米VS 1mm）的系统比单一来源。

背柱与双并行使用专用电源的信息Steerability，计算模型

In spinal cord stimulation (SCS), concordance of stimulation-induced paresthesia over painful body regions is a necessary condition for therapeutic ...

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Medicine

11.7K 次观看.  Neuromodulation. 使用一个数学模型脊髓刺激，我们发现，一个独立的电力来源多源系统为每个联系人可以针对更多的中央点上刺激背柱（100比3）和50倍更多的领域转向决议（ 0.02毫米VS 1mm）的系统比单一来源。

视频: Dorsal Column Steerability with Dual Parallel Leads using Dedicated Power Sources:  A Computational Model

A Novel Capsulorhexis Technique Using Shearing Forces with Cystotome

Purpose:
To demonstrate a capsulorhexis technique using predominantly shearing forces with a cystotome on a virtual reality simulator and on a human eye.
Method:
Our technique involves creating the initial anterior capsular tear with a cystotome to raise a flap. The flap left unfolded on the lens surface. The cystotome tip is tilted horizontally and is engaged on the flap near the leading edge of the tear. The cystotome is moved in a circular fashion to direct the vector forces. The loose flap is constantly swept towards the centre so that it does not obscure the view on the tearing edge.
Results:
Our technique has the advantage of reducing corneal wound distortion and subsequent anterior chamber collapse. The capsulorhexis flap is moved away from the tear leading edge allowing better visualisation of the direction of tear. This technique offers superior control of the capsulorhexis by allowing the surgeon to change the direction of the tear to achieve the desired capsulorhexis size.
Conclusions:
The EYESI Surgical Simulator is a realistic training platform for surgeons to practice complex capsulorhexis techniques. The shearing forces technique is a suitable alternative and in some cases a far better technique in achieving the desired capsulorhexis.

This video demonstrates a novel capsulorhexis technique in modern cataract surgery. Capsulorhexis is the most difficult and important part of phacoemulsification surgery.

一种新型撕囊技术，使用剪切力与Cystotome

Purpose:
To demonstrate a capsulorhexis technique using predominantly shearing forces with a cystotome on a virtual reality simulator and on a human eye....

科研

医学

In vivo Dual Substrate Bioluminescent Imaging

Our understanding of how and when breast cancer cells transit from established primary tumors to metastatic sites has increased at an exceptional rate since the advent of in vivo bioluminescent imaging technologies 1-3. Indeed, the ability to locate and quantify tumor growth longitudinally in a single cohort of animals to completion of the study as opposed to sacrificing individual groups of animals at specific assay times has revolutionized how researchers investigate breast cancer metastasis. Unfortunately, current methodologies preclude the real-time assessment of critical changes that transpire in cell signaling systems as breast cancer cells (i) evolve within primary tumors, (ii) disseminate throughout the body, and (iii) reinitiate proliferative programs at sites of a metastatic lesion. However, recent advancements in bioluminescent imaging now make it possible to simultaneously quantify specific spatiotemporal changes in gene expression as a function of tumor development and metastatic progression via the use of dual substrate luminescence reactions. To do so, researchers take advantage for two light-producing luciferase enzymes isolated from the firefly (Photinus pyralis) and sea pansy (Renilla reniformis), both of which react to mutually exclusive substrates that previously facilitated their wide-spread use in in vitro cell-based reporter gene assays 4. Here we demonstrate the in vivo utility of these two enzymes such that one luminescence reaction specifically marks the size and location of a developing tumor, while the second luminescent reaction serves as a means to visualize the activation status of specific signaling systems during distinct stages of tumor and metastasis development. Thus, the objectives of this study are two-fold. First, we will describe the steps necessary to construct dual bioluminescent reporter cell lines, as well as those needed to facilitate their use in visualizing the spatiotemporal regulation of gene expression during specific steps of the metastatic cascade. Using the 4T1 model of breast cancer metastasis, we show that the in vivo activity of a synthetic Smad Binding Element (SBE) promoter was decreased dramatically in pulmonary metastasis as compared to that measured in the primary tumor 4-6. Recently, breast cancer metastasis was shown to be regulated by changes within the primary tumor microenvironment and reactive stroma, including those occurring in fibroblasts and infiltrating immune cells 7-9. Thus, our second objective will be to demonstrate the utility of dual bioluminescent techniques in monitoring the growth and localization of two unique cell populations harbored within a single animal during breast cancer growth and metastasis.

In vivo Dual Substrate Bioluminescent Imaging

Herein we describe the methods to construct, visualize, and quantify the bioluminescent reactions of both firefly and renilla luciferase enzymes expressed in metastatic breast cancer cells during their growth and metastasis in vivo.

在体内的双基体生物光学成像

Our understanding of how and when breast cancer cells transit from established primary tumors to metastatic sites has increased at an exceptional rate ...

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Shoulder pain is a commonly reported symptom following laparoscopic procedures such as myomectomy or hysterectomy, and recent studies have shown that lowering the insufflation pressure during surgery may reduce the risk of post-operative pain. In this pilot study, a method is presented for measuring the intra-abdominal space available to the surgeon during laproscopy, in order to examine whether the relaxation produced by deep neuromuscular blockade can increase the working surgical space sufficiently to permit a reduction in the CO2 insufflation pressure. Using the laproscopic grasper, the distance from the promontory to the skin is measured at two different insufflation pressures: 8 mm Hg and 12 mm Hg. After the initial measurements, a neuromuscular blocking agent (rocuronium) is administered to the patient and the intra-abdominal volume is measured again. Pilot data collected from 15 patients shows that the intra-abdominal space at 8 mm Hg with blockade is comparable to the intra-abdominal space measured at 12 mm Hg without blockade. The impact of neuromuscular blockade was not correlated with patient height, weight, BMI, and age. Thus, using neuromuscular blockade to maintain a steady volume while reducing insufflation pressure may produce improved patient outcomes.

This article presents a method for measuring the working abdominal volume during laproscopic myomectomy using the surgical grasper, and applies this technique to obtain pilot data on whether deep neuromuscular blockade (NMB) can enable the use of lower insufflation pressure. Reduced insufflation pressure during laproscopic surgery has been shown to reduce post-operative pain, and thus the use of NMB during surgery may enable improved patient outcomes.

深神经肌肉阻滞信息到更大的在腹腔镜腹腔容积

Shoulder pain is a commonly reported symptom following laparoscopic procedures such as myomectomy or hysterectomy, and recent studies have shown that ...

Ischemic Tissue Injury in the Dorsal Skinfold Chamber of the Mouse: A Skin Flap Model to Investigate Acute Persistent Ischemia

Despite profound expertise and advanced surgical techniques, ischemia-induced complications ranging from wound breakdown to extensive tissue necrosis are still occurring, particularly in reconstructive flap surgery. Multiple experimental flap models have been developed to analyze underlying causes and mechanisms and to investigate treatment strategies to prevent ischemic complications. The limiting factor of most models is the lacking possibility to directly and repetitively visualize microvascular architecture and hemodynamics. The goal of the protocol was to present a well-established mouse model affiliating these before mentioned lacking elements. Harder et al. have developed a model of a musculocutaneous flap with a random perfusion pattern that undergoes acute persistent ischemia and results in ~50% necrosis after 10 days if kept untreated. With the aid of intravital epi-fluorescence microscopy, this chamber model allows repetitive visualization of morphology and hemodynamics in different regions of interest over time. Associated processes such as apoptosis, inflammation, microvascular leakage and angiogenesis can be investigated and correlated to immunohistochemical and molecular protein assays. To date, the model has proven feasibility and reproducibility in several published experimental studies investigating the effect of pre-, peri- and postconditioning of ischemically challenged tissue.

The window of the murine dorsal skinfold chamber presented visualizes a zone of acute persistent ischemia of a musculocutaneous flap. Intravital epi-fluorescence microscopy permits for direct and repetitive assessment of the microvasculature and quantification of hemodynamics. Morphologic and hemodynamic results can further be correlated with histological and molecular analyses.

在背皮褶商会鼠标的缺血性组织损伤：一个皮瓣模型，探讨急性缺血持续

Despite profound expertise and advanced surgical techniques, ischemia-induced complications ranging from wound breakdown to extensive tissue necrosis are ...

Isometric Contractility Measurement of the Mouse Mesenteric Artery Using Wire Myography

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and drugs. It is widely used in many studies on the physiological functions of vascular smooth muscle, the pathogenesis of vascular diseases such as hypertension, and the development of smooth muscle relaxant drugs. The mouse is a widely used model animal with a large pool of disease models and genetically modified strains. We introduced this method to measure the isometric contraction of mouse mesenteric artery in detail. A 1.4-mm segment of mouse mesenteric resistance artery was isolated and mounted on a myograph chamber by passing two steel wires through its lumen. After equilibration and normalization steps, the vessel segment was potentiated by a high-K+ solution twice prior to the contraction assay. As an example of the application of this method in drug development, we measured the relaxant effect of a novel natural substance, neoliensinine, isolated from a Chinese herb, embryos of the lotus seed (Nelumbo nucifera Gaertn.) on mouse mesenteric arteries. The vessel segments mounted on the myograph chamber were stimulated with a high-K+ solution. When the force tension reached a stable sustained phase, cumulative doses of neoliensinine were added to the chamber. We found that neoliensinine had a dose-dependent relaxant effect on smooth muscle contraction, thus suggesting that it bears potential activity against hypertension. In addition, as the vessel segment can survive at least 4 hours after mounting and maintain contractility induced by the high-K+ solution for many times, we suggest that the wire myograph system may be used for the time-consuming process of drug screening.

The wire myograph technique is used to investigate vascular smooth muscle functions and screen new drugs. We report a detailed protocol for measuring the isometric contractility of the mouse mesenteric artery and for screening new relaxants of vascular smooth muscle.

用线 Myography 测定小鼠肠系膜动脉的等轴收缩力

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and ...

Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis

Central venous stenosis is an important entity contributing to arteriovenous fistula (AVF) failure. A murine AVF model was modified to create a partial ligation of the inferior vena cava (IVC) in the outflow of the fistula, mimicking central venous stenosis. Technical aspects of this model are introduced. The aorta and IVC are exposed, following an abdominal incision. The infra-renal aorta and IVC are dissected for proximal clamping, and the distal aorta is exposed for puncture. The IVC at the midpoint between the left renal vein and the aortic bifurcation is carefully dissected to place an 8-0 suture beneath the IVC. After clamping the aorta and IVC, an AVF is created by puncturing the infra-renal aorta through both walls into the IVC with a 25 G needle, followed by ligating a 22 G intra-venous (IV) catheter and IVC together. The catheter is then removed, creating a reproducible venous stenosis without occlusion. The aorta and IVC are unclamped after confirming primary hemostasis. This novel model of central vein stenosis is easy to perform, reproducible, and will facilitate studies on AVF failure.

An aortocaval fistula was created by puncturing the murine infra-renal aorta through both walls into the inferior vena cava and was followed by creation of a stenosis in its outflow via partial ligation of the inferior vena cava. This reproducible model can be used to study central venous stenosis.

中央静脉狭窄病的Murine模型,使用具有流出狭窄病的动脉静脉瘘管病

Central venous stenosis is an important entity contributing to arteriovenous fistula (AVF) failure. A murine AVF model was modified to create a partial ...

A Porcine Corneal Endothelial Organ Culture Model Using Split Corneal Buttons

Experimental research on corneal endothelial cells is associated with several difficulties. Human donor corneas are scarce and rarely available for experimental investigations as they are normally needed for transplantation. Endothelial cell cultures often do not translate well to in vivo situations. Due to the biostructural characteristics of non-human corneas, stromal swelling during cultivation induces substantial corneal endothelial cell loss, which makes it difficult to perform cultivation for an extended period of time. Deswelling agents such as dextran are used to counteract this response. However, they also cause significant endothelial cell loss. Therefore, an ex vivo organ culture model not requiring deswelling agents was established. Pig eyes from a local slaughterhouse were used to prepare split corneal buttons. After partial corneal trephination, the outer layers of the cornea (epithelium, bowman layer, parts of the stroma) were removed. This significantly reduces corneal endothelial cell loss induced by massive stromal swelling and Descemet&#39;s membrane folding throughout longer cultivation periods and improves general preservation of the endothelial cell layer. Subsequent complete corneal trephination was followed by the removal of the split corneal button from the remaining eye bulb and cultivation. Endothelial cell density was assessed at follow-up times of up to 15 days after preparation (i.e., days 1, 8, 15) using light microscopy. The preparation technique used allows a better preservation of the endothelial cell layer enabled by less stromal tissue swelling, which results in slow and linear decline rates in split corneal buttons comparable to human donor corneas. As this standardized organo-typically cultivated research model for the first time allows a stable cultivation for at least two weeks, it is a valuable alternative to human donor corneas for future investigations of various external factors with regards to their effects on the corneal endothelium.

Here, a step-by-step protocol for the preparation and cultivation of porcine split corneal buttons is presented. As this organo-typically cultivated organ culture model shows cell death rates within 15 days, comparable to human donor corneas, it represents the first model allowing long-term cultivation of non-human corneas without adding toxic dextran.

使用分裂的角质按钮的孔膜内皮器官培养模型

Experimental research on corneal endothelial cells is associated with several difficulties. Human donor corneas are scarce and rarely available for ...

In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy

Several hip pathologies have been attributed to abnormal morphology with an underlying assumption of aberrant biomechanics. However, structure-function relationships at the joint level remain challenging to quantify due to difficulties in accurately measuring dynamic joint motion. The soft tissue artifact errors inherent in optical skin marker motion capture are exacerbated by the depth of the hip joint within the body and the large mass of soft tissue surrounding the joint. Thus, the complex relationship between bone shape and hip joint kinematics is more difficult to study accurately than in other joints. Herein, a protocol incorporating computed tomography (CT) arthrography, three-dimensional (3D) reconstruction of volumetric images, dual fluoroscopy, and optical motion capture to accurately measure the dynamic motion of the hip joint is presented. The technical and clinical studies that have applied dual fluoroscopy to study form-function relationships of the hip using this protocol are summarized, and the specific steps and future considerations for data acquisition, processing, and analysis are described.

In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy

Dual fluoroscopy accurately captures in vivo dynamic motion of human joints, which can be visualized relative to reconstructed anatomy (e.g., arthrokinematics). Herein, a detailed protocol to quantify hip arthrokinematics during weight-bearing activities of daily living is presented, including the integration of dual fluoroscopy with traditional skin marker motion capture.

在维沃 使用双氟镜检查进行动态负重活动时臀部关节肌学的量化

Several hip pathologies have been attributed to abnormal morphology with an underlying assumption of aberrant biomechanics. However, structure-function ...

Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity

Old compression vertebrae fracture or congenital kyphoscoliosis with abnormal vertebral body development and other diseases that invade the spine may cause severe thoracolumbar kyphotic deformity, often accompanied by intractable low back pain or compression of the spinal cord, leading to severe neurological symptoms or even paralysis. If conservative treatment cannot relieve the symptoms or correct the deformities, surgical treatment is usually needed. For severe kyphotic deformity, reconstruction of the physiological curvature and rigid fixation determine the prognosis of the patients. Osteotomy and orthopedics are the standard procedure for deformities with severe compression of the front and middle column, but the trauma to the patients is high, with a long operation time and massive blood loss. To avoid these disadvantages, we have developed a modified technique to remove the diseased vertebra unilaterally. In this technique, we use a modified trephine to resect the vertebral columns like in the pedicle screw technique by adding a locking instrument that can restrict the trephine to lower the risk of osteotomy and shorten the surgery time and blood loss.

We describe a modified technique for resecting the posterior vertebral column unilaterally based on a modified trephine for patients with thoracolumbar kyphotic deformity.

胸腰椎后凸畸形患者改良后椎柱切除术

Old compression vertebrae fracture or congenital kyphoscoliosis with abnormal vertebral body development and other diseases that invade the spine may ...

大鼠 DRG 压缩模型的标准化 Tuina 协议

Analgesic Effect of Tuina on Rat Models with Compression of the Dorsal Root Ganglion Pain

Neuropathic pain is a prevalent condition that affects 6.9%-10% of the population and results from nerve damage due to various etiologies, such as lumbar disc herniation, spinal canal stenosis, and intervertebral foramen stenosis. Although Tuina, a traditional Chinese manual therapy, has shown analgesic effects in clinical practice for the treatment of neuropathic pain, its underlying neurobiological mechanisms remain unclear. Animal models are essential for elucidating the basic principles of Tuina. In this study, we propose a standardized Tuina protocol for rats with compression of the dorsal root ganglion (DRG), which involves inducing DRG compression by inserting a stainless steel rod into the intervertebral foramen, performing Tuina manipulation with specific parameters of location, intensity, and frequency in a controlled environment, and assessing the behavioral and histopathological outcomes of Tuina treatment. This article also discusses the potential clinical implications and limitations of the study and suggests directions for future research on Tuina.

作者聚焦： 推拿对压迫背根神经节疼痛的大鼠模型的镇痛作用  

This article presents a manipulation for treating chronic compression of the dorsal root ganglion in rats using Tuina therapy, along with a method for evaluating its effectiveness based on pain behavior and histopathological results.

推拿对大鼠模型的镇痛作用，压迫背根神经节疼痛

Neuropathic pain is a prevalent condition that affects 6.9%-10% of the population and results from nerve damage due to various etiologies, such as lumbar ...