Objective To review the progress of the research on therelationship between the central nervous system injury and the heterotopic ossification. Methods The recent articles on the central nervous system injury and the heterotopic ossification were extensively reviewed, and the related clinical signs, symptoms, pathogenesis diagnosis, risk factors, prophylaxis, and treatment of the neurogenic heterotopic ossification were investigated. Results The possible mechanism for the neurogenic heterotopic ossification might involve the roles of thebone morphogenetic protein and the basic fibroblast growth factor, which were suggested as mediators in differentiation of the progenitor cells. Sonographic, serum creatine phosphokinase, and C-reactive protein were recommended as the useful screening tools for heterotopic ossification. Colchicine and rofecoxib could be used for the prophylaxis or treatment of heterotopic ossification. Conclusion The research on the neurogenic heterotopic ossification has achieved a great development but further studies in this field are still required.
Objective To compare heterotopic ossification between femoral head reconstruction and total hip arthroplasty(THA) in patients with ischemic necrosis of femoral head(INFH). Methods Between June 1994 and December 2004, the femoral heads were repaired in 1 005 patients with INFH,the total hip was replaced in 485 patients with INFH. The rate of heterotopic ossification was observed in 74 (Ficat Ⅲ to Ⅳ stages) of 1 005 patients and 80 of 485 patients given THA to compared the results of the two methods. Results These patients were followed up 2 to 10 years(6.5 years on average). The rates of heterotopic ossification were 5.4%(4/74) and 22.5%(18/80), respectively. There was statistically significant difference between two operative methods (Plt;0.01). Conclusion The rate of heterotopic ossification of femoral head reconstruction is lower than that of THA, so femoral head reconstruction is a better operative method for young patients and THA is suitable for old patients.
ObjectiveTo explore and discuss the effects of lanthanum carbonate on serum calcium and phosphorus of continuous ambulatory peritoneal dialysis (CAPD) patients with chronic renal failure receiving calcitriol pulse therapy due to secondary hyperparathyroidism (SHPT). MethodsCAPD patients caused by SHPT in peritoneal dialysis centre of the Qingdao Municipal Hospital of Eastern Hospital from March to June, 2013 were selected and randomly divided into two groups (lanthanum carbonate group and calcium carbonate group). The lanthanum carbonate group were treated with oral lanthanum carbonate and calcitriol pulse therapy, while the calcium carbonate group were treated with calcium carbonate and calcitriol. Change of levels of serum calcium, phosphorus and iPTH were observed and statistic analysis was conducted using SPSS 17.0. ResultsA total of 40 CAPD patients were included, 20 cases in each group. After 12-week treatment, levels of serium phosphate (t=5.095, P=0.000) and iPTH (t=1.225, P=0.000) in the lanthanum carbonate group were significantly lower than those before treatment. The levels of serum calcium (t=1.127, P=0.001) and phosphate (t=2.035, P=0.000) in the lanthanum carbonate group were significantly lower than those in the calcium carbonate group (P < 0.05). ConclusionLanthanum carbonate serves as a useful approach to improve hypercalcemia and the hyperphosphatemia in CAPD patients receiving calcitriol pulse therapy due to SHPT.
Objective To review the research progress of heterotopic ossification (HO) pathogenesis.Methods Recent articles about HO including the risk factors and pathogenesis were reviewed and comprehensively analyzed. Results The pathogenesis of HO is not completely understood, but the extracellular factors, signaling pathways, and transcription factors in the pathogenesis of HO are understood deeply, such as bone morphogenic protein, Smad signaling, and core binding factor α1/runt-related transcription factor 2, which are probably involved in HO. Furthermore, some related microRNAs are also probably involved in HO. Conclusion The pathogenesis of HO should be further investigated so as to lay a foundation for preventing and treating HO.
Objective To investigate the surgery tactics for ossification of ligamentum flavum (OLF) associated with dural ossification (DO) in the thoracic spine and the cl inical outcome. Methods Between June 2006 and December 2009, 98 patients with thoracic spinal stenosis secondary to OLF were treated, and DO was found in 18 cases during operation. There were 11 males and 7 females with a mean age of 58 years (range, 46-73 years). The disease duration ranged from 5 to 48 months (mean,20 months). All patients underwent surgical decompression because of recent neurological aggravation. Both DO and OLF were resected with octagonal decompression by dissecting pedicle flavum tunnel. The Japanese Orthopaedic Association (JOA) score, modified Oswestry Disabil ity Index (ODI), and the Cobb angle were used to evaluate the effectiveness. Results The initial symptoms were significantly alleviated postoperatively. All patients had transient cerebrospinal fluid (CSF) leakage postoperatively, the CSF leakage disappeared after 8-10 days of conservative treatment. All the incisions healed by first intention. There was no complication of neurologic function deterioration, meningitis, wound infection, or spinocutaneous fistula. Eighteen patients were followed up 20-60 months (mean, 49 months). No recurrence of spinal cord compression symptoms,or neurologic function deterioration was observed at last follow-up. The JOA scores and effectiveness and modified ODI scores were significantly improved after 1 month and 12 months of operation when compared with preoperative scores (P lt; 0.05). The Cobb angles of kyphosis of the involved vertebrae were (6.7 ± 1.6)° before operation and (8.0 ± 1.2)° after 12 months of operation, showing significant difference (t=4.000，P=0.001). Postoperative T2-weighted axial MRI, sagittal MRI scan, and short T1 inversion recovery MRI showed that compressed deformity of the spinal cord returned to normal. Conclusion The surgery tactics for thoracic spinal stenosis secondary to the OLF with DO is safe, and no patching dura mater tears is effective.