| ObjectiveTo investigate the diagnostic value of failed back surgical syndrome(FBSS) by CT and MRI, and establish the relationship between clinical symptoms and imaging manifestation.MethodsWe have retrospectively studied131patients who suffered from lumbar intervertebral disc herniation and underwent decompression operation by CT and MRI from Febrary2009through June2011. And diagnosed "weak" as FBSS by the curative evaluation standard of MacNab lumbago, leg pain,using Dual source CT(Somatom Definition scanner2010A) and Siemens1.5T MR scaner (MAGNETOM Sonata) or GE3.0T MR scaner(Signa HD). MPR, VR and enhancement scanning would be taken if necessary, and the imaging signs included vertebral olisthy, stenosis of vertebral canal and lateral recess, intervertebral discs reherniation or protrusion, intervertebral disk infection and epidural scar and conglutination, and then the correlated risk factors of FBSS analyzed by the logistic regression analysis in SPSS13.0software.ResultsThere were35patients diagnosed as FBSS (26.7%), and the main imaging manifestation are as follows:vertebral olisthy(n=16),stenosis of vertebral canal and lateral recess(n=13), intervertebral discs reherniation or protrusion (n=12), intervertebral disk infection (n=9) and epidural scar and conglut i nation (n=19). the risk factors of FBSS was epidural scar and conglutination,intervertebral discs reherniation or protrusion, intervertebral disk infection, vertebral olisthy and stenosis of vertebral canal and lateral recess ranging high to low(p<0.05).GonclusionThe formation of epidural scar and conglutination is the main reason for FBSS. CT associated with MRI could easily allow us figure out the intervertebral discs and vertebral canal display after laminectomy, and it is very useful in positioning and observation of epidural scar,which also can provide an important imaging information for clinical diversity treatment. ObjectiveTo establish the hypertrophic scar models of rats and investigate the effect of ozone on the healing of wound and hypertrophic scar in rats.MethodsHypertrophic scar models of bilateral circular full-thickness skin wounds were made on the back of rats by surgical incision method, and then the rats were divided into three groups:①blank control group with no treatment,②cxygen group treated with5mL pure oxygen,③ozone group treated with5mL of30-40μg/ml ozone. Rats were injected twice a week after14d in the latter two groups. Hypertrophic scar/granulation tissue samples were extracted before injection,7d,14d, and21d after injection,respectively.The appearance of hypertrophic scar/granulation tissue as well as the expression of tumor necrosis factor-a and basic fibroblast growth factor in each group were detected by hematoxylin-eosin staining immunohistochemistry and the hydroxyproline content also mesured.Statistical analysis:The experimental data was analyzed by the software of SPSS13.0, and an associated probability of5%(p<0.05) was considered significant.ResultsThe area of hypertrophic scar was smaller after wound healing in the ozone group, compared with the blank control and oxygen groups, besides, there were more epithelia generated and less inflammatory cell infiltration, thinner collagen fibers and more breakages.Content changes of TNF-a:all the expressions of TNF-a have the increased gradually trend after injection (p<0.05).Before injection and7days after injection, there was no significant difference in all groups(p>0.05),14days and21days after injection,the ozone group compared with the control group and the oxygen group compared with the control group, there were significantly difference (p<0.05), and the order of the the expression of TNF-a from high to low was the control group, the oxygen group and the ozone group (p<0.05)Content changes of bFGF:all the expressions of bFGF have the increased gradually trend after injection (p<0.05),7days after injection, the ozone group compared with the control group, there were significantly difference (p<0.05),14days and21days after injection, bFGF of the ozone group higher than the control group and the oxygen group (p<0.05)Content changes of hydroxyproline:all the content of HYP have the increased gradually trend after injection (p<0.05), before injection, there was no significant difference in all groups(p>0.05),7days,14days and21days after injection, HYP content of the ozone group lower than the control group and the oxygen group (p<0.05)ConclusionThe study findings suggest that ozone can reduce the inflammatory cell infiltration via its anti-inflammatory effect, decrease the oversynthesis of collagens by inhibiting the expression of TNF-α, and inhibit the inflammatory granulation tissue as well as the scar proliferation by the high expression level of the bFGF. |
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