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Peng B.-G.,Institute of Spinal Surgery of Armed Police Force
World Journal of Orthopaedics | Year: 2013

Discogenic low back pain is a serious medical and social problem, and accounts for 26%-42% of the patients with chronic low back pain. Recent studies found that the pathologic features of discs obtained from the patients with discogenic low back pain were the formation of the zones of vascularized granulation tissue, with extensive innervation in fissures extending from the outer part of the annulus into the nucleus pulposus. Studies suggested that the degeneration of the painful disc might originate from the injury and subsequent repair of annulus fibrosus. Growth factors such as basic fibroblast growth factor, transforming growth factor ß1, and connective tissue growth factor, macrophages and mast cells might play a key role in the repair of the injured annulus fibrosus and subsequent disc degeneration. Although there exist controversies about the role of discography as a diagnostic test, provocation discography still is the only available means by which to identify a painful disc. A recent study has classified discogenic low back pain into two types that were annular disruption-induced low back pain and internal endplate disruption-induced low back pain, which have been fully supported by clinical and theoretical bases. Current treatment options for discogenic back pain range from medicinal anti-inflammation strategy to invasive procedures including spine fusion and recently spinal arthroplasty. However, these treatments are limited to relieving symptoms, with no attempt to restore the disc's structure. Recently, there has been a growing interest in developing strategies that aim to repair or regenerate the degenerated disc biologically. © 2013 Baishideng.

Peng B.,Institute of Spinal Surgery of Armed Police Force | Fu X.,Institute for Basic Research | Pang X.,General Hospital of Armed Police Force | Li D.,General Hospital of Armed Police Force | And 3 more authors.
Pain Physician | Year: 2012

Background: To accurately assess the effect of any therapy for treating discogenic low back pain, the natural history of such pain should be known beforehand. However, until now, no pathological characteristic could be used to predict the disease course of low back pain. Objective: To better instruct the clinical treatment of discogenic low back pain, a prospective clinical study was performed to observe the natural history of the disease. Study Design: A prospective clinical study during a 4-year follow-up period. Setting: The study was performed at a spinal center in China. Methods: A total of 279 patients with chronic low back pain were included from June 2006 through October 2007. Using discography, 156 patients (56%) were diagnosed to have discogenic back pain. A 101-point numerical rating scale (NRS) was used to assess the back pain symptoms and the Oswestry Disability Index (ODI) was used to assess lumbar function. Results: Of the 156 patients, 131 (84%) completed the study at 4-year follow-up. At the end of follow-up, 17 patients (13.0%) had their low back pain symptoms alleviated and lumbar function improved; 10 patients (7.6%) were slightly improved; 16 patients (12.2%) had their symptoms aggravated; and 88 patients (67.2%) experienced the same pain and disability as before. Although the average NRS and ODI scores obtained during the 4-year follow-up study gradually decreased, statistical significances were found in such changes (P < 0.05,and P < 0.05, respectively); however, the improvement rates of both pain (7.6%) and disability (5.2%) were very low. Limitations: The shortcoming of this study is its relatively small sample size. Conclusion: The present study indicated that the natural history of discogenic low back pain was chronic but persistent, and that the pain and disability in most patients did not improve over time.

Li Y.,Liaoning Medical University | Li Y.,Institute of Spinal Surgery of Armed Police Force | Pang X.,Institute of Spinal Surgery of Armed Police Force | Yang H.,Institute of Spinal Surgery of Armed Police Force | And 2 more authors.
Oncology Letters | Year: 2015

Hemolymphangioma is a malformation of the lymphatic and blood vessels. To the best of our knowledge, only a limited number of hemolymphangioma cases have been reported in the literature thus far, with no cases developed in the waist region. The present study reported the case of a 17‑year‑old male patient with hemolymphangioma growing on the waist, presented with back pain for four months. Upon physical examination, the lesion was identified to be oval in shape, soft and compressible, with mild tenderness. No abnormalities were detected in the results of laboratory examinations. However, a magnetic resonance imaging (MRI) scan revealed a tumor with low signal intensity on T1‑weighted imaging (WI) and high signal intensity on T2‑WI. The mass was successfully removed during surgery. During the seven‑month follow‑up period, the patient was asymptomatic with no evidence of recurrence. The present study discussed the imaging findings and pathological features of this uncommon case and reviewed the relevant literature. © 2015, Spandidos Publications. All Rights Reserved.

Peng B.,Institute of Spinal Surgery of Armed Police Force | Pang X.,Institute of Spinal Surgery of Armed Police Force | Li D.,Institute of Spinal Surgery of Armed Police Force | Yang H.,Institute of Spinal Surgery of Armed Police Force
Medicine (United States) | Year: 2015

Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosiswith cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. with concomitant cervical vertigo and hypertension that were treated successfully with ACDF. This study obtained the approval of the medical ethics committee of our hospital (General Hospital of Armed Police Force, Beijing, China). The written informed consent was obtained from the 2 patients before anterior cervical surgery. © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Chen Z.,Institute of Spinal Surgery of Armed Police Force | Peng B.,Institute of Spinal Surgery of Armed Police Force | Li Y.,Institute of Spinal Surgery of Armed Police Force | Zhu J.,Institute of Spinal Surgery of Armed Police Force
Zhonghua yi xue za zhi | Year: 2014

OBJECTIVE: To evaluate the clinical outcomes of Biofelx dynamic stabilization system in the treatment of lumbar degenerative disease (LDD).METHODS: A total of 29 patients (16 males, 13 females) received the treatment of Bioflex between June 2011 and April 2013 were recruited. There were with lumbar spinal stenosis (n = 15), lumbar disc herniation (n = 10) and lumbar spondylolisthesis (n = 4). And they underwent one-segment (n = 14), two-segment (n = 10), three-segment (n = 3) and four-segment (n = 2) implantations. Mean age was 52.3 (38-62) years. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical outcomes. And lumbar radiography was used to observe disc height (DH) and range of motion (ROM) in fixed segment and cranial adjacent segment before and after operation.RESULTS: The mean follow-up period was 22.6 ± 2.1 (8-32) months. The mean ODI score decreased from 39.96 ± 2.58 preoperatively to 11.26 ± 1.76 at 3 months postoperatively (P < 0.05) and 3.97 ± 1.30 at the last follow-up (P < 0.05). The mean VAS score for low back pain dropped from 7.34 ± 0.80 preoperatively to 2.63 ± 1.01 at 3 months postoperatively (P < 0.05) and 0.91 ± 0.32 at the last follow-up (P < 0.05). The mean VAS score for leg pain deceased from 8.63 ± 0.95 preoperatively to 2.13 ± 0.62 at 3 months postoperatively and 0.58 ± 0.65 at the last follow-up (P < 0.05). The implanted segment preserved some ROM at the last follow-up. Compared to preoperative, no statistically significance existed in postoperative DH and ROM (P > 0.05).CONCLUSION: The clinical outcomes of Bioflex system are excellent in the treatment of LDD. As an effective therapy for non-fusion of LDD, it may preserve some ROM of fixed segment and prevent increased range of motion in adjacent segment.

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