后纵韧带骨化(ossification of the posterior longitudinal ligament,OPLL)是指后纵韧带发生异位骨化的一种病理状态。对伴有神经损害的颈椎OPLL患者,建议行手术治疗。传统的颈椎前路手术一般通过切除对应椎间盘或椎体、暴露并切除骨...后纵韧带骨化(ossification of the posterior longitudinal ligament,OPLL)是指后纵韧带发生异位骨化的一种病理状态。对伴有神经损害的颈椎OPLL患者,建议行手术治疗。传统的颈椎前路手术一般通过切除对应椎间盘或椎体、暴露并切除骨化物来直接解除脊髓和神经根的压迫,适用于椎管侵占率>60%、OPLL<3个节段的患者[1]。常用术式包括颈前路椎体次全切除融合术(anterior cervical corpectomy and fusion,ACCF)和前路颈椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF)。2018年之后的新术式包括Lee等[2]发明的椎体截骨前移术(vertebral body sliding osteotomy,VBSO)及史建刚等[3]改良的颈椎前路椎体骨化物复合体前移融合术(anterior controllable antedisplacement fusion,ACAF),即通过截骨后将骨化物连同前方椎体一同牵引前移来达到减压效果。前路手术可以直接解除OPLL的压迫,但缺点是并发症发生率较高[4]。OPLL患者颈椎前路手术常见的并发症包括:术中并发症(如硬膜囊损伤与脑脊液漏、脊髓或神经根损伤、椎动脉损伤)、术后早期并发症(如血肿、喉返神经麻痹、喉上神经损伤、吞咽困难)、术后远期并发症(如相邻节段退变、植骨不融合与假关节形成)[5]。为了进一步系统认识前路手术治疗颈椎OPLL的风险和影响因素,笔者主要对上述并发症及相关因素和预防措施的研究进展综述如下。展开更多
Two kinds of rosin derivatives, （2-hydroxy-3-（methacryloyloxy）propyl 7-isopropyl-1,4a-dimethyl-1,2,3,4,4a,4b,5,6,10,10a- decahydrophenanthrene-1-carboxylate） （HMPIDDC） and （（（7-isopropyl-1,4a-dimethyl-1,2,3,4...Two kinds of rosin derivatives, （2-hydroxy-3-（methacryloyloxy）propyl 7-isopropyl-1,4a-dimethyl-1,2,3,4,4a,4b,5,6,10,10a- decahydrophenanthrene-1-carboxylate） （HMPIDDC） and （（（7-isopropyl-1,4a-dimethyl-1,2,3,4,4a,9,10,10a-octahydrophenan- thren-1-yl）methyl）azanediyl）bis（2-hydroxypropane-3,1-diyl）bis（2-methylacrylate） （IDOMAHM） were synthesized under mild and easy to implement conditions. The two derivatives were employed as the rigid monomers to copolymerize with acrylated epoxidized soybean oil （AESO）, as so to improve the performance of the cured resins. The chemical structures of HMPIDDC and IDOMAHM were confirmed by nuclear magnetic resonance （NMR） and Fourier Transform Infrared （FT-IR） before copolymerization. The curing behaviors of pristine AESO, AESO/HMPIDDC blend, and AESO/IDOMAHM blend were monitored by differential scanning calorimetry （DSC）. Moreover, the thermal and mechanical properties of the cured resins were evaluated by universal mechanical testing, dynamic mechanical analysis （DMA） and thermogravimetric analysis （TGA）. The results demonstrated that after the introduction of HMPIDDC and IDOMAHM, the glass transition temperature and mechanical properties of the copolymerized resin were significantly increased. In one word, HMPIDDC and IDOMAHM showed dramatic potential to be used as bio-based compounds to improve the properties of soybean-oil based thermosets.展开更多
文摘后纵韧带骨化(ossification of the posterior longitudinal ligament,OPLL)是指后纵韧带发生异位骨化的一种病理状态。对伴有神经损害的颈椎OPLL患者,建议行手术治疗。传统的颈椎前路手术一般通过切除对应椎间盘或椎体、暴露并切除骨化物来直接解除脊髓和神经根的压迫,适用于椎管侵占率>60%、OPLL<3个节段的患者[1]。常用术式包括颈前路椎体次全切除融合术(anterior cervical corpectomy and fusion,ACCF)和前路颈椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF)。2018年之后的新术式包括Lee等[2]发明的椎体截骨前移术(vertebral body sliding osteotomy,VBSO)及史建刚等[3]改良的颈椎前路椎体骨化物复合体前移融合术(anterior controllable antedisplacement fusion,ACAF),即通过截骨后将骨化物连同前方椎体一同牵引前移来达到减压效果。前路手术可以直接解除OPLL的压迫,但缺点是并发症发生率较高[4]。OPLL患者颈椎前路手术常见的并发症包括:术中并发症(如硬膜囊损伤与脑脊液漏、脊髓或神经根损伤、椎动脉损伤)、术后早期并发症(如血肿、喉返神经麻痹、喉上神经损伤、吞咽困难)、术后远期并发症(如相邻节段退变、植骨不融合与假关节形成)[5]。为了进一步系统认识前路手术治疗颈椎OPLL的风险和影响因素,笔者主要对上述并发症及相关因素和预防措施的研究进展综述如下。
基金supported by the Youth Innovation Promotion Association of the Chinese Academy of Sciences(Grant No.2012229)Natural Sciences Foundation of Ningbo City(Grant No.2014A610110)+1 种基金Research Project of Technology Application for Public Welfare of Zhejiang Province(Grant No.2014C31143)National Natural Science Foundation of China(Grant Nos.51373194,51203176)
文摘Two kinds of rosin derivatives, （2-hydroxy-3-（methacryloyloxy）propyl 7-isopropyl-1,4a-dimethyl-1,2,3,4,4a,4b,5,6,10,10a- decahydrophenanthrene-1-carboxylate） （HMPIDDC） and （（（7-isopropyl-1,4a-dimethyl-1,2,3,4,4a,9,10,10a-octahydrophenan- thren-1-yl）methyl）azanediyl）bis（2-hydroxypropane-3,1-diyl）bis（2-methylacrylate） （IDOMAHM） were synthesized under mild and easy to implement conditions. The two derivatives were employed as the rigid monomers to copolymerize with acrylated epoxidized soybean oil （AESO）, as so to improve the performance of the cured resins. The chemical structures of HMPIDDC and IDOMAHM were confirmed by nuclear magnetic resonance （NMR） and Fourier Transform Infrared （FT-IR） before copolymerization. The curing behaviors of pristine AESO, AESO/HMPIDDC blend, and AESO/IDOMAHM blend were monitored by differential scanning calorimetry （DSC）. Moreover, the thermal and mechanical properties of the cured resins were evaluated by universal mechanical testing, dynamic mechanical analysis （DMA） and thermogravimetric analysis （TGA）. The results demonstrated that after the introduction of HMPIDDC and IDOMAHM, the glass transition temperature and mechanical properties of the copolymerized resin were significantly increased. In one word, HMPIDDC and IDOMAHM showed dramatic potential to be used as bio-based compounds to improve the properties of soybean-oil based thermosets.
