Objective To investigate the effect of notochordal cells (NCs) conditioned medium (NCCM) on theprol iferation and differentiation of bone marrow mesenchymal stem cells (BMSCs). Methods NCs and BMSCs wereisolated from the thoracolumbar intervertebral disc and the femurs of 4-week-old Japanese white rabbits, respectively. NCswere cultured with DMEM/F12 medium containing 15% FBS for 5 days to prepare NCCM. The experiment consisted of2 groups: BMSCs were cultured with NCCM in experimental group and with DMEM/F12 medium containing 15% FBSin control group. The prol iferation of BMSCs was assessed by cell counting kit-8 at 1, 3, 5, 7, 9, and 14 days after culture;the expression of proteoglycan and collagen type II were determined by immunofluorescence and real-time fluorescentquantitative PCR at 7 and 14 days after culture. Results NCs and BMSCs were successfully isloated. At 5, 7, 9, and 14days, the number of BMSCs in the experimental group was significantly more than those in the control group (P lt; 0.05).At 7 and 14 days, there was no expression or less expression of proteoglycan and collagen type II in the control group;however, there was a lot of expression of proteoglycan and collagen type II in the experimental group, and the expressionswere higher at 14 days than at 7 days. At 7 and 14 days after culture, the mRNA expressions of proteoglycan and collagentype II were significantly higher in the experimental group than in the control group (P lt; 0.05), and at 14 days than at 7days in the experimental group (P lt; 0.05). Conclusion NCCM can promote the prol iferation and the differentiation ofBMSCs into chondroyte-like cells, which provides the basis for NCs and BMSCs as seed cells in the treatment of degenerativedisc disease.
Objective To discuss the key issues in the diagnosis and treatment of degenerative disc disease and thetherapeutic effect of transforaminal lumbar interbody fusion on it. Methods From September 2004 to August 2006, 15 cases of degenerative disc disease were treated by transforaminal lumbar interbody fusion, including 8 males and 7 females with the age of 33-46 years. All cases were single-level degenerative disc diseases, including 1 case of L3,4, 8 cases of L4,5 and 6 cases of L5, S1. The course of the disease was 2 -10 years. Preoperatively, the score of visual analogue scale (VAS) was 8.9 ± 1.8 and the score of Oswestry disabil ity index (ODI) was 51.4 ± 8.3. All patients had received normal conventional treatment for at least 3 months and had no therapeutic effect before operation. Results The operation time was 120-180 minutes (150 minutes on average) and the intra-operative blood loss was 200-500 mL (360 mL on average). There was no severe compl ication, except that the muscle tone of anterior tibia in one case decreased to the third level, which recovered to the 5- level 3 months after operation. A total of 15 cases were followed up for 12-24 months (18 months on average). All patients got interbody bony fusion 12 months after operation with the fusion rate of 100%. Postoperatively, the score of VAS was 2.8 ± 1.6 and the score of ODI was 19.1 ± 3.2, indicating there were significant difference in comparison with postoperative ones (P lt; 0.05). The improvement rates of postoperative VAS and ODI were 61.8% ± 7.3% and 64.3% ± 5.5%, respectively. For the therapeutic effect, 6 cases were regardedas excellent, 8 good, 1 fair, and the choiceness rate was 93.3%. All patients resumed their jobs and normal l ives. Conclusion Transforaminal lumbar interbody fusion is effective for the treatment of lumbar degenerative disc disease, but the indications for operation must be strictly defined.