Journal of neurosurgery. Spine
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Comparative Study
Biomechanical comparison of two new atlantoaxial fixation techniques with C1-2 transarticular screw-graft fixation.
Two new techniques for atlantoaxial fixation have been recently described. In one technique, C-2 intralaminar screws are connected with C-1 lateral mass screws; in the second, C-1 and C-3 lateral mass screws are interconnected and C-2 is wired sublaminarly. Both techniques include a C1-2 interspinous graft. The authors compared these techniques with the gold-standard, interspinous graft-augmented C1-2 transarticular screw fixation and with a control C1-2 interspinous graft fixation procedure alone. ⋯ Biomechanically, the gold-standard C1-2 transarticular screw fixation outperformed the two new techniques during lateral bending and axial rotation. Wiring C-2 to C1-3 rods provided greater stability than C1-2 laminar screws, but it sacrificed C2-3 mobility. It is unknown whether the small differences observed biomechanically would lead to clinically relevant differences in fusion rates.
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The authors sought to clarify the role, if any, of advanced glycation end-products (AGEs) in disc degeneration. ⋯ These results suggest that the accumulation of AGEs and their interaction with their receptor in the nucleus pulposus might result in the downregulation of aggrecan production responsible for disc degeneration.
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The purpose of this study was to investigate the therapeutic time window for antiinflammatory treatment within the first 24 hours of spinal cord injury (SCI). The authors have shown that an anti-CD11d antibody treatment attenuates leukocyte infiltration and improves neurological function when administered beginning 2 hours after SCI. A more clinically relevant time for the initiation of treatment after SCI, however, is 6 or more hours postinjury. ⋯ These findings suggest that antiinflammatory treatments that reduce secondary tissue damage after SCI may be delayed until 6 hours postinjury and still be effective.