Spine
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Mechanobiology study of gene expression changes as a result of compressive overload of anular fibrochondrocytes. ⋯ The up-regulation of the ECM genes with nominal pressure highlights the mechanobiological importance of common activity in fibrocartilage homeostasis. Differential regulation of the 2 primary collagen types with high pressure indicates a capacity of the anulus to remodel according to pathomechanical conditions.
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This study clarifies the relation between the results of the Scoliosis Research Society Outcomes Instrument (SRS-24) and radiographic parameters of back deformity in Japanese idiopathic scoliosis patients. ⋯ The patients did not have negative self-image regarding back appearance when the thoracic curve Cobb angle was less than 30 degrees but had a negative self-image when the thoracic curve Cobb angle was more than 40 degrees and the rotation angle was more than 20 degrees. On the other hand, the lumbar curve Cobb angle and the rotation angle did not correlate with patient self-image. The results of the present study will help to define the parameters for the initiation of active treatment and physicians should maintain or reduce scoliotic deformity so that the thoracic curve Cobb angle is less than 40 degrees and the rotation angle is less than 20 degrees in idiopathic scoliosis.
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Case Reports
Cerebrospinal fluid fistula secondary to dural tear in anterior cervical discectomy and fusion: case report.
A case of cerebrospinal fistula secondary to a dural tear during anterior cervical discectomy and fusion. ⋯ Early identification of this complication and aggressive treatment with insertion of lumbar drain, CSF drainage for 4-5 days, and coverage of the dural tear with fibrin sealant or autologous fascia graft can prevent the development of any consequences.
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A non-human primate lumbar intertransverse process arthrodesis model was used to evaluate the effectiveness of different formulations of recombinant human bone morphogenetic protein-2 (rhBMP-2) to induce consistent bone formation. ⋯ This study shows the importance of carrier optimization and final implant protein concentration for the successful delivery of rhBMP-2. By combining the properties of the ACS with the CRM, the required dosage of rhBMP-2 was diminished by more than 3-fold in the non-human primate model. This finding suggests that the currently available concentration of rhBMP-2 (1.5 mg/mL) could be successful for achieving posterolateral spine fusion when combined with an osteoconductive bulking agent that can support the induced new bone formation.
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Feasibility analysis of percutaneous posterolateral thoracic microendoscopic discectomy in a human cadaver model. ⋯ Thoracic microendoscopic discectomy allows for a posterolateral approach to thoracic disc herniation without entry into the chest cavity that consistently gives access to the majority of the canal while requiring only a minimal amount of bone removal. This technique provides an approach angle similar to that obtained with other posterolateral discectomy techniques while limiting the morbidity associated with exposure.