Spine
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We measured the expression and responses of Toll-Like Receptor 4 (TLR4) activation in the intervertebral disc (IVD) in vitro and in vivo. We hypothesize that stimulation of the IVD with the TLR4 ligand lipopolysaccharide (LPS) results in upregulation of a coordinated set of proinflammatory mediators and inhibition of matrix expression, both consistent with a molecular profile of degeneration. ⋯ This study provides the first evidence that IVD cells express TLR4 and are responsive to TLR4 activation by upregulating a coordinated set of inflammatory cytokines. This study suggests that intradiscal injection of LPS offers a model for triggering inflammation of the IVD, demonstrating that inflammatory insults alone may potentially trigger degenerative changes of the IVD.
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Experimental study. ⋯ The high-dose parecoxib-soaked absorbable gelatin sponge can prevent peridural fibrosis without complications. The low-dose parecoxib and cellulose membrane provided no significant benefit vis-à-vis prevention of peridural fibrosis, as adduced from the lack of any statistically significant difference between the test and control rats.
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Multicenter Study
Selective thoracic fusion in Lenke 1C curves: prevalence and criteria.
Multicenter retrospective analysis of prospectively collected data. ⋯ 3.
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Comparative Study
Comparison of image quality and radiation exposure from C-arm fluoroscopes when used for imaging the spine.
Cadaveric imaging study. ⋯ This is the first time that the spine image quality and radiation exposure of commonly used C-arm machines have been compared. The OEC was ranked the best, produced the best quality images, and had the least amount of radiation.
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Multivariate analysis of prospectively collected registry data. ⋯ After univariate and multivariate analyses, Medicaid insurance status was found to be a risk factor for postoperative complications. This corresponds to an ever-growing body of medical literature that has shown similar trends and raises the concern of underinsurance.