European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Spinal tuberculosis represents a challenging disease to treat, not because of the technical expertise or the time required to cure it, but more so because of the decisions involved to treat it. The Medical Research Council (MRC) Working Party on Tuberculosis of the Spine designed trials to help address several questions. ⋯ Improvement in quality of life is also accompanied by higher patient expectations. Though developing nations may lack the resources now, eventually patients will demand better functional and cosmetic results after being afflicted by this disfiguring and potentially disabling disease, and the "Hong Kong operation" represented the best outcome, provided resources were available.
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Tuberculosis (TB) continues to be an important public health problem in developed countries especially in deprived socioeconomic groups, older people, immunocompromised patients, drug-therapy resistant cases and the immigrant population. The spine is the most frequent location of musculoskeletal TB. The wide range of clinical presentations results in difficulties and delays in diagnosis. ⋯ In this essay the highlights of TB imaging are reviewed through published literature. In addition, we review retrospectively the radiological findings of 48 patients with tuberculous spondylitis treated from 1993 to 2010. There were 23 male and 25 female patients with a mean age of 53 years.
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5-Aminolevulinic acid (5-ALA)-based fluorescence-guided surgery was shown to be beneficial for cerebral malignant gliomas. Extension of this technique for resection of meningiomas and cerebral metastasis has been recently evaluated. Aim of the present study is to evaluate the impact of fluorescence-guided surgery in spinal tumor surgery. ⋯ The present study demonstrates that spinal intramedullary gliomas and the majority of spinal intradural meningiomas are 5-ALA positive. As a surgical consequence, especially in intramedullary gliomas, the use of 5-ALA fluorescence seems to be beneficial.
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Adolescent Idiopathic Scoliosis (AIS) is considered a complex genetic disease, in which malfunctioning or dysregulation of one or more genes has been proposed to be responsible for the expressed phenotype. However, to date, no disease causing genes has been identified and the pathogenesis of AIS remains unknown. The aim of this study is, therefore, to identify specific molecules with differing expression patterns in AIS compared to healthy individuals. ⋯ This study reports on the expression of molecules that have not been described previously in AIS. We also provide for the first time gene interaction pathways in AIS pathogenesis. These genes are involved in various bone regulatory and developmental pathways and many of them can be grouped into clusters to participate in a particular biological pathway. Further studies can be built on our findings to further elucidate the association between different biological pathways and the pathogenesis of AIS.
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Risk factors for falling in elderly people remain uncertain, and the effects of spinal factors and physical ability on body balance and falling have not been examined. The objective of this study was to investigate how factors such as spinal sagittal alignment, spinal range of motion, body balance, muscle strength, and gait speed influence falling in the prospective cohort study. ⋯ Good spinal sagittal alignment, muscle strength and 10-m gait speed improve body balance and reduce the risk of fall. Muscle strength and physical ability are also important for spinal sagittal alignment. Body balance training, improvement of physical abilities including muscle training, and maintenance of spinal sagittal alignment can lead to prevention of fall.