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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Case Reports
Fusionless posterior hemivertebra resection in a 2-year-old child with 16 years follow-up.
We present the case of a 2-year-old patient with congenital scoliosis due to a lumbar hemivertebra. The current gold standard treatment of such an abnormality would be hemivertebra resection and short level posterior spinal fusion. However, due to the young age of the patient, we considered that application of a fusionless solution might offer advantages in terms of retaining normal segmental motion and the potential for growth. ⋯ To our knowledge a fusionless surgical solution for the treatment of a hemivertebra has never been described before. Although this is only a single case, the good result with a long follow-up suggests the technique is worthwhile considering when planning the treatment of a lumbar hemivertebra in very young children.
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Comparative Study
Influence of different commercial scaffolds on the in vitro differentiation of human mesenchymal stem cells to nucleus pulposus-like cells.
Cell-based therapies for regeneration of the degenerated intervertebral disc (IVD) are an alternative to current surgical intervention. Mesenchymal stem cells (MSCs), in combination with a scaffold, might be ideal candidates for regenerating nucleus pulposus (NP), the pressure-distributing part of the IVD. While the use of growth factors for MSCs differentiation currently receives major attention, in this study we compare the performance of sponge-like matrixes in supporting cell differentiation into NP-like cells. ⋯ Collagen supports provide a readily available, medically approved and effective scaffold for chondrogenic differentiation in vitro, but the phenotype of differentiated MSCs is not yet completely equivalent to that of NP cells.
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The correlation of cervical biomechanics and neck pain in young patients has, to date, only been described in terms of small cohorts. This study focuses on the correlation of chronic neck pain and cervical biomechanics. ⋯ This study describes the largest cohort of biomechanical data of the cervical spine in young adult recorded to date. The findings demonstrate that no correlation was found between neck pain, CROM and maximal torque in the study cohort. On this basis, we conclude that the CROM and maximal cervical torque should not be used as indicators to measure the progress of chronic neck pain in physiotherapy training and sports medicine for the young adult.
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The aim of the study was to undertake the process of cultural adaptation of the Brace Questionnaire (BrQ) into Polish. ⋯ Polish version of the BrQ is reliable and can be used in adolescents with idiopathic scoliosis wearing the brace to assess their quality of life.
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Even though transarticular screw (TAS) fixation has been commonly used for posterior C1-C2 arthrodesis in both traumatic and non-traumatic lesions, anterior TAS fixation C1-2 is a less invasive technique as compared with posterior TAS which produces significant soft tissue injury, and there were few reports on percutaneous anterior TAS fixation and microendoscopic bone graft for atlantoaxial instability. The goals of our study were to describe and evaluate a new technique for anterior TAS fixation of the atlantoaxial joints for traumatic atlantoaxial instability by analyzing radiographic and clinical outcomes. ⋯ Percutaneous anterior TAS fixation and microendoscopic bone graft could be an option for achieving C1-C2 stabilization with several potential advantages such as less tissue trauma and better accuracy. Bilateral TAS fixation and morselized autograft affords effective fixation and solid fusion by a minimally invasive approach.