Application of restorative neurostimulation for chronic mechanical low back pain in an older population with 2-year follow up.

Introduction: Data on the Medicare-aged population show that older patients are major consumers of low back pain (LBP) interventions. An effective approach for patients with mechanical LBP that has been refractory to conservative management is restorative neurostimulation. The efficacy of restorative neurostimulation has been demonstrated in multiple prospective studies, with published follow-up over 4 years, showing a consistent durable effect.

Real-World Evidence for Restorative Neurostimulation in Chronic Low Back Pain-a Consecutive Cohort Study.

Background: Neuromuscular instability of the lumbar spine resulting from impaired motor control and degeneration of the multifidus muscle is a known root cause of refractory chronic low back pain (LBP). An implantable neurostimulation system that aims to restore multifidus motor control by stimulating the L2 medial branch of the dorsal ramus thereby relieving pain and reducing disability has demonstrated clinically significant benefits in the clinical trial setting. The 1-year results of a single-site real-world cohort study are presented.

Clinical performance of a bone-anchored annular closure device in older adults.

Lumbar discectomy is a common surgical procedure in middle-aged adults. However, outcomes of lumbar discectomy among older adults are unclear. Lumbar discectomy patients with an annular defect ≥6 mm width were randomized to receive additional implantation with a bone-anchored annular closure device (ACD, n=272) or no additional implantation (controls, n=278).

Open versus minimally invasive TLIF: literature review and meta-analysis.

Study Design: This study is a comparative, literature review.

Objective: The aim of this study is to provide a comparative analysis of open vs. minimally invasive TLIF using a literature review and a meta-analysis.

Surgical Experience and Complications in 50 Patients Treated with an Anular Closure Device Following Lumbar Discectomy.

Objective: To examine the results of an anular closure device for prevention of lumbar disc reherniation in daily routine practice.

Methods: Fifty patients with large anular defects were treated with limited discectomy and a bone-anchored anular closure device. The device physically occludes the defect in the anulus fibrosus and is intended for prevention of lumbar disc reherniation.

Seasonality effects on consumers' preferences over quality attributes of different beef products.

Using discrete choice modelling, the study investigates 946 American consumers' willingness-to-pay and preferences for diverse beef products. A novel experiment was used to elicit the number of beef products that each consumer would purchase. The range of products explored in this study included ground, diced, roast, and six cuts of steaks (sirloin, tenderloin, flank, flap, New York and cowboy/rib-eye).

Two-year real-world results of lumbar discectomy with bone-anchored annular closure in patients at high risk of reherniation.

Purpose: To determine the safety and effectiveness of limited lumbar discectomy with additional implantation of an annular closure device (ACD) among patients at high risk of herniation recurrence treated in routine clinical practice.

Methods: This was a prospective, single-center study of lumbar discectomy for sciatica caused by intervertebral disc herniation with adjunctive ACD implantation to reduce herniation recurrence risk among high-risk patients with large annular defects. Patients returned for follow-up visits at 6 weeks, 12 weeks, 26 weeks, 1 year, and 2 years.

A retrospective and consecutive analysis of the epidemiology and management of spinal cavernomas over the last 20 years in a single center.

Spinal cavernous malformations (SCM) are rare lesions often presenting with acute onset of symptoms and progressive neurological deterioration due to hemorrhage into the spinal cord. With the aid of modern techniques, their surgical removal became much safer. The present study was undertaken to analyze the outcome of our series of surgically and conservatively treated patients with SCM.

Management of traumatic spinal injuries in children and young adults.

Purpose: Spinal injuries are rarely seen in pediatric patients and therapeutic options are still poorly defined. The present study is aimed to present our experience with a rather large series of children and young adults suffering from traumatic spinal injury.

Patients And Methods: Between 1990 and 2010, 75 consecutive pediatric patients with spinal injuries were treated in our institution.

A speed limit compliance model for dynamic speed display sign.

Introduction: Violating speed limits is a major cause of motor vehicle crashes. Various techniques have been adopted to ensure that posted speed limits are obeyed by drivers. This study investigates the effect of dynamic speed display signs (DSDSs) on drivers' compliance with posted speed limit.

Cervical spondylodiscitis--a clinical analysis of surgically treated patients and review of the literature.

Objective: The aim of this study was to analyze our clinical and neurological results of surgically treated patients suffering from cervical spondylodiscitis with focusing particularly on the surgical methods used and to review the literature.

Patients And Methods: We present a series of 21 patients operated with cervical spondylodiscitis between 1998 and 2011. Basic demographic data, comorbidities, the radiological segments involved, the surgical strategy with special consideration of the material used and the clinical outcome were evaluated retrospectively.

Elderly patients are at increased risk for mortality undergoing surgical repair of dens fractures.

Objective: Dens fractures are common cervical injuries in advanced aged patients. The presented study was undertaken to analyze the clinical results and risks of surgically treated patients with dens fractures over 70 years.

Methods: Data of 28 patients (17 female, 11 male) over 70 years treated from September 2004 to October 2009 were recorded.

Intramedullary spinal cord astrocytomas: the influence of localization and tumor extension on resectability and functional outcome.

Background: Intramedullary spinal cord tumors (IMSCT) are rare lesions, ependymomas and astrocytomas being the most common ones. Different studies have been published showing results of different treatment strategies as extensive/ limited surgery, biopsy and adjuvant radiation therapy with regard to functional outcome and survival. The present study was undertaken to analyse our series of surgically treated intramedullary astrocytomas in order to identify factors with impact on functional outcome and resectability.

Non-destructive label-free monitoring of collagen gel remodeling using optical coherence tomography.

Matrix remodeling plays a fundamental role in physiological and pathological processes, as well as in tissue engineering applications. In this paper, optical coherence tomography (OCT), a non-destructive optical imaging technology, was used to image collagen gel remodeling by smooth muscle cells (SMCs). The optical scattering properties of collagen-SMC gels were characterized quantitatively by fitting OCT data to a theoretical model.

Poly (ADP-ribose) polymerase-1 initiated neuronal cell death pathway--do androgens matter?

Activation of poly (ADP-ribose) polymerases (PARP) contributes to ischemic damage by causing neuronal nicotinamide adenine dinucleotide (NAD(+)) depletion, release of apoptosis-inducing factor and consequent caspase-independent cell death. PARP-mediated cell death is sexually dimorphic, participating in ischemic damage in the male brain, but not the female brain. We tested the hypothesis that androgen signaling is required for this male-specific neuronal cell death pathway.

Evaluation of new radiolucent polymer headholder pins for use in intraoperative computed tomography.

Object: With the introduction of intraoperative CT (iCT) scanning, neurosurgeons can now obtain images of the brain during surgery, offering the possibility of intraoperative resection control and monitoring of potential intraoperative complications. The combination of iCT with neuronavigation makes it possible to update the reference scans intraoperatively when necessary. However, the headholder pins normally used for iCT scanning still show artifacts.

Causal role of apoptosis-inducing factor for neuronal cell death following traumatic brain injury.

Traumatic brain injury (TBI) consists of two phases: an immediate phase in which damage is caused as a direct result of the mechanical impact; and a late phase of altered biochemical events that results in delayed tissue damage and is therefore amenable to therapeutic treatment. Because the molecular mechanisms of delayed post-traumatic neuronal cell death are still poorly understood, we investigated whether apoptosis-inducing factor (AIF), a pro-apoptotic mitochondrial molecule and the key factor in the caspase-independent, cell death signaling pathway, plays a causal role in neuronal death following TBI. Using an in vitro model of neuronal stretch injury, we demonstrated that AIF translocated from mitochondria to the nucleus of neurons displaying axonal disruption, chromatin condensation, and nuclear pyknosis in a caspase-independent manner, whereas astrocytes remained unaffected.

Ischemic insult to cerebellar Purkinje cells causes diminished GABAA receptor function and allopregnanolone neuroprotection is associated with GABAA receptor stabilization.

Cerebellar Purkinje cells (PC) are particularly vulnerable to ischemic injury and excitotoxicity, although the molecular basis of this sensitivity remains unclear. We tested the hypothesis that ischemia causes rapid down-regulation of GABA(A) receptors in cerebellar PC, thereby increasing susceptibility to excitotoxicity. Oxygen-glucose deprivation (OGD) caused a decline in functional GABA(A) receptors, within the first hour of re-oxygenation.

Soluble epoxide hydrolase gene deletion is protective against experimental cerebral ischemia.

Background And Purpose: Cytochrome P450 epoxygenase metabolizes arachidonic acid to epoxyeicosatrienoic acids (EETs). EETs are produced in the brain and perform important biological functions, including vasodilation and neuroprotection. However, EETs are rapidly metabolized via soluble epoxide hydrolase (sEH) to dihydroxyeicosatrienoic acids (DHETs).

Multiple cerebral cavernous malformations associated with extracranial mesenchymal anomalies.

Cerebral cavernous malformations (CCM) are common hamartous dysplasias characterized by abnormally dilated vascular channels. CCM mostly occur sporadically, and multiple occurrence of CCM is highly suggestive of a genetic origin of the disorder. Typical clinical symptoms are seizures, hemorrhages, focal neurological deficits, and headaches.

Mitochondrial mechanism of neuroprotection by CART.

We previously demonstrated that the neuropeptide cocaine- and amphetamine-regulated transcript (CART) is protective against focal cerebral ischemia in vivo and against neuronal cell death in culture induced by oxygen-glucose deprivation (OGD). The mechanism of neuroprotection by CART is unknown, in part due to lack of knowledge regarding its putative receptor. Using a yeast two-hybrid system with CART's carboxy-terminal to screen a mouse brain cDNA library, we uncovered a potential direct interaction between CART and subunit B of the mitochondrial enzyme succinate dehydrogenase (SDHB).

Microsurgical anatomy of the mesencephalic veins.

Object: The mesencephalic veins drain crucial brainstem areas. Due to the narrowness of the tentorial notch, these veins can become obstructed as a result of herniation or surgery, leading to hemorrhage and severe consequences for the patient. There is little in the literature about the mesencephalic veins.

Delayed neuronal death after brain trauma involves p53-dependent inhibition of NF-kappaB transcriptional activity.

Acute and chronic neurodegeneration, for example, following brain injury or Alzheimer's disease, is characterized by programmed death of neuronal cells. The present study addresses the role and interaction of p53- and NF-kappaB-dependent mechanisms in delayed neurodegeneration following traumatic brain injury (TBI). After experimental TBI in mice p53 rapidly accumulated in the injured brain tissue and translocated to the nucleus of damaged neurons, whereas NF-kappaB transcriptional activity simultaneously declined.

[Clinical and diagnostic characteristics of T1 root syndrome].

Background: Among radicular lesions, those affecting the T1 root are rare. Together with the similarity of symptoms to C8 syndrome, which is more common, this makes the diagnosis of T1 radiculopathy complicated. The clinical and diagnostic specifics of T1 syndrome are shown here based on three cases.

Mechanism of progesterone neuroprotection of rat cerebellar Purkinje cells following oxygen-glucose deprivation.

The survival of rat Purkinje cell (PCs) cerebellar cultures was used to test the hypothesis that progesterone is protective against oxygen-glucose deprivation through potentiation of GABA(A) receptor activity. Electrophysiological recordings confirm that PCs develop robust excitatory and inhibitory synapses in culture. Exposure of cultured PCs to increasing concentrations of progesterone during oxygen-glucose deprivation revealed a concentration-dependent protection by progesterone, with significant protection observed at physiological concentrations, as low as 10 nm.