Extracellular Vesicles Derived from Ligament Tissue Transport Interleukin-17A to Mediate Ligament-To-Bone Crosstalk in Ankylosing Spondylitis.

Pathological new bone formation is a critical feature of the progression of ankylosing spondylitis (AS), and spine ankylosis is a distinctive feature of this condition. Ligaments are the primary regions of pathological new bone formation in AS. Here, it is demonstrated that ligament tissue-derived extracellular vesicles (EVs) and their interleukin-17A (IL-17A) cargo mediate the communication between the tissue and other cells.

Coronal deformity in ankylosing spondylitis with concomitant thoracolumbar kyphosis: patterns, manifestations and surgical strategies.

Purpose: To evaluate different patterns of coronal deformity secondary to ankylosing spondylitis (AS), to propose relevant treatment strategies, and to assess efficacy of asymmetrical pedicle subtraction osteotomy (APSO).

Methods: Coronal deformity was defined as coronal Cobb angle over 20º or coronal balance distance (CBD) more than 3 cm. 65 consecutive AS patients with concomitant coronal and sagittal deformity who underwent PSO were included.

Nrf-2/ROS/NF-κB pathway is modulated by cynarin in human mesenchymal stem cells in vitro from ankylosing spondylitis.

Ankylosing spondylitis (AS) is an immune chronic inflammatory disease, resulting in back pain, stiffness, and thoracolumbar kyphotic deformity. Based on the reported anti-inflammatory and antioxidant capacities of cynarin (Cyn), this study explored its protective role and molecular mechanisms in mesenchymal stem cells (MSCs) from AS. The target pathways and genes were verified using Western blotting, quantitative real-time polymerase chain reaction, and immunofluorescent staining, while molecular docking analysis was conducted.

The Use of Osteobiologics in Single versus Multi-Level Anterior Cervical Discectomy and Fusion: A Systematic Review.

Study Design: Systematic literature review.

Objectives: In this study we assessed evidence for the use of osteobiologics in single vs multi-level anterior cervical discectomy and fusion (ACDF) in patients with cervical spine degeneration. The primary objective was to compare fusion rates after single and multi-level surgery with different osteobiologics.

Is the pelvic incidence a determinant factor for kyphosis curve patterns of ankylosing spondylitis patients?

To investigate the influence of pelvic incidence (PI) on the kyphosis curve patterns and clinical outcomes in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis and to construct a classification of AS according to the PI value for surgical decision-making. 107 AS patients underwent single-level lumbar pedicle subtraction osteotomy (PSO) and finished a minimal of 2-year follow-up. All patients were divided into three groups: low PI (PI ≤ 40°), moderate PI (40° < PI ≤ 60°), and high PI (PI > 60°).

Risk factors of hip joint structural changes following pedicle subtraction osteotomy for ankylosing spondylitis-related thoracolumbar kyphosis: a minimum two-year observation.

Purpose: To determine the clinical- and surgical-related factors of hip joint structural changes in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis who underwent PSO.

Methods: Hip involvement was assessed by the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-h) and defined by a score of at least 2. 52 patients with BASRI-h scores maintained and 78 patients with BASRI-h scores increased during follow-up were retrospectively reviewed.

Orientation of Osteotomized Vertebrae in 2-Level Pedicle Subtraction Osteotomy Plays a Crucial Role in the Remodeling of Harmonious Sagittal Curve for Severe Thoracolumbar Kyphotic Deformity Caused by Ankylosing Spondylitis.

Background: Few studies reported the remodeling of harmonious sagittal curve after 2-level pedicle subtraction osteotomy (PSO) for severe thoracolumbar kyphosis in ankylosing spondylitis (AS).

Objective: To investigate how the orientation of osteotomized vertebrae (OV) affects the remodeling of harmonious sagittal curve in patients with AS undergoing 2-level PSO.

Methods: Twenty-six patients treated with 2-level PSO were reviewed.

Junctional Kyphosis after Correction with Long Instrumentation for Late Posttraumatic Thoracolumbar Kyphosis: Characteristics and Risk Factors.

Objective: Junctional kyphosis is a common complication after corrective long spinal fusion for adult spinal deformity. Whereas there is still a paucity of data on junctional kyphosis, specifically among late posttraumatic thoracolumbar kyphosis (LPTK) patients. Thus, the aim of this study was to investigate the characteristics and risk factors of junctional kyphosis in LPTK patients receiving long segmental instrumented fusion.

Remodeling morphology of the subluxated osteotomy vertebra in closing-opening wedge osteotomy in ankylosing spondylitis: would the anterior bony beak blunt?

Introduction: To investigate the remodeling morphology of subluxated osteotomy vertebra in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis after single-level closing-opening wedge osteotomy (COWO).

Materials And Methods: Standing lateral radiographs were taken to evaluate sagittal parameters including lumbar lordosis (LL), C7 sagittal vertical axis (SVA), global kyphosis (GK), sacral slope (SS), and pelvic tilt (PT). Radiographic parameters of the osteotomy vertebra included osteotomized vertebra angle (OVA), sagittal translation (ST), anterior height (AH), posterior height (PH), and middle height (MH) of the osteotomy vertebrae.

Pedicle Morphology of Lower Thoracic and Lumbar Spine in Ankylosing Spondylitis Patients with Thoracolumbar Kyphosis: A Comparison with Fracture Patients.

Objective: The pedicle morphology of ankylosing spondylitis (AS)-related thoracolumbar kyphosis patients may be different from that of individuals with normal spine due to the ectopic ossification and kyphotic deformity. However, there was no literature analyzing the pedicle morphology of AS patients with thoracolumbar kyphosis. Therefore, the present study aimed to investigate the pedicle morphology of lower thoracic and lumbar spine (T9-L5) in ankylosing spondylitis (AS)-related thoracolumbar kyphosis patients.

Scoliosis: an unusual clinical presentation of paraspinal ganglioneuroma.

Purpose: To comprehensively present the clinical characteristics and treatment strategies in patients with scoliosis secondary to ganglioneuroma (S-GN).

Methods: Six patients with S-GN treated surgically at a median age of 12 years were retrospectively reviewed and the median follow-up period was 6 years (4-14 years). The radiological features of GN and the associated scoliosis were evaluated.

Does the thoracolumbar kyphosis secondary to ankylosing spondylitis affect the iliac trajectory of S2AI screw?

Background: The study aimed to evaluate the influence of thoracolumbar kyphosis secondary to ankylosing spondylitis (AS) on parameters of S2AI trajectory and to compare the ideal S2AI trajectory with those of the non-deformity patients with AS, sagittal deformity patients without AS, and the normal population reported in literatures.

Methods: Sagittal parameters including global kyphosis (GK), pelvic tilt (PT) and sacral slope (SS) were measured. Besides, according to the simulated ideal S2AI trajectory on the CT images, trajectory parameters were measured including Sag angle, Tsv angle, Max-length, Sacral distance and Iliac width.

Influence of lumbar sagittal profile on pelvic orientation and pelvic motion during postural changes in patients with ankylosing spondylitis-related thoracolumbar kyphosis following pedicle subtraction osteotomy.

Objective: The objective of this study was to investigate the impact of the lumbar sagittal profile on pelvic orientation and pelvic motion during postural changes in patients with ankylosing spondylitis (AS) and thoracolumbar kyphosis and to evaluate the potential risk of prosthetic dislocation after total hip arthroplasty (THA) following pedicle subtraction osteotomy (PSO).

Methods: Seventy-two patients with AS-related thoracolumbar kyphosis following spinal osteotomy were retrospectively reviewed, and 21 healthy volunteers were recruited as a control group. Pre- and postoperative 2D full-body images in standing and sitting positions were obtained to evaluate the anterior pelvic plane angle (APPA), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), proximal femur angle (PFA), and femoroacetabular flexion during postural changes.

Improvement of Pulmonary Function in Arthrogryposis Multiplex Congenita Patients Undergoing Posterior Spinal Fusion Surgery for Concomitant Scoliosis: A Minimum of 3-Year Follow-up.

Objective: We sought to investigate the long-term outcome of pulmonary function for arthrogryposis multiplex congenita (AMC) patients undergoing posterior spinal fusion (PSF) and to further determine influential factors.

Methods: Eighteen AMC patients with a minimum of 3-year follow-up after PSF were prospectively collected. All the patients underwent a pulmonary function test before surgery and at the final follow-up.

Low expression of TCP1 (T-Complex 1) and PSMC1 (Proteasome 26S subunit, ATPase 1) in heterotopic ossification during ankylosing spondylitis.

Heterotopic ossification (HO) is frequently seen in patients with spinal injuries. Therefore, this study aimed to characterize the association of HO with ankylosing spondylitis (AS) through gene expression profiling. The human transcriptomic datasets (GSE73754 and GSE94683) were obtained from the Gene Expression Omnibus database for analysis.

Failure patterns and related risk factors of sagittal reconstruction following pedicle subtraction osteotomy in patients with ankylosing spondylitis and thoracolumbar kyphosis.

Objective: The aim of this study was to analyze the specific patterns and risk factors of sagittal reconstruction failure in ankylosing spondylitis (AS)-related thoracolumbar kyphosis after pedicle subtraction osteotomy (PSO).

Methods: A retrospective study was performed in patients with AS and thoracolumbar kyphosis after lumbar PSO with a minimum follow-up of 2 years. Patients were classified as having successful realignment (group A), inadequate correction immediately postoperatively (group B), and sagittal decompensation during follow-up (group C) according to the immediately postoperative and latest follow-up sagittal vertical axis (SVA).

Occult Andersson lesions in patients with ankylosing spondylitis: undetectable destructive lesions on plain radiographs.

Background: Andersson lesions (ALs) are not uncommon in ankylosing spondylitis (AS). Plain radiography (PR) is widely used for the diagnosis of ALs. However, in our practice, there were some ALs in AS patients that could not be detected on plain radiographs.

Variation patterns of cervical alignment in ankylosing spondylitis-related thoracolumbar kyphosis following pedicle subtraction osteotomy in the sitting position: an EOS-based investigation.

Objective: Both unchanged upper cervical lordosis combined with decreased lower cervical lordosis and decreased upper cervical lordosis combined with decreased lower cervical lordosis have been reported to occur after correction surgery for adult spinal deformity. However, variations in cervical alignment after correction surgery in patients with ankylosing spondylitis (AS) have not been investigated. The current study aimed to investigate the variations in cervical alignment following the correction surgery in AS patients with thoracolumbar kyphosis.

Does the Change of Acetabular Anteversion Result From Lumbar Pedicle Subtraction Osteotomy in Ankylosing Spondylitis-Related Kyphosis After Primary Total Hip Arthroplasty?

Study Design: Retrospective study.

Objectives: To analyze the change in acetabular anteversion (AA) after lumbar pedicle subtraction osteotomy (PSO) in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis who have already undergone total hip arthroplasty (THA).

Methods: AS patients with thoracolumbar kyphosis following lumbar PSO from January 2005 to January 2020 were retrospectively reviewed.

Does the Level of Pedicle Subtraction Osteotomy Affect the Surgical Outcomes in Ankylosing Spondylitis-Related Thoracolumbar Kyphosis With the Same Curve Pattern?

Study Design: A retrospective study.

Objective: To investigate the effect of pedicle subtraction osteotomy (PSO) level on the surgical outcomes in ankylosing spondylitis-related thoracolumbar kyphosis with the same curve pattern.

Methods: ankylosing spondylitis (AS) patients with thoracolumbar kyphosis, who underwent 1-level lumbar PSO between March 2006 and June 2017, were retrospectively reviewed.

When Can One-level Pedicle Subtraction Osteotomy Obtain Satisfied Outcomes for Severe Thoracolumbar Kyphosis with Global Kyphosis ≥80° in Ankylosing Spondylitis: A Comparison with Two-level Pedicle Subtraction Osteotomy.

Study Design: A retrospective study.

Objective: The aim of this study was to make a thorough comparison of clinical and radiographic outcomes between ankylosing spondylitis (AS) patients with severe kyphosis who underwent one- or two-level pedicle subtraction osteotomy (PSO) and to determine the indications of one-level PSO.

Summary Of Background Data: Traditionally, one-level PSO was considered being able to obtain 35° to 40° correction.

The contribution of pre-existing spinal pseudarthrosis to the surgical correction for thoracolumbar kyphosis secondary to ankylosing spondylitis.

The correction of global kyphosis (GK) for ankylosing spondylitis (AS) patients with pre-existing pseudarthrosis were frequently over 45°. Mismatch between kyphosis correction of GK and pedicle subtraction osteotomy (PSO) may be ascribed to contribution of pseudarthrosis. The aim of the present study was to evaluate surgical outcomes of PSO away from the level of pseudarthrosis and to elucidate the contribution of pre-existing spinal pseudarthrosis in surgical correction of thoracolumbar kyphosis caused by AS.

On the pedicle subtraction osteotomy technique and its modifications during the past two decades: a complementary classification to the Schwab's spinal osteotomy classification.

Purpose: To propose a complementary classification to the Schwab's osteotomy classification that would regroup together under a common umbrella different published pedicle subtraction osteotomy (PSO) variations that are commonly used, to have a common language and complete the spine surgeon's armamentarium when dealing with rigid spinal deformities.

Methods: The 2 general types corresponding to the grades 3 and 4 of the Schwab classification were separated into 6 gradual subtypes (grades 3A, 3B, 3C, 4A, 4B, 4C). The classification is based on the amount of resected pedicle, the inclusion or not of the disc above, and the location of the axis of rotation.

Distal Adding-on Phenomenon in Scoliosis Secondary to Chiari Malformation Type I: Incidence and Risk Factors.

Study Design: A retrospective study.

Objective: The aim of this study was to investigate the incidence and risk factors for distal adding-on (AO) phenomenon after posterior spinal fusion (PSF) in scoliosis secondary to Chiari malformation type I (CMS) patients with right major thoracic curve.

Summary Of Background Data: Distal AO phenomenon is a common complication observed in adolescent idiopathic scoliosis (AIS), which is significantly associated with unsatisfactory outcomes.

Utility of Natural Sitting Lateral Radiograph in the Diagnosis of Segmental Instability for Patients with Degenerative Lumbar Spondylolisthesis.

Background: Segmental instability in patients with degenerative lumbar spondylolisthesis is an indication for surgical intervention. The most common method to evaluate segmental mobility is lumbar standing flexion-extension radiographs. Meanwhile, other simple radiographs, such as standing upright radiograph, a supine sagittal magnetic resonance imaging (MRI) or supine lateral radiograph, or a slump or natural sitting lateral radiograph, have been reported to diagnose segmental instability.