Improved Posterolateral Lumbar Spinal Fusion Using a Biomimetic, Nanocomposite Scaffold Augmented by Autologous Platelet-Rich Plasma.

Remodeling of the human bony skeleton is constantly occurring with up to 10% annual bone volume turnover from osteoclastic and osteoblastic activity. A shift toward resorption can result in osteoporosis and pathologic fractures, while a shift toward deposition is required after traumatic, or surgical injury. Spinal fusion represents one such state, requiring a substantial regenerative response to immobilize adjacent vertebrae through bony union.

Patient-reported Outcomes Following Surgical Intervention for Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis.

Study Design: This was a systematic review and meta-analysis.

Objective: This study aims to perform a systematic review and quantitative meta-analysis of patient-reported outcome measures after spinal fusion for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Radiographic correction of scoliosis is extensively reported in the literature but there is a need to study the impact of spinal fusion on patient-reported outcome measures.

Link protein N-terminal peptide and fullerol promote matrix production and decrease degradation enzymes in rabbit annulus cells.

Purpose: Intervertebral disc degeneration is a major cause of back pain. Novel therapies for prevention or reversal of disc degeneration are needed. It is desirable for potential therapies to target both inflammation and matrix degeneration.

Nanoparticle fullerol alleviates radiculopathy via NLRP3 inflammasome and neuropeptides.

The present study aimed to evaluate the analgesic effect of the antioxidant nanoparticle fullerol in a mouse radiculopathy and a dorsal root ganglion (DRG) culture models. Intervertebral disk degeneration causes significant hyperalgesia and nerve inflammation. Pain sensitization and inflammatory reaction were counteracted by fullerol when disk material was bathed in 10 or 100μM of fullerol prior to implantation.

Dynamic Evaluation of the Cervical Spine and the Spinal Cord of Symptomatic Patients Using a Kinetic Magnetic Resonance Imaging Technique.

Purpose: The purpose of this study was to examine the movement of the spinal cord and its relationship to the spinal canal in patients with mild spondylosis using kinetic magnetic resonance imaging (kMRI).

Methods: Weight-bearing, multiposition kMRI was performed on symptomatic patients through a full range of flexion-extension. A total of 52 study patients were selected based on the C2-C7 Cobb angle of sagittal alignment: lordotic (from 30 to 45 degrees).

Growth-Factor Nanocapsules That Enable Tunable Controlled Release for Bone Regeneration.

Growth factors are of great potential in regenerative medicine. However, their clinical applications are largely limited by the short in vivo half-lives and the narrow therapeutic window. Thus, a robust controlled release system remains an unmet medical need for growth-factor-based therapies.

The Evaluation and Observation of "Hidden" Hypertrophy of Cervical Ligamentum Flavum, Cervical Canal, and Related Factors Using Kinetic Magnetic Resonance Imaging.

Study Design Retrospective cohort study. Objective The objective was to measure the change of flavum ligament diameter during positional changes of the cervical spine using kinetic magnetic resonance imaging (MRI) and to examine the correlational diameter changes of the flavum ligament, disk bulging, and the spinal canal from extension to flexion positions. Methods One hundred eight-nine patients underwent kinetic MRI in neutral, extension, and flexion positions.

The Occupancy of the Components in the Cervical Spine and Their Changes with Extension and Flexion.

Study Design Retrospective case series. Objectives The kinematics of the cervical spine has been investigated by many researchers. However, the occupancy of the disk bulges, spinal cord, ligamentum flavum, and the rest of the canal as well as the changes of these structures with motion have not yet been investigated.

The effect of bone morphogenetic protein-2 injection at different time points on intervertebral disk degeneration in a rat tail model.

Study Design: Prospective in vivo rat tail model of disk degeneration comparing the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) injection over various time points and grades of degeneration.

Objective: To evaluate the effect of timing and disk grade on rhBMP-2 injection in a rat tail model of disk degeneration.

Summary Of Background Data: rhBMP-2 stimulates the proliferation of intervertebral disk cells and the secretion of extracellular matrix.

Effect of head and neck positioning on cerebral perfusion during shoulder arthroscopy in beach chair position.

The aim of this prospective cohort study was to investigate the effect of head and neck positioning on cerebral perfusion during shoulder arthroscopy in the beach chair position. Regional cerebral tissue oxygen saturation (rSO2) was monitored intraoperatively using near-infrared spectroscopy on 51 consecutive patients undergoing arthroscopic shoulder surgery in the beach chair position. The head of each subject was manipulated by the examiner and sequentially positioned for 45 seconds in terminal flexion, extension, bilateral rotation, and bilateral lateral bending.

Effect of cervical kyphotic deformity type on the motion characteristics and dynamic spinal cord compression.

Study Design: Retrospective analysis of kinematic magnetic resonance images.

Objective: To provide baseline data on the segmental angular and translational motion of the degenerated cervical spine by subtype of kyphotic cervical deformity and to elucidate the relationship between motion and degree of spinal cord compression.

Summary Of Background Data: Kyphotic deformities of the cervical spine are relatively common and are classified as either global or focal.

A novel osteogenic oxysterol compound for therapeutic development to promote bone growth: activation of hedgehog signaling and osteogenesis through smoothened binding.

Osteogenic factors are often used in orthopedics to promote bone growth, improve fracture healing, and induce spine fusion. Osteogenic oxysterols are naturally occurring molecules that were shown to induce osteogenic differentiation in vitro and promote spine fusion in vivo. The purpose of this study was to identify an osteogenic oxysterol more suitable for clinical development than those previously reported, and evaluate its ability to promote osteogenesis in vitro and spine fusion in rats in vivo.

Migration inhibitory factor enhances inflammation via CD74 in cartilage end plates with Modic type 1 changes on MRI.

Background: Type 1 Modic changes are characterized by edema, vascularization, and inflammation, which lead to intervertebral disc degeneration. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine closely related to the inflammatory cytokines detected in degenerative intervertebral disc tissues. However, the existence and role of MIF and its receptor CD74 in intervertebral disc degeneration have not been elucidated.

Lumbar clinical adjacent segment pathology: predilection for proximal levels.

Study Design: Retrospective case series.

Objective: To evaluate reoperations for lumbar adjacent segment pathology (ASP) during a 10-year period.

Summary Of Background Data: ASP after lumbar arthrodesis is an important clinical problem.

The Compensatory Relationship of Upper and Subaxial Cervical Motion in the Presence of Cervical Spondylosis.

Study Design: This study was an in vivo kinematic magnetic resonance imaging analysis of cervical spinal motion in human subjects.

Objective: The objective of the study was to identify associations between disk degeneration in the subaxial cervical spine and upper cervical spinal motion in patients with general age-related cervical spondylosis.

Summary Of Background Data: The kinematic relationship between the occipital-atlantoaxial complex and subaxial cervical spine in patients with cervical spondylosis and decreased cervical motion is not well understood.

Secreted phosphoprotein 24 kD (Spp24) and Spp14 affect TGF-β induced bone formation differently.

Transforming growth factor-β (TGF-β) and bone morphogenetic proteins (BMPs) have opposing but complementary functions in directing bone growth, repair, and turnover. Both are found in the bone matrix. Proteins that bind to and affect the activity of these growth factors will determine the relative abundance of the growth factors and, therefore, regulate bone formation.

BMP-2 adverse reactions treated with human dose equivalent dexamethasone in a rodent model of soft-tissue inflammation.

Study Design: Basic science rodent model of bone morphogenetic protein-2 (BMP-2) soft-tissue inflammation.

Objective: This study investigated the anti-inflammatory effect of human dose equivalent (HDE) dexamethasone (DM) for treatment of BMP-2-related soft-tissue inflammation in a rodent model and suggests an appropriate dose for utilization in the clinical practice of spine surgeons.

Summary Of Background Data: BMP-2 is frequently used in spinal surgery to augment fusion.

Prevalence and motion characteristics of degenerative cervical spondylolisthesis in the symptomatic adult.

Study Design: Retrospective analysis of kinetic magnetic resonance images.

Objective: To define the prevalence of degenerative cervical spondylolisthesis in symptomatic patients and to analyze the motion characteristics and influence on the spinal canal at the affected level.

Summary Of Background Data: When compared with lumbar spondylolisthesis, there are few studies evaluating cervical spondylolisthesis, and the prevalence and motion characteristics of cervical spondylolisthesis are not well defined.

Factors affecting dynamic foraminal stenosis in the lumbar spine.

Background Context: Lumbar foraminal stenosis is a common clinical problem and a significant cause of lower extremity radiculopathy. Minimal in vivo data exists quantifying changes in foraminal area (FA) as the spine moves from flexion to extension in the lumbar spine or on the relationship between FA and lumbar segmental angular motion, translational motion (TM), or disc bulge migration.

Purpose: To use kinetic magnetic resonance imaging (kMRI) to evaluate changes in dimensions of lumbar neural foramina during weight bearing in neutral, flexion, and extension positions.

Cerebral desaturation events during shoulder arthroscopy in the beach chair position: patient risk factors and neurocognitive effects.

Background: Patients undergoing shoulder surgery in the beach chair position may be at increased risk for serious neurocognitive complications due to cerebral ischemia. We sought to define the incidence, patient risk factors, and clinical sequelae of intraoperative cerebral desaturation events.

Methods: Regional cerebral tissue oxygen saturation (rSO2) was monitored intra-operatively using near-infrared spectroscopy (NIRS) on 50 consecutive patients.

The effect of corticosteroid administration on soft-tissue inflammation associated with rhBMP-2 use in a rodent model of inflammation.

Study Design: In vivo rodent model.

Objective: Investigate the effect of systemic corticosteroid administration on soft-tissue inflammation after local delivery of recombinant human bone morphogenetic protein-2 (rhBMP-2).

Summary Of Background Data: Corticosteroid use in cases of soft-tissue inflammation associated with the use of rhBMP-2 has been reported in clinical studies, but the effectiveness of its use and appropriate timing remain unclear.

Kinetic magnetic resonance imaging analysis of lumbar segmental mobility in patients without significant spondylosis.

Purpose: The purpose of this study was to examine lumbar segmental mobility using kinetic magnetic resonance imaging (MRI) in patients with minimal lumbar spondylosis.

Methods: Mid-sagittal images of patients who underwent weight-bearing, multi-position kinetic MRI for symptomatic low back pain or radiculopathy were reviewed. Only patients with a Pfirrmann grade of I or II, indicating minimal disc disease, in all lumbar discs from L1-2 to L5-S1 were included for further analysis.

Analysis of Relationship between Paraspinal Muscle Fatty Degeneration and Cervical Spine Motion Using Kinetic Magnetic Resonance Imaging.

The alignment and mobility of the cervical spine is influenced by factors related to the vertebral bodies, intervertebral discs, ligaments, facet joints, and muscles. Few reports have described the role played by the paraspinal muscles in cervical spine mobility. In this study, we investigate the relationship between fatty degeneration of the paraspinal muscles and cervical motion as assessed with kinetic magnetic resonance imaging (kMRI).

Fetal cardiac circulation in isolated aortic atresia assessed with ultrasound.

Congenital heart diseases are common, with an incidence of more than 8 in 1000 live births. Aortic atresia is a rare diagnosis and its prognosis is very poor. In this article, we present a case of isolated aortic atresia, a very rare cardiovascular anomaly, and its fetal ultrasound findings which include blood flow at foramen ovale from left to right, right deviation of the interventricular septum, dysfunction of the mitral valve and cardiomegaly.