Enhancing proliferation and optimizing the culture condition for human bone marrow stromal cells using hypoxia and fibroblast growth factor-2.

This study aimed to determine the cellular characteristics and behaviors of human bone marrow stromal cells (hBMSCs) expanded in media in a hypoxic or normoxic condition and with or without fibroblast growth factor-2 (FGF-2) treatment. hBMSCs isolated from the vertebral body and expanded in these four groups were evaluated for cellular proliferation/migration, colony-forming units, cell-surface characterization, in vitro differentiation, in vivo transplantation, and gene expression. Culturing hBMSCs using a particular environmental factor (hypoxia) and with the addition of FGF-2 increased the cellular proliferation rate while enhancing the regenerative potential, modulated the multipotency-related processes (enhanced chondrogenesis-related processes/osteogenesis, but reduced adipogenesis), and increased cellular migration and collagen formation.

Novel Technique for Isolating Human Bone Marrow Stem Cells Using Hyaluronic Acid Hydrogel.

Centrifugation based on density gradients is a general methodology for isolating human bone marrow (hBM)-derived mesenchymal stem cells (hBMSCs). The mononuclear cell (MNC) layer can be obtained using a density gradient solution in the conventional protocol, but it is not suitable for direct transplantation due to the possible toxicity of this solution. The results obtained are also influenced by the skill level when applying the technique, which involves time-consuming processes.

Autogenous Mesenchymal Stem Cells from the Vertebral Body Enhance Intervertebral Disc Regeneration via Paracrine Interaction: An in Vitro Pilot Study.

Several in vivo studies have found that transplanting mesenchymal stem cells (MSCs) into degenerative intervertebral discs (IVDs) leads to regeneration of disc cells. Since the exact underlying mechanisms are not understood, we investigated the mechanisms of action of MSCs in regeneration of degenerative IVDs via paracrine actions. Human MSCs and degenerative disc cells from the same donor vertebrae were directly or indirectly cocultured.

Human bone marrow stem cells cultured under hypoxic conditions present altered characteristics and enhanced in vivo tissue regeneration.

Human bone marrow mesenchymal stem cells (hBMSCs) were isolated from bone marrow of the vertebral body. The hBMSCs were cultured under either hypoxic (1% O2) or normoxic (21% O2; control) conditions and the characteristics as mesenchymal stem cells were compared. Results revealed that hypoxia reduced proliferative potential and colony-forming efficiency of hBMSCs, and significantly enhanced osteogenic and chondrogenic differentiation.

Differential effect of water-soluble chitin on collagen synthesis of human bone marrow stem cells and human periodontal ligament stem cells.

Human bone marrow stem cells (hBMSCs) represent a promising regenerative material because of their mutipotency, including their ability to regenerate collagenous soft tissues. We previously found that water-soluble chitin (WSC) enhances the ability of human periodontal ligament stem cells (hPDLSCs) to synthesize collagen tissue. The aim of this study was to determine the effects of WSC on hBMSCs and hPDLSCs for the collagen synthesis both in vitro and in vivo.

Instrumented Minimally Invasive Spinal-Transforaminal Lumbar Interbody Fusion (MIS-TLIF): Minimum 5-Year Follow-Up With Clinical and Radiologic Outcomes.

Study Design: A retrospective study.

Objective: To determine the clinical and radiologic outcomes of the long-term results of instrumented minimally invasive spinal-transforaminal lumbar interbody fusion (MIS-TLIF) in unstable, single-level, low-grade, isthmic spondylolisthesis (IS) or degenerative spondylosis (DS) including degenerative spondylolisthesis, foraminal stenosis with central stenosis, degenerative disk disease, and recurrent disk herniation.

Summary Of Background Data: MIS-TLIF is a common surgical procedure to treat lumbar spondylolisthesis.

Adjacent segment degeneration after lumbar interbody fusion with percutaneous pedicle screw fixation for adult low-grade isthmic spondylolisthesis: minimum 3 years of follow-up.

Background: Although favorable clinical outcomes have been reported for instrumented lumbar interbody fusion (LIF), adjacent segment degeneration (ASD) has been reported as a long-term complication after LIF.

Objective: To investigate ASD after instrumented LIF performed at a single level and only for the homogeneous disease of adult low-grade isthmic spondylolisthesis.

Methods: A total of 128 patients who had undergone LIF for the treatment of adult low-grade isthmic spondylolisthesis involving the lower lumbar spine at our institution between February 2001 and December 2004 were retrospectively reviewed by chart review and telephone survey.

Dynamic lumbar spinal stenosis : the usefulness of axial loaded MRI in preoperative evaluation.

Two cases of dynamic lumbar spinal stenosis were identified by the authors using axial loaded magnetic resonance image (MRI). In both cases, the patients presented with neurogenic claudication but MRI in decumbency showed no definite pathologic condition associated with their symptoms. In contrast, axial loaded MRI demonstrated constrictive spinal stenosis and a significantly decreased dural sac caused by epidural fat buckling and thickening of the ligamentum flavum in both cases.

Thrombosis of left common iliac artery following anterior lumbar interbody fusion: case report and review of literatures.

We report on a case of thrombosis of the left common iliac artery following anterior lumbar interbody fusion (ALIF) of L4-5 in a 79-year-old man with no previous medical problems, including peripheral vascular disease. After completing the ALIF procedure, the surgeon could not feel the pulsation of the left dorsalis pedis artery, and the oxygen saturation (SaO(2)) had fallen below 90% from pulse oxymetry on the left great toe. Thrombectomy was successfully performed after confirming the thrombus in the left common iliac artery using Computed Tomography (CT) angiography.

Mini-transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion augmented by percutaneous pedicle screw fixation: a comparison of surgical outcomes in adult low-grade isthmic spondylolisthesis.

Study Design: Retrospective clinical data analysis.

Objective: To compare clinical results with radiologic results of 2 fusion techniques for adult low-grade isthmic spondylolisthesis.

Summary Of Background Data: There is clear evidence that lumbar interbody fusion using anterior and posterior approaches provides a high fusion rate, good sagittal alignment, and good clinical outcomes.

Spinal cord herniation after multilevel anterior cervical corpectomy and fusion for ossification of the posterior longitudinal ligament of the cervical spine.

The authors report the case of a 52-year-old man who had undergone resection of an ossified posterior longitudinal ligament via the anterior approach. The patient experienced postoperative neurological deterioration that may have been caused by a massive cord herniation associated with a dural defect at the corpectomy site. Spinal cord herniation may develop as a complication of anterior cervical decompression.

CT-guided percutaneous vertebroplasty in the treatment of an upper thoracic compression fracture.

Percutaneous vertebroplasty (PVP) has been used to relieve pain and to prevent further collapse of the vertebral body in patients with an osteoporotic compression fracture. The most commonly affected site for the use of PVP is the thoracolumbar junction. There are few reports that have described on the usefulness of PVP in the treatment of a high thoracic compression fracture.

Percutaneous endoscopic approach for highly migrated intracanal disc herniations by foraminoplastic technique using rigid working channel endoscope.

Study Design: A retrospective analysis of 59 patients operated for excision of soft highly migrated intracanal lumbar disc herniations by percutaneous endoscopic foraminoplasty.

Objective: To describe a safe and effective percutaneous endoscopic technique for removal of migrated herniations and report the results on the basis of modified MacNab criteria.

Summary Of Background Data: Migrated herniations pose a great challenge even for experienced endoscopic surgeons.

Anterior minimally invasive approaches for the cervical spine.

The percutaneous endoscopic discectomy (PECD) with working channel endoscope (WSH) endoscopy set could be a safe and effective minimally invasive surgical option for non-contained cervical disc herniation in selected patients. Judicious use of the end-firing Ho: Yttrium-Aluminium-Garnet (YAG) laser for both decompressive and thermoannuloplasty effect during the percutaneous endoscopic cervical annuloplasty (PECA) is mandatory in order to prevent possible injury to spinal cord or root. Although the percutaneous cervical stabilization (PCS) using the cervical B-Twin may not completely replace the cervical arthrodesis, this minimally invasive procedure can preserve anterior structures and thereby retain segmental stability and prevent the possible kyphotic progression after fusion surgery.

CHARITE versus ProDisc: a comparative study of a minimum 3-year follow-up.

Study Design: A retrospective study.

Objectives: To evaluate and compare clinical and radiologic outcomes of the CHARITE and ProDisc.

Summary Of Background Data: There is no clinical report comparing CHARITE and ProDisc.

Modified transcorporeal anterior cervical microforaminotomy for cervical radiculopathy: a technical note and early results.

A prospective analysis of the first twenty patients operated for cervical radiculopathy by a new modification of transcorporeal anterior cervical foraminotomy technique. To evaluate early results of a functional disc surgery in which decompression for the cervical radiculopathy is done by drilling a hole in the upper vertebral body and most of the disc tissue is preserved. Earlier approaches to cervical disc surgery either advocated simple discectomy or discectomy with fusion, ultimately leading to loss of motion segment.

Factors affecting prognosis of patients who underwent corpectomy and fusion for treatment of cervical ossification of the posterior longitudinal ligament: analysis of 47 patients.

Objective: Even though cervical ossification of the posterior longitudinal ligament (OPLL) has several unique clinical features compared with spondylotic myelopathy or cervical disc disease, there have been few reports about factors affecting prognosis after decompression using corpectomy. To clarify the prognostic factors for cervical OPLL, the authors analyzed the clinical and radiologic parameters of 47 patients retrospectively.

Methods: The patients were classified into a good-prognosis group and a poor-prognosis group according to the changes of Nurick grade after operation.

Fluoroscopically assisted percutaneous translaminar facet screw fixation following anterior lumbar interbody fusion: technical report.

Study Design: A technical report of fluoroscopically assisted percutaneous translaminar facet screw fixation after anterior lumbar interbody fusion (ALIF).

Objectives: To describe a minimally invasive translaminar facet screw fixation technique that was modified from the Magerl method, and to assess its technical feasibility and clinical efficacy.

Summary Of Background Data: There is no previous study in the literature on percutaneous translaminar facet screw fixation assisted only by fluoroscopy without using any specially designed guiding device.