A Novel "De-tension"-guided Anterior Decompression Strategy-Thoracic Anterior Controllable Antedisplacement Fusion (TACAF) for Multilevel Ossification of Posterior Longitudinal Ligament in Thoracic Spine: A Retrospective Study with at Least 2-Year Follow-Up.

Objective: To propose a novel surgical strategy-thoracic anterior controllable antedisplacement fusion (TACAF) to treat multilevel thoracic ossification of the posterior longitudinal ligament (mT-OPLL), and investigate its safety and efficacy.

Methods: Between January 2019 and December 2021, a total of 49 patients with thoracic myelopathy due to mT-OPLL surgically treated with TACAF were retrospectively reviewed. Patients' demographic data, radiologic parameters, and surgery-related complications, modified Japanese Orthopedic Association (mJOA) and visual analog scale (VAS) scores, thoracic kyphosis (TK), kyphosis angle in fusion area (FSK), thoracic curvature, spinal cord curvature, and curvature of curved rod in surgical region, diameter, and area of the spinal cord at the most compressed level were included.

Three-dimensional imaging analysis for the diagnosis of dural ossification in thoracic ossification of the ligamentum flavum: a multicenter study.

Background: Unforeseen dural ossification (DO) increases the risk of complications in the surgical management of thoracic ossification of the ligamentum flavum (OLF). Several methods have been proposed to identify DO; however, these approaches either have low diagnostic accuracy or poor feasibility. Therefore, we aimed to determine the relationship between DO and the severity and range of thoracic OLF compression using a 3-dimensional (3D) imaging analysis and to evaluate its superiority in diagnosing DO over conventional measurement methods.

Metagenomic next-generation sequencing for the detection of pathogenic microorganisms in patients with pulmonary infection.

Objective: To explore the clinical value of metagenomic next-generation sequencing (mNGS) in diagnosing pulmonary infectious diseases.

Methods: A retrospective analysis was performed on 82 patients with pulmonary infection who were admitted to the Eighth Affiliated Hospital of Guangxi Medical University & Guigang City People's Hospital from January 2020 to December 2021. The pathogens were detected by mNGS and conventional methods (culture and PCR).

The effect of K-line classification in different cervical dynamic position on surgical outcomes in patients with ossification of the posterior longitudinal ligament after anterior controllable antedisplacement and fusion.

Purpose: To investigate whether the K-line classification in different cervical dynamic position of patients with Ossification of the Posterior Longitudinal Ligament (OPLL) affects clinical outcome after Anterior Controllable Antedisplacement and Fusion (ACAF) surgery.

Methods: A total of 93 patients who suffered from cervical spondylosis caused by OPLL underwent ACAF surgery between June 2015 and December 2017 in a single institution. Neutral, neck-flexed and neck-extended cervical radiographs were obtained from every patient.

Anterior controllable antedisplacement and fusion: quantitative analysis of a single surgeon's learning experience.

Background Context: Anterior controllable antedisplacement and fusion (ACAF) is a novel surgical technique for the treatment of ossification of the posterior longitudinal ligament (OPLL) but the surgical learning curve for this technique has not been previously characterized.

Purpose: The aim of this study was to quantify a surgeon's learning curve for ACAF and the effect of surgeon experience on postoperative outcomes.

Study Design: Prospective study of a single institution and single surgeon experience with ACAF surgery.

Anatomical Evaluation of Spinal Nerve and Cervical Intervertebral Foramina in Anterior Controllable Antedisplacement and Fusion Surgery: A Cadaveric and Radiologic Study.

Objective: To achieve the anatomical evaluation of spinal nerve and cervical intervertebral foramina in anterior controllable antedisplacement and fusion (ACAF) surgery, a novel surgical technique with the wider decompression, through a cadaveric and radiologic study.

Methods: Radiographic data of consecutive 47 patients (21 by ACAF and 26 by anterior cervical corpectomy and fusion [ACCF]) who have accepted surgery for treatment of cervical ossification of the posterior longitudinal ligament(OPLL) and stenosis from March 2017 to March 2018 were retrospectively reviewed and compared between an ACAF group and ACCF group. Three postoperative radiographic parameters were evaluated: the decompression width and the satisfaction rate of decompression at the entrance zone of intervertebral foramina on computed tomography (CT), and the transverse diameter of spinal cord in the decompression levels on magnetic resonance imaging (MRI).

The clinical value of three-dimensional measurement in the diagnosis of thoracic myelopathy caused by ossification of the ligamentum flavum.

Background: Thoracic ossification of the ligamentum flavum (OLF) is a major cause of thoracic myelopathy, which is often accompanied by multiple segmental stenosis or other degenerative spinal diseases. However, in the above situations, it is difficult to determine the exact segment responsible. The objective of this study was to analyze three-dimensional (3D) radiological parameters in order to establish a novel diagnostic method for discriminating the responsible segment in OLF-induced thoracic myelopathy, and to evaluate its superiority compared to the conventional diagnostic methods.

Anterior Controllable Antedisplacement and Fusion (ACAF) vs Posterior Laminoplasty for Multilevel Severe Cervical Ossification of the Posterior Longitudinal Ligament: Retrospective Study Based on a Two-Year Follow-up.

Objectives: To compare the clinical outcomes of anterior controllable antedisplacement fusion (ACAF), a new surgical technique, with laminoplasty for the treatment of multilevel severe cervical ossification of the posterior longitudinal ligament (OPLL) based on a 2-year follow-up.

Methods: Clinical data of 53 patients (21 by ACAF and 32 by laminoplasty) who have accepted surgery for treatment of cervical myelopathy caused by multilevel severe OPLL (occupying rate ≥ 50%) from March 2015 to March 2017 were retrospectively reviewed and compared between ACAF group and laminoplasty group. Operative time, blood loss, and complications of the two groups were recorded.

Consensus statement on diagnosis and treatment of cervical ossification of posterior longitudinal ligament from Asia Pacific Spine Society (APSS) 2020.

Purpose: The study aimed to develop an evidence-based expert consensus statement on diagnosis and treatment of cervical ossification posterior longitudinal ligament (OPLL).

Method: Delphi method was used to perform such survey, and the panel members from Asia Pacific Spine Society (APSS) 2020 were invited to answer the open-ended questions in rounds 1 and 2. Then the results were summarized and developed into a Likert-style questionnaire for voting in round 3, and the level of agreement was defined as 80%.

Snake-Eye Screwing: A Novel Free-Hand Technique of Pedicle Screw Placement in Cervicothoracic Spine and Preliminary Clinical Results.

Objective: To propose a novel technique of free-hand pedicle screw placement in cervicothoracic spine (snake-eye method) and evaluate the preliminary effects and safety in clinical practice.

Methods: This is a retrospective study and we defined the period of this study as from December 2017 to April 2019 in our institution. Forty patients were included in this study who underwent cervicothoracic internal fixation in our hospital, and all patients undergoing implantation of 200 pedicle screws were divided into two groups.

How much space of the spinal canal should be restored by hoisting the vertebrae-OPLL complex for sufficient decompression in anterior controllable antedisplacement and fusion? A multicenter clinical radiological study.

Background Context: Anterior controllable antedisplacement and fusion (ACAF) is a novel surgical technique for the treatment of ossification of the posterior longitudinal ligament (OPLL). Its prognostic factors for decompression have not been well studied. Additionally, no detailed radiological standard has been set for hoisting the vertebrae-OPLL complex (VOC) in ACAF.

Novel Technique as a Revision Surgery for Failed Anterior Cervical Corpectomy and Fusion in the Treatment of Cervical Myelopathy Due to Ossification of the Posterior Longitudinal Ligament.

Objective: This article aimed to introduce a novel technique, the "seesaw technique," for failed anterior cervical corpectomy and fusion (ACCF) in the treatment of cervical ossification of the posterior longitudinal ligament.

Methods: A patient who underwent ACCF 12 years ago and suffered gradually deteriorating neurologic function was referred to our institution. Preoperative imaging showed residual ossified mass at C5/6 level, causing compression to his spinal cord.

Anterior controllable antidisplacement and fusion surgery for the treatment of extensive cervico-thoracic ossification of posterior longitudinal ligament with severe myelopathy: case report and literature review.

OPLL generally occurs in the cervical spine and involves no more than three vertebral segments, while extensive OPLL that involves the cervico-thoracic spine and spans over multiple segments is rare. Surgically it is difficult to achieve a satisfactory clinical outcome without surgical complications via the traditional anterior or posterior approaches. We report the first application of Anterior controllable antidisplacement and fusion (ACAF) in treating extensive cervico-thoracic OPLL.

Computer-Based 3D Simulations to Formulate Preoperative Planning of Bridge Crane Technique for Thoracic Ossification of the Ligamentum Flavum.

BACKGROUND The bridge crane technique is a novel surgical technique for the treatment of thoracic ossification of the ligamentum flavum (TOLF), but its preoperative planning has not been studied well, which limits the safety and efficacy of surgery to some extent. The purpose of this study was to investigate the method of application and effect of computer-aided preoperative planning (CAPP) on the bridge crane technique for TOLF. MATERIAL AND METHODS This retrospective multi-center included 40 patients with TOLF who underwent the bridge crane technique from 2016 to 2018.

Risk assessment of vertebral artery injury in anterior controllable antedisplacement and fusion (ACAF) surgery: a cadaveric and radiologic study.

Purpose: We have introduced a novel surgery technique named anterior controllable antedisplacement and fusion (ACAF) for the treatment of ossification of the posterior longitudinal ligament. As reported, the satisfactory postoperative outcome can be attributed to the larger decompression width. However, it may associate with high prevalence of vertebral artery injury (VAI) theoretically.

Application of the Theory of Planned Behavior in Environmental Science: A Comprehensive Bibliometric Analysis.

Since the theory of planned behavior (TPB) was proposed by Ajzen in 1985, it has attracted extensive interest and been widely applied worldwide. Although an increasing number of studies have employed the TPB in the domain of environmental science, there have been no attempts to retrospectively analyze existing articles. The current study aimed to holistically understand the application status of the TPB in environmental science from a knowledge domain visualization perspective.

MiR-499a-5p suppresses apoptosis of human nucleus pulposus cells and degradation of their extracellular matrix by targeting SOX4.

Emerging evidence suggests that microRNAs (miRNAs, miRs) play important roles in the development of intervertebral disc degeneration (IVDD). Nonetheless, the expression level and biological function of miR-499a-5p in IVDD are still unclear. In this study, we found that miR-499a-5p was significantly downregulated in degenerative tissues of the human nucleus pulposus (NP) compared with healthy tissues.

Theory of Bowstring Disease: Diagnosis and Treatment Bowstring Disease.

Bowstring disease (BSD) is a new classification of spine disease caused by axial stretched lesion on nerve roots and the spinal cord, which is differentiated from disc herniation and canal stenosis in that it is caused by nerve compression lesions. BSD could be caused by mismatched growth rates between the spine and nerve roots (the juvenile type), or by imbalanced degenerative rates between the spine column and nerve roots (degenerative type). Here, we propose that there are several self-adjust mechanisms to relieve axial nerve tension: (i) nerve growth; (ii) posture adjustment and low back pain; (iii) autogenous degeneration of intervertebral disc; and (iv) idiopathic and degenerative scoliosis.

Computer-assisted virtual operation planning in anterior controllable anterior-displacement and fusion surgery for ossification of the posterior longitudinal ligament based on actual computed tomography data.

Objectives: To investigate the effect of computer-assisted virtual operation planning (CAVOP) on anterior controllable anterior-displacement and fusion (ACAF) surgery for ossification of the posterior longitudinal ligament (OPLL).

Patients And Methods: A total of 25 patients with OPLL were enrolled in the study from September 2017 to December 2017. Preoperative Computed tomography (CT) scanning data were input into Mimics software to reconstruct three-dimensional (3D) models of actual cervical OPLL.

ACVR1-knockout promotes osteogenic differentiation by activating the Wnt signaling pathway in mice.

Osteogenic differentiation refers to the process of bone formation and remodeling, which is controlled by complex molecular mechanisms. Activin A receptor type I (ACVR1) is reported to be associated with osteogenic differentiation. However, the underlying molecular mechanism remains elusive.

Low-Intensity Pulsed Ultrasound Treatment Accelerates Angiogenesis by Activating YAP/TAZ in Human Umbilical Vein Endothelial Cells.

As a non-invasive method, low-intensity pulsed ultrasound (LIPUS) can accelerate fracture healing. The mechanisms responsible for the enhanced fracture healing need to be studied further. Activation of YAP/TAZ, key mediators of the Hippo signaling pathway, could promote angiogenesis and vascular remodeling.

A novel revision surgery for treatment of cervical ossification of the posterior longitudinal ligament after initial posterior surgery: preliminary clinical investigation of anterior controllable antidisplacement and fusion.

Background: Cervical ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. Posterior decompression surgery is reported to be an effective and comparatively safe procedure with few complications for treatment of patients with myelopathy caused by OPLL. However, some patients require revision surgery because of late neurological deterioration due to OPLL progression or kyphotic changes in cervical alignment.

Effects of MicroRNA-494 on Astrocyte Proliferation and Synaptic Remodeling in the Spinal Cord of a Rat Model of Chronic Compressive Spinal Cord Injury by Regulating the Nogo/Ngr Signaling Pathway.

Background/aims: Chronic compression of the spinal cord causes the loss of motor neurons in the anterior horn, but the precise and extensive mechanism for the loss is not completely determined. Therefore, this study aims to explore the role of microRNA-494 (miR-494) in the proliferation of astrocytes and in the synaptic remodeling in the spinal cord of a rat model of chronic spinal cord injury (SCI) by regulating the Nogo/NgR signaling pathway.

Methods: A rat model of chronic, compressive SCI was established, and the spinal cord state, blood supply changes, and astrocyte apoptosis were observed.

Morphometric Analysis of the Uncinate Process as a Landmark for Anterior Controllable Antedisplacement and Fusion Surgery: A Study of Radiologic Anatomy.

Objective: This study used the uncinate process (UP) base as the landmark to measure the various distances of the interested anatomic structures to improve the practicality of anterior controllable antedisplacement and fusion (ACAF) for ossification of the posterior longitudinal ligament (OPLL).

Methods: Computed tomographic (CT) scan data of 20 OPLL patients were studied. We investigated the base distance of the UP, transverse foramen (TF) to UP base, pedicle to UP base, posterior to anterior UP, maximal width of OPLL, and width of the vertebrae-OPLL complex (VOC).