Piriformis muscle syndrome: A cross-sectional imaging study in 116 patients and evaluation of therapeutic outcome.

Objectives: To increase the clinical awareness of piriformis muscle syndrome (PMs) by reporting cross-sectional imaging findings, the clinical impact of imaging studies and treatment outcome.

Methods: Within a 10-year-period, 116 patients referred for radiological evaluation of clinically suspected PMs, with excluded lumbar pathology related to symptomatology, were prospectively studied with MRI and/or computed tomography (CT). Piriformis muscle (PM), sciatic nerve (SN), piriformis region and sacroiliac joints were evaluated.

Molecular profile of major growth factors in lumbar intervertebral disc herniation: Correlation with patient clinical and epidemiological characteristics.

The involvement of growth factors (GFs) in the pathogenesis of lumbar intervertebral disc (ID) herniation and the spontaneous resorption of herniated ID fragments remains only partially elucidated. A simultaneous assessment of the transcript levels of numerous GFs and their association with clinical and epidemiological profiles of human ID herniation would provide valuable insight into the biology and clinical course of the disease. In the present study, we examined simultaneously the transcript levels of vascular endothelial growth factor (VEGF), transforming growth factor β1 (TGF‑β1), basic fibroblast growth factor 2 (bFGF2), platelet derived growth factor (PDGF) isoforms and receptors, epidermal growth factor (EGF) and insulin growth factor‑1 (IGF‑1) in herniated and control ID specimens and investigated their correlation with the clinicopathological profiles of patients suffering from symptomatic lumbar ID herniation.

Evaluation of the reliability of a new non-invasive method for assessing the functionality and mobility of the spine.

Unlabelled: For the evaluation of the functionality and mobility of the spine, several methods have been developed. The purpose of this study was to estimate the test-retest reliability of the Spinal Mouse, a new, non-invasive, computer-assisted wireless telemetry device for the assessment of the curvatures, the mobility and the functionality of the spine.

Materials And Methods: the test-retest reliability was evaluated in 50 adults with back or low back pain.

The study of the thrombin generation mechanism and the effect of low molecular weight heparin as thromboprophylaxis in patients undergoing total knee and hip replacement.

Introduction: The recommended duration of post-operative Low-Molecular-Weight-Heparins (LMWHs) thromboprophylaxis in Total-Hip-Replacement (THR) and Total-Knee-Replacement (TKR) surgery is controversial. Our aim is to study the thrombin generation (TG) modifications induced by surgery and to evaluate the effect of LMWH on TG during and after the recommended duration.

Patients/methods: Thirty-one patients received 4000IU anti-Xa/day of enoxaparin, 8-hours post-operatively (15 THR for 30-days and 16 TKR for 15-days).

Spinal osteosarcoma.

Although osteosarcoma represents the second most common primary bone tumor, spinal involvement is rare, accounting for 3%-5% of all osteosarcomas. The most frequent symptom of osteosarcoma is pain, which appears in almost all patients, whereas more than 70% exhibit neurologic deficit. At a molecular level, it is a tumor of great genetic complexity and several genetic disorders have been associated with its appearance.

Safety and effectiveness of retrorectal presacral approach for lumbosacral axial instrumentation. A clinical study.

This prospective study aimed to quantify the risks and complications associated with AxiaLIF in a series of 29 patients. AxiaLIF is a fusion technique using a percutaneous retrorectal, presacral corridor approach to access the L5-S1 and L4-L5 intervertebral spaces transaxially, through the body of S1 and L5 vertebrae. The fusion rate in the present series was 92% and the reported results ranged from 68% to 100%.

Non-operative treatment of peroneal split syndrome: a case report.

Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level of the retrofibular groove. It is an increasingly recognized, albeit frequently overlooked, cause of lateral ankle pain. Several surgical options have been documented for managing this entity, however there are no reports emphasizing the role of conservative treatment.

Impaired clearance of apoptotic cells leads to HMGB1 release in the bone marrow of patients with myelodysplastic syndromes and induces TLR4-mediated cytokine production.

Excessive pro-inflammatory cytokine production in the bone marrow has been associated with the pathogenesis of myelodysplastic syndromes. We herein investigated the involvement of toll-like receptors and their endogenous ligands in the induction/maintenance of the inflammatory process in the marrow of patients with myelodysplastic syndromes. We evaluated the expression of toll-like receptors in marrow monocytes of patients (n=27) and healthy controls (n=25) by flow-cytometry and also assessed the activation of the respective signaling using a real-time polymerase chain reaction-based array.

Study of the quantitative, functional, cytogenetic, and immunoregulatory properties of bone marrow mesenchymal stem cells in patients with B-cell chronic lymphocytic leukemia.

The bone marrow (BM) microenvironment has clearly been implicated in the pathogenesis of B-cell chronic lymphocytic leukemia (B-CLL). However, the potential involvement of BM stromal progenitors, the mesenchymal stem cells (MSCs), in the pathophysiology of the disease has not been extensively investigated. We expanded in vitro BM-MSCs from B-CLL patients (n=11) and healthy individuals (n=16) and comparatively assessed their reserves, proliferative potential, differentiation capacity, and immunoregulatory effects on T- and B-cells.

Dual lag screw cephalomedullary nail versus the classic sliding hip screw for the stabilization of intertrochanteric fractures. A prospective randomized study.

This study is a randomized prospective study comparing two fracture fixation implants, the extramedullary sliding hip screw (SHS) and the dual lag screw cephalomedullary nail, in the treatment of intertrochanteric femoral fractures in the elderly. One hundred and sixty-five patients with low-energy intertrochanteric fractures, classified as AO/OTA 31A, were prospectively included during a 2-year period (2005-2006). Patients were randomized into two groups: group A included 79 hip fractures managed with sliding hip screws and group B included 86 fractures treated with cephalomedullary nails.

Sliding screw implants for extracapsular hip fractures.

Hip fractures are associated with significant mortality and morbidity for the patients, more dependent residual status, and increased socio-economic cost. Many hip-fracture patients experience severe functional impairment, and most never recover their pre-fracture level of function. Current research has sought to identify the most effective treatments to reduce the incidence of hip fractures, improve survival and quality of life, and minimize complications and disability.

Respiratory effects, hemodynamic changes and cement leakage during multilevel cement balloon kyphoplasty.

Purpose: The purpose of this study is to evaluate the effects of multilevel balloon kyphoplasty (BK) on blood pressure, blood gases and cement leakage.

Methods: This is a prospective study of 63 patients: 31 were treated for osteoporotic vertebral compressive fractures (OVCF) and 32 for osteolytic tumors (OT). Twenty-six patients were treated at 1 level, 15 at 2, 2 at 3, 6 at 4, 3 at 5, 4 at 6, 5 at 7 and 2 at 8.

Spinal cord ischemia after endovascular embolization of a type II endoleak following endovascular aneurysm repair.

Background: We report a rare case of severe spinal cord ischemia with neurological consequences in a patient who presented after endovascular treatment of a type II endoleak following endovascular aneurysm repair.

Methods And Results: An enlarging abdominal aortic aneurysm post-endovascular aneurysm repair was detected owing to a persistent type II endoleak caused by a communication between the iliolumbar and L4 lumbar artery for which the patient underwent supraselective embolization with particles and coils. Immediately after the procedure, the patient experienced an acute onset of neurological symptoms in the right lower limb while limb arterial perfusion remained unaffected.

Predictive value of Tokuhashi and Tomita scores in patients with metastatic spine disease.

Objective: Our aim was to determine the best preoperative prognostic score to safely propose operative intervention for patients with metastatic spinal disease.

Methods: This prospective cohort study included 52 consecutive patients who underwent surgery between 1997 and 2007 to alleviate pain and preserve or restore neurological function. All patients were prospectively evaluated with the Tokuhashi score and retrospectively with the Tomita score to compare their surgery indications.

Pregnancy-related low back pain.

Pregnancy related low back pain is a common complaint among pregnant women. It can potentially have a negative impact on their quality of life. The aim of this article is to present a current review of the literature concerning this issue.

Bacterial wound contamination during simple and complex spinal procedures. A prospective clinical study.

Background Context: Spinal procedures have a potential of intraoperative contamination. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) have been used to diagnose postoperative infections after spinal surgery. However, it has not been demonstrated if there is an association between surgical site contamination and clinical manifestation of postoperative infection based on inflammatory markers and patients' clinical course.

Effect of two sitting postures on lumbar sagittal alignment and intervertebral discs in runners.

Purpose: We evaluated in vivo changes in lumbar lordosis and intervertebral discs in runners and assessed the relationship between these changes and degenerative disc disease in runners with and without a history of low back pain.

Materials And Methods: Using open upright magnetic resonance (MR) imaging, we prospectively studied changes in lumbar lordosis and intervertebral discs of 25 elite long-distance runners in two sitting postures (neutral and extended) before and after 1 h of running and compared the results with disc height and dehydration/degeneration. Seventeen of the 25 runners had a history of low back pain.

Pathophysiology and biomechanics of the aging spine.

AGING OF THE SPINE IS CHARACTERIZED BY TWO PARALLEL BUT INDEPENDENT PROCESSES: the reduction of bone mineral density and the development of degenerative changes. The combination of degeneration and bone mass reduction contribute, to a different degree, to the development of a variety of lesions. This results in a number of painful and often debilitating disorders.

Knee joint anterior malalignment and patellofemoral osteoarthritis: an MRI study.

Objectives: To evaluate patellofemoral congruency measurements on MRI and correlate the findings with severity of ipsilateral osteoarthritis.

Methods: We retrospectively reviewed 650 consecutive knee MRI examinations from 622 patients divided into two age groups: ≤50 and >50 year-old. The femoral sulcus angle (SA) and depth (SD), lateral patellar displacement (LPD), lateral patellofemoral angle (LPFA), tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index as well as the grade of focal cartilage defects (ranging from I to IV) in the patellofemoral region were assessed in each subject on axial and sagittal fat-saturated intermediate-w MR images.

Reversal of tetraplegia in a patient with haematogenous cervical epidural abscess.

Pyogenic haematogenous cervical epidural abscess complicated by tetraplegia is an uncommon entity, but its clinical importance overshadows its rarity. Predisposing risk factors for spinal epidural abscess include diabetes, intravenous drug abuse, liver disease, renal failure, malignancy, HIV, infection elsewhere, rheumatoid conditions, trauma and a number of spinal interventions. Lack of recovery and death are much more frequent when complete paralysis exists since more than 24 to 48 hours.

Role of receptor for hyaluronic acid-mediated motility (RHAMM) in low molecular weight hyaluronan (LMWHA)-mediated fibrosarcoma cell adhesion.

Hyaluronan (HA) modulates key cancer cell functions through interaction with its CD44 and receptor for hyaluronic acid-mediated motility (RHAMM) receptors. HA was recently found to regulate the migration of fibrosarcoma cells in a manner specifically dependent on its size. Here, we investigated the effect of HA/RHAMM signaling on the ability of HT1080 fibrosarcoma cells to adhere onto fibronectin.

Herpes virus infection can cause intervertebral disc degeneration: a causal relationship?

It has been proposed that intervertebral disc degeneration might be caused by low-grade infection. The purpose of the present study was to assess the incidence of herpes viruses in intervertebral disc specimens from patients with lumbar disc herniation. A polymerase chain reaction based assay was applied to screen for the DNA of eight different herpes viruses in 16 patients and two controls.

Low molecular weight heparin inhibits melanoma cell adhesion and migration through a PKCa/JNK signaling pathway inducing actin cytoskeleton changes.

Low molecular weight heparin (LMWH) has significant antimetastatic capabilities and affects cancer progression in humans through, not fully defined mechanisms. Here we evaluated its activity at the intracellular level and how it is correlated with melanoma cell adhesion and migration. LMWH inhibited M5 and A375 melanoma cell adhesion and migration in a dose-dependent manner (p⩽0.

Limb salvage after gas gangrene: a case report and review of the literature.

Gas gangrene is a necrotic infection of soft tissue associated with high mortality, often necessitating amputation in order to control the infection. Herein we present a case of gas gangrene of the arm in an intravenous drug user with a history of intramuscular injections with normal saline in the shoulder used to provoke pain for recovery after drug induced coma. The patient was early treated with surgery and antibiotics rendering possible the preservation of the limb and some of its function.