The Development of a Nationwide, Multicenter Electronic Database for Spinal Instrumentation Surgery in Japan: Japanese Spinal Instrumentation Society Database (JSIS-DB).

(1) Background: Despite the number of complicated and expensive spine surgery procedures maintained by the national health insurance system in Japan, until now there has been no large-scale multicenter clinical database for this field to understand and improve healthcare expenditure and treatment outcomes. The purpose of this report is to announce the establishment and methodology of a nationwide registry system for spinal instrumentation surgeries by the Japanese Spinal Instrumentation Society (JSIS), and to report the progress over the first 1.5 years of this database's operation.

A Japanese nationwide multicenter survey on perioperative complications of corrective fusion for elderly patients with adult spinal deformity.

Background: Recently, corrective fusion surgery for patients with adult spinal deformity (ASD) has become common in Japan. This study aimed to clarify the status of surgeries for ASD in Japan, focusing on perioperative complications. A nationwide multicenter survey gathering information on surgically treated ASD patients was conducted by the committee for Adult Spinal Deformity of the Japanese Scoliosis Society.

Cervical myelopathy due to a solitary osteochondroma: a case report.

Introduction: Osteochondroma is the most common benign bone tumor. However, the incidence of osteochondroma in the spine is reported to be very rare.

Case Description: This report presents the case of a 57-year-old man who suffered from osteochondroma of the cervical spine.

The relationship between the anatomy of the nuchal ligament and postoperative axial pain after cervical laminoplasty: cadaver and clinical study.

Study Design: A cadaver and clinical study investigated the attachment of the nuchal ligament to the cervical spinous process.

Objective: To investigate the anatomical details of the attachment of the nuchal ligament to the spinous process and the relationship between the morphology of the nuchal ligament and postoperative axial pain after laminoplasty.

Summary Of Background Data: The relationship between the length of the C6 spinous process and the morphology of the nuchal ligament and occurrence of postoperative axial pain has not been elucidated.

Adjacent segment degeneration after single-segment PLIF: the risk factor for degeneration and its impact on clinical outcomes.

Purpose: To investigate: (1) the risk factors for radiologic cranial adjacent segment degeneration (ASD) after single-segment PLIF at the same level, and (2) the impact of the ASD on the clinical outcomes.

Methods: From October 2004 to May 2009, 109 patients who underwent PLIF for degenerative instability at L4/5 and have more than 2 years follow-up were studied retrospectively. We measured the preoperative bone mineral density (BMD), lumbar lordosis, the lumbosacral joint angle, the lumbar inclination, the height and the dynamic angulation of the intervertebral space at the fused segments and the upper adjacent segment, the sliding displacement between L3 and L4.

Genetic differences in the osteogenic differentiation potency according to the classification of ossification of the posterior longitudinal ligament of the cervical spine.

Study Design: We categorized the four types of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine into two groups. We biochemically investigated the genetic differences in the osteogenic differentiation potency between the two groups.

Objective: To investigate the genetic differences in the osteogenic differentiation potency according to the OPLL classification.

Surgical outcomes of foramen magnum decompression for syringomyelia associated with Chiari I malformation: relation between the location of the syrinx and body pain.

Background: There have been few reports about the relation between the morphology of syrinxes and body pain in syringomyelia associated with Chiari I malformation. To investigate this phenomenon, the relation between the location of the syrinx and body pain before and after foramen magnum decompression (FMD) were evaluated.

Methods: The subjects were 20 patients with Chiari I malformation associated with syringomyelia who underwent FMD.

Preserving the C7 spinous process with its muscles attached: effect on axial symptoms after cervical laminoplasty.

Background: Many efforts to reduce axial symptoms after cervical laminoplasty have been tried and reported; nevertheless, avoiding the axial symptoms has not yet been solved. There have been some reports that preserving the muscles attached to the C7 spinous process could reduce axial symptoms. The purpose of this study was to investigate whether axial symptoms can be reduced by preserving the C7 spinous process with its muscles attached during cervical laminoplasty.

A functional RNAi screen for Runx2-regulated genes associated with ectopic bone formation in human spinal ligaments.

Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by ectopic ossification in the spinal ligaments, which enlarges with time and compresses the spinal cord, resulting in serious neurological symptoms. We previously reported that Runx2 expression was enhanced in spinal ligament cells from OPLL patients (OPLL cells). To clarify genes regulated by Runx2, Runx2 expression was first enhanced by culturing primary OPLL cells in osteogenic medium (OS induction) and then inhibited by siRNAs targeted to Runx2.

Possible role of extracellular nucleotides in ectopic ossification of human spinal ligaments.

To reveal the involvement of extracellular nucleotides in the ossification process in ossification of the posterior longitudinal ligament of the spine (OPLL), the mRNA expression profiles of P2 purinoceptors, mechanical stress-induced ATP release, and ATP-stimulated expression of osteogenic genes were analyzed in ligament cells derived from the spinal ligament of OPLL patients (OPLL cells) and non-OPLL cells derived from the spinal ligaments of cervical spondylotic myelopathy patients as a control. The extracellular ATP concentrations of OPLL cells in static culture were significantly higher than those of non-OPLL cells, and this difference was diminished in the presence of ARL67156, an ecto-nuclease inhibitor. Cyclic stretch markedly increased the extracellular ATP concentrations of both cell types to almost the same level.

Cervical range of motion and alignment after laminoplasty preserving or reattaching the semispinalis cervicis inserted into axis.

Study Design: A radiographic study in 111 patients using radiographs was conducted.

Objective: To clarify whether the modified laminoplasty with C3 laminectomy preserving the semispinalis cervicis (SSC) inserted into C2 could maintain the postopertive range of motion (ROM) and sagittal alignment compared with conventional C3-C7 laminoplasty reattaching the muscle to C2.

Summary Of Background Data: Intraoperative injury of the SSC is relevant to the significant loss of ROM and the malalignment after laminoplasty.

Cervical spinal motion before and after surgery in patients with Chiari malformation type I associated with syringomyelia.

Object: There have been few reports about the cervical spinal motion in patients with Chiari malformation Type I (CM-I) associated with syringomyelia. To investigate this phenomenon, the relationship between the preoperative cervical range of motion (ROM) and the stage of cerebellar tonsillar descent as well as the cervical ROM before and after foramen magnum decompression (FMD) were evaluated.

Methods: Thirty patients who had CM-I associated with syringomyelia and who underwent FMD participated in the study.

Surgical outcomes in adult patients with syringomyelia associated with Chiari malformation type I: the relationship between scoliosis and neurological findings.

Object: The clinical characteristics of pediatric scoliosis associated with syringomyelia have been reported in previous studies, but scoliosis associated with syringomyelia in adults is rarely treated, and there is a paucity of detailed studies. In the present study of adult syringomyelia associated with Chiari malformation Type I, the authors investigated the relationships among the syrinx, scoliosis, and neurological data.

Methods: The population was composed of 27 patients (> or = 20 years of age) who underwent foramen magnum decompression for the treatment of syringomyelia.

Axial symptoms after cervical laminoplasty with C3 laminectomy compared with conventional C3-C7 laminoplasty: a modified laminoplasty preserving the semispinalis cervicis inserted into axis.

Study Design: Results of C4-C7 laminoplasty with C3 laminectomy and C3-C7 laminoplasty were compared.

Objectives: To clarify prospectively whether the modified laminoplasty preserving the semispinalis cervicis inserted into C2 could reduce the axial symptoms compared with conventional laminoplasty reattaching the muscle to C2.

Summary Of Background Data: Intraoperative damage of the semispinalis cervicis is relevant to the development of axial symptoms after laminoplasty.

An immunohistochemical evaluation of extracellular matrix components in the spinal posterior longitudinal ligament and intervertebral disc of the tiptoe walking mouse.

Ossification of the posterior longitudinal ligament (OPLL) in the spine is caused by systemic and/or regional factors affecting the regulation of osteocartilaginous formation and maintenance. The aims of this study were to elucidate the relationship between the degeneration of the intervertebral discs and changes in the posterior longitudinal ligament (PLL) in the tiptoe walking (ttw) mouse, an animal model of OPLL, and to analyze the sequential changes of the cells producing extracellular matrix components using immunohistochemical methods. At 6 weeks of age, the discs degenerated and the chondrocytes in the nucleus pulposus were positive for chondroitin-6-sulfate in the ttw mice.

Interaction between proteoglycans and alpha-elastin in construction of extracellular matrix of human yellow ligament.

One type of large proteoglycan and three types of small proteoglycans (decorin, decorin-subtype, and biglycan) were purified by chromatography, and alpha-elastin was isolated by alkali treatment from human yellow ligaments taken at the time of operation. The interaction of the proteoglycans with immobilized alpha-elastin on a sensor was analyzed by surface plasmon resonance, and we confirmed that each of the small proteoglycans exhibited a specific binding to alpha-elastin. The binding sites of small proteoglycans were contained in the protein cores.

Inadvertent C2-C3 union after C1-C2 posterior fusion in adults.

Introduction: Some authors pointed out that there were more than a few patients with inadvertent C2-C3 union after C1-C2 posterior fusion, although few detailed studies of C2-C3 union have been reported. The purpose of this study was to clarify whether C2-C3 union accelerated adjacent C3-C4 disc degeneration after C1-C2 posterior fusion and to investigate the related factors for C2-C3 union.

Methods: Sixteen patients with rheumatoid arthritis (RA group) (4 males, 12 females, mean age 60 years, mean follow-up period 4 years and 3 months) and fifteen patients without RA (non-RA group) (11 males, 4 females, mean 52 years, mean follow-up period 3 years and 10 months) who underwent C1-C2 posterior fusion were radiologically assessed.

Muscle atrophy after treatment with Halovest.

Study Design: A prospective study was conducted on the sequential changes in the muscles around the cervical spine following external fixation for an extended period.

Objective: Muscular atrophy around the cervical spine following prolonged external fixation with a Halovest and subsequent recovery from the atrophy were examined.

Summary Of Background Data: There are a number of reports on the usefulness of the Halovest.

Nationwide survey on complications of spine surgery in Japan.

The Japan Spine Research Society carried out a nationwide survey on complications of the spine, enrolling a total of 16 157 patients who had undergone spine surgery in 196 institutes in the 1-year period from January to December 2001. Diseases, surgical procedures, and complications were surveyed in detail. Forty-nine percent of patients were aged 60 years or older, which was remarkably increased in comparison with the percentage reported by the 1994 survey (37.

Correlation between severity of rheumatoid arthritis and manner and extent of cervical lesion.

Abstract To determine the proper management of treatment for rheumatoid cervical lesions, we investigated the clinical course of the cervical spine in rheumatoid arthritis (RA). The severity of RA was classified into three groups according to the disease subsets advocated by Ochi et al.: the less erosive subset (LES), the more erosive subset (MES), and mutilating disease (MUD).

Role of prostaglandin I2 in the gene expression induced by mechanical stress in spinal ligament cells derived from patients with ossification of the posterior longitudinal ligament.

Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by ectopic bone formation in the spinal ligaments, and mechanical stress has been suggested to play an important role in the progression of OPLL. To identify the genes that participate in OPLL, the differential display reverse transcription-polymerase chain reaction (RT-PCR) method was used. A 283-base pair cDNA fragment corresponding to prostaglandin I2 (PGI2) synthase was highly expressed in OPLL cells compared with non-OPLL cells.

Possible roles of CTGF/Hcs24 in the initiation and development of ossification of the posterior longitudinal ligament.

Study Design: A biochemical and histochemical study investigating the role of CTGF/Hcs24 in the ossification of the posterior longitudinal ligament (OPLL) was conducted.

Objective: To clarify the involvement of CTGF/Hcs24 in ectopic bone formation in OPLL through endochondral ossification using human tissue.

Summary Of Background Data: Previous studies have shown that various cytokines are involved in the occurrence or development of ectopic bone formation in OPLL.

Adult scoliosis in syringomyelia associated with Chiari I malformation.

Study Design: In adult syringomyelia associated with Chiari I malformation, the spinal deformity, the configuration of cerebellar tonsillar descent, the configuration of syrinx, and the clinical evaluation before and after surgery were investigated.

Objectives: To investigate the characteristics of the scoliosis in syringomyelia associated with Chiari I malformation.

Summary Of Background Data: In previous studies, the clinical characteristics of pediatric scoliosis associated with syringomyelia have been reported.