Spontaneous Facet Joint Osteoarthritis in NFAT1-Mutant Mice: Age-Dependent Histopathologic Characteristics and Molecular Mechanisms.

Background: Facet joint (FJ) osteoarthritis (FJOA) is a widely prevalent spinal disorder but its pathogenesis remains unclear, largely due to the difficulties in conducting longitudinal human studies and lack of spontaneous-FJOA animal models for mechanistic investigations. This study aimed to investigate whether spontaneous FJOA occurs in mice bearing mutant NFAT1 (nuclear factor of activated T cells 1) transcription factor.

Methods: The lumbar FJs of 50 NFAT1-mutant mice and of 50 wild-type control mice, of both sexes, were examined by histopathology, quantitative gene expression analysis, semiquantitative immunohistochemistry, and a novel FJOA scoring system for semiquantitative assessment of the histopathologic changes at 2, 6, 12, and 18 months of age.

Establishment of a university academic spine center: from concept to reality.

In fewer than five years, the University of Kansas Hospital Spine Center became the largest and most comprehensive spine care facility in the greater metropolitan Kansas City area. The 22,000-square-foot facility has 27 exam rooms, four specialized diagnostic rooms, 11 pre-/post-interventional procedure rooms, and a 4000-square-foot outpatient rehabilitation gym. Patients can meet with their physicians, undergo diagnostic tests and treatment, and attend therapy sessions in one location.

Radiographic and patient-based outcome analysis of different bone-grafting techniques in the surgical treatment of idiopathic scoliosis with a minimum 4-year follow-up: allograft versus autograft/allograft combination.

Background Context: Autograft and allograft have been equally successful in achieving arthrodesis, but whether there is any difference in their effect on patient outcome, especially early, has not been determined.

Purpose: To determine if autograft in addition to allograft is associated with decreased healing period pain, increased early function, or both.

Study Design: This is a retrospective comparative case series.

Comparison of trunk and spine deformity in adolescent idiopathic scoliosis.

Background: Cobb measurement of standing radiographs is the standard for clinical assessment of coronal spinal deformity. Angle of trunk inclination (ATI) is an accepted clinical measurement of trunk asymmetry, and has variable reported correlations with Cobb angles. Transverse plane spine deformity is most accurately measured using axial computed tomography.

Subsequent, unplanned spine surgery and life survival of patients operated for neuropathic spine deformity.

Study Design: Retrospective study of a prospectively assembled cohort.

Objective: To characterize the survival from subsequent spine surgery and the life survival of patients treated surgically for severe spinal deformity due to neuropathic diseases.

Summary Of Background Data: Survivorship analysis is widely used to study the natural history of disease processes and of treatments provided, but has very seldom been used to study patients' course after surgery for spinal deformity associated with neuropathic diseases.

Converting SRS-24, SRS-23, and SRS-22 to SRS-22r: establishing conversion equations using regression modeling.

Study Design: Cross-sectional mail questionnaire.

Objective: Assess the feasibility of translating total and domain scores from Scoliosis Research Society (SRS)-24, SRS-23, and SRS-22 to SRS-22r.

Summary Of Background Data: Three successive editions of the original SRS-24 health-related quality-of-life questionnaire have resulted from efforts to improve its psychometric properties and validate its use in patients down to 10 years of age.

Transverse plane pelvic rotation increase (TPPRI) following rotationally corrective instrumentation of adolescent idiopathic scoliosis double curves.

Background: We have occasionally observed clinically noticeable postoperative transverse plane pelvic rotation increase (TPPRI) in the direction of direct thoracolumbar/lumbar rotational corrective load applied during posterior instrumentation and arthrodesis for double (Lenke 3 and 6) adolescent idiopathic scoliosis (AIS) curves. Our purposes were to document this occurrence; identify its frequency, associated variables, and natural history; and determine its effect upon patient outcome.

Methods: Transverse plane pelvic rotation (TPPR) can be quantified using the left/right hemipelvis width ratio as measured on standing posterior-anterior scoliosis radiographs.

The effect of starting point placement technique on thoracic transverse process strength: an ex vivo biomechanical study.

Background: The use of thoracic pedicle screws in spinal deformity, trauma, and tumor reconstruction is becoming more common. Unsuccessful screw placement may require salvage techniques utilizing transverse process hooks. The effect of different starting point placement techniques on the strength of the transverse process has not previously been reported.

Identification of Scoliosis Research Society-22r Health-Related Quality of Life questionnaire domains using factor analysis methodology.

Study Design: Cross-sectional mail questionnaire.

Objective: Examination of the underlying construct validity of the Scoliosis Research Society-22r (SRS-22r) Health-Related Quality of Life (HRQoL) Questionnaire using factor analysis.

Summary Of Background Data: The original SRS-24 HRQoL questionnaire has undergone a series of modifications in an effort to further improve its psychometric properties and validate its use in patients from 10 years of age until well into adulthood.

The International Research Society of Spinal Deformities (IRSSD) and its contribution to science.

From the time of its initial, informal meetings starting in 1980 to its formal creation in 1990, the IRSSD has met on a bi-annual basis to discuss all aspects of the spine and associated deformities. It has encouraged open discussion on all topics and, in particular, has tried to be the seed-bed for new ideas. The members are spread around the world and include people from all areas of academia as well as the most important people, the patients themselves.

Analysis of instrumentation/fusion survivorship without reoperation after primary posterior multiple anchor instrumentation and arthrodesis for idiopathic scoliosis.

Background: During the past 25 years, spinal instrumentation systems and surgical techniques used to treat idiopathic scoliosis have evolved, achieving fewer patient restrictions during arthrodesis healing, shorter constructs, and better correction. The purposes of this retrospective comparative study were to determine the survivorship of the implant/fusion without reoperation and the risk factors influencing such survival.

Methods: From 1989 through 2002, 208 consecutive patients (index patient included, age 10-20 years) underwent primary posterior instrumentation and arthrodesis with the same multiple anchor implant system by one surgeon, a co-designer of the system.

Growing rods for infantile scoliosis in Marfan syndrome.

Study Design: Retrospective review.

Objective: To evaluate the effectiveness of a new growing rod technique in controlling infantile scoliosis in patients with Marfan syndrome.

Summary Of Background Data: Infantile scoliosis in patients with Marfan syndrome is nearly always progressive and poorly controlled by bracing, yet previous studies have shown poor results with first-generation extensible spinal rod techniques.

Pelvic fixation of growing rods: comparison of constructs.

Study Design: Retrospective review.

Objective: To analyze outcomes and complications of growing rods fixed to the pelvis.

Summary Of Background Data: Growing systems with pelvic foundations are used for neuromuscular/syndromic scoliosis.

The effect of posterior thoracic spine anatomical structures on motion segment flexion stiffness.

Study Design: This in vitro human cadaveric study tested the loss of thoracic motion segment flexion stiffness after sequential posterior upper instrumented vertebra anchor placement techniques and posterior column destabilization.

Objective: This study was designed to determine the possible destabilizing effects of upper thoracic instrumentation anchor site preparation.

Summary Of Background Data: Proximal junctional kyphosis after instrumentation and arthrodesis for scoliosis and related spine deformities has recently been reported to range from 10% to 46%.

Treatment of adolescent idiopathic scoliosis with quantified trunk rotational strength training: a pilot study.

Study Design: Prospective clinical trial.

Objectives: To test the hypothesis that quantified trunk rotational strength training will equalize any strength asymmetry, increase strength overall, and stabilize adolescent idiopathic scoliosis.

Summary Of Background Data: Bracing, the only generally accepted form of adolescent idiopathic scoliosis nonoperative therapy, has many shortcomings.

The prevalence of increased proximal junctional flexion following posterior instrumentation and arthrodesis for adolescent idiopathic scoliosis.

Study Design: Retrospective case series.

Objective: To determine the prevalence of proximal junctional sagittal plane flexion increase after posterior instrumentation and arthrodesis.

Summary Of Background Data: Increased flexion proximal to the junction of the instrumented and fused spinal region with the adjacent mobile spine seems to be a relatively recent observation, may be increasing, and is occasionally problematic.

Dual growing rod technique followed for three to eleven years until final fusion: the effect of frequency of lengthening.

Study Design: Retrospective case review of children completing dual growing rod treatment at our institutions. Patients had a minimum of 2 years follow-up.

Objective: To identify the factors influencing dual growing rod treatment outcome followed to final fusion.

Transverse plane pelvic rotation in adolescent idiopathic scoliosis: primary or compensatory?

Several studies have suggested that the pelvis is involved in the etiology or pathogenesis of adolescent idiopathic scoliosis (AIS). The purpose of this retrospective, cross-sectional radiographic study is to identify any correlation between the transverse plane rotational position of the pelvis in stance and operative-size idiopathic or congenital scoliosis deformities, using Scheuermann's kyphosis and isthmic spondylolisthesis patients for comparison. The hypothesis tested was that the direction of transverse pelvic rotation is the same as that for a thoracic scoliosis.

The reliability and concurrent validity of the Scoliosis Research Society-22r patient questionnaire compared with the Child Health Questionnaire-CF87 patient questionnaire for adolescent spinal deformity.

Study Design: This is a clinic-based cross-sectional study involving 2 health-related quality-of-life (HRQL) questionnaires.

Objectives: To compare the score distribution and reliability of the spinal deformity specific Scoliosis Research Society-22r (SRS-22r) questionnaire and the established generic Child Health Questionnaire-CF87 (CHQ-CF87), and to assess the concurrent validity of the SRS-22r using the CHQ-CF87 in an adolescent spine deformity population.

Summary Of Background Data: Different questionnaires are commonly thought to be necessary to assess the HRQL of adolescent and adult populations.

Trunk rotational strength asymmetry in adolescents with idiopathic scoliosis: an observational study.

Background: Recent reports have suggested a rotational strength weakness in rotations to the concave side in patients with idiopathic scoliosis. There have been no studies presenting normative values of female adolescent trunk rotational strength to which a comparison of female adolescents with idiopathic scoliosis could be made. The purpose of this study was to determine trunk rotational strength asymmetry in a group of female adolescents with AIS and a comparison group of healthy female adolescents without scoliosis.