Progressive change in joint degeneration in patients with knee or hip osteoarthritis treated with fentanyl in a randomized trial.

Purpose: Opioids improve pain from knee and hip osteoarthritis (OA) and decrease the functional impairment of patients. However, there is a possibility that opioids induce analgesia and suppress the physiological pain of OA in patients, thereby inducing the progression of OA changes in these patients. The purpose of the current study was to investigate the possibility of progressive changes in OA among patients using opioids.

Dichotomizing sensory nerve fibers innervating both the lumbar vertebral body and the area surrounding the iliac crest: a possible mechanism of referred lateral back pain from lumbar vertebral body.

Study Design: Animal study.

Objective: To determine the existence of dichotomizing sensory nerve fibers innervating both the lumbar vertebral body and the area surrounding the iliac crest (ASIC).

Summary Of Background Data: Elderly patients with osteoporosis sometimes experience lumbar vertebral fracture and may feel diffuse nonlocalized pain in the back, the lateral portion of the trunk, and the ASIC.

Virtual endoscopic imaging of the spine.

Study Design: Prospective trial of virtual endoscopy in spinal surgery.

Objective: To investigate the utility of virtual endoscopy of the spine in conjunction with spinal surgery.

Summary Of Background Data: Several studies have described clinical applications of virtual endoscopy to visualize the inside of the bronchi, paranasal sinus, stomach, small intestine, pancreatic duct, and bile duct, but, to date, no study has described the use of virtual endoscopy in the spine.

Health-related quality of life and low back pain of patients surgically treated for scoliosis after 21 years or more of follow-up: comparison among nonidiopathic scoliosis, idiopathic scoliosis, and healthy subjects.

Study Design: A case-control study.

Objective: To compare health-related quality of life and low back pain of healthy subjects with those of patients with nonidiopathic scoliosis (non-IS) and idiopathic scoliosis (IS) 21 years or more after surgery.

Summary Of Background Data: There have been a very small number of reports on long-term results of surgery for non-IS.

Long-term clinical outcomes of surgery for adolescent idiopathic scoliosis 21 to 41 years later.

Study Design: A case control study.

Objective: To determine the clinical outcome of middle-aged patients surgically treated for adolescent idiopathic scoliosis and to compare their outcomes with assessments of age- and sex-matched healthy controls.

Summary Of Background Data: Several long-term follow-up studies have been published on the clinical outcomes of surgical treatment for adolescent idiopathic scoliosis in patients who have reached their 20s or 30s.

Associations between proinflammatory cytokines in the synovial fluid and radiographic grading and pain-related scores in 47 consecutive patients with osteoarthritis of the knee.

Background: One of the sources of knee pain in osteoarthritis (OA) is believed to be related to local chronic inflammation of the knee joints, which involves the production of inflammatory cytokines such as tumor necrosis factor alpha (TNFα), interleukin (IL)-6, and nerve growth factor (NGF) in the synovial membrane, and these cytokines are believed to promote pathological OA. In the present study, correlations between proinflammatory cytokines in knee synovial fluid and radiographic changes and functional scores and pain scores among OA patients were examined.

Methods: Synovial fluid was harvested from the knees of 47 consecutive OA patients, and the levels of TNFα, IL-6, and NGF were measured using enzyme-linked immunosorbent assays.

Single-level instrumented posterolateral fusion versus non-instrumented anterior interbody fusion for lumbar spondylolisthesis: a prospective study with a 2-year follow-up.

Background: Surgery for lumbar spondylolisthesis is widely performed. However, there have been no reports comparing posterolateral and anterior interbody fusion prospectively. We compared instrumented posterolateral fusion with anterior interbody fusion for L4 spondylolisthesis in a prospective study.

Uni- and bilateral instrumented posterolateral fusion of the lumbar spine with local bone grafting: a prospective study with a 2-year follow-up.

Study Design: Prospective trial.

Objective: To examine the bone union and clinical results after unilateral or bilateral instrumented posterolateral fusion surgery using a local bone graft.

Summary Of Background Data: The iliac crest bone graft technique for lumbar posterolateral fusion surgery is widely used; however, donor site problems such as pain and sensory disturbance have been reported.

Lumbar disc degeneration induces persistent groin pain.

Study Design: Prospective study of 212 patients with groin pain but without low back pain.

Objective: To evaluate discogenic groin pain without low back pain or radicular pain.

Summary Of Background Data: Patients feel low back pain originating from discogenic disease.

One, two-, and three-level instrumented posterolateral fusion of the lumbar spine with a local bone graft: a prospective study with a 2-year follow-up.

Study Design: Prospective trial.

Objective: To examine the difference in bone union and clinical results after one-, two-, and three-level instrumented posterolateral fusion surgery using a local bone graft.

Summary Of Background Data: The iliac crest bone graft technique for lumbar posterolateral fusion surgery is widely used; however, donor site problems such as pain and sensory disturbance have been reported.

18F-fluorodeoxyglucose-PET for patients with suspected spondylitis showing Modic change.

Study Design: Prospective cohort study.

Objective: To examine the utility of 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) to diagnose pyogenic spondylitis in patients showing Modic change.

Summary Of Background Data: Vertebral bone marrow infection may appear as Modic type 1 signal on magnetic resonance imaging, so it is difficult to distinguish between common Modic change and infection.

Single-level instrumented posterolateral fusion of the lumbar spine with a local bone graft versus an iliac crest bone graft: a prospective, randomized study with a 2-year follow-up.

The iliac crest bone grafting (ICBG) technique for lumbar posterolateral fusion surgery is widely used; however, donor site problems such as pain and sensory disturbance have been reported. Local bone is available for fusion surgery, but its reliability as a graft has not been fully reported. In the current study, we examined single-level instrumented posterolateral fusion with a local bone graft versus an ICBG in a prospective randomized study.

Effectiveness of L2 spinal nerve infiltration for selective discogenic low back pain patients.

Background: It has been reported that rat L5/6 lumbar discs are innervated mainly by L2 dorsal root ganglion neurons. We previously reported that L2 spinal nerve infiltration was effective for discogenic low back pain (DLBP) patients, although the diagnosis was based only on the results of physical examination, plain films, and magnetic resonance imaging (MRI). The purpose of the current study was to evaluate L2 spinal nerve block for DLBP patients retrospectively based on MRI findings and surgical results.

The effects of risedronate and exercise on osteoporotic lumbar rat vertebrae and their sensory innervation.

Study Design: Investigation of sensory innervation of rat osteoporotic lumbar vertebrae using in vitro and in vivo models.

Objective: To investigate (1) sensory innervation of osteoporotic rat vertebrae, (2) effects of risedronate on sensory neurons, (3) effects of osteoporosis treatment on bone mineral densities (BMDs) and the sensory innervation.

Summary Of Background Data: Osteoporotic patients without fractures sometimes experience vague low back pain of unknown origin.

Proinflammatory cytokines in the cerebrospinal fluid of patients with lumbar radiculopathy.

In pathologic radicular pain of lumbar spinal stenosis, cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukins (ILs) play a crucial role in the pathogenesis of nerve degeneration and pain. We investigated TNF-α and IL-6 levels in the cerebrospinal fluid (CSF) of patients with radicular pain caused by lumbar spinal stenosis (LSS). A total of 30 LSS patients and 10 age-matched controls were examined.

Low back pain after lumbar discectomy in patients showing endplate modic type 1 change.

Study Design: Prospective cohort study.

Objective: To examine the relationship between low back pain after discectomy for disc herniation and Modic type 1 change.

Summary Of Background Data: Lumbar vertebral bone marrow change is divided into Modic types.

Existence of pyogenic spondylitis in Modic type 1 change without other signs of infection: 2-year follow-up.

The relationship of Modic change to pain and inflammation remains to be unclear. Recently, some authors have reported that Modic type 1 signals are closely related to infection. However, if the patients do not have severe back pain, fever, or an abnormal blood profile, it is difficult to distinguish between common Modic change and infection.

Change in Modic type 1 and 2 signals after posterolateral fusion surgery.

Study Design: Prospective cohort study.

Objective: To examine the change of Modic Type 1 to Type 2 after posterolateral fusion surgery.

Summary Of Background Data: Lumbar vertebral bone marrow change is divided into Modic types.

Evaluation of low back pain using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire for lumbar spinal disease in a multicenter study: differences in scores based on age, sex, and type of disease.

Background: The Japanese Orthopaedic Association (JOA) has investigated the JOA Back Pain Evaluation Questionnaire (JOABPEQ) to evaluate several aspects of low back pain in patients. The score includes five categories (25 items) selected from the Roland Morris Disability Questionnaire and Short Form 36, and a visual analogue scale. Japanese physicians have recently used these scores to evaluate back pain; however, the efficacy has not been fully explored in large-scale studies.

Rotational hypermobility of disc wedging using kinematic CT: preliminary study to investigate the instability of discs in degenerated scoliosis in the lumbar spine.

The number of patients showing lumbar degenerative scoliosis, including disc wedging, has increased, and examination of the mechanism of spinal nerve compression due to lateral and rotational mobility of the lumbar spine is necessary. Thirty-two patients with L4-L5 disc wedging but without antero- or retrospondylolisthesis and ten age-matched controls were examined. The angle of disc wedging and change in the angle between left and right bending were evaluated by anterior-posterior X-ray images of patients while they were in a standing position.

Lumbar posterolateral fusion inhibits sensory nerve ingrowth into punctured lumbar intervertebral discs and upregulation of CGRP immunoreactive DRG neuron innervating punctured discs in rats.

Degeneration of lumbar intervertebral discs is thought to be a cause of low back pain. Studies have found that a cause of discogenic low back pain is intervertebral disc inflammation and axonal growth of afferent fibers innervating the disc. Lumbar spine fusion for chronic discogenic low back pain is considered an effective procedure.

Nerve growth factor of cultured medium extracted from human degenerative nucleus pulposus promotes sensory nerve growth and induces substance p in vitro.

Study Design: We investigated the mechanism of discogenic low back pain using an in vitro model.

Objective: To evaluate the axonal growth and induction of a painful neuropeptide, substance P (SP), using rat dorsal root ganglion (DRG) neurons and degenerated human disc cells in vitro.

Summary Of Background Data: Degeneration of the lumbar intervertebral disc is a cause of low back pain.

Results of surgery for discogenic low back pain: a randomized study using discography versus discoblock for diagnosis.

Study Design: Randomized, controlled study.

Objective: To evaluate the diagnosis of discogenic low back pain (LBP) with discography and discoblock.

Summary Of Background Data: Discogenic LBP is usually diagnosed by magnetic resonance imaging and discography.

Nuclear factor-kappa B decoy suppresses nerve injury and improves mechanical allodynia and thermal hyperalgesia in a rat lumbar disc herniation model.

Nuclear factor-kappa B (NF-kappaB) is a gene transcriptional regulator of inflammatory cytokines. We investigated the transduction efficiency of NF-kappaB decoy to dorsal root ganglion (DRG), as well as the decrease in nerve injury, mechanical allodynia, and thermal hyperalgesia in a rat lumbar disc herniation model. Forty rats were used in this study.