Publications by authors named "Wong Hee Kit"
Study Design: Cross-sectional Cohort Study.
Objective: To determine the cervicothoracic inflection point in an asymptomatic, adult population.
Introduction: The cervicothoracic inflection point (CTIP) is an important sagittal marker to understand for patients with cervical deformities.
Article Synopsis
- - The study investigated how matrix metalloproteinase-2 (MMP-2) contributes to ligamentum flavum (LF) hypertrophy in a rat model and assessed the effects of elastin-derived peptides (EDPs) on MMP-2 and tissue inhibitors (TIMPs) in LF cells.
- - After inducing mechanical stress through surgery, researchers observed significant changes in LF structure, including increased thickness and cellular changes, alongside elevated MMP-2 and TIMP levels after 6 and 12 weeks.
- - EDPs were found to suppress MMP-2 expression and alter TIMP levels in isolated rat LF cells, highlighting a complex interaction where EDPs enhance the MMP-2/TIMPs
Study Design: Cross-sectional cohort study.
Objective: To classify spinal morphology using the "current" and "theoretical" Roussouly systems and assess sagittal alignment in an asymptomatic cohort.
Methods: 467 asymptomatic volunteers were recruited from 5 countries.
Article Synopsis
- The study aimed to evaluate the distribution of GAP scores among a diverse group of healthy volunteers and assess spinal shape differences based on alignment categories, age, and geography.
- The research involved 467 asymptomatic participants from five countries, measuring various spinal parameters through advanced imaging techniques.
- The findings indicated significant age-related differences in spinal alignment, with older individuals showing a higher rate of severe disproportionality and notable differences in key spinal metrics compared to younger participants.
Article Synopsis
- Surgical treatment for cancer patients with epidural spinal cord compression has evolved significantly, particularly with the rise of minimally invasive surgical (MIS) techniques and separation surgery over the past 17 years.
- A study of 383 patients showed increasing numbers of surgeries performed and a notable reduction in blood loss and transfusion rates, with those treated more recently experiencing better neurological improvements and mobility.
- Despite these advancements in surgical technique and patient outcomes, overall survival rates remained unchanged, highlighting the need for a multidisciplinary approach to patient management.
Study Design: Prospective, cross-sectional study.
Objective: In a geographically diverse population of asymptomatic volunteers, we sought to report the incidence of pelvic obliquity (PO), establish normative values of PO across patient factors, and assess the correlation of PO with radiographic parameters.
Summary Of Background Data: PO is defined as the misalignment of the pelvis and can be assessed through several anatomic landmarks.
Objective: To define a novel radiographic measurement, the posterior cranial vertical line (PCVL), in an asymptomatic adult population to better understand global sagittal alignment.
Methods: We performed a multicenter retrospective review of prospectively collected radiographic data on asymptomatic volunteers aged 20-79. The PCVL is a vertical plumb line drawn from the posterior-most aspect of the occiput.
Study Design: Prospective cohort study.
Objectives: To show population variance in the Inflection Point (IP) and its role in defining maximum Thoracic Kyphosis (TK) and Lumbar Lordosis (LL).
Methods: 468 asymptomatic adult volunteers were included in the Multi-Ethnic Normative Alignment Study (MEANS).
Background Context: Current definition of lumbar lordosis uses the L1-S1 angle. Prevailing classification of sagittal spinal morphology, derived from a young adult population, classifies the spine into four subtypes defined by their sacral slope (SS) and curve morphology.
Purpose: To describe physiological sagittal alignment of the lumbar spine across age groups using three main parameters that dictate the lumbar curve: angular magnitude, span, and apex.
Purpose: Assess normative values of sagittal spinal and lower extremity alignment in asymptomatic volunteers of three difference races.
Methods: Asymptomatic volunteers between the ages of 18-80 years were enrolled prospectively and then analyzed retrospectively from six different centers. Volunteers included reported no significant neck or back pain, nor any known spinal disorder(s).
Study Design: This is a basic science, animal research study.
Objective: This study aims to explore, in rodent models, the effectiveness of systemic nonsteroidal anti-inflammatory drugs in reducing recombinant human bone morphogenetic protein-2 (rhBMP-2) induced neuroinflammation.
Summary Of Background Data: rhBMP-2 is increasingly used to augment fusion in lumbar interbody fusion surgeries, although it can cause complications including postoperative radiculitis.
Article Synopsis
- A prospective study examined the lumbar shape and sagittal parameters in 468 asymptomatic volunteers aged 18 to 80 from 5 countries.
- Moderate correlations were found between pelvic incidence (PI) and proximal lumbar lordosis (pLL), as well as between thoracic kyphosis and the lumbar parameters.
- The study revealed a clear distinction in mean PI based on lumbar apex levels, with lower PI linked to an apex at L4 and higher PI associated with L3.
Article Synopsis
- This study focuses on the prevalence and characteristics of spondylolisthesis and retrolisthesis in spine patients using a cross-sectional design at a single clinic.
- The research involved analyzing clinical data and radiographic images of 256 patients, identifying that spondylolisthesis occurs mainly at the L4/5 level and retrolisthesis at L3/4.
- Notable risk factors for spondylolisthesis included increasing age, female gender, and certain occupational activities, while distinct spinal alignment characteristics were observed in both conditions.
Article Synopsis
- A retrospective cohort study examined adverse events (AEs) in 199 patients after surgical treatment of thoracolumbar fractures, focusing on incidence and predictive factors.
- The overall AE rate was 46.7%, with significant occurrences including urinary tract infections and hospital-acquired pneumonia, while factors like higher TLICS scores and polytrauma increased the risk of AEs.
- The findings emphasize that the absence of neurological deficits is associated with a lower rate of adverse events, highlighting the importance of patient assessment prior to surgery.
Objective: The role of the craniocervical complex in spinal sagittal alignment has rarely been analyzed but it may play a fundamental role in postoperative mechanical complications. The aim of the study is to analyze the normative value of the cervical inclination angle (CIA) in an adult asymptomatic multiethnic population.
Methods: Standing full-spine EOS of adult asymptomatic volunteers from 5 different countries were analyzed.
Depression is one of the most prevalent mental disorders associated with reductions in bone mineral density and increased fracture risk. Fluoxetine is a highly prescribed selective serotonin reuptake inhibitor (SSRI) in the treatment of depression and is reported to be a risk factor for fractures. The present study examined the effect of fluoxetine on bone microarchitecture and the mechanical properties under chronic mild stress (CMS), a rodent model of depression.
View Article and Find Full Text PDFArticle Synopsis
- The study is a cross-sectional cohort aimed at understanding sagittal plane alignment and balance in asymptomatic adults from various countries.
- It challenges existing sagittal alignment guidelines, showing they were based on data from spinal deformity patients, making them less applicable to the general population.
- The results identified four key parameters that can help define normal spinal alignment in healthy individuals, ultimately improving surgical outcomes.
Study Design: Multicenter Cohort.
Objective: Assess normative values of sagittal spinal and lower extremity alignment in asymptomatic volunteers stratified by age and gender.
Summary Of Background Data: Our understanding of ideal sagittal alignment is still evolving.
Background: Spinal alignment can have a significant impact on a patient's overall quality of life. Predicting the ideal sagittal spinal alignment of a specific individual is still a difficult task. The Multi-Ethnic Alignment Normative Study (MEANS) investigated skeletal alignment, including the spine and lower extremities, of the largest multi-ethnic cohort of asymptomatic adult volunteers.
View Article and Find Full Text PDFPurpose: Previous studies on adults with degenerative scoliosis (ADS) have been fixed the threshold of PI-LL mismatch less than 10° for achieving good clinical outcomes. Recent studies discussed that PI-LL mismatch should consider individual pelvic incidence (PI) and should be set first in a normal population. The purpose of this study is to assess the variability of PI-LL mismatch according to PI in an asymptomatic population.
View Article and Find Full Text PDFPurpose: Our study aimed to evaluate non-inferiority of ProDisc-C to anterior cervical discectomy and fusion (ACDF) in terms of clinical outcomes and incidence of adjacent segment disease (ASD) at 24-months post-surgery in Asian patients with symptomatic cervical disc disease (SCDD).
Methods: This multicentre, prospective, randomized controlled trial was initiated after ethics committee approval at nine centres (China/Hong Kong/Korea/Singapore/Taiwan). Patients with single-level SCDD involving C3-C7-vertebral segments were randomized (2:1) into: group-A treated with ProDisc-C and group-B with ACDF.
Study Design: Retrospective Exact Matched case-control study.
Objectives: Surgical treatment delay in AIS due to family preferences is common. This study aims to quantify the increase in risks as the Cobb angle increases and provide a Quantifiable Risk Reference Table that can be utilized for counseling.
Study Design: Retrospective cohort study.
Objectives: To compare outcomes of percutaneous pedicle screw fixation (PPSF) to open posterior stabilization (OPS) in spinal instability patients and minimal access separation surgery (MASS) to open posterior stabilization and decompression (OPSD) in metastatic spinal cord compression (MSCC) patients.
Methods: We analysed patients who underwent surgery for thoracolumbar metastatic spine disease (MSD) from Jan 2011 to Oct 2017.
Background: The purpose of this study was to investigate the affecting factors on pelvic incidence (PI) and to test the hypothesis that PI changes even after skeletal maturity probably due to hypermobility of the sacroiliac joint using a large international multi-center database.
Methods: A prospective and cross-sectional healthy adult volunteers, ages 18-80 years, across 5 countries were used. Radiographic measurements included standard whole body alignment parameters.
Purpose: To radiographically compare lateral entry point S2-alar-iliac (L-S2AI) screw with conventional S2AI (C-S2AI) and conventional iliac screw (CIS) lengths and trajectories.
Methods: Twenty-five preoperative CT scans of consecutive patients undergoing adult spinal deformity realignment surgery over a random 2-year period were analysed. Maximum in-bone length, caudal and lateral trajectories of CIS, C-S2AI, and L-S2AI screws were measured and compared using One-way ANOVA with Tukey's post hoc tests.