A novel technique for posterior lumbar interbody fusion to obtain a good local lordosis angle: anterior-release posterior lumbar interbody fusion.

Herein, we describe a novel posterior lumbar interbody fusion (PLIF) technique with annulus fibrosus (AF) release and the use of expandable cages (called "anterior-release PLIF" [ARPLIF]). In this technique, posterior column osteotomy (PCO) and AF release provide excellent intervertebral mobility. AF release involves circumferentially peeling off the AF above or below the endplate between the fixed vertebrae under radiographic guidance without cutting the AF and anterior longitudinal ligament.

Accuracy of Lateral Mass Screw Insertion during Cervical Spine Surgery without Fluoroscopic Guidance and Comparison of Postoperative Screw Loosening Rate among Unicortical and Bicortical Screws Using Computed Tomography.

Introduction: Pedicle screws (PSs) or lateral mass screws (LMSs) are used in posterior cervical spine fixation. The former are more firmly fixed but are associated with the risk of neurovascular injury and should be inserted using intraoperative imaging or navigation, which may prolong the surgical duration and is not feasible in all hospitals. This prospective clinical study aimed to evaluate the outcomes of LMS insertions without fluoroscopic guidance and screw loosening rates at 6 months postoperatively using computed tomography (CT).

Revision surgery after cervical laminoplasty: report of five cases and literature review.

Background Context: Revision surgery after laminoplasty is rarely performed, and there are few reports of this procedure in the English literature.

Purpose: To evaluate the reasons why patients underwent revision surgery after laminoplasty and to discuss methods of preventing the need for revision surgery. A literature review with a comparative analysis between previous reports and present cases was also performed.

Assessment of pure single nerve root resection in the treatment of spinal schwannoma: focus on solitary spinal schwannomas located below the thoracolumbar junction.

Background: The incidence of neurological deficits is reportedly low after sacrificing the affected nerve root during spinal schwannoma treatment. Although the incidence has been widely reported, the operative method for nerve root resection has been not clarified. To evaluate the safety of pure nerve root resection, we focused on solitary spinal schwannomas below the thoracolumbar level and investigated the effect of affected nerve resection.

Disc regeneration therapy using marrow mesenchymal cell transplantation: a report of two case studies.

Study Design: Marrow mesenchymal cells (MSCs) contain stem cells and possess the ability to regenerate bone, cartilage, and fibrous tissues. Here, we applied this regenerative ability to intervertebral disc regeneration therapy in an attempt to develop a new spinal surgery technique.

Objective: We analyzed the regenerative restoration ability of autologous MSCs in the markedly degenerated intervertebral discs.

Degenerative spondylolisthesis does not influence surgical results of laminoplasty in elderly cervical spondylotic myelopathy patients.

The objective of the study was to investigate the comorbidity of degenerative spondylolisthesis (DS), in elderly cervical spondylotic myelopathy (CSM) patients in our hospital, and the correlation between surgical results and preoperative DS. There are few studies on the outcome of laminoplasty for CSM with DS. A total of 49 elderly patients (>65 years old) who eventually had surgical treatment for CSM were evaluated.

Temporal changes in the tensile strength of ultra-high-molecular-weight polyethylene cable embedded in muscle tissue.

Background: Wires and cables have been used extensively for spinal sublaminar wiring, but damages to the spinal cord due to compression by metal wires have been reported. We have used more flexible ultra-high-molecular-weight polyethylene cable (Tekmilon tape) instead of metal wires since 1999 and have obtained good clinical outcomes. Although the initial strength of Tekmilon tape is equivalent to metal wires, the temporal changes in the strength of Tekmilon tape in the body should be investigated to show that sufficient strength is maintained over time until bone union is complete.

Raloxifene: its ossification-promoting effect on female mesenchymal stem cells.

Background: Raloxifene acts like estrogen in preventing bone loss in postmenopausal women, but it selectively activates biological responses in bone tissue. It has a direct effect on osteoblasts' differentiation and bone formation in bone marrow culture. However, the point at which raloxifene has an effect on bone marrow-derived mesenchymal stem cells (MSCs), regardless of sex difference, is not known.

Evaluation of reliability of post-tetanic motor-evoked potential monitoring during spinal surgery under general anesthesia.

Study Design: A prospective research.

Objective: Compare the reliability of post-tetanic motor-evoked potential (p-MEP) monitoring in the detection of motor injury during spinal surgery with that of conventional MEP (c-MEP).

Summary Of Background Data: Myogenic MEPs are sensitive to suppression by anesthetics and neuromuscular blockade.

Does developmental canal stenosis influence surgical results of bilateral open-door laminoplasty for cervical spondylotic myelopathy?

Object: The purpose of this study was to investigate the prevalence of developmental canal stenosis in patients with cervical spondylotic myelopathy (CSM), and the correlation between surgical results and degree of developmental canal stenosis.

Methods: A total of 112 patients who eventually had surgical treatment for CSM were evaluated. Male patients whose sagittal spinal diameter was < 14 mm and females whose sagittal diameter was < 13 mm even at one level were classified as having developmental canal stenosis.

The application of tetanic stimulation of the unilateral tibial nerve before transcranial stimulation can augment the amplitudes of myogenic motor-evoked potentials from the muscles in the bilateral upper and lower limbs.

Background: Recently, we reported a new technique to augment motor-evoked potentials (MEPs) under general anesthesia, posttetanic MEP (p-MEP), in which tetanic stimulation of the peripheral nerve before transcranial stimulation enlarged amplitudes of MEPs from the muscle innervated by the nerve subjected to tetanic stimulation. In the present study, we tested whether tetanic stimulation of the left tibial nerve can also augment amplitudes of MEPs from the muscles which are not innervated by the nerve subjected to tetanic stimulation.

Methods: Thirty patients undergoing spinal surgery under propofol-fentanyl anesthesia with partial neuromuscular blockade were examined.

Cervical laminoplasty combined with muscle release in patients with athetoid cerebral palsy.

Study Design: A retrospective study comparing cervical laminoplasty with or without muscle release for the treatment of cervical myelopathy resulting from athetoid cerebral palsy.

Objective: To assess the effectiveness of muscle release in the treatment of athetoid cerebral palsy.

Summary Of Background Data: While anterior and/or posterior spinal fusion has been generally accepted as necessary in surgical treatment for cervical myelopathy due to athetoid cerebral palsy, several studies have shown relatively favorable results following laminoplasty.

Bone regeneration by grafting of an autogenous cultured bone/ceramic construct.

The in vivo osteogenic potential of autogenous cultured bone/ceramic constructs in large animals or humans is unknown, and thus we performed a preliminary study of this issue prior to clinical application. All autogenous cultured-bone/ceramic constructs at 3 weeks after implantation in dogs showed obvious histological bone formation within the ceramic pores. In many pores, the HE staining of decalcified specimens revealed thick lamellar bone formation on the pore surface of ceramic.

Upper thoracic spinal cord injury without vertebral bony lesion: a report of two cases.

Study Design: Case report.

Objectives: To describe a rarely reported type of upper thoracic spinal cord injury without vertebral bony lesion in two cases with multiple trauma.

Summary Of Background Data: Because it is supported by the stiffness of the rib cage, the upper thoracic spine has greater stability than the cervical and lumbar regions, and thus its fracture or fracture dislocation is less frequent.

Sagittal alignment of cervical flexion and extension: lateral radiographic analysis.

Study Design: An analysis of lateral radiographs in the upright, flexion-extension position.

Objectives: To document and define the differences in cervical flexion-extension kinematics as they relate to changes of alignment in upright cervical lordosis.

Summary Of Background Data: No previous study has reported the association between sagittal plane cervical rotation kinematics and changes of alignment in upright cervical lordosis.