Lumbar disc space height in relation to neural foraminal dimensions and patient characteristics: A morphometric analysis from L1-S1 using computed tomography.

Introduction: The normative relationship between lumbar intervertebral disc space height (DSH) and neuroforaminal dimensions (NFD) has yet to be defined.

Research Question: The purpose of this study was to investigate the relationship between lumbar DSH and NFD using computed tomography (CT), accounting for influences of patient demographic and anthropometric characteristics.

Materials And Methods: We analyzed CT imaging of 350 female and 350 male patients.

Assessment of Anteroposterior Diameter and Interpedicular Distance in the Approximation of Cervical Spinal Canal Area.

Rationale and objectives This study seeks to generate a model based on two linear measurements, anteroposterior (AP) diameter and interpedicular (IPD) distance, to approximate the cervical central canal (CCC) area in a non-pathologic patient population by employing area calculations of shapes such as ellipse, rectangle, and triangle. Secondarily, this study aims to generate second-order approximations (SOAs), using the aforementioned shape approximations, to increase the utility of this linear measurement-based model. Methods The authors reviewed medical and radiographic records of patients aged 18-35 who received computed tomography (CT) imaging of the cervical spine to collect AP diameter, IPD distance, and area of the CCC from C2-3 to C6-7.

Oblique lateral interbody fusion at L5-S1: feasibility, surgical approach window, incision line, and influencing factors.

Purpose: The primary aim of this study was to describe the feasibility, surgical approach window (SAW), and incision line (IL) for oblique lateral interbody fusion at L5-S1 (OLIF51) using computed tomography (CT). A secondary aim was to identify associations among approach characteristics and demographic and anthropometric factors.

Methods: We performed a radiographic study of 50 male and 50 female subjects who received abdominal CT imaging.

The Reoperation, Readmission, and Complication Rates at 30 Days Following Lumbar Decompression for Cauda Equina Syndrome.

Background and objective Cauda equina syndrome (CES) is considered a surgical emergency, and its primary treatment involves decompression of the nerve roots, typically in the form of discectomy or laminectomy. The primary aim of this study was to determine the complication, reoperation, and readmission rates within 30 days of surgical treatment of CES secondary to disc herniation by using the PearlDiver database (PearlDiver Technologies, Colorado Springs, CO). The secondary aim was to assess preoperative risk factors for a higher likelihood of complication occurrence within 30 days of surgery for CES.

Normative Measurements of L1-S1 Segmental Angulation, Disk Space Height, and Neuroforaminal Dimensions Using Computed Tomography.

Background And Objectives: To establish normative anatomic measurements of lumbar segmental angulation (SA) and disk space height (DSH) in relation to neuroforaminal dimensions (NFDs), and to uncover the influence of patient demographic and anthropometric characteristics on SA, DSH, and NFDs.

Methods: NFDs, SA, and anterior, middle, and posterior DSH were measured using computed tomography of 969 patients. NFDs were defined as sagittal anterior-to-posterior width, foraminal height, and area.

Double-Plate Technique for Long-Construct Anterior Cervical Discectomy and Fusion.

The standard technique for multilevel anterior cervical discectomy and fusion (ACDF) uses a single plate to span multiple vertebral levels. However, the usage of single long plates is linked to potential hardware failure and screw pullout from stress overload. A single long plate is also more likely to fail at the caudal levels.

Normative Measurements of L1 to S1 Neuroforaminal Dimensions Derived From Plain Film Radiography, Computed Tomography, and Magnetic Resonance Imaging.

Study Design: Retrospective cohort.

Objective: To report normative measurements of L1 to S1 lumbar neuroforamina on plain film radiography (PFR), computed tomography (CT), and magnetic resonance imaging (MRI), accounting for patients' sex and ethnicity.

Background: The quantitative criteria fothe diagnosis of neuroforaminal stenosis remains unknown.

Comparison of L1-S1 neuroforaminal dimensions derived from plain film radiography versus computed tomography.

Purpose: To compare measurements of lumbar neuroforaminal dimensions (NFD) derived from plain film radiography (PFR) and computed tomography (CT) of young patients without spinal pathology.

Methods: We analyzed 213 patients between 18 and 35 years of age without spinal pathology who received PFR and CT within one year of each other. NFD were defined as foraminal height, sagittal anterior-to-posterior width, and area.

CT-based analysis of oblique lateral interbody fusion from L1 to L5: location of incision, feasibility of safe corridor approach, and influencing factors.

Purpose: The primary aim was to measure the safe corridor (SC), surgical incision anterior margin (AM), and posterior margin (PM) for OLIF bilaterally from L1 to L5. The secondary aim was to determine the feasibility of approach via the SC. The tertiary aim was to analyze the influence of demographic and anthropometric factors on OLIF parameters.

Leucine Repeat Rich Kinase 1 Controls Osteoclast Activity by Managing Lysosomal Trafficking and Secretion.

We previously demonstrated that mice with targeted deletion of the leucine repeat rich kinase 1 () gene were osteopetrotic due to the failure of osteoclasts to resorb bone. To determine how LRRK1 regulates osteoclast activity, we examined the intracellular and extracellular acidification with an acidotropic probe, acridine orange, in live osteoclasts on bone slices. We examined lysosome distribution in osteoclasts by localization of LAMP-2, cathepsin K, and v-ATPase by immunofluorescent staining with specific antibodies.

Accounting for age in prediction of discharge destination following elective lumbar fusion: a supervised machine learning approach.

Background Context: The number of elective spinal fusion procedures performed each year continues to grow, making risk factors for post-operative complications following this procedure increasingly clinically relevant. Nonhome discharge (NHD) is of particular interest due to its associations with increased costs of care and rates of complications. Notably, increased age has been found to influence rates of NHD.

Comparison of cervical, thoracic, and lumbar vertebral bone quality scores for increased utility of bone mineral density screening.

Purpose: To evaluate the associations among the validated lumbar vertebral bone quality (VBQ) score, and cervical and thoracic VBQ scores.

Methods: Radiographic records of 100 patients who underwent synchronous MRI of the cervical, thoracic, and lumbar spine were retrieved. DEXA-validated lumbar VBQ was calculated using median signal intensity (MSI) of the L1-L4 vertebrae and L3 CSF.

Opportunistic assessment of bone density in patients with adolescent idiopathic scoliosis using MRI-based vertebral bone quality.

Patients with Adolescent Idiopathic Scoliosis (AIS) have increased prevalence of lower bone mineral density (BMD) compared to healthy adolescents. Our goal was to compare bone density in patients with AIS and a nonaffected control group using an MRI-based vertebral bone quality (VBQ) score. We reviewed 50 consecutive lumbar MRIs of patients with AIS and of 50 nonaffected controls that were matched for age and sex.

Allograft Versus Autograft in Anterior Cervical Discectomy and Fusion: A Propensity-Matched Analysis.

Objective To compare the 30-day complication rate associated with allograft versus autograft in anterior cervical discectomy and fusion (ACDF) and to determine preoperative factors that may influence complication rate. Methods The American College of Surgeons National Surgical Quality Improvement Program database was retrospectively queried from 2014 to 2017 for all procedures with CPT codes for ACDF (22551). Patients undergoing ACDF with either autograft or allograft were matched by propensity scores based on age, sex, body mass index, and comorbidities.

Differences in pathways contributing to thyroid hormone effects on postnatal cartilage calcification versus secondary ossification center development.

The proximal and distal femur epiphyses of mice are both weight-bearing structures derived from chondrocytes but differ in development. Mineralization at the distal epiphysis occurs in an osteoblast-rich secondary ossification center (SOC), while the chondrocytes of the proximal femur head (FH), in particular, are directly mineralized. Thyroid hormone (TH) plays important roles in distal knee SOC formation, but whether TH also affects proximal FH development remains unexplored.

Intra- and inter-observer reliability of the novel vertebral bone quality score.

Purpose: To assess the intra- and inter-observer reliability of the novel vertebral bone quality (VBQ) scoring system.

Methods: Four orthopedic surgery residents at various levels of training (PGY1-4) evaluated 100 noncontrast, T1-weighted MRIs of the lumbar spine. VBQ was calculated as quotient of the median of L1-L4 average signal intensity (SI) and the L3 cerebral spinal fluid (CSF) SI, as described by Ehresman et al.

Prolyl Hydroxylase Domain-Containing Protein 3 Gene Expression in Chondrocytes Is Not Essential for Bone Development in Mice.

We previously showed that conditional disruption of the gene in chondrocytes led to a massive increase in long bone trabecular bone mass. Loss of gene expression or inhibition of PHD2 activity by a specific inhibitor resulted in a several-fold compensatory increase in expression in chondrocytes. To determine if expression of PHD3 plays a role in endochondral bone formation, we conditionally disrupted the gene in chondrocytes by crossing floxed () mice with mice.

Hyperphosphatemia, a Cause of High Anion Gap Metabolic Acidosis: Report of a Case and Review of the Literature.

BACKGROUND Hyperphosphatemia is a common problem in patients with kidney failure. It is usually mild and rarely severe enough to cause metabolic acidosis on its own. Besides kidney failure, use of phosphate containing enemas, rhabdomyolysis, and tumor lysis syndrome are common causes of severe hyperphosphatemia.

Effects of Thyroxine (T4), 3,5,3'-triiodo-L-thyronine (T3) and their Metabolites on Osteoblast Differentiation.

Studies involving human genetic mutations and mutant mouse models have provided irrevocable evidence for a key role for thyroid hormones (THs) in the regulation of skeletal growth. While T3 binds to TH receptors with higher affinity than T4, T4 occupied TH receptors have also been reported in the nucleus under euthyroid conditions raising the possibility that T4 bound nuclear receptors may be biologically relevant in thyroid syndromes with elevated free T4 and reduced T3 levels. We, therefore, evaluated the direct effects of T4, T3, and their metabolites (rT3 and T2) in stimulating osteoblast differentiation using MC3T3-E1 preosteoblasts which do not produce detectable levels of deiodinases.

At-Home Versus In-Clinic INR Monitoring: A Cost-Utility Analysis from The Home INR Study (THINRS).

Background: Effective management of patients using warfarin is resource-intensive, requiring frequent in-clinic testing of the international normalized ratio (INR). Patient self-testing (PST) using portable at-home INR monitoring devices has emerged as a convenient alternative. As revealed by The Home INR Study (THINRS), event rates for PST were not significantly different from those for in-clinic high-quality anticoagulation management (HQACM), and a cumulative gain in quality of life was observed for patients undergoing PST.

Construction and validation of the chronic acquired polyneuropathy patient-reported index (CAP-PRI): A disease-specific, health-related quality-of-life instrument.

Introduction: Generic health-related quality-of-life (HRQOL) patient-reported outcome measures have been used in patients with chronic immune-mediated polyneuropathies. We have created a disease-specific HRQOL instrument.

Methods: The chronic acquired polyneuropathy patient-reported index (CAP-PRI) was developed and validated in multiple steps.

The Roles and Mechanisms of Actions of Vitamin C in Bone: New Developments.

Vitamin C is an important antioxidant and cofactor that is involved in the regulation of development, function, and maintenance of several cell types in the body. Deficiencies in vitamin C can lead to conditions such as scurvy, which, among other ailments, causes gingivia, bone pain, and impaired wound healing. This review examines the functional importance of vitamin C as it relates to the development and maintenance of bone tissues.

RE1-Silencing Transcription Factor (Rest) is a Novel Regulator of Osteoblast Differentiation.

RE1-silencing transcription factor (Rest) has been identified as a master negative regulator of neuronal differentiation. Nothing is known about Rest function in bone cells. In this study, we examined the Rest expression levels and role during osteoblast differentiation.

Emerging multifunctional roles of Claudin tight junction proteins in bone.

The imbalance between bone formation and resorption during bone remodeling has been documented to be a major factor in the pathogenesis of osteoporosis. Recent evidence suggests a significant role for the tight junction proteins, Claudins (Cldns), in the regulation of bone remodeling processes. In terms of function, whereas Cldns act "canonically" as key determinants of paracellular permeability, there is considerable recent evidence to suggest that Cldns also participate in cell signaling, ie, a "noncanonical function".