Comparisons of direct costs, outcomes, and cost-utility of decompression surgery with fusion versus decompression alone for degenerative lumbar spondylolisthesis.

Background: Cost-utility analysis of surgery for degenerative lumber spondylolisthesis (DS) is essential for healthcare providers and patients to select appropriate treatment. The purpose of this study was to review the cost-utility of decompression alone versus decompression with fusion for DS.

Methods: A retrospective review of 99 consecutive patients who were treated for Meyerding grade 1 DS at two representative spine centers was performed.

Extremely high preoperative C7 slope limits compensatory cervical lordosis after muscle-preserving selective laminectomy.

Purpose: A high C7 slope induces C2-C7 lordosis to compensate for cervical sagittal balance adjustments. A muscle-preserving selective laminectomy (SL) can maintain this compensation postoperatively. This study evaluated the effect of an extremely high C7 slope on C2-C7 lordotic compensation following SL.

Distribution of ossified spinal lesions in patients with severe ossification of the posterior longitudinal ligament and prediction of ossification at each segment based on the cervical OP index classification: a multicenter study (JOSL CT study).

Background: In patients with ossification of the posterior longitudinal ligament (OPLL) in the cervical spine, it is well known that the thoracic ossified lesions often coexist with the cervical lesions and can cause severe myelopathy. However, the prevalence of OPLL at each level of the thoracic and lumbar spinal segments is unknown. The aims of this study were to investigate how often OPLL occurs at each level in the thoracolumbar spine in patients with a radiological diagnosis of cervical OPLL and to identify the spinal levels most likely to develop ossification.

Narrow width of muscle-preserving selective laminectomy demonstrated sufficient surgical outcomes and reduced surgical invasiveness.

Sufficient width of laminectomy or laminoplasty is considered a criterion for successful surgical outcomes following posterior cervical decompression. No previous study has focused on surgical outcomes achieved by wide versus narrow decompression. This study examined whether narrow laminectomy width (LW) affected surgical outcomes in cervical compressive myelopathy (CCM).

Impact of Frailty and Comorbidities on Surgical Outcomes and Complications in Adult Spinal Disorders.

Study Design: Retrospective review of surgically treated 481 adult patients with spinal disorders.

Objective: The aim of this study was to elucidate the effect of frailty and comorbidities on postoperative health-related quality of life (HRQoL) and complication rates.

Summary Of Background Data: Elective surgeries for spinal disorders not only improve clinical outcomes but also have high complication rates.

Posterior spinal cord shift does not affect surgical outcomes after muscle-preserving selective laminectomy.

Postoperative posterior spinal cord shift (PSS) has been considered a required radiographic endpoint of posterior decompression procedures. To achieve PSS, laminoplasty for cervical compressive myelopathy (CCM) has been consecutively performed on four or more laminae (C2-C7, C3-C7, or C3-C6). However, the clinical significance of PSS remains controversial.

Possible involvement of monoamine neurons in the emotional abnormality in Kir6.2-deficient mice.

ATP-sensitive potassium (K) channels consist of two structurally different subunits: a pore-forming subunit of the Kir6.0-family (Kir6.1 or Kir6.

Exploration for reliable radiographic assessment method for hinge-like hypermobility at atlanto-occipital joint.

Purpose: Hinge-like hyper-mobility is occasionally observed at the atlanto-occipital (O-C1) joint. However, it has not been clear if this kind of hinge-like hyper-mobility at the O-C1 joint should be regarded as "pathologic", or referred to as "instability". To solve this issue, we aimed to establish a reliable radiographic assessment method for this specific type of O-C1 instability and figure out the "standard value" for the range of motion (ROM) of the O-C1 joint.

Development of a low-cost EMG biofeedback device kit as an educational tool for physical therapy students.

[Purpose] Electromyography biofeedback therapy is applied to various diseases during physical therapy for motor learning. Our aim was to develop a low-cost electromyography biofeedback device kit that students could build by themselves in class and to evaluate whether this kit was an adequate educational tool for physical therapy students. [Subjects and Methods] This study included 34 volunteers from a 3 year physical therapy vocational school and a 4 year university course.

Fine-tuning the Predictive Model for Proximal Junctional Failure in Surgically Treated Patients With Adult Spinal Deformity.

Study Design: Multicenter retrospective study.

Objective: To validate and improve the predictive model for proximal junctional failure (PJF) with or without the bone mineral density (BMD) score.

Summary Of Background Data: PJF is a serious complication of surgery for adult spinal deformity (ASD).

Muscle-Preserving Selective Laminectomy Maintained the Compensatory Mechanism of Cervical Lordosis After Surgery.

Study Design: A retrospective single-center study.

Objective: The aim of this study was to evaluate the compensatory mechanism of cervical lordosis (CL), the changes in cervical sagittal alignment, and range of motion (ROM) after muscle-preserving selective laminectomy (SL).

Summary Of Background Data: CL increases as a compensatory mechanism for the adjustment of cervical sagittal balance or horizontal gaze.

Effect of the upper instrumented vertebral level (upper vs. lower thoracic spine) on gait ability after corrective surgery for adult spinal deformity.

Background Context: The relationship between gait pattern and the level of upper instrumented vertebra (UIV) in surgically treated patients with adult spinal deformity (ASD) has not been fully documented.

Purpose: This study aimed to assess the effect of UIV level for the gait pattern in ASD.

Study Design/setting: A prospective case series was carried out.

Cervical laminectomy of limited width prevents postoperative C5 palsy: a multivariate analysis of 263 muscle-preserving posterior decompression cases.

Purpose: Between 2006 and 2010, we performed wide laminectomy (wide LAM) alone, with decompression performed between the bilateral medial margin of the zygapophyseal joints, or double-door laminoplasty (DL) combined with wide LAM for cervical compressive myelopathy (CCM). From 2010, instead of wide LAM and DL, we began to perform narrow LAM, where the laminectomy width was no more than 2-3 mm wider than the spinal cord width (SW). This study aimed to elucidate the risk factors for C5 palsy by reviewing surgical outcomes.

Global Spinal Alignment in Cervical Kyphotic Deformity: The Importance of Head Position and Thoracolumbar Alignment in the Compensatory Mechanism.

Background: Previous studies have evaluated cervical kyphosis (C-kypho) using cervical curvature or chin-brow vertical angle, but the relationship between C-kypho and global spinal alignment is currently unknown.

Objective: To elucidate global spinal alignment and compensatory mechanisms in primary symptomatic C-kypho using full-spine radiography.

Methods: In this retrospective multicenter study, symptomatic primary C-kypho patients (Cerv group; n = 103) and adult thoracolumbar deformity patients (TL group; n = 119) were compared.

q-Space Myelin Map imaging for longitudinal analysis of demyelination and remyelination in multiple sclerosis patients treated with fingolimod: A preliminary study.

Background: Fingolimod (FTY) is an oral sphingosine-1-phosphate receptor modulator that reduces relapse and slows brain atrophy in multiple sclerosis (MS) patients. In addition, FTY has been shown to enhance remyelination in certain animal models.

Objective: To analyze feasibility of a novel q-space Myelin Map imaging to monitor demyelination and remyelination under FTY treatment in MS patients.

Drop Body Syndrome: A Distinct Form of Adult Spinal Deformity.

Study Design: A retrospective observational study.

Objective: This study examined the role of skeletal muscles in the spinal alignment of lumbar degenerative kyphosis (LDK).

Summary Of Background Data: Adult spinal deformity (ASD) may present as LDK, which is unusual in that it typically lacks any coronal deformity.

Functional brain mapping using specific sensory-circuit stimulation and a theoretical graph network analysis in mice with neuropathic allodynia.

Allodynia, a form of neuropathic pain, is defined as pain in response to a non-nociceptive stimulus. The brain regions responsible for pain, which are not normally activated, can be activated in allodynic mice by providing a suitable stimulus to Aβ-fibers, which transmit signals from tactile sensory fibers. Functional MRI (fMRI) can be used to objectively observe abnormal brain activation.

Effect of imidafenacin on the urodynamic parameters of patients with indwelling bladder catheters due to spinal cord injury.

Study Design: A retrospective study.

Objectives: To investigate the effect of imidafenacin on the urodynamic parameters of patients with indwelling bladder catheters due to spinal cord injury (SCI).

Setting: Spinal center (Tokyo, Japan).

Oxygen Sensing Mechanisms: A Physiological Penumbra.

This review tackles the unresolved issue of the existence of oxygen sensor in the body. The sensor that would respond to changes in tissue oxygen content, possibly along the hypoxia-normoxia-hyperoxia spectrum, rather than to a given level of oxygen, and would translate the response into lung ventilation changes, the major adaptive process. Studies on oxygen sensing, for decades, concentrated around the hypoxic ventilatory response generated mostly by carotid body chemoreceptor cells.

Walking balance and compensatory gait mechanisms in surgically treated patients with adult spinal deformity.

Background Context: Gait patterns and their relationship to demographic and radiographic data in patients with adult spinal deformity (ASD) have not been fully documented.

Purpose: This study aimed to assess gait pattern in patients with ASD and the effect of corrective spinal surgery on gait.

Design/setting: This is a prospective case series.

CT-based morphological analysis of spinal fractures in patients with diffuse idiopathic skeletal hyperostosis.

Purpose: To clarify correlations between spinal fracture and delayed paralysis in patients with diffuse idiopathic skeletal hyperostosis (DISH) using computed tomography (CT) with multiplanar reformatting (CT-MPR). DISH increases susceptibility to unstable spinal fractures, leading to neurological deterioration. The pathomechanism of the neurological injury is unclear.

Standing Balance and Compensatory Mechanisms in Patients With Adult Spinal Deformity.

Study Design: A prospective case series.

Objective: The aim of this study was to compare the standing balance and posture between patients with adult spinal deformity (ASD) and healthy volunteers (HVs).

Summary Of Background Data: The effect of ASD on standing posture and balance has not been fully documented.