Postoperative early initiation of sequential exercise program in preventing persistent spinal pain syndrome type-2 after modified transforaminal lumbar interbody fusion: a prospective randomized controlled trial.

Purpose: This prospective randomized controlled trial aimed to investigate the impact of early postoperative sequential motor control (starting first day post-operatively) and core stabilization training (starting fifth week post-operatively) compared to conventional exercise (starting fifth weeks post-operatively) on the risk of developing persistent spinal pain syndrome type-2 (PSPS-T2).

Methods: 395 patients with lumbar degenerative diseases (LDDs) undergoing modified transforaminal lumbar interbody fusion and a 12-week postoperative exercise program (sequential vs. conventional exercise: 214 vs.

Augmented Central Pain Processing Occurs after Osteoporotic Vertebral Compression Fractures and Is Associated with Residual Back Pain after Percutaneous Vertebroplasty.

Study Design: A retrospective analysis.

Purpose: To investigate the occurrence of central sensitization (CS) in patients with osteoporotic vertebral compression fractures (OVCFs) and identify the association between CS and residual back pain (RBP).

Overview Of Literature: RBP is a vexing complication that affects 6.

Altered central pain processing in patients with degenerative lumbar diseases and its association with low physical activity levels after lumbar spinal surgeries: a retrospective cohort analysis.

Purpose: To investigate the occurrence of altered central pain modulation in patients with degenerative lumbar diseases (DLDs) and to analyze its association with physical activity (PA) 3 years after lumbar decompression and fusion.

Methods: Preoperative assessments of pressure pain thresholds (PPTs), temporal summation (TS), conditioned pain modulation (CPM) and pain were, respectively, recorded in 304 patients. These patients further underwent International Physical Activity Questionnaire (IPAQ) and both pain-related and psychological assessments 3 years post-operation.

The role of leisure-time physical activity in maintaining cervical lordosis after anterior cervical fusion and its impact on the motor function in patients with hirayama disease: a retrospective cohort analysis.

Background: Surgical treatment has been increasingly performed in Hirayama disease (HD) patients to limit excessive neck flexion and restore cervical lordosis. However, postoperative recurrence of cervical lordosis loss may restart the progress of HD. Many studies have demonstrated a relationship between neck muscle strength and cervical lordosis, and it is widely accepted that leisure-time physical activity (LTPA) can increase muscle strength.

Association of joint hypermobility with range of cervical motion and its impact on the motor unit loss in patients with Hirayama disease.

Introduction/aims: Some patients with Hirayama disease (HD) may have generalized joint hypermobility (GJH), which may excessively increase cervical range of motion (ROM) and then worsen the HD. The purpose of this study was to identify the frequency of GJH in HD patients and to analyze the effect of GJH on cervical ROM and the severity of HD.

Methods: The Beighton scoring system (≥4) was used to diagnose GJH in 84 HD patients.

Changes in Self-Esteem in Patients with Hirayama Disease and its Association with Prognosis After Anterior Cervical Fusion Procedures.

Objective: To quantify self-esteem in patients with Hirayama disease (HD) and investigate the impact of this psychosocial factor on surgical outcomes in HD.

Methods: The Rosenberg Self-Esteem Scale (RSES) was measured in 58 patients with HD before anterior cervical fusion. These patients further underwent motor unit number estimation, handgrip strength, disabilities of the arm, shoulder and hand (DASH), Beck Anxiety Inventory (BAI) and Beck Depression Index (BDI) before and 18 months after operation.

Loss of cervical sagittal alignment worsens the cervical spinal lesions in patients with Hirayama disease.

Objective: To quantify the cervical sagittal alignment in patients with Hirayama disease (HD) and to investigate the effect of loss of cervical sagittal alignment upon the cervical spinal lesions in HD.

Methods: Cervical sagittal alignments were measured in 253 HD patients and 63 healthy subjects by C2-C7 Cobb and a modified method of Toyama et al. Motor unit number estimation (MUNE) was performed in bilateral abductor pollicis brevis (APB) in all HD patients, and 31 patients further underwent cervical diffusion tensor imaging (DTI).

Altered central pain processing assessed by quantitative sensory testing in patients with failed back surgery syndrome.

Objective: To investigate the presence of altered central pain processing in patients with failed back surgery syndrome (FBSS) using quantitative sensory testing (QST).

Methods: This study included 34 patients with FBSS, 102 patients post-lumbar surgery without low back pain (LBP), and 102 healthy subjects. All subjects underwent both pressure pain threshold (PPT) and conditioned pain modulation (CPM) in both local and remote pain-free areas, as well as temporal summation (TS) in a remote pain-free area.

Early surgical intervention alleviates sensory symptoms following acute traumatic central cord syndrome.

Purpose: To investigate the impact of early versus delayed surgery on sensory abnormalities in acute traumatic central cord syndrome (ATCCS).

Methods: Pressure pain threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM) and pain assessments were performed in 72 ATCCS patients (early vs. delayed surgical treatment: 32 vs.

Comparison of time-dependent resistance isometric exercise and active range of motion exercise in alleviating the sensitization of postoperative axial pain after cervical laminoplasty.

Background: Postoperative axial pain (PAP) is a significant complication after cervical laminoplasty.

Objective: To investigate pain sensitization in PAP patients and effects of time-dependent resistance isometric exercise compared to active range-of-motion exercise on PAP.

Study Design: Retrospective cohort analysis.

Preoperative dynamic quantitative sensory testing in remote pain-free areas is associated with axial pain after posterior cervical spinal surgeries.

Background: Postoperative axial pain (PAP), characterized by pain and/or stiffness around the posterior neck, periscapular areas and/or shoulder region, is a vexing complication affecting 5-60% of patients undergoing posterior cervical decompression. Given its relatively high frequency and negative impact on patients' physical and mental status, efforts preoperatively to confirm patients at risk of developing PAP to offer more efficient pain management to minimize this complication have a high priority. The aim of this study is to investigate the role of preoperative dynamic quantitative sensory testing (QST) in predicting the PAP after posterior cervical decompression.

Comparison of Intraoperative Neuromonitoring Outcome in Treating Thoracic Ossification of the Ligamentum Flavum Through En Bloc Versus Piecemeal Laminectomy.

Study Design: A retrospective cohort analysis.

Objective: The aim of this study was to investigate the impact of piecemeal versus en bloc laminectomies on spinal cord in thoracic ossification of ligamentum flavum (TOLF) through intraoperative changes of motor-evoked potentials (MEPs) and somatosensory-evoked potentials (SEPs).

Summary Of Background Data: Surgical treatment is indicated for symptomatic TOLF, and both piecemeal and en bloc laminectomies are commonly used methods.

Early surgery improves peripheral motor axonal dysfunction in acute traumatic central cord syndrome: A prospective cohort study.

Objective: To investigate the impact of early vs. delayed surgical decompression on peripheral motor axonal dysfunction following acute traumatic central cord syndrome (ATCCS).

Methods: Both axonal excitability testing and motor unit number estimation (MUNE) were performed in 30 ATCCS patients (early- vs.

Intraoperative electromyographic techniques for the decision-making of tumor-involved nerve root resection for treating spinal schwannomas.

Background Context: Total removal of spinal schwannomas is ideal but it sometimes requires tumor-involved root resection, which increases the risk of postoperative motor deterioration (PMD). Therefore, it is important for clinicians to predict the impact of tumor-involved root resection on motor function in spinal schwannomas.

Purpose: To investigate the role of intraoperative electromyographic (EMG) techniques in decision-making of tumor-involved root resection for treating spinal schwannomas.

Quantitative assessment of motor impairment and surgical outcome in Hirayama disease with proximal involvement using motor unit number index.

Objective: To assess the feasibility of motor unit number index (MUNIX) in quantitatively evaluating Hirayama disease (HD) with proximal involvement and to identify the effectiveness of anterior cervical fusion (ACF) in treating atypical HD with proximal involvement.

Methods: This study included 28 atypical HD patients with proximal involvement (proximal-distal vs. distal-proximal groups: 5 vs.

Preoperative electrophysiologic assessment of C5-innervated muscles in predicting C5 palsy after posterior cervical decompression.

Purpose: To investigate the feasibility of both needle electromyography (EMG) and proximal nerve conduction studies (NCS) in predicting C5 palsy after posterior cervical decompression.

Methods: This study included 192 patients with cervical myelopathy undergoing laminoplasty or laminectomy. Preoperatively, all patients accepted bilateral needle EMG detection and proximal NCS that consisted of supramaximally stimulating Erb's point and recording compound muscle action potential (CMAP) from bilateral deltoid.

Motor-evoked potentials in the intraoperative decision-making of circumferential decompression via posterior approach for treating thoracic posterior longitudinal ligament ossification.

Background Context: Surgical treatment is indicated for symptomatic thoracic ossification of posterior longitudinal ligament (OPLL), and circumferential decompression (CD) is a promising option. However, the risk of postoperative paralysis in ventral decompression of CD is as high as 30%. Therefore, it is important to balance surgical outcomes and safety of ventral decompression.

Motor unit number index in quantitatively assessing motor root lesions and monitoring treatment outcomes in patients with lumbosacral radiculopathy.

Introduction: We investigated the feasibility of motor unit number index (MUNIX) in quantitatively assessing motor root lesions and tracking different treatment outcomes in lumbosacral radiculopathy (LR).

Methods: Bilateral MUNIX was recorded from the abductor hallucis, extensor digitorum brevis, and tibialis anterior in 44 normal controls and 108 patients with LR, and this was repeated approximately 12 months after treatment in 60 patients with LR.

Results: More abnormalities were observed when side-to-side differences of MUNIX measurements were used to evaluate LR (P < .

Early Surgical Decompression Ameliorates Dysfunction of Spinal Motor Neuron in Patients With Acute Traumatic Central Cord Syndrome: An Ambispective Cohort Analysis.

Study Design: An ambispective cohort analysis.

Objective: The aim of this study was to investigate the impact of early (≤2 weeks) versus delayed (>2 weeks) surgical intervention on the spinal motor neurons at and distal to injury site in acute traumatic central cord syndrome (ATCCS).

Summary Of Background Data: Accumulating evidence demonstrated degeneration in distal lower motor neurons (LMNs) following spinal cord injury, and this secondary degeneration may exacerbate motor impairments and limit spontaneous motor recovery.

Split-hand phenomenon quantified by the motor unit number index for distinguishing cervical spondylotic amyotrophy from amyotrophic lateral sclerosis.

Objectives: To investigate and compare split-hand phenomenon quantified by motor unit number index (MUNIX) between patients with cervical spondylotic amyotrophy (CSA) and those with amyotrophic lateral sclerosis (ALS).

Methods: MUNIX was performed on abductor pollicis brevis (APB), abductor digiti minimi (ADM) and first dorsal interosseous (FDI) in 46 CSA patients, 39 ALS patients and 41 healthy subjects. Split-hand measurements including split-hand index (SHI=ABP×FDI/ADM), ratio of APB to ADM (AA), ratio of FDI to ADM (FA) were measured by compound muscle action potential (CMAP) and MUNIX.

Motor unit number index (MUNIX) in the quantitative assessment of severity and surgical outcome in cervical spondylotic amyotrophy.

Objective: To assess the feasibility of motor unit number index (MUNIX) in the quantitative assessment of the cervical spondylotic amyotrophy (CSA).

Methods: MUNIX was recorded bilaterally on the abductor pollicis brevis, abductor digiti minimi, biceps brachii and middle deltoid in 41 normal controls and 47 patients with CSA (distal-type to proximal-type ratio: 25 to 22). Additionally, patients were assessed on handgrip strength (HGS), the disabilities of arm, shoulder and hand (DASH) and Medical Research Council (MRC) scales.

Changes in Central Motor Conduction Time and Its Implication on Dysfunction of Distal Upper Limb in Distal-Type Cervical Spondylotic Amyotrophy.

Purpose: Distal-type cervical spondylotic amyotrophy (CSA) is an uncommon syndrome associated with cervical spondylosis. The pathogenic mechanism of distal-type CSA is still unclear. The aim of the current study was to analyze central motor conduction time (CMCT) in the cases with distal-type CSA and to investigate the role of cervical cord compressive injury in the distal-type CSA.

CAN anterior cervical fusion procedures prevent the progression of the natural course of Hirayama disease? An ambispective cohort analysis.

Objective: To clarify the effectiveness of anterior cervical fusion (ACF) in the treatment of Hirayama disease (HD).

Methods: Sixty-nine HD patients who accepted ACF procedures underwent dynamic F-waves before and soon after operation, and 36 of the 69 patients underwent pre- and postoperative magnetic resonance imaging (MRI). Motor unit number estimation, handgrip strength (HGS) and disabilities of arm, shoulder and hand (DASH) were performed in these 36 HD patients and in the other 24 patients who accepted neither neck-collar support nor operation, and these tests were reassessed about one year after initial test.

F-waves of peroneal and tibial nerves in the differential diagnosis and follow-up evaluation of L5 and S1 radiculopathies.

Purpose: To investigate F-wave as a method to identify a specific root lesion of L5 or S1 and to quantitatively evaluate the severity and progression of motor root lesions in lumbosacral radiculopathies (LR).

Methods: Both peroneal and tibial F-waves were performed bilaterally in 142 patients with unilateral L5 or S1 radiculopathies and 37 controls along with Medical Research Council (MRC) evaluation, and soleus H-reflexes were tested bilaterally in 78 of these 142 cases. Both F-wave and MRC were re-evaluated approximately 1 year after initial examination in 65 patients.

Altered motor axonal excitability in patients with cervical spondylotic amyotrophy.

Objective: To investigate the changes in motor axonal excitability properties in cervical spondylotic amyotrophy (CSA).

Methods: Threshold tracking was used to measure the median motor axons in 21 patients with CSA, 10 patients with cervical spondylotic radiculopathy (CSR) and 16 normal controls.

Results: Compared with normal controls, patients with distal-type CSA showed increased threshold electrotonus hyperpolarization (TEh [90-100]) and increased superexcitability on the symptomatic side (P < 0.