Spine

BACKGROUND: Cystic fibrosis (CF) is the most common life-threatening, inherited disease in white populations which causes several dysfunctions, including postural abnormalities. Physical therapy may help in some consequences of these postural abnormalities, such as pain, trunk deformity and quality of life. OBJECTIVES: To determine the effects of a range of physical therapies for managing postural abnormalities in people with cystic fibrosis, specifically on quality of life, pain and trunk deformity...

OBJECTIVES: To describe a transforaminal endoscopic spinal decompression technique for treating adult patients with isthmic spondylolisthesis and report preliminary surgical and radiological results. BACKGROUND: Spondylolisthesis is prevalent in the general population. Surgical approaches for symptomatic spondylolisthesis that is refractory to conservative treatment vary. Direct repair of pars fractures and spinal nerve decompression with or without fusion have been reported with varied clinical results...

Parasites are arguably among the strongest drivers of natural selection, constraining hosts to evolve resistance and tolerance mechanisms. Although, the genetic basis of adaptation to parasite infection has been widely studied, little is known about how epigenetic changes contribute to parasite resistance and eventually, adaptation. Here, we investigated the role of host DNA methylation modifications to respond to parasite infections. In a controlled infection experiment, we used the three-spined stickleback fish, a model species for host-parasite studies, and their nematode parasite Camallanus lacustris...

Objectives: Once-weekly teriparatide (W-TPTD) is an effective drug for patients with osteoporosis; however, some patients discontinue W-TPTD owing to its adverse drug reactions (ADRs). Sequential treatment with W-TPTD and antiresorptive therapy may be effective in treating such patients. In this study, we evaluate the efficacy of this sequential treatment regimen. Methods: This retrospective study was conducted at a single institution in Japan. The target subjects were patients with osteoporosis who started W-TPTD treatment...

Chronic back pain patients may require escalating doses of systemic opioids. In refractory cases, implantation of an intrathecal drug delivery system (IDDS) may provide effective relief of pain and improve overall function. This system infuses opioid directly into the cerebrospinal fluid via a catheter. While efficacious, it can be associated with complications, one of the most severe being the formation of a catheter-tip granuloma that can lead to permanent neurological deficits. We present a case of a 38-year-old male with an IDDS for pain related to retroperitoneal fibrosis, who began developing worsening back pain along with new-onset lower extremity weakness...

Traumatic lumbosacral dissociation is a unique, but well-documented, phenomenon that generally stems from high-energy impact injuries to the lower lumbar spine. Patients typically present with complicated and multisystem injuries with wide-ranging neurological deficits below the level of trauma. This presents stark challenges regarding the diagnosis, management, and surgical correction technique utilized. In this study, we present the case of a 21-year-old, morbidly obese, male patient that presented after a traumatic motor vehicle accident with L5-S1 lumbosacroiliac dissociation, cauda equina syndrome, and left lower extremity monoplegia...

Three-dimensional (3D) printing has revolutionized medical training and patient care. Clinically it is used for patient-specific anatomical modeling with respect to surgical procedures. 3D printing is heavily implemented for simulation to provide a useful tool for anatomical knowledge and surgical techniques. Fused deposition modeling (FDM) is a commonly utilized method of 3D printing anatomical models due to its cost-effectiveness. A potential disadvantage of FDM 3D printing complex anatomical shapes is the limitations of the modeling system in providing accurate representations of multifaceted ultrastructure, such as the facets of the lumbar spine...

Introduction Minimally invasive spine surgery has become more prevalent in recent years, but the delivery of interbody devices with small footprints may insufficiently restore the disc space, which may lead to instability and non-union. Vertically expandable interbody implants have partially addressed this limitation, but lateral fusion support remains a concern. The purpose of this study was to evaluate two-year safety and effectiveness outcomes with a multidimensional, expandable interbody fusion device (Luna 3D Interbody Fusion System, Benvenue Medical, Inc...

A 79-year-old woman presented with acute-onset right leg pain in the setting of 3 months of progressive gait deterioration and bilateral leg weakness. On exam she had right lower extremity hyperreflexia and weakness. Lumbar spine magnetic resonance imaging demonstrated L3-L5 central canal stenosis with L4-L5 spondylolisthesis and a previously undiagnosed tethered cord. She underwent minimally invasive left segmental sublaminoplasty at L3-L4 and L4-L5 for spinal cord decompression with onlay arthrodesis resulting in resolution of her radicular pain and improved strength...

BACKGROUND: Riding a motorcycle involves a risk of suffering from ailments of the musculoskeletal system. These can be caused, i.a., by long-term persistence of a unfavorable body position, vibrations or the necessity of wearing a protective helmet. One of the occupational groups that use motorcycles are road traffic police officers. There are few literature reports of ailments related to riding a motorcycle, especially as regards police officers using these vehicles while on duty. The key objective of this research was to investigate the occurrence of locomotor system disorders during a motorcycle ride or after it, among Polish police officers who actively ride motorcycles...

Synapses are highly compartmentalized functional units that operate independently on each other. In Huntington's disease (HD) and other neurodegenerative disorders, this independence might be compromised due to insufficient glutamate clearance and the resulting spill-in and spill-out effects. Altered astrocytic coverage of the presynaptic terminals and/or dendritic spines as well as a reduced size of glutamate transporter clusters at glutamate release sites have been implicated in the pathogenesis of diseases resulting in symptoms of dys-/hyperkinesia...

Quebec platelet disorder (QPD) is a condition that causes delayed-onset bleeding after hemostatic challenges. While there are interventional spine procedure (ISP) guidelines for managing patients on blood thinners or with common bleeding disorders, there are none for approaching patients with unique coagulopathies. We report a patient with QPD and extensive history of postprocedural bleeding complications (PPBCs) who presented with chronic cervical facet pain. After consulting a hematologist and administering antifibrinolytic agent with platelet transfusions, the patient underwent medial branch nerve blocks (MBNBs) followed by radiofrequency ablation (RFA) without experiencing PPBCs...

CASES: We describe 3 pediatric spinal deformity cases that experienced neuromonitoring changes or neurologic changes in which intraoperative ultrasound allowed for evaluation of the site of cord compression to direct management. This resulted in complete neurologic recovery in all 3 patients. CONCLUSIONS: Intraoperative ultrasound is a useful adjunct in pediatric orthopaedic spine surgery with neuromonitoring signal loss.

CASE: We report the first documented case of chylous leak recognized intraoperatively during posterior spinal instrumentation and fusion for juvenile scoliosis in a female patient with a history of thoracotomy and decortication for an empyema. CONCLUSIONS: Thoracic duct injury can lead to severe morbidity and mortality because of chylothorax formation. Although chylous leaks are a well-documented complication of the anterior approach to spine surgery, leaks during the posterior approach are rarely reported...

No abstract text is available yet for this article.

Coronavirus disease 2019 (COVID-19) outbreak started in December 2019 that caused difficulties for clinical work. Practical work experience in our spinal outpatient and emergency department during the COVID-19 pandemic is summarized in this article, with combined evidence-based medical evidence to explore a standardized process of diagnosis and treatment for spinal diseases. Outpatient reservation, continuous screening, triage, and isolation, first consultation accountability system, pandemic reporting system, and online revisit were strictly followed...

OBJECTIVE: The purpose of this study was to elucidate the reciprocal changes in the upper cervical profile and the risk factors for increasing cervical sagittal vertical axis (cSVA) after laminoplasty for ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. PATIENTS AND METHODS: This retrospective study included thirty-nine consecutive patients (30 men and 9 women) with cervical OPLL who underwent cervical laminoplasty. We recorded the operative time, blood loss, Japanese Orthopaedic Association (JOA) score recovery rate...

Marfan syndrome (MFS) is an autosomal genetic disorder of connective tissue, due to alterated fibrillin-1. The aim of our study was to verify the rate of fractures in children with MFS in correlation to bone mineral density and compare the prevalence to the general population in the same latitude. We enrolled 80 patients (37 girls and 43 boys) with the diagnosis of Marfan syndrome, median age 10 y (3 to 17 years). Fracture occurrence was inferred from medical records of patients with MFS. Bone mineral density (BMD) was measured at lumbar spine, femoral neck and total femur by dual-energy x-ray absorptiometry...

Bisphenol-A (BPA) exposure can affect cognitive functions of rodents and humans. However, whether information inputs for these functions in the brain are perturbed by BPA remains unclear. Here, visual perception in rats was assessed by testing their ability to discriminate between vertical and horizontal grating. We found that BPA exposure (1 mg/kg/day) during gestation and lactation markedly decreased the grating discrimination ability in rat pups (postnatal 21 days). The results of neuronal functions in the primary visual cortex (V1) showed that the orientation selectivity and signal extraction ability and fidelity were notably decreased after BPA exposure...

PURPOSE: Recently, trabecular bone score (TBS) has emerged as an important supplementary assessment tool in osteoporosis diagnosis and management. The high incidence of fragility fracture within the non-osteoporotic range of bone mineral density (BMD), among systemic lupus erythematosus (SLE) patients, highlights the crucial role of bone microarchitecture in osteoporosis. This study aimed to evaluate whether TBS identified existing vertebral fractures (VF) more accurately than BMD in SLE patients...