Spine

OBJECTIVE: This study aimed to assess the impact of full endoscopic transforaminal discectomy (FETD) on clinical outcomes and complications in both obese and non-obese patients presenting with lumbar disc herniation (LDH). METHODS: A systematic search of relevant literature was conducted across various primary databases until November 18, 2023. Operative time and hospitalization were evaluated. Clinical outcomes included preoperative and postoperative assessments of the Oswestry Disability Index (ODI) and visual analogue scale (VAS) scores, conducted to delineate improvements at 3 months postoperatively and during the final follow-up, respectively...

The glymphatic system plays an important role in the transportation of cerebrospinal fluid (CSF) and the clearance of metabolite waste in brain. However, current imaging modalities for studying the glymphatic system are limited. Herein, we apply NIR-II nanoprobes with non-invasive and high-contrast advantages to comprehensively explore the function of glymphatic system in mice under anesthesia and cerebral ischemia-reperfusion injury conditions. Our results show that the supplement drug dexmedetomidine (Dex) enhances CSF influx in the brain, decreases its outflow to mandibular lymph nodes, and leads to significant differences in CSF accumulation pattern in the spine compared to isoflurane (ISO) alone, while both ISO and Dex do not affect the clearance of tracer-filled CSF into blood circulation...

BACKGROUND: The effects on bone mineral density (BMD)/fracture between type 1 (T1D) and type 2 (T2D) diabetes are unknown. Therefore, we aimed to investigate the causal relationship between the two types of diabetes and BMD/fracture using a Mendelian randomization (MR) design. METHODS: A two-sample MR study was conducted to examine the causal relationship between diabetes and BMD/fracture, with three phenotypes (T1D, T2D, and glycosylated hemoglobin [HbA1c]) of diabetes as exposures and five phenotypes (femoral neck BMD [FN-BMD], lumbar spine BMD [LS-BMD], heel-BMD, total body BMD [TB-BMD], and fracture) as outcomes, combining MR-Egger, weighted median, simple mode, and inverse variance weighted (IVW) sensitivity assessments...

OBJECTIVE: This study aims to test the reliability and validity of the translated Arabic version of EQ-5D-5 L. METHODS: The study was conducted on 100 patients operated upon for degenerative spine diseases coming for follow up in the outpatient clinic of a Tertiary care hospital. Test-retest reliability was assessed by completing the self-administered tool in two follow up visits, one week apart, by 50 patients. Internal consistency was evaluated by Cronbach's alpha...

INTRODUCTION: Retained shrapnel from gunshots is a common occurrence; however, retained shrapnel within the spinal canal is exceedingly uncommon. Guidelines for removal and treatment of these cases are a difficult topic, as surgical removal is not necessarily without consequence, and retention can lead to possible further injury or a secondary disease process of plumbism, which can be difficult to diagnose in this population. CASE PRESENTATION: This case report provides a unique example of a young patient with retained shrapnel from a gunshot...

Adolescent idiopathic scoliosis is the deformity of the human spine in three-dimensional space. It is a disease with a long course and difficult to recover in a short time. Currently, spinal orthotic braces are an effective non-surgical treatment for this condition. However, existing spinal orthotic braces are still deficient. For example, existing spinal orthotics braces have no way of knowing how correct, effective, and comfortable a patient is wearing the orthotics. Based on distributed pressure monitoring technology, this paper conducts pressure acquisition and compensation research on spinal orthotics used by adolescent patients...

PURPOSE: The role of thoracolumbar fascia (TLF) in the development of chronic low back pain (CLBP) has growing evidence in the literature. Although CLBP is reported in individuals with idiopathic scoliosis (IS), its relationship with the TLF has yet not been established. This study aims to evaluate the TLF and its relationship with CLBP in IS. METHODS: A total of 60 individuals were included in the study. They were divided into three groups as follows: painful scoliosis (n = 20, age: 17...

PURPOSE: Lumbar spinal stenosis (LSS) is a prevalent disorder, and surgery for LSS is a common procedure. Postoperative complications occur after any surgery and impose costs for society and costs and additional morbidity for patients. Since complications are relatively rare, medical registries of large populations may provide valuable knowledge. However, recording of complications in registries can be incomplete. To better estimate the true prevalence of complications after LSS surgery, we reviewed two different sources of data and recorded complications for a sample of Norwegian LSS patients...

The goal of this experimental study was to quantify the influence of helical pitch and gantry rotation time on image quality and file size in ultrahigh-resolution photon-counting CT (UHR-PCCT). Cervical and lumbar spine, pelvis, and upper legs of two fresh-frozen cadaveric specimens were subjected to nine dose-matched UHR-PCCT scan protocols employing a collimation of 120 × 0.2 mm with varying pitch (0.3/1.0/1.2) and rotation time (0.25/0.5/1.0 s). Image quality was analyzed independently by five radiologists and further substantiated by placing normed regions of interest to record mean signal attenuation and noise...

The transpedicular procedure has been widely used in spinal surgery. The determination of the best entry point is the key to perform a successful transpedicular procedure. Various techniques have been used to determine this point, but the results are variable. This study was carried out to determine the posterior endpoint of the lumbar pedicle central axis on the standard anterior-posterior (AP) fluoroscopic images. Computer-aided design technology was used to determine the pedicle central axis and the posterior endpoint of the pedicle central axis on the posterior aspect of the vertebra...

We previously showed in rats that pre- and postnatal deficiencies in iron and omega-3 (n-3) fatty acids can impair bone development, with additive and potentially irreversible effects when combined. This study aimed to investigate, in female rats consuming a combined iron and n-3 fatty acid deficient (ID + n-3 FAD) diet preconception, whether supplementation with iron and docosahexaenoic/eicosapentaenoic acid (DHA/EPA), alone and in combination, can prevent bone impairments in offspring. Using a 2 × 2 factorial design, female Wistar rats consuming an ID + n-3 FAD diet preconception were randomised to receive an: 1) iron supplemented (Fe + n-3 FAD), 2) DHA/EPA supplemented (ID + DHA/EPA), 3) Fe + DHA/EPA, or 4) ID + n-3 FAD diet from gestational day 10 throughout pregnancy and lactation...

The mechanisms that underly reproductive hormone effects on cognition, neuronal plasticity, and AD risk, particularly in relation to gonadotropin LH receptor (LHCGR) signaling, remain poorly understood. To address this knowledge gap and clarify the impact of circulating steroid hormones the therapeutic effects of CNS LHCGR activation, we delivered the LHCGR agonist human chorionic gonadotropin (hCG) intracerebroventricularly (ICV) and evaluated functional, structural, plasticity-related signaling cascades, Aβ pathology, and transcriptome differences in reproductively intact and ovariectomized (OVX) APP/PS1 AD female mice...

STUDY DESIGN: Retrospective multicenter cohort study. OBJECTIVE: Recurrent lumbar disc herniation (ReLDH) is a common condition requiring surgical intervention in a large proportion of cases. Evidence regarding the appropriate choice between repeat microdiscectomy (RD) and instrumented surgery (IS) is lacking. To understand the indications for either of the procedures and compare the results, we aimed to provide an overview of spine surgeon practice in France. METHODS: This retrospective, multicenter analysis included adults who underwent surgery for ReLDHs between December 2020 and May 2021...

Intervertebral disc degeneration is characterized by deterioration in structural support that is potentially followed by stimulated neuronal ingrowth, and dysfunction of cellular physiology in the disc. Discogenic low back pain originates from nociceptors within the intervertebral disc or the cartilage endplate. This narrative review examines the mechanisms of disc degeneration, the association between degeneration and pain, and the current diagnosis and treatment of discogenic low back pain. Mechanisms of disc degeneration include dysregulated homeostasis of the extracellular matrix of the disc, altered spine mechanics, DNA damage, oxidative stress, perturbed cell signaling pathways, and cellular senescence...

INTRODUCTION: Current treatment of spinal metastases (SM) aims on preserving spinal stability, neurological status, and functional status as well as achieving local control. It consists of spinal surgery followed by radiotherapy and/or systemic treatment. Adjuvant therapy usually starts with a delay of a few weeks to prevent wound healing issues. Intraoperative radiotherapy (IORT) has previously been successfully applied during brain tumor, breast and colorectal carcinoma surgery but not in SM, including unstable one, to date...

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BACKGROUND: The least significant change (LSC) threshold of 0.03 g/cm² is used to interpret bone mineral density (BMD) scans in the general population. Our working hypothesis was that the current LSC threshold would not be applicable in obese populations. AIMS: The aim of this study was to calculate the LSC in an obese population. METHODS: We performed an interventional study among 120 obesity patients, in whom two measurements of BMD were performed at 3 sites...

PURPOSE: The aim of the study was to determine the effect of trauma etiology on the management, functional outcomes and psychiatric characteristics of suicide jumpers and patients who accidentally fall from height. METHODS: 89 patients (48 accidental falls and 41 suicidal jumpers) who had undergone spinal surgery were included in the study. The patients were evaluated clinically and radiologically. Visual Analog Scale (VAS), Roland Morris Disability Questionnaire (RMDQ) and McGill Pain Questionnaire (MPQ) were performed for functional evaluation...

Traumatic heterotopic ossification (HO) of the lower extremity is relatively rare but is of major importance in clinical practice. They are defined as posttraumatic abnormal formations of bone within soft tissue outside of the skeletal system. This article describes the clinical case of a 31-year-old male patient who suffered 2 traumatic events within 12 months-a gunshot wound in the lumbar spine/gluteal region followed by a severe traumatic brain injury with intracranial hemorrhage in a traffic accident as a pedestrian...

Although the measurements of the lumbar spine and pelvic flexion have shown that subjects with radiculopathy exhibited greater decreases of motion when compared with subjects with low back pain, there is still a lack of evidence regarding the changes in flexion relaxation ratio in patients with radiculopathy. The aims of this study were to investigate the flexion relaxation ratio and flexion of the lumbar spine and pelvis in subjects with low back pain (LBP) and LBP with radiculopathy (LBPR) in comparison with healthy subjects (CG-control group)...