Role of Posterior Ligamentous Reinforcement in Proximal Junctional Kyphosis: A Cadaveric Biomechanical Study.

STUDY DESIGN: Cadaveric biomechanical study. PURPOSE: The purpose of this study was to biomechanically evaluate the effect of preserving or augmenting the interspinous ligament (ISL) and supraspinous ligament (SSL; ISL/SSL) complex between the upper instrumented vertebra (UIV) and UIV+1 using a cadaveric model. OVERVIEW OF LITERATURE: Adult spinal deformity is becoming an increasingly prevalent disorder, and proximal junctional kyphosis (PJK) is a well-known postoperative complication following long spinal fusion. METHODS: Pure moments of 4 and 8 Nm were applied to the native and instrumented spine, respectively (n=8). The test conditions included the following: native spine (T7-L2), fused spine (T10-L2), fused spine with a hand-tied suture loop through the spinous processes at T9-T10, and fused spine with severed T9-T10 ISL/SSL complex. RESULTS: The flexion range of motion (ROM) at T9-T10 of the fused spine loaded at 8 Nm increased by 62% compared to that of the native spine loaded at 4 Nm. The average flexion ROM at T9-T10 for the suture loop and severed ISL/SSL spines were 141% (p=0.13) and 177% (p=0.66) of the native spine at 4 Nm, respectively (p-values vs. fused). CONCLUSIONS: Transection of the ISL/SSL complex did not significantly change flexion ROM at the proximal junctional segment following instrumented spinal fusion. Furthermore, augmentation of the posterior ligamentous tension band with a polyester fiber suture loop did not mitigate excessive flexion loads on the proximal junctional segment. We postulate that the role of the posterior ligamentous tension band in mitigating PJK is secondary to the anterior column support provided by the vertebral body and intervertebral disc.

Strain differences in the chronic mild stress animal model of depression and anxiety in mice.

Chronic mild stress (CMS) has been reported to induce an anhedonic-like state in mice that resembles some of the symptoms of human depression. In the present study, we used a chronic mild stress animal model of depression and anxiety to examine the responses of two strains of mice that have different behavioral responsiveness. An outbred ICR and an inbred C57BL/6 strain of mice were selected because they are widely used strains in behavioral tests. The results showed that the inbred C57BL/6 and outbred ICR mice were similarly responsive to CMS treatment in sucrose intake test (SIT) and open field test (OFT). However, the two strains showed quite different responses in forced swimming test (FST) and novelty-suppressed feeding (NSF) test after 3 weeks of CMS treatment. Only C57BL/6 mice displayed the depression- and anxiety-like behavioral effects in response to CMS treatment in FST and NSF test. Our results suggest that there are differences in responsiveness to CMS according to the different types of strain of mice and behavioral tests. Therefore, these results provide useful information for the selection of appropriate behavioral methods to test depression- and anxiety-like behaviors using CMS in ICR and C57BL/6 mice.

Quantitative three-dimensional analysis of embryonic chick morphogenesis via microcomputed tomography.

Embryonic development is a remarkably complex and rapidly evolving morphogenetic process. Although many of the early patterning events have been well described, understanding the anatomical changes at later stages where clinically relevant malformations are more likely to be survivable has been limited by the lack of quantitative 3D imaging tools. Microcomputed tomography (Micro-CT) has emerged as a powerful tool for embryonic imaging, but a quantitative analysis of organ and tissue growth has not been conducted. In this study, we present a simple method for acquiring highly detailed, quantitative 3D datasets of embryonic chicks with Micro-CT. Embryos between 4 and 12 days (HH23 and HH40) were labeled with osmium tetroxide (OT), which revealed highly detailed soft tissue anatomy when scanned at 25 µm resolution. We demonstrate tissue boundary and inter-tissue contrast fidelity in virtual 2D sections are quantitatively and qualitatively similar to those of histological sections. We then establish mathematical relationships for the volumetric growth of heart, limb, eye, and brain during this period of development. We show that some organs exhibit constant exponential growth (eye and heart), whereas others contained multiple phases of growth (forebrain and limb). Furthermore, we show that cardiac myocardial volumetric growth differs in a time and chamber specific manner. These results demonstrate Micro-CT is a powerful technique for quantitative imaging of embryonic growth. The data presented here establish baselines from which to compare the effects of genetic or experimental perturbations. Quantifying subtle differences in morphogenesis is increasingly important as research focuses on localized and conditional effects.