Biomechanical Evaluation of an Anterior Upper Thoracic Plate Fixation System: An In Vitro Human Cadaveric Study.

OBJECTIVE: This study aimed to evaluate the biomechanical characteristics of the anterior upper thoracic plate fixation system (AUTP). METHODS: Twelve specimens were divided into 2 groups: the AUTP group and the anterior cervical locking plate (ACLP) group. Bone mineral density was assessed in all specimens. The specimens were loaded with pure bending moments of ±4 Nm to move toward extension/flexion, right/left lateral tilt, and right/left axial rotation. Each specimen was tested in 3 load cycles under 3 conditions (native, destabilized, and torsion). The tightening moments were assessed in every screw using a torsion meter. RESULTS: The tightening moment of the AUTP screws was more pronounced than the ACLP (P < 0.05). Significant decreases after stabilization with the AUTP compared with the native situation were observed in the AUTP group (P < 0.05). In terms of the direction of lateral tilt and torsion, the neutral zone increased significantly after stabilization with the AUTP compared with the native situation (P < 0.05). CONCLUSIONS: The AUTP was shown to provide more rigidity to the destabilized spine than the ACLP.

Transcript levels of major interleukins in relation to the clinicopathological profile of patients with tuberculous intervertebral discs and healthy controls.

OBJECTIVES: The purpose of the present study was to simultaneously examine the transcript levels of a large number of interleukins (ILs; IL-9, IL-10, IL-12, IL-13, IL-16, IL-17, IL-18, IL-26, and IL-27) and investigate their correlation with the clinicopathological profiles of patients with tuberculous intervertebral discs. METHODS: Clinical data were collected from 150 patients participating in the study from January 2013 to December 2013. mRNA expression levels in 70 tuberculous, 70 herniated, and 10 control intervertebral disc specimens were determined by real-time polymerase chain reaction. RESULTS: IL-10, IL-16, IL-17, IL-18, and IL-27 displayed stronger expression in tuberculous spinal disc tissue than in normal intervertebral disc tissue (P<0.05). Our results illustrated multiple correlations among IL-10, IL-16, IL-17, IL-18, and IL-27 mRNA expression in tuberculous samples. Smoking habits were found to have a positive correlation with IL-17 transcript levels and a negative correlation with IL-10 transcript levels (P<0.05). Pain intensity, symptom duration, C-reactive protein levels, and the erythrocyte sedimentation rate exhibited multiple correlations with the transcript levels of several ILs (P<0.05). CONCLUSIONS: The experimental data imply a double-sided effect on the activity of ILs in tuberculous spinal intervertebral discs, suggesting that they may be involved in intervertebral discs destruction. Our findings also suggest that smoking may affect the intervertebral discs destruction process of spinal tuberculosis. However, further studies are necessary to elucidate the exact role of ILs in the intervertebral discs destruction process of spinal tuberculosis.

Treatment results in the differential surgery of intradural extramedullary schwannoma of 110 cases.

STUDY DESIGN: A retrospective study of intradural extramedullary schwannoma. OBJECTIVE: The purpose of this study was to compare treatment results in the differential surgery of intradural extramedullary schwannoma. BACKGROUND: A reference guide to the surgical procedures available to treat intradural extramedullary schwannoma has not yet been established. METHODS: The study retrospectively reviewed 110 patients: Group A: laminectomy+microscopic excision; Group B: hemilaminectomy+microscopic excision; Group C: laminectomy+microscopic excision+pedicle screw fixation. Researchers selected patients for this retrospective review by applying the following criteria: 1) back pain spread out from the tumor level, sensory and motor loss; 2) treatment by surgery; 3) clinical diagnosis made by physical examination, magnetic resonance imaging (MRI), and pathology; 4) a minimum clinical and radiologic follow-up of 12 months. The clinical outcomes were assessed by comparing the Visual Analogue Pain Scores (VAS) and the Japanese Orthopedic Association Scores (JOA score). The study also performed a cost-effectiveness analysis. RESULTS: Cervical vertebrae: The estimated blood loss in Group B was significantly less than in Group C (P<0.05) (Table 1). Thoracic vertebrae: The duration of hospital stay and estimated blood loss in Group A was significantly less than in Group C (P<0.05) (Table 2, 3). Lumbar vertebrae: The resection rate in Group C was significantly higher than in Group A and Group B (P<0.05) (Table 4). Treatment in Group B was the least expensive, and therefore, the most cost-effective. CONCLUSION: In the case of appropriate surgical indications, the study suggests that hemilaminectomy+microscopic excision is advantageous in the removal of cervical schwannoma, and that laminectomy+microscopic excision is advantageous in the removal of thoracic schwannoma; lumbar intradural extramedullary schwannoma can be managed by laminectomy+microscopic excision+pedicle screw fixation.

Transcript levels of major MMPs and ADAMTS-4 in relation to the clinicopathological profile of patients with tuberculous intervertebral discs and healthy controls.

OBJECTIVES: The purpose of the present study was to simultaneously examine the transcript levels of a large number of MMPs (-3, -8, -9, -13 and -14) and ADAMTS-4 and to investigate their correlation with the clinicopathological profile of patients suffering from tuberculous intervertebral discs. DESIGN AND METHODS: Clinical data were collected from 130 patients participating in the study from March 2011 to April 2012. mRNA expression levels were determined by means of the real-time polymerase chain reaction in 60 tuberculous (TB), 60 herniated, and 10 control intervertebral disc (ID) specimens. RESULTS: MMP-8, -9, -13, and -14 that showed a stronger expression in spinal TB disc tissue compared to normal ID tissue (P<0.05). Our results showed multiple positive correlations among MMP-8, -9, and -13 mRNA in TB samples. Smoking habits were found to significantly up-regulate the transcript levels of MMP-3 and -13 (P<0.05). Pain intensity, duration of symptoms, CRP, and ESR significantly affected the transcript levels of several MMPs (P<0.05). CONCLUSIONS: The MMPs may drive extracellular matrix destruction in spinal tuberculosis intervertebral discs. The experimental data imply a synergistic effect on the activity of these MMPs in spinal tuberculosis intervertebral discs. Furthermore, the experimental data suggest that smoking plays an unfavourable role in the prognosis of spinal tuberculosis intervertebral discs. Moreover, pain intensity, duration of symptoms, CRP, and ESR may affect the process of extracellular matrix destruction by increasing the expression of MMPs in spinal tuberculosis intervertebral disc samples.

The role of α-zearalanol in reversing bone loss induced by ovarian hormone deficiency in rats.

To assess the ability of α-zearalanol (α-ZAL) to prevent bone loss in an ovariectomized (OVX) rat model of osteoporosis, α-ZAL was administered intragastrically to rats. After 35 days, the total body bone mineral density (BMD) was assessed in all rats. All sections were processed for immunohistochemistry and hematoxylin and eosin staining. One-way ANOVA and an LSD multiple-range test were used to determine the significant differences between groups. BMD was lower in the OVX and OVX + α-ZAL high-dose (OVX + High) groups compared to the sham-operated (Sham), OVX + 17ß-ethinylestradiol (OVX + E(2)), OVX + α-ZAL medium-dose (OVX + Medium) and OVX + α-ZAL low-dose (OVX + Low) groups (P < 0.05). Clear bone trabeculae arrangements were observed in the OVX + E(2,) OVX + Medium and OVX + Low groups. The expressions of bone morphogenetic proteins and basic fibroblast growth factor were up-regulated in the OVX + E(2), OVX + Medium and OVX + Low groups compared to the OVX and OVX + High groups (P < 0.05). The OVX + E(2), OVX + Medium and OVX + Low groups showed lower levels of bone Gla protein, bone alkaline phosphatase, tartrate-resistant acid phosphatase and tumor necrosis factor α expressions than the OVX and OVX + High groups (P < 0.05). The administration of α-ZAL to ovariectomized rats reverses bone loss and prevents osteoporosis.

Beneficial effect of interleukin-1 receptor antagonist protein on spinal cord injury recovery in the rat.

We assessed the effect of treatment with the interleukin-1 receptor antagonist protein (IRAP) on morphological and functional recovery in a rat model of SCI. All sections were processed for immunohistochemistry, hematoxylin-eosin, and Nissl staining. Rats were assessed for hind limb motor function using the Basso, Beattie, and Bresnahan (BBB) hind limb locomotor rating scale and the inclined plane test. At 1, 48, and 72 h after operation, there was a significant increase in neurofilament proteins and brain-derived neurotrophic factor expression in the IRAP group I when compared with the saline group I and the sham-operated group I (P < 0.05). The mean inclined plane scores and BBB scores for the IRAP group II were higher than the saline group II at 1, 2, 3, and 4 weeks post-injury (P < 0.05). In conclusion, treatment with IRAP enhanced neuronal survival after SCI.

Protective effects of Polygonatum sibiricum polysaccharide on ovariectomy-induced bone loss in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: To assess the ability of traditional Chinese medicine Polygonatum sibiricum polysaccharide to prevent bone loss in the ovariectomized rat. MATERIALS AND METHODS: PSP was administered intragastrically to the rats. After 35 days, the total body bone mineral density (BMD) was assessed in all of the rats. All sections were processed for immunohistochemistry and hematoxylin-eosin staining (H.E.). RESULTS: BMD was lower in the ovariectomized group (OVX, 0.163 g/cm(2)), the group that received a moderate dose of PSP on OVX animals (OVX+MP, 0.163 g/cm(2)) and the group that received a low dose of PSP on OVX animals (OVX+LP, 0.162 g/cm(2)) than in the sham-operated group (SHAM, 0.180 g/cm(2)), the OVX+E(2) group (OVX+E(2), 0.176 g/cm(2)) and the group that received a high dose of PSP on OVX animals (OVX+HP, 0.174 g/cm(2)) (P<0.05). Clear arrangements of bone trabeculae were observed in the OVX+E(2) and OVX+HP. The expression of bone morphogenetic proteins (BMP) and basic fibroblast growth factor (bFGF) in the OVX, OVX+MP and OVX+LP was down regulated compared to the SHAM, OVX+E(2) and OVX+HP (P<0.05). The rats in the OVX+E(2) and OVX+HP had lower levels of bone Gla protein (BGP), bone alkaline phosphatase (BALP), tartrate-resistant acid phosphatase (TRAP) and tumor necrosis factor α(TNF-α) expression than the rats in the OVX, OVX+MP and OVX+LP (P<0.05). CONCLUSION: This experiment demonstrates that the administration of PSP to ovariectomized rats reverses bone loss and prevents osteoporosis.