Spinal sagittal balance and spinopelvic parameters in patients with degenerative lumbar spinal stenosis; a comparative study.

OBJECTIVE: This study aims to evaluate the spinal sagittal balance and the spinopelvic parameters in patients with degenerative lumbar spinal stenosis and healthy controls in Iranian population. METHODS: We performed a case-control study in which 48 patients with lumbar spine stenosis and 54 age- and sex-matched healthy subjects with back pain were eligible for participation. We used INFINITT picture archiving and communication systems (PACS) of the Chamran Hospital for selecting the patients for the study group. The sagittal balance, pelvic incidence, lumbar lordosis, and sacral slope were measured in all the patients and controls using thoracolumbosacral radiographies in the standing position. RESULTS: There was no significant difference between the 2 groups regarding the baseline characteristics. The prevalence of sagittal imbalance was significantly higher in the patients with lumbar spine stenosis in comparison with the controls (31.2% vs. 14.8%; P<0.001). The sacral slope was significantly lower in patients with lumbar canal stenosis than the healthy controls (31.39°±11.2 vs. 43.7°±8.4; P<0.001). The lumbar lordosis was significantly lower in patients with lumbar canal stenosis than the controls (31.27°±12.4 vs. 45.8°±10.7; P < 0.001). The pelvic incidence was not significantly different between the 2 groups (50.16°±11.9 vs. 52°±9.6; P=0.342). CONCLUSION: The degenerative lumbar canal stenosis is associated with increased sagittal imbalance and decreased lumbar lordosis and sacral slope in a sample of the Iranian adult population.

Genistein Suppression of Matrix Metalloproteinase 2 (MMP-2) and Vascular Endothelial Growth Factor (VEGF) Expression in Mesenchymal Stem Cell Like Cells Isolated from High and Low Grade Gliomas

Objective: Brain tumors cause great mortality and morbidity worldwide, and success rates with surgical treatment remain very low. Several recent studies have focused on introduction of novel effective medical therapeutic approaches. Genistein is a member of the isoflavonoid family which has proved to exert anticancer effects. Here we assessed the effects of genistein on the expression of MMP-2 and VEGF in low and high grade gliomas in vitro. Materials and Methods: High and low grade glioma tumor tissue samples were obtained from a total of 16 patients, washed with PBS, cut into small pieces, digested with collagenase type I and cultured in DMEM containing 10% FBS. When cells reached passage 3, they were exposed to genistein and MMP-2 and VEGF gene transcripts were determined by quantitative real time PCR (qRT-PCR). Results: Expression of MMP-2 demonstrated 580-fold reduction in expression in low grade glioma cells post treatment with genistein compared to untreated cells (P value= 0.05). In cells derived from high grade lesions, expression of MMP-2 was 2-fold lower than in controls (P value> 0.05). Genistein caused a 4.7-fold reduction in VEGF transcript in high grade glioma cells (P value> 0.05) but no effects were evident in low grade glioma cells. Conclusion. Based on the data of the present study, low grade glioma cells appear much more sensitive to genistein and this isoflavone might offer an appropriate therapeutic intervention in these patients. Further investigation of this possibility is clearly warranted.