Spine
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A retrospective review of charts and radiographs of all consecutive patients who underwent kyphoplasty at the authors' center from the initial procedure in September 2000 to the end of the collection period in July 2002. ⋯ This study demonstrated a higher rate of subsequent fracture after kyphoplasty compared with natural history data for untreated fractures. Most of these occurred at an adjacent level within 2 months of the index procedure. After this 2-month period, there were only occasional subsequent fractures, which occurred at remote levels. This confirms biomechanical studies showing that cement augmentation places additional stress on adjacent levels. Patients with an increase in back pain after kyphoplasty should be evaluated carefully for subsequent adjacent fractures, especially during the first 2 months after the index procedure.
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Comparative Study
Collagen and proteoglycan abnormalities in the GDF-5-deficient mice and molecular changes when treating disk cells with recombinant growth factor.
A magnetic resonance image, histologic, biochemical, and gene expression study was conducted to characterize the effects of growth and development factor-5 (GDF-5) deficiency on the health of the intervertebral disc. ⋯ The intervertebral disc is markedly affected by GDF-5 deficiency. This relatively simple (single gene) system with a known molecular defect may be useful in studies designed to define the response of the intervertebral disc to treatment with growth factor in vivo.
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An animal model of postlaminectomy lumbar column sagittal plane deformity was designed in rats. ⋯ Kyphosis and consequent traction of the lumbar spine is one of the causes for increased epidural fibrosis formation after laminectomy. On the contrary, establishment of lordosis and relaxation of the lumbar spine decreased the scar tissue formation in rats.
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Distribution and appearance of tumor necrosis factor-alpha (TNF-alpha) in the dorsal root ganglion (DRG) exposed to experimental disc herniation were investigated using an immunohistochemical method in rats. ⋯ The immunoreactivity of TNF-alpha in the DRG directly exposed to nucleus pulposus increases during 2 weeks. A collapse of the positive cells was seen in the DRG directly exposed to the nucleus pulposus.