Spine
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Study Design. Retrospective cohort study. Objective. ⋯ There were no deaths. Conclusion. Given meticulous multidisciplinary planning and execution, major spine surgery can be safely and successfully performed in patients with significant residua of CHD.
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Cadaveric laboratory study. ⋯ N/A.
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Narrative overview of the focus issue on cervical spondylotic myelopathy (CSM). ⋯ By way of this issue, we have summarized current knowledge gaps and limitations in the evidence to provide direction for future research and investigation. These include the need for a unified nomenclature for referring to CSM, the need to specify the incidence of myelopathy and the prevalence of ossification of the posterior longitudinal ligament, and the need to explore both the safety and efficacy of neuroprotective and neuroreparative pharmacological strategies. Further work is also required to optimize the management of patients with minimal symptoms.
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In vitro study to develop an intervertebral disc degeneration organ culture model, using coccygeal bovine intervertebral discs (IVDs) and injection of proteolytic enzymes MMP-3, ADAMTS-4, and HTRA1. ⋯ MMP-3, ADAMTS-4, and HTRA1 provoked neither visible matrix degradation nor major shifts in gene expression. However, cell activity was significantly reduced and HTRA1 induced loss of disc height that positively correlated with changes in GAG/DNA content. The use of higher doses of these enzymes or a combination thereof may, therefore, be necessary to induce disc degeneration.