Spine
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In vivo degenerative changes of rabbit intervertebral discs after partial disc replacements were evaluated radiologically and histologically in a controlled trial. ⋯ The antidegenerative effects of partial disc replacement surgery were demonstrated by quantitative radiologic and histologic analyses. Degeneration of the anulus fibrosus after the replacement treatment was delayed by preserving disc height and occupying the space of the nucleus pulposus. Properly designed implants and minimally invasive techniques are necessary for long-term success.
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We investigated involvement of EphB/ephrinB system in neuropathic pain. ⋯ Expression of ephrinB2 is enhanced by nerve injury in neurons in DRG and spinal cord, while its receptor EphB1 is expressed in spinal cord. These results suggest that induction of ephrinB2 might activate EphB1/ephrinB2 signaling pathway to regulate synaptic plasticity and reorganization, and that ephrinB2 siRNA could be a potential therapeutic agent for neuropathic pain.
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Comparative Study
Comparison of segmental pedicle screw instrumentation versus anterior instrumentation in adolescent idiopathic thoracolumbar and lumbar scoliosis.
A retrospective study. ⋯ Surgical correction of both the frontal and sagittal plane deformity are comparable to anterior instrumentation. Shorter lengths of surgery and hospital stay are the potential benefits of posterior surgery. Posterior segmental pedicle screw instrumentation offer significant advantages and is a viable alternative to standard anterior instrumentation in idiopathic thoracolumbar and lumbar scoliosis.
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Cadaveric biomechanical study and retrospective chart review. ⋯ Segmental fixation of burst fractures with screws at the level of the fracture offers improved biomechanical stability. Theoretically, segmental fixation provides for additional fixation points that may aid in fracture reduction and kyphosis correction. This specific parameter is not evaluated in this study but will be an important outcome measure for a planned randomized controlled trial.
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Retrospective radiographic/imaging study. ⋯ There is a close linear association between the facet fluid index and the amount of radiographic instability at L4-L5. Facet fluid on MRI should raise high suspicion of lumbar instability.