Spine
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An anatomic study of the iliolumbar ligament was performed in association with lumbosacral disc degeneration. ⋯ If the iliolumbar ligaments (especially the posterior band of the ligament) of a male patient are short and have a large cross-sectional area, the lumbosacral junction can be stabilized by the ligaments, with the L5-S1 disc being protected from degeneration. The L4-L5 disc may be prone to degeneration.
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Peripheral sensory functions in patients with radiculopathy resulting from lumbar disc herniation and in control individuals were analyzed using current perception threshold testing. ⋯ Current perception threshold testing showed that the functions of A-beta, A-delta, and C fibers deteriorated in patients with lumbar radiculopathy. This technique may be useful for quantifying sensory nerve dysfunction in patients with radiculopathy.
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Changes in expression of voltage-dependent ion channel subunits were examined in the radicular pain state. Furthermore, antinociceptive effects of gabapentin on radicular pain were compared with effects on peripheral neuropathic pain. ⋯ The reduction of Na(v)1.9 found in all three models may link to the neuropathic pain state, including radicular pain. The lower sensitivity to gabapentin in rats with peripheral neuropathic pain might be partly explained by the marked upregulation of Ca(v)alpha2delta in the dorsal root ganglions, suggesting that gabapentin may be more effective in radicular pain treatment.
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Neurogenic mixed evoked potentials are used routinely to monitor the spinal cord during spine surgery. This study investigates the differential sensory-motor contribution by using collision techniques. ⋯ Both standard and conditioned neurogenic mixed evoked potentials are proposed to provide combined sensory and motor spinal pathway monitoring.
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Rat and human intervertebral disc specimens were examined immunohistochemically. Reverse transcription polymerase chain reaction (RT-PCR) analysis was also performed on rat disc tissue to demonstrate the existence of Fas ligand. ⋯ We demonstrated the existence of Fas ligand on disc cells, which should play a key role in the potential molecular mechanism to maintain immune privilege of the disc. Immune privilege and Fas ligand expression of the intervertebral disc may provide a new insight for basic science research as well as clinical treatments for disc degenerative diseases, including disc herniation with radicular pain.