European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Historically, metastatic spine tumor surgery has been palliative for pain control, to maintain neurologic and ambulatory function. The thought of curing cancer with limited metastatic disease by resecting the primary and the metastatic lesions is becoming more common. Multilevel spondylectomy for resection of metastatic disease has been reported in the literature, mostly at the thoracic or lumbar level with some success. Reconstruction of the lumbosacral junction after tumor resection is a difficult endeavor and several techniques have been utilized. Subcutaneous anterior pelvic fixation has been described for the treatment of unstable pelvic fractures. ⋯ The authors describe a novel percutaneous rod technique and construct for buttressing a posterior spinal construct to a subcutaneous anterior pelvic fixator after tumor resection of the lumbo-pelvic junction. They manage to salvage a difficult situation for which they should be commended. This technique may be useful in situations where instrumentation has to be preformed to the pelvis: i.e., in tumor reconstruction, fusions such as neuromuscular scoliotic disease to the pelvis, to augment a lumbo-pelvic construct when a nonunion occurs or in osteoporotic patients as a salvage procedure.
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Dogs are often used as an animal model in spinal research, but consideration should be given to the breed used as chondrodystrophic (CD) dog breeds always develop IVD degeneration at an early age, whereas non-chondrodystrophic (NCD) dog breeds may develop IVD degeneration, but only later in life. The aim of this study was to provide a mechanical characterization of the NCD [non-degenerated intervertebral discs (IVDs), rich in notochordal cells] and CD (degenerated IVDs, rich in chondrocyte-like cells) canine spine before and after decompressive surgery (nucleotomy). ⋯ Spinal biomechanics significantly differ between NCD and CD dogs and researchers should consider this aspect when using the dog as a model for spinal research.
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To evaluate the effect of a large perfusion-bioreactor cell-activated bone substitute, on a two-level large posterolateral spine fusion sheep model. ⋯ We found that bioreactor-generated cell-based bone substitutes seemed superior in fusion ability when compared to cell-free bone substitute and comparable to autograft in fusion ability, but not in bone structure. This combined with the favorable biocompatible abilities and strength comparable to human cancellous bone indicates that it might be a suitable bone substitute in spine fusion procedures.
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The incidence of osteoporotic fractures is increasing with an ageing population. This has potential consequences for health services, patients and their families. Treatment of osteoporotic vertebral compression fractures (OVCFs) has been limited to non-surgical measures so far. The social and functional consequences of balloon kyphoplasty, a recent development for the treatment of VCF, were assessed in this cohort study. ⋯ The reduction in mortality and drift in social functionality at 1 year following treatment with balloon kyphoplasty suggests that it is a viable option for the management of OVCFs.
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Implantation of TheraCyte 4 × 10(6) live parathyroid cells can increase the bone marrow density of the spine of ovariectomized rats. There has been no published study examining the effect of such implantation on spinal fusion outcomes. The purpose of this study was to examine the effect of TheraCyte-encapsulated parathyroid cells on posterolateral lumbar fusions in a rat model. ⋯ This pilot animal study revealed that there were more fusions in rats that received TheraCyte-encapsulated 4 × 10(6) live parathyroid cells than in control rats without significant change in serum calcium or phosphorus concentrations. As with any animal study, the results may not extrapolate to a higher species. Further studies are needed to determine if these effects are clinically significant.