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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There have been few studies on revision surgery for clinically symptomatic adjacent segment degeneration (CASD). We aimed to find the incidence of revision surgery due to CASD and to analyze the factors that affected CASD at the L3-4 level after L4-5 or L4-5-S1 level fusion surgery over a long-term follow-up period. ⋯ We determined six significant factors affecting CASD development. Among these risk factors, facet degeneration, isthmic-type spondylolisthesis, and the type of fusion show higher hazard ratios and seem to be clinically more relevant than the other three factors (age, overall lordosis, and segmental lordosis).
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The potential of stem cell niches (SCNs) in the intervertebral disc (IVD) region, which may be of great significance in the regeneration process, was recently proposed. To the best of our knowledge, no previous in vitro study has examined the characteristics of stem cells derived from the potential SCN of IVD (ISN). Therefore, increasing knowledge on ISN-derived stem cells (ISN-SCs) may provide a greater understanding of IVD degeneration and regeneration processes. We aimed to demonstrate the existence of ISN-SCs and to compare their characteristics with bone marrow mesenchymal stem cells (BMSCs) in vitro. ⋯ To the best of our knowledge, this is the first in vitro study aimed towards determining the existence and characteristics of ISN-SCs, which belong to the MSC family and with greater osteogenic and chondrogenic abilities than BMSCs according to our data. This finding may be of great significance for additional studies that investigate the migration of ISN-SCs into the IVD, and may provide a new perspective on different biological approaches for IVD self-regeneration.
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Patients undergoing lumbar spine surgery are a heterogeneous population and their expectations of surgery are likely to vary depending on individual and group characteristics. Our goal was to assess associations between expectations and demographic, psychological, and clinical characteristics in patients undergoing lumbar spine surgery. ⋯ There were wide variations in expectations among patients. Multiple demographic, psychological, and clinical characteristics were associated with expectations, with disability due to pain being the most consistently associated variable.
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Pedicle screw placement is an increasingly common procedure for the correction of spine degenerative disease, deformity and trauma. However, screw placement is demanding, with complications resulting from inaccurate screw placement. While several different techniques have been developed to improve accuracy, they all have their limitations. ⋯ Our cadaver study indicates that pedicle screw placement with the system is accurate and should be investigated in larger in vitro and in vivo studies.