World Neurosurg
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To compare outcomes of three-dimensional-printed porous titanium (Ti) versus polyetheretherketone (PEEK) cage implantation for stand-alone lateral lumbar interbody fusion (SA-LLIF) in treatment of symptomatic adjacent segment degeneration. ⋯ In patients undergoing stand-alone lateral lumbar interbody fusion to treat adjacent segment degeneration, Ti cages had a significantly lower overall subsidence rate compared with PEEK cages. Furthermore, Ti cages resulted in fewer recommendations for revision surgery. Whether greater pain reduction in the Ti group is associated with earlier or higher fusion rates needs to be further elucidated.
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The objectives of this study were to conduct a systematic review of the literature to determine the optimal treatment method for patients with atlanto-occipital dislocation (AOD) and to identify possible factors influencing their outcomes. ⋯ Prognosis of AOD is unfavorable in adults with dislocations resulting from road traffic accidents, those with types I and II AOD, and patients younger than 22 years and older than 47 years. Surgical treatment was optimal for adult patients with an AOD, and treatment outcomes did not depend on the number of occipitocervical fusion levels. Immobilization with the halo device showed no advantages over use of an external orthosis.
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The objective of the study was to quantify the effect of cage material (titanium-alloy vs. polyetheretherketone or PEEK) and design (porous vs. solid) on subsidence and osseointegration. ⋯ The choice of material and design is critical to cage mechanical and biological performances. A porous titanium cage can reduce subsidence risk and generate biological stability through bone on-growth and ingrowth.
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C1/2 facet configurations and clivus-canal-angles (CXAs) have been proposed as criteria for posterior fusion in Chiari I malformation (CMI). ⋯ For adult CMI without BI, C1/2 facet configurations and CXA are irrelevant. FMD alone provides excellent long-term outcomes. In CMI with BI, anterior C1 facet displacements indicate C1/2 instability. Posterior fusions can be reserved for patients with ventral compression or C1/2 instability.
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Neuroinflammation triggers sequelae after spinal cord injury (SCI). Inhibition of inflammation promotes recovery after SCI. MicroRNAs regulate many pathophysiological processes, including inflammation. Any role for miR-181a-5p in the inflammatory response after SCI remains unclear. Thus, we evaluated the effects of miR-181a-5p on inflammation in PC12 cells and the underlying mechanism in play. ⋯ miR-181a-5p attenuated the inflammatory response of LPS-induced PC12 cells by directly inhibiting HMGB1; thus, miR-181a-5p may serve as a therapeutic target in SCI.