development-rat-caudal-interbody-fusion-model-pilot-feasibility

Development of a Rat Caudal Interbody Fusion Model: A Pilot Feasibility Study

Rat caudal vertebrae are widely used in bone regeneration and spinal fusion research as convenient sites for testing bone graft materials and implants. ...

The Jikei University School of Medicine

Surgical treatment of spinal metastases has been associated with high morbidity and mortality in patients with sarcopenia based on low skeletal muscle mass. We assessed physical performance using the Eastern Cooperative Oncology Group performance status scale and the Barthel Index on the 30th day after palliative surgery for spinal metastases and investigated the effectiveness of surgery according to sarcopenia assessed by skeletal muscle mass.

Clinical study of preoperative skeletal muscle mass as a predictor of physical performance recovery following palliative surgery for spinal metastases.

A 73-year-old woman presented with degenerative kyphoscoliosis. Radiographs revealed sagittal and coronal imbalance with lumbar spinal stenosis. Extreme lateral interbody fusion (XLIF) was performed in the first stage of 2-stage surgery, and a closed-suction drainage tube was placed in the retroperitoneal cavity. Postoperatively, there was massive bleeding through the tube. Contrast-enhanced computed tomography revealed lumbar artery injury, which required emergency arterial embolization.

Retroperitoneal Hematoma Due to Drainage Tube Insertion in Extreme Lateral Interbody Fusion: A Case Report.

Intraspinal Epidermoid Cyst with Calcification: A Case Report.

A 58-year-old man presented with lumbar spinal stenosis due to epidural lipomatosis. He underwent transsacral canal plasty (TSCP), in a manner similar to epidural adhesiolysis, which can be performed under local anesthesia. His leg pain improved dramatically in the year after surgery. Furthermore, magnetic resonance images during this time show neural decompression by reduction of the amount of epidural fat.

Transsacral Canal Plasty for Decompression of Lumbar Spinal Stenosis in a Patient With Epidural Lipomatosis: A Case Report.

Paradoxical Response after MISt for Spinal Tuberculosis Worsened Neurologic Symptoms: A Case Report.

Invariant natural killer T (iNKT) cells are innate-like T lymphocytes that express an invariant T cell receptor α chain and contribute to bridging innate and acquired immunity with rapid production of large amounts of cytokines after stimulation. Among effecter subsets of iNKT cells, follicular helper NKT (NKT) cells are specialized to help B cells. However, the mechanisms of NKT cell differentiation remain to be elucidated. In this report, we studied the mechanism of NKT cell differentiation induced by pneumococcal surface protein A and α-galactosylceramide (P/A) vaccination. We found that Gr-1 cells helped iNKT cell proliferation and NKT cell differentiation in the spleen by producing interleukin-27 (IL-27) in the early phase after vaccination. The neutralization of IL-27 impaired NKT cell differentiation, which resulted in compromised antibody production and diminished protection against  infection by the P/A vaccine. Our data indicated that Gr-1 cell-derived IL-27 stimulated mitochondrial metabolism, meeting the energic demand required for iNKT cells to differentiate into NKT cells. Interestingly, Gr-1 cell-derived IL-27 was induced by iNKT cells via interferon-γ production. Collectively, our findings suggest that optimizing the metabolism of iNKT cells was essential for acquiring specific effector functions, and they provide beneficial knowledge on iNKT cell-mediated vaccination-mediated therapeutic strategies.

IL-27 regulates the differentiation of follicular helper NKT cells via metabolic adaptation of mitochondria.

Trans-sacral canal plasty (TSCP) is a minimally invasive lumbar spine surgery under local anaesthesia. TSCP is expected to be effective regardless of whether the patient has had previous surgery. However, there are cases in which open revision surgery is required after TSCP. This study aimed to identify risk factors for open revision surgery after TSCP in order to determine surgical indications and limitations. A retrospective case-control study was conducted in patients who underwent TSCP for lumbar spine disease. Data of 112 patients were analysed. During an observation period of 7-23 months, 34 patients (30.4%) required open revision surgery and 78 (69.6%) did not. The following patient background characteristics were investigated: age, sex, body mass index (BMI), diagnosis, history of spine surgery and the institution where the surgery was performed. Comorbidities were scored using the Elixhauser Comorbidity Index. Preoperative imaging parameters were investigated, including the lesion level (L4/5, L5/S1, other), presence of intervertebral instability, dural sac area, presence of bony stenosis and presence of epidural lipoma. Multivariate analysis revealed that intervertebral instability (odds ratio 2.56, confidence interval 1.00-6.51,  = 0.046) and a narrow dural sac area (odds ratio 0.98, confidence interval 0.97-0.99,  = 0.002) were significant risk factors for open revision surgery after TSCP.

Factors leading to open revision surgery after trans-sacral canal plasty for lumbar spine disease.

A 62-year-old woman receiving romosozumab for 3 months underwent extreme lateral interbody fusion (XLIF) for lumbar degenerative spondylolisthesis. From 1 week after surgery, she experienced gradually increasing pain from the right groin to the front of the thigh. Examination revealed ossifying myositis in bilateral psoas major muscles. Etidronate treatment was initiated, improving pain after 4 days. Computed tomography showed lesion disappearance by 3 months after surgery.

Myositis Ossificans of the Psoas Major Muscle After XLIF With Preoperative Administration of Romosozumab: A Case Report.

Study DesignRetrospective cohort study.ObjectivesTo determine the ideal cage placement position in transforaminal lumbar interbody fusion (TLIF) surgery to prevent vertebral endplate cyst (VEC) formation and improve bone union rates.MethodsThis study retrospectively analyzed 69 patients who underwent TLIF, and 88 intervertebral levels were observed. Patients were categorized into peripheral, central, and mixed types based on the cage placement. The incidence of VEC formation and endplate injuries (EIs) were assessed using computed tomography 1 year postoperatively. Factors associated with VEC formation and non-union, including patient demographics, clinical data, cage placement, Hounsfield unit values, and intraoperative EIs, were analyzed.ResultsVECs occurred in 55.7% of surgical levels and were significantly associated with non-union ( < .001). Center-type cage placement was a strong predictor of VEC formation ( = .028, OR = 16.3, 95% confidence interval [CI]: 1.36-195.0), along with EIs ( = .003, OR = 5.86, 95% CI: 1.80-19.0). In contrast, pre-existing VECs appeared to have a protective effect ( = .046, OR = 0.272, 95% CI: 0.076-0.979).ConclusionsCage placement in the central region significantly increases the risk of VEC formation and non-union. Periphery-type placement may be preferable to reduce endplate damage and improve fusion outcomes. Preventing EIs and optimizing cage positioning are critical to minimize VEC formation. Further prospective studies are needed to refine surgical strategies and improve long-term outcomes following TLIF.

Article	Year
Clinical study of preoperative skeletal muscle mass as a predictor of physical performance recovery following palliative surgery for spinal metastases. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association\| PubMed ID: 35811255	2023
Retroperitoneal Hematoma Due to Drainage Tube Insertion in Extreme Lateral Interbody Fusion: A Case Report. JBJS case connector\| PubMed ID: 35852166	2022
Intraspinal Epidermoid Cyst with Calcification: A Case Report. Spine surgery and related research\| PubMed ID: 36348675	2022
Transsacral Canal Plasty for Decompression of Lumbar Spinal Stenosis in a Patient With Epidural Lipomatosis: A Case Report. JBJS case connector\| PubMed ID: 36656263	2022
Paradoxical Response after MISt for Spinal Tuberculosis Worsened Neurologic Symptoms: A Case Report. Spine surgery and related research\| PubMed ID: 37841034	2023
IL-27 regulates the differentiation of follicular helper NKT cells via metabolic adaptation of mitochondria. Proceedings of the National Academy of Sciences of the United States of America\| PubMed ID: 38394242	2024
Factors leading to open revision surgery after trans-sacral canal plasty for lumbar spine disease. Frontiers in surgery\| PubMed ID: 38872727	2024
Myositis Ossificans of the Psoas Major Muscle After XLIF With Preoperative Administration of Romosozumab: A Case Report. JBJS case connector\| PubMed ID: 39028835	2024
Impact of Cage Placement on Vertebral Endplate Cyst Formation and Bone Union in Transforaminal Lumbar Interbody Fusion. Global spine journal\| PubMed ID: 40293858	2026

Taku Ikegami

Biography

JoVE Journal Publications

Other Publications