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Find video protocols related to scientific articles indexed in Pubmed.
The use of a modified fulcrum for fulcrum bending radiographs: a technical note.
J Orthop Surg (Hong Kong)
PUBLISHED: 08-29-2014
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We describe a modified fulcrum design to overcome limitations of a traditional fulcrum. The modified fulcrum is a triangular prism-shaped foam with rounded and padded edges. The 3 faces of the fulcrum represent 3 different heights (17.0 cm, 17.5 cm, and 21.0 cm). For fulcrum bending radiographs of the thoracic curve, the patient is placed on an X-ray table in a lateral decubitus position over the fulcrum. The apex of the appropriate height of the fulcrum is positioned under the rib corresponding to the apex of the curve, such that the ipsilateral shoulder is lifted off the X-ray table for maximum passive bending force to the curve. For fulcrum bending radiographs of the lumbar curve, the fulcrum is positioned directly under the apex of the curve such that the ipsilateral iliac crest is lifted off the X-ray table.
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Insertional torque and pullout strength of pedicle screws with or without repositioning: a porcine study.
J Orthop Surg (Hong Kong)
PUBLISHED: 08-29-2014
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PURPOSE. To evaluate the insertion torque and pullout strength of pedicle screws with or without repositioning. METHODS. 20 fresh porcine lumbar vertebrae of similar size were used. The entry point was at the site just lateral and distal to the superior facet joint of the vertebra, and to a depth of 35 mm. A 6.2-mm-diameter, 35-mm-long pedicle screw was inserted parallel to the superior end plate on one side as control. On the other side, an identical screw was first inserted 10º caudal to the superior end plate, and then repositioned parallel to the superior end plate. The insertional torque and pullout strength were measured. RESULTS. Three of the specimens were excluded owing to pedicle fractures during the pullout test. Repositioned pedicle screws were significantly weaker than controls in terms of the maximum insertional torque (3.20 ± 0.28 vs. 2.04 ± 0.28 Nm, 36% difference, p<0.01) and pullout strength (1664 ± 378 vs.1391 ± 295 N, p<0.01). CONCLUSION. Repositioning pedicle screws should be avoided, especially when the pedicle wall is breached. If repositioning is deemed necessary, augmentation with polymethyl methacrylate or a screw with a larger diameter should be considered.
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Quantitative assessment of column-specific degeneration in cervical spondylotic myelopathy based on diffusion tensor tractography.
Eur Spine J
PUBLISHED: 08-24-2014
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Cervical spondylotic myelopathy (CSM) is a common spinal cord disorder in the elderly. Diffusion tensor imaging (DTI) has been shown to be of great value for evaluating the microstructure of nerve tracts in the spinal cord. Currently, the quantitative assessment of the degeneration on the specific tracts in CSM is still rare. The aim of the present study was to use tractography-based quantification to investigate the column-specific degeneration in CSM.
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Increased low-frequency oscillation amplitude of sensorimotor cortex associated with the severity of structural impairment in cervical myelopathy.
PLoS ONE
PUBLISHED: 08-11-2014
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Decreases in metabolites and increased motor-related, but decreased sensory-related activation of the sensorimotor cortex (SMC) have been observed in patients with cervical myelopathy (CM) using advanced MRI techniques. However, the nature of intrinsic neuronal activity in the SMC, and the relationship between cerebral function and structural damage of the spinal cord in patients with CM are not fully understood. The purpose of this study was to assess intrinsic neuronal activity by calculating the regional amplitude of low frequency fluctuations (ALFF) using resting-state functional MRI (rs-fMRI), and correlations with clinical and imaging indices. Nineteen patients and 19 age- and sex-matched healthy subjects underwent rs-fMRI scans. ALFF measurements were performed in the SMC, a key brain network likely to impaired or reorganized patients with CM. Compared with healthy subjects, increased amplitude of cortical low-frequency oscillations (LFO) was observed in the right precentral gyrus, right postcentral gyrus, and left supplementary motor area. Furthermore, increased z-ALFF values in the right precentral gyrus and right postcentral gyrus correlated with decreased fractional anisotropy values at the C2 level, which indicated increased intrinsic neuronal activity in the SMC corresponding to the structural impairment in the spinal cord of patients with CM. These findings suggest a complex and diverging relationship of cortical functional reorganization and distal spinal anatomical compression in patients with CM and, thus, add important information in understanding how spinal cord integrity may be a factor in the intrinsic covariance of spontaneous low-frequency fluctuations of BOLD signals involved in cortical plasticity.
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Key -vertebral Screws Strategy for Main Thoracic Curve Correction in Patients with Adolescent Idiopathic Scoliosis.
J Spinal Disord Tech
PUBLISHED: 07-31-2014
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The following study was a prospective radiographic and retrospective clinical data assessment of adolescent idiopathic scoliosis (AIS) patients who underwent a key-vertebral screws strategy (KVSS) at a single institution with a minimum of two years follow-up.
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Intervertebral disc regeneration: do nutrients lead the way?
Nat Rev Rheumatol
PUBLISHED: 06-10-2014
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Strategies for the biological repair of intervertebral discs derive from the premise that disc degeneration results from impaired cellular activity and, therefore, that these structures can be induced to regenerate by implanting active cells or providing factors that restore normal cellular activity. In vitro and animal studies using this approach have had some success, but whether this success can be reproduced in degenerate human lumbar discs is unknown. Successful repair requires that the disc cells remain viable and active; they therefore need an adequate supply of nutrients. However, as the disc degenerates, the nutrient supply decreases, thereby limiting cell activity and viability. Current biologic approaches might place additional demands on an already precarious nutrient supply. Here, we discuss whether the loss of nutrients associated with disc degeneration limits the effectiveness of biologic approaches, and indicate that this neglected problem requires investigation if clinical application of such therapies is to succeed.
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Bioengineering a Multicomponent Spinal Motion Segment Construct-A 3D Model for Complex Tissue Engineering.
Adv Healthc Mater
PUBLISHED: 04-10-2014
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Intervertebral disc degeneration is an important clinical problem but existing treatments have significant drawbacks. The ability to bioengineer the entire spinal motion segment (SMS) offers hope for better motion preservation strategies but is extremely challenging. Here, fabrication of a multicomponent SMS construct with complex hierarchical organization from mesenchymal stem cells and collagen-based biomaterials, using a module-based integrative approach, is reported. The construct consists of two osteochondral subunits, a nucleus pulposus (NP-)-like core and a multi-lamellae annulus fibrosus (AF-)-like component. Chondrogenic medium is crucial for stabilizing the osteochondral subunits, which are shown to allow passive nutrient diffusion, while cyclic compression is necessary for better fiber matrix organization. Cells adhere, survive, and interact with the NP-like core. Cyclic torsional loading stimulates cell alignment in the AF-like lamellae and the number of lamellae affects the mechanical properties of the construct. This work represents an important milestone in SMS tissue engineering and provides a 3D model for studying tissue maturation and functional remodeling.
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A meta-analysis identifies adolescent idiopathic scoliosis association with LBX1 locus in multiple ethnic groups.
J. Med. Genet.
PUBLISHED: 04-10-2014
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Adolescent idiopathic scoliosis (AIS) is a common rotational deformity of the spine that presents in children worldwide, yet its etiology is poorly understood. Recent genome-wide association studies (GWAS) have identified a few candidate risk loci. One locus near the chromosome 10q24.31 LBX1 gene (OMIM #604255) was originally identified by a GWAS of Japanese subjects and replicated in additional Asian populations. To extend this result, and to create larger AIS cohorts for the purpose of large-scale meta-analyses in multiple ethnicities, we formed a collaborative group called the International Consortium for Scoliosis Genetics (ICSG).
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Prediction of myelopathic level in cervical spondylotic myelopathy using diffusion tensor imaging.
J Magn Reson Imaging
PUBLISHED: 03-21-2014
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To investigate the use of a newly designed machine learning-based classifier in the automatic identification of myelopathic levels in cervical spondylotic myelopathy (CSM).
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Mesenchymal stem cells reduce intervertebral disc fibrosis and facilitate repair.
Stem Cells
PUBLISHED: 03-01-2014
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Intervertebral disc degeneration is associated with back pain and radiculopathy which, being a leading cause of disability, seriously affects the quality of life and presents a hefty burden to society. There is no effective intervention for the disease and the etiology remains unclear. Here, we show that disc degeneration exhibits features of fibrosis in humans and confirmed this in a puncture-induced disc degeneration (PDD) model in rabbit. Implantation of bone marrow-derived mesenchymal stem cells (MSCs) to PDD discs can inhibit fibrosis in the nucleus pulposus with effective preservation of mechanical properties and overall spinal function. We showed that the presence of MSCs can suppress abnormal deposition of collagen I in the nucleus pulposus, modulating profibrotic mediators MMP12 and HSP47, thus reducing collagen aggregation and maintaining proper fibrillar properties and function. As collagen fibrils can regulate progenitor cell activities, our finding provides new insight to the limited self-repair capability of the intervertebral disc and importantly the mechanism by which MSCs may potentiate tissue regeneration through regulating collagen fibrillogenesis in the context of fibrotic diseases.
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Time-varying surface electromyography topography as a prognostic tool for chronic low back pain rehabilitation.
Spine J
PUBLISHED: 02-12-2014
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Nonsurgical rehabilitation therapy is a commonly used strategy to treat chronic low back pain (LBP). The selection of the most appropriate therapeutic options is still a big challenge in clinical practices. Surface electromyography (sEMG) topography has been proposed to be an objective assessment of LBP rehabilitation. The quantitative analysis of dynamic sEMG would provide an objective tool of prognosis for LBP rehabilitation.
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A correlation study between in-brace correction, compliance to spinal orthosis and health-related quality of life of patients with Adolescent Idiopathic Scoliosis.
Scoliosis
PUBLISHED: 01-28-2014
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It has been proposed that in-brace correction is the best guideline for prediction of the results of brace treatment for patients with Adolescent Idiopathic Scoliosis (AIS). However, bracing may be a stressful experience for patients and bracing non-compliance could be psychologically related. The purpose of this study was to assess the correlation between brace compliance, in-brace correction and QoL of patients with AIS.
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Reducing radiation exposure in early-onset scoliosis surgery patients: novel use of ultrasonography to measure lengthening in magnetically-controlled growing rods.
Spine J
PUBLISHED: 01-17-2014
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Magnetically-controlled growing rod (MCGR) technology has been reported for the treatment of early-onset scoliosis (EOS). Such technology allows for regular and frequent outpatient rod distractions without the need for additional surgery. However, pre- and postdistraction spine radiographs are required to verify the amount of lengthening. This increased exposure to ionizing radiation in developing children significantly increases their risk profile for radiation-induced cancer and noncancerous morbidity.
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Surgical technique for lumbar intervertebral disc transplantation in a goat model.
Eur Spine J
PUBLISHED: 01-07-2014
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Fresh-frozen intervertebral disc transplantation was determined to be an effective treatment for degenerative disc diseases in rhesus monkeys and in humans. Further research in improving different aspects of disc allografts transplantation is needed and will be investigated in large animal models. This study reports the detailed surgical technique of intervertebral disc transplantation without internal fixation and the important notes to ensure success in goats.
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Is diffusion anisotropy a biomarker for disease severity and surgical prognosis of cervical spondylotic myelopathy?
Radiology
PUBLISHED: 10-28-2013
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Purpose To explore the value of diffusion-tensor (DT) imaging in addressing the severity of cervical spondylotic myelopathy (CSM) and predicting the outcome of surgical treatment. Materials and Methods From July 2009 to May 2012, 65 volunteers were recruited for this institutional review board-approved study, and all gave informed consent; 20 volunteers were healthy subjects (age range, 41-62 years), and 45 were patients with CSM (age range, 43-86 years). Anatomic and DT 3.0-T magnetic resonance images were obtained. Surgical decompression was performed in 22 patients with CSM, and patients were followed up for 6 months to 2 years. The clinical severity of myelopathy and postoperative recovery were assessed by using the modified Japanese Orthopaedic Association (mJOA) score. A recovery ratio (comparison of postoperative with preoperative mJOA score) of more than 50% indicated a good clinical outcome of surgery. DT findings, patient age, T2 high signal intensity (HSI), and somatosensory evoked potential (SEP) were analyzed by using a logistic regression model to predict the surgical outcome of patients with CSM. Results A significant difference in cervical cord mean fractional anisotropy (FA) was found between healthy subjects and patients with CSM (0.65 ± 0.05 [standard deviation] vs 0.52 ± 0.13, P < .001). FA values were significantly correlated with the severity of neurologic dysfunction indicated by mJOA score (r(2) = 0.327, P = .016). Logistic regression analysis showed that mean FA (P = .030) and FA at the C2 vertebra (P = .035) enabled prediction of good surgical outcome; however, preoperative mJOA (P = .927), T2 HSI (P = .176), SEP amplitude (P = .154), and latency (P = .260) did not. Conclusion FA is a biomarker for the severity of myelopathy and for subsequent surgical outcome. © RSNA, 2013 Online supplemental material is available for this article.
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In vivo stimulation of bone formation by aluminum and oxygen plasma surface-modified magnesium implants.
Biomaterials
PUBLISHED: 07-28-2013
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A newly developed magnesium implant is used to stimulate bone formation in vivo. The magnesium implant after undergoing dual aluminum and oxygen plasma implantation is able to suppress rapid corrosion, leaching of magnesium ions, as well as hydrogen gas release from the biodegradable alloy in simulated body fluid (SBF). No released aluminum is detected from the SBF extract and enhanced corrosion resistance properties are confirmed by electrochemical tests. In vitro studies reveal enhanced growth of GFP mouse osteoblasts on the aluminum oxide coated sample, but not on the untreated sample. In addition to that a small amount (50 ppm) of magnesium ions can enhance osteogenic differentiation as reported previously, our present data show a low concentration of hydrogen can give rise to the same effect. To compare the bone volume change between the plasma-treated magnesium implant and untreated control, micro-computed tomography is performed and the plasma-treated implant is found to induce significant new bone formation adjacent to the implant from day 1 until the end of the animal study. On the contrary, bone loss is observed during the first week post-operation from the untreated magnesium sample. Owing to the protection offered by the Al2O3 layer, the plasma-treated implant degrades more slowly and the small amount of released magnesium ions stimulate new bone formation locally as revealed by histological analyses. Scanning electron microscopy discloses that the Al2O3 layer at the bone-implant interface is still present two months after implantation. In addition, no inflammation or tissue necrosis is observed from both treated and untreated implants. These promising results suggest that the plasma-treated magnesium implant can stimulate bone formation in vivo in a minimal invasive way and without causing post-operative complications.
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Diffusion tensor imaging of somatosensory tract in cervical spondylotic myelopathy and its link with electrophysiological evaluation.
Spine J
PUBLISHED: 07-24-2013
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Abnormal somatosensory evoked potential (SEP) (ie, prolonged latency) has been associated with poor surgical prognosis of cervical spondylotic myelopathy (CSM).
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Prognosis of spontaneous thoracic curve correction after the selective anterior fusion of thoracolumbar/lumbar (Lenke 5C) curves in idiopathic scoliosis.
Spine J
PUBLISHED: 04-01-2013
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Prognosis of minor lumbar curve correction after selective thoracic fusion in idiopathic scoliosis is well defined. However, the prognosis of minor thoracic curve after isolated anterior fusion of the major lumbar curve has not been well described.
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Low-modulus Mg/PCL hybrid bone substitute for osteoporotic fracture fixation.
Biomaterials
PUBLISHED: 03-31-2013
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In this paper, we describe a new biodegradable composite composed of polycaprolactone and magnesium. Incorporation of magnesium micro-particles into the polycaprolactone matrix yields mechanical properties close to those of human cancellous bone, and in vitro studies indicate that the silane-coated Mg/PCL composites have excellent cytocompatibility and osteoblastic differentiation properties. The bioactivity of the composites is manifested by the formation of calcium and phosphate after immersion in simulated body fluids. The bulk mechanical properties can be maintained for 2 months before obvious degradation takes place. The in vivo animal study reveals a larger amount of new bone formation on the silane-coated Mg/PCL composites compared to conventional PMMA and pure polycaprolactone and our results suggest potential clinical applications of the sliane-coated Mg/PCL composites.
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Quantitative analysis of fiber tractography in cervical spondylotic myelopathy.
Spine J
PUBLISHED: 02-25-2013
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Diffusion tensor fiber tractography is an emerging tool for the visualization of spinal cord microstructure. However, there are few quantitative analyses of the damage in the nerve fiber tracts of the myelopathic spinal cord.
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Lumbar disc degeneration is linked to a carbohydrate sulfotransferase 3 variant.
J. Clin. Invest.
PUBLISHED: 02-13-2013
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Lumbar disc degeneration (LDD) is associated with both genetic and environmental factors and affects many people worldwide. A hallmark of LDD is loss of proteoglycan and water content in the nucleus pulposus of intervertebral discs. While some genetic determinants have been reported, the etiology of LDD is largely unknown. Here we report the findings from linkage and association studies on a total of 32,642 subjects consisting of 4,043 LDD cases and 28,599 control subjects. We identified carbohydrate sulfotransferase 3 (CHST3), an enzyme that catalyzes proteoglycan sulfation, as a susceptibility gene for LDD. The strongest genome-wide linkage peak encompassed CHST3 from a Southern Chinese family-based data set, while a genome-wide association was observed at rs4148941 in the gene in a meta-analysis using multiethnic population cohorts. rs4148941 lies within a potential microRNA-513a-5p (miR-513a-5p) binding site. Interaction between miR-513a-5p and mRNA transcribed from the susceptibility allele (A allele) of rs4148941 was enhanced in vitro compared with transcripts from other alleles. Additionally, expression of CHST3 mRNA was significantly reduced in the intervertebral disc cells of human subjects carrying the A allele of rs4148941. Together, our data provide new insights into the etiology of LDD, implicating an interplay between genetic risk factors and miRNA.
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Assessment of skeletal maturity in scoliosis patients to determine clinical management: a new classification scheme using distal radius and ulna radiographs.
Spine J
PUBLISHED: 02-02-2013
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Assessment of skeletal maturity in patients with adolescent idiopathic scoliosis (AIS) is important to guide clinical management. Understanding growth peak and cessation is crucial to determine clinical observational intervals, timing to initiate or end bracing therapy, and when to instrument and fuse. The commonly used clinical or radiological methods to assess skeletal maturity are still deficient in predicting the growth peak and cessation among adolescents, and bone age is too complicated to apply.
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Is the speed of chronic compression an important factor for chronic spinal cord injury rat model?
Neurosci. Lett.
PUBLISHED: 01-29-2013
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To evaluate the effect of expansion speed on chronic compressive spinal cord injury in the rat.
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The effects of microenvironment in mesenchymal stem cell-based regeneration of intervertebral disc.
Spine J
PUBLISHED: 01-20-2013
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Recent studies have demonstrated new therapeutic strategy using transplantation of mesenchymal stem cells (MSCs), especially bone marrow-derived MSCs (BM-MSCs), to preserve intervertebral disc (IVD) structure and functions. It is important to understand whether and how the MSCs survive and thrive in the hostile microenvironment of the degenerated IVD. Therefore, this review majorly examines how resident disc cells, hypoxia, low nutrition, acidic pH, mechanical loading, endogenous proteinases, and cytokines regulate the behavior of the exogenous MSCs.
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The proximal thoracic curve in adolescent idiopathic scoliosis: surgical strategy and management outcomes.
Global Spine J
PUBLISHED: 10-04-2011
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There is no consensus on the definition of a structural proximal thoracic curve (PTC) and the indications for fusion. As such, we assessed a single institutes experience in the management of large PTCs (>35 degrees) in patients with adolescent idiopathic scoliosis (AIS) who were either fused or not fused. A retrospective radiographic analyses of 30 consecutive AIS patients with double thoracic curves who underwent PSF with a minimum of 2 years follow-up were included for review. The patients were divided into two groups: group 1 (n?=?15 patients) with fusion extended up to T2 or T3 and group 2 (n?=?15) with fusion limited to T5 or below. Shoulder balance was assessed according to clavicular angle, first-rib difference, and radiographic shoulder height difference (SHD). PTCs were defined based on a Cobb angle of >35, the presence of apical rotation, and a positive T1 tilt. The decision to fuse the PTC was based on curve magnitude only, with those between 35 and 45 degrees undergoing a selective fusion of the main thoracic curve (MTC), with both curves fused if the PTC was more than 45 degrees. In group 1, there were eight females and seven males. Their ages ranged between 12 and 33 years, with a mean of 16.2 ± 5.5 years. Postoperatively, the mean PTC correction was 45.6%, which statistically differed from preoperative status (p?=?0.001). No statistical difference was noted in T1 tilt and the first-rib difference from preoperative to postoperative follow-up (p?>?0.05). However, the clavicular angle and SHD were increased significantly at the immediate postoperative interval (p??0.05). Group 2 consisted of one male and 14 females. The mean age was 16.4 ± 4 years (range: 11 to 28 years). The mean spontaneous PTC correction was 28.3% and remained essentially unchanged at the end of the follow-up. The improvement in the curve from preoperative status was highly statistically significant (p?=?0.001). All radiographic shoulder parameters exhibited a significant increase in the immediate postoperative period and at last follow-up, and shoulder balance improvement was not noted on follow-up. Although both groups were not statistically similar with regards to the preoperative PTC, AVR, apical vertebral translation, and shoulder parameters, no significant difference could be found in PTC or shoulder parameters between both groups at last follow-up (p?>?0.05). Our study illustrates important observations that should be considered in defining the PTC for fusion consideration. Spontaneous correction of the PTC occurs in structural curves greater than 35 degrees and less than 45 degrees, and this correction is maintained over time. Despite that correction, radiographic shoulder parameters are expected to slightly increase. Nonfusion strategy may be appropriate for PTCs between 35 and 45 degrees. After fusion of both the MTC and the PTC, the radiographic shoulder parameters did not significantly differ. Preoperative radiographic shoulder parameters are not predictive of postoperative shoulder imbalance.
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Time-frequency analysis of somatosensory evoked potentials for intraoperative spinal cord monitoring.
J Clin Neurophysiol
PUBLISHED: 09-28-2011
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To evaluate the potential use of time-frequency analysis and its reliability in intraoperative somatosensory evoked potential (SEP) monitoring.
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Management of degenerative disk disease and chronic low back pain.
Orthop. Clin. North Am.
PUBLISHED: 09-28-2011
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Degenerative disk disease is a strong etiologic risk factor of chronic low back pain (LBP). A multidisciplinary approach to treatment is often warranted. Patient education, medication, and cognitive behavioral therapies are essential in the treatment of chronic LBP sufferers. Surgical intervention with a rehabilitation regime is sometimes advocated. Prognostic factors related to the outcome of different treatments include maladaptive pain coping and genetics. The identification of pain genes may assist in determining individuals susceptible to pain and in patient selection for appropriate therapy. Biologic therapies show promise, but clinical trials are needed before advocating their use in humans.
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Pyogenic spondylitis.
Int Orthop
PUBLISHED: 09-05-2011
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Pyogenic spondylitis is a neurological and life threatening condition. It encompasses a broad range of clinical entities, including pyogenic spondylodiscitis, septic discitis, vertebral osteomyelitis, and epidural abscess. The incidence though low appears to be on the rise. The diagnosis is based on clinical, radiological, blood and tissue cultures and histopathological findings. Most of the cases can be treated non-operatively. Surgical treatment is required in 10-20% of patients. Anterior decompression, debridement and fusion are generally recommended and instrumentation is acceptable after good surgical debridement with postoperative antibiotic cover.
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Reducing perioperative blood loss and allogeneic blood transfusion in patients undergoing major spine surgery.
J Bone Joint Surg Am
PUBLISHED: 07-22-2011
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At present, individual techniques, including intraoperative acute normovolemic hemodilution, use of tranexamic acid, use of intrathecal morphine, proper positioning, and modification of operative techniques, seem most promising for reducing perioperative blood loss and allogeneic blood transfusion in patients undergoing major spine surgery. Other techniques including preoperative autologous predonation; mandatory discontinuation of use of antiplatelet agents; intraoperative and postoperative red-blood-cell salvage; use of aprotinin, epsilon-aminocaproic acid, recombinant factor VIIa, or desmopressin; induced hypotension; avoidance of hypothermia; and minimally invasive operative techniques require additional studies to either establish their effectiveness or address safety considerations.
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Osteoprotegerin deficiency attenuates strontium-mediated inhibition of osteoclastogenesis and bone resorption.
J. Bone Miner. Res.
PUBLISHED: 05-26-2011
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Strontium (Sr) exerts an anabolic and antiresorptive effect on bone, but the mechanism remains unknown. Osteoprotegerin (OPG) expressed by osteoblasts plays an important role in regulating bone homeostasis by inhibiting osteoclastogenesis and bone resorption. This study aims at evaluating the role of OPG in Sr-mediated inhibition of osteoclastogenesis and bone resorption. Six-week-old Opg knockout (KO) male mice and their wild-type (WT) littermates were treated orally with vehicle (Veh) or Sr compound (4 mmol/kg) daily for 8 weeks. Bone mass and microstructure in the lumbar spine (L(4)) and proximal tibia were analyzed with micro-computed tomography (µCT). Bone remodeling was evaluated with serum biochemical analysis and static and dynamic bone histomorphometry. Osteoclast differentiation potential and gene expression were analyzed in bone marrow cells. The findings demonstrate that Sr compound treatment results in greater bone volume and trabecular number than Veh treatment in WT mice. The anabolic response of trabecular bone to Sr treatment is attenuated in KO mice. Although Sr treatment significantly decreases in vitro osteoclastogenesis and bone resorption in WT mice, these effects are attenuated in KO mice. Furthermore, Sr treatment profoundly increases Opg gene expression in the tibias and OPG protein levels in the sera of WT mice. This study concludes that the inhibition of osteoclastogenesis and bone resorption is possibly associated with OPG upregulation by Sr treatment.
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"Spring-back" closure associated with open-door cervical laminoplasty.
Spine J
PUBLISHED: 05-23-2011
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Spring-back complication after open-door laminoplasty as described by Hirabayashi is a well-known risk, but its definition, incidence, and associated neurologic outcome remain unclear.
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A population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished functional status.
J Bone Joint Surg Am
PUBLISHED: 04-08-2011
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Little is known regarding juvenile disc degeneration in individuals with normal spinal alignment. Consequently, the purpose of this study was to assess the prevalence, determinants, and clinical relevance associated with juvenile disc degeneration of the lumbar spine in individuals without spinal deformities.
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Comparison of blind source separation methods in fast somatosensory-evoked potential detection.
J Clin Neurophysiol
PUBLISHED: 03-15-2011
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Blind source separation (BSS) is a promising method for extracting somatosensory-evoked potential (SEP). Although various BSS algorithms are available for SEP extraction, few studies have addressed the performance differences between them. In this study, we compared the performance of a number of typical BSS algorithms on SEP extraction from both computer simulations and clinical experiment. The algorithms we compared included second-order blind identification, estimation of signal parameters via rotation invariance technique, algorithm for multiple unknown signals extraction, joint approximate diagonalization of eigenmatrices, extended infomax, and fast independent component analysis. The performances of these BSS algorithms were determined by the correlation coefficients between the true and the extracted SEP signals. There were significant differences in the performances of the various BSS algorithms in a simulation study. In summary, second-order blind identification using six covariance matrix denoting SOBI6 was recommended as the most appropriate BSS method for fast SEP extraction from noisy backgrounds.
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Natural history of spinal deformity in a patient with Ehlers-Danlos syndrome: case report with 20-year follow-up.
Spine J
PUBLISHED: 02-24-2011
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Scoliosis can present in patients with Ehlers-Danlos syndrome (EDS) and can be surgically treated despite possible complications. The long-term natural history of the progression of spinal deformity, particularly scoliosis, and associated complications in EDS patients remains relatively unknown.
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Somatosensory-evoked potentials as an indicator for the extent of ultrastructural damage of the spinal cord after chronic compressive injuries in a rat model.
Clin Neurophysiol
PUBLISHED: 02-16-2011
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Somatosensory-evoked potentials (SEPs) were found to correlate well with the disability and postoperative recovery in patients with cervical spondylotic myelopathy. Yet the exact pathophysiology behind it remains to be elucidated. This study aims to characterise the ultrastructural changes of a chronically compressive spinal cord with various SEP responses in a rat model.
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The efficacy and complications of posterior hemivertebra resection.
Eur Spine J
PUBLISHED: 01-28-2011
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There have been several reports on hemivertebra resection via a posterior-only procedure. However, the number of reported cases is small, and various types of instrumentation have been used. In our study, we retrospectively investigated 56 consecutive cases of congenital scoliosis that were treated by posterior hemivertebra resection with transpedicular instrumentation. Radiographs were reviewed to determine the type and location of the hemivertebra, the coronal curve magnitude and the sagittal alignment pre-operatively, post-operatively and at the latest follow-up. Radiographs were also used to assess implant failure and inter-body fusion. Surgical reports and patient charts were reviewed to record any peri-operative complications. Fifty-eight posterior hemivertebrae resections from 56 patients aged 1.5-17 years with fully segmented non-incarcerated hemivertebra were evaluated. The average age at surgery was 9.9 years (1.5-17 years). The average follow-up was 32.9 months (24-58 months). The mean fusion level was 5.0 segments (2-11 segments). There was a mean improvement of 72.9% in the segmental scoliosis, from 42.4° before surgery to 12.3° at the time of the latest follow-up, and there was a mean improvement of 70% in segmental kyphosis from 42.0° to 14.5° over the same time period. The thoracic kyphosis (T5-T12) averaged 10.8° before surgery and 23.9° at the latest follow-up. The lumbar lordosis (L1-S1) averaged -52.8° before surgery and -51.6° at the latest follow-up. Two cases with neurological claudications had complete recovery immediately after the surgery. There was one case of delayed wound healing, two fractures of the pedicle at the instrumented level, two rod breakages and one proximal junction kyphosis that required revision. There were no neurological complications. Radiolucent gaps were found in the residual space after resection on the lateral view in five cases, without any sign of implant failure or correction loss. Our results show that one-stage posterior hemivertebra resection with transpedicular instrumentation can achieve excellent correction, 360° decompression and short fusion without neurological complications. Pedicle cutting still remains a challenge in younger children when using bisegmental instrumentation. In addition, the radiolucent gaps in the residual space require further investigation.
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Orientation entropy analysis of diffusion tensor in healthy and myelopathic spinal cord.
Neuroimage
PUBLISHED: 01-16-2011
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The majority of nerve fibers in the spinal cord run longitudinally, playing an important role in connecting the brain to the peripheral nerves. There is a growing interest in applying diffusion tensor imaging (DTI) to the evaluation of spinal cord microarchitecture. The current study sought to compare the organization of longitudinal nerve fibers between healthy and myelopathic spinal cords using entropy-based analysis of principal eigenvector mapping. A total of 22 subjects were recruited, including 14 healthy subjects, seven cervical myelopathy (CM) patients with single-level compression, and one patient suffering from multi-level compression. Diffusion tensor magnetic resonance (MR) images of the cervical spinal cord were obtained using a pulsed gradient, spin-echo echo-planar imaging (SE-EPI) sequence with a 3T MR system. Regions of interest (ROIs) were drawn manually to cover the spinal cord, and Shannon entropy was calculated in principal eigenvector maps. The results revealed no significant differences in orientation entropy values along the whole length of cervical spinal cord in healthy subjects (C2-3: 0.73±0.05; C3-4: 0.71±0.07; C4-5: 0.72±0.048; C5-6: 0.71±0.07; C6-7: 0.72±0.07). In contrast, orientation entropy values in myelopathic cord were significantly higher at the compression site (0.91±0.03), and the adjacent levels (above: 0.85±0.03; below: 0.83±0.05). This study provides a novel approach to analyze the orientation information in diffusion MR images of healthy and diseased spinal cord. These results indicate that orientation entropy can be applied to determine the contribution of each compression level to the overall disorganization of principal nerve tracts of myelopathic spinal cord in cases with multi-level compression.
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A multidisciplinary rehabilitation programme for patients with chronic low back pain: a prospective study.
J Orthop Surg (Hong Kong)
PUBLISHED: 09-03-2010
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To examine the effectiveness of a multidisciplinary rehabilitation programme for patients with chronic low back pain in Hong Kong, and to identify factors associated with work resumption.
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In vitro generation of an osteochondral interface from mesenchymal stem cell-collagen microspheres.
Biomaterials
PUBLISHED: 08-19-2010
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Creating biological interfaces between mechanically dissimilar tissues is a key challenge in complex tissue engineering. An osteochondral interface is essential in preventing mechanical failure and maintaining normal function of cartilage. Despite tremendous efforts in developing osteochondral plugs, formation of the osteochondral interface with proper zonal organization has not yet been reported. Here, we present a mesenchymal stem cell-collagen microsphere-based approach for complex tissue engineering and demonstrate in vitro formation of a stem cell-derived osteochondral interface with calcified cartilage interface separating a non-calcified cartilage layer and an underlying bone layer. Cells at the interface region are hypertrophic chondrocytes while the extracellular matrix in this region contains collagen type II and X, calcium deposits and vertically running fibers. The simultaneous presence of appropriate medium and configuration during co-culture is necessary for the interface formation.
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The "X-Factor" index: a new parameter for the assessment of adolescent idiopathic scoliosis correction.
Eur Spine J
PUBLISHED: 07-17-2010
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The correction rate (CR) and fulcrum bending correction index (FBCI) based on the fulcrum bending radiograph (FBR) were parameters introduced to measure the curve correcting ability; however, such parameters do not account for contributions by various, potential extraneous "X-Factors" (e.g. surgical technique, type and power of the instrumentation, anesthetic technique, etc.) involved in curve correction. As such, the purpose of the following study was to propose the concept of the "X-Factor Index" (XFI) as a new parameter for the assessment of the correcting ability of adolescent idiopathic scoliosis (AIS). A historical cohort radiographic analysis of the FBR in the setting of hook systems in AIS patients (Luk et al. in Spine 23:2303-2307, 1998) was performed to illustrate the concept of XFI. Thirty-five patients with AIS of the thoracic spine undergoing surgical correction were involved in the analysis. Plain posteroanterior (PA) plain radiographs were utilized and Cobb angles were obtained for each patient. Pre- and postoperative PA angles on standing radiograph and preoperative fulcrum bending angles were obtained for each patient. The fulcrum flexibility, curve CR, and FBCI were determined for all patients. The difference between the preoperative fulcrum bending angle and postoperative PA angle was defined as Angle(XF), which accounted for the correction contributed by "X-Factors". The XFI, designed to measure the curve correcting ability, was calculated by dividing Angle(XF) by the fulcrum flexibility. The XFI was compared with the curve CR and FBCI by re-evaluating the original data in the original paper (Luk et al. in Spine 23:2303-2307, 1998). The mean standing PA and FBR alignments of the main thoracic curve were 58.3° and 24.5°, respectively. The mean fulcrum flexibility was 58.8%. The mean postoperative standing PA alignment was 24.7°. The mean curve CR was 58.0% and the mean FBCI was 101.1%. The mean XFI was noted as 1.03%. The CR was significantly positively correlated to curve flexibility (r = 0.66; p < 0.01).The FBCI (r = -0.47; p = 0.005) and the XFI (r = -0.45; p = 0.007) were significantly negatively correlated to curve flexibility. The CR was not correlated to Angle(XF) (r = 0.29; p = 0.089).The FBCI (r = 0.97; p < 0.01) and the XFI (r = 0.961; p < 0.01) were significantly positively correlated to Angle(XF). Variation in XFI was noted in some cases originally presenting with same FBCI values. The XFI attempts to quantify the curve correcting ability as contributed by "X-Factors" in the treatment of thoracic AIS. This index may be a valued added parameter to accompany the FBCI for comparing curve correction ability among different series of patients, instrumentation, and surgeons. It is recommended that the XFI should be used to document curve correction, compare between different techniques, and used to improve curve correction for the patient.
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Experts comment concerning Grand Rounds case entitled "Closing-opening wedge osteotomy for severe, rigid thoraco-lumbar post-tubercular kyphosis" (by S. Rajasekaran, P. Rishimugesh Kanna and Ajoy Prasad Shetty).
Eur Spine J
PUBLISHED: 07-13-2010
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Prevention or correction of severe kyphotic deformity in addition to eradication of the infective focus has become the modern standard of management of tuberculosis of the spine. Circumferential excision of the kyphus is now technically feasible with the development of rigid pedicle screw fixation system and intraoperative spinal cord monitoring in the past two decades.
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Fear of movement/(re)injury in Chinese patients with chronic pain: Factorial validity of the Chinese version of the Tampa Scale for Kinesiophobia.
J Rehabil Med
PUBLISHED: 07-07-2010
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To assess the factor structure of the Chinese version of the Tampa Scale for Kinesiophobia (TSK).
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Minimizing cryopreservation-induced loss of disc cell activity for storage of whole intervertebral discs.
Eur Cell Mater
PUBLISHED: 06-10-2010
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Severe intervertebral disc (IVD) degeneration often requires disc excision and spinal fusion, which leads to loss of spinal segment mobility. Implantation of an allograft disc or tissue engineered disc construct emerges as an alternative to artificial disc replacement for preserving the motion of the degenerated level. Establishment of a bank of cadaveric or engineered cryopreserved discs enables size matching, and facilitates clinical management. However, there is a lack of understanding of the behaviour of disc cells during cryopreservation, as well as how to maximize their survival, such that disc graft properties can be preserved. Here, we report on the effect of alterations in cooling rates, cryoprotective agents (CPAs), and duration of pre-cryopreservation incubation in CPA on cellular activity in whole porcine lumbar discs. Our results indicated that cooling rates of -0.3 degrees C/min and -0.5 degrees C/min resulted in the least loss of metabolic activity in nucleus pulposus (NP) and annulus fibrosus (AF) respectively, while metabolic activity is best maintained by using a combination of 10% dimethylsulphoxide (DMSO) and 10% propylene-glycol (PG) as CPA. By the use of such parameters, metabolic activity of the NP and the AF cells could be maintained at 70% and 45%, respectively, of that of the fresh tissue. Mechanical testing and histological evaluation showed no significant differences in mechanical properties or alterations in disc structure compared to fresh discs. Despite the limitations of the animal model, our findings provide a framework for establishing an applicable cryopreservation protocol for human disc allografts or tissue-engineered disc constructs.
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Intervertebral disc degeneration: new insights based on "skipped" level disc pathology.
Arthritis Rheum.
PUBLISHED: 05-28-2010
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Typically, age and abnormal physical loading ("wear and tear") have been associated with the development of intervertebral disc degeneration. In the past decade, various additional etiologic factors for disc degeneration have been sporadically reported in the literature; however, many investigators continue to place tremendous emphasis on the effects of age and biomechanics associated with disc degeneration. The aim of this study was to provide additional insight into the notion that age and biomechanics are key factors in the development of disc degeneration. To this end, we addressed the prevalence of and risk factors associated with a unique pattern of disc degeneration of the lumbar spine, "skipped" level (nonconsecutive) disc degeneration (SLDD).
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An automated ECG-artifact removal method for trunk muscle surface EMG recordings.
Med Eng Phys
PUBLISHED: 05-19-2010
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This study aimed at developing a method for automated electrocardiography (ECG) artifact detection and removal from trunk electromyography signals. Independent Component Analysis (ICA) method was applied to the simulated data set of ECG-corrupted surface electromyography (SEMG) signals. Independent Components (ICs) correspond to ECG artifact were then identified by an automated detection algorithm and subsequently removed. The detection performance of the algorithm was compared to that by visual inspection, while the artifact elimination performance was compared with Butterworth high pass filter at 30 Hz cutoff (BW HPF 30). The automated ECG-artifact detection algorithm successfully recognized the ECG source components in all data sets with a sensitivity of 100% and specificity of 99%. Better performance indicated by a significantly higher correlation coefficient (p<0.001) with the original EMG recordings was found in the SEMG data cleaned by the ICA-based method, than that by BW HPF 30. The automated ECG-artifact removal method for trunk SEMG recordings proposed in this study was demonstrated to produce a very good detection rate and preserved essential EMG components while keeping its distortion to minimum. The automatic nature of our method has solved the problem of visual inspection by standard ICA methods and brings great clinical benefits.
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A meta-analysis of the clinical effectiveness of school scoliosis screening.
Spine
PUBLISHED: 04-16-2010
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A meta-analysis that systematically reviewed the evaluation studies of a scoliosis screening program reported in the literature.
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Entropy-based analysis for diffusion anisotropy mapping of healthy and myelopathic spinal cord.
Neuroimage
PUBLISHED: 03-23-2010
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The present study utilized diffusion MR imaging and fractional anisotropy (FA) mapping to delineate the microstructure of spinal cord. The concept of Shannon entropy was introduced to analyze the complex microstructure of healthy and injured spinal cords based on FA map. A total of 30 volunteers were recruited in this study with informed consent, including 13 healthy adult subjects (group A, 25±3 years), 12 healthy elderly subjects (group B, 53±7 years) and 5 cervical spondylotic myelopathy (CSM) patients (group C, 53±15 years). Diffusion MRI images of cervical spinal cord were taken using pulsed gradient spin-echo-echo-planar imaging (SE-EPI) sequence with a 3T MR system. The region of interest was defined to cover the spinal cord in FA maps. The Shannon entropy of FA values of voxels in the cord was calculated as well as the average FA values. The significant differences were determined among three groups using one-way ANOVA and post-hoc test. As compared with adult and elderly healthy subjects, the entropy of whole spinal cord was significantly lower in CSM patients (group A: 6.07±0.18; B: 6.01±0.23; C: 5.32±0.44; p<0.05). Whereas there were no significant difference in FA values among groups (group A: 0.62±0.08; B: 0.64±0.09; C: 0.64±0.12). In CSM patients, there was a loss of architectural structural complexity in the cervical spinal cord tissue as noted by the lower Shannon entropy value. It indicated the potential application of entropy-based analysis for the diagnosis of the severity of chronic compressive spinal cord injuries, i.e. CSM.
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Identification of detailed time-frequency components in somatosensory evoked potentials.
IEEE Trans Neural Syst Rehabil Eng
PUBLISHED: 03-08-2010
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Somatosensory evoked potential (SEP) usually contains a set of detailed temporal components measured and identified in time domain, providing meaningful information on physiological mechanisms of the nervous system. The purpose of this study is to reveal complex and fine time-frequency features of SEP in time-frequency domain using advanced time-frequency analysis (TFA) and pattern classification methods. A high-resolution TFA algorithm, matching pursuit (MP), was proposed to decompose a SEP signal into a string of elementary waves and to provide a time-frequency feature description of the waves. After a dimension reduction by principle component analysis (PCA), a density-guided K-means clustering was followed to identify typical waves existed in SEP. Experimental results on posterior tibial nerve SEP signals of 50 normal adults showed that a series of typical waves were discovered in SEP using the proposed MP decomposition and clustering methods. The statistical properties of these SEP waves were examined and their representative waveforms were synthesized. The identified SEP waves provided a comprehensive and detailed description of time-frequency features of SEP.
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In vivo anabolic effect of strontium on trabecular bone was associated with increased osteoblastogenesis of bone marrow stromal cells.
J. Orthop. Res.
PUBLISHED: 03-03-2010
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In vitro studies have demonstrated that strontium (Sr) could increase osteogenic differentiation of bone marrow stromal cells (BMSCs). We investigated the in vivo effect of Sr on BMSCs. Thirty-six female rats were randomly divided into the following groups: sham operated and treated with either vehicle (Sham + Veh) or Sr compound (Sham + Sr) and ovariectomized and treated with either vehicle (OVX + Veh) or Sr compound (OVX + Sr). Vehicle and Sr were orally administrated daily starting immediately after the surgery and continuing for 12 weeks. The anabolic effect of Sr on trabecular bone was determined at the structural and tissue level by microCT and histomorphometry, respectively. Colony formation assays demonstrated that BMSCs exhibited higher osteogenic colony but lower adipogenic colony in Sr-treated versus Veh-treated OVX rats. The mRNA level of osteogenic genes was higher, while the mRNA level of adipogenic genes was lower in BMSCs from Sr-treated versus Veh-treated Sham and OVX rats. The effect of Sr on rat BMSCs was reproducible in human BMSCs. Taken together, this study suggests that the anabolic effect of Sr on normal or osteoporotic bones is associated with increased osteoblastic differentiation of BMSCs.
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Infective spondylitis in southern chinese: a descriptive and comparative study of ninety-one cases.
Spine
PUBLISHED: 03-03-2010
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A retrospective review of infective spondylitis patients assessed at a major, tertiary referral centre in Hong Kong.
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Prediction of scoliosis correction with thoracic segmental pedicle screw constructs using fulcrum bending radiographs.
Spine
PUBLISHED: 02-02-2010
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A retrospective series of 35 idiopathic scoliosis patients underwent spinal fusion with a segmental thoracic pedicle screw system.
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Association of JAG1 with bone mineral density and osteoporotic fractures: a genome-wide association study and follow-up replication studies.
Am. J. Hum. Genet.
PUBLISHED: 01-21-2010
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Bone mineral density (BMD), a diagnostic parameter for osteoporosis and a clinical predictor of fracture, is a polygenic trait with high heritability. To identify genetic variants that influence BMD in different ethnic groups, we performed a genome-wide association study (GWAS) on 800 unrelated Southern Chinese women with extreme BMD and carried out follow-up replication studies in six independent study populations of European descent and Asian populations including 18,098 subjects. In the meta-analysis, rs2273061 of the Jagged1 (JAG1) gene was associated with high BMD (p = 5.27 x 10(-8) for lumbar spine [LS] and p = 4.15 x 10(-5) for femoral neck [FN], n = 18,898). This SNP was further found to be associated with the low risk of osteoporotic fracture (p = 0.009, OR = 0.7, 95% CI 0.57-0.93, n = 1881). Region-wide and haplotype analysis showed that the strongest association evidence was from the linkage disequilibrium block 5, which included rs2273061 of the JAG1 gene (p = 8.52 x 10(-9) for LS and 3.47 x 10(-5) at FN). To assess the function of identified variants, an electrophoretic mobility shift assay demonstrated the binding of c-Myc to the "G" but not "A" allele of rs2273061. A mRNA expression study in both human bone-derived cells and peripheral blood mononuclear cells confirmed association of the high BMD-related allele G of rs2273061 with higher JAG1 expression. Our results identify the JAG1 gene as a candidate for BMD regulation in different ethnic groups, and it is a potential key factor for fracture pathogenesis.
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Signal-to-noise ratio of intraoperative tibial nerve somatosensory-evoked potentials.
J Clin Neurophysiol
PUBLISHED: 01-21-2010
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To reveal the intrinsic signal-to-noise ratio (SNR) of single-trial somatosensory-evoked potentials (SEP). SEP was recorded from 13 scoliosis patients during surgery. The power of SEP was estimated with least-square fitting to obtain the most accurate value and then to estimate the SNR of every trial of SEP. The SNR of cortical SEP from 13 cases presented individual difference among each other. According to the mean and standard deviation, the coefficients of variation of cortical and subcortical SEP were 4.2% and 23%, respectively. The SNR of SEP was estimated to be -24 +/- 1 dB in cortical SEP and -22 +/- 5 dB in subcortical SEP. The lowest SNR of individual case was found to be -30 dB in cortical SEP and -53 dB in subcortical SEP. The results showed that SNR of intraoperative SEP recordings varies from person to person and presents a higher variability in subcortical than that in cortical, with a broad range from -53 to -5 dB. The results from this study can be used to understand the nature of SEP signals, which could guide researchers and designers on SEP denoising method selection, extraction, and measurement, as well as equipment development.
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Flexion-relaxation ratio in sitting: application in low back pain rehabilitation.
Spine
PUBLISHED: 01-15-2010
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A multiple-comparative study between normal and low back pain (LBP) patients before and after rehabilitation.
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Predictability of the fulcrum bending radiograph in scoliosis correction with alternate-level pedicle screw fixation.
J Bone Joint Surg Am
PUBLISHED: 01-06-2010
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The fulcrum bending radiograph accurately predicts scoliosis curve correction in patients with thoracic adolescent idiopathic scoliosis who are managed with hooks. We assessed the predictive value of the fulcrum bending radiograph in the context of alternate-level pedicle screw fixation of the scoliotic spine.
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A gait stability investigation into FES-assisted paraplegic walking based on the walker tipping index.
J Neural Eng
PUBLISHED: 11-17-2009
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The gait outcome measures used in clinical trials of paraplegic locomotor training determine the effectiveness of improved walking function assisted by the functional electrical stimulation (FES) system. Focused on kinematic, kinetic or physiological changes of paraplegic patients, traditional methods cannot quantify the walking stability or identify the unstable factors of gait in real time. Up until now, the published studies on dynamic gait stability for the effective use of FES have been limited. In this paper, the walker tipping index (WTI) was used to analyze and process gait stability in FES-assisted paraplegic walking. The main instrument was a specialized walker dynamometer system based on a multi-channel strain-gauge bridge network fixed on the frame of the walker. This system collected force information for the handle reaction vector between the patients upper extremities and the walker during the walking process; the information was then converted into walker tipping index data, which is an evaluation indicator of the patients walking stability. To demonstrate the potential usefulness of WTI in gait analysis, a preliminary clinical trial was conducted with seven paraplegic patients who were undergoing FES-assisted walking training and seven normal control subjects. The gait stability levels were quantified for these patients under different stimulation patterns and controls under normal walking with knee-immobilization through WTI analysis. The results showed that the walking stability in the FES-assisted paraplegic group was worse than that in the control subject group, with the primary concern being in the anterior-posterior plane. This new technique is practical for distinguishing useful gait information from the viewpoint of stability, and may be further applied in FES-assisted paraplegic walking rehabilitation.
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A biodegradable polymer-based coating to control the performance of magnesium alloy orthopaedic implants.
Biomaterials
PUBLISHED: 11-05-2009
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Magnesium and its alloys may potentially be applied as degradable metallic materials in orthopaedic implantations due to their degradability and resemblance to human cortical bone. However, the high corrosion rate and accumulation of hydrogen gas upon degradation hinders its clinical application. In this study, we adopt a new approach to control the corrosion rate by coating a controllable polymeric membrane fabricated by polycaprolactone and dichloromethane onto magnesium alloys, in which the pore size was controlled during the manufacturing process. The addition of the polymeric membrane was found to reduce the degradation rate of magnesium, and the bulk mechanical properties were shown to be maintained upon degradation. The in-vitro studies indicated good cytocompatibility of eGFP and SaOS-2 osteoblasts with the polymer-coated samples, which was not observed for the uncoated samples. The in-vivo study indicated that the uncoated sample degraded more rapidly than that of the polymer-coated samples. Although new bone formation was found on both samples, as determined by Micro-CT, higher volumes of new bone were observed on the polymer-coated samples. Histological analysis indicated no inflammation, necrosis or hydrogen gas accumulation on either of the samples during degradation. Collectively, these data suggest that the use of polymeric membrane may be potentially applied for future clinical use.
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Effect of iliac screw insertion depth on the stability and strength of lumbo-iliac fixation constructs: an anatomical and biomechanical study.
Spine
PUBLISHED: 09-23-2009
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Comparison of feasibility and safety of the placement of short and long iliac screws by anatomic and biomechanical evaluations as they apply to lumbo-iliac fixation construct.
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Biochemical consequences of sedlin mutations that cause spondyloepiphyseal dysplasia tarda.
Biochem. J.
PUBLISHED: 08-05-2009
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SEDT (spondyloepiphyseal dysplasia tarda) is a late-onset X-linked recessive skeletal dysplasia caused by mutations in the gene SEDL coding for sedlin. In the present paper, we investigated four missense mutations observed in SEDT and compare biochemical and cellular characteristics relative to the wild-type protein to address the mechanism of disease and to gain insight into the function of the sedlin protein. In situ hybridization and immunohistochemical experiments in mouse growth plates revealed sedlin to be predominantly expressed in proliferating and hypertrophic chondrocytes. Cell culture studies showed that the wild-type protein localized predominantly in the vicinity of the nucleus and the Golgi, with further localization around the cytoplasm, whereas mutation resulted in mislocalization. The D47Y mutant was expressed similarly to the wild-type, but the S73L, F83S and V130D mutants showed particularly low levels of expression that were rescued in the presence of the proteasome inhibitor MG132 (benzyloxycarbonyl-leucylleucylleucinal). Furthermore, whereas the D47Y mutant folded similarly and had similar stability to the wild-type sedlin as shown by CD and fluorescence, the S73L, F83S and V130D mutants all misfolded during expression. Two independent assays showed that the D47Y mutation resulted in an increased affinity for the transport protein particle component Bet3 compared with the wild-type sedlin. Our results suggest that the sedlin mutations S73L, F83S and V130D cause SEDT by sedlin misfolding, whereas the D47Y mutation may influence normal TRAPP (transport protein particle) dynamics.
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JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.