Spine

Study Design. Prospective observational and analytic study. Objective. To investigate whether spontaneous intervertebral disc degeneration (IVDD) occurring in both chondrodystrophic (CD) and nonchondrodystrophic dogs (NCD) can be used as a valid translational model for human IVDD research. Summary of Background Data. Different animal models are used in IVDD research, but in most of these models IVDD is induced manually or chemically rather than occurring spontaneously. Methods. A total of 184 intervertebral discs (IVDs) from 19 dogs of different breeds were used. The extent of IVDD was evaluated by macroscopic grading, histopathology, glycosaminoglycan content, and matrix metalloproteinase 2 activity. Canine data were compared with human IVD data acquired in this study or from the literature. Results. Gross pathology of IVDD in both dog types (CD and NCD) and humans showed many similarities, but the cartilaginous endplates were signifi cantly thicker and the subchondral cortices signifi cantly thinner in humans than in dogs. Notochordal cells were still present in the IVDs of adult NCD but were not seen in the CD breeds or in humans. Signs of degeneration were seen in young dogs of CD breeds ( < 1 year of age), whereas this was only seen in older dogs of NCD breeds (5-7 years of age). The relative glycosaminoglycan content and metalloproteinase 2 activity in canine IVDD were similar to those in humans: metalloproteinase 2 activity increased and glycosaminoglycan content decreased with increasing severity of IVDD. Conclusion. IVDD is similar in humans and dogs. Both CD and NCD breeds may therefore serve as models of spontaneous IVDD for human research. However, as with all animal models, it is important to recognize interspecies differences and, indeed, the intraspecies differences between CD and NCD breeds (early vs. late onset of IVDD, respectively) to develop an optimal canine model of human IVDD.

Directionally-ordered cellular structures that impede water motion, such as cell membranes and myelin, result in water mobility that is also directionally-dependent. Diffusion tensor imaging characterizes this directional nature of water motion and thereby provides structural information that cannot be obtained by standard anatomic imaging. Quantitative apparent diffusion coefficients and fractional anisotropy have emerged from being primarily research tools to methods enabling valuable clinical applications. This review describes the clinical utility of diffusion tensor imaging, including the basic principles of the technique, acquisition, data analysis, and the major clinical applications.

Background context: Ketorolac Tromethamine (ketorolac) is a nonsteroidal anti-inflammatory drug (NSAID) with proven efficacy in decreasing postoperative pain in various surgical settings, including the treatment of spine deformities. However, some studies have raised questions regarding the potential side effects of this agent, such as increased bleeding and inhibition of bony fusion.Purpose: This study was conducted to determine whether there is

Postures are known to be able to affect emotion and motivation. Much less is known about whether (affective) modulation of eye blink startle occurs following specific postures. The objective of the current study was to explore this. Participants in the present study were requested to assume three different sitting postures: with the spine flexed (slouched), neutral upright, and extended. Each posture was assumed for four minutes, and was followed by the administration of brief selfreport questionnaires before proceeding to the next posture. The same series of postures and measures were repeated prior to ending the experiment. Results indicate that, relative to the other postures, the extended sitting posture was associated with an increased startle, was more unpleasant, arousing, had smaller levels of dominance, induced more discomfort, and was perceived as more difficult. The upright and flexed sitting postures differed in the level of self-reported positive affect, but not in eye blink startle amplitudes. Citation: Ceunen E, Zaman J, Vlaeyen JWS, Dankaerts W, Van Diest I (2014) Effect of Seated Trunk Posture on Eye Blink Startle and Subjective Experience: Comparing Flexion, Neutral Upright Posture, and Extension of Spine. PLoS ONE 9(2): e88482.

BACKGROUND CONTEXT: Laminectomy is an effective surgical technique for the treatment of cervical OPLL along multilevel. However, postoperative kyphosis and probable neurological deterioration have been frequently reported after laminectomy. PURPOSE: We analyzed the changes in the cervical curvature after laminectomy and subsequent changes in neurological status in treating ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. STUDY DESIGN/SETTING: Retrospective study. PATIENT SAMPLE: The authors reviewed the 38 patients who underwent cervical laminectomy between 1999 and 2003. OUTCOME MEASURES: The preoperative symptoms, Japanese Orthopedic Association (JOA) score and recovery rate was reviewed using medical records. The OPLL type was classified to continous, segmental, mixed and local type. The cervical global angle and range of motion (ROM) was measured by posterior tangent method at preoperation and the last follow-up. METHODS: According to the cervical global angle, the cervical curvature was distributed into three types; lordosis, straight, and kyphosis. The change in cervical curvature was also reviewed in lateral radiographs. RESULTS: A total 19 patients were available to review medical records. There were 14 male and 5 female, whose mean age at the time of surgery was 61.26 years. The mean follow-up period was 68.57 months. OPLL classification scheme, continous type was in 8 patients, mixed and segmental type was 5 patients each, and others type was in one patient. The preoperative JOA score was 10.21 6 3.08, postoperative JOA score was significantly improved to 13.73 6 2.9 (p !0.001) and the recovery rate at the last follow-up was 51.95%. The preoperative global angle was -10.61 and postoperative global angle was -10.31 . The preoperative ROM was 31.0 and postoperative them was 23.4 . There was no statistical significance in change of cervical curvature and ROM. A 16 of the 19 patients were preoperatively shown lordotic cervical curvature, and 3 patients were straight. At last follow-up, 14 patients kept the lordotic curvature, 2 patients changed from lordosis to kyphosis. One patient who cervical curvature was changed from lordosis to kyphosis during follow-up period underwent cervical fusion operation after 9 years of operation. CONCLUSIONS: Through the long-term results of laminectomy in treating cervical OPLL, the postoperative kyphosis was not common in patient with OPLL. The OPLL itself may serve as supporter of spinal column. For patients with maintained cervical lordosis, cervical laminectomy can be advocated.

The impact of aging on the morphology of the osseous spine is still debated. Clinical studies usually record combined aging effects, as well as age-related degenerative changes. The aim of this study was to determine the impact of (degeneration-independent) aging on the morphology of the osseous human spine during adulthood. Various osseous dimensions of human spinal landmarks at all major vertebral levels have been assessed in macroscopically normal Swiss skeletons (N = 71), with historically known sex and age at death, as well as in larger Central European skeletal samples (N = 277) with anthropologically determined individual age and sex. All measurements were correlated with individual age (or age group) by linear regression and analyzed separately for each sex. Only few osseous spinal dimensions, and only in men, correlate significantly with individual age. Generally, the significant dimensions show an increase in size during adulthood. Similar tendencies, but with significant alterations of spinal measurements in women as well, can be found in the larger samples with anthropologically determined sex and age group. Increase of certain spinal dimensions found in this study may be a reflection of an increase in the robustness of individuals with age. Because of the absence of a significant secular alteration of stature within the well-recorded sample, we exclude secular change in body dimensions as a major bias.

Study Design. Prospective observational study. Objective. To determine the typical trajectory of pain during the fi rst 6 months after spinal fusion surgery for adolescent idiopathic scoliosis (AIS) and the extent to which certain demographic, medical, and psychological variables modify this trajectory. Summary of Background Data. Pain after spinal fusion surgery for AIS may not improve predictably with elapsed healing time, and limited data exist on predictors of the course of pain during the initial months after surgery. Methods. Fifty patients ages 11 to 17 (mean = 14.5, standard deviation = 1.9) with AIS and undergoing posterior spinal fusion surgery comprised the study sample. Pain outcomes were assessed at 4 time points after surgery (2-week, 6-week, 3-month, and 6-month postsurgery). Preoperative predictor variables comprising demographics, baseline Cobb angle, body mass index, baseline pain, and psychological variables (anxiety, negative mood, and confi dence in ability to control pain) were assessed 2 weeks before surgery. Perioperative predictor variables comprising pain, pain coping effi cacy, negative mood, surgery length, length and lowest level of fusion, and analgesic use were assessed by self-report or record review. Multilevel growth models were used to evaluate hypotheses pertaining to predictors of pain trajectories. Results. Pain level on average declined predictably with days since surgery ( b = − 0.14 to − 0.19, P < 0.01).