Spinal Changes Research Articles

Thalassaemia Patients with Polymorphism of COL1A1 Sp1 are at Greater Risk of Spine Degenerative Changes.

To explore the association of the COL1A1 Sp1 polymorphism with decreased bone density and spinal changes in β-thalassaemia patients. Cross-sectional, comparative study. Place and Duration of the Study: University of Health Sciences, Lahore, from May 2020 to June 2021. A total of 110 participants (55patients and 55 controls) of either gender, with ages ranging from 18-40 years were enrolled in the study. Bone density parameters including T-score, Z-score, bone-transmission time (BTT), and amplitude-dependent speed of sound (ADSOS) were assessed by ultrasound bone profiler. Lumbar spine radiographs were collected from patients and assessed for spine changes. Genotype analysis was done by HRM-PCR. Data were analysed using SPSS version 23. All bone density parameters were significantly lower in β-thalassaemai patients (p<0.001). Spine degenerative changes were more obvious in patients with age <25 years (p=0.04). Loss of lumbar lordosis was seen in 74.5% of the patients. The frequency of mutant allele (ss) was 7.3% while heterozygous (Ss) frequency was found to be 33.6%. The polymorphism showed significant association with T-scores (p=0.03) and ADSOS (p=0.02) in patients. Radiographic grades were higher in osteopenic and osteoporotic patients (p=0.04). The association of polymorphism with decreased bone density in β-thalassaemia patients revealed the potential role of genetics in bone changes and related disorders. Bone Density, COL1A1 Polymorphism, Osteoporosis, Thalassaemia.

Paramedian versus midline approach of spinal anesthesia: a systematic review and meta-analysis with trial sequential analysis.

Midline approach of spinal anesthesia has been widely used for patients undergoing surgical procedures. However, it might not be effective for obstetric patients and elderly with degenerative spine changes. Primary objective was to examine the success rate at the first attempt between the paramedian and midline spinal anesthesia in adults undergoing surgery. Databases of MEDLINE, EMBASE, and CENTRAL were searched from their starting date until February 2023. Randomized clinical trials (RCTs) comparing theparamedian versus midline approach of spinal anesthesia were included. Theprimary outcome was the success rate at the first attempt of spinal anesthesia. Our review included 36 RCTs (n = 5379). Compared to the midline approach, paramedian approach may increase success rate at the first attempt but the evidence is very uncertain (OR: 0.47, 95% CI 0.27-0.82, ρ = 0.007, level of evidence:very low). Our pooled data indicates that the paramedian approach likely reduced incidence of post-spinal headache (OR: 2.07, 95% CI 1.51-2.84, ρ < 0.00001, level of evidence:moderate). The evidence suggests that the paramedian approach may result in a reduction in the occurrence of paresthesia (OR: 1.61, 95% CI 1.06-2.45, ρ = 0.03, level of evidence:low). Our meta-analysis of 36 RCTs showed that paramedian approach may result in little to no difference in success rate at the first attempt owing to its very low level of evidence. However, given the low level of evidence and studies with small sample sizes, these findings need to be interpreted with caveat. CRD42023397781.

A Retrospective Study of Degenerative Cervical Myelopathy and the Surgical Management Within Northern Ireland.

Degenerative cervical myelopathy (DCM) is a condition of growing concern due to its increasing incidence among the ageing population. It involves age-associated pathological changes of the cervical spine that can result in spinal cord compression. This can lead to deficits in motor and sensory function of the upper and lower limbs, issues with balance and dexterity, as well as bladder and bowel disturbance. Patients can be categorised as having mild, moderate, or severe degenerative cervical myelopathy depending on their modified Japanese Orthopaedic Association (mJOA) score. This condition is generally managed surgically; however, patients with mild degenerative cervical myelopathy may be offered or opt for non-surgical treatment initially. The main aim of this study is to evaluate the surgical management of patients with DCM and to ascertain the degree of mJOA improvement from pre-surgery and one-year post-surgery follow-up. The second aim of the study is to explore the demographics within Northern Ireland who are diagnosed with DCM and who undergo surgery. This information could allow for better planning of services in the future for this patient cohort. This is a retrospective review of the surgical management of degenerative cervical myelopathy within the Regional Spinal Orthopaedic Unit in Northern Ireland over three years with one-year follow-up. The data was retrospectively collected from the Fracture Outcome Research Database. A total of 102 patients (10:7, male:female) with DCM were retrospectively evaluated. Exclusion criteria included all patients diagnosed with spinal tumour, fracture, central cord syndrome, and dislocation. Two patients were removed due to incorrect coding of DCM diagnosis and were not included. Key variables assessed were gender, age, symptoms, type of surgery, complications, and MRC score and mJOA score pre-surgery, 48 hours, six months, and one year post surgery. The choice of surgery was guided by the maximal angle of compression, the number of vertebral levels involved, patient comorbidities, and anesthetic risk. The sample consisted of 60 men (58.82%) and 42 women (41.17%) with an average age of 57.17 ± 12.13 years ranging from 27 to 83 years old. Statistical analysis was conducted to explore the effect of time before and after surgery up to one year on the mJOA score. There was a significant difference in mJOA score pre-surgery and at six months and one year post surgery (R = 0.579053, p <0.001). Of the patients,61.8% with a length of stay greater than three days and 71.4% of patients with a length of stay greater than seven days had a posterior approach surgery. A multiple linear regression analysis revealed that the mJOA score pre-surgery and the presence of complications significantly predicted the length of stay post-surgery (β -1.044, p = .011 and β -5.791, p = .028). The first key finding of this study is that the mJOA score tends to improve after surgery for the majority of patients, particularly at six months, which is consistent with the literature. The second key finding is that anterior approach surgery is associated with a lower rate of complications and shorter post-surgery length of stay in hospital compared to posterior approach surgery. The third key finding is that the pre-surgery mJOA score and the presence of complications post surgery significantly predict the post-surgery length of stay.

Dependence of the severity of pain in the lower back and degenerative changes in the lumbar spine in skydivers depending on the experience of training

Purpose of the study: to assess risk factors for the development of nonspecific back pain syndrome in skydivers.Materials and methods: A single-center, prospective, non-randomized study included 173 men aged 25 to 55 years who had been followed up with low back pain for 1 to 5 years. The main group included 89 people involved in parachuting (experience from 5 to 20 years, number of jumps — 276 (167; 387) times), the comparison group — 84 patients who had never jumped with a parachute. Depending on the total number of jumps, the main group was divided into 2 subgroups: less than 198 (n = 29) and more than 198 parachute jumps (n = 60). All patients underwent clinical neurological examination and magnetic resonance imaging (MRI) of the spine. MRI was used to quantify the presence of disc tissue displacements, the presence of straightening lordosis, and spondylolisthesis. Statistical processing of the obtained data was carried out using the IBM SPSS Statistics 25 program.Results: a correlation was established between the appearance of disc tissue displacement in the spine according to MRI and the number of parachute jumps in the main group (r = 0.430; p &lt; 0.001). The indicated pathological changes in the spine in paratroopers occurred when the total number of jumps was 198 or more. Among parachutists of the main group, displacement of disc tissue in the spine correlated with the level of pain intensity (r = 0.337; p &lt; 0.001) and the degree of functional impairment according to the results of the questionnaires Oswestry (r = 0.325; p &lt; 0.001) and Roland Morris (r = 0.292; p &lt; 0.001). The highest rate of pain syndrome and degree of disability was in the subgroup of paratroopers with extensive experience (p &lt; 0.05), while other groups of patients had no differences in this indicator.Conclusions: in skydiving athletes, the intensity of pain in the lower back and the degree of degenerative-dystrophic changes depended on the number of parachute jumps.

Engineering memory with an extrinsically disordered kinase.

Synaptic plasticity plays a crucial role in memory formation by regulating the communication between neurons. Although actin polymerization has been linked to synaptic plasticity and dendritic spine stability, the causal link between actin polymerization and memory encoding has not been identified yet. It is not clear whether actin polymerization and structural changes in dendritic spines are a driver or a consequence of learning and memory. Using an extrinsically disordered form of the protein kinase LIMK1, which rapidly and precisely acts on ADF/cofilin, a direct modifier of actin, we induced long-term enlargement of dendritic spines and enhancement of synaptic transmission in the hippocampus on command. The activation of extrinsically disordered LIMK1 in vivo improved memory encoding and slowed cognitive decline in aged mice exhibiting reduced cofilin phosphorylation. The engineered memory by an extrinsically disordered LIMK1 supports a direct causal link between actin-mediated synaptic transmission and memory.

Microglia-mediated calcium-permeable AMPAR accumulation in the nucleus accumbens drives hyperlocomotion during cocaine withdrawal

During withdrawal from cocaine, calcium permeable-AMPA receptors (CP-AMPAR) progressively accumulate in nucleus accumbens (NAc) synapses, a phenomenon linked to behavioral sensitization and drug-seeking. Recently, it has been suggested that neuroimmune alterations might promote aberrant changes in synaptic plasticity, thus contributing to substance abuse-related behaviors. Here, we investigated the role of microglia in NAc neuroadaptations after withdrawal from cocaine-induced conditioned place preference (CPP). We depleted microglia using PLX5622-supplemented diet during cocaine withdrawal, and after the place preference test, we measured dendritic spine density and the presence of CP-AMPAR in the NAc shell. Microglia depletion prevented cocaine-induced changes in dendritic spines and CP-AMPAR accumulation. Furthermore, microglia depletion prevented conditioned hyperlocomotion without affecting drug-context associative memory. Microglia displayed fewer number of branches, resulting in a reduced arborization area and microglia control domain at late withdrawal. Our results suggest that microglia are necessary for the synaptic adaptations in NAc synapses during cocaine withdrawal and therefore represent a promising therapeutic target for relapse prevention.

Trends in prehospital cervical collar utilization in trauma patients: Closer, but not there yet.

This study aims to assess the change in cervical spine (C-spine) immobilization frequency in trauma patients over time. We hypothesize that the frequency of unnecessary C-spine immobilization has decreased. A retrospective chart review of adult trauma patients transported to our American College of Surgeons-verified Level I trauma center from January 1, 2014, to December 31, 2021, was performed. Emergency medical services documentation was manually reviewed to record prehospital physiology and the application of a prehospital cervical collar (c-collar). C-spine injuries were defined as cervical vertebral fractures and/or spinal cord injuries. Univariate and year-by-year trend analyses were used to assess changes in C-spine injury and immobilization frequency. Among 2906 patients meeting inclusion criteria, 12% sustained C-spine injuries, while 88% did not. Patients with C-spine injuries were more likely to experience blunt trauma (95% vs. 68%, p < 0.001), were older (46 years vs. 41 years, p < 0.001), and had higher Injury Severity Scores (31 vs. 18, p < 0.001). They also exhibited lower initial systolic blood pressures (108 mm Hg vs. 119 mm Hg, p < 0.001), lower heart rates (92 beats/min vs. 97 beats/min, p < 0.05), and lower Glasgow Coma Scale scores (9 vs. 11, p < 0.001). In blunt trauma, c-collars were applied to 83% of patients with C-spine injuries and 75% without; for penetrating trauma, c-collars were applied to 50% of patients with C-spine injuries and only 8% without. Among penetrating trauma patients with C-spine injury, all patients either arrived quadriplegic or did not require emergent neurosurgical intervention. The proportion of patients receiving a c-collar decreased in both blunt and penetrating traumas from 2014 to 2021 (blunt-82% in 2014 to 68% in 2021; penetrating-24% in 2014 to 6% in 2021). Unnecessary C-spine stabilization has decreased from 2014 to 2021. However, c-collars are still being applied to patients who do not need them, both in blunt and in penetrating trauma cases, while not being applied to patients who would benefit from them.

Effect of Pelvic External Beam Radiation Therapy on Bone Mineral Density: A Secondary Analysis of a Phase 3 Randomized Controlled Trial

Pelvic radiation therapy may lead to decreased bone mineral density (BMD) and increased risk of fracture that could be of particular concern in patients with prostate cancer who also receive androgen deprivation therapy (ADT). We performed an exploratory analysis of a randomized, double-masked, placebo-controlled trial to determine whether exposure to prior pelvic external beam radiation therapy (XRT) affects BMD and risk of fracture in patients with prostate cancer treated with ADT. Patients with nonmetastatic prostate cancer aged ≥70 years or <70 years with low BMD (T-score < -1) or osteoporotic fracture who had been receiving ADT for ≥12 months were randomly assigned to receive densoumab or placebo every 6 months for 3 years. BMD was measured at baseline and at months 1, 3, 6, 12, 24, and 36. We applied multivariable linear mixed-effects models with an interaction term between the treatment arm and exposure to prior pelvic XRT to evaluate differential XRT effect on percent BMD change between the 2 treatment arms. Among 1407 eligible patients, 31% (n = 447) received prior pelvic XRT. There was no significant difference in any clinical fractures among patients with (5.8%, 26 of 447) or without (5.2%, 50 of 960) prior pelvic XRT (P = .42). Prior pelvic XRT was associated with a significant (0.54%) improvement in BMD (95% CI, 0.05-1.02) in the placebo group and a nonsignificant (0.04%) decline in BMD (95% CI, -0.47 to -0.35) in the denosumab group (interaction P = .007). There was no significant difference in pelvic XRT effect on percent BMD change in the lumbar spine (P = .65) or total hip (P = .39) between the 2 treatment groups. We did not find sufficient evidence to suggest any detrimental effect of pelvic XRT on the treatment effect from denosumab on percent BMD change, with only an approximately 5% incidence of clinical fractures.

Radiological Assessment of Morphological Changes of Lumbar Spine: From First to 9th Decade of Life.

Analysis of lumbar spine radiograms of 1,496 Jeju islanders of Korea. To look into the age- and gender-matched incidences of morphological changes and their severities. There have been several prior research on the prevalence and severity of age-related diseases, both related and unrelated. Those offer some fundamental clinical data for clinicians. Radiograms of 1,496 patients (555 males and 941 females) from the first to 9th decade were examined for this study. Sagittal and coronal alignment, disc space narrowing, spur formation including diffuse idiopathic spinal hyperostosis (DISH), spondylolisthesis, and ballooned discs associated with biconcave bodies due to osteoporosis were among the parameters of lumbar spine morphologies examined on high-quality radiographs by both human observers and computers. The alignment of the lumbar spine altered after birth and set at growth maturity, and then the curve was maintained till the end of the 5th decade afterward and the curve gradually hypolordotic. There were three types of coronal alignment abnormalities can be seen: idiopathic, osteopathic, and discogenic (degenerative lumbar scoliosis [DLS]). DLS developed after 6th decade. There was no scoliosis associated with spondylolysis or the post-laminofacetectomy period. Disc space narrowing and corporal spur formation were not seen till the end of 3rd decade comparatively speaking, the corporal spurs generated in the non-scoliotic spine were smaller than those in the scoliotic spine. DISH began to appear in the 5th-decade patients and its incidences increased gradually afterward. Porosis-related vertebral body collapse started to happen after 6th decade. There are three different types of spondylolisthesis: anterior, posterior, and lateral. The lateral slip occurred only in the scoliotic spine. All types were related to degenerative discs. It has been shown that the morphology of the lumbar spine changes throughout time.

Exploring the Interplay of Muscular Endurance, Functional Balance, and Limits of Stability: A Comparative Study in Individuals with Lumbar Spondylosis Using a Computerized Stabilometric Force Platform.

Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving the management and well-being of affected individuals. This study aimed to assess lumbar extensor endurance, functional balance, and limits of stability in individuals with lumbar spondylosis compared to age-matched healthy individuals and explore the correlations among these parameters within the lumbar spondylosis group. The lumbar spondylosis group consisted of 60 individuals initially screened by an orthopedician and referred to physical therapy. Age-matched healthy controls (n = 60) were recruited. Inclusion criteria encompassed adults aged 45-70 years for both groups. Lumbar extensor endurance was assessed using the Sorensen test, functional balance with the Berg Balance Scale, and limits of stability using a computerized stabilometric force platform. Lumbar extensor endurance was significantly lower in individuals with lumbar spondylosis compared to healthy controls (23.06 s vs. 52.45 s, p < 0.001). Functional balance, as assessed by the Berg Balance Scale, demonstrated a significant decrement in the lumbar spondylosis group (48.36 vs. 53.34, p < 0.001). Additionally, limits of stability variables, under both eyes-open and eyes-closed conditions, exhibited marked impairments in the lumbar spondylosis group (p < 0.001 for all variables). Within the lumbar spondylosis group, lumbar extensor endurance exhibited significant positive correlations with functional balance (0.46, p < 0.001) and negative correlations with limits of stability variables (r ranging from -0.38 to -0.49, p < 0.01 for all variables). This study underscores the significance of addressing lumbar extensor endurance, functional balance, and stability impairments in the comprehensive management of lumbar spondylosis.

Complex Treatment of Headaches Caused by Degenerative-Dystrophic Changes in the Cervical Spine with Symptoms of Venous Hyperemia

The necessity of developing alternative approaches to the treatment of headaches caused by degenerative-dystrophic changes in the cervical spine is substantiated. The results of clinical and instrumental studies of various treatment methods are presented. The effectiveness of acupuncture in the complex treatment of headaches has been proven.

Antidepressant-like effects of the Punica granatum and citalopram combination are associated with structural changes in dendritic spines of granule cells in the dentate gyrus of rats.

Introduction: Natural products such as phytoestrogens-enriched foods or supplements have been considered as an alternative therapy to reduce depressive symptoms associated with menopause. It is known that the aqueous extract of Punica granatum (AE-PG) exerts antidepressant-like effects by activating β-estrogen receptors and facilitates the antidepressant response of the clinical drug citalopram (CIT). However, the effects on neuroplasticity are unknown. Objectvie investigated the antidepressant-like response of combining AE-PG and CIT at sub-optimal doses, analyzing their effects on the formation and maturation of dendrite spines in granule cells as well as on the dendrite complexity. Methods: Ovariectomized Wistar rats (3-month-old) were randomly assigned to one of the following groups: A) control (saline solution as vehicle of CIT and AE-PG, B) AE-PG at a sub-threshold dose (vehicle of CIT plus AE-PG at 0.125mg/kg), C) CIT at a sub-threshold dose (0.77mg/kg plus vehicle of AE-PG), and D) a combination of CIT plus AE-PG (0.125mg/kg and 0.77mg/kg, respectively). All rats were treated intraperitoneally for 14 days. Antidepressant-like effects were evaluated using the force swimming test test (FST). The complexity of dendrites and the number and morphology of dendrite spines of neurons were assessed in the dentate gyrus after Golgi-Cox impregnation. The expressions of the mature brain-derived neurotrophic factor (mBDNF) in plasma and of mBDNF and synaptophysin in the hippocampus, as markers of synaptogenesis, were also determined. Results: Administration of CIT combined with AE-PG, but not alone, induced a significant antidepressant-like effect in the FST with an increase in the dendritic complexity and the number of dendritic spines in the dentate gyrus (DG) of the hippocampus, revealed by the thin and stubby categories of neurons at the granular cell layer. At the same time, an increase of mBDNF and synaptophysin expression was observed in the hippocampus of rats that received the combination of AE-PG and CIT.

Vertebral changes in the lumbar spine of adults presenting with chronic low back pain at a Referral Hospital in western Kenya

Background: Chronic low back pain is a common musculoskeletal symptom affecting the lower part of the spine. It is described as pain and discomfort around the lumbar region lasting for more than twelve weeks. The symptoms of chronic low back pain might range from a dull ache to a stubbing or shooting sensation. This nature of pain may be localized around the axial region or radiate to the lower limbs affecting the patients’ daily activities. The aim of this study, therefore, was to evaluate vertebral changes in the lumbar spine of adults presenting with chronic low back pain at Kakamega County General and Referral Hospital.&#x0D; Methods: This was a cross-sectional quantitative descriptive study whereby; patients’ data was collected during patients’ presentation at orthopedic outpatient clinic and MRI department. Purposive sampling of lumbar spine Magnetic resonance imaging scans was used to obtain data. A total of 144 patients were selected using the Yamane Taro formula. Anatomical vertebral changes of the lumbar spine were assessed from the selected MRIs to evaluate the structural causes of chronic low back pain. Descriptive statistics such as frequency and percentage were used in analyzing the data.&#x0D; Results: It was noted that osteophytes were the most pathological changes causing chronic low back pain while fractures were the least common. Osteophytic changes in the vertebra and desiccation of the intervertebral discs can predispose one to chronic lower back pain.&#x0D; Conclusion: The study recommends early screening and treatment of lower back pain to avert its sequelae.

Changes in sagittal vertebral–pelvic ratios in children with a high position of the large trochanter after surgical treatment

BACKGROUND: Alteration in the anatomical shape and structure of the proximal femur is a common orthopedic problem in children. In most cases, this is accompanied by a high position of the large trochanter, which leads not only to the development of extraarticular impingement syndrome and the progression of coxarthrosis, but also to impaired vertebralpelvic relations.&#x0D; AIM: To evaluate the effect of the transposition of the large trochanter in children on changes in the radiological parameters of sagittal vertebralpelvic ratios.&#x0D; MATERIALS AND METHODS: The study included 20 patients (20 hip joints) aged 915 years with deformity of the proximal femur, which was accompanied by a high position of the large trochanter. The patients underwent clinical and X-ray examination before and after surgical treatment, i.e., transposition of the large trochanter according to original methods. The pelvic angle, lumbar lordosis, thoracic kyphosis, pelvic deviation angle, sacral tilt, and sagittal vertical axis (SVA) were evaluated. The obtained data were analyzed statistically.&#x0D; RESULTS: Excessive pelvic anteversion and vertical posture of the hyperlordotic type are characteristics of the patients analyzed. These signs were manifested as a significant increase in global lumbar lordosis and the angle of inclination of the sacrum and a decrease in the angle of inclination of the pelvis, in combination with a negative imbalance in SVA. The surgery made it possible to normalize the articulotrochanteric distance index and increase the angle of inclination of the pelvis while reducing the sacral slope, which improved global lumbar lordosis.&#x0D; CONCLUSIONS: After the surgical intervention, in addition to restoring normal ratios in the hip joint and eliminating the extraarticular femoroacetabular impingement syndrome, the hyperlordotic type of vertical posture transformed toward the normal one in accordance with the classification of R. Rousully, which resulted in the prevention of the development of degenerative and dystrophic changes in the lumbar spine.

Degenerative changes in the intervertebral joints of the cervical spine after anterior interbody fusion and intervertebral disc arthroplasty

Objective. To study the effect of arthroplasty and anterior interbody fusion in the cervical spine on degenerative changes in the adjacent intervertebral joints.Material and Methods. A retrospective cohort study included 46 patients (22 with cervical total disc arthroplasy – CTDA, and 24 with anterior cervical discectomy and fusion – ACDF) with symptoms of cervical spondylogenic compression myelopathy and/or radiculopathy. The degree of degeneration of facet joints adjacent to the operated segments was evaluated 12 months after surgical treatment. Degenerative changes in the cervical spine were assessed using CT according to the Okamoto classification. Vidar Dicom Viewer 3.2 software was used to view images and evaluate intervertebral joints. Statistical processing was performed using IBM SPSS Statistics 23. Data were presented as median and 25th and 75th percentiles – Me [Q1; Q3].Results. The mean age of patients in both groups was 47 [39; 52] years (Mann – Whitney U-test, p = 0.047). In the ACDF group it was 48 [42; 55] years and in the CTDA group – 42 [36; 52] years. Comparison of degenerative changes in the ACDF group before and after treatment (Wilcoxon analysis) showed a statistically significant difference in the cranial (p = 0.023), and caudal (p = 0.001) joints, with the progression of degeneration degree. In the CTDA group, no difference between pre- and post-treatment degeneration degree (Wilcoxon analysis) was found in either cranial joints (p = 0.157) or caudal joints (p = 0.161).Conclusion. Surgeries to stabilize spinal segments in degenerative diseases undeniably affect the development of the adjacent level syndrome. However, the use of endoprosthetic technology makes it possible to aggravate the degree of degenerative changes in the intervertebral joints of adjacent segments to a lesser extent.

Simulation of the Mechanical Behavior of the Degradation L4-L5 Lumbar Spine

Degenerative changes in the lumbar spine significantly reduce the quality of life of people. To fully understand the biomechanics of the affected spine, it is crucial to consider the biomechanical alterations caused by degeneration of the intervertebral disc (IVD). Therefore this study is aimed at the development of a discrete element model of the mechanical behavior of the L4-L5 spinal motion segment, which covers all the degeneration grades from healthy IVD to its severe degeneration, and numerical study of the influence of the IVD degeneration on stress state and biomechanics of the spine. To analyze the effects of IVD degeneration on spine biomechanics we simulated physiological loading conditions using compressive forces. The results of modeling showed that at the initial stages of degenerative changes, an increase in the amplitude and area of maximum compressive stresses in the disc is observed. At the late stages of disc degradation, a decrease in the value of intradiscal pressure and a shift in the maximum compressive stresses in the dorsal direction are observed. Such an influence of the degradation of the geometric and mechanical parameters of the tissues of the disc leads to the effect of bulging, which in turn will lead to the formation of an intervertebral hernia.

Adult cervical spine deformity: a state-of-the-art review.

Adult cervical deformity is a structural malalignment of the cervical spine that may present with variety of significant symptomatology for patients. There are clear and substantial negative impacts of cervical spine deformity, including the increased burden of pain, limited mobility and functionality, and interference with patients' ability to work and perform everyday tasks. Primary cervical deformities develop as the result of a multitude of different etiologies, changing the normal mechanics and structure of the cervical region. In particular, degeneration of the cervical spine, inflammatory arthritides and neuromuscular changes are significant players in the development of disease. Additionally, cervical deformities, sometimes iatrogenically, may present secondary to malalignment or correction of the thoracic, lumbar or sacropelvic spine. Previously, classification systems were developed to help quantify disease burden and influence management of thoracic and lumbar spine deformities. Following up on these works and based on the relationship between the cervical and distal spine, Ames-ISSG developed a framework for a standardized tool for characterizing and quantifying cervical spine deformities. When surgical intervention is required to correct a cervical deformity, there are advantages and disadvantages to both anterior and posterior approaches. A stepwise approach may minimize the drawbacks of either an anterior or posterior approach alone, and patients should have a surgical plan tailored specifically to their cervical deformity based upon symptomatic and radiographic indications. This state-of-the-art review is based upon a comprehensive overview of literature seeking to highlight the normal cervical spine, etiologies of cervical deformity, current classification systems, and key surgical techniques.

Age-Dependent Regulation of Dendritic Spine Density and Protein Expression in Mir324 KO Mice.

Dendritic spines are small, dynamic protrusions along the dendrite that comprise more than 90% of excitatory connections in the brain, making them essential sites for neuronal communication. These synaptic sites change throughout the process of development, reducing in density and shifting morphology as synapses are refined. One important class of dendritic spine regulators is microRNA (miRNA), small-noncoding RNAs that post-transcriptionally regulate gene expression. Several studies suggest that miRNA-324-5p regulates dendritic spine formation. In addition, we have previously shown that miR-324-5p plays a role in seizure and long-term potentiation, both of which involve dendritic spine changes. In this study, we aimed to characterize the role of miRNA-324-5p in developmental spine regulation by assessing the effect of Mir324 knockout (KO) on dendritic spine density and expression of a subset of dendritic proteins at select developmental time points. We show that miR-324-5p expression is developmentally regulated and peaks at 4weeks of age. We demonstrate that loss of miR-324-5p expression leads to differential changes in both target protein expression and spine density at different time points during development, disrupting the pattern of spine density changes and leading to a premature loss of dendritic spines in KO mice, which is compensated later. Our findings indicate that miR-324-5p plays a role in synaptic refinement across development. Additionally, our data illustrate the importance of context in the study of miRNA, as regulation by and/or of miRNA can vary dramatically across development and in disease.

Hydrogen‑rich saline promotes neuronal recovery in mice with cerebral ischemia through the AMPK/mTOR signal‑mediated autophagy pathway.

This study explored the protective effect and mechanism of hydrogen‑rich saline (HRS) on the neurological function of mice with cerebral ischemia. Effects of HRS on neurological function in mice with cerebral ischemia were evaluated by neurological function scores. Infarct volume and histological damage were evaluated by 2,3,5‑triphenyl tetrazolium chloride staining (TTC staining). Golgi‑Cox staining was conducted to measure the morphological changes of neuronal dendrites and dendritic spines. The expression of neuronal markers was detected by immunofluorescence. Western blot was used to detect protein expression. The infarct volume of mice in the HRS‑H group decreased significantly compared to that of the distal middle cerebral artery occlusion (dMCAO) group. Mice in the HRS‑H group had a lower neurological deficit score than that in the dMCAO group. Compared to the dMCAO group, the activity of superoxide dismutase (SOD) and the level of glutathione (GSH) significantly increased in the HRS‑H group. Compared with the dMCAO group, the number of apoptotic cells in the HRS‑H group decreased. Administration of HRS was shown to be able to decrease cavitation of the brain cortex after ischemia. The spine density in the HRS‑H group increased compared to that of the dMCAO group. In the in vitro experiment, compared with the oxygen‑glucose deprivation (OGD) group, the active oxygen content in the 75% HRM group decreased, and the mitochondrial membrane potential and adenosine triphosphate (ATP) content increased. Compared with the OGD group, the ratio of P‑AMPK and the levels of LC3II/LC3I in the hydrogen‑rich medium (HRM) group was upregulated, and P‑mTOR levels and P62 levels in the HRM group were down‑regulated. HRS can enhance neuroplasticity after ischemia and promote neurological recovery in mice with cerebral ischemia, which may involve the autophagy pathway mediated by the AMPK/mTOR signaling pathway.

OA05 Cycling: a tool for cardiovascular exercise in patients with established ankylosing spondyloarthritis

OA05 Cycling: a tool for cardiovascular exercise in patients with established ankylosing spondyloarthritis