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The purpose of this study was to examine factors affecting the severity of neurological deficits and intractable back pain in patients with insufficient bone union following osteoporotic vertebral fracture (OVF). Reports of insufficient union following OVF have recently increased. Patients with this lesion have various degrees of neurological deficits and back pain. However, the factors contributing to the severity of these are still unknown. A total of 45 patients with insufficient union following OVF were included in this study. Insufficient union was diagnosed based on the findings of vertebral cleft on plain radiography or CT, as well as fluid collection indicating high-intensity change on T2-weighted MRI. Multivariate logistic regression analysis was performed to determine the factors contributing to the severity of neurological deficits and back pain in the patients. Age, sex, level of fracture, duration after onset of symptoms, degree of local kyphosis, degree of angular instability, ratio of occupation by bony fragments, presence or absence of protrusion of flavum, and presence or absence of ossification of the anterior longitudinal ligament (OALL) in the adjacent level were used as explanatory variables, while severity of neurological deficits and back pain were response variables. On multivariate analysis, factors significantly affecting the severity of neurological deficits were angular instability of more than 15 degrees [adjusted odds ratio (OR), 9.24 (95% confidence interval, CI 1.49-57.2); P < 0.05] and ratio of occupation by bony fragments in the spinal canal of more than 42% [adjusted OR 9.23 (95%CI 1.15-74.1); P < 0.05]. The factor significantly affecting the severity of back pain was angular instability of more than 15 degrees [adjusted OR 14.9 (95%CI 2.11-105); P < 0.01]. On the other hand, presence of OALL in the adjacent level reduced degree of back pain [adjusted OR 0.14 (95%CI 0.03-0.76); P < 0.05]. In this study, pronounced angular instability and marked posterior protrusion of bony fragments in the canal were factors affecting neurological deficits. In addition, marked angular instability was a factor affecting back pain. These findings are useful in determining treatment options for patients with insufficient union following OVF. [ABSTRACT FROM AUTHOR]

This work describes the application of advanced microfabrication technologies including silicon micromachining and polymer replica molding towards the field of tissue engineering of complex tissues and organs. As a general approach, tissue engineering of skin, bone and cartilage using cell transplantation on biodegradable matrices has achieved great success. However, such techniques encounter difficulties when applied to complex tissues and vital organs. The principal limitation for such applications is the lack of an intrinsic blood supply for the tissue engineered organ, which experiences significant cell death when the tissue thickness is increased above the 1–2 mm range. In this work, the concept of microfabricated scaffolds is introduced, with the goal of producing organ templates with feature resolution of 1 micron, well in excess of that necessary to fashion the capillaries which comprise the microcirculation of the organ. Initial efforts have resulted in high resolution biocompatible polymer scaffolds produced by replica molding from silicon micromachined template wafers. These scaffolds have been successfully seeded with endothelial cells in channels with dimensions as small as the capillaries. [ABSTRACT FROM AUTHOR]

Seasonal variations in photosynthetic rates by microphytobenthos and phytoplankton at the Isshiki tidal flat in Mikawa Bay were measured with a 14C combustion method. In addition, diurnal variations in the photosynthetic rate and photosynthesis versus irradiance (P-I) curves were obtained through in situ incubation. The photosynthetic rate of microphytobenthos (annual average, 13.9 ± 6.4 mg C m−2 h−1) did not show a remarkable change, and they maintained a higher production rate than phytoplankton (annual average 9.0 ± 5.1 mg C m−2 h−1) throughout the year. The P-I curves from in situ experiments showed that the photosynthetic activity of microphytobenthos at the laboratory irradiance (250 μE m−2 s−1) was 56% of that at the maximum irradiance (1200 μE m−2 s−1) in situ. In the in situ experiments, the chlorophyll a concentration, photosynthetic rate, and activity of microphytobenthos varied greatly throughout the day, influenced by tidal submersion/emersion and daylight. From an analysis of these results, it is considered that microphytobenthos contributed greatly to primary production in this ecosystem throughout the year by adapting suitably to intertidal environments. [ABSTRACT FROM AUTHOR]

Background: Balloon kyphoplasty (BKP) is a method for the management of osteoporotic vertebral body fracture (OVF). However, improvement in back pain (BP) is poor in some patients, also previous reports have not elucidated the exact incidence and risk factors for residual BP after BKP. We clarified the characteristics of residual BP after BKP in patients with OVF., Hypothesis: In this study, we hypothesize that some risk factors may exist for residual BP 2 years after the treatment of OVF with BKP., Patients and Methods: A multicenter cohort study was performed where patients who received BKP within 2 months of OVF injury were followed-up for 2 years. BP at 6 months after surgery and final observation was evaluated by Visual Analog Scale (VAS) score. Patients with a score of 40 mm or more were allocated to the residual BP group, and comparisons between the residual back pain group and the improved group were made for bone density, kyphosis, mobility of the fractured vertebral body, total spinal column alignment, and fracture type (fracture of the posterior element, pedicle fracture, presence or absence of posterior wall damage, etc.). Also, Short Form 36 (SF-36) for physical component summary (PCS) and mental component summary (MCS) at the final follow-up was evaluated in each radiological finding., Results: Of 116 cases, 79 (68%) were followed-up for 2 years. Two years after the BKP, 26 patients (33%) experienced residual BP. Neither age nor sex differed between the groups. In addition, there was no difference in bone mineral density, BKP intervention period (period from onset to BKP), and osteoporosis drug use. However, the preoperative height ratio of the vertebral body was significantly worse in the residual BP group (39.8% vs. 52.1%; p  = 0.007). Two years after the operation, the vertebral body wedge angle was significantly greater in the residual BP group (15.7° vs. 11.9°; p  = 0.042). In the multiple logistic regression model with a preoperative vertebral body height ratio of 50% or less [calculated by receiver operating characteristic (ROC) curve], the adjusted odds ratio for residual BP was 6.58 (95% confidence interval 1.64-26.30; p  = 0.007); similarly, patients with vertebral body height ratio less than 50% had a lower score of SF-36 PCS 24.6 vs. 32.2 p  = 0.08., Conclusion: The incidence of residual BP 2 years after BKP was 33% in the current study. The risk factor for residual BP after BKP was a preoperative vertebral body height ratio of 50% or less, which should be attentively assessed for the selection of a proper treatment scheme and to provide adequate stabilization., Level of Evidence: III., Competing Interests: Conflict of InterestThe authors declare that they have no competing interests., (© Indian Orthopaedics Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)