Search

Many people experience low back pain caused by degenerative disease of the lumbar spine; this includes spinal stenosis, spondylolisthesis, disc degeneration, and disc herniation. Conservative management of degenerative disease, which includes physical therapy, lifestyle modifications, and medications, is the initial approach. If this approach fails, a surgical procedure may be the next step. Previously, open lumbar surgery would have been the planned procedure; today, minimally invasive spine surgery gives patients another choice. Perioperative nurses should understand how minimally invasive spine surgery differs from the open procedure, the steps involved during a minimally invasive procedure, the benefits of this type of procedure, and nursing considerations for patients undergoing minimally invasive spinal procedures. [ABSTRACT FROM AUTHOR]

Introduction: Neurogenesis in the adult brain may play an important role in memory and cognition; however, knowledge of neurogenic markers in the human brain remains limited. We compared the single-nucleus transcriptome of the hippocampus with that of other cortical regions to identify hippocampus-specific neurogenic markers. Methods: We analyzed 26,189 nuclei from four human brains collected within 16 h of death. Clustering and annotation were performed to examine differential expression, gene ontology, and intercellular communication. DCX expression was validated by ddPCR. Results: Immature markers such as DCX, CALB2, NES, SOX2, PAX6, DPYSL3, and TUBB3 were expressed in both hippocampus and prefrontal cortex, with higher levels in the prefrontal cortex. ddPCR confirmed higher expression of DCX in the prefrontal cortex. DCX was involved in both neurogenesis and neuroprotection pathways. Conclusion: Neurogenic markers are not definitive indicators of adult neurogenesis as their roles are more complex than previously understood. [ABSTRACT FROM AUTHOR]

Purpose: To analyze of the results of spine surgical treatment of athletes with lumbar degenerative disease and development of a surgical strategy based on the preoperative symptoms and radiological changes in the lumbar spine. Methods: For 114 athletes with lumbar degenerative disease were included in the present study. Four independent groups were studied: (1) microsurgical/endoscopic discectomy (n = 35); (2) PRP therapy in facet joints (n = 41); (3) total disc replacement (n = 11); (4) lumbar interbody fusion (n = 27). We evaluated postoperative clinical outcomes and preoperative radiological results. The average postoperative follow-up was 5 (3;6), 3.5 (3;5), 3 (2;4) and 4 (3;5) years, respectively. The analysis included an assessment of clinical outcomes (initial clinical symptoms, chronic pain syndrome level according to the VAS, quality of life according to the SF-36 questionnaire, degree of tolerance to physical activity according to the subjective Borg Rating of Perceived Exertion Scale) and radiological data (Dynamic Slip, Dynamic Segmental Angle, degenerative changes in the facet joint according to the Fujiwara classification and disc according to the Pfirrmann classification; changes in the diffusion coefficient using diffusion-weighted MRI). Results: The median and 25–75% quartiles timing of return to sports were 12.6 (10.2;14.1), 2.8 (2.4;3.7), 9 (6;12), and 14 (9;17) weeks, respectively. We examined the type of surgical treatment utilized, as well as the preoperative clinical symptoms, severity of degenerative changes in the intervertebral disc and facet joint, the timing of return to sports, the level of pain syndrome, the quality of life according to SF-36, and the degree of tolerance to physical activity. We then developed a surgical strategy based on individual preoperative neurological function and lumbar morphological changes. Conclusions: In this retrospective study, we report clinical results of four treatment options of lumbar spine degenerative disease in athletes. The use of developed patient selection criteria for the analyzed surgical techniques is aimed at minimizing return-to-play times. [ABSTRACT FROM AUTHOR]

Background: Parkinson’s, a degenerative disease characterized by motor and non-motor symptoms, gradually leads to disability and affects ordinary gestures, including patients’ home oral hygiene. Given that poor oral conditions, with decayed teeth, halitosis, and periodontal inflammation, can represent a critical issue in patients with low compliance in oral hygiene, the aim of this review was to investigate overall oral health in patients with Parkinson’s disease (PD). Methods: A search on PubMed, Cochrane Library and Scopus databases was conducted to identify relevant publications: studies concerning patients with PD, their oral health conditions, and oral hygiene, also in terms of inflammation and plaque control, were included. Risk of bias analysis and qualitative analysis were performed. Results: Of 226 records found through the electronic search, a total of 16 studies were finally included in the systematic review. Outcomes without consistent differences between PD patients and healthy patients (control group) mainly regarded: the frequency of brushing (at least twice a day), the brushing methods (generally variable) and the frequency of dental visits (mostly regular for both groups). In patients with PD, use of interdental devices was lower, and presence of plaque was higher: due to self-reported difficulties, 15–29% of them need help for oral care, against the 1% in the healthy group. Furthermore, the longer duration and higher severity of PD seem to adversely affect overall oral health conditions. Discussion: Since poor oral conditions of patients with PD are associated with their disability in conducting proper home procedures, it is necessary for dental practitioners to focus on specific and personalized instructions, to be easily delivered to caregivers.

Osteoarthritis, a prevalent form of arthritis linked to bone degeneration, particularly affects the elderly population. In Indonesia, its prevalence rises with age, impacting various ethnic groups, notably women, and leading to substantial disability in individuals aged 65 and older. Vigilance is essential against potential complications like gastritis, bleeding, or kidney issues resulting from prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs). The condition's pathophysiology involves joint aging, injuries, excessive use, genetic predisposition, obesity, and hormonal changes. Its clinical signs develop gradually but can accelerate due to injuries or joint strain, significantly reducing patient productivity and life quality. Managing osteoarthritis involves non-drug approaches like education, physical and exercise therapy, followed by medication and supportive devices. The treatment selection depends on severity and the number of affected joints, aiming to control pain, improve joint function, ease physical limitations, and hinder disease progression and complications. Prompt intervention with suitable modalities aligned with the patient's condition offers a favorable prognosis. Factors like muscle weakness, obesity, and depressive disorders can exacerbate osteoarthritis outcomes. Comprehensive management addressing these factors can significantly improve the prognosis and enhance the patient's quality of life.

Commonly plaguing in the frigid zone of the world, vitamin D deficiency, as indicated by low levels of 25-hydroxyvitamin D, exacerbated inflammatory responses and impaired endothelial function. Leukoaraiosis (LA) is a prevalent cause of cognitive dysfunction in the elderly and is potentially associated with inflammatory responses. This study aimed to investigate the impact of vitamin D on the severity of LA.

Aims: Shoulder arthroplasty is effective in the management of end-stage glenohumeral joint arthritis. However, it is major surgery and patients must balance multiple factors when considering the procedure. An understanding of patients’ decision-making processes may facilitate greater support of those considering shoulder arthroplasty and inform the outcomes of future research. Methods: Participants were recruited from waiting lists of three consultant upper limb surgeons across two NHS hospitals. Semi-structured interviews were conducted with 12 participants who were awaiting elective shoulder arthroplasty. Transcribed interviews were analyzed using a grounded theory approach. Systematic coding was performed; initial codes were categorized and further developed into summary narratives through a process of discussion and refinement. Data collection and analyses continued until thematic saturation was reached. Results: Two overall categories emerged: the motivations to consider surgery, and the information participants used to inform their decision-making. Motivations were, broadly, the relief of pain and the opportunity to get on with life and regain independence. When participants’ symptoms and restrictions prevented them enjoying life to a sufficient extent, this provided the motivation to proceed with surgery. Younger participants tended to focus on maintaining employment and recreational activities, and older patients were eager to make the most of their remaining lifetime. Participants gathered information from a range of sources and were keen to optimize their recovery where possible. An important factor for participants was whether they trusted their surgeon and were prepared to delegate responsibility for elements of their care. Conclusion: Relief of pain and the opportunity to get on with life were the primary reasons to undergo shoulder arthroplasty. Participants highlighted the importance of the patient-surgeon relationship and the need for accurate information in an accessible format which is relevant to people of different ages and functional demands. Cite this article: Bone Jt Open 2024;5(7):543–549.

Background: Accumulation of advanced glycation end products (AGEs) has contribution in development of Alzheimer's disease (AD), vascular dementia (VAD), and mild cognitive impairment (MCI). AGEs activate several signaling pathways that have roles in development of those diseases via receptor for advanced glycation end product (RAGE), this receptor has its soluble form called sRAGE which has ability to bind AGEs but could not induce molecular signaling. Based on this property, sRAGE could work as RAGE decoy and prevent pathological effect of AGEs accumulation. This meta-analysis is aimed to evaluate correlation between sRAGE plasma level and risk of AD, VAD, and MCI. Methods: Standardized mean difference with 95% coincidence interval was used as effect size. Inverse variance was used as analysis method with random effect model. Egger test and funnel plot were used to assess publication bias. Results: We found 424 articles through database searching. Among those articles, 15 articles that fulfilled our eligibility criteria. After selection based on inclusion and exclusion criteria, only 5 articles were included in this meta-analysis. Our analysis found that AD and VAD patients have lower levels of plasma sRAGE when compared to healthy control. Significant correlation between low sRAGE plasma level and MCI was not found. However, publication bias is found in MCI group. Publication bias of VAD group could not be assessed due to limited number of studies. Conclusions: Here, we show inverse relationship between sRAGE and the incidence of AD alongside VAD suggests that lower sRAGE plasma levels may be associated with a higher incidence of AD and VAD. However, some limitations in sample size and minimal studies may introduce bias into our results. [ABSTRACT FROM AUTHOR]

Symptomatic cervical spondylosis is often treated with anterior cervical discectomy and fusion (ACDF). However, few factors can predict which cervical level will degenerate and require intervention. This analysis evaluates preprocedural factors associated with level of first-time single-level ACDF. We performed a retrospective analysis of patients who underwent single-level ACDF without prior history of spine surgery. Mann Whitney U-tests and Spearman rank-order correlation were performed for analyses of associations between variables of interest and ACDF level. Adjusted odds-ratios were calculated by proportional-odds logistic regression, with age, sex, body mass index, current tobacco use, history of neck trauma, preoperative radicular symptoms, and preoperative myelopathic symptoms as covariates. One hundred forty-one patients met inclusion criteria, and age demonstrated a negative correlation with ACDF level, such that younger patients tended to have ACDF performed at inferior subaxial levels (P = 0.0006, rho = −0.31, moderately strong relationship). Patients with preoperative radicular symptoms and myelopathic symptoms were more likely to have ACDF performed at inferior (P = 0.0001) and superior (P < 0.0001) levels, respectively. Patient sex, body mass index, current tobacco use, and history of neck trauma were not predictive of ACDF level. When adjusting for the above variables in a proportional-odds ordinal logistic regression model, a one-year increase in age conferred a 4% increase in the odds of requiring an ACDF at a given superior level compared to the adjacent inferior level. Age is correlated with level of first-time single level ACDF. Individual subaxial levels may have unique biomechanical properties that influence degeneration. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective review of a single institution cohort. Objective. The goal of this study is to identify features that predict delayed achievement of minimum clinically important difference (MCID) following elective lumbar spine fusion using PatientReported Outcomes Measurement Information System (PROMIS) surveys. Summary of Background Data. Preoperative prediction of delayed recovery following lumbar spine fusion surgery is challenging. While many studies have examined factors impacting the achievement of MCID for patient-reported outcomes in similar cohorts, few studies have assessed predictors of early functional improvement. Methods. We retrospectively reviewed patients undergoing elective one-level posterior lumbar fusion for degenerative pathology. Patients were subdivided into two groups based on achievement of MCID for each respective PROMIS domain either before six months (“early responders”) or after six months (“late responders”) following surgical intervention. Multivariable logistic regression analysis was used to determine features associated with odds of achieving distribution-based MCID before or after six months follow up. Results. 147 patients were included. The average age was 64.3± 13.0 years. At final follow-up, 57.1% of patients attained MCID for PI and 72.8% for PF. However, 42 patients (49.4%) reached MCID for PI by six months, compared to 44 patients (41.1%) for PF. Patients with severe symptoms had the highest probability of attaining MCID for PI (OR 10.3; P=0.001) and PF (OR 10.4; P=0.001) Preoperative PROMIS symptomology did not predict early achievement of MCID for PI or PF. Patients who received concomitant iliac crest autograft during their lumbar fusion had increased odds of achieving MCID for PI (OR 8.56; P=0.001) before six months. Conclusion. Our study demonstrated that the majority of patients achieved MCID following elective one-level lumbar spine fusion at long-term follow-up, although less than half achieved this clinical benchmark for each PROMIS metric by six months. We also found that preoperative impairment was not associated with when patients would achieve MCID. Further prospective investigations are warranted to characterize the trajectory of clinical improvement and identify the risk factors associated with poor outcomes more accurately. [ABSTRACT FROM AUTHOR]

The contributions of the present Continuing Nutrition Education (CNE) Conference on "Nutrition and Brain Health" provide a representative overview of gut-brain interactions and their role in acute and chronic brain diseases. Nutrition plays a crucial and lifelong role in brain health. A well-balanced diet can significantly impact cognitive function, mood and overall brain health by influencing brain development and neuroplasticity. Advances in fields like nutrigenomics (the study of how genetics and nutrition interact) and the microbiome are shedding light on the complex relationships between nutrition and brain health. As our understanding deepens, more precise dietary recommendations and personalized approaches to support brain health may emerge. However, there are still some areas where the role of nutrition in brain health remains unclear. These include individual variability, the long-term effects of nutrition, nutrient interactions, the influence of complex dietary patterns, the gut-brain connection and the effects of aging on brain plasticity. The aim of this proceeding is to delve into some of these issues to lay out a comprehensive rundown of the existing knowledge in the field. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Both instrumented and stand-alone lateral lumbar interbody fusion (LLIF) have been widely used to treat lumbar degenerative disease. However, it remains controversial as whether posterior internal fixation is required when LLIF is performed. This meta-analysis aims to compare the radiographic and clinical results between instrumented and stand-alone LLIF. Methods PubMed, EMBASE and Cochrane Collaboration Library up to March 2023 were searched for studies that compared instrumented and stand-alone LLIF in the treatment of lumbar degenerative disease. The following outcomes were extracted for comparison: interbody fusion rate, cage subsidence rate, reoperation rate, restoration of disc height, segmental lordosis, lumbar lordosis, visual analog scale (VAS) scores of low-back and leg pain and Oswestry Disability Index (ODI) scores. Results 13 studies involving 1063 patients were included. The pooled results showed that instrumented LLIF had higher fusion rate (OR 2.09; 95% CI 1.16–3.75; P = 0.01), lower cage subsidence (OR 0.50; 95% CI 0.37–0.68; P

Introduction: Musculoskeletal-related chronic pain is one of the most disabling in the world, with knee osteoarthrosis (OA) being one of the main causes of functional limitation and chronic pain among people over 45 years of age. In view of this, the expansion of telehealth services, including telerehabilitation, allows less restricted access to health services, reducing expenses and saving time. Purpose: The aim of the study was to verify the barriers to the implementation of telerehabilitation in the treatment of chronic musculoskeletal diseases compared to face-to-face rehabilitation. Data Source: The data were obtained from PubMed, Scopus, the Virtual Health Library (VHL), Cochrane, and the Web of Science databases. Methods: This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to answer the PICOT question, “What are the barriers to implementing a telerehabilitation program for older people with knee osteoarthritis?”. The risk of bias was analyzed using the Review Manager program (RevMan). A search for articles was conducted and included only randomized clinical trials with older people with knee OA, selected by two blinded authors, according to inclusion and exclusion criteria, without publication time restriction, in the PROSPERO registry CRD42022316488. Results: The barriers to telerehabilitation have been overcome with the diversification of means of communication, the various possible ways of monitoring these patients from a distance, and the scheduling of face-to-face assessments and reassessments. The results presented in this review indicate that the barriers to implementing treatment protocols have been overcome, leading to clinical results which showed that there were no differences between the telerehabilitation and face-to-face groups for the clinical condition investigated. Conclusion: The barriers to telerehabilitation, which were more related to Internet access, telecommunication devices, personal relationships, and adequate monitoring of the exercise protocol, were overcome by diversifying the means of communication and delivering the exercise protocol for the implementation of telerehabilitation.

Background: Both instrumented and stand-alone lateral lumbar interbody fusion (LLIF) have been widely used to treat lumbar degenerative disease. However, it remains controversial as whether posterior internal fixation is required when LLIF is performed. This meta-analysis aims to compare the radiographic and clinical results between instrumented and stand-alone LLIF. Methods: PubMed, EMBASE and Cochrane Collaboration Library up to March 2023 were searched for studies that compared instrumented and stand-alone LLIF in the treatment of lumbar degenerative disease. The following outcomes were extracted for comparison: interbody fusion rate, cage subsidence rate, reoperation rate, restoration of disc height, segmental lordosis, lumbar lordosis, visual analog scale (VAS) scores of low-back and leg pain and Oswestry Disability Index (ODI) scores. Results: 13 studies involving 1063 patients were included. The pooled results showed that instrumented LLIF had higher fusion rate (OR 2.09; 95% CI 1.16–3.75; P = 0.01), lower cage subsidence (OR 0.50; 95% CI 0.37–0.68; P < 0.001) and reoperation rate (OR 0.28; 95% CI 0.10–0.79; P = 0.02), and more restoration of disc height (MD 0.85; 95% CI 0.18–1.53; P = 0.01) than stand-alone LLIF. The ODI and VAS scores were similar between instrumented and stand-alone LLIF at the last follow-up. Conclusions: Based on this meta-analysis, instrumented LLIF is associated with higher rate of fusion, lower rate of cage subsidence and reoperation, and more restoration of disc height than stand-alone LLIF. For patients with high risk factors of cage subsidence, instrumented LLIF should be applied to reduce postoperative complications. [ABSTRACT FROM AUTHOR]

The transforaminal lumbar interbody fusion (TLIF) is among the most utilized methods for the surgical treatment of lumbar degenerative disc disease. The TLIF has advanced significantly with several iterative changes since its inception in the early 1980s, with the advent of several generations of interbody types, shapes, and materials. Steerable curvilinear interbodies are among the most recent innovations in this space and may offer biomechanical advantages, namely in preservation of lumbar and segmental lordosis. While radiographic parameters have been investigated for other cage shapes and lumbar interbody fusion techniques, no study has investigated postoperative radiographic outcomes specific to TLIFs done with curvilinear interbodies. This study is a retrospective review of TLIFs performed with curvilinear interbodies between 2019 and 2022 at a single institution. Upright radiographs were obtained preoperatively and at several timepoints postoperatively. Radiographic variables including interspace height and segmental lordosis were collected. 26 surgeries with 32 curvilinear interbodies were performed across 3 years. There was significant increase in segmental lordosis at the L4-L5 (p = 0.0183) and L5-S1 levels (p = 0.004) as well as interspace height postoperatively at levels L3-L4 (p = 0.011) and L4-L5 (p = 0.002). Pain as measured with the numeric rating scale significantly improved in the overall cohort postoperatively (p<0.001). TLIF with curvilinear interbody placement increases segmental lordosis and interspace height at the L4-L5 and L5-S1 levels, and increased interspace height at the L3-L4 and L4-L5 levels. Further investigation into additional radiographic parameters is warranted and expanded cohort size would benefit deeper analysis of other spinal levels. As an increasing number of cage designs and materials are brought to market, studies such as this allow for better understanding of cage specific outcomes allowing for better informed device selection. [ABSTRACT FROM AUTHOR]

Introduction: Musculoskeletal-related chronic pain is one of the most disabling in the world, with knee osteoarthrosis (OA) being one of the main causes of functional limitation and chronic pain among people over 45 years of age. In view of this, the expansion of telehealth services, including telerehabilitation, allows less restricted access to health services, reducing expenses and saving time. Purpose: The aim of the study was to verify the barriers to the implementation of telerehabilitation in the treatment of chronic musculoskeletal diseases compared to face-to-face rehabilitation. Data Source: The data were obtained from PubMed, Scopus, the Virtual Health Library (VHL), Cochrane, and the Web of Science databases. Methods: This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to answer the PICOT question, "What are the barriers to implementing a telerehabilitation program for older people with knee osteoarthritis?". The risk of bias was analyzed using the Review Manager program (RevMan). A search for articles was conducted and included only randomized clinical trials with older people with knee OA, selected by two blinded authors, according to inclusion and exclusion criteria, without publication time restriction, in the PROSPERO registry CRD42022316488. Results: The barriers to telerehabilitation have been overcome with the diversification of means of communication, the various possible ways of monitoring these patients from a distance, and the scheduling of face-to-face assessments and reassessments. The results presented in this review indicate that the barriers to implementing treatment protocols have been overcome, leading to clinical results which showed that there were no differences between the telerehabilitation and face-to-face groups for the clinical condition investigated. Conclusion: The barriers to telerehabilitation, which were more related to Internet access, telecommunication devices, personal relationships, and adequate monitoring of the exercise protocol, were overcome by diversifying the means of communication and delivering the exercise protocol for the implementation of telerehabilitation. [ABSTRACT FROM AUTHOR]

BACKGROUND: The parameters of the spine and pelvis are interrelated. The changes in their values are closely related to the occurrence, development and symptoms of degenerative spinal diseases. At the present stage, clinical workers focus on the changes in postoperative coronal and sagittal parameters to evaluate the overall balance of the spine after operation, while ignoring the relationship with paraspinal muscle and the role of paraspinal muscle in the process of spinal degeneration. OBJECTIVE: To summarize the previous studies on the relationship between the degeneration of paraspinal muscle and sagittal alignment, and analyze the interaction between changes in the relative position of skeleton structures and degeneration of paraspinal muscle during spinal degeneration. METHODS: A computer-based online retrieval of CNKI, WanFang, and VIP was conducted with the Chinese key words “sagittal spinal deformity, sagittal alignment, spinal-pelvic parameter, paraspinal muscle, degeneration, human cadaver model, imaging, MRI”. The retrieval of Medline, PubMed, and Web of Science databases was performed with the English key words “sagittal spinal deformity, sagittal alignment, spinal-pelvic parameter, paraspinal muscle, degeneration, imaging, MRI”. The preliminary screening was carried out by reading the title and abstract, and the literature was screened according to the inclusion and exclusion criteria. Finally, a total of 78 articles were included for result analysis. RESULTS AND CONCLUSION: (1) In recent years, researchers have noticed that paraspinal muscles play a corresponding role in maintaining sagittal alignment, and spinal degeneration can be delayed by protecting and improving paraspinal muscle function. (2) The researchers used different methods to detect the degree of paraspinal muscle degeneration, and selected different kinds of sagittal parameters to describe the sagittal alignment. After analyzing the degeneration of paraspinal muscles and the changes in sagittal parameters, we found that there was a correlation between them, and the correlation was affected by age, race and other factors. (3) Poor sagittal alignment is an important anatomic factor determining paraspinal muscle degeneration. A high pelvic incidence of anatomical parameters has often been reported as a risk factor for sagittal alignment. However, the smaller pelvic incidence is more prone to sagittal imbalance due to the smaller compensatory capacity of paraspinal muscles. (4) The paraspinal muscles continue to affect the sagittal alignment through a compensatory mechanism continuously. To combat spinal imbalance during spinal degeneration, the paraspinal muscles are in a state of high muscle load, causing pain, fatigue, atrophy and degeneration. [ABSTRACT FROM AUTHOR]

Background: Missense VCP gene variants lead to a disruption in protein homeostasis causing a spectrum of progressive degenerative diseases. Myopathy is the most frequent manifestation characterized by slowly progressing weakness of proximal and distal limb muscles. We present a family with myopathy due to c.277C > T variant in VCP gene. Case presentation: The patient's phenotype includes symmetrical muscle wasting and weakness in the proximal parts of the limbs and axial muscles, a wide based gait, lordotic posture, positive Gowers' sign, mild calf enlargement, impaired mobility, elevated CK, and myopathy in proximal limb muscles. Whole body MRI revealed fatty replacement, predominantly affecting right vastus intermedius and medialis, gastrocnemius and soleus in calf, abdomen wall and lumbar muscles. Next-generation sequencing analysis revealed a pathogenic heterozygous variant c.277C > T (p.(Arg93Cys)) in exon 3 of the VCP gene. Segregation analysis showed that the detected variant is inherited from the affected father who developed symptoms at 60. Conclusion: The patients described experienced muscle wasting and weakness in the proximal and distal parts of the limbs which is a common finding in VCP related disease. Nevertheless, the patient has distinguishing features, such as high CK levels, early onset of the disease, and rapid mobility decline. [ABSTRACT FROM AUTHOR]

The objective of the study is to improve the results of patients undergoing lumbar spine surgery who are at high risk for anesthesia and/or surgical complications. Two independent groups were compared: the study group (SG, n = 40) (standardized neuroanesthetic protocol with multimodal analgesia) and the control group (CG, n = 40) (intravenous anesthesia based on propofol and fentanyl). The data were collected using prospective observation of early and long-term results of lumbar fusion. After 24 months, the level of functional state and quality of life were studied. Patients in the SG did not have statistically significant changes in intraoperative hemodynamics; the best indicators of cognitive functions were noted. The effectiveness of the SG compared with the CG was confirmed by a statistically significantly lower amount of perioperative opioid drugs required (p = 0.01) and a minimal level of incisional pain (p < 0.05). An intergroup comparison of the adverse effects of anesthesia revealed a significantly lower number in the SG (n = 4) compared to the CG (n = 16) (p = 0.004). The number of postoperative surgical complications was comparable (p = 0.72). Intergroup comparison showed improved ODI, SF-36, and the Macnab scale at 24 months after surgery in the SG compared to the CG (p < 0.05). Long-term clinical results correlated with the level of incisional pain in the first three postoperative days. Our standardized neuroanesthetic protocol ensured effective treatment of postoperative incisional pain, significantly decreased the perioperative use of opioids, reduced adverse anesthesia events, and improved long-term clinical results in patients with high risk factors for anesthetic complications who undergoing open lumbar spine surgery. [ABSTRACT FROM AUTHOR]

Spine surgery has undergone rapid advancements over the past several decades with the emergence of robotic and minimally invasive surgery (MIS). While conventional MIS spine surgery has had relative success, its complication profile has warranted continued efforts to improve clinical outcomes. We discuss the functional, clinical, and financial aspects of four robotic options for spinal pathologies, namely ROSA, Mazor X, Da Vinci, and ExcelsiusGPS, and conduct a bibliometric analysis to better understand current trends and applications of these robots as the field of robotic spine surgery continues to grow. An extensive search of English-language published literature on robotic-assisted spinal surgery was performed in Elsevier’s Scopus database. A bibliometric analysis was then performed on the top 100 most cited papers. The search yielded articles regarding robotic-assisted spine surgery application, limitations, and functional outcomes secondary to spine pathology. Accuracy analyses of 1733 screw placements were reviewed. The top 100 papers were published between 1992 and 2020, with a significant increase from 2015 onwards. The top publishing institution was John Hopkins University (n = 8). The top contributing author was Dr. Isador H. Lieberman (n = 6). The USA (n = 34) had the most articles on robotic spinal surgery, followed by Germany (n = 12). This review examines robotic applications in spine surgery, including four available options: ROSA, Mazor X, Da Vinci, and ExcelsiusGPS. Publication output over time, surgical outcomes, screw accuracy, and cost-effectiveness of these technologies have been investigated here. Certain robots have functional, clinical, and financial differences worth noting. Given the dearth of existing literature reporting postoperative complications and long-term comparative outcomes, there is a clear need for further studies on this matter. [ABSTRACT FROM AUTHOR]

Vincent Q Pham,1 Hannah M Miller,2 Elise O Fernandez,3 Daniel de Marchi,4 Hongtu Zhu,4 David Fleischman2 1Northeast Ohio Medical University, Rootstown, OH, USA; 2Department of Ophthalmology, University of North Carolina, Chapel Hill, NC, USA; 3School of Medicine, University of North Carolina, Chapel Hill, NC, USA; 4Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USACorrespondence: David Fleischman, Department of Ophthalmology, University of North Carolina, 5126 Bioinformatics Bldg #7040, Chapel Hill, NC, 27599-7040, USA, Tel +1 919 966-5296, Fax +1 919 966-1908, Email david8fleischman@gmail.comPurpose: Falls are associated with ocular trauma in the elderly. However, it is unlikely for a fall to cause ocular injury unless there is a disruption in the protective maneuvers that shield the face. We suspect ocular injury may be an early indicator of systemic or neurologic degeneration. This study investigates the 5-year incidence of cardiovascular and neurodegenerative diseases in older patients who sustained ocular or periorbital injuries.Patients and Methods: This was a retrospective cohort study. The study population included 141 patients over the age of 65 who sustained trauma to the eye, orbit, or eyelid between April 2011 and June 2016. The control population included 141 patients with a similar range of comorbidities who received cataract surgery during the same period. The study measured new diagnoses of various disorders during the 5-year period following presentation.Results: There were a total of 180 females and 102 males in the study. The mean ages of the control and subject group were 76 and 81.8, respectively. Of our twelve tested comorbidity types, patients that suffered a periocular trauma were more likely to develop heart failure (p=0.00244), dementia (p=0.00002), Alzheimer’s disease (p=0.00087), and vascular disease (p=0.00037).Conclusion: Geriatric patients who sustained ocular and periocular injuries had a greater incidence of heart failure, dementia, Alzheimer’s disease, and atherosclerosis diagnoses in the 5-year period following injury. The findings of this study suggest that periocular trauma may be an early indicator of underlying degenerative or systemic disease. Ophthalmologists should ensure proper primary care follow-up in conjunction with recovery from injury.Keywords: ocular injury, comorbidities, eye injury, degenerative disease

Abstract Study Design This is a retrospective study. Objective The aim of the study was to evaluate the efficacy of self-anchored lateral lumbar interbody fusion (SA-LLIF) in lumbar degenerative diseases. Methods Forty-eight patients with lumbar degenerative disease between January 2019 and June 2020 were enrolled in this study. All patients complained of low back and leg pain, which were aggravated during standing activities and alleviated or disappeared during lying. After general anesthesia, the patient was placed in the right decubitus position. The anterior edge of the psoas major muscle was exposed through an oblique incision of approximately 6 cm, using an extraperitoneal approach. The psoas major muscle was then properly retracted dorsally to expose the disc. After discectomy, a suitable cage filled with autogenous bone graft from the ilium was implanted. Two anchoring plates were inserted separately into the caudal and cranial vertebral bodies to lock the cage. Clinical efficacy was evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI). Lumbar lordosis, intervertebral disc height, spondylolisthesis rate, cage subsidence and fusion rate were also recorded. Results A total of 48 patients were enrolled in this study, including 20 males and 28 females, aged 61.4 ± 7.3 (range 49–78) years old. Surgery was successfully performed in all patients. Lumbar stenosis and instability were observed in 22 cases, disc degenerative disease in eight cases, degenerative spondylolisthesis in nine cases, degenerative scoliosis in six cases, and postoperative revision in three cases. In addition, five patients were diagnosed with osteoporosis. The index levels included L2–3 in three patients, L3–4 in 13 patients, L4–5 in 23 patients, L2–4 in three patients, and L3–5 in six patients. The operation time was 81.1 ± 6.4 (range 65–102) min. Intraoperative blood loss was 39.9 ± 8.5 (range 15–72) mL. No severe complications occurred, such as nerve or blood vessel injuries. The patients were followed up for 11.7 ± 2.3 (range 4–18) months. At the last follow-up, the VAS decreased from 6.2 ± 2.3 to 1.7 ± 1.1, and the ODI decreased from 48.4% ± 11.2% to 10.9% ± 5.5%. Radiography showed satisfactory postoperative spine alignment. No cage displacement was found, but cage subsidence 2–3 mm was found in five patients without obvious symptoms, except transient low back pain in an obese patient. The lumbar lordosis recovered from 36.8° ± 7.9° to 47.7° ± 6.8°, and intervertebral disc height recovered from 8.2 ± 2.0 mm to 11.4 ± 2.5 mm. The spondylolisthesis rate decreased from 19.9% ± 4.9% to 9.4% ± 3.2%. The difference between preoperative and last follow-up was statistically significant (P

Objective. To determine the main demographic factors that influence preoperative expectations of patients with degenerative diseases of the lumbosacral spine. Material and Methods. A cross-sectional study was performed for 103 patients with degenerative diseases of the lumbosacral spine who were scheduled for surgery in the period from 2019 to 2021. General demographic data, level of patient’s education and the presence of previous surgeries were taken into account. Expectations for surgical treatment outcome were assessed using a translated and adapted Russian version of the Hospital for Special Surgery – Lumbar Spine Surgery Expectations Survey (HSS-LSSES) questionnaire. The quality of life of patients was assessed using the general questionnaires: European Quality of Life-5 Dimensions (EQ-5D-5L) and the 36-item Short-Form Health Survey (SF-36), as well as the disease-specific Oswestry Disability Index (ODI). Results. It was found that, according to HSS-LSSES, patients’ expectations for the upcoming surgical intervention are the higher, the older the patient’s age, the higher the general and emotional state of health, vitality, ODI scores, as well as the severity of pain syndrome, and the lower the mental health score. Patients with a high level of education and prior spinal surgery have lower expectations for subsequent surgery. Conclusion. The expectations of patients for the surgical treatment for degenerative disease of the lumbosacral spine depend on the patient’s age, level of education, anamnesis and severity of decline in the quality of life.

Background: Cranial cruciate ligament disease is one of the leading causes of pelvic limb claudication in canines and osteoarthritis in the stifle joint. Historically, studies have focused on surgical options to improve the stability of the stifle joint, although none of the techniques described in the literature prevents the development of osteoarthritis. Aim: This study aimed at proving the presence of osteoarthritis at the time of diagnosis of cranial cruciate ligament rupture, as well as evaluating the benefits of administering diacerein or chondroprotective coadjuvants to the extracapsular fabelo-tibial technique. Methods: Seventeen dogs aged between 2 and 8, weighing more than 25 kg, with no predilection for breed or sex, were operated on using this technique. These were divided into three groups: Diacerein (DAR), Chondroprotector (CP), and Control. The animals were treated for 90 days and controlled clinically, radiologically, and using multidimensional scales for pain and quality of life. The statistical analysis used was descriptive and through non-parametric tests. Results: All patients had some degree of osteoarthritis at the beginning of the study associated with the presence of pain. The treated groups improved the claudication scores; however, the changes were significant for the diacerein group. The pain score improved in all animals, including those in the Control group; however, the differences were significant only in the treated groups. On the other hand, no significant differences were detected in the radiological studies, so it would be convenient to perform this study over more than 90 days. Conclusion: The surgical treatment accompanied by drugs that act on the degradation of articular cartilage has better clinical results. [Open Vet J 2023; 13(3.000): 297-306]

Abstract Protein aggregate species play a pivotal role in the pathology of various degenerative diseases. Their dynamic changes are closely correlated with disease progression, making them promising candidates as diagnostic biomarkers. Given the prevalence of degenerative diseases, growing attention is drawn to develop pragmatic and accessible protein aggregate species detection technology. However, the performance of current detection methods is far from satisfying the requirements of extensive clinical use. In this review, we focus on the design strategies, merits, and potential shortcomings of each class of detection methods. The review is organized into three major parts: native protein sensing, seed amplification, and intricate program, which embody three different but interconnected methodologies. To the best of our knowledge, no systematic review has encompassed the entire workflow, from the molecular level to the apparatus organization. This review emphasizes the feasibility of the methods instead of theoretical detection limitations. We conclude that high selectivity does play a pivotal role, while signal compilation, multilateral profiling, and other patient‐oriented strategies (i.e. less invasiveness and assay speed) are also important.

BackgroundMissense VCP gene variants lead to a disruption in protein homeostasis causing a spectrum of progressive degenerative diseases. Myopathy is the most frequent manifestation characterized by slowly progressing weakness of proximal and distal limb muscles. We present a family with myopathy due to c.277C > T variant in VCP gene.Case presentationThe patient‘s phenotype includes symmetrical muscle wasting and weakness in the proximal parts of the limbs and axial muscles, a wide based gait, lordotic posture, positive Gowers’ sign, mild calf enlargement, impaired mobility, elevated CK, and myopathy in proximal limb muscles. Whole body MRI revealed fatty replacement, predominantly affecting right vastus intermedius and medialis, gastrocnemius and soleus in calf, abdomen wall and lumbar muscles. Next-generation sequencing analysis revealed a pathogenic heterozygous variant c.277C > T (p.(Arg93Cys)) in exon 3 of the VCP gene. Segregation analysis showed that the detected variant is inherited from the affected father who developed symptoms at 60.ConclusionThe patients described experienced muscle wasting and weakness in the proximal and distal parts of the limbs which is a common finding in VCP related disease. Nevertheless, the patient has distinguishing features, such as high CK levels, early onset of the disease, and rapid mobility decline.

Background: The incidence of primary osteoarthritis knee is gradually increasing among young individuals. The increasing prevalence of obesity, sedentary lifestyle, sporting activity, and vitamin D deficiency (VDD) has been hypothesized for this shifting disease trend. This study was designed to look for the association of serum vitamin D among these young arthritic patients. Aim: To look for the association of serum vitamin D in younger knee osteoarthritis (KOA) patients. Methods: In a 2-year observational study, 146 non-obese KOA patients of 35-60 years were evaluated clinically (Knee injury and Osteoarthritis Outcome Score, KOOS) and radiologically (Kellegren-Lawrence stage, KL). The serum 25(OH) D level of these patients and 146 normal healthy individuals of same age group were estimated. Results: Both the groups were comparable in terms of age and sex. The average serum 25 (OH) D levels in healthy individuals and KOA patients were 45.83 ng/mL and 34.58 ng/mL, respectively (P < 0.001). Inadequate serum 25 (OH) D levels (< 30ng/mL) was found in 46.57% of KOA patients and 24% of normal healthy participants indicating a significant positive association (odds ratio 2.77, 95%CI: 1.67-4.54, P < 0.001). The 25(OH)D level in KL grade I, II, III and IV was 43.40, 30.59, 31.56 and 33.93 ng/mL respectively (no difference, P = 0.47). Similarly, the KOOS score in sufficient, insufficient and deficient groups were 65.31, 60.36 and 65.31, respectively (no difference, P = 0.051). Conclusion: The serum 25 (OH) D levels are significantly low in younger KOA patients. However, the clinical and radiological severities have no association with serum vitamin D level. [ABSTRACT FROM AUTHOR]

Background and Objectives: Lumbar spinal stenosis (LSS) is a degenerative condition posing significant challenges in clinical management. Despite the use of radiological parameters and patient-reported outcome measures like the Oswestry Disability Index (ODI) for evaluation, there is limited understanding of their interrelationship. This study aimed to investigate the correlation between preoperative MRI parameters and ODI scores in patients with LSS undergoing surgical treatment. Materials and Methods: A retrospective analysis was conducted on 86 patients diagnosed with LSS over a 5-year period. Preoperative MRI measurements, including the cross-sectional area of the psoas muscle, lumbar canal stenosis, neural foramina area, and facet joint osteoarthritis, were assessed. ODI scores were collected preoperatively and at a 1-year follow-up. Statistical analyses were performed using IBM SPSS Statistics software (version 26). Results: Weak to moderate correlations were observed between certain MRI parameters and ODI scores. The initial ODI score had a weak positive correlation with the severity of lumbar canal stenosis according to Schizas criteria (rho = 0.327, p = 0.010) and a moderate negative correlation with the relative cross-sectional area of the psoas muscle (rho = −0.498, p = 0.000). At 1-year follow-up, the ODI had a weak negative correlation with the relative cross-sectional area of the psoas muscle (rho = −0.284, p = 0.026). Conclusions: While the severity of LSS showed a weak correlation with initial ODI, it was not a predictor of 1-year postoperative ODI. Furthermore, although the cross-sectional area of the thecal sac, the sagittal area of the neural foramen, and the grade of facet joint osteoarthritis influence the imagistic severity, none of them correlate with ODI. These findings underscore the need for a comprehensive model that integrates multiple imaging and clinical parameters for a holistic understanding of LSS and its functional outcomes. [ABSTRACT FROM AUTHOR]

Study Design: This is a retrospective study. Objective: The aim of the study was to evaluate the efficacy of self-anchored lateral lumbar interbody fusion (SA-LLIF) in lumbar degenerative diseases. Methods: Forty-eight patients with lumbar degenerative disease between January 2019 and June 2020 were enrolled in this study. All patients complained of low back and leg pain, which were aggravated during standing activities and alleviated or disappeared during lying. After general anesthesia, the patient was placed in the right decubitus position. The anterior edge of the psoas major muscle was exposed through an oblique incision of approximately 6 cm, using an extraperitoneal approach. The psoas major muscle was then properly retracted dorsally to expose the disc. After discectomy, a suitable cage filled with autogenous bone graft from the ilium was implanted. Two anchoring plates were inserted separately into the caudal and cranial vertebral bodies to lock the cage. Clinical efficacy was evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI). Lumbar lordosis, intervertebral disc height, spondylolisthesis rate, cage subsidence and fusion rate were also recorded. Results: A total of 48 patients were enrolled in this study, including 20 males and 28 females, aged 61.4 ± 7.3 (range 49–78) years old. Surgery was successfully performed in all patients. Lumbar stenosis and instability were observed in 22 cases, disc degenerative disease in eight cases, degenerative spondylolisthesis in nine cases, degenerative scoliosis in six cases, and postoperative revision in three cases. In addition, five patients were diagnosed with osteoporosis. The index levels included L2–3 in three patients, L3–4 in 13 patients, L4–5 in 23 patients, L2–4 in three patients, and L3–5 in six patients. The operation time was 81.1 ± 6.4 (range 65–102) min. Intraoperative blood loss was 39.9 ± 8.5 (range 15–72) mL. No severe complications occurred, such as nerve or blood vessel injuries. The patients were followed up for 11.7 ± 2.3 (range 4–18) months. At the last follow-up, the VAS decreased from 6.2 ± 2.3 to 1.7 ± 1.1, and the ODI decreased from 48.4% ± 11.2% to 10.9% ± 5.5%. Radiography showed satisfactory postoperative spine alignment. No cage displacement was found, but cage subsidence 2–3 mm was found in five patients without obvious symptoms, except transient low back pain in an obese patient. The lumbar lordosis recovered from 36.8° ± 7.9° to 47.7° ± 6.8°, and intervertebral disc height recovered from 8.2 ± 2.0 mm to 11.4 ± 2.5 mm. The spondylolisthesis rate decreased from 19.9% ± 4.9% to 9.4% ± 3.2%. The difference between preoperative and last follow-up was statistically significant (P<0.05). Conclusion: SA-LLIF can provide immediate stability and good results for lumbar degenerative diseases with a standalone anchored cage without posterior internal fixation. [ABSTRACT FROM AUTHOR]

Retinitis pigmentosa (RP) is the leading cause of inherited blindness with a genetically heterogeneous disorder. Currently, there is no effective treatment that can protect vision for those with RP. In recent decades, the rd1 mouse has been used to study the pathological mechanisms of RP. Molecular biological studies using rd1 mice have clarified the mechanism of the apoptosis of photoreceptor cells in the early stage of RP. However, the pathological changes in RP over time remain unclear. The unknown pathology mechanism of RP over time and the difficulty of clinical treatment make it urgent to perform more refined and spatially informed molecular biology studies of RP. In this study, spatial transcriptomic analysis is used to study the changes in different retinal layers of rd1 mice at different ages. The results demonstrate the pattern of photoreceptor apoptosis between rd1 mice and the control group. Not only was oxidative stress enhanced in the late stage of RP, but it was accompanied by an up-regulation of the VEGF pathway. Analysis of temporal kinetic trends has further identified patterns of changes in the key pathways of the early and late stages, to help understand the important pathogenesis of RP. Overall, the application of spatial transcriptomics to rd1 mice can help to elucidate the important pathogenesis of RP involving photoreceptor apoptosis and retinal remodeling. [ABSTRACT FROM AUTHOR]

ObjectivesCircular RNAs (circRNAs) are noncoding RNAs that compete against other endogenous RNA species, such as microRNAs, and have been implicated in many diseases. In this study, we investigated the role of a new circRNA (circSLC7A2) in osteoarthritis (OA).Materials and methodsThe relative expression of circSLC7A2 was significantly lower in OA tissues than it was in matched controls, as shown by real-time quantitative polymerase chain reaction (RT-qPCR). Western blotting, RT-qPCR and immunofluorescence experiments were employed to evaluate the roles of circSLC7A2, miR-4498 and TIMP3. The in vivo role and mechanism of circSLC7A2 were also conformed in a mouse model.ResultscircSLC7A2 was decreased in OA model and the circularization of circSLC7A2 was regulated by FUS. Loss of circSLC7A2 reduced the sponge of miR-4498 and further inhibited the expression of TIMP3, subsequently leading to an inflammatory response. We further determined that miR-4498 inhibitor reversed circSLC7A2-knockdown-induced OA phenotypes. Intra-articular injection of circSLC7A2 alleviated in vivo OA progression in a mouse model of anterior cruciate ligament transection (ACLT).ConclusionsThe circSLC7A2/miR-4498/TIMP3 axis of chondrocytes catabolism and anabolism plays a critical role in OA development. Our results suggest that circSLC7A2 may serve as a new therapeutic target for osteoarthritis.

Proteins involved in the Alzheimer's disease (AD), such as amyloid precursor protein (APP) and presenilin-1 (PS1), play critical roles in early development of the central nervous system (CNS), as well as in innate immune and glial cell responses. Familial AD is associated with the presence of APPswe and PS1dE9 mutations. However, it is still unknown whether these mutations cause deficits in CNS development of carriers. We studied genome-wide gene expression profiles of differentiated neural progenitor cells (NPCs) from wild-type and APPswe/PS1dE9 mouse embryo telencephalon. The occurrence of strong innate immune and glial cell responses in APPswe/PS1dE9 neurospheres mainly involves microglial activation, inflammatory mediators and chemokines. APPswe/PS1dE9 neurospheres augmented up to 100-fold CCL12, CCL5, CCL3, C3, CX3CR1, TLR2 and TNF-alpha expression levels, when compared to WT neurospheres. Expression levels of the glia cell marker GFAP and microglia marker Iba-1 were up to 20-fold upregulated in APPswe/PS1dE9 neurospheres. The secretome of differentiated APPswe/PS1dE9 NPCs revealed enhanced chemoattraction of peripheral blood mononuclear cells. When evaluating the inferred protein interaction networks constructed from the array data, an improvement in astrocyte differentiation in APPswe/PS1dE9 neurospheres was evident in view of increased GFAP expression. Transgenic NPCs differentiated into neural phenotypes presented expression patterns of cytokine, glial cells, and inflammatory mediators characteristic of APPswe/PS1dE9 adult animals. Consequently, the neurogenic niche obtained from differentiation of embryonic APPswe/PS1dE9 neurospheres spontaneously presents several alterations observed in adult AD brains. Finally, our data strengthen pathophysiological hypotheses that propose an early neurodevelopmental origin for familial AD. [ABSTRACT FROM AUTHOR]

Inflammation or inflamm-aging is a chronic low-grade inflammation that contributes to numerous types of degenerative diseases among the elderly and might be impeded by introducing an anti-inflammatory agent like Moringa oleifera Lam (moringa) and Zingiber officinale Roscoe (ginger). Therefore, this paper aims to review the role of moringa and ginger in suppressing inflamm-aging to prevent degenerative diseases. Various peer-reviewed publications were searched and downloaded using the reputed search engine "Pubmed" and "Google Scholar". These materials were reviewed and tabulated. A comparison between these previous findings was made based on the mechanism of action of moringa and ginger against degenerative diseases, focusing on their anti-inflammatory properties. Many studies have reported the efficacy of moringa and ginger in type 2 diabetes mellitus, neurodegenerative disease, cardiovascular disease, cancer, and kidney disease by reducing inflammatory cytokines activities, mainly of TNF-α and IL-6. They also enhanced the activity of antioxidant enzymes, including catalase, glutathione, and superoxide dismutase. The anti-inflammatory activities can be seen by inhibiting NF-κβ activity. Thus, the anti-inflammatory potential of moringa and ginger in various types of degenerative diseases due to inflamm-aging has been shown in many recent types of research. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is a common degenerative joint disease that affects millions of people worldwide. Magnetic resonance imaging (MRI) has emerged as a powerful tool for the evaluation and monitoring of OA due to its ability to visualize soft tissues and bone with high resolution. This review aims to provide an overview of the current state of MRI in OA, with a special focus on the knee, including protocol recommendations for clinical and research settings. Furthermore, new developments in the field of musculoskeletal MRI are highlighted in this review. These include compositional MRI techniques, such as T2 mapping and T1rho imaging, which can provide additional important information about the biochemical composition of cartilage and other joint tissues. In addition, this review discusses semiquantitative joint assessment based on MRI findings, which is a widely used method for evaluating OA severity and progression in the knee. We analyze the most common scoring methods and discuss potential benefits. Techniques to reduce acquisition times and the potential impact of deep learning in MR imaging for OA are also discussed, as these technological advances may impact clinical routine in the future. [ABSTRACT FROM AUTHOR]

The relationship between various factors predisposing to the formation of spondylolisthesis, including degenerative spondylolisthesis, has been analyzed by many authors. However, not all observations are consistent. In this review, we identified factors whose impact on the prevalence of spondylolisthesis was most often mentioned in the literature. These included gender, age, bone mineral density, ethnic origin, and oophorectomy. The results were inclusive in terms of physical activity, pregnancy status, and use of hormone replacement therapy. Associations between diabetes and smoking were very poorly marked. The literature so far has identified a number of factors significantly affecting the incidence of degenerative spondylolisthesis. These include age, gender, body weight, ethnic origin, bone mineral density, and hormonal balance. Radiological parameters, which include iliac crest, pelvic tilt, pelvic incidence, sacral slope, and lumbar lordosis, may also be of great importance for assessing changes in the occurrence and progression. However, the authors do not agree on the real significance of individual factors. The aim of this review was to identify the factors predisposing to the formation of degenerative spondylolisthesis, the importance of which has been suggested in the current literature. The systematization of knowledge in this field can allow a more accurate adjustment of the treatment plan for each patient affected by this condition. [ABSTRACT FROM AUTHOR]

Purpose of Review: Apraxia of speech (AOS) is a motor speech disorder that has long been recognized to occur secondary to acute neurologic insults and, more recently, to neurodegenerative diseases as a harbinger for progressive supranuclear palsy and corticobasal syndrome. This article reviews recent findings regarding the clinic phenotypes of AOS, neuroimaging correlates, and the underlying disease processes. Recent Findings: Two clinical subtypes of AOS map onto two underlying 4-repeat tauopathies. New imaging techniques have recently been applied to the study of progressive AOS. There is no data on the impact of behavioral intervention, although studies of nonfluent/agrammatic primary progressive aphasia that include patients with AOS suggest some benefit in speech intelligibility and maintenance. Summary: While recent findings suggest subtypes of AOS exist that are linked to molecular pathology and have important implications for disease progression, further research is needed to assess outcome of behavioral and other types of intervention. [ABSTRACT FROM AUTHOR]

Repeated exposure to environmental ozone causes a chronic state of oxidative stress. This state is present in chronic degenerative diseases and induces a loss of control of the inflammatory response. Redox system dysfunction and failures in control of inflammatory responses are involved in a vicious circle that maintains and increases the degenerative process. The intestine also responds to secondary reactive species formed by exposure to ozone doses, generating noxious stimuli that increase degenerative damage. This review aims to elucidate how environmental pollution, mainly by ozone, induces a state of chronic oxidative stress with the loss of regulation of the inflammatory response, both in the intestine and in the brain, where the functionality of both structures is altered and plays a determining role in some neurodegenerative and chronic degenerative diseases. For this purpose, we searched for information on sites such as the Cochrane Library Database, PubMed, Scopus, and Medscape. Reviewing the data published, we can conclude that environmental pollutants are a severe health problem. Ozone pollution has different pathways of action, both molecular and systemic, and participates in neurodegenerative diseases such as Parkinson's and Alzheimer's disease as well in bowel diseases as Inflammatory Bowel Disease, Crohn's Disease, and Irritable Bowel Syndrome. [ABSTRACT FROM AUTHOR]

Patients presenting with degenerative spinal changes are often poor surgical candidates due to associated co-morbidities, frailty, or sarcopenia. Additionally, surgeries of a degenerative spine can prove difficult due to the distortion of normal surgical anatomy. Therefore, many patients are managed conservatively with a variety of modalities, including over-the-counter and prescription medications. Nevertheless, several patients do not experience adequate relief from pain with analgesic medications, precipitating multiple hospital visits, and usage of resources. As a result, back pain is regarded as a major economic burden, with total costs of associated treatment exceeding $100 billion annually. Pharmacogenetics is a relatively novel method of evaluating an individual's response to analgesic medications, through analysis of germline polymorphisms. It entails obtaining a genetic sample, often via buccal swab or peripheral blood sample, and genetic analysis achieved through either polymerase chain reaction +/− Sanger sequencing, microassays, restriction length fragment polymorphism analysis, or genetic library preparation and next generation sequencing. The potential efficacy of pharmacogenetic analysis has been highlighted across several specialities to date. However, a paucity of evidence exists regarding spine surgery populations. Nevertheless, regular prospective pharmacogenetic analysis may ultimately prove beneficial when concerning degenerative spinal cohorts due to aforementioned surgical and economic considerations. The purpose of this narrative review is to outline how metaboliser profile variants affect the pharmacokinetics of specific analgesia used to treat back pain, and to discuss the current potential and limitations of employing regular pharmacogenetic analysis for spine surgery populations with degenerative conditions. [ABSTRACT FROM AUTHOR]

Osteoartritis (OA) memengaruhi 303 juta orang di dunia dan menjadi salah satu masalah kesehatan yang harus diwaspadai. Terapi penyembuhan OA secara total belum ada. Platelet-rich plasma (PRP) saat ini menjadi target peneliti untuk penanganan pasien OA. Tujuan: Mengetahui efektivitas terapi adjuvan injeksi PRP pada pasien OA sendi lutut yang mendapatkan NSAIDs. Metode: Studi observasional dengan pendekatan cohort retrospektif dilakukan pada pasien osteoartritis sendi lutut di Rumah Sakit Jember Klinik dan Rumah Sakit Daerah Balung. Jumlah sampel yang didapatkan sebanyak 16 pasien. Penelitian ini membandingkan terapi non-steroidal anti-inflammatory drugs (NSAID) tunggal dan NSAID dengan adjuvan PRP. Evaluasi terapi dengan menilai perubahan derajat keparahan gambaran klinis menggunakan kuesioner Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC). Uji Fisher’s exact digunakan untuk membandingkan efektivitas terapi. Hasil: terdapat perubahan derajat keparahan gambaran klinis dari 16 sampel pasien. Sebanyak 11 pasien mengalami penurunan derajat keparahan gambaran klinis, dengan rincian 8 pasien (72,7%) dari kelompok terapi NSAIDs dengan adjuvan PRP dan 3 pasien (27,3%) dari kelompok pasien OA yang mendapatkan NSAIDs tanpa adjuvan PRP. Simpulan: Terapi adjuvan injeksi PRP pada pasien OA yang mendapatkan NSAIDs lebih efektif memperbaiki derajat keparahan gambaran klinis penyakit dibandingkan dengan pasien OA yang mendapatkan NSAIDs tanpa adjuvan injeksi PRP.

Study Design: This was a retrospective study. Objective: Since a better understanding of modifiable risk factors for proximal junctional disease (PJD) may lead to improved postoperative outcomes and less need of revision surgery, the aim of the present study is to determine whether sarcopenia and osteopenia are independent risk factors for PJD in patients undergoing lumbar fusion. Summary of Background Data: PJD is one of the most frequent complications following posterior instrumented spinal fusion. It is characterized by a spectrum of pathologies ranging from proximal junctional kyphosis (PJK) to proximal junctional failure (PJF). The etiology of PJD is multifactorial and currently not fully understood. Patient-specific factors, such as age, body mass index, osteoporosis, sarcopenia, and the presence of other comorbidities, can represent potential risk factors. Materials and Methods: A retrospective review of patients, aging 50–85 years, who underwent a short (≤3 levels) posterior lumbar fusion for degenerative diseases was performed. Through magnetic resonance imaging (MRI), central sarcopenia and osteopenia were evaluated, measuring the psoas-to-lumbar vertebral index (PLVI) and the M-score. A multivariate analysis was performed to determine the independent risk factors for PJD, PJK, and PJF. Results: A total of 308 patients (mean age at surgery 63.8 ± 6.2 years) were included. Ten patients (3.2%) developed a PJD and all required revision surgery. Multivariate regression identified PLVI (P = 0.02) and M-score (P = 0.04) as independent risk factors for both PJK (P = 0.02 and P = 0.04, respectively) and PJF (P = 0.04 and P = 0.01, respectively). Conclusions: Sarcopenia and osteopenia, as measured by PLVI and M-score, proved to be independent risk factors for PJD in patients who undergo lumbar fusion for degenerative diseases. Clinical Trial Registration: The present study was approved by the Institutional Review Board, CE AVEC 208/2022/OSS/IOR.

Study Design: This was a prospective multicenter study. Background: Adjacent segment degenerative disease (ASDd) is a common complication of open transforaminal lumbar interbody fusion (O-TLIF), the leading cause of which is initial adjacent segment degeneration (ASD). To date, various surgical techniques for the prevention of ASDd have been developed, such as, simultaneous use of interspinous stabilization (IS) and preventive rigid stabilization of the adjacent segment. The use of these technologies is often based on the subjective opinion of the operating surgeon, or on the assessment of one of the predictors of ASDd. Only sporadic studies are devoted to a comprehensive study of risk factors of ASDd development and personalized performance of O-TLIF. Purpose: The purpose of this study was to evaluate long-term clinical outcomes and the incidence of degenerative disease of the adjacent proximal segment using clinical-instrumental algorithm for preoperative planning to O-TLIF. Materials and Methods: The prospective, nonrandomized, multicenter cohort study included 351 patients who underwent primary O-TLIF, and the adjacent proximal segment had initial ASD. Two cohorts were identified. The prospective cohort included 186 patients who were operated by using the algorithm of personalized O-TLIF performance. The control retrospective cohort consisted of patients (n = 165), from our own database who had been operated on previously without the algorithmized approach. Treatment outcomes were analyzed by Visual Analog Scale (VAS) assessment of pain syndrome, Oswestry Disability Index (ODI) scores, physical component score (PCS) and mental component score (MCS) scores of the Short Form 36 questionnaire, frequency of ASDd was compared between studied cohorts. Results: Thirty-six months after follow-up, the prospective cohort had better SF36 MCS/PCS outcomes, less disability according to ODI, and lower pain level according to VAS (P < 0.05). The incidence of ASDd in the prospective cohort was 4.9%, which was significantly lower than in the retrospective cohort (9%). Conclusions: The prospective use of a clinical-instrumental algorithm for preoperative planning of rigid stabilization, depending on the biometric parameters of the proximal adjacent segment, significantly reduced the incidence of ASDd and improved long-term clinical outcomes compared with the retrospective group.

Background: Degenerative diseases in orthopaedics have become a significant global public health issue with the aging of the population worldwide. The traditional medical interventions, including physical therapy, pharmacological therapy and even surgery, hardly work to modify degenerative progression. Stem cell–based therapy is widely accepted to treat degenerative orthopaedic disease effectively but possesses several limitations, such as the need for strict monitoring of production and storage and the potential risks of tumorigenicity and immune rejection in clinical translation. Furthermore, the ethical issues surrounding the acquisition of embryonic stem cells are also broadly concerned. Exosome-based therapy has rapidly grown in popularity in recent years and is regarded as an ideal alternative to stem cell–based therapy, offering a promise to achieve ‘cell-free’ tissue regeneration. Methods: Traditionally, the native exosomes extracted from stem cells are directly injected into the injured site to promote tissue regeneration. Recently, several modified exosome–based strategies were developed to overcome the limitations of native exosomes, which include mainly exogenous molecule loading and exosome delivery through scaffolds. In this paper, a systematic review of the exosome-based strategy for degenerative disease in orthopaedics is presented. Results: Treatment strategies based on the native exosomes are effective but with several disadvantages such as rapid diffusion and insufficient and fluctuating functional contents. The modified exosome–based strategies can better match the requirements of the regeneration in some complex healing processes. Conclusion: Exosome-based strategies hold promise to manage degenerative disease in orthopaedics prior to patients reaching the advanced stage of disease in the future. The timely summary and highlights offered herein could provide a research perspective to promote the development of exosome-based therapy, facilitating the clinical translation of exosomes in orthopaedics. Translational potential of this article: Exosome-based therapy is superior in anti-senescence and anti-inflammatory effects and possesses lower risks of tumorigenicity and immune rejection relative to stem cell–based therapy. Exosome-based therapy is regarded as an ideal alternative to stem cell–based therapy, offering a promise to achieve ‘cell-free’ tissue regeneration.