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We partitioned Antarctic ice mass changes (2003-2020) into the contributions of surface mass balance (SMB) and ice discharge over 27 drainage basins, based on the combined estimates of satellite gravimetry and altimetry observations and a numerical SMB model. Our analysis indicates that the ice discharge has played a dominating role in ongoing ice mass losses and accelerations, especially in the glaciers near Amundsen and Bellingshausen Sea in West Antarctica. In particular, the mass losses in the Thwaites and Pine Island Glaciers have been mostly controlled by ice discharge, while the contribution of SMB has been minor. On the other hand, SMB contributed large portions of ice mass imbalance in East Antarctica, such as glaciers near the Dronning Maud Land and Wilkes Land. An inaccurate GIA model is a potential source of uncertainty in our estimates.

The ice mass balance of Antarctica has been steadily and strongly decreasing over recent decades, with major ramifications for global sea levels. Satellite remote sensing offers global, daily coverage of ice mass changes, which is essential for understanding land ice changes and their effects on global climate. However, we need to correct for processes including firn densification, glacial isostatic adjustment, elastic compensation of the Earth’s surface, ocean tides, and inverse barometer effect. Of these corrections, understanding the changes to the firn layer constitutes one of the largest uncertainties in making estimates of the surface mass balance from space. Furthermore, the development of firn models that aid our understanding of firn densification processes is hampered by a lack of observations.Radar sounder reflections contain information about the roughness and permittivity of the reflecting interface, allowing us to map the spatial variability of the ice surface characteristics. In 2022, a helicopter-mounted ice-penetrating radar system developed by the University of Texas Institute for Geophysics collected high-quality radar observations over the Dotson Ice Shelf, West Antarctica. These surveys obtained clearly defined surface and bed reflections. We derived near-surface density along these survey flight lines using the radar statistical reconnaissance method developed by Grima, 2014. We calibrated our estimates with contemporary observations, including ground penetrating radar, a shallow ice core, an Autonomous phase-sensitive Radio Echo-sounder (ApRES), and radar soundings of well-defined surfaces from a calibration flight.

The use of BMP-2 in orthopedic surgery is limited by uncertainty surrounding its effects on the differentiation of mesenchymal stem cells (MSCs) and how this is affected by cellular aging. This study compared the effects of recombinant human BMP-2 (rhBMP-2) on osteogenic and adipogenic differentiation between senescent and non-senescent MSCs. Senescent and non-senescent MSCs were cultured in osteogenic and adipogenic differentiation medium containing various concentrations of rhBMP-2. The phenotypes of these cells were compared by performing a calcium assay, adipogenesis assay, staining, real-time PCR, western blotting, and microarray analysis. rhBMP-2 induced osteogenic differentiation to a lesser extent (P

Favorable clinical outcomes have been reported for oblique lateral interbody fusion (OLIF) for various lumbar degenerative diseases. However, there is only limited evidence on the safety and effectiveness of OLIF in degenerative spondylolisthesis with lumbar facet cyst (LFC), and OLIF is often regarded as a relative contraindication for these patients. The authors prospectively enrolled patients who underwent a single-level OLIF for degenerative spondylolisthesis with LFC to evaluate the morphological changes of LFC and their clinical significance following OLIF. Twenty patients with a mean age of 69.6 years (range, 65–86 years) were enrolled. At 1 week postoperative, 5 (25%) patients had a residual cyst, whereas 15 (75%) patients had completely resolved cysts on magnetic resonance imaging (MRI). No patient had a residual cyst on the 1-year postoperative MRI. Patients with cyst resolution (n=15) on the 1-week postoperative MRI had a larger slip percentage difference on the preoperative dynamic radiograph when compared with patients with no cyst resolution (n=5) (4.7%±2.8% vs 1.3%±0.3%, P =.002). The group with cyst resolution also showed a greater expansion of facet fluid width following OLIF, although this was not statistically significant (1.2±0.7 mm vs 0.7±0.5 mm, P =.098). For both groups, all preoperative clinical scores showed a significant improvement at 1 year after OLIF, but there was no significant difference between the groups at all time points. Preliminary 1-year follow-up results from this prospective series suggest that OLIF can be a useful option for fusion surgery in LFC patients with apparent segmental instability. [ Orthopedics . 2021;44(5):306–312.]

STUDY DESIGN Retrospective case-control study. OBJECTIVE The aim of this study was to describe and compare the sagittal spinal alignment between patients with and without the ossification of the ligamentum flavum in the thoracic spine (TOLF). SUMMARY OF BACKGROUND DATA Although mechanical factors play an important role in the development of TOLF, limited evidence exists on the association of sagittal spinal alignment and TOLF in the literature. METHODS The present study assessed the preoperative sagittal alignment parameters in consecutive patients who underwent posterior decompression for TOLF in a single institution between January 2014 and December 2019. The sagittal parameters of the patients with TOLF were compared to those of the age- and sex-matched control group with lumbar spondylosis. RESULTS The TOLF group (n = 43 [23 men, 20 women]), with a mean age of 69.5 (range: 41-86) years, and the control group (n = 86) were compared. The TOLF group had a significantly smaller sacral slope (27.60 ± 7.49 vs. 30.61 ± 8.15, P = 0.045) and lumbar lordosis (36.84 ± 13.63 vs. 45.08 ± 9.90, P

Study design Prospective cohort study. Objective The aim of this study was to evaluate the predictive value of comprehensive geriatric assessment (CGA) for early postoperative complications in elderly patients (aged 65 years or older) following lumbar spinal stenosis surgery. Summary of background data CGA is a multidisciplinary evaluation modality proven to be effective in various fields of geriatrics. However, limited evidence exists on the effectiveness of CGA in lumbar spinal stenosis patients in the literature. Methods We prospectively enrolled consecutive patients who were at least 65 years' old and were scheduled to undergo elective surgery for lumbar spinal stenosis. One day before the operation, multidomain CGA was performed on the patient's functional status, comorbidities, nutrition, cognition, and psychological status. Patients with deficits in three or more CGA domains were defined as frail. The occurrence of postoperative complications (Clavien and Dindo grade 2 or higher) within 30 days after the surgery was assessed as the outcome. The predictive value of CGA was evaluated using crosstab and logistic regression analysis and compared to that of other risk stratification systems, including modified Frailty Index-5, -11, and American Society of Anesthesiologists Physical Classification System. Results A total of 261 patients were included in the study, and 25 (9.6%) patients were assigned to the "frail" group. There were 27 (10.3%) patients with a postoperative complication (general: n = 20, 7.7%, surgical: n = 7, 2.7%) within postoperative 30 days. Patients with a complication showed significantly more deficits on preoperative CGA than those without complications (P = 0.004). On multivariate logistic regression analysis, frailty based on CGA (odds ratio = 3.51, P = 0.031) and the modified Frailty Index-11 (odds ratio = 3.13, P = 0.038) were associated with the occurrence of general complications. Conclusion Frailty based on CGA was significantly associated with early general complications following surgery for lumbar spinal stenosis in patients older than 65 years. Level of evidence 2.

BACKGROUND CONTEXT Biportal endoscopic decompressive laminectomy is a widely performed procedure and shows acceptable clinical outcomes. However, the evidence regarding the advantages of biportal endoscopic surgery is weak, a randomized controlled trial is therefore warranted. PURPOSE To compare the clinical efficacies of biportal endoscopic and microscopic decompressive laminectomy in patients with lumbar spinal stenosis. STUDY DESIGN Randomized controlled trial. PATIENT SAMPLE Sixty-four participants suffering from low back and leg pain with single-level lumbar spinal stenosis who required decompressive laminectomy. OUTCOME MEASURES Outcomes were assessed with the use of patient-reported outcome measures, visual analog scale (VAS) score for low back and lower extremity radiating pain, Oswestry disability index (ODI), European Quality of Life-5 Dimensions (EQ-5D) score, and painDETECT for neuropathic pain. Surgery-related outcomes including operation time, length of hospital stay, postoperative drainage, and serum creatine phosphokinase were evaluated. Perioperative ( METHODS All participants were randomly assigned in a 1:1 ratio to undergo biportal endoscopic or microscopic decompressive laminectomy. The primary outcome was the ODI score at 12 months after surgery based on a modified intention-to-treat strategy. The secondary outcomes included VAS score for low back and lower extremity radiating pain, ODI scores, EQ-5D score, and painDETECT score. There were no sources of funding and no conflicts of interest associated with this study. RESULTS There was no significant difference between groups in the mean ODI score at 12 months after surgery (30 in the microscopy vs. 29 in the biportal endoscopy group, p=.635). There were also no significant differences in low back and lower extremity pain VAS scores, ODI, EQ-5D scores, and painDETECT scores at the 3-, 6-, or 12-month follow-up. Operation time, length of hospital stay, serum creatine phosphokinase, and perioperative complications, such as durotomies and symptomatic hematoma, showed no significant differences between the groups; however, one participant underwent additional revision surgery 9 months after the index surgery in the microscopy group. CONCLUSIONS Despite the study design limitation of relatively short duration of follow-up, this trial suggests that biportal endoscopic decompressive laminectomy is an alternative to and offers similar clinical outcomes as microscopic open surgery in patients with symptomatic lumbar spinal stenosis.

Study design Retrospective case series. Purpose We reviewed the cases that showed significant improvement of intraoperative neurophysiological monitoring (IONM) signals during spine surgery to assess whether there is a correlation with signal improvement and postoperative clinical status and its clinical significance. Overview of literature To reduce the risk of neural injury, many spine surgeons are using multimodality IONM. Although many studies attempted to identify valid alarm criteria for predicting postoperative neurologic deterioration, studies concerning the improvement of IONM signals are rare. Methods We reviewed all spine surgery cases with IONM data treated at our department between January 2013 and May 2017. We found cases showing significant IONM signal improvements. We prospectively analyzed the neurological and clinical outcomes of these patients and compared outcomes pre- and postoperatively. Results Among 317 cases with the IONM data, we found 29 cases that showed IONM signal improvement compared with baseline. There were 27 cases of compressive myelopathy: 22 had a degenerative cause at the cervical spine, and five, at the thoracic spine. There were two cases of huge neurogenic tumor each at the craniovertebral junction and at the lumbar spine. Both motor-evoked potentials (MEPs) and somatosensory-evoked potentials (SSEPs) signals were improved in six cases, only the MEPs signal improved in 10, and only SSEP signal improved in 13 cases. All cases showed the IONM signal improvement consistently after the decompression procedure during surgery. All patients had a significant improvement in neurological function and subjective symptoms, and none had neurologic deterioration postoperatively. Conclusions Improvement of IONM signals during surgery may indicate that no unrecognized neural injury occurred during surgery and a favorable postoperative neurological outcome can be expected.

Supplemental Digital Content is available in the text., Study Design: This is a prospective, stratified randomized, multicenter, 4-year follow-up study. Objective: The authors aimed to evaluate the long-term clinical efficacy and safety of CaO-SiO2-P2O5-B2O3 glass ceramics (BGS-7) spacers in 1-level posterior lumbar interbody fusion (PLIF) at a 4-year follow-up. Summary of Background Data: According to 1-year follow-up results, BGS-7 spacer showed similar fusion rates and clinical outcomes compared with titanium cage. A long-term follow-up study beyond 2 years is necessary to investigate the status of intervertebral bone graft volumes. Moreover, longer follow-up is mandatory to also evaluate the safety and efficacy of BGS-7 spacers, because they remain in the intervertebral space for a long time. Materials and Methods: In this prospective, randomized, multicenter, 4-year follow-up study, we evaluated 62 of the 74 patients who underwent 1-level PLIF. During 1-level PLIF, titanium cages filled with autologous local bone were inserted into the control group patients and BGS-7 spacers were inserted to the experimental group patients. Bone fusion was evaluated by plain radiography and thin-section computed tomography. Visual Analog Scale (VAS), the Oswestry Disability Index (ODI), Short Form-36 Health Survey (SF-36), and evaluation of safety were conducted after 48 months. Results: Computed tomography scan showed a bone fusion rate of 90.6% in the BGS-7 spacer group and 93.3% in the control group, with no significant differences between groups. The BGS-7 spacer group showed a significantly larger area directly fused to the endplate than the control group (P

Study design This was a cross-sectional cohort study. Objective The objective of this study was to identify the prevalence of sleep disturbance in patients with symptomatic lumbar spinal stenosis (LSS) and to establish the relationship between sleep disturbance and both functional disability and health-related quality of life in patients with symptomatic LSS. Summary of background data Despite the possible association between LSS and poor sleep quality, there has been no study regarding the relationship between LSS and sleep disturbance. Materials and methods A total of 148 patients with LSS were divided into the poor sleeper and nonpoor sleeper groups according to Global Pittsburgh Sleep Quality Index (PSQI) score. Demographic data, Visual Analog Scale (VAS) score for back and leg pain, Oswestry Disability Index (ODI), and EuroQol 5-dimension questionnaire (EQ-5D) were compared between both groups. Multiple regression analysis was performed with ODI or ODI without sleep component as the dependent variable and age, sex, PSQI, VAS for back pain, VAS for leg pain as independent variables. Results Of the 148 patients who participated in this study, 54 (36.5%) and 94 (63.5%) patients were classified into nonpoor sleeper and poor sleeper groups. Although there were no differences in demographic data or VAS for back or leg pain between the nonpoor sleeper and poor sleeper groups, poor sleepers demonstrated significantly higher ODI scores, and lower EQ-5D than nonpoor sleepers (P=0.003 and 0.004, respectively). There were significant correlations between the global PSQI score and both the ODI score and EQ-5D. Although the surgical treatment group showed significantly higher VAS for back pain, VAS for leg pain, ODI scores, and lower EQ-5D than the conservative treatment group, the ratio of poor to nonpoor sleepers was not different between both groups (P=0.733). In the surgical treatment group, the percent of poor sleeper decreased from 65.1% to 47.6% 6 months after surgery (P Conclusions The present study demonstrated that 'poor sleep quality' is a prevalent condition (63.5%) in patients with symptomatic LSS. Poor sleep quality has an adverse effect on functional disability and health-related quality of life in symptomatic LSS patients.

To analyze pelvic compensation during walking in patients with severe sagittal plane deformity by using motion analysis. A total of 44 patients with sagittal plane deformity who were scheduled to undergo surgery were included. Motion analysis was performed 3 consecutive times during walking to estimate the anterior pelvic tilt (Ant-PT) angle, trunk kyphosis (TK) angle, and distance of the center of gravity (CoG) from the center of mass (CoM) of the pelvic segment, and hip and knee joint angles during gait. The patients were classified into Ant-PT+/Ant-PT−, TK+/TK−, and CoG+/CoG− groups according to the changes in Ant-PT angle, TK angle, and distance of the CoG from the CoM of the pelvic segment. Increases and decreases in the values of the variables from the first trial to the third trial were indicated with “+” and “−” signs, respectively. The mean Ant-PT angle, TK angle, and distance of the CoG from the CoM of the pelvic segment increased progressively, and the differences in the values of these variables from the first to the third trials were statistically significant (P = 0.046, P = 0.004, and P = 0.007 for the Ant-PT angle, TK angle, and distance of the CoG from the CoM of pelvic segment, respectively). Among the 44 patients, 27 and 34 were classified into the Ant-PT+ and CoG+ groups, respectively. Older age and higher body mass index (BMI) were significantly associated with the Ant-PT+ group. The CoG+ group demonstrated a significantly higher height and weight than the CoG− group. Higher BMI, height, and weight are risk factors for progressive worsening of dynamic sagittal imbalance. These slides can be retrieved under Electronic Supplementary Material.

In this study, we compared the quality characteristics of soft morning roll bread with different contents of two Korean high-yield tongil-type rice varieties, namely Hanareum4 and Keumkang1. The final and setback viscosities increased with increasing rice flour ratio as determined by a Rapid Visco Analyzer. The pH of the dough decreased as the rice flour ratio was decreased from 70% to 0%, regardless of the rice cultivar, and the dough rose more when less rice flour was added. During the final fermentation stage, the volumes of the dough containing Keumkang1 were 32.2, 27.5, 23.0, and 21.0 mL when 0, 30, 50, and 70% rice flour were added, respectively. The SEM images reveal that the dough forms a net-like morphology during fermentation, due to the decomposition of the wheat and rice flour. The volume and moisture contents of soft morning roll bread ranged in 90-192.5 mL and 38.25-40.06%, respectively. The volume of the Keumkang1-containing bread loaf was higher than that of the Hanareum4-containing loaf. Texture profile analysis (TPA) results suggest that the hardness and chewiness of the bread containing 30% Keumkang1 is very similar to that of the 100%-wheat bread regardless of rice varieties. The results suggest that Keumkang1 can replace wheat at a 30% level for morning roll bread purposes.

The purpose of this study was to assess the immediate postoperative clinical outcomes and perform a preliminary analysis of the effectiveness of biportal endoscopic approaches to lumbar decompressive laminectomy in the treatment of lumbar spinal stenosis.All participants (64 patients) were randomly assigned in a 1:1 ratio to either the biportal endoscopic lumbar decompressive laminectomy (BE-D) group or the mini-open microscopic lumbar decompressive laminectomy (MI-D) group. Early postoperative outcomes were evaluated using clinical and surgical technique-related outcomes. The visual analog scale (VAS) pain score was measured at 6 time points after surgery (at 4, 8, 16, 24, and 48 hours and 2 weeks). Surgical technique-related outcomes were also analyzed.There were no significant differences in the preoperative demographics between the 2 groups. The VAS pain score from 8 to 48 hours (P0.05) was significantly lower in the BE-D group than in the MI-D group. Moreover, the total amount of fentanyl usage was higher in the MI-D group than in the BE-D group after surgery (P = 0.026). The length of hospital stay was lower in the BE-D group than in the MI-D group (P = 0.048). The operative time and creatinine phosphokinase level were not significantly different between the groups (P0.05). Postoperative drainage was significantly higher in the BE-D group than in the MI-D group.BE-D was associated with rapid pain recovery, low fentanyl usage, and early discharge after surgery, but its other benefits have not yet been shown.

OBJECTIVES To evaluate survival and functional outcomes in surgically-treated spinal metastasis patients and to identify the prognostic value of the remaining options for systemic treatment. METHODS The current study reviewed 100 consecutive patients who received surgery for spinal metastasis in a single center from March 2012 to June 2016. The decision for surgery had been made in a weekly multidisciplinary tumor board after considering multiple factors. Among these factors, those associated with the functional outcome were identified using crosstab and logistic regression analyses. Survival analysis applying the Kaplan-Meier curve and the Cox proportional hazards model was used to identify factors associated with improved survival. RESULTS Of the 100 patients, there were 62 men and 38 women, with a mean age of 60.4 years at the time of surgery. The median postoperative survival of the whole cohort was 16.2 months (95% confidence interval: 10.1-22.3). When patients were stratified by the functional outcome, a significantly large proportion of patients with good functional outcome (Eastern Cooperative Oncology Group performance status better than 3) had an available option for systemic treatment at the time of surgery (P

Ice shelf dynamics and morphology play an important role in the stability of floating bodies of ice, in turn impacting their ability to buttress upstream grounded ice. We use a combination of satellite-derived data, airborne and ground-based radar data, and oceanographic data collected at the Nansen Ice Shelf in East Antarctica to examine the spatial variations in ice shelf draft, the cause and effects of ice shelf strain rates, and the role of a suture zone driving channelization of ocean water and resulting sub-ice shelf melt and freeze-on. We also use the datasets to assess limitations that may arise from examining only a sub-set of the data, in particular the reliance on hydrostatic balance equations applied to surface digital elevation models to determine ice draft morphology. We find that the Nansen Ice Shelf has highly variable basal morphology driven primarily by the formation of basal crevasses near the onset of floating ice convergence in the suture zone. This complex morphology is reflected in the ice shelf strain rates but not in the calculated hydrostatic balance thickness, which underestimates the scale of vertical and horizontal variability at the ice shelf base. The combination of thinner ice in the channelized suture zone, enhanced melt rates near the ice shelf edge, and complex strain rates driven by ice dynamics and morphology have led to the formation of fractures within the suture zone that have resulted in large-scale calving events. Other Antarctic ice shelves may also have complex morphology, which is not reflected in the satellite data, yet may influence their stability.

Limited evidence is available in the literature regarding the fate of the unfused structural thoracic curve following selective thoracolumbar-lumbar curve fusion (SLF) in Lenke 6C adolescent idiopathic scoliosis (AIS) patients. Therefore, we compared the outcomes of SLF between Lenke 6C and 5C AIS patients. We retrospectively reviewed 31 patients Lenke 5C (n = 18) and Lenke 6C (n = 13) AIS patients who underwent SLF at a single institution. Multiple radiological parameters were measured using whole-spine radiographs taken before and after surgery and at the last follow-up visit. SRS-22 at the final follow-up was obtained for clinical assessment. A total of 31 patients with a mean age of 14.6 years at operation who were followed for a mean of 6.4 years were included in this study. The Cobb angle of the unfused thoracic curve was spontaneously corrected immediately following SLF and increased slightly but not significantly at the final follow-up in both groups (Lenke 5C: pre 33.0°, post 14.4°, final 19.4°, Lenke 6C: pre 46.1°, post 31.7°, final 34.2°). At every time point, the thoracic Cobb angle was significantly larger in the Lenke 6C. SRS-22 score at the final follow-up, including the self-image domain, did not differ between the two groups. In this study, SLF for Lenke 6C AIS achieved a significant spontaneous correction of the unfused thoracic curve and yielded a comparable SRS-22 result at the final follow-up to that of Lenke 5C. Our findings suggest that SLF is a viable treatment option for Lenke 6C AIS.

Study Design: Cross-sectional study. Objective: To compare handgrip strength (HGS), paraspinal muscles’ (PSM) volume, and their effects on clinical symptom severity between the patients with sagittal imbalance (SI) and symptomatic lumbar spinal stenosis (LSS). Methods: A total of 54 paired consecutive patients with SI and LSS were enrolled after propensity score matching. Preoperative HGS, cross-sectional area (CSA) of psoas (PS) and multifidus (MF) muscles, and patient-reported measures, including visual analog scale (VAS) for back/ leg pain, Oswestry Disability Index (ODI), and EuroQOL (EQ-5D) were compared between both groups. Within each SI and LSS group, patient-reported measures were compared between high and low HGS subgroups. The correlation of HGS and CSA of PSMs to patient-reported measures was evaluated. Results: There was no difference in HGS between 2 groups, however, the CSA of PS and MF muscles in SI group was significantly lower than those in LSS group. Patients with low HGS showed inferior results for ODI and EQ-5D, compared to those with high HGS subgroup in both SI and LSS groups. HGS and CSA of MF muscle were correlated with ODI in both groups. Conclusions: There was no significant difference between the SI and LSS groups in HGS, however, PSMs’ volume in SI group were significantly lower than those in LSS group. Therefore SI would be associated with loss of localized muscle mass in back area, rather than global skeletal muscle weakness. HGS and PSMs’ volume were adversely associated with functional status in SI and LSS patients.

STUDY DESIGN A prospective observational study. OBJECTIVE This study was done to examine the influence of hand grip strength (HGS) on surgical outcomes of adult spinal deformity (ASD) patients. SUMMARY OF BACKGROUND DATA No study has investigated the relation between hand grip strength and treatment outcome of adult spinal deformity correction surgery. METHODS A total of 78 consecutive patients who underwent adult spinal deformity correction surgery were included in this study. Patients were assigned to either the high HGS (≥ 26 kg for men and ≥ 18 kg for women, n = 26) or the low HGS (< 26 kg for men and < 18 kg for women, n = 52) based on their preoperative measurements. The Oswestry disability index (ODI), EQ-5D, and visual analog scale (VAS) for back pain were assessed preoperatively, and 3 months, 6 months, and 12 months postoperatively. The primary outcome measure was ODI scores 12 months after surgery. The secondary outcome measures included the overall ODI scores, EQ-5D, and VAS for back pain, assessed at each time point during the 12-months follow-up. RESULTS The ODI score at 12 months after surgery was significantly lower in the high HGS group than the low HGS group (P

Background Risk factors for unfavorable surgical outcomes are dependent on the definitions of the unfavorable surgical outcomes. The aims of this study were to compare risk factors for each unfavorable surgical outcome according to two different definitions of “unfavorable” surgical outcomes after surgery for lumbar spinal stenosis (LSS) as well as compare the clinical course from the preoperative period to 3 years postoperatively between cases with favorable and unfavorable outcomes according to the two different definitions. Methods Overall, 295 patients who underwent spine surgery for LSS and a follow-up evaluation at 3 years postoperatively were enrolled and divided into favorable and unfavorable groups, based on two different definitions for unfavorable surgical outcomes, as evaluated at 12 months postoperatively: the patient-reported outcome (PRO) and minimal clinically important difference (MCID) methods. In the PRO method, patients with a postoperative Oswestry Disability Index (ODI) score > 22 were considered as having an “unfavorable” outcome, whereas in the MCID method, those with a postoperative ODI score that changed Results In the PRO method, female sex (P = 0.011; odds ratio (OR): 2.340), elementary school attainment (vs. university attainment; P = 0.035; OR: 2.875), and higher preoperative ODI score (P = 0.028; OR: 2.340) were associated with higher odds for an unfavorable surgical outcome. In the MCID method, a higher preoperative ODI score was associated with higher odds (P Conclusion A higher preoperative ODI score may be a risk factor for postoperative ODI > 22 after surgery for LSS. It may also be associated with higher odds for improvements in the ODI score of > 12.8.

There is increasing evidence supporting an association between sitting time and low back pain (LBP). However, the degree of the association between the total daily sitting time and LBP in the general population is poorly understood.The present study aimed (1) to analyze the association between the duration of sitting time and LBP, and (2) to examine this association according to the degree of physical activity in population over 50 years of age with a nationally representative sample of Korean adults.This is a cross-sectional study.Data from version VI-2, 3 of the Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2014 and 2015 were analyzed.Multiple logistic regression was performed to find the rates of association between chronic LBP, level of sitting time, and physical activity.Nationwide health surveys and examinations were conducted in general Korean representative populations (n=7,550 in 2014, n=7,380 in 2015). Chronic LBP was defined as self-reported LBP lasting for more than 30 days during the past 3 months in a health survey. Sitting time and daily physical activity were evaluated using the long version of the International Physical Activity Questionnaires (IPAQ). The duration of sitting time was divided into two categories according to the median value (7 hours) and further divided into four categories using quartiles. Physical activity was also divided into low and high physical activity according to duration of mid- to high-intensity activities. There were no sources of funding and no conflicts of interest associated with the present study.On multiple logistic regression analysis, sitting time more than 7 hours/day was significantly associated with LBP (adjusted odds ratio 1.33, p.001). The risk of LBP increased with increasing duration of sitting time. In participants with low levels of physical activity, the duration of sitting time showed more positive association with LBP than that in all the participants and participants with high levels of physical activity.Longer duration of sitting time is a risk factor for LBP. Furthermore, long duration of sitting time with low physical activity further increases the risk of LBP.

This study was carried out to compare the physiochemical properties and quality characteristics of porridge made from different Korean rice varieties, including high yield tongil-type rice. The rice varieties used in this study were 4 tongil-type (Areum, Namcheon, Hanareum3, Hanareum4) and 5 japonica-type rices (Unkwang, Daebo, Goami4, Dodamssal and Hwaseonchal). The protein and amylose contents of the varieties ranged from 6.0% (Namcheon) to 7.3% (Hanareum3) and from 5.0% (Hwaseonchal) to 42.8% (Dodamssal). Compared to the other varieties, Hwaseonchal and Dodamssal had low final and setback viscosity values in the rapid-visco analyzer test. The color value of the porridge ranged between 52.90 and 71.12 for the L value, -2.06 and -1.01 for the a value, and -5.59 and -2.62 for the b value. SEM images revealed distinct differences in the endosperm structure of rice varieties as well as the porridge. Furthermore, porridge made from Hwaseonchal rice had the highest spreadability, followed by porridge made from others non-glutinous rice varieties, Goami4 rice, and Dodamssal rice. The results of this study suggested that rice varieties with different amylose contents could be effectively used to control the viscosity of rice porridge. In laboratory experiments, the sensory test did not indicate significant differences except for the mouthfeel. The mouthfeel of the porridge depended on the amylose content of rice. This study suggested that tongil-type rice variety such as Hanareum4 could be substituted with Japonica type rice for making porridge.

Study design This was a retrospective cohort study. Purpose We evaluated the predictive value of the Spinal Instability Neoplastic Score (SINS) system for spinal adverse events (SAEs) in patients with single spinal metastatic tumor. Overview of literature The SINS system was developed to assess spinal instability in patients with single metastatic spinal tumor. However, the system's potential predictive value for SAEs has been partially studied. Methods This system was applied to a retrospective cohort of 78 patients with single spinal metastatic tumors. The patients underwent surgical treatment and were postoperatively followed up for at least 2 years or until death. The attribution of each score and total SINS to SAE (vertebral compression fracture [VCF] and spinal cord compression [SCC]) occurrence was assessed using the Cox proportional hazards model. Results SAEs occurred on average 7 months after diagnosis of spinal metastasis. The mean survival rate post diagnosis was 43 months. Multivariate analysis using the Cox proportional hazards model revealed that the pain (p =0.029) and spinal alignment (p =0.001) scores were significantly related to VCF occurrence, whereas the pain (p =0.008) and posterolateral involvement (p =0.009) scores were related to SCC occurrence. Conclusions Among the components of the SINS system, while pain and spinal alignment showed a significant association with VCF occurrence, pain and posterolateral involvement showed association with SCC occurrence.

Objective To determine the amount of screws needed to achieve an adequate skill level for pedicle screw placement (PSP) via the freehand technique in the nondeformed thoracolumbar spine using the cumulative summation test for learning curve (LC-CUSUM) analysis. Methods This study includes the first 85 patients who underwent pedicle screw installation in the thoracic and lumbar spine by a single orthopedic surgeon. The surgeon had 1 years' experience of fellowship training in a tertiary teaching hospital. The learning curve of freehand PSP was investigated using the LC-CUSUM analysis. Procedure success was defined as acceptable accuracy of PSP, which was divided into group 1 (the screw breaches the pedicle's cortex by less than 2 mm) and group 2 (the screw is completely within the pedicle). Results A total of 52 cases and 313 pedicle screws were included and analyzed in this study. The LC-CUSUM analysis signaled competency for freehand PSP at the 115th pedicle screw (17th case) in group 1 and at the 312th pedicle screw (52nd case) in group 2. This means that a trainee with no experience with freehand PSP reached an adequate accuracy level of PSP with less than 2 mm pedicle breaches at the 115th screw and completely within the pedicle at the 312th screw. There were no major complications, such as neurovascular injury, and life-threatening complications. Conclusions In this study, the learning curve analysis demonstrated that a substantial learning period may be necessary before an adequate level of performance is achieved for freehand PSP in the nondeformed thoracolumbar spine.

STUDY DESIGN A cross-sectional study. OBJECTIVE This study was designed to analyze the relationship between the presence and severity of depression and low back pain (LBP) in a representative sample of the general population using a self-report screening questionnaire for depression. SUMMARY OF BACKGROUND DATA There is increasing evidence supporting an association between depression and LBP. However, the degree of the association between these two conditions in the general population is poorly understood. METHODS Health surveys and examinations were conducted on a nationally representative sample (n = 7550) of Koreans. LBP status was determined by a simple survey response concerning LBP >30 days during the past 3 months. Depression was defined as individuals with a total score >10 on the Patient Health Questionnaire (PHQ)-9 survey. The severity of depression was categorized as none (0-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe (20-27) according to PHQ-9 score. Data regarding demographics, socioeconomic history, and comorbid health conditions were used to analyze adjusted, weighted logistic regression models. RESULTS In the Korean population, the prevalence of depression was significantly greater in individuals with LBP (20.3%) than in those without LBP (4.5%). On multivariate logistic regression analysis, the presence of depression was significantly associated with LBP (adjusted odd ratio [aOR]: 3.93, P < 0.001). The risk of LBP increased with increasing severity of depression as follows: severe depression (aOR: 9.28, P

To investigate the prevalence of frailty in patients with symptomatic lumbar spinal stenosis (LSS) and a propensity score-matched control group, and to analyze the association between symptomatic LSS and frailty. This study included 2 groups: 1 consisting of patients with symptomatic LSS (LSS group) and the other including healthy elderly subjects without degenerative spinal disease (control group). Baseline sociodemographic data, variables regarding frailty assessment, and clinical outcomes were collected. The frailty was assessed with Fried criteria. Between the LSS and control groups, the prevalence of frailty was compared. Among all participants, risk factors for frailty were identified using multivariate logistic regression. Totally, 843 subjects participated (142 in LSS group and 701 in control group) in this study. After the propensity score matching (142 in each group), the LSS group had significantly higher prevalence of frail than the control group (P

취반방법이 유색미밥의 항산화 활성에 미치는 영향을 살펴보기 위해 유색미 비율별(0, 5, 10, 15 및 20%)로 첨가했을 때 취반방법별로 제조한 유색미밥의 기능성분 및 라디칼 소거 활성을 살펴보았다. 아밀로그램 특성은 유색미 혼합비율이 증가함에 따라 최고점도, 최저점도, 강하점도, 최종점도, 치반점도가 유의적으로 감소하였다. 건강홍미의 수분결합력은 혼합비율이 증가함에 따라 증가하였고 조생흑찰은 감소하였으며, 팽윤력은 감소, 용해도는 증가하는 경향을 보였다. 유색미의 혼합비율별 식미 특성은 외관, 경도, 찰기 및 밸런스는 백미에 비해 떨어지는 것으로 나타났다. 유색미 혼합비율과 취반방법에 따른 유색미밥의 총 폴리페놀, 플라보노이드 함량 및 라디칼 소거 활성은 유색미의 혼합비율이 증가함에 따라 유의적으로 증가하였다. 총 폴리페놀 및 플라보노이드 함량은 조생흑찰 20% 첨가, 10% 발효주정을 첨가하여 일반밥솥으로 취반한 경우 각각 461.83 μg GAE/g sample 및 127.38 μg CE/g sample로 높게 나타났다. 유색미밥의 주요 페놀 화합물은 protocatechuic acid, p-coumaric acid 및 ferulic acid 등으로 나타났다. 건강홍미의 DPPH 및 ABTS 라디칼 소거 활성은 20% 첨가, 10% 발효주정을 첨가하여 압력밥솥으로 취반한 경우 각각 13.38 및 29.29 mg TE/100 g sample로 나타났고, 조생흑찰은 20% 첨가, 10% 발효주정을 첨가하여 일반밥솥으로 취반한 경우 각각 34.00 및 49.59 mg TE/100 g sample로 높은 활성을 나타내었다. 이상의 결과 유색미밥은 발효주정을 첨가하여 취반하였을 때 높은 라디칼 소거 활성을 나타내어 소량의 발효주정을 첨가하여 밥을 짓는 방법은 산업적으로 이용이 가능할 것으로 생각된다.

PURPOSE We prospectively assessed the early radiographic and clinical outcomes (minimum follow-up of 2 years) of robot-assisted pedicle screw fixation (Robot-PSF) and conventional freehand pedicle screw fixation (Conv-PSF). MATERIALS AND METHODS Patients were randomly assigned to Robot-PSF (37 patients) or Conv-PSF (41 patients) for posterior interbody fusion surgery. The Robot-PSF group underwent minimally invasive pedicle screw fixation using a pre-planned robot-guided screw trajectory. The Conv-PSF underwent screw fixation using the freehand technique. Radiographic adjacent segment degeneration (ASD) was measured on plain radiographs, and clinical outcomes were measured using visual analogue scale (VAS) and Oswestry disability index (ODI) scores regularly after surgery. RESULTS The two groups had similar values for radiographic ASD, including University California at Los Angeles grade, vertebral translation, angular motion, and loss of disc height (p=0.320). At final follow-up, both groups had experienced significant improvements in back VAS, leg VAS, and ODI scores after surgery (p

Background Vertebroplasty represents an established treatment option for osteoporotic vertebral compression fracture (OVCF), but its radiographic and clinical outcomes have not been clearly described in patients with intra-vertebral cleft (IVC). The aim of this study was to assess vertebral height restoration, recollapse and change of back pain in OVCF patients with or without IVC. Methods The records of 108 patients with IVC (group I) and 233 patients without IVC (group II) were included in our analysis between March 2001 and February 2014. The heights of the anterior, middle, and posterior columns, as well as the wedge angle (WA) of the fractured vertebral body were measured. For each vertebral column, the mean height of the superior and inferior vertebral body served as reference. Pre-operative, postoperative, and final compression rates (CR), as well as restoration and recollapse rates were calculated for each column. Subjective back pain was assessed as the numeric rating scale (NRS) score. Results The overall incidence of IVC in OVCF patients who underwent vertebroplasty was 20.8% (127/611 patients). Group I showed significantly higher CR over the entire follow-up period, with the exception of CR for the anterior column at final follow-up, and CR for the posterior column throughout the follow-up. The mean restoration rates at the anterior and middle column immediately after vertebroplasty were also significantly larger in group I. Recollapse rate in all columns was similar for groups I and II. The mean wedge angle was significantly larger in group I over the entire follow-up period. The groups did not differ in terms of NRS score at final follow-up. Conclusions Vertebroplasty restores vertebral body heights and WA more effectively in OVCF patients with IVC, and provides satisfactory radiographic and clinical outcomes regardless of the presence of IVC.

We evaluated the proximate composition, free sugar content, fatty acid composition, carotenoid content, total phenol content, and radical scavenging activity of the grain from various Korean maize hybrid cultivars grown in two different cropping seasons. The moisture, crude ash, crude fat, crude protein, total starch, and amylose contents were significantly higher in most of the maize hybrid cultivars when grown in the early-season than when grown in the late-season. The free sugar content, fatty acid composition, carotenoid content, and total phenol content differed significantly between cultivars and cropping seasons. The highest unsaturated fatty acid compositions of maize hybrids of early-season and late-season were 86.05 and 86.29%, respectively, in the Daanok cultivar. The carotenoid contents were significantly higher in maize hybrids of late-season compared to those of early-season. The highest total phenol content was 108.09 mg/100 g in Singwangok of the late-season. The radical scavenging activity of maize hybrids differed significantly between cultivars and cropping seasons.

Linguistic and psychometric validation of a translated questionnaire.To validate the Korean version of Zurich claudication questionnaire (ZCQ) both linguistically and psychometrically.The ZCQ is considered as a disease specific and gold standard measure for evaluation of patients with lumbar spinal stenosis (LSS). However, there has been no validated Korean version of the ZCQ.The ZCQ was translated forward and backward, culturally adapted by 2 independent translators, and approved by an expert committee. The final version of the Korean ZCQ was added to a routine questionnaire including a visual analog pain scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and the European Quality of Life-5 dimensions (EQ-5D). Psychometric validation included reliability by internal consistency using Cronbach's alpha, the test-retest reliability using intraclass correlation coefficient (ICC), and concurrent validity by comparing the Korean ZCQ to VAS for back/leg pain, ODI, and EQ-5D using Pearson correlation.A total of 109 patients were included in this study. The test-retest intraclass correlation coefficient (ICC) of the ZCQ was shown to have good reliability for all three domains: the ICCs for symptom, function, and satisfaction domains were 0.79, 0.84, and 0.91, respectively. Internal consistency of the Korean ZCQ for the symptom, function, and satisfaction domains was also excellent (Cronbach α = 0.894, 0.939, and 0.961, respectively). For concurrent validity, all three domains of the Korean ZCQ were significantly correlated with external criteria including VAS for back/leg pain, ODI, and EQ-5D. In the assessment of responsiveness, 21 patients who completed the ZCQ both before and after surgery demonstrated significantly different scores for symptom and disability domains.The validated Korean version of the ZCQ is a transculturally equivalent, reliable, and valid tool for use in assessing symptoms, function, and satisfaction with treatment in patients with LSS.3.

Background Context Even though catastrophizing can negatively moderate the outcome of surgery for lumbar spinal stenosis (LSS), it is still unclear whether pain catastrophizing is an enduring stable or a dynamic structure related to pain intensity after spine surgery. Purpose The purpose of this study was to determine whether catastrophizing would change in patients who undergo spinal surgery for LSS. Study Design A prospective observational cohort study was carried out. Study Sample Patients who underwent spine surgery for LSS comprised the study sample. Outcome Measures The Visual Analog Pain Scale (VAS) scores for back/leg pain, Oswestry Disability Index (ODI), and Pain Catastrophizing Scale (PCS) were the outcome measures. Methods The present observational cohort consisted of 138 patients between the ages of 40 and 80 years who were scheduled to undergo surgery for LSS. Among them, a total of 96 patients underwent a 3-year assessment after surgery. The PCS questionnaire was used for pain catastrophizing assessment before and 3 years after surgery. The VAS for back and leg pain, and ODI were assessed 3 and 6 months, and 1 and 3 years after surgery. The correlations between variables were analyzed before and 3 years after surgery. To clarify the causal relationship, time-series and linear mixed models were also used. Results At 3 years after surgery, ODI, VAS for back and leg pain, and PCS scores were significantly decreased. The correlation of PCS with VAS and ODI was significant both before and 3 years after surgery. The correlation between change in pain or disability and change in pain catastrophizing from preoperative to 3 years after surgery was also significant. In the causal relationship between pain and catastrophizing, overall changes in pain and disability were significant predictors of overall changes in pain catastrophizing from baseline to 3 year after surgery. Conclusion The present study shows that pain catastrophizing can change in association with the improvement in pain intensity after spine surgery. Therefore, catastrophizing may not be an enduring stable construct, but a dynamic construct.