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Study Design: Retrospective cohort study. Purpose: This study aimed to explore the morphometry of the Thai lumbar vertebrae. Overview of Literature: The cortical bone trajectory (CBT) is a novel approach for vertebral screw fixation aimed at addressing spinal instability associated with spinal disorders. The morphometry of the lumbar vertebrae is crucial in tailoring screw design for each CBT application, given the significant variations in optimal screw sizes, lengths, and angles among populations. Methods: A total of 300 dried lumbar columns were used to measure the pedicle height (PH) and width (PW), length for cortical bone trajectory (LCT), cephalad screw angle (CSA), axial cortical bone trajectory angle (ACA), and possible cortical zones for the CBT. Results: The following average values were calculated: PH in L1, 15.09±1.44 mm; PW in L5, 16.96±2.42 mm; LCT in L3, 35.75±2.61 mm; CSA in L1, 20.85°±2.30°; and ACA in L5, 21.83°±2.49°. Women generally had shorter PH and PW than men, with significant differences across lumbar levels. The LCT was significantly shorter in women and was notably different between the left and right sides. The CSA and ACA varied significantly between sexes and sides, with specific lumbar levels showing wider angles in one sex over the other. The most common cortical zones for screw tips were Z3 and Z10, with high incidences across all lumbar levels. Conclusions: This study presents detailed lumbar vertebral morphometry data specific to the Thai population. The results are essential for CBT application in screw fixation procedures. This information will contribute to the production of optimally designed screws for Thai patients in the future. [ABSTRACT FROM AUTHOR]

Study designPreliminary clinical trial.PurposeTo determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain.Overview of literaturePRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown in vitro and in vivo to potentially stimulate intervertebral disc matrix metabolism.MethodsInclusion criteria for this study included chronic low back pain without leg pain for more than 3 months; one or more lumbar discs (L3/L4 to L5/S1) with evidence of degeneration, as indicated via magnetic resonance imaging (MRI); and at least one symptomatic disc, confirmed using standardized provocative discography. PRP releasate, isolated from clotted PRP, was injected into the center of the nucleus pulposus. Outcome measures included the use of a visual analog scale (VAS) and the Roland-Morris Disability Questionnaire (RDQ), as well as X-ray and MRI (T2-quantification).ResultsData were analyzed from 14 patients (8 men and 6 women; mean age, 33.8 years). The average follow-up period was 10 months. Following treatment, no patient experienced adverse events or significant narrowing of disc height. The mean pain scores before treatment (VAS, 7.5±1.3; RDQ, 12.6±4.1) were significantly decreased at one month, and this was generally sustained throughout the observation period (6 months after treatment: VAS, 3.2±2.4, RDQ; 3.6±4.5 and 12 months: VAS, 2.9±2.8; RDQ, 2.8±3.9; p

Introduction: Although kissing spine syndrome in the lumbar spinal region is a relatively common condition in older adults, no study examining its biomechanical characteristics has been reported. We hypothesized that kissing of the spinous processes during extension causes an increase in the flexural rigidity of the spine and significantly limits the deformation behavior of extension, which in turn might cause lower back pain. Methods: Three test models (human cadavers A, B, and C) were prepared by removing supraspinal/interspinous ligaments between L4 and L5. The dental resin was attached to the cephalocaudal spinous process so that the spinous processes between L4 and L5 were almost in contact with each other to simulate the condition of a kissing spine. The flexion-extension direction's torque–range-of-motion (torque–ROM) curve was generated with a six-axis material tester for biomechanical measurements. Results: In all three models, the maximum ROMs at the time of extension were smaller than those at the time of flexion, and no sudden increase in torque was observed during extension. Conclusion: The results indicated no apparent biomechanical effects of kissing between the spinous processes, suggesting that the contact between the spinous processes has little involvement in the onset of lower back pain. [ABSTRACT FROM AUTHOR]

Abstract Introduction Platelet-rich plasma (PRP) is a fraction of plasma in which several growth factors are concentrated at high levels. The active soluble releasate isolated following platelet activation of PRP (PRP-releasate) has been demonstrated to stimulate the metabolism of IVD cells in vitro. The in vivo effect of PRP-releasate on degenerated IVD remains unknown. The purpose of this study was to determine the reparative effects of autologous PRP-releasate on degenerated intervertebral discs (IVDs). Methods To induce disc degeneration, New Zealand white rabbits (n = 12) received anular puncture in two noncontiguous discs. Autologous PRP and PPP (platelet-poor plasma) were isolated from fresh blood using two centrifugation techniques. Four weeks after the initial puncture, releasate isolated from clotted PPP or PRP (PPP- or PRP-releasate), or phosphate-buffered saline (PBS; control) was injected into the punctured discs. Disc height, magnetic resonance imaging (MRI) T2-mapping and histology were assessed. Results Anular puncture produced a consistent disc narrowing within four weeks. PRP-releasate induced a statistically significant restoration of disc height (PRP vs. PPP and PBS, P

Aim: To demonstrate a single posterior approach, total en bloc spondylectomy (TES) could be performed safely without preoperative embolization in spinal metastasis patients. Materials and Methods: Thirteen solitary spinal metastasis patients (five males) underwent single posterior approach TES at the thoracolumbar spine without preoperative embolization from January 2018 to January 2020. The primary sites were the breast (n = 4), hepatocellular carcinoma (n = 2), colon (n = 2), and others (n = 5). All patients underwent single posterior TES. The Eastern Cooperative Oncology Group, Frankel neurological status, operative time and blood loss, and any complications were all recorded. The patients were regularly followed‐up with radiography, computed tomography, and magnetic resonance imaging to detect any local recurrences. Results: The mean operative time was 354.6 min, and the mean operative blood loss was 2134.62 ml. None of the patients experienced any perioperative complications. Within the follow‐up period (3–24 months), no local recurrences were detected. Two patients (15.38%) were found to have distant metastasis to adjacent and remote vertebrae. Three patients were lost to follow‐up, and three patients died of disease. Six patients showed an improved ECOG functional status by at least one grade. Four of Frankel A patients improved their neurological status by at least one grade. Conclusion: Even without embolization, single posterior TES at the thoracolumbar spine is safe and effective for short‐term local control in solitary spinal metastasis. However, TES cannot prevent distant metastasis. Longer‐term follow‐up studies will be able to further identify the benefits of TES for the long‐term local control of diseases. [ABSTRACT FROM AUTHOR]

A study of FixJ, which is a response regulator of the two-component signal transduction pathway involved in the transcriptional activation of nitrogen fixation genes of sinorhizobium meliloti, is presented. The results are consistent with a scenario in which a transcriptionally active species of FixJ is a homodimer of the phosphorylated form.

Abstract Background There have been scarce large-scale studies investigating the personality of patients with malignant tumors. The purpose of this study is to determine the characteristic personality in malignant tumors outpatients. Methods Three thousand and three among 5013 consecutive outpatients who consented to answer the Japanese Maudsley Personality Inventory questionnaires were divided into two groups. 603 outpatients diagnosed with malignant tumors (M group) and the other 2400 outpatients (non-M group) were enrolled in this study. We determined three scores such as introversion/extroversion (E-score), neuroticism (N-score), and lie detection (L-score). All data were used to compare the two groups. Results Average E-score was slightly higher, and average N-score was slightly lower in M group than that in non-M group, and no significant differences between the two groups. However, the average L-score in M group was significant higher than that in non-M group (p Conclusion Outpatients with malignant tumors showed a significantly higher L-score on MPI when compared with patients with non-malignant tumors. These results stress the importance of taking the mentality of patients with cancer into consideration when conducting treatment and care.