bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macrophage Migration Inhibitory Factor Inhibits the Migration of Cartilage End Plate-Derived Stem Cells by Reacting CD74
Authors: Xiong C. , Huang B. , Zhou Y. , Cun Y. , Liu L. , Wang J. , Li C. , Pan Y. , Wang H. 
Published: May 2014

Introduction Macrophage migration inhibitory factor (MIF) is a multifunctional cytokine that regulates inflammatory reactions and the pathophysiology of many inflammatory diseases. Intervertebral disc (IVD) degeneration is characterized by an inflammatory reaction, but the potential role of MIF in IVD degeneration has not yet been determined. Recent studies have shown that MIF and its receptor, CD74, are involved in regulating the migration of human mesenchymal stem cells (MSCs). Thus, MIF might impair the ability of mesenchymal stem cells (MSCs) to home to injured tissues. Our previous studies indicated that cartilage endplate-derived stem cells (CESCs) as a type of MSCs exist in human degenerate IVDs. Here, we investigate the role of MIF in regulating the migration of CESCs. Material and Method CESCs were isolated and identified. Results We have shown that MIF was distributed in human degenerate IVD tissues and was subject to regulation by the proinflammatory cytokine tumor necrosis factor-α. Furthermore, in-vitro cell migration assays revealed that nucleus pulposus (NP) cells inhibited the migration of CESCs in a number-dependent manner, and enzyme-linked immunosorbent assays revealed that the amount of MIF in conditioned medium was significantly increased as a function of increasing cell number. In addition, recombinant human MIF inhibited the migration of CESCs in a dose-dependent manner. CESCs migration was restored when an antagonist of MIF, (S, R)-3(4-hydroxyphenyl)-4, 5-dihydro-5-isoxazole acetic acid methyl ester (ISO-1), was added. Finally, a CD74 activating antibody (CD74Ab) was used to examine the effect of CD74 on CESCs motility and inhibited the migration of CESCs in a dose-dependent manner. Conclusion We have identified and characterized a novel regulatory mechanism governing cell migration during IVD degeneration. The results will benefit understanding of another possible mechanism for IVD degeneration, and might provide a new method to repair degenerate IVD by enhancing CESCs migration to degenerated NP tissues to exert their regenerative effects. Disclosure of Interest None declared
Positive Results of Bacterial Culture for Herniated Lumbar Disc-Preliminary Results
Authors: Wu Y. , Li B. 
Published: May 2014

Introduction Recent studies have shown the possibility of involvement of bacterial infection during the intervertebral disc degeneration and low back pain, but there is still controversial. The aim of this study is to investigate whether there is bacterial materials in degenerated intervertebral disc tissues of patients. Materials and Methods A total of 20 degenerated intervertebral discs were collected from 16 patients who underwent spinal surgeries, due to disc herniation. Aerobic and anaerobic bacterial cultures were performed for each nucleus pulposus. Ligamentum flavums collected before discectomy were also conducted bacterial cultures for patients with Modic changes. Results The disc materials from four patients (six discs) had positive results of microbiological culture. Particles chain bacteria was found in one disc. The sample of two discs of one patient showed coagulase-negative staphylococci. Staphylococcus aureus and coagulase-negative staphylococci were found in another patient. Staphylococcus epidermidis existed in two discs of the same person who had fever after operation. The positive ratio of microbiological culture is 4 out of 16 (25%) patients or 6 out of 20 (30%) discs. All these four individuals had not Modic change. Conclusion These results showed the existence of bacteria in the disc materials obtained during back surgeries. These bacteria could be preexisted in the degenerated disc or just from contamination. The differentiation of these two causes is need for further study. Disclosure of Interest None declared References Stirling A, Worthington T, Rafiq M, Lambert PA, Elliott TS. Association between sciatica and Propionibacterium acnes. Lancet 2001;357(9273):2024–2025 Albert HB, Sorensen JS, Christensen BS, Manniche C. Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy. Eur Spine J 2013;22(4):697–707
Clinical and Radiological Determinant of Surgical Outcome of Lumbar Disc Disease
Authors: Singh P. K. 
Published: May 2014

Introduction Degeneration of lumbar disc is inevitable pathology and its clinical and radiological reflection is extremely variable from patient to patient. Such clinical and radiological heterogeneity of disc degenerative diseases causes variety of surgical dilemma. However, surgical treatment of lumbar degenerative disc disease is mostly individualized approach based. The current research is focused on the clinical and radiological determinant, which can predict the outcome of the patients who are opting for surgical treatment. Materials and Methods After Institutional Ethical Committee approval, prospectively 82 cases (age between 18 and 65) of lumbar disc disease has been included in the study who undergone for surgical treatment. Every patient has been evaluated thoroughly clinically and radiologicaly. Postoperative outcome are recorded using modified Oswestry back pain score system and the results were analyzed. Results For each patient clinical, demographical, X-ray stress view, and MRI findings are collected and statistically correlated with surgical outcome of the patient. The mean age of the study group 44.3 years. Male gender were predominant 76% of the total sample size. Disc degeneration, facetal arthropathy, Modic changes, and listhesis were high on the list, which determines the outcome of the surgery. Conclusion Clincoradiolgical predictors can be taken into account while defining outcome of the surgery of degenerative disc disease. Disclosure of Interest None declared
Diagnosis and Treatment of Degenerative Lumbar Scoliosis with Root Pain
Authors: Liang Y. 
Published: May 2014

Introduction Degenerative lumbar scoliosis is a common type in degenerative lumbar disease. In clinic, root pain is very general except back pain. The objective of our research is to explain and summarize which segments frequently occur root pain, what is the diagnosis methods, and significance of surgical treatment. Materials and Methods The research included retrospectively 46 patients suffering degenerative lumbar scoliosis with root pain, undergoing surgical treatment in our hospital during May 2005 to September 2009, all of them have complete follow-up data. The segments of root pain were judged through physical examination, radiography, and selective nerve root injection. According to the the scoliosis type and degree, we chose different surgical procedures, (1) simple decompression, (2) decompression with short segment fixation, (3) decompression and orthopedics with long segment fixation. The patients’ radiographic results were analyzed by X-ray and MRI, functional conditions were evaluated by Oswestry disability index (ODI) and visual analog scale (VAS). Results The research included 46 patients, the average follow-up was 5.8 years. Male patients were 20, and female patients were 26 in our research. According to segments of root pain: L2-3 (4 patients), L3-4 (9 patients), L4-5 (21 patients), L5-S1 (12 patients); surgical procedures: simple decompression (4 patients), decompression with short segment fixation (35 patients), decompression and orthopedics with long segment fixation (7 patients). A total of 42 patients had bony fusion by radiography. In scoliosis orthopedics group, the cobb angle dropped from 19.3 ± 15.2 degrees preoperatively to 9.2 ± 5.3 degrees at final follow-up. ODI of all patients dropped from 59.22 ± 22.31 preoperatively to 15.23 ± 11.12; and VAS dropped from 7.3 ± 1.8 to 2.3 ± 1.4 at final follow-up, respectively. Conclusion (1) Root pain of degenerative lumbar scoliosis usually located to the segment, which just under the bulge side (39/46, 84.8%), rather than concave side. (2) Radiography and selective nerve root injection were helpful to ensure the pain segment and position. (3) Most degenerative lumbar scoliosis patients undergoing root pain can proceed simple decompression or decompression with short segment fixation, only few patients need to proceed decompression and orthopedics with long segment fixation. Disclosure of Interest None declared
Diffusion Tensor Imaging for Quantitative Evaluation of Lumbar Intervertebral Disc Degeneration
Authors: Oikawa Y. , Eguchi Y. , Watanabe A. , Orita S. , Yamauchi K. , Suzuki M. , Sakuma Y. , Kubota G. , Inage K. , Sainoh T. , Sato J. , Fujimoto K. , Takahashi K. , Ohtori S. 
Published: May 2014

Introduction Pfirrmann classification, T2- and T1ρ mapping using MRI are tools to evaluate intervertebral disc (IVD) degeneration. Diffusion tensor imaging (DTI) and diffuion tensor tractography (DTT) are neuroimaging tools for visualizing highly anisotropic tissues. Recently, DTI is used for evaluation of degenerated IVDs. The purpose of this study is to provide evidence for the efficacy of DTI and DTT in the quantitative evaluation of degenerated IVDs. Materials and Methods Three patients with discogenic low back pain underwent DTI and DTT on a 3.0 T MR scanner. We evaluated 12 discs from L2-3 to L5-S in each patient. Pfirrmann classification on conventional MR imaging, fractional anisotropy (FA) value, morphological classification on DTT, and number of tracking fibers were evaluated. IVD was divided into three layers in a concentric manner from the center; FA value was measured at each layer. DTT was classified into ring, donut, and disk type. Results With Pfirrmann classifications, six, two, and four discs were grades 2, 3, and 4, respectively. With DTT classification, six, one, and five discs were ring, donut, and disk types, respectively. All grades 2,1, and3 discs corresponded to ring type, and all grade 4 and the other grade 3 discs corresponded to disk type. FA value of the intermediate layer was 0.10 for ring type, 0.21 for donut, and 0.23 for disk type. FA value of the inner layer was 0.06 for ring type, 0.09 for donut, and 0.20 for disk type. The number of tracking fibers was increased in disk types. Conclusion This study showed that shape on DTT correlated to Pfirrmann classification, and DTT of discs can describe the IVD degeneration process. A previous study showed that water content tended to decrease in IVD degeneration. The increasing FA value and number of the tracking fibers may reflect a decreased water content and tissue degeneration. Thus, DTI and DTT can visualize and quantitatively evaluate IVD degeneration. DTI and DTT may detect degeneration and evaluate repair and regeneration. Disclosure of Interest None declared
In Vitro Tissue Regeneration by Human Degenerated Nucleus Pulposus Cells in Hyperosmotic Culture Medium
Authors: Krouwels A. , Popov J. , Plomp S. , Dhert W. , Oner C. , Bank R. , Creemers L. 
Published: May 2014

Introduction Healthy intervertebral disc (IVD) cells normally reside in a high osmolality environment of 450 to 550 mOsm/kg and extracellular matrix production by MSC cells has been shown to increase with increasing osmolality. However, it is not known how human degenerated disc cells are affected by osmolality. The aim of the current study was to determine the effects of osmolality on tissue regeneration by human degenerated NP cells. Materials and Methods The osmolality of standard chondrogenic culture medium (DMEM, 2% ascorbic acid-2 phosphate, 2% human serum albumin, 2% insulin-transferring selenium-X, 1% penicillin/streptomycin, 10 ng/mL transforming growth factor β2 [TGF-β2]) was adjusted with NaCl and sucrose from 340 to 400, 450, and 500 mOsm/kg. IVD cells from four human donors (Thompson grade III) were cultured for 28 days in high density (1*10^6 cells/cm2) on collagen II coated filters. LDH analysis was performed to analyze toxicity. Samples were stained with Safranin-O for glycosaminoglycans (GAGs) and with immunohistochemistry for collagen II. Gene expression was evaluated by qPCR and a collagen low-density array. Matrix content as reflected by glycosaminoglycan (GAG) production was measured with a dimethylmethylene blue (DMMB) assay and DNA content with a Picogreen assay. Statistical analysis included univariate analysis of variance with randomized block design and post hoc Dunnet t-test. Results No cytotoxic effects were found in any of the conditions tested. Gene expression showed an osmolality-dependent increase compared with standard medium in collagen II and aggrecan only when NaCl was used (see Fig. 1A, B for p-values). However, at the protein level, no effect of increased osmolality using NaCl was found. This could not be explained by MMP gene expression levels, as these seemed lower at high osmolality. Tissues cultured in the presence of the osmolyte sucrose appeared to contain less proteoglycans, but this difference was not significant. Conclusion In conclusion, in the current culture system, the increased expression of matrix genes with osmolality appears to be osmolyte dependent rather than osmolality dependent. Moreover, the absence of an effect at the protein level suggests adjusting osmolality with NaCl to enhance matrix production by IVD cells is not required. Disclosure of Interest None declared
Neither a Lumbar Disc nor a Thoracic Disc; L1-L2 Disc Located in Region of Spine Biomechanical and Neural Transition Zone
Authors: Sharifi G. , Abolhasani E. , Hosseinzadeh M. , Shafizadeh M. , Mousavi A. 
Published: May 2014

Introduction Although L1-L2 disc is anatomically located in lumbar region, its specific location poses a caveat to the surgeon for both conus medullaris present in this area and the great biomechanical standpoint in thoracolumbar region. Materials and Methods In our experience with this group of patients, we used trans-facet pedicle-sparing approach to care for conus medullaris. In addition, we performed short segment fusion to augment this highly demanding biomechanical region. Since the year 2008, we operated 13 cases with L1-L2 disc with this technique. Only two cases presented with severe L2 radiculopathy and the rest came with feature of cauda equine or conus problem. Axial back pain was crucial symptom in eight cases. Two patients had simultaneous disc problem in L2-L3 and one patient had T12-L1 disc protrusion. After operation, patients received Jewett hyperextension brace for 3 months. In one patient with central hard calcified disc, we performed thoracoabdominal approach and decompression from anterior. All surgery performed under high magnification of microscope and bone removal was done by powered drill. Results In six cases, decompression was performed bilaterally to reach the central portion of the disc. Pedicle screw was used for fixation in all patients. TLIF banana cage was used in five cases and spinous process bone used as interbody graft in four cases. There was no aggravation in neurological deficit and we have no problem with CSF leak or wound. Fusion achieved in all patients and axial back pain resolved successfully. Conclusion Although L1-L2 innately considered a lumbar disc, we suggest that they should be considered as thoracic disc and the surgeon should not solely rely on where the conus terminated in MRI. In this location, small traction can lead to catastrophic neurological damage; therefore, by using trans-facet pedicle-sparing under microscopic guide the cord should be decompressed by drill. In addition, to prevent neurological injury, Kerrison should not be placed under already stenotic canal. Disclosure of Interest None declared
The Optimal Insertion Position of the Lumbar Interspinous Dynamic Stabilization Device: A Biomechanical Evaluation
Authors: Hai Y. , Zu D. 
Published: May 2014

Introduction To evaluate the optimal insertion position of the Coflex lumbar interspinous dynamic stabilization device, a biomechanical study was conducted. Materials and Methods Six fresh adult human cadaveric lumbar spine specimens (L1-L5) were mounted in a materials testing machine (MTS) by embedding to clamps with L1 and L5 vertebrae. L3/4 motion segment of each specimen was operated by selective decompression and Coflex interspinous device insertion. The L3 and L4 vertebrae was inserted one needle attached with four marker points, respectively, which were used to record the range of motion (ROM). Each lumbar spine specimen was tested according to the loading sequence at five condition models: intact (keeping lumbar ligamenta and facet joints intact); partial destabilized (resection of L3/4 interspinous ligamenta, ligamentum flavum, facet capsule, and bilateral resection 50% of L3 inferior facets); 10 mm insertion (distance between apex of U-shaped Coflex and dural sac was 10 mm), 5 mm insertion (the distance was 5 mm), and 0 mm insertion (the distance was 0 mm). Each lumbar spine specimen was tested according to a loading sequence consisting of flexion, extension, left/right lateral bending, left/right axial rotation, loaded with pure moments of 8 Nm, and was recorded the ROM of operative segment at the third time. ROM of five condition models in six directions, respectively, was analyzed with one-way ANOVA test and multiple comparisons are based on LSD method. Results The ROMs of the 5 and 0 mm group were on significant differences ( p > 0.05) comparing with the intact group in flexion (F = 8.472), extension (F = 18.310), left (F = 16.809), and right axial rotation (F = 6.624), but they were significantly different comparing with the partial destabilized group in the same directions ( p < 0.01). There were significant differences ( p < 0.01) in the ROM of left lateral bending (F = 7.700) and right lateral bending (F = 12.473) between the 5 and 0 mm group and the intact group, but there was no difference comparing with the partial destabilized group in the same directions ( p > 0.05). The 10 mm group had significant high ROM in six directions than the intact group ( p < 0.01), but were no differences comparing with the partial destabilized group ( p > 0.05). Conclusion The insertion of Coflex interspinous dynamic stabilization device can maintain the stability of a partially destabilized specimen back to an intact one in flexion, extension, and axial rotation when distance between apex of U-shaped Coflex and dural sac was 5 mm or less, but cannot return the stability in lateral bending. The Coflex cannot return the stability of a partially destabilized specimen back to an intact one in six directions when distance between apex of U-shaped Coflex and dural sac was or more 10 mm. Disclosure of Interest None declared
Correlation of Clinical Outcome and Radiological Parameters for Activ L Total Disc Replacement
Authors: Shi Lu B. 
Published: May 2014

Introduction Summary of Background Data Radiological results are important parameters for total disc replacement (TDR) patients, but the correlation of various radiological parameters with clinical results is still controversial. Study design A prospective clinical study. Purpose To assess the clinical and radiological results for patients who underwent Activ L total disc replacement, and to correlate various radiological parameters with clinical outcome. Materials and Methods From March 2009 to March 2012, 32 patients with degenerative disc diseases (DDD) underwent either mono- or bi-segmental lumbar TDR, of whom 30 (93.7%) with 36 prosthesis had an average follow-up of 28.8 months (12-46 months). Clinical parameters such as Visual Analogue Scale (VAS), and Oswestry Disability Index (ODI) were evaluated preoperatively and at 1, 2, and 3 years postoperatively. Radiological parameters as range of motion (ROM), intervertebral disc height (IDH) of the index and adjacent segments, coronal and sagittal positions of the prosthesis, and lumbar lordosis were also performed. Prosthesis subsidence and heterotopic ossification were observed during the follow-up period. Results Thirty patients had 1 year follow-up, 20 of whom had 2 years follow-up and 15 of whom had 3 years follow-up. The VAS (back pain), VAS (leg pain), and ODI score showed significant improvement after surgery ( p < 0.001), and there was no significant difference between each follow-up ( p > 0.8754). At the 3-year follow-up, ROM of the index level and the upper adjacent level showed significant increase ( p < 0.0128), while the lower adjacent level showed no obvious increase of ROM ( p = 0.4205). Immediately after surgery, IDH of the index level showed a significant increase ( p < 0.0071), but the difference disappeared at the 3-year follow-up ( p = 0.0597). The IDH of the upper and lower adjacent level showed no significant difference during the 3-year follow-up ( p > 0.6669). Compared with preoperative data, the lumbar lordosis showed no obvious difference during the 3-year follow-up ( p = 0.2643). According to one of the radiological criteria, 75% of the prostheses were rated as ideally positioned, 16.7% were discretely shifted, 5.6% were slightly shifted, and 2.7% were markedly shifted in the coronal plane. In the sagittal plane, 13.9% of the prostheses were rated as ideally positioned, 22.2% were discretely shifted, and 63.9% were suboptimally placed. At each patient's final follow-up, the radiological parameters did not correlate with clinical results ( p < 0.001). Conclusion The short- and mid-term results of Activ L prosthesis for degenerative disc diseases are satisfying. Our data indicate poor correlation between various radiological parameters and clinical outcome. Disclosure of Interest None declared