bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal epidural arteriovenous fistula with perimedullary drainage
Authors: Krings Timo , Mull Michael , Bostroem Azize , Otto Juergen , Hans Franz J. , Thron Armin 
Published: January 2008

✓ The classic angiographically demonstrated features of spinal dural arteriovenous fistulas are shunts of radiculomeningeal branches with radicular veins draining exclusively in the direction of perimedullary veins and thereby causing venous congestion. These shunts are located at the point where the radicular vein passes the dura mater. Spinal epidural arteriovenous shunts, however, normally do not drain into the perimedullary veins and are, therefore, asymptomatic, presumably because of a postulated reflux-impeding mechanism between the dural sleeves. The authors report on a patient in whom an epidural arteriovenous shunt showed delayed retrograde drainage into perimedullary veins, leading to the classic clinical (and magnetic resonance imaging–based) findings of venous congestion. Intraoperatively the angiographically established diagnosis was confirmed. Coagulation of both the epidural shunt zone and the radicular vein resulted in complete obliteration of the fistula, as confirmed on repeated angiography.
This rare type of fistula should stimulate considerations on the role of valvelike mechanisms normally impeding retrograde flow from the epidural plexus to perimedullary veins and suggest that, in certain pathological circumstances, epidural fistulas can drain retrogradely into perimedullary veins as an infrequent variant of spinal arteriovenous shunts.
Facet cyst in the lumbar spine: radiological and histopathological findings and possible pathogenesis
Authors: Kusakabe Takashi , Kasama Fumio , Aizawa Toshimi , Sato Tetsuro , Kokubun Shoichi 
Published: January 2008

Object
The authors define facet cyst as a cyst located beside the facet joint and exhibiting a communication with the joint, as demonstrated on arthrography and subsequent computed tomography (CT) of the joint space. The purpose of this study was to determine the pathogenesis of facet cysts based on their radiological and histological features.

Methods
Forty-six juxtafacet cysts in 45 patients (26 men and 19 women, age range 41–82 years) were surgically treated after evaluation by arthrography and subsequent CT scanning. A communication channel between the cyst and the joint was confirmed in all cases and thus the lesions were designated facet cysts. In almost all patients the involved facet joint showed moderate to severe degeneration. After a thorough preoperative radiological evaluation, these cysts were excised en bloc by medial facetectomy with the entire ligamentum flavum. The specimens were cut axially at the maximum diameter and were histologically investigated.
Morphologically, the cysts exhibited three shapes, appearing as: 1) a small protrusion, 2) a semicircular cyst, or 3) a round cyst. The cyst walls consisted of elastic and collagen fibers undergoing fibrinoid degeneration, but no synovial lining cells were detected. The cystic cavities were regularly filled with fibrinoids, and myxoid degeneration was found particularly in the larger cysts.

Conclusions
Facet cysts are closely related to the degeneration of the neighboring facet joint. Analysis of the findings in this histological study suggests that there are several shapes of facet cysts. The authors propose that the shape could depend on the stage of the cyst’s development.
Regression of retroodontoid pseudotumors following C-1 laminoplasty
Authors: Suetsuna Futoshi , Narita Hozumi , Ono Atsushi , Ohishi Hirotaka 
Published: January 2008

✓The authors report a new technique for C-1 laminoplasty without fusion in the treatment of cervical myelopathy associated with a retroodontoid pseudotumor (also known as a phantom tumor).
The authors review the cases of three patients who underwent C-1 laminoplasty in which hydroxyapatite was used and fusion was not performed. All patients suffered from severe progressive myelopathy before surgery. Magnetic resonance imaging revealed a retroodontoid pseudotumor compressing the spinal cord at the C-1 level in all cases. Computed tomography was performed to examine the extent of bone erosion at the atlantoaxial joint and dens. Clinical parameters included neurological function, measured using the Japanese Orthopaedic Association score, and neck pain. Imaging parameters included pre- and postoperative atlas–dens intervals; the space available for the spinal cord; instability of the atlantoaxial joints; osteoarthritic changes of the atlantoaxial joint; postoperative changes in T2 high-intensity signal; and postoperative alteration in the size of the pseudotumor.
Magnetic resonance imaging demonstrated complete disappearance of the pseudotumor in two cases and partial reduction in one case. In all three cases sufficient neurological recovery was observed. The mean recovery rate was 87.0%.
This new technique is less invasive than standard procedures, preserves the cervical range of motion, and avoids the morbidity of obtaining a bone graft and placing instrumentation. The authors conclude that C-1 laminoplasty without fusion is an option in the surgical management of cervical myelopathy associated with a retroodontoid pseudotumor, either without C1–2 instability or with slight, but reducible, C1–2 instability.
Cervical pedicle screw fixation in 100 cases of unstable cervical injuries: pedicle axis views obtained using fluoroscopy
Authors: Yukawa Yasutsugu , Kato Fumihiko , Yoshihara Hisatake , Yanase Makoto , Ito Keigo 
Published: January 2008

Object
The authors conducted a study to introduce the imaging technique in which pedicle axis views are obtained using fluoroscopy to match the screw entry point with pedicle orientation and to report the clinical results and safety of cervical pedicle screw fixation (PSF) in patients treated for unstable cervical injuries.

Methods
One hundred consecutive patients with unstable cervical injuries underwent PSF in which the authors used fluoroscopic imaging to acquire pedicle axis views. There were 87 men and 13 women whose mean age was 42.5 years. The accuracy of PS placement was examined postoperatively using axial computed tomography (CT) and oblique radiography. Screw malpositioning was classified either as screw exposure (< 50% of the screw outside the pedicle) or pedicle perforation (> 50% of the screw outside the pedicle boundaries).
The mean operative time was 97.6 minutes, and the mean estimated blood loss was 221 ml. Local vertebral alignment around the injured segment measured 6.0° of kyphosis preoperatively and 6.7° of lordosis postoperatively. Solid posterior bone fusion was achieved in all but three patients who died shortly after surgery. There was no secondary dislodgment of instrumentation in 95% of these 97 cases. Of the 419 cervical PSs, 43 (10.3%) were of the screw-exposure type and 17 (4.0%) of the pedicle-perforation type. There were two surgery-related complications: one penetration of a probe into the vertebral artery and one radiculopathy. There were six postoperative complications: two cases of instrumentation failure associated with loss of correction, three cases of correction loss (> 10°), and one case of deep wound infection.

Conclusions
Solid posterior fusion without secondary dislodgment of hardware was demonstrated in 95% of the cases. The incidence of complications associated with cervical PSF was not high. Postoperative CT scanning showed that 17 (4.0%) of 419 screws perforated the pedicle. It appears that fluoroscopy performed using pedicle axis views improves the accuracy and safety of cervical PS insertion.
Thoracic myelopathy caused by ossification of the ligamentum flavum: clinical features and surgical results in the Japanese population
Authors: Aizawa Toshimi , Sato Tetsuro , Sasaki Hirotoshi , Kusakabe Takashi , Morozumi Naoki , Kokubun Shoichi 
Published: January 2008

Object
Data obtained in patients with thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) were retrospectively reviewed to clarify clinical features and surgical outcomes in the Japanese population.

Methods
Seventy-two patients who underwent surgery for OLF-induced myelopathy in the Miyagi Prefecture, Japan, between 1988 and 2002 were observed for at least 2 years. Clinical data were collected from medical and operative records. The patients were evaluated pre- and postoperatively using the modified Japanese Orthopaedic Association (JOA) scale (maximum score 11). The relationships among various factors (age, sex, and preoperative duration of symptoms) affecting the preoperative severity of myelopathy and postoperative improvement were also examined.

Conclusions
In this series the surgical outcome was relatively good and depended on the severity of myelopathy; thus early and correct diagnosis is required to avoid poorer results. The male/female ratio was 3.2 and the mean patient age at surgery was 61 years for men and 68 for women. The patients commonly noticed numbness or pain in their lower legs or gait disturbances. In a total of 104 decompressed intervertebral disc levels, more than 80% of the ossified ligaments were at the T9–10 level or lower. The mean preoperative JOA score of 5.1 improved to 7.9 after an average of 46 months. The postoperative results statistically depended on the preoperative severity of myelopathy. Among studies of patients with OLF-related myelopathy, the present study had the largest sample size, which should help clarify the clinical features of OLF myelopathy.
Accuracy and safety of pedicle screw fixation in thoracic spine trauma
Authors: Fisher Charles G. , Sahajpal Vic , Keynan Ory , Boyd Michael , Graeb Douglas , Bailey Christopher , Panagiotopoulos Kostas , Dvorak Marcel F. 
Published: January 2008

Object
The authors evaluated the accuracy of placement and safety of pedicle screws in the treatment of unstable thoracic spine fractures.

Methods
Patients with unstable fractures between T-1 and T-10, which had been treated with pedicle screw (PS) placement by one of five spine surgeons at a referral center were included in a prospective cohort study. Postoperative computed tomography scans were obtained using 3-mm axial cuts with sagittal reconstructions. Three independent reviewers (C.B., V.S., and D.G.) assessed PS position using a validated grading scale. Comparison of failure rates among cases grouped by selected baseline variables were performed using Pearson chi-square tests. Independent peri- and postoperative surveillance for local and general complications was performed to assess safety.
Twenty-three patients with unstable thoracic fractures treated with 201 thoracic PSs were analyzed. Only PSs located between T-1 and T-12 were studied, with the majority of screws placed between T-5 and T-10. Of the 201 thoracic PSs, 133 (66.2%) were fully contained within the pedicle wall. The remaining 68 screws (33.8%) violated the pedicle wall. Of these, 36 (52.9%) were lateral, 27 (39.7%) were medial, and five (7.4%) were anterior perforations. No superior, inferior, anteromedial, or anterolateral perforations were found. When local anatomy and the clinical safety of screws were considered, 98.5% (198 of 201) of the screws were probably in an acceptable position. No baseline variables influenced the incidence of perforations. There were no adverse neurological, vascular, or visceral injuries detected intraoperatively or postoperatively.

Conclusions
In the vast majority of cases, PSs can be placed in an acceptable and safe position by fellowship-trained spine surgeons when treating unstable thoracic spine fractures. However, an unacceptable screw position can occur.
Tethered cord due to spina bifida occulta presenting in adulthood: a tricenter review of 61 patients
Authors: Rajpal Sharad , Tubbs R. Shane , George Timothy , Oakes W. Jerry , Fuchs Herbert E. , Hadley Mark N. , Iskandar Bermans J. 
Published: January 2008

Object
Children with spina bifida occulta require early surgery to prevent neurological deficits. The treatment of patients with a congenitally tethered cord who present in adulthood remains controversial.

Methods
The authors studied the medical records of 61 adult patients who underwent surgical untethering for spina bifida occulta at three institutions between 1994 and 2003. Patients who had undergone prior myelomeningocele repair or tethered cord release surgery were excluded.
The most common intraoperative findings were lipomyelomeningocele (41%) and a tight terminal filum (36%). The follow-up duration ranged from 10.8 to 149.5 months. Of the 34 patients with back pain, status improved in 65%, worsened in 3%, remained unchanged in 18%, and improved and later recurred in 15%. Lower-extremity pain improved in 16 patients (53%), remained unchanged in 23%, improved and then recurred in 17%, and worsened in 7%. Lower-extremity weakness improved in 47%, remained unchanged in 47%, and improved and then recurred in 5%. Finally, of the 17 patients with lower-extremity sensory changes, status improved in 35%, remained unchanged in 35%, and the information on five patients was unavailable. Surgical complications included three wound infections, one cerebrospinal fluid leak, and two pseudomeningoceles requiring surgical revision. One patient developed acute respiratory distress syndrome and sepsis postoperatively and died several days later.

Conclusions
Adult-age presentation of a congenital tethered cord is unusual. Despite a slight increase in postoperative neurological injury in adults, surgery has relatively low risk and offers good potential for neurological improvement or stabilization. As they do in children, the authors recommend early surgery in adults with this disorder. The decision to undertake surgery, however, should be modulated by other factors such as a patient's general medical condition and risk posed by anesthesia.
Surgical outcomes in adult patients with syringomyelia associated with Chiari malformation Type I: the relationship between scoliosis and neurological findings
Authors: Ono Atsushi , Suetsuna Futoshi , Ueyama Kazumasa , Yokoyama Toru , Aburakawa Shuichi , Numasawa Takuya , Wada Kanichiro , Toh Satoshi 
Published: January 2008

Object
The clinical characteristics of pediatric scoliosis associated with syringomyelia have been reported in previous studies, but scoliosis associated with syringomyelia in adults is rarely treated, and there is a paucity of detailed studies. In the present study of adult syringomyelia associated with Chiari malformation Type I, the authors investigated the relationships among the syrinx, scoliosis, and neurological data.

Methods
The population was composed of 27 patients (≥ 20 years of age) who underwent foramen magnum decompression for the treatment of syringomyelia. The patients were divided into two groups: those with scoliosis of 10° or more (Group A) and those without scoliosis (Group B). The authors assessed the length of the syrinx, duration of morbidity, and clinical status before and after surgery based on the Japanese Orthopaedic Association (JOA) Scale.
There were 15 cases in Group A and 12 in Group B. The mean length of the syrinx was 12.8 vertebral bodies (VBs) in Group A and 7.2 VBs in Group B. The mean duration of morbidity was 14.2 years in Group A and 6.8 years in Group B. The mean preoperative JOA score was 10.1 in Group A and 14.4 in Group B, whereas the mean postoperative JOA scores were 11.9 and 15.8, respectively. There were significant differences between Groups A and B in length of the syrinx, duration of morbidity, and pre- and postoperative JOA scores.

Conclusions
In patients with syringomyelia and scoliosis the syringes spanned a greater number of VBs, the duration of morbidity was greater, neurological dysfunction was more severe, and surgical results were poorer. Scoliosis could be a predicting factor of the prognosis in patients with syringomyelia and Chiari malformation Type I.
Medical management of Pott disease in the thoracic and lumbar spine: a prospective clinical study
Authors: Kotil Kadir , Alan M. Servet , Bilge Turgay 
Published: January 2008

ObjectThe aim of this study was to evaluate conservative medical management of 44 patients with Pott disease. The prognostic significance of various clinical, radiological, and long-term follow-up findings in these patients was also evaluated.MethodsBetween January 1990 and January 2005 data were collected prospectively at the authors' clinic in 44 patients with Pott disease in the thoracic or lumbar spine. These patients had no major neurological deficits or severe spinal deformities. The study population consisted of 21 male (48%) and 23 female (52%) patients, with a mean age of 42.1 years (range 10–70 years). The most common region of Pott disease was the thoracolumbar junction (18 cases; 41%), followed by the thoracic (16 cases; 36%) and lumbar (10 cases; 23%) regions. All patients presented with abscesses. With the exception of two cases, all had kyphotic angles smaller than 30°. At presentation, 20 patients had neurological signs of spinal cord compression during clinical examination. Both clinical and biopsy findings were used in all cases for diagnosis. A diagnosis was confirmed by a positive biopsy specimen culture in 19 (43.2%) of 44 cases, and histopathological findings were compatible with the results of these cultures in all cases. All patients were treated with antituberculous chemotherapy, and the diseases in only two (4.5%) was resistant to the regimen. An independent observer assessed the clinical and imaging findings after a mean follow-up duration of 40 months.Forty-two (95.4%) of the 44 patients were successfully treated with conservative medical management and attained acceptable spinal deformity angles, and none of these patients had any residual instability, radiculopathy, or neurological compromise. Only 4.5% of the patients experienced residual spine deformity (as much as a 30° kyphotic angle), which was clinically obvious but biomechanically stable.ConclusionsPatients with Pott disease in the lumbar or thoracic region, without neurological deficits or kyphosis, can be treated conservatively in the vast majority of cases. Indications for surgery need to be redefined given these new data.
Evidence of blood–brain barrier dysfunction and CSF immunoglobulin synthesis in Down Syndrome Regression Disorder
Authors: Santoro Jonathan D. , Eduthan Neetha Paul , Khoshnood Mellad M. , Jafarpour Saba , Boyd Natalie K. , Vogel Benjamin N. , Nguyen Lina , Kazerooni Lilia , Britton Eleanor , Lyford Hannah R. , Galbraith Matthew D. , Rachubinski Angela L. , Espinosa Joaquin M. 
Published: February 2025

AbstractObjectivesThis study sought to evaluate proteomic, metabolomic, and immune signatures in the cerebrospinal fluid of individuals with Down Syndrome Regression Disorder (DSRD).MethodsA prospective case–control study comparing proteomic, metabolomic, and immune profiles in individuals with DSRD was performed. Samples were obtained from a biorepository of affected individuals and compared to clinically available data and previously obtained neurodiagnostic studies. Individuals with DSRD were compared to individuals with established neuroinflammatory conditions (e.g., multiple sclerosis), and neurotypical controls undergoing a lumbar puncture for headaches. Samples underwent high‐throughput proteomic, metabolomic, and immune marker profiling. Data was compared across groups and clinical phenotypes. Gene set enrichment analysis and pathway analyses were utilized to analyze the data.ResultsIn total, 34 individuals with DSRD, 22 neuroinflammatory controls, and 27 neurotypical controls were enrolled in the study. We observed a highly significant concordance in dysregulated proteomics signatures in DSRD and neuroinflammatory controls versus healthy controls, most prominently upregulation of many immunoglobulin sequences. In addition, individuals with DSRD displayed strong upregulation of liver‐derived plasma proteins and erythrocyte proteins in the CSF, indicating poor blood–brain barrier integrity. The immune marker profile of DSRD is clearly similar to other neuroimmunological conditions, including strong elevation of MIP3‐α, eotaxin, and IFN‐γ.InterpretationIndividuals with DSRD have unique CSF proteomic and metabolomic signatures consistent with neuroinflammation and increased blood–brain barrier permeability. The CSF of individuals with DSRD was more comparable to individuals with neuroinflammatory disorders than neurotypical controls, indicating the potential for an immune etiology of disease.
Inducing Cuproptosis with Copper Ion‐Loaded Aloe Emodin Self‐Assembled Nanoparticles for Enhanced Tumor Photodynamic Immunotherapy
Authors: Yu Zhen , Cao Lei , Shen Yue , Chen Jieqi , Li Huizhen , Li Chengmin , Yin Ji‐Ye , Li Yueqin , Meng Yingcai , Li Xiangping 
Published: February 2025

AbstractImmunotherapy has fundamentally transformed the clinical treatment landscape for non‐small cell lung cancer (NSCLC). While its effectiveness is ultimately limited by patient heterogeneity and immunosuppressive tumor microenvironment. Photodynamic therapy (PDT), as an emerging antitumor immunotherapy, has shown its unique therapeutic advantages. However, previous studies often overlooked the potential toxicity of photosensitizers (PS), making the discovery of safe and effective PS a pressing clinical need. In this study, Aloe Emodin (AE), a medicinal plant natural compound, was loaded with copper ions (Cu), and self‐assembled into nanoparticles (NPs) under the modification of PEG2k‐DSPE‐FA. NPs can target, accumulate, and reside within tumor sites, responsively releasing copper ions and AE, thus dual‐functioning by inducing tumor cell death via cuproptosis and enhancing PDT effects. The LLC tumor‐bearing mouse model demonstrated that NPs induce the maturation of dendritic cells (DCs) in vivo, promote lymphocyte infiltration, transform “cold tumors” into “hot tumors” and significantly enhance the efficacy of immune checkpoint blockade (ICB). This study provides experimental evidence of AE as a clinically promising PDT agent and offers a novel perspective for the synergistic treatment of clinical NSCLC.
Low‐Pressure Sulfide All‐Solid‐State Lithium‐Metal Pouch Cell by Self‐Limiting Electrolyte Design
Authors: Xu Fuqiang , Wu Yujing , Wang Lutong , Zhang Ziqi , Liu Guoshun , Guo Chang , Wu Dengxu , Yi Chuang , Luo Jixian , He Weitao , Xu Chang , Yang Ming , Li Hong , Chen Liquan , Wu Fan 
Published: February 2025

AbstractAll‐solid‐state lithium‐metal batteries (ASSLMBs) with sulfide solid electrolytes have gained significant attention due to their potential for high energy density and enhanced safety. However, their development has been hindered by rapid lithium dendrite growth, low coulombic efficiency, poor battery rate performance, and poor cycling stability, posing a major obstacle to their commercialization. Herein, a multifunctional composite sulfide electrolyte (M‐CSE) is reported that is dynamically stable with lithium metal, promoting uniform Li+ deposition without dendrites. The resulting ASSLMBs exhibit an areal capacity of 10 mAh cm−2, an energy density of 219 Wh kg−¹, and a current density of 3.76 mA cm−2, with a capacity retention of 95.04% after 500 cycles at 0.5C. The assembled lithium swagelok cell and solid‐state lithium‐metal pouch cells have relatively low pressures, with the swagelok cell stack pressure ≈30 MPa and the pouch cell stack pressure also ≈2 MPa. More importantly, mass production of ultra‐low‐pressure pouch cells is realized by 3D printing technology, marking a crucial breakthrough for practical applications.