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Incidence and Skeletal Features of Developmental Cervical and Lumbar Spinal Stenosis
Kasai Yuichi,Paholpak Permsak,Wisanuyotin Taweechok,Sukitthanakornkul Nattharada,Hanarwut Parika,Chaiyamoon Arada,Iamsaard Sitthichai,Mizuno Tetsutaro 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.2
Study Design: Cross-sectional study.Purpose: To report the prevalence and relationship of developmental cervical and lumbar spinal stenosis (DCSS and DLSS) with the bone parameters of the skull and extremities.Overview of Literature: DCSS and DLSS are found occasionally in daily practice. DCSS and DLSS can cause compressive myelopathy, radiculopathy, and cauda equina syndrome; however, data on their prevalence and correlation with skull and skeletal extremity profiles is scarce.Methods: A cross-sectional measurement study of 293 whole-body dried-bone samples was conducted. We measured the anteroposterior (AP) and transverse diameter of the fourth to sixth cervical vertebrae (C4–C6) and third to fifth lumbar vertebrae (L3–L5). Stenosis of the cervical spine and lumbar spine was defined as an AP diameter of <12 mm and <13 mm, respectively. We also measured the skull circumference, the AP and transverse diameters of the foramen magnum, the inner and outer inter distances between the left and right orbital bones, the humerus length, and the femoral length. Kruskal-Wallis and post hoc analyses were used in the statistical analyses.Results: The age was 22–93 years. DCSS was found in 59 (20.1%) and DLSS in 28 (9.6%). Twelve samples had both DCSS and DLSS (development spinal stenosis, DSS). When compared to the “no spinal stenosis sample,” DSS (−), DCSS and DSS had a significantly smaller skull circumference, the transverse diameter of the foramen magnum, and inner and outer distance between the orbital bone (<i>p</i><0.05). There was no significant difference in humeral length, femoral length, or AP diameter of the foramen magnum.Conclusions: DCSS was correlated with a small skull, a small transverse diameter of the foramen magnum, and a small orbital bone. A small skull was strongly associated with a small cervical canal. DLSS, on the other hand, was unrelated to either a small cervical canal or a small skull.
Koji Akeda,Kohshi Ohishi,Koichi Masuda,Won C. Bae,Norihiko Takegami,Junichi Yamada,Tomoki Nakamura,Toshihiko Sakakibara,Yuichi Kasai,Akihiro Sudo 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.3
Study Design: Preliminary clinical trial. Purpose: To 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 Literature: PRP, 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. Methods: Inclusion 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). Results: Data 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 <0.01, respectively). The mean T2 values did not significantly change after treatment. Conclusions: We demonstrated that intradiscal injection of autologous PRP releasate in patients with low back pain was safe, with no adverse events observed during follow-up. Future randomized controlled clinical studies should be performed to systematically evaluate the effects of this therapy.