2011, Vol.18, No.4

Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03

pISSN : 2093-4378 / eISSN : 2093-4386
https://journal.kci.go.kr/krspine

Study Design: An experimental animal study. Objectives: To create a more appropriate disc degeneration model which shows how Interleukin 1α may induce the activation of metalloproteinases within the nucleus pulposus. Summary of Literature Review: There are few disc degeneration models wherein there is activation of metalloproteinases within the nucleus pulposus without structural destruction of the intervertebral disc. Materials and Methods: Three consecutive intervertebral discs in New Zealand White Rabbits were exposed. Each disc was injected with 0.1ml of saline (Saline group), 0.1ml of 1μg/ml (IL-1 group), 0.1ml of 10μg/ml (IL-10 group) of IL-1α through a 30-gauge needle. The lumbar spine was harvested 12 weeks after operation. We then analyzed radiographic findings and histological changes. Results: There was no difference in the radiological disc height index among the three groups; 0.071 in saline group, 0.045 in IL-1 group and 0.058 in IL-10 group (p=0.194). The histological cellularity of the nucleus pulposus revealed a decrease in the number of cells (p=0.0001,1.42 in saline group vs. 3.00 in IL-10 group; p=0.001, 2.00 in IL-1 group and 3.00 in IL-10). The histological matrix of the nucleus pulposus was 1.42 in saline group and 2.42 in IL-10(p=0.007), which meant that there had been condensation of the extracellular nucleus pulposus matrix. Conclusions: The results of this study demonstrate that interleukin-1α may contribute to degradation of the nucleus pulposus. This is useful for future study into the effects of the cytokine inhibitor on matrix regeneration and cellularity in the nucleus pulposus in intervertebral disc disease.

Study Design: A retrospective study. Objectives: To evaluate the clinical and radiological outcomes of anterior cervical fusion within Harms cage versus an iliac bone block graft. Summary of Literature Review: There is no current consensus regarding the optimal material for anterior cervical fusion. Materials and Methods: This was a single-center study of 107 patients who either underwent anterior cervical fusion with an iliac bone block graft (n=56; group A) or a cancellous bone graft within the cervical Harms titanium cage (n=51; group B). Anterior plating occurred in all cases. Clinical outcomes and complications were evaluated using Visual Analogue Scale (VAS) scores and Odom’s Criteria. Radiological outcomes were evaluated by the height of vertebral bodies, sagittal lordosis, the rate of bony union, and the subsidence of cage. Results: The VAS of donor site pain was significantly higher in group A than in group B at the final follow-up. Sagittal lordosis was increased in both groups, but was significantly higher in group B than group A. The rate of bony union was 95% and 91% for both groups 6 months after surgery and reached 100% for both groups at the final follow-up. In terms of cage subsidence, the highest point of subsidence was at the inferior and posterior aspect of the cage and the average amount of subsidence was approximately 1.3 mm at final follow-up. Conclusions: Anterior cervical fusion using a cancellous bone graft within Harms titanium cage is a good method for anterior cervical fusion with iliac bone block.

Study Design: A retrospective study. Objectives: To evaluate the effectiveness of unilateral extrapedicular approach in the treatment of osteoporotic compression fracture,as compared to transbipedicular approach. Summary of Literature Review: There has been no comparative study assessing this topic. Materials and Methods: 115 patients presenting with percutaneous vertebroplasty between Mar. 2002 and Feb. 2009, were divided into three groups: Group A (43 vertebrae; 29 patients) who were treated with bipedicular approach, Group B (66 vertebrae; 47 patients)treated with early cases of unilateral extrapedicular approach, and Group C (43 vertebrae; 39 patients) treated with late cases of unilateral extrapedicular approach. We analyzed radiological test results including the volume of injected cement and the distribution of intravertebral body, cement leakage, height restoration and kyphosis correction. Statistical analysis was done using SPSS. Clinical results were analyzed using VAS scores. Results: The mean follow-up period varied from one year at minimum to seven years and six months at maximum. The mean volume of injected cement was 3.39cc/5.39cc/3.79cc for groups A, B and C respectively. Cement leakage was at 13.4/34.8/12.8% in each group. Cement leakage was higher in group B, but most leakage took place in early cases that we tried to inject more and more cement in early inexperienced period. Bilaterally well distributed cement in the vertebral body was at 85.7/76.9% in groups B and C respectively. VAS scores improved from 8.4/8.3/8.5 preoperatively to 2.0/2.0/1.6 postoperatively. Conclusions: Percutaneous vertebroplasty treated with unilateral extrapedicular approach can lessen perioperative operating