Our study showed that the posterior approach only procedure obtained better clinical outcomes than combined posterior and anterior surgeries. It might be a better surgical treatment for thoracic spinal tuberculosis in aged patients with poor health status, especially for cases in early phase of bone destruction and/or mild and moderate kyphosis.

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Responsiveness of the first somatosensory area (SI) of the cerebral cortex was investigated in the marmoset monkey (Callithrix jacchus) in association with cooling-induced, reversible inactivation of the second somatosensory area, SII. The aim was to determine whether SI responsiveness to peripheral tactile stimulation depends on SII and therefore whether SI and SII in the marmoset occupy hierarchically equivalent positions in a parallel organizational scheme for thalamocortical tactile processing as appears to be the case in nonprimate mammals. Inactivation of SII was achieved when the temperature over SII was lowered to < or =12 degrees C, as indicated by abolition of the SII-evoked potentials generated by brief tap stimuli to the hand or foot, and by abolition of tactile responses in single SII neurons located at the margin beneath the block. The effect of SII inactivation on SI-evoked potentials was examined in 16 experiments by simultaneous recording of the SI- and SII-evoked potentials. SI-evoked potentials were never abolished and remained unaffected in 11 cases. In three experiments there was a small reduction in amplitude and inconsistent effects in the remaining two. Responsiveness to controlled tactile stimuli was examined quantitatively in 31 individual SI neurons of different functional classes before, during, and after the inactivation of SII. Tactile responsiveness in individual SI neurons was never abolished by SII inactivation, remaining unchanged in 20 neurons (65%) while undergoing some reduction in the remaining 11 SI neurons (35%). This reduction of tactile responsiveness in one-third of SI neurons is most likely attributable to a removal of a facilitatory influence emanating from SII, based on the observation that background activity of the affected neurons was also reduced. Furthermore, phase locking of SI responses to vibrotactile stimulation was unchanged when SII was inactivated. The retention of responsiveness in SI neurons when SII was inactivated by cooling in the marmoset demonstrates that tactile inputs can reach SI without traversing an indirect, serially organized path through SII. The present results, together with our previous observations that responsiveness in the majority of SII neurons survived SI inactivation, demonstrate that there is a parallel organization of the SI and SII areas for tactile processing in the marmoset monkey and that SI and SII occupy hierarchically equivalent positions in a parallel processing network. There is therefore no longer justification for the view that there are fundamental differences in the organization of thalamocortical tactile processing for SI and SII between simian primates, in general, and other mammals.

The functional organization of the primate somatosensory system at thalamocortical levels has been a matter of controversy, in particular, over the extent to which the primary and secondary somatosensory cortical areas, SI and SII, are organized in parallel or serial neural networks for the processing of tactile information. This issue was investigated for the marmoset monkey by recording from 55 single tactile-sensitive neurons in the lateral division of the ventral posterior nucleus of the thalamus (VPL) with a projection to either SI or SII, identified with the use of the antidromic collision technique. Neurons activated from the hand and distal forearm were classified according to their peripheral source of input and characterized in terms of their functional capacities to determine whether the direct thalamic input can account for tactile processing in both SI and SII. Both the SI- and SII-projecting samples contained a slowly adapting (SA) class of neurons, sensitive to static skin displacement, and purely dynamically sensitive tactile neurons that could be subdivided into two classes. One was most sensitive to high-frequency (> or =100 Hz) cutaneous vibration whose input appeared to be derived from Pacinian sources, while the other was sensitive to lower frequency vibration (< or =100 Hz) or trains of rectangular mechanical pulse stimuli, that appeared to receive its input from rapidly adapting (RA) afferent fibers presumed to be associated with intradermal tactile receptors. There appeared to be no systematic differences in functional capacities between SI- and SII-projecting neurons of each of these three classes, based on receptive field characteristics, on the form of stimulus-response relations, and on measures derived from these relations. These measures included threshold and responsiveness values, bandwidths of vibrational sensitivity, and the capacity for responding to cutaneous vibrotactile stimuli with phase-locked, temporally patterned impulse activity. The analysis indicates that low-threshold, high-acuity tactile information is conveyed directly to both SI and SII from overlapping regions within the thalamic VP nucleus. This direct confirmation of a parallel functional projection to both SI and SII in the marmoset is consistent with our separate studies at the cortical level that demonstrate first, that tactile responsiveness in SII largely survives the SI inactivation and second, that SI responsiveness is largely independent of SII. It therefore reinforces the evidence that SI and SII occupy a hierarchically equivalent network for tactile processing.