The IP-CHA spacer contributed to high bone fusion rates of the spacers and hinges of the laminae, and there were no complications associated with their use. Cervical laminoplasty with the IP-CHA spacers is a safe and simple method that yields sufficient fixation strength and provides sufficient bone bonding within a short period of time after operation.

Introduction The number of cases of osteoporotic vertebral compression fracture (OVCF) with intravertebral cleft (IVC) with delayed neurologic deficit (DND) is increasing as the population ages. However, the cause of DND is poorly understood, and no definitive treatment of the disease has been established. The purpose of this study was to clarify the radiographic parameters contributing to the occurrence of DND, and to evaluate the efficacy and safety of percutaneous vertebroplasty for this pathology. Methods Percutaneous vertebroplasty was prospectively performed for 244 patients with OVCF with IVC; 30 had DND and 214 did not. Radiographic parameters of local kyphotic angle, percent spinal canal compromise and intravertebral instability were investigated for correlations to DND. Procedural outcomes were evaluated using visual analog scale (VAS), Oswestry Disability Index (ODI), and modified Frankel grades. Results Before vertebroplasty, no substantial difference in local kyphotic angle was seen between OVCF with IVC with and without DND, but percent spinal canal compromise and intravertebral instability were greater in OVCF with IVC with DND (P \ 0.001). After vertebroplasty, 25 of 30 cases (84 %) of OVCF with IVC with DND achieved clinically meaningful improvement (CMI), but 5 (17 %) did not. Patients with CMI showed substantial improvements in intravertebral instability (P \ 0.001), and no change in local kyphotic angle or percent spinal canal compromise. In five patients without CMI, four showed an initial improvement, but subsequent vertebral fracture adjacent to the treated vertebra caused neurologic re-deterioration. One patient with percent spinal canal compromise 54.9 % and intravertebral instability 4°achieved no neurologic improvement following vertebroplasty. No serious complications or adverse events related to the procedure were encountered. ConclusionsIntravertebral instability is the dominant cause of DND. Percutaneous vertebroplasty appears effective and safe in the treatment of OVCF with IVC with DND. Patients with less intravertebral instability and severe spinal canal compromise could be candidates for conventional surgical treatment.

To assess the effect of endothelial progenitor cells on the axon growth of cortex neurons, we transplanted CD133 cells derived from human peripheral blood to an organotypic coculture system consisting of spinal cord and cortex from neonatal rats. The axon growth from cortex to spinal cord was significantly promoted in cultures after CD133 cells transplantation compared with that of the control cultures. In addition, real-time reverse transcription-PCR showed a significant upregulation of vascular endothelial growth factor mRNA in the spinal cord of the cultures containing CD133 cells. In contrast, the transplanted cells did not differentiate into endothelial cells. These data suggest that CD133 cells may promote axonal regeneration by upregulating vascular endothelial growth factor mRNA in spinal cord tissues.

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Our data showed a significant pattern of CMCT parameters and low CMCT-ADM/AH ratios in patients with CTM. The measurement of CMCT is valuable as a noninvasive technique for screening patients with CTM or CCM before magnetic resonance imaging.

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Purpose Intervertebral disc degeneration is considered to be a major feature of low back pain. Furthermore, oxidative stress has been shown to be an important factor in degenerative diseases such as osteoarthritis and is considered a cause of intervertebral disc degeneration. The purpose of this study was to clarify the correlation between oxidative stress and intervertebral disc degeneration using Broad complexTramtrack-Bric-a-brac and cap'n'collar homology 1 deficient (Bach 1-/-) mice which highly express heme oxygenase-1 (HO-1). HO-1 protects cells from oxidative stress. Methods Caudal discs of 12-week-old and 1-year-old mice were evaluated as age-related models. Each group and period, 5 mice (a total of 20 mice, a total of 20 discs) were evaluated as age-related model. C9-C10 caudal discs in 12-week-old Bach 1-/-and wild-type mice were punctured using a 29-gauge needle as annulus puncture model. Each group and period, 5 mice (a total of 60 mice, a total of 60 discs) were evaluated. The progress of disc degeneration was evaluated at pre-puncture, 1, 2, 4, 8 and 12 weeks post-puncture. Radiographic, histologic and immunohistologic analysis were performed to compare between Bach 1-/-and wild-type mice. Results In the age-related model, there were no significant differences between Bach 1-/-and wild-type mice radiologically and histologically. However, in the annulus puncture model, histological scoring revealed significant difference at 8 and 12 weeks post-puncture. The number of HO-1 positive cells was significantly greater in Bach 1-/-mice at every period. The apoptosis rate was significantly lower at 1 and 2 weeks post-puncture in Bach 1-/-mice. Conclusions Oxidative stress prevention may avoid the degenerative process of the intervertebral disc after puncture, reducing the number of apoptosis cells. High HO-1 expression may also inhibit oxidative stress and delay the process of intervertebral disc degeneration.

Study design: Organotypic coculture model using brain cortex and spinal cord of neonatal rats was used to test the effect of chondroitinase ABC (ChABC) on corticospinal axon growth. Objective: Chondroitin sulfate proteoglycan (CSPG) is neurite outgrowth inhibitory factor that combines with reactive astrocyte at the lesion site to form a dense scar that acts as a barrier to regenerating axons. ChABC is a bacteria enzyme that digests the glycosaminoglycan side chain of CSPG. We investigated the effect of ChABC on corticospinal axon growth quantitatively using the organotypic cocultures of brain cortex and spinal cord. Setting: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University. Method: We used organotypic cocultures with neonatal brain cortex and spinal cord as an in vitro assay system for assessing axon growth. After administering ChABC, we counted the number of axons passing through a reference line running parallel to the junction between the brain cortex and spinal cord 500 and 1000 mm from the junction. The immunoreactivity of CSPG was assessed. Result: The average number of axons after ChABC administration was significantly greater than in the control group. Administration of ChABC decreased CSPG expression in this coculture system. Conclusion: ChABC induces axonal regeneration by degrading CSPG after central nerve system injury. ChABC has great potential for future therapeutic use in spinal cord-injured patients.