A definitive verdict could not be reached regarding which approach is better for the treatment of OVCF. Although unilateral PKP was associated with shorter operative time, less X- ray exposure frequency and dosage of PMMA than bilateral PKP. There was no apparent difference in the short- and long-term clinical outcomes and complications between them. However, bilateral PKP approaches were higher than unilateral PKP in term of the restoration rate. But on account of lack of some high-quality evidence, we hold that amounts of high-quality randomized controlled trials should be required and more complications should be analysed to resolve which surgical approach is better for the treatment of OVCF in the future.

Anterior CORP has a higher postoperative JOA score and neurological recovery rate compared with posterior LAMP. However, significant higher reoperation rate, operation time and blood loss should be taken into consideration when anterior CORP is used. High-quality RCTs with long-term follow-up and large sample size are needed.

BackgroundThe cervicothoracic junction (CTJ) site accounts for approximately 10% of all spinal metastases. The complex anatomical and biomechanical features increase the difficulty in surgical treatment of the CTJ metastases. However, few studies in the literature on surgical treatment for spinal metastases are focusing on this special area. The aim of this study was to evaluate the surgical outcome of patients with CTJ metastases and analyze the prognostic factor for the postoperative survival.MethodsTotal of 34 patients with CTJ metastases who underwent surgery in our department were retrospectively analyzed. We evaluated records for the details of medical history, treatment, surgery, radiographic imaging, and follow-up. Outcomes were assessed by overall survival as well as modified Tokuhashi score, SINS, Frankel grade, visual analog scale (VAS), and Karnofsky Performance Status (KPS).ResultsThe entire patients’ median survival time was 12.4 months (range, 3.5–36.2 months). Pain improved in 32 patients (94.12%), and the postoperative VAS scores were significantly improved compared with preoperative data. Majority of patients (71%) maintained or improved their Frankel scores 1 year after surgery. KPS scores improved in 13 patients (38%), remained stable in 19 (56%), and worsened in 2 (6%) postoperatively. Notably, patients with neurological deficit that did not improve after surgery had significantly worse median survival than those who had either no deficit or who improved after surgery. There were no instrumentation failures in this study.ConclusionsSurgical treatment is effective for patients of CTJ metastases, with a tolerable rate of complications. Remained or regained ambulatory status predicted overall survival. Thus, prompt and aggressive decompressive surgery is recommended for CTJ metastases patients with neurological impairment.

Objective: This study was a retrospective multivariable analysis for risk factors of poor outcome in patients who underwent anterior hybrid approach, and discussed the causes of worsening of postoperative local alignment. Methods: A total of 86 patients with progressive spinal cord compression and local kyphosis underwent an anterior hybrid approach (ACDF+ACCF), between June 2011 and June 2017. We evaluated clinical outcome by the Japanese Orthopaedic Association (JOA) score and recovery rate. Patients were divided into two groups according to the worsening and improving of postoperative local alignment. Multivariate logistic regression analysis was applied to the evaluation of risk factors. Mann-Whitney U test, independent t test, and chi-squared test were performed for the comparison of local kyphosis between postoperative and last follow-up. Results: There were twenty patients who had a recovery rate of less than 50%. Advance age, longer duration of symptoms, bigger T1 slope angle, and lower change of local kyphosis angle were significantly associated with a poor clinical outcome by multivariate logistic regression analysis. The cause of worsening of postoperative local alignment had T1 slope, C2-7 sagittal vertical axis (SVA), adjacent segment degeneration (ASD), and implant subsidence. Conclusions: The change of local kyphosis was a predictor of clinical outcome after the hybrid approach. Furthermore, postoperative ASD, implant subsidence, T1 slope, and C2-7 Cobb were associated with recurrence of postoperative cervical kyphosis.

Background: Vasculogenic mimicry (VM) plays an important role in human glioma progression and resistance to antiangiogenic therapy as a compensatory neovascularization mechanism in malignant tumors. Caveolin-1 (Cav-1) has been found to contribute to VM formation. However, it remains largely unknown whether Cav-1 expression correlates with VM in glioma. Methods: In this study, we examined CAV-1 expression levels and vasculogenic mimicry in human glioma cell lines and in 94 human gliomas with different grades and presented cox proportional hazards regression. The molecular role of Cav-1 in glioma cells was investigated using quantitative polymerase chain reaction (qRT-PCR) assays, Western blotting, CCK-8 assays, tubule formation assays. Results: Cav-1 expression and VM formation were positively correlated with each other and both are closely associated with glioma development and progression as evidenced by the presence of cystic tumor, the shortened survival time and advanced-stage glioma in glioma patients with Cav-1 overexpression/increased VM formation. Cav-1 promoted U251 glioma cell proliferation and VM formation in a Matrigel-based 3D culture model. VM-associated factors including hypoxia-inducible factor 1α (HIF-1α) and p-Akt was significantly elevated by Cav-1 overexpression but suppressed by siCav-1 in U251 cells. Conclusion: Collectively, our study identifies Cav-1 as an important regulator of glioma cell proliferation and VM formation, contributing to glioma development and progression.