Mechanical vibration (MV) of a muscle causes position-sense errors during and after application. Isometric muscle contraction at a shorter (hold-short conditioning) or longer (hold-long conditioning) length causes limb position-sense errors after the muscle returns to its intermediate length by means of intrafusal muscle thixotropy. However, it is unclear whether MV enhances these thixotropic position-sense errors. We studied the after-effects of MV on position-sense errors induced by hold-short and hold-long conditioning in the biceps of 12 healthy men. After hold-short conditioning, subjects perceived that the conditioned forearm was placed in a more extended position than occurred in reality; after hold-long conditioning, a more flexed position was perceived. Use of MV with hold-short or hold-long conditioning enhanced both errors, which were most obvious at 100 HZ. These results suggest that MV and muscle conditioning work together efficiently to develop intrafusal muscle thixotropy. MV combined with hold-long conditioning may alleviate thixotropically increased muscle stiffness, such as in spastic hypertonia.

Short-length muscle contraction (hold-short conditioning) causes limb position sense errors after the muscle returns to its intermediate length; this is due to intrafusal muscle thixotropy, which raises the muscle spindle sensitivity. In humans, contraction of muscles in the upper body (referred to as the Jendrassik manoeuvre) reinforces tendon reflexes in the lower limbs. However, it is unclear whether such a reinforcement manoeuvre enhances thixotropic position sense errors. We studied the effect of quadriceps contraction on upper limb position sense errors induced by hold-short conditioning of the biceps in 12 healthy men. Quadriceps contraction increased the tonic vibration reflex of the biceps, suggesting that quadriceps contraction has a reinforcing effect similar to that of the Jendrassik manoeuvre. After hold-short conditioning of the right biceps, subjects perceived that the conditioned forearm was placed in a more extended position than it actually was. Such position sense errors were enhanced during quadriceps contraction and the degree of error was increased with the intensity of the quadriceps contraction. These results suggest that limb position sense is affected by remote muscle contraction.

Introduction:Degenerative lumbar kyphoscoliosis is a serious clinical condition that affects activities of daily living. This study aimed to investigate the age-related progression of nonoperative degenerative lumbar kyphoscoliosis, to clarify its final state in elderly people, and to identify factors associated with its progression.Methods: This retrospective longitudinal study included 115 nonoperative cases (mean age at first consultation, 70.9 years; range, 50-89 years). All were followed up for >6 years. The analysis included changes between initial and latest measurements in the coronal parameters (Cobb angle, L4 tilt angle, intervertebral angle, lateral spondylolisthesis, and C7-central sacral vertical line) and sagittal parameters (thoracic kyphosis, lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope, sagittal vertical axis, and vertebral wedging rate). Factors in scoliosis progression were investigated by analyzing the correlations between the initial parameter values and the increase in Cobb angle. Results:Changes in the coronal parameters increased with age from 50s to 70s but decreased significantly in those aged 80s. Sagittal parameters increased by the age group, accelerating in those aged 80s, with the progression of vertebral wedging. In patients aged 50s-70s, the increase in Cobb angle correlated significantly with the initial Cobb angle, L4 tilt angle, and L4/L5 intervertebral angle.However, in the cases without initial scoliosis, the increase in Cobb angle correlated significantly only with the L4 tilt angle. There were no significant differences in any parameter according to the use of a trunk brace or medication for osteoporosis. Conclusions: L4 tilt angle is an important factor in the progression of degenerative scoliosis. The progression of scoliosis gradually ends after the age of 80 years with the decreasing variation of L4 tilt * * % *

Introduction: This study aimed to compare the clinical and radiological results of transforaminal lumbar interbody fusion (TLIF) with a boomerang-shaped cage and traditional posterior lumbar interbody fusion (PLIF) according to fused level and elucidate whether TLIF could replace PLIF at all lumbar levels. Methods: The study investigated 128 patients with lumbar spondylolisthesis who underwent a single-level TLIF or traditional PLIF. Intraoperative blood loss, operative time, and recovery rate were analyzed. Percent slip, disc height, and local lordosis at the fused level were measured using X-ray images from preoperation to the final follow-up. Results: No significant differences in recovery rate were observed at any level. The operative time and intraoperative blood loss were significantly less in the TLIF group at the L4/5 and L5/S1 levels. There were no significant differences in disc height or local lordosis at the L3/4 and L4/5 levels, and a satisfactory level of maintenance after the operation was achieved in both groups. However, at the L5/S1 level, postoperative maintenance after TLIF could not be achieved, and the obtained disc height and local lordosis in TLIF significantly decreased. Conclusions: Compared with traditional PLIF, TLIF was a less invasive procedure with a shorter operative time and lesser blood loss. TLIF could obtain similar local lordosis and disc height as PLIF at the L3/4 and L4/5 levels. At the L5/S1 level, the postoperative maintenance of local lordosis and disc height after TLIF was inferior to that after PLIF. On the basis of our results, we do not recommend performing TLIF at only the L5/S1 level.

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