We evaluated the chondroprotective effects of wogonin by investigating its effects on the gene expression and production of matrix metalloproteinase-3 (MMP-3) in primary cultured rabbit articular chondrocytes, as well as on production of MMP-3 in the rat knee. Rabbit articular chondrocytes were cultured in a monolayer, and RT-PCR was used to measure interleukin-1beta (IL-1beta)-induced expression of MMP-3, MMP-1, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), and type II collagen. In rabbit articular chondrocytes, the effects of wogonin on IL-1beta-induced production and proteolytic activity of MMP-3 were investigated using western blot analysis and casein zymography, respectively. The effect of wogonin on MMP-3 protein production was also examined in vivo. In rabbit articular chondrocytes, wogonin inhibited the expression of MMP-3, MMP-1, MMP-13, and ADAMTS-4, but increased expression of type II collagen. Furthermore, wogonin inhibited the production and proteolytic activity of MMP-3 in vitro, and inhibited production of MMP-3 protein in vivo. These results suggest that wogonin can regulate the gene expression and production of MMP-3, by directly acting on articular chondrocytes.
Animals ; Blotting, Western ; Caseins ; Chondrocytes ; Collagen Type II ; Gene Expression ; Interleukin-1beta ; Knee ; Models, Theoretical* ; Osteoarthritis* ; Rats ; Thrombospondins

OBJECTIVE: The purpose of this study was to evaluate the results obtained in patients who underwent staged 360-degree fusion with posterior fusion following anterolateral fusion for unstable thoracolumbar burst fractures. METHODS: The authors performed 360-degree fusion for thoracolumbar burst fractures in 21 patients between 2006 and 2010. We reviewed the medical records and follow-up data including pre- and postoperative neurological status, spinal canal compromise, segmental kyphotic angulations, complications, visual analogue scale (VAS) pain scores, and revision surgery rates. RESULTS: The mean computed tomography-measured preoperative spinal canal compromise was 55.9+/-20.7%. The segmental kyphotic deformity measured 20.2+/-4.4degrees preoperatively and had been corrected to 4.5+/-2.8degrees postoperatively. The mean vertebral body height loss of 57.4+/-6.9% improved significantly to 1.2+/-0.7% at the final follow-up examination. The mean preoperative VAS pain score of 8.2+/-0.8 improved to 1.5+/-0.6 at discharge. There were no cases of vascular complication, neurological deterioration, or revision surgery. CONCLUSION: Unstable burst fracture of thoracolumbar spine managed by staged posterior fusion and anterolateral interbody fusionis effective for kyphosis correction, significant canal decompression, pain reduction, maintaining stabilization and neurological improvement.
Body Height ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Medical Records ; Spinal Canal ; Spinal Fractures ; Spinal Fusion ; Spine

OBJECTIVE: The purpose of this study is to examine radiological adjacent segment degeneration (ASD) and clinical results after two levels percutaneous pedicle screw fixation. METHODS: From 2007 to 2009, 34 patients who underwent percutaneous pedicle screw fixation on L3-4-5 or L4-5-S1 for lumbar degenerative disorders were selected. According to the presence of radiological ASD, ASD group and non-ASD group were compared for clinical results and radiologic results such as total lordotic angle (TLA), segmental lordotic angle (SLA) via lumbar X-rays during follow up periods. Furthermore, we compared pre-operative degree of disc degeneration at adjacent segment between two groups via MRI. RESULTS: The mean follow-up period and mean age were 27.38+/-9.45 months and 59.21+/-12.73 years. ASD group were 7 patients, and non-ASD group were 27 patients. The mean age of the ASD group (67.40+/-4.81) was significantly older than that of the non-ASD group (57.46+/-13.18). Pre-operative disc degeneration of cranial adjacent segment in ASD group were 6 patients (25.9%), whereas that in non-ASD group were 4 patients (14.8%), showing that preoperative disc degeneration was significantly more severe in the ASD group. CONCLUSION: Percutaneous pedicle screw fixation is favorable technique to prevent ASD for two levels fusion, however, when the patient is old or the preoperative disc degeneration of the adjacent segment is severe, there is the risk of postoperative ASD, and thus special attention should be paid during the follow-up period.
Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Spinal Fusion

OBJECTIVE: The authors conducted a retrospective study of patients with degenerative lumbar spinal disorders who received a posterior lumbar interbody fusion (PLIF) with the IS(R) cage. METHODS: We assessed 105 patients who underwent on a PLIF with or without pedicle screws using the IS(R) cage in our institute from November 2007 to December 2008. Clinical outcomes were analyzed with a Visual Analog Scale (VAS) for back and leg pain. Radiographs were obtained before and after the surgery. In some cases, a lumbar spinal computed tomography scan was obtained. Radiological outcomes of intercage distance, fusion rate, and intervertebral disc height were assessed. In scoliosis or lateral translation, the extent of correction was examined. RESULTS: The mean VAS score for back pain improved from 6.86 preoperatively to 2.66 at postoperative month 12, and the score for leg pain decreased from 7.92 to 1.78. The mean intervertebral disc height was 8.71+/-2.35mm before the surgery, and it increased to 11.67+/-1.77mm at 7 days postoperative and decreased to 9.57+/-1.90mm at 6 months postoperative. The fusion rate was 95.65%. For scoliosis or lateral translation, thesegmental angle of scoliosis decreased from 11.10+/-5.82degrees before the surgery to 5.61+/-3.71degrees by month 6 postoperative. The extent of the lateral translation changed from 6.04+/-1.73mm before the surgery to 3.56+/-4.99mm at month 6 postoperative. CONCLUSION: There have been low complication rates with the IS(R) cage during the follow-up period, and the results of this study demonstrates a wide fusion area, partial reduction of lateral translation and scoliosis, good clinical success, and a high fusion rate.
Back Pain ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Leg ; Retrospective Studies ; Scoliosis ; Spinal Fusion

OBJECTIVE: To investigate the clinical characteristics of male population who underwent vertebroplasty for osteoporotic compression fracture and evaluate the clinical, radiological outcomes compared to female group. METHODS: The medical records and radiological data were reviewed in total 155 patients who underwent vertebroplasty for osteoporotic vertebral compression fracture from February 2006 to November 2009. We compared 32 male patients with 123 female patients in terms of preoperative factors, intraoperative factors, and clinical and radiologic outcomes. RESULTS: The mean age of male group was 67.8~8.6 years and their mean T-score on bone mineral density (BMD) was -3.2+/-0.8. The mean age of female group was 71.8+/-8.9 years and their mean T-score was -3.7+/-0.7 (p=0.025 for age, p=0.002 for BMD). Male patients (21 out of 32, 65.6%) had more frequent traumatic event than female patients (51 out of 123, 41.5%) (p=0.012). The secondary osteoporosis was more frequently seen in male group than female group (53.1% vs 26.8%, p=0.005). The lump cement distribution pattern was found more frequently in male group than female group (46.9% vs 28.5%, p=0.040). There was no statistically significant difference between the two groups in clinical outcomes. CONCLUSION: Male patients had significantly more risk factors for secondary osteoporosis and obvious traumatic event than female group. Clinicians should always be aware of secondary causes of osteoporosis and history of traumatic events in male patients with osteoporotic compression fracture and also pay attention to correct the cause of secondary osteoporosis and recommend anti-osteoporosis management.
Bone Density ; Female ; Fractures, Compression ; Humans ; Male ; Medical Records ; Osteonecrosis ; Osteoporosis ; Risk Factors ; Vertebroplasty

OBJECTIVE: There are few studies of osteoporotic burst fractures with spinal canal compromise that were treated with kyphoplasty. The purpose of this study was to assess the efficacy and the safety of kyphoplasty for the treatment of thoracolumbar spine osteoporotic burst fractures without neurological deficits and to investigate predictors that can improve the effectiveness of this treatment. METHODS: From October 2004 until December 2010, 79 osteoporotic burst fracture patients with asymptomatic spinal canal compromise were treated by kyphoplasty. Kyphoplasty involved injecting polymethylmethacrylate (PMMA) from the anterior one-third of the vertebral body into the posterior one-third of the vertebral body. PMMA powder and liquid were mixed in a ratio of 1:3 at 21-23degrees C. Preoperative and postoperative visual analog scores (VAS), kyphotic angles, the heights of the vertebral body, and the degrees of spinal canal compromise were analyzed. The relationships between the factors and the VAS difference between the preoperative and postoperative states were analyzed. RESULTS: The mean postoperative VAS, the postoperative kyphotic angle, the vertebral body height measurement from the anterior and the middle of the body were significantly improved after kyphoplasty (p<0.05). Postoperatively, the mean VAS was restored from 7.35 to 2.11, the postoperative kyphotic angle was restored from 18.21degrees to 12.08degrees, the vertebral body height measurement from the anterior of the body was from 18.56mm to 23.54mm and the middle of the body was from 24.81mm to 27.90mm. Among the variables, only the duration of symptoms before surgical treatment was implicated as a factor in the outcome (p<0.01). CONCLUSION: Kyphoplasty is a very effective and safe therapeutic modality for the treatment of osteoporotic burst fractures without neurological deficits. The standardization of this procedure helps to avoid complications. In the acute stages, early treatment is more effective for the reduction of pain. Further investigation is warranted in order to assess the effectiveness of early surgery in improving outcome.
Body Height ; Humans ; Kyphoplasty ; Osteoporotic Fractures ; Polymethyl Methacrylate ; Spinal Canal ; Spine

OBJECTIVE: To compare clinical and radiologic results of two graft materials for anterior cervical discectomy and fusion (ACDF) with rigid plate fixation for cervical spinal disorder. METHODS: Twenty-eight patients treated with single-level ACDF with rigid plate fixation were retrospectively reviewed. They were divided into twogroups: Polyetheretherketone (PEEK) cage filled with beta-tricalcium phosphate (beta-TCP) in Group A (n=15); and autogenous tricortical iliac bone graft in group B (n=13). The average follow-up durations were 16.3 months and 19.90 months for group A and group B, respectively. Clinical outcomes were graded using the visual analogue scale (VAS) score and neck disability index (NDI). Interbody height, segmental kyphotic angle and overall kyphotic angle were used as parameters to evaluate radiographic change in the 2 treatment groups. RESULTS: Clinically, VAS scores and NDI significantly improved after the surgery in both groups (p<0.05). Clinical and radiologic evaluation demonstrated no significant intergroup differences (p>0.05). The fusion rates after 12 months in group A and B were 93.3% and 100%, respectively. One case of cage subsidence which resulted in pseudoarthrosis occurred in group A. However, statistical analysis did not show difference in fusion rate between the two groups (p>0.05). CONCLUSION: ACDF using PEEK cage filled with alpha-TCP showed comparable clinical and radiologic results with the standard of autogenous iliac bone graft. However, pseudoarthrosis did occur even with rigid plate and screw fixation in ACDF using PEEK cage filled with beta-TCP. There is high likelihood of emerging pseudoarthrosis, especially when there is a sign of chronic and progressive cage subsidence.
Calcium Phosphates ; Cervical Vertebrae ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Ketones ; Neck ; Polyethylene Glycols ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion ; Transplants

OBJECTIVE: Most patients wear cervical braces regardless of any anterior cervical discectomy and fusion (ACDF) technique for cervical disc herniation, even in the plating. We compared clinical and radiological results in patients with cervical disc herniations. The purpose of this study was to evaluate the efficacy of plate insertion during ACDF and determine if this could eliminate the need for external cervical braces after ACDF. METHODS: In this study, we evaluated 67 patients treated for single level cervical disc herniation with radiculopathy. The patients were divided into two groups: 30 patients treated with ACDF using a Solis(R) cage with plating who did not wear a cervical brace after the operation (Group I: Plated group), and 37 patients treated with ACDF using a Solis(R) cage without plating who wore a cervical brace for 3 months (Group II: Non-plated group). Clinical outcomes were assessed using the neck disability index (NDI), and visual analogue scale (VAS) for neck and arm pain at different times after the surgery. In addition, modified MacNab's grading criteria were used to assess the subjective patients' outcome at the last follow-up. Fusion was assessed at 6, 12, and 18 months after the surgery using upright AP, lateral, and flexion-extension views. RESULTS: Excellent or good results were achieved in the most patients from both groups. Patients in both groups showed marked pain relief in terms of neck and arm pain scores over all time intervals. The NDI scores in both groups significantly improved when compared to preoperative scores; however, at 1 and 2 months after the surgery, patients in Group I (Plated group) had significantly better NDI scores compared to Group II (Non-plated group). Higher rates of fusion were reported in Group I over all time intervals although none of these were statistically significant. There were two patients who required second surgery for cage subsidence in Group II. CONCLUSION: Our study demonstrates that anterior cervical fusion with plating for cervical radiculopathy is a safe and effective treatment which can eliminate unnecessary need for an external cervical brace.
Arm ; Braces ; Diskectomy ; Follow-Up Studies ; Humans ; Neck ; Radiculopathy

OBJECTIVE: Since the 1990s, due to postoperative loss of mobility and adjacent segmental disease after anterior cervical fusion, many different types of cervical artificial discs have been developed as alternative implants. The purposes of this study are investigation and comparison of radiographic and clinical outcomes between two different types of prostheses, Bryan(R) and Mobi-C(R). METHODS: We retrospectively evaluated 33 patients who were treated for cervical degenerative disc disease that resulted in radiculopathy and/or myelopathy between May 2004 and April 2009. Seventeen patients underwent Bryan(R) cervical disc arthroplasty and sixteen patients underwent Mobi-C(R) arthroplasty. The radiographic outcomes were assessed by measuring the cervical lordosis, segmental lordosis, range-of-motion (ROM) of the cervical spine (C2-7), functional segmental unit (FSU), prosthesis' shell and the upper adjacent segment. The clinical results were evaluated according to the Visual Analogue Scale (VAS) for axial pain and radiculopathy, Odom's criteria, and the modified Prolo's economic and functional outcome rating scale. RESULTS: The age of the study population ranged from 24 to 69 years with a mean age of 48 years vs. 46 years in the Bryan(R) and Mobi-C(R) groups, respectively. The mean duration of follow-up was 23.7 months in the Bryan(R) group and 11.3 months in the Mobi-C(R) group. The changes of overall cervical sagittal angle were not significantly different between two groups, but the increase of segmental sagittal angle (0.85degrees in Bryan(R), 8.04degrees in Mobi-C(R)), ROM of the FSU(-0.51degrees in Bryan(R), 2.47degrees in Mobi-C(R)) and ROM of the shell (1.77degrees in Bryan(R), 5.28degrees in Mobi-C(R)) were significantly higher in Mobi-C(R) group than in Bryan(R) group (p<0.05). The clinical results were not significantly different between two groups. CONCLUSION: The Mobi-C(R) prosthesis showed more favorable radiographic results than that of the Bryan(R) prosthesis, however, the clinical outcomes were similar in both groups. Large-scale and long-term follow-up studies are needed to confirm our results.
Animals ; Arthroplasty ; Follow-Up Studies ; Humans ; Lordosis ; Prostheses and Implants ; Radiculopathy ; Retrospective Studies ; Spinal Cord Diseases ; Spine

OBJECTIVE: We applied chest radiographs to scoliosis screening for conscription. Prevalence, types of scoliosis, and insight of examinees with scoliosis were investigated. METHODS: In this study, chest radiographs of 2417 males, who had been given an examination for conscription at the Seoul Regional Military Manpower Administration from April 2009 to May 2009, were analyzed. The prevalence of scoliosis more than a 10 degrees Cobb angle was calculated. The insight of scoliosis was investigated in every examinee and thoracolumbar radiographs were checked in those examinees with more than a 20 degree Cobb angle. RESULTS: Among 1904 males, 477 (19.7%) exhibited scoliosis involving more than a 5 degrees Cobb angle were and 131 (5.4%) exhibitedmore than a 10 degree Cobb angle. In those 131 cases, 18 (13.7%) had a known history of problems with scoliosis. Among the group measuring less than a 10 degree Cobb angle, 1.7% of them misunderstood scoliosis. Insight of scoliosis increased according to the severity of spinal curvature; however, nearly half of the cases with a 20 degree or greater Cobb angle had no insight with respect to their scoliosis. CONCLUSION: In male adolescents, the prevalence of scoliosis with a greater than 10 degree Cobb angle was 5.4% and there was a low insight with respect to scoliosis.
Adolescent ; Benzeneacetamides ; Humans ; Male ; Mass Screening ; Military Personnel ; Piperidones ; Prevalence ; Scoliosis ; Thorax