Objective: Spinal cord injury (SCI) often results in irreversible neurological deficits and poses a critical public health issue. The molecular mechanisms governing cellular responses postinjury remain incompletely understood. Wnt signaling is known to influence neurogenesis and axonal regeneration. In particular, Wnt ligands and their antagonists, such as secreted frizzled-related protein 4 (SFRP4), are differentially expressed following SCI. This study investigated the role of the Wnt3a/SFRP4 signaling axis in regulating neuronal cell fate. Methods: Human neuroblastoma SH-SY5Y and rat pheochromocytoma PC12 cell lines were obtained from the American Type Culture Collection. The metabolic activity of cells—used as a surrogate marker for proliferation—was assessed using the Alamar Blue assay. To mimic neurodegeneration associated with SCI, cells were treated with lipopolysaccharide (LPS). The effects of Wnt3a and SFRP4 were analyzed both individually and in combination under normal conditions and LPS-induced stress. Results: Wnt3a treatment alone significantly increased metabolic activity in untreated and LPS-treated cells, indicating a proliferative effect. However, cotreatment with Wnt3a and SFRP4 reduced proliferation, particularly in the presence of LPS. SFRP4 alone demonstrated variable effects depending on cellular conditions, with some enhancement of metabolic activity in the LPS model but reduced activity when combined with Wnt3a. Conclusion These findings suggest that the effect of SFRP4 on Wnt3a-mediated signaling is context-dependent, potentially promoting proliferation in normal conditions but antagonizing Wnt3a activity under stress. A deeper understanding of the Wnt signalosome and SFRP family interactions could shed light on novel therapeutic strategies for modulating neuroinflammation and promoting repair after SCI.

STUDY DESIGN: Retrospective cohort study. PURPOSE: To compare the clinical and radiological outcomes of modified mini-open transforaminal lumbar interbody fusion (modMOTLIF) and open TLIF (OTLIF). OVERVIEW OF LITERATURE: Minimally invasive transforaminal lumbar interbody fusion (MTLIF) is associated with less blood loss, shorter hospital stay, and less pain. However, it has concerns like increased radiation exposure, steep learning curve, and instrumentation cost. We modified the MTLIF technique by direct freehand insertion of pedicle screws using stab incisions without tubular retractors. METHODS: The study included 24 patients in the modMOTLIF group and 27 patients in the OTLIF group. The average follow-up period was 25.6 months. Clinical outcomes were measured using Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores. Serial X-rays were acquired at 1, 3, 6, 12, and 24 months to assess the union and presence of instability. We also compared blood loss and length of hospital stay in both groups. RESULTS: All patients showed progressive improvement in VAS and ODI scores. No differences were observed in the preoperative and postoperative ODI and VAS leg scores between the groups. The immediate postoperative VAS back score was significantly higher in the OTLIF group than in the modMOTLIF group; however, no difference was observed at 1 and 2 years. Radiological analysis showed nonunion in one and two patients in the OTLIF and modMOTLIF groups, respectively. The average blood loss was 63 mL in the mod-MOTLIF group and 254 mL in the OTLIF group. The mean hospital stay was 3 days for the modMOTLIF group and 5 days for the OTLIF group. CONCLUSIONS: modMOTLIF was associated with reduced blood loss and shorter hospital stay compared with OTLIF. No significant differences were observed in the clinical and radiological outcomes between the groups after 2 years despite reduced back pain in the immediate postoperative period in patients who underwent modMOTLIF.
Back Pain ; Cohort Studies ; Follow-Up Studies ; Humans ; Learning Curve ; Leg ; Length of Stay ; Pedicle Screws ; Postoperative Period ; Radiation Exposure ; Retrospective Studies ; Visual Analog Scale