Yusufstone1185

Temporal changes and statistical associations were examined to identify risk factors for LBP at 24 weeks. RESULTS At 24 weeks, 25% of OVFs failed to achieve union. The LBP group consisted of 71% of non-union and 48% of union cases. Stepwise multinomial regression analysis showed VKA at 24 weeks over 25° was significant risk factor for the LBP group (odds ratio 6.24, 95% confidence interval 1.77 - 22.02, p = 0.004). Significant differences in VKA emerged during treatment in the LBP group, but PI-LL showed the tendency not to change throughout the treatment period. Non-union was correlated with VKA (area under the curve 0.864). CONCLUSION Although spino-pelvic malalignment is considered as a pre-existing factor for LBP, VKA exacerbated by non-union predominantly led to LBP after a new OVF. Each incidence of OVF should be treated to limit further morphological changes to the fractured vertebra. LEVEL OF EVIDENCE 3.STUDY DESIGN Retrospective analysis. OBJECTIVE The aim of this study was to develop and validate a nomogram for the prediction of lung metastasis in patients with malignant primary spinal tumors. SUMMARY OF BACKGROUND DATA In patients with malignant primary spinal tumors, lung metastasis is usually found by computed tomography (CT) and is considered to be an essential factor affecting the prognosis and survival. METHODS We retrospectively collected 580 malignant primary osseous spinal neoplasms patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic analysis were used to identify independent factors. These prognostic factors were included in the nomograms. The nomograms were validated based on its calibration, discrimination, and clinical utility. The overall survival of the patients was analyzed using the Kaplan-Meier method and the survival differences were tested by the log-rank test. RESULTS We randomly divided all these patients (n = 580) into a training cohort (n = 408) and a validation cohort (n = 172). The results showed that the risk of lung metastasis was independently influenced by histologic type, use of surgery, clinical T stage, clinical N stage, and tumor extension (all P  less then  0.05). The nomogram consisted of five clinical features and provided good calibration and discrimination in the training and validation cohort, with an area under the curve of 0.858 and 0.811, respectively. Decision curve analysis showed that the nomogram was clinically useful. The Kaplan-Meier curves showed a significant difference between the higher and lower risk of lung metastasis groups (P  less then  0.001). CONCLUSION Nomograms were developed to predict the risk of lung metastasis in patients with malignant primary spinal tumors. The nomogram showed favorable discrimination and calibration values, which may help optimize treatment decision-making for patients. LEVEL OF EVIDENCE 4.STUDY DESIGN Retrospective review OBJECTIVE. To ascertain impact of pre-procedural MRI or nuclear medicine Tc99m-DMP scintigraphy on the treatment plan when compared with plain films and/or CT prior to vertebral augmentation procedures. SUMMARY OF BACKGROUND DATA Over one million vertebral compression fractures (VCFs) occur in the U.S. annually with over 150,000 individuals hospitalized each year. Physical exam and history are essential to the workup of VCFs, but imaging remains necessary for confirming the diagnosis. VCFs can be imaged with various modalities and there is limited data on the comparative effectiveness of different imaging modalities. Selleck Necrostatin 1S METHODS 650 consecutive patients treated with vertebral augmentation at a single institution between May of 2013 and April of 2018 were reviewed. Pre-procedure imaging of the spine obtained within 30 days prior to the procedure were reviewed. Pre-procedure imaging results were cross-referenced against the levels treated by vertebral augmentation to determine whether there was a change in the levels treated after receiving an MRI or NM imaging study. RESULTS 363 patients had adequate imaging for inclusion. 154 of these 363 patients (42.4%) had an alteration of their treatment plan based upon the MR or NM imaging. Fewer vertebral levels were treated in 33, different levels were treated in 41, and more levels were treated in 80 patients. CONCLUSION MRI or nuclear medicine bone scan imaging prior to vertebral augmentation altered the location and number of levels treated in a large percentage of patients, adding specificity to treatment over findings on radiographs or CT alone. LEVEL OF EVIDENCE 3.STUDY DESIGN Biochemical and immunohistochemical analyses by the human intervertebral disc (IVD) cells and tissues. OBJECTIVE To examine the expression of glial cell line-derived neurotrophic factor (GDNF) and its receptors, GDNF family receptor (GFR) α1 and rearranged during transfection (RET) in the human IVD cells and the tissues with the early and advanced stages of degeneration. SUMMARY OF BACKGROUND DATA The neurotrophin family, including nerve growth factor (NGF), has been reported to be expressed in the IVDs and plays a role in hyperalgesia and neuronal sensitization. Despite having properties similar to the NGF, the expression of GDNF in the IVD remains unknown. METHODS Human IVD cells were cultured in monolayer. Immunohistochemical analyses and western blotting were performed to examine the protein levels of GDNF and its receptors. To examine the effect of proinflammatory cytokines, cells were cultured in the presence of interleukin-1β (IL-1β). The immunohistochemical expression of these proteins was also evaluated using human IVD tissues with different stages of degeneration. RESULTS Immunofluorescent reactivity against anti-GDNF, GFRα1, and RET antibodies was identified in human IVD cells. In protein extracts from IVD cells, those protein expressions were also identified by Western blot. IL-1β significantly stimulated the mRNA expression of GDNF compared to that of the control group. There was no significant effect of IL-1β on the mRNA expression of GFRα1 and RET. The percentage of GDNF-immunopositive cells in advanced degenerated discs was significantly higher than that in early degenerated discs, whereas those of GFRα1 and RET showed no significant differences. CONCLUSIONS GDNF and its receptors were constitutively expressed in the human IVD cells. GDNF expression was significantly enhanced by proinflammatory stimuli, and in the microenvironment with advanced tissue degeneration. LEVEL OF EVIDENCE N/A.