Using cross-linked hyaluronic acid gel to prevent postoperative lumbar epidural space adhesion: in vitro and in vivo studies

AbstractPurposeHyaluronic acid prevents tissue adhesion after different surgeries. Physical barriers and inflammatory regulation have been suggested to be involved in the mechanism of these clinical effects. However, the molecular mechanism by which hyaluronic acid prevents epidural adhesion has not yet been reported.MethodsIn the current in vivo studies, we investigated cross-linked hyaluronic acid gel in the regulation of scar gene expression, the accumulation of fibroblasts in scar tissue, and the prevention of epidural adhesion. The effect of cross-linked hyaluronic acid gel on the secretion of inflammatory factors was observed in vitro. In addition, to ensure the accuracy and reliability of the in vivo gene expression results, we used a cell model to detect the target genes in vitro.ResultsThe expression levels of TGF β1 and COL1A1 mRNA were decreased in the cross-linked hyaluronic acid gel-treated group, and the protein expression of levels TGFβ1 and COL1A1 were also reduced, as detected by Western blotting in vitro and in vivo (P 
Source: European Spine Journal - Category: Orthopaedics Source Type: research

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Conclusion. Compression spinal cord injury is the end of a cascade involving increasing intracanal pressure, decreasing canal volume, and hypoperfusion. Rapid relief of compression leads to MEP return. SCBF monitoring can detect ischemia preinjury, giving surgeons an opportunity for early intervention. Level of Evidence: 4
Source: Spine - Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research
ConclusionsAfter this literature review and analysis of post-operative stenosis, it seems important to provide some advice to avoid revision surgeries more or less induced by the surgery. It looks interesting when performing simple decompression without fusion in the lumbar spine to analyse the risk of instability induced by the decompression and facet resection but also by a global balance analysis. Regarding pre-operative stenosis in a previously operated area, different causes may be evocated, like screw or cage malpositionning but also insufficient decompression which is a common cause. Intraoperatively, the use of neu...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Mohammed K Al Harbi, Khaled A Alattas, Muhanad Alnajar, Muneera F AlbuthiSaudi Journal of Anaesthesia 2020 14(1):123-126 An 80-year-old male patient presented with 2 weeks history of low back pain undergoing posterior spinal fusion with laminectomy in the prone position. The patient was induced with fentanyl, propofol, and rocuronium, and then he was positioned in the prone position. After 6 h of starting the surgery, the patient started to be hypotension and bradycardia followed by pulseless electrical activity (PEA). Code blue was activated intraoperatively with immediate initiation of cardiopulmonary resuscitation (CPR...
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Conclusions: A composite of chitosan-hydroxyapatite at a 20:80 ratio induced bone formation after experimental laminectomy in rats and led to spinal fusion, which was assessed by radiology and biomechanical tests. No functional complications in posture or walking were observed at 90 days post-surgery, despite biomechanical changes in the spine. PMID: 31679322 [PubMed - as supplied by publisher]
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Conclusion: In this 77 year-old female, the preoperative MR and CT scans were interpreted as showing a "typical" large left L2-L3 herniated disc. This proved at surgery to be a massive left L2-L3 synovial cyst. As demonstrated in this case, older patients with degenerative lumbar disease/stenosis, may have synovial cysts that mimic disc herniations both clinically and on preoperative diagnostic studies. PMID: 31583165 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
We report an uncommon case of osteoid osteoma recurring as an aggressive osteoblastoma of the spine. A 15-years-old male consulted in our department with long-term painful scoliosis. The CT-scans and MRI revealed a sclerotic bone forming tumor of 7mm diameter consistent with a osteoid osteoma. A percutaneous radiofrequency ablation was performed with complete resolution of the symptoms. After 6 months, the symptoms recurred. A new CT and a MRI showed a growth of the nidus on the right L4 lamina, with a size of 15mm. Therefore, a marginal resection by laminectomy of L4 was performed. Pathology confirmed an epithelioid osteo...
Source: Neurocirugia - Category: Neurosurgery Authors: Tags: Neurocirugia (Astur) Source Type: research
ConclusionThis is the first case in the literature to describe a post-laminectomy pseudarthrosis leading to a significant sagittal malalignment in a patient with ochronotic spondyloarthropathy. Management of such a case is challenging as the spine is partially ankylosed; therefore, a long construct is advisable to avoid ankylosing disorders related complications.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
ConclusionsTo our knowledge, this is the first report of spondylodiscitis caused byAspergillus terreus after an abdominal penetrating injury. The histological finding of chronic suppurative osteomyelitis and the radiological findings strongly suggested direct inoculation ofAspergillus terreus.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
ConclusionGiven these encouraging findings, we advocate early reduction and percutaneous fixation of U- or H-shaped sacral fractures. Although technically demanding, this method restores the normal pelvic parameters and improves neurological function.Level of evidenceIV, retrospective observational study.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
We report a rare case of traumatic lumbar disc herniation mimicking epidural hematoma. Patient concerns: A 39-year old man presented with acute bilateral leg and back pain, following a crushing injury caused by a crane collapse. Diagnosis: A computed tomography scan revealed multiple compression fractures of the thoracolumbar spine, including a burst fracture of the L4 vertebral body. Magnetic resonance imaging (MRI) showed an epidural mass, extending longitudinally and causing dural sac compression behind the L3 vertebra. The mass had isosignal intensity on T1-weighted imaging and showed mixed high and low signals o...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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