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Study Design: A retrospective study of prospectively collected radiographic and clinical data. Objective: This study aims to investigate the relationship between endplate morphology parameters and the incidence of cage subsidence in patients with mini-open single-level oblique lateral lumbar interbody fusion (OLIF). Methods: We included 119 inpatients who underwent OLIF from February 2015 to December 2017. A total of 119 patients with single treatment level of OLIF were included. Plain anteroposterior and lateral radiograph were taken preoperatively, postoperatively, and during follow-up. The correlation between disc height, endplate concave angle/depth, cage position and cage subsidence were investigated. Functional rating index (Visual Analogue Scale for pain, and Roland Morris Disability Questionnaire) were employed to assess clinical outcomes. Results: Cage subsidence was more commonly seen at the superior endplates (42/119, 35.29%) than at the inferior endplates (6/119, 5.04%) (p < 0.01). More importantly, cage subsidence was significantly less in patients with superior endplates that were without concave angle (3/20, 15%) than with concave angle (37/99, 37.37%) (p < 0.05). Cage subsidence correlated negatively with preoperative anterior disc height (r = −0.21, p < 0.05), but positively with disc distraction rate (r = 0.27, p < 0.01). Lastly, the distance of cage to the anterior edges of the vertebral body showed a positive correlation (r = 0.26, p < 0.01). Conclusions: This study for the first time demonstrated that endplate morphology correlates with cage subsidence after OLIF. Since relatively flat endplates with smaller concave angle significantly diminish the incidence of subsidence, the morphology of cage surface should be taken into consideration when designing the next generation of cage. In addition, precise measurement of the disc height to avoid over-distraction, and more anteriorly placement of the cage is suggested to reduce subsidence. [ABSTRACT FROM AUTHOR]

Microfibrillar‐associated proteins (MFAPs) are extracellular matrix glycoproteins, which play a role in microfibril assembly, elastinogenesis, and tissue homeostasis. MFAPs consist of five subfamily members, including MFAP1, MFAP2, MFAP3, MFAP4, and MFAP5. Among these, MFAP2 and MFAP5 are most closely related, and exhibit very limited amino acid sequence homology with MFAP1, MFAP3, and MFAP4. Gene expression profiling analysis reveals that MFAP2, MFAP5, and MFAP4 are specifically expressed in osteoblastic like cells, whereas MFAP1 and MFAP3 are more ubiquitously expressed, indicative of their diverse role in the tropism of tissues. Molecular structural analysis shows that each MFAP family member has distinct features, and functional evidence reveals discrete purposes of individual MFAPs. Animal studies indicate that MFAP2‐deficient mice exhibit progressive osteopenia with elevated receptor activator of NF‐κB ligand (RANKL) expression, whereas MFAP5‐deficient mice are neutropenic, and MFAP4‐deficient mice displayed emphysema‐like pathology and the impaired formation of neointimal hyperplasia. Emerging data also suggest that MFAPs are involved in cancer progression and fat metabolism. Further understanding of tissue‐specific pathophysiology of MFAPs might offer potential novel therapeutic targets for related diseases, such as skeletal and metabolic disorders, and cancers. [ABSTRACT FROM AUTHOR]

Objectives: Recently, studies on microRNAs (miRNAs) and their targets and related genes have provided new therapeutic opportunities for controlling intervertebral disc degeneration (IDD). We aimed to investigate the effects of miR-148a-3p overexpression on IDD progression., Materials and Methods: This study used microRNA microarrays to analyze key regulators of IDD. Q-PCR was used to verify the IL-1β-induced down-regulation of miR-148a-3p expression both in nucleus pulposus (NP) tissues of IDD patients and in degenerated NP cells (NPCs) of rats. Rat NPC micromass cultures and ex vivo intervertebral disc (IVD) culture models were established, and histological staining was performed to verify the effect of miR-148a-3p on the general morphology and proteoglycan and collagen contents of IVDs. In addition, q-PCR and western blotting analyses were performed to examine the expression of ECM molecules and matrix-degrading enzymes. A luciferase reporter assay was used to confirm the target genes of miR-148a-3p., Results: Our data revealed that miR-148a-3p was down-regulated in IDD. Overexpression of miR-148a-3p had no effect on ACAN or COL2A1 gene expression but decreased MMP3, MMP13, and ADAMTS5 gene expression. The matrix deposited by miR-148a-3p-overexpressing rat NPCs contained high levels of proteoglycans and collagen. The ex vivo experiments verified that agomiR-148a-3p alleviated the NPC matrix degradation induced by IL-1β. A luciferase reporter assay confirmed that miR-148a-3p directly targeted ADAMTS5 and MMP13., Conclusion: We proved that miR-148a-3p can attenuate ECM loss and protect NP function by inhibiting matrix-degrading enzymes., Competing Interests: The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: The aim of this study was to present early clinical and radiological outcomes of percutaneous pedicle screw fixation (PPSF) combined with vertebroplasty (VP) in the treatment of Kümmell's disease with intravertebral instability., Methods: In this study, 21 consecutive patients (4 male and 17 female; mean age = 75.6 years; age range=65-86 years) who suffered from stage II and III Kümmell's disease with intravertebral instability were prospectively recruited from 2012 to 2016 and treated with PPSF combined with VP. The Cobb angle (CA) or wedge angle (WA) in both flexion and extension positions was measured using lateral radiographs, computed tomography, or magnetic resonance imaging. In addition to these radiological parameters, clinical outcome measures, including the visual analog scale (VAS) and the Oswestry Disability Index (ODI) were collected preoperatively; 1 week and 1, 3, 6, and 12 months postoperatively; and then annually. Complications were also recorded., Results: The mean follow-up was 19.3 (range=12-36) months. The mean operating time was 135.4 (range, 110-175) min, and the mean estimated blood loss was 106.9 (range, 50-165) mL. The mean VAS score and ODI significantly decreased from 7.7±1.1 and 65.3%±7.7% preoperatively to 3.4±0.6 and 30.0%±7.6% postoperatively, respectively (p<0.05). At the final follow-up, the mean VAS score and ODI were 2.5±0.8 and 21.5%±8.8%, respectively (p>0.05). CA and WA significantly decreased from 26.9°±9.7° and 21.3°±6.0° preoperatively to 12.7°±7.2° to 8.6°±4.5° postoperatively, respectively (p<0.05). At the final follow-up, CA was 4.2°±2.0°, and WA was 4.7°±1.8° (p>0.05). No major complications were encountered during the follow-up period., Conclusion: PPSF combined with VP seems to be an effective surgical option for the treatment of Kümmell's disease with intravertebral instability., Level of Evidence: Level IV, Therapeutic study.