Cytokine Profile From the Ligamentum Flavum in Patients With Ossification of the Posterior Longitudinal Ligament in the Cervical Spine

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Takafumi Yayama ◽  
Kanji Mori ◽  
Hideki Saito ◽  
Hitomi Fujikawa ◽  
Masahiro Kitagawa ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ligamentum Flavum ◽  
Posterior Longitudinal Ligament ◽  
Cytokine Profile

Biomechanics of Cervical Spine Ligaments

1999 ◽  
Author(s):  
Narayan Yoganandan ◽  
Srirangam Kumaresan ◽  
Frank A. Pintar
Keyword(s):  
Cervical Spine ◽  
Young’S Modulus ◽  
Modulus Of Elasticity ◽  
Ligamentum Flavum ◽  
Young's Modulus ◽  
Posterior Longitudinal Ligament ◽  
Biomechanical Properties ◽  
Cross Sectional ◽  
Interspinous Ligament ◽  
Young’S Modulus Of Elasticity

Abstract The purpose of the present study was to determine the geometrical and biomechanical properties of human cervical spine ligaments from the axis to the first thoracic level. A total of 33 human cadavers were used. Geometrical data included the length and cross-sectional area measurements. Biomechanical properties included force, deflection, stiffness, energy, stress, strain, and Young’s modulus of elasticity. These data were obtained for the anterior longitudinal ligament, posterior longitudinal ligament, joint capsules, ligamentum flavum, and interspinous ligament. Geometrical characteristics were determined using cryomicrotomy techniques and biomechanical properties were obtained using in situ failure tensile testing. Force-deformation responses of each ligament type and at each spinal level were normalized. The joint capsules and ligamentum flavum exhibited the highest area of cross-section (p < 0.005). The longitudinal ligaments responded with the highest length measurements. The strain parameters were higher for the ligaments of the posterior complex, i.e., interspinous ligament, joint capsules, and ligamentum flavum, than for the ligaments of the anterior complex, i.e., the anterior and posterior longitudinal ligaments. In contrast, the failure stress and Young’s modulus of elasticity were higher for the anterior and posterior longitudinal ligaments compared to the ligaments of the posterior complex. These findings delineate the relative contribution of the anterior and posterior ligaments in the human cervical spine.

An ultrastructural study on the ligamentum flavum of the cervical spine in patients with ossification of the posterior longitudinal ligament

2006 ◽  
Vol 39 (4) ◽  
pp. 198-202 ◽  
Author(s):  
Sueo Nakama ◽  
Tomomi Ihara ◽  
Masao Sugamata ◽  
Teruaki Endo ◽  
Motohiko Ooyama ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ultrastructural Study ◽  
Ligamentum Flavum ◽  
Posterior Longitudinal Ligament

Geometric and Mechanical Properties of Human Cervical Spine Ligaments

2000 ◽  
Vol 122 (6) ◽  
pp. 623-629 ◽  
Author(s):  
Narayan Yoganandan ◽  
Srirangam Kumaresan ◽  
Frank A. Pintar
Keyword(s):  
Mechanical Properties ◽  
Cervical Spine ◽  
Young’S Modulus ◽  
Ligamentum Flavum ◽  
Young's Modulus ◽  
Statistical Significance ◽  
Posterior Longitudinal Ligament ◽  
Cross Sectional ◽  
Interspinous Ligament ◽  
Biomechanical Behavior

This study characterized the geometry and mechanical properties of the cervical ligaments from C2–T1 levels. The lengths and cross-sectional areas of the anterior longitudinal ligament, posterior longitudinal ligament, joint capsules, ligamentum flavum, and interspinous ligament were determined from eight human cadavers using cryomicrotomy images. The geometry was defined based on spinal anatomy and its potential use in complex mathematical models. The biomechanical force-deflection, stiffness, energy, stress, and strain data were obtained from 25 cadavers using in situ axial tensile tests. Data were grouped into middle (C2–C5) and lower (C5–T1) cervical levels. Both the geometric length and area of cross section, and the biomechanical properties including the stiffness, stress, strain, energy, and Young’s modulus, were presented for each of the five ligaments. In both groups, joint capsules and ligamentum flavum exhibited the highest cross-sectional area p<0.005, while the longitudinal ligaments had the highest length measurements. Although not reaching statistical significance, for all ligaments, cross-sectional areas were higher in the C5–T1 than in the C2–C5 group; and lengths were higher in the C2–C5 than in the C5–T1 group with the exception of the flavum (Table 1 in the main text). Force-deflection characteristics (plots) are provided for all ligaments in both groups. Failure strains were higher for the ligaments of the posterior (interspinous ligament, joint capsules, and ligamentum flavum) than the anterior complex (anterior and posterior longitudinal ligaments) in both groups. In contrast, the failure stress and Young’s modulus were higher for the anterior and posterior longitudinal ligaments compared to the ligaments of the posterior complex in the two groups. However, similar tendencies in the structural responses (stiffness, energy) were not found in both groups. Researchers attempting to incorporate these data into stress-analysis models can choose the specific parameter(s) based on the complexity of the model used to study the biomechanical behavior of the human cervical spine. [S0148-0731(00)01006-2]

scholarly journals Impact of Diabetes Mellitus on Cervical Spine Surgery for Ossification of the Posterior Longitudinal Ligament

2021 ◽  
Vol 10 (15) ◽  
pp. 3375
Author(s):  
Atsushi Kimura ◽  
Katsushi Takeshita ◽  
Toshitaka Yoshii ◽  
Satoru Egawa ◽  
Takashi Hirai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cervical Spine ◽  
Postoperative Complications ◽  
Spine Surgery ◽  
Posterior Longitudinal Ligament ◽  
Lower Extremity Function ◽  
Cervical Spine Surgery ◽  
The Impact

Ossification of the posterior longitudinal ligament (OPLL) is commonly associated with diabetes mellitus (DM); however, the impact of DM on cervical spine surgery for OPLL remains unclear. This study was performed to evaluate the influence of diabetes DM on the outcomes following cervical spine surgery for OPLL. In total, 478 patients with cervical OPLL who underwent surgical treatment were prospectively recruited from April 2015 to July 2017. Functional measurements were conducted at baseline and at 6 months, 1 year, and 2 years after surgery using JOA and JOACMEQ scores. The incidence of postoperative complications was categorized into early (≤30 days) and late (>30 days), depending on the time from surgery. From the initial group of 478 patients, 402 completed the 2-year follow-up and were included in the analysis. Of the 402 patients, 127 (32%) had DM as a comorbid disease. The overall incidence of postoperative complications was significantly higher in patients with DM than in patients without DM in both the early and late postoperative periods. The patients with DM had a significantly lower JOA score and JOACMEQ scores in the domains of lower extremity function and quality of life than those without DM at the 2-year follow-up.

Factors for a Good Surgical Outcome in Posterior Decompression and Dekyphotic Corrective Fusion with Instrumentation for Thoracic Ossification of the Posterior Longitudinal Ligament: Prospective Single-Center Study

2017 ◽  
Vol 13 (6) ◽  
pp. 661-669 ◽  
Author(s):  
Shiro Imagama ◽  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
Tetsuro Hida ◽  
Kenyu Ito ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Outcomes ◽  
Ligamentum Flavum ◽  
Posterior Longitudinal Ligament ◽  
Neurophysiological Monitoring ◽  
Posterior Decompression ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Estimated Blood Loss ◽  
Significant Factors

Abstract BACKGROUND Surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) is still challenging, and factors for good surgical outcomes are unknown. OBJECTIVE To identify factors for good surgical outcomes with prospective and comparative study. METHODS Seventy-one consecutive patients who underwent posterior decompression and instrumented fusion were divided into good or poor outcome groups based on ≥50% and &lt;50% recovery rates for the Japanese Orthopaedic Association score. Preoperative, intraoperative, and postoperative findings were compared in the 2 groups, and significant factors for a good outcome were analyzed. RESULTS Patients with a good outcome (76%) had significantly lower nonambulatory rate and positive prone and supine position tests preoperatively; lower rates of T-OPLL, ossification of the ligamentum flavum, high-intensity area at the same level, thoracic spinal cord alignment difference, and spinal canal stenosis on preoperative magnetic resonance imaging; lower estimated blood loss; higher rates of intraoperative spinal cord floating and absence of deterioration of intraoperative neurophysiological monitoring; and lower rates of postoperative complications (P &lt; .0005). In multivariate logistic regression analysis, negative prone and supine position test (odds ratio [OR]: 17.00), preoperative ambulatory status (OR: 6.05), absence of T-OPLL, ossification of the ligamentum flavum, high-intensity area at the same level (OR: 5.84), intraoperative spinal cord floating (OR: 4.98), and lower estimated blood loss (OR: 1.01) were significant factors for a good surgical outcome. CONCLUSION This study demonstrated that early surgery is recommended during these positive factors. Appropriate surgical planning based on preoperative thoracic spinal cord alignment difference, as well as sufficient spinal cord decompression and reduction of complications using intraoperative ultrasonography and intraoperative neurophysiological monitoring, may improve surgical outcomes.

scholarly journals Facet joint degeneration adversely affects ultrasound imaging of the lumbar spine

2019 ◽  
Vol 21 (2) ◽  
pp. 131
Author(s):  
Karthikeyan Srinivasan ◽  
Hong Kuan Kok ◽  
Mona Mubarak ◽  
William Torregianni ◽  
Robert Whitty
Keyword(s):  
Lumbar Spine ◽  
Ligamentum Flavum ◽  
Facet Joint ◽  
Posterior Longitudinal Ligament ◽  
Joint Degeneration ◽  
Neuraxial Block ◽  
Interspinous Space ◽  
Facet Joint Degeneration ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri

Aim: Ultrasound of neuraxis can be used to identify the best possible inter-spinous space to perform neuraxial block. The aim of this study was to assess the anatomical correlation between neuraxial ultrasound and magnetic resonance imaging (MRI).Material and method: Twenty-one patients who underwent MRI of the lumbar spine had ultrasound of lumbar neuraxis performed by an experienced operator. Each lumbar interspinous space was graded on ultrasound as good [posteriorcomplex (ligamentum flavum and duramater) and anterior complex (posterior longitudinal ligament) visible], intermediate (either anterior complex or posterior complex visible) or poor (both anterior complex and posterior complex not visible) in both the transverse median (TM) and paramedian sagittal oblique (PSO) plane. Pre-determined MRI parameters were measured by a radiologist blinded to sonographic findings at each inter-spinal level.Results: Seventy-eight lumbar interspinous spaces were evaluated. There was a significant association (p<0.004) between the facet joint degeneration on MRI and the poor ultrasound view in the transverse median (TM) group. The odds of obtaining a poor view in TM plane was 7 times higher (95% CI 1.7-28.9, p=0.007) in the presence of facet joint degeneration. None of the other variables had a significant association with a poor neuraxial view in the TM plane. Poor views in the parasagittal oblique (PSO) plane did not correlate with any of the variables measured on MRI.Conclusion: Facet joint degeneration is a major contributing factor to poor neuraxial ultrasound views in the TM plane. 

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