The present study aimed to evaluate the value of pre-operative magnetic resonance imaging (MRI) combined with electromyography (EMG) for predicting clinical outcome following surgical management of cervical spondylotic myelopathy (CSM). A total of 94 patients with cervical compressive myelopathy were prospectively enrolled and treated with anterior, posterior and posterior-anterior united decompression between October 2007 and February 2009. Prior to surgery 1.5-T MRI and EMG were performed in all patients. The patients were classified into four types based on the presence (+) or absence (−) of an increased signal intensity (ISI) on the T2-weighted magnetic resonance (MR) images and also based on the positive (+)/negative (−) results of the EMG. The four types were as follows: Type I, MRI/EMG (−/−); Type II, MRI/EMG (+/−); Type III, MRI/EMG (−/+); and Type IV, MRI/EMG (+/+). The clinical outcome was also graded according to a modified Japanese Orthopedic Association (JOA) scoring system. Furthermore, pre- and post-operative clinical data were statistically analyzed to explore the correlation between the factors. There were 36 cases (38%) of Type I, 16 (17%) of Type II, 13 (14%) of Type III and 29 (31%) of Type IV. According to the analysis of the clinical data between the four types, there were significant differences in the disability classifications, pre-operative JOA scores and disease duration (P<0.05), but there were no significant differences in gender, age or cord compression ratios (P>0.05). Until the final follow-up, there was a significant difference in the recovery ratio between the four study groups (Hc=27.46, P<0.05). Further comparison showed that the surgical outcome was best in Type I patients and worst in Type IV patients. In conclusion, there was a distinct correlation between classification and the rate of clinical improvement. Patients who had a negative EMG and those without an ISI on T2-weight images tended to suffer only mild symptoms, a short disease duration and, most significantly, experience a good surgical outcome.

Osteosarcoma is a malignant bone tumor, and clinically detectable metastases can be detected in ~ 15–20% of patients when they seek medical advice; patients with metastatic disease have extremely poor prognosis. Here, we examined the involvement of the microRNA miR‐505 in osteosarcoma. Eighty‐four patients seeking treatment for osteosarcoma were included in the study group (SG), and 63 healthy subjects were allocated to the control group (CG). Normal human bone cells MG‐63 and U20S cells were transfected with miR‐505 mimics, miR‐NC, HMGB1 RNA for targeted inhibition (si‐HMGB1), and si‐NC to examine the effects on HMGB1 expression. Cell proliferation, invasion, and apoptosis were measured using CCK‐8, scratch assays, and flow cytometry (FCM), respectively, and the relationship between miR‐505 and HMGB1 was determined using the dual‐luciferase reporter assay. In patient tissues and serum, miR‐505 was expressed at a low level, and HMGB1 was expressed at a high level, with an area under curve of > 0.9. Furthermore, the expression of miR‐505 and HMGB1 in tissues had a positive association with that in the serum, whereas the expression of miR‐505 had a negative association with that of HMGB1 in tissues only. Overexpression of miR‐505 and silencing of HMGB1 suppressed the proliferation, migration, and invasion of osteosarcoma cells and increased the rate of apoptosis, whereas the co‐transfected miR‐505 mimics + si‐HMGB1 demonstrated a more significant inhibitory effect on the proliferation and invasion of osteosarcoma cells and a higher apoptosis rate. miR‐505 may inhibit the proliferation and invasion and promote apoptosis of osteosarcoma cells by targeting and suppressing HMGB1.

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We recommend a individualized approach when it is difficult to determine an anterior or posterior surgery for multilevel CSM. Rehabilitation training should be carried out as early as possible.

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