ObjectiveThis study evaluated the efficiency of a curved polyetheretherketone (PEEK) cage in comparison with a wedge PEEK cage according to radiologic and clinical outcomes in patients with cervical degenerative disease.MethodsA total of 37 patients who suffering from cervical disc disease with radiculopathy or myelopathy were reviewed retrospectively. Seventeen patients were underwent anterior cervical discectomy and interbody fusion with a curved shape PEEK cage (curved cage group), and twenty patients with wedge shape PEEK cage (wedge cage group). Clinical assessment was graded using Odom's criteria, NDI score and VAS score. For radiologic analysis, disc height (DH), segmental angle (SA), subsidence were measured at the preoperative and last follow up.ResultsA comparison of the preoperative and postoperative results revealed improvements after the surgery in the DH and SA in both cage groups. The change of postoperative DH between the preoperative and the last follow-up in wedge cage group and curved cage group was 6.85% and 25.5%, respectively. The change of postoperative SA was 1.75° and 0.95°, respectively. There was no statistically significant difference in the DH and SA between the 2 groups. The subsidence rate in the wedge cage group and curved cage group was 20% and 6%, respectively.ConclusionThe 2 different cage groups showed significant improvements in the disc height, segmental angle and clinical outcomes. However, the shape of PEEK Cage influences the tendency for subsidence. Increasing contact surface area and fitting into two adjacent vertebral body prevent significant subsidence.

We investigated the question of whether cholesterol catabolite can influence expression of inflammatory cytokines via Toll-like receptors (TLR) in monocytic cells. Treatment of THP-1 monocytic cells with 27-hydroxycholesterol (27OHChol) resulted in induction of gene transcription of TLR6 and elevated level of cell surface TLR6. Addition of FSL-1, a TLR6 agonist, to 27OHChol-treated cells resulted in transcription of the IL-1α gene and enhanced secretion of the corresponding gene product. However, cholesterol did not affect TLR6 expression, and addition of FSL-1 to cholesterol-treated cells did not induce expression of IL-1α. Using pharmacological inhibitors, we investigated molecular mechanisms underlying the expression of TLR6 and IL-1α. Treatment with Akt inhibitor IV or U0126 resulted in significantly attenuated expression of TLR6 and IL-1α induced by 27OHChol and 27OHChol plus FSL-1, respectively. In addition, treatment with LY294002, SB202190, or SP600125 resulted in significantly attenuated secretion of IL-1α. These results indicate that 27OHChol can induce inflammation by augmentation of TLR6-mediated production of IL-1α in monocytic cells via multiple signaling pathways.

ObjectiveVentricular enlargement following head injury is a frequent finding but cases requiring shunt operation are rare. The incidence and developing factors of post-traumatic hydrocephalus (PTH) have been variously reported, but studies for factors influencing outcomes of shunt operation for PTH are rare. The incidence of PTH requiring shunt operation, causing injuries, and factors influencing outcome of shunt operation need to be identified.MethodsIn total, 1,142 patients suffering from traumatic brain injury (TBI) between January 2007 and December 2012 were admitted to our department. Of them, 23 patients underwent shunt operation for diagnosed PTH. In this clinical study, we reviewed retrospectively our TBI database and in the 23 patients, we evaluated outcomes with Glasgow Outcome Score just before the operation, at 14 days, 3 months, and 6 months according to initial Glasgow Coma Scale (GCS) score, interval time between shunt operation and trauma, and lumbar cerebrospinal fluid (CSF) pressure.ResultsThe incidence of PTH treated with shunt operation was 2.01%. Subdural hematoma (SDH) was the most common preceding head injury. The outcomes of shunt operation were not related with lumbar CSF pressure or interval time from trauma, but initial GCS score correlated with the outcome.ConclusionIn present study, 2.01% of TBI patients underwent shunt operation. SDH was the most common preceding injury. Admission GCS score was related to the outcome of shunt operation. However, there were no correlation between the outcome of shunt operation and initial lumbar CSF pressure or interval time of shunt operation after the trauma.

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