EMG Profiles of Masticatory Muscles during Gum Chewing.

Kashiwagi, Kousuke; Tokunaga, Tohru; Shao, Mei-in; Tanaka, Masahiro; Kawazoe, Takayoshi

doi:10.2186/jjps.37.1223

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“…While intrinsic causes include genetic and dietary factors; biomechanical alterations are the major extrinsic factors leading to its development. 3 , 15 , 17 It has been demonstrated that when tensile forces act across ligamentum flavum, there are local elevations in BMP-2, TGF-beta, and SOX. 18 These factors lead to enhanced differentiation of fibroblasts into chondroblasts and osteoblasts; thereby leading to OLF.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Myelopathy in Ossified Ligamentum Flavum: Surgical Management and Long-Term Outcome Following 2 Different Techniques of Surgical Decompression

Bagga

Shetty

Viswanathan

et al. 2021

Global Spine Journal

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Study Design: Retrospective cohort study. Objective: Thoracic ossified ligamentum flavum (TOLF) has been reported to present with varying degrees of neuro-deficit and multiple factors have been purported to affect its outcome. Purpose of study was to analyze factors affecting outcome and impact of ultrasonic osteotome (UO). Methods: We retrospectively reviewed patients treated for thoracic myelopathy secondary to OLF between 2010 and 2017. 77 patients with complete clinico-radiological records and 2 years follow-up were included. Initial 45 patients, conventional high-speed burr (HSB-group A) was used for decompression. In others, UO was used in combination with HSB (group B). Myelopathy was graded using modified Japanese orthopaedic association grading pre-operatively and each postoperative visit. At final follow-up, recovery rate was calculated. Radiological details including location, morphology, dural ossification, signal change and spinal ossifications were recorded. Results: Mean mJOA at presentation and final follow-up were 4.3±1.8 and 7.6±1.9 respectively (p = 0.001). HRR was 49.9±23 at final follow-up. A significant reduction in dural tear (12.5%; 29%) and surgical time (125.8±49.5; 189.4±52.5) were observed in group B (p = 0.00). However, there was no statistically significant difference (p = 0.18) in recovery rates between groups A (44.8±26.1) and B (52.8±24.3). Symptom duration (p = 0.00), severity of myelopathy (p = 0.04) and cord signal changes on MRI (p = 0.02) were important predictors of outcome. Conclusion: Use of UO significantly reduced operative time and dural tears, although resulted in similar recovery rate as compared with HSB. Pre-operative severity of myelopathy, symptom duration and presence of cord signal change were the most significant predictors of outcome.

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