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General Posters and Index 2013 International Society for the Study of the Lumbar Spine 40TH Annual Meeting SCOTTSDALE, AZ, USA May 13-17, 2013 Abstract Proceedings 40th Annual Meeting May 13-17, 2013 ISSLS 2013 - SCOTTSDALE Institute for Clinical Sciences Sahlgrenska Academy PO Box 426 SE-405 30 Gothenburg • Sweden www.issls.org GENERAL POSTERS overgrowth stiffness located superior end- GP1 plate by using PMMA maybe show an im- SUITABILITY EVALUATION OF RESTORING pact factor for further adjacent deformity. THE INTERVERTEBRAL DISC MECHANICS IN The change of pressure in disc with a dam- TREATING OSTEOPROTIC VERTEBRAL aged endplate was supposed to develop FRACTURE USING KYPHOPLASTY WITH abnormal intradiscal pressure in flexion also PMMA OR CALCIUM-P BASED CEMENT been shown to increase loading of the adja- Haoju Lo, Hung-Ming Chen cent anterior vertebral cortex. Our study The Orthopaedic Department, Ren-Ai indicated a compression fracture treated Branch, Taipei City Hospital, Taiwan with kyphoplasty by PMMA or CaP based cement must be evaluated according the INTRODUCTION: The biomechanical tests damaged structures. about the filler materials paid little atten- tion to vertebral endplate or intervertebral disc in treating compression fracture. Im- GP2 pact of cement leakage into disks on the ASSESSMENT OF PAIN BEHAVIOR IN A RAT development of adjacent fractures was not- MODEL OF INTERVERTEBRAL DISK INJURY ed. There is only a limited understanding USING THE CATWALK GAIT ANALYSIS SYS- how the load shift of the intervertebral disc TEM after a kyphoplasty with different cement. Masayuki Miyagi, MD, PhD *1,2, Tetsuhiro The intervertebral disc should be showed Ishikawa, MD, PhD *1, Hiroto Kamoda, MD, altered disc pressure profile. PhD *1, Miyako Suzuki, MD*1, Yoshihiro MATERIALS AND METHODS: 3D finite- Sakuma, MD*1, Sumihisa Orita, MD, PhD*1, element osteoporotic model of L1–L3 were Yasuhiro Oikawa, MD*1, Yasuchika Aoki, developed. The influence of augmentation MD, PhD*3, Tomoaki Toyone, MD, PhD*4, level as well as bipedicular filling with Kazuhisa Takahashi, MD, PhD*1, Gen Inoue, PMMA or CaP based cement was investi- MD, PhD*1, Seiji Ohtori, MD, PhD*1 gated. The risk factors (anterior wall defi- *1 Department of Orthopaedic Surgery, ciency and superior endplate cleft) were Graduate School of Medicine, Chiba Univer- also taken into consider as variables. Last, a sity, leakage of cement was also simulated. *2 Alan Edwards Center for Research on RESULTS: The stresses and strains in the Pain, Faculty of Dentistry, McGill University vertebrae close to an augmentation were *3 Department of Orthopaedic Surgery, increased, and change their distribution Toho University Sakura Medical Center with different risk factors. In PMMA groups, *4 Department of Orthopaedic Surgery, higher stresses and strains were noted over Teikyo University Chiba Medical Center endplate and disc when risk factors exist. The pressure in a bulge of the augmented INTRODUCTION: There are few reports ex- endplate and disc were increased to almost amining low back pain behavior in animal 20% of its value before the augmentation, models. The CatWalk is a computer-assisted resulting in a stiffening of the intervertebral gait analysis system that provides an auto- disc. In CaP cement, in leakage model, seem mated way to assess gait function and pain- to show more suitable in mechanics if leak- related alterations of this behavior. The age happened. purpose of current study is to investigate DISCUSSION: With an intact endplate, the pain behavior in a rat model of IVD injury two augmented cements shows no signifi- using the CatWalk gait analysis system. cantly difference in restoring of strength METHODS: In the IVD injury group, L5/6 and stiffness. With a damaged endplate, disks were injured with a 24-gauge needle. 98 GENERAL POSTERS Simultaneously, the neurotracer Fluoro- Gold (FG) was injected into the L5/6 IVDs. In INTRODUCTION: Fractalkine (CX3CL1) and the sham group, FG was injected into the its receptor (CX3CR1) comprise a chemokine L5/6 IVDs only. Animals in an additional system involved in leukocyte recruitment control group received no operation. One, and adhesion in chronic inflammatory dis- 2, 3, and 4 weeks after surgery, the gait of ease, but its role in spinal degenerative dis- rats in the three groups was investigated eases is unknown. The purpose of this study using the CatWalk system. One, 2, and 4 is to investigate weeks after surgery, in IVD injury and sham 1) The role of CX3CL1/CX3CR1 chemokine groups, dorsal root ganglia (DRGs) from the on hypertrophy of the ligamentum flavum L1 to L6 levels were resected. DRGs were in lumbar spinal stenosis compared with immunostained for calcitonin gene-related that of non-degenerative spinal condition. peptide (CGRP). 2) Correlation between expression of RESULTS: In the IVD injury group, the mean CX3CL1/CX3CR1 chemokine and thickness of stands of hind paws and the mean duty cy- ligamentum flavum. cle of front paws at some time points were METHODS: The m RNA concentrations of significantly higher compared with the sham CX3CL1/CX3CR1 chemokine were analyzed group. Furthermore, the mean stride length in the surgically obtained ligamentum of the front and hind paws and the mean flavum specimens from lumbar spinal ste- swing speed of the front and hind paws at nosis (LSS) (n =10) and non-degenerative some time points were significantly shorter spinal condition (NDS) (n =11) by real-time compared with the sham group. The pro- PCR. The localization of CX3CL1/CX3CR1 portion of CGRP-immunoreactive, FG- chemokine within the ligament flavum was labeled neurons among all FG-labeled DRG determined using immunohistochemical neurons in the IVD injury group was signifi- study. Plasma levels of soluble FKN (sFKN) cantly higher than the corresponding pro- and CX3CR1 were measured by enzyme- portion in the sham group. linked immunosorbent assay (ELISA), re- DISCUSSION: These results suggest that IVD spectively. The thickness of the ligament injury produced significant changes in rat flavum was measured with axial T1- gait, including longer stance phases and weighted magnetic resonance imaging. shorter strides. In the future, we may be able to apply the CatWalk system to the evaluation of behavior associated with pain in rat and mouse models of low back pain. GP3 HYPERTROPHY OF THE LIGAMENT FLAVUM IN DEGENERATIVE LUMBAR STENOSIS AS- SOCIATED WITH THE INCREASED EXPRES- SION OF FRACTALKINE (CX3CL1)/CX3CR1 CHEMOKINE In-Soo Oh, MD1, Dong-Whan Sur, MD1, Kee- RESULT: The CX3CL1/CX3CR1 chemokine Yong Ha, MD2. positive cell ratio in the LF observed in LSS Department of Orthopaedic Surgery, In- group as substantially higher than in NDS cheon St. Mary's Hospital1, Seoul St. Mary's group (P= 0.030). In ELISA, the plasma levels Hospital2, College of Medicine, The Catholic of sFKN were significantly increased in LSS University of Korea, Seoul, Korea 99 GENERAL POSTERS patients compared with patients in the oth- modulus and phase angle in the dynamic er groups (P = 0.006). There was greater test were worked out respectively with help CX3CL1/CX3CR1 expression in LSS patients of software. as quantified by RT-PCR (P = 0.004, 0.01). RESULTS: In the static compression test, Thickness of LF in patients was significantly mimic group have a similar stress/strain correlated with serum CX3CL1 level (r = curve with normal group, whereas control 0.48, P < 0.01) and with RNA Expression of group shows obvious difference. In the dy- CX3CL1/CX3CCX3CR1 (r = 0.62, P < 0.01)(r = namic test, results of the storage modulus, 0.64, P < 0.01) loss modulus and phase angle showed DISCUSSION: This study identified for the simlar tendency that the maximum mean first time that increases in Fractalkine and values (297.2~362.5KPa, 15.7~24.0KPa, CX3CR1-expresexpressing monocytes, T 2.4~4.6°, respectively) were in control group lymphocytes, and NK cells are significantly and the minimum (187.2~226.2KPa, related to LF hypertrophy, which may pro- 10.1~14.8KPa, 2.0~3.5°, respectively) in vide new conceptual and therapeutic ap- normal group. And the mean values in mim- proaches for treating spinal stenosis. ic group were 242.8~290.5KPa, 12.4~18.2KPa, 2.3~4.1°, respectively. It should be noted that values of the storage GP4 modulus were elevated with increasing fre- COMPARATIVE STUDY OF LUMBAR quency, while values of the loss modulus INTERVERTEBRAL DISC BIOMECHANICAL and phase angle were reduced with CHARACTERISTICS WITH OR WITHOUT inceasing frequency. HYDROGEL INJECTION AFTER NUCLEUS DISCUSSION: Injecting hydrogels after nu- DISCECTOMY cleus discectomy can not only better re- Gao Manman, Zhou Zhiyu, Deng Wenbin, serve the normal lumbar geometric struc- Dai Xuejun, Zou Xuenong ture but also improve the biomechanical Department of Spine Surgery/Orthopedic properties compared with simple discecto- Research Institute The First Affiliated my. hospital of Sun Yat-sen University INTRODUCTION: Injecting hydrogels as sub- GP5 stitute of nucleus pulposus after nucleus SPINO-PELVIC-RHYTHM IN NORMAL SUB- discectomy partially restores the geometric JECTS AND HIGH-CLASS ATHLETES WHO structure of lumbar intervertebral discs. OVERCAME CHRONIC LOW BACK PAIN This study investigated both the static and Kiyotaka Hasebe1,2, Koichi Sairyo3, Yasushi dynamic mechanical properties of lumbar Hada1, Akira Dezawa3, Yu Okubo4, Koji intervertebral discs with or without hydro- Kaneoka2, and Yoshio Nakamura2 gels injection after nucleus discectomy. 1Department of Rehabilitation, Teikyo Uni- METHODS: The lumbar intervertebral discs versity Mizonokuchi
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