Biomechanical comparison of transfacet screws to lateral mass screw-rod constructs in the lower cervical spine.

PURPOSE: Transfacet screws have been used as an alternative posterior fixation in the cervical spine. There is lack of spinal stability of the transfacet screws either as stand-along constructs or combined with anterior plate. This study was designed to evaluate spinal stability of transfacet screws following posterior ligamentous injury and combined with anterior plate, respectively, and compare transfacet screws to lateral mass screw-rod constructs. METHODS: Flexibility tests were conducted on eight cadaveric specimens in an intact and injury, and instrumented with the transfacet screw fixation and lateral mass screw-rod construct at C5-C7 levels either after section of the posterior ligamentous complex or combined with an anterior plate and a mesh cage for C6 corpectomy reconstruction. A pure moment of ±2.0 Nm was applied to the specimen in flexion-extension, lateral bending, and axial rotation. Ranges of motion (ROM) were calculated for the C5-C7 segment. RESULTS: ROM with the transfacet screws was 22 % of intact in flexion-extension, 9 % in lateral bending and 11 % in axial rotation, while ROM with the lateral mass screw-rod construct was 9 % in flexion-extension, 8 % in lateral bending and 22 % in axial rotation. The only significant difference between two constructs was seen in flexion-extension (5.8 ± 4.2° vs. 2.4 ± 1.2°, P = 0.002). When combined with an anterior plate and mesh cage, the transfacet screw fixation reduced ROM to 3.0° in flexion-extension, 1.2° in lateral bending, and 1.1° in axial rotation, which was similar to the lateral mass screw-rod construct. CONCLUSIONS: This study identified the transfacet screw fixation, as stand-alone posterior fixation, was equivalent to the lateral mass screw-rod constructs in axial rotation and lateral bending except in flexion-extension. When combined with an anterior plate, the transfacet screw fixation was similar to the lateral mass screw-rod construct in motion constraint. The results suggested the transfacet screw fixation a biomechanically effective way as supplementation of anterior fixation.

Kinematics and load-sharing of an anterior thoracolumbar spinal reconstruction construct with PEEK rods: An in vitro biomechanical study.

BACKGROUND: Polyetheretherketone rod constructs provide adequate spinal stability. Kinematics and load sharing of anterior thoracolumbar reconstruction with polyetheretherketone rods under preload remains unknown. METHODS: Eight human cadaveric specimens (T11-L3) were subjected to a pure moment of 5.0Nm in flexion-extension, lateral bending and axial rotation, and flexion-extension with a compressive preload of 300N. An anterior reconstruction of L1 corpectomy was conducted with a surrogate bone graft and anterior rod constructs (polyetheretherketone or titanium rods). An axial load-cell was built in the surrogate bone graft to measure the compressive force in the graft. Range of motion, neutral zone and compressive force in the graft were compared between constructs. FINDINGS: The polyetheretherketone rod construct resulted in more motion than the titanium rod construct, particularly in extension (P=0.011) and axial rotation (P=0.001), but less motion than the intact in all directions except in axial rotation. There was no difference in range of motion or neutral zone between constructs in flexion-extension under preload. The polyetheretherketone rod construct kept the graft compressed 52N which was similar to the titanium rod construct (63N), but allowed the graft compressed more under the preload (203N vs. 123N, P=0.003). The compressive forces fluctuated in flexion-extension without preload, but increased in flexion and decreased in extension under preload. INTERPRETATION: The polyetheretherketone rod construct allowed more motion compared to the titanium rod construct, but provided stability in flexion and lateral bending without preload, and flexion and extension under preload. The anterior graft shared higher load under preload, particularly for the polyetheretherketone rod construct. The results of this study suggest that rigidity of rods in the anterior reconstruction affects kinematic behavior and load sharing.

Mir-664 promotes osteosarcoma cells proliferation via downregulating of FOXO4.

BACKGROUND: Uncontrol cell growth and proliferation is acknowledged to responsible for cancer-related deaths by disorganizing the balance of growth promotion and growth limitation. Aberrant expression of microRNA play essential roles in cancer development, leads to cell proliferation, growth and survival, and promotes the development of various human tumors, including osteosarcoma. Elucidating the molecular mechanism of this abnormality in osteosarcoma carcinogenesis may improve diagnostic and therapeutic strategies for this malignancy. METHODS: The expression of miR-664 in osteosarcoma cell lines and osteosarcoma tissues was examined using real-time PCR. The effects of miR-664 on osteosarcoma cell proliferation were evaluated by 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay, colony formation and Anchorage-independent growth ability assay. The effect of miR-664 on FOXO4 was determine by luciferase assays and western blot assay. RESULTS: The expression of miR-664 was markedly upregulated in osteosarcoma cell lines and tissues, and upregulation of miR-664 enhanced, whereas downregulation of miR-664 inhibited the proliferation of osteosarcoma cells in vivo. Furthermore, using bioinformatics and biological approaches, we showed that miR-664 directly targeted and suppressed the expression of tumor suppressors FOXO4. CONCLUSIONS: Our findings suggest that miR-664 functions as an oncogene miRNA and has an important role in promoting human osteosarcoma cell proliferation by suppressing FOXO4 expression. These data suggests that miR-664 may represent a novel therapeutic target of microRNA-mediated suppression of cell proliferation in osteosarcoma.