Multi-sensory Gamma Stimulation Ameliorates Alzheimer's-Associated Pathology and Improves Cognition.

We previously reported that inducing gamma oscillations with a non-invasive light flicker (gamma entrainment using sensory stimulus or GENUS) impacted pathology in the visual cortex of Alzheimer's disease mouse models. Here, we designed auditory tone stimulation that drove gamma frequency neural activity in auditory cortex (AC) and hippocampal CA1. Seven days of auditory GENUS improved spatial and recognition memory and reduced amyloid in AC and hippocampus of 5XFAD mice. Changes in activation responses were evident in microglia, astrocytes, and vasculature. Auditory GENUS also reduced phosphorylated tau in the P301S tauopathy model. Furthermore, combined auditory and visual GENUS, but not either alone, produced microglial-clustering responses, and decreased amyloid in medial prefrontal cortex. Whole brain analysis using SHIELD revealed widespread reduction of amyloid plaques throughout neocortex after multi-sensory GENUS. Thus, GENUS can be achieved through multiple sensory modalities with wide-ranging effects across multiple brain areas to improve cognitive function.

Interchromosomal homology searches drive directional ALT telomere movement and synapsis.

Telomere length maintenance is a requisite feature of cellular immortalization and a hallmark of human cancer. While most human cancers express telomerase activity, ∼10%-15% employ a recombination-dependent telomere maintenance pathway known as alternative lengthening of telomeres (ALT) that is characterized by multitelomere clusters and associated promyelocytic leukemia protein bodies. Here, we show that a DNA double-strand break (DSB) response at ALT telomeres triggers long-range movement and clustering between chromosome termini, resulting in homology-directed telomere synthesis. Damaged telomeres initiate increased random surveillance of nuclear space before displaying rapid directional movement and association with recipient telomeres over micron-range distances. This phenomenon required Rad51 and the Hop2-Mnd1 heterodimer, which are essential for homologous chromosome synapsis during meiosis. These findings implicate a specialized homology searching mechanism in ALT-dependent telomere maintenance and provide a molecular basis underlying the preference for recombination between nonsister telomeres during ALT.

Teriparatide Does not Have Beneficial Effects on Bone Healing in Complete Atypical Femur Fractures.

Teriparatide is an anabolic drug sometimes administered to patients who have atypical femoral fracture (AFF). However, whether teriparatide has beneficial effects on bone healing remains uncertain. The present study aimed to analyze the association between teriparatide and bone healing in complete AFF. A total of 59 consecutive cases (58 patients) who underwent intramedullary nailing for complete AFF were categorized based on postoperative use of teriparatide into the non-teriparatide (non-TPTD, n = 34) and teriparatide groups (TPTD, n = 25). Time-to-bone union was evaluated and compared between the two groups. Additionally, multiple regression analysis was performed to evaluate factors affecting time-to-bone union. All participants were women, with a mean age of 77.6 years (range: 62-92). No significant difference in time-to-bone union was found between the non-TPTD and TPTD groups (5.5 months vs. 5.8 months, p = 0.359). Two patients in the non-TPTD group underwent reoperation (p = 0.503) due to failure caused by inadequate fixation, and both achieved bone healing after additional fixation with blocking screws. Multiple regression analysis revealed that the anterior gap of the fracture site postoperatively was a factor affecting time-to-bone union (p = 0.014). The beneficial effect of teriparatide on bone healing in complete AFF could not be confirmed. Additional randomized controlled trials are required. Nonetheless, appropriate techniques, including efforts to reduce the gap on the tensile side during the surgery, are important for reliable bone healing.

Minimum clinically important difference and substantial clinical benefit in patients with chronic temporomandibular disorders.

BACKGROUND: Research on temporomandibular disorder (TMD) responsiveness is scarce and limited regarding patients' representativeness. OBJECTIVE(S): This study aimed to estimate minimum clinically important difference (MCID) and substantial clinical benefit (SCB) among a large and diverse patient population regarding sex and age. METHODS: In this study, 162 patients participated from five hospitals. MCID and SCB in pain, functional disability and quality of life were examined with anchor-based methods. Patients' global impression of change was used as the anchor. Area under the curve (AUC) values were determined for testing accuracy. Changes from baseline and coefficient of variation by responsiveness status were calculated to explain the results of accuracy. RESULTS: SCB was estimated to be 2.18 for the numeric rating scale (NRS) for pain (AUC: 0.80 [95% CI: 0.72-0.88]) in all patients and 2.50 in women (AUC: 0.81 [95% CI: 0.71-0.89]). The estimated SCB of NRS for discomfort (1.50) and Jaw Functional Limitation Scale for mastication (1.35) had wide CIs for AUCs. Likewise, the estimated MCIDs of NRS for pain (0.80) and NRS for discomfort (1.50) had wide CIs for AUCs. Among non-responders who did not achieve the MCID of NRS for pain, the coefficient of variation was very high for all outcomes other than the NRS for pain. CONCLUSION: This study investigated the responsiveness of patients with TMD using a large and diverse patient sample. SCB in pain decrease can be used to assess the responsiveness of patients with TMD. Composite outcomes should be developed to estimate MCID.

Effectiveness of Chuna (or Tuina) Manual Therapy for Temporomandibular Disorder: A Systematic Review.

Background: Temporomandibular disorder (TMD) affects patients' quality of life (QoL) because of the resulting structural and functional impairment and pain. Objective: This study aimed to evaluate the evidence regarding the effectiveness, safety and improvement in QoL in patients who underwent Chuna manual therapy (CMT) for TMD. Methods: We searched 11 databases and included randomized controlled trials (RCT) on CMT for TMD published before March 2020. A meta-analysis was conducted, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method was used to evaluate the evidence level. We included 12 RCTs that compared CMT and conventional care. Results: CMT showed significantly better patient pain reduction, functional improvement and QoL. A superior result was seen in the use of CMT in conjunction with Traditional Chinese Medicine (TCM) or conventional care. CMT showed no minor or serious adverse events compared with medical treatments. The evidence level was low for all outcomes, except QoL. Conclusions: We found that CMT for TMD resulted in functional improvement, pain reduction and improvement in QoL, with fewer adverse events. However, since the evidence level varied from very low to moderate due to imprecision and the risk of bias with the included studies, we are limited in determining the efficacy of Chuna therapy using these studies. High-quality, well-designed and large-scale RCTs are needed to conclusively determine the clinical efficacy of CMT in TMD.

Short Symptom Duration Is Associated With Superior Outcomes in Patients Undergoing Primary Hip Arthroscopy: A Systematic Review.

PURPOSE: To evaluate the effect of duration of preoperative hip pain symptoms on outcomes in patients undergoing primary hip arthroscopy for the treatment of femoroacetabular impingement syndrome. METHODS: A systematic review of the literature was conducted with the following key words: "hip arthroscopy," "outcomes," "femoroacetabular impingement," "duration," "symptoms," "time," "delay," "earlier," and "timing" was performed in PubMed and Cochrane in May 2022. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used for this review. When available, article information including the author, study type, study period, and follow-up, demographics, preoperative duration of symptoms, surgical outcome tools, and secondary surgeries were recorded. RESULTS: Six studies including 3,298 hips were included in this systematic review. Five studies had a minimum of 2 years' follow-up, and 1 study had a minimum of 5 years' follow-up. Femoroacetabular impingement (including subtypes cam and pincer impingement) was a surgical indication in all 6 studies and the most common indication for surgery. All 6 studies reported patient-reported outcome scores. All studies conducted statistical analyses comparing the duration of symptoms' effect on outcomes and found superior outcomes in patients with shorter duration of symptoms before hip arthroscopy. In 3 studies, modified Harris Hip Score, Hip Outcome Score - Activities of Daily Living, Hip Outcome Score - Sports-Specific Subscale, and visual analog scale for satisfaction ranged from 79.1-82.6, 86.3-88.4, 75-75.5. and 75.3-82.5, respectively, in cohorts with <2-year duration of symptoms, compared with 72-77.7, 79.6-84, 65.0-66.7, and 69.7-75.3 in >2-year cohort. Similarly, in one study, the <2-year duration group was reported to have a conversion to total hip arthroplasty rate of 0.6% and an overall secondary surgery rate of 0.9%, whereas the >2-year duration group had a conversion to total hip arthroplasty rate of 6.4% and an overall secondary surgery rate of 10.1%. CONCLUSIONS: Patients with hip pain symptoms of less than 2 years before arthroscopic treatment of femoroacetabular impingement syndrome have better outcomes than those patients who had a longer duration of symptoms. However, significant improvements can still be expected regardless of time between onset of symptoms and surgery. LEVEL OF EVIDENCE: Level IV, systematic review of Level III and Level IV studies.

Patients Undergoing Primary Hip Arthroscopy Report Favorable Outcomes at Minimum 10 Year Follow-Up: A Systematic Review.

PURPOSE: (1) To evaluate minimum 10-year PROs (patient-reported outcomes) and survivorship after primary hip arthroscopy and (2) to identify predictors of failure for secondary arthroscopy and conversion to total hip arthroplasty (THA). METHODS: A systematic review of the literature was conducted with the following key words: "hip arthroscopy," "long-term," "outcomes," "ten-year," "survivorship," "10-year," "15-year," "fifteen-year," 20-year," "twenty-year," and "femoroacetabular impingement" in PubMed and Embase in March 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Level I to Level IV evidence was included and reported on minimum 10-year outcomes or greater after primary hip arthroscopy. Long-term studies were defined as minimum 10-year follow-up in accordance with established standards in the literature. Case reports, review articles, technique articles, and opinion articles were excluded. Articles not in English were excluded. Title, author, publication date, study design, demographic, number of hips, follow-up time, study period, indications for hip arthroscopy, PROs, predictors of failure for THA, and rates of secondary surgeries were recorded. Survivorship was defined as a nonconversion to THA. P < .05 was defined as statistical significance. RESULTS: Twelve studies met the inclusion criteria. In total, 4 studies were Level III, and 8 studies were Level IV. A total of 1,344 hips were included, and follow-up ranged from 10 to 20 years. Femoroacetabular impingement syndrome was the most common indication for hip arthroscopy. Ten of the 12 studies reported on PROs, and 8 studies reported significant improvement after hip arthroscopy at long-term follow-up. The remaining 2 studies reported favorable outcomes that satisfied clinical benefit thresholds at minimum 10-year follow-up. Five studies reported clinical benefit where each patient cohort achieved 80% minimal clinically important difference and 75% patient acceptable symptomatic state for at least one PRO. Rates of secondary arthroscopy ranged from 4.5% to 24%, and rates of conversion to THA varied from 0% to 44.1%. Older age and chondral damage were the most commonly cited predictors for conversion to THA. CONCLUSIONS: At long-term follow-up, patients who underwent primary hip arthroscopy demonstrated favorable outcomes and variable rates of secondary surgeries. Patients undergoing hip arthroscopy within the last 20 years with Tönnis grade <1 and labral repair experienced greater than 90% survivorship. Chondral damage and older age were the most cited predictors for conversion to THA. LEVEL OF EVIDENCE: Level IV, systematic review of Level III and Level IV studies.

The Neuroprotective Effects of Dendropanax morbifera Water Extract on Scopolamine-Induced Memory Impairment in Mice.

This study investigated the neuroprotective effects of Dendropanax morbifera leaves and stems (DMLS) water extract on scopolamine (SCO)-induced memory impairment in mice. First, we conducted experiments to determine the protective effect of DMLS on neuronal cells. Treatment with DMLS showed a significant protective effect against neurotoxicity induced by Aß(25-35) or H2O2. After confirming the neuroprotective effects of DMLS, we conducted animal studies. We administered DMLS orally at concentrations of 125, 250, and 375 mg/kg for 3 weeks. In the Y-maze test, SCO decreased spontaneous alternation, but treatment with DMLS or donepezil increased spontaneous alternation. In the Morris water-maze test, the SCO-treated group showed increased platform reach time and decreased swim time on the target platform. The passive avoidance task found that DMLS ingestion increased the recognition index in short-term memory. Furthermore, memory impairment induced by SCO reduced the ability to recognize novel objects. In the Novel Object Recognition test, recognition improved with DMLS or donepezil treatment. In the mouse brain, except for the cerebellum, acetylcholinesterase activity increased in the SCO group and decreased in the DMLS and donepezil groups. We measured catalase and malondialdehyde, which are indicators of antioxidant effectiveness, and found that oxidative stress increased with SCO but was mitigated by DMLS or donepezil treatment. Thus, our findings suggest that ingestion of DMLS restored memory impairment by protecting neuronal cells from Aß(25-35) or H2O2-induced neurotoxicity, and by reducing oxidative stress.

Break-induced telomere synthesis underlies alternative telomere maintenance.

Homology-directed DNA repair is essential for genome maintenance through templated DNA synthesis. Alternative lengthening of telomeres (ALT) necessitates homology-directed DNA repair to maintain telomeres in about 10-15% of human cancers. How DNA damage induces assembly and execution of a DNA replication complex (break-induced replisome) at telomeres or elsewhere in the mammalian genome is poorly understood. Here we define break-induced telomere synthesis and demonstrate that it utilizes a specialized replisome, which underlies ALT telomere maintenance. DNA double-strand breaks enact nascent telomere synthesis by long-tract unidirectional replication. Proliferating cell nuclear antigen (PCNA) loading by replication factor C (RFC) acts as the initial sensor of telomere damage to establish predominance of DNA polymerase δ (Pol δ) through its POLD3 subunit. Break-induced telomere synthesis requires the RFC-PCNA-Pol δ axis, but is independent of other canonical replisome components, ATM and ATR, or the homologous recombination protein Rad51. Thus, the inception of telomere damage recognition by the break-induced replisome orchestrates homology-directed telomere maintenance.

Role of intraretinal cysts in the prediction of postoperative closure and photoreceptor damages of the idiopathic full-thickness macular hole.

BACKGROUND: To determine whether it would be effective in predicting the results of the postoperative full-thickness macular hole (FTMH) closure when intraretinal cyst (IRC) is present. METHODS: Case-control study. Patients with idiopathic FTMH who underwent pars plana vitrectomy with internal limiting membrane peeling were retrospectively reviewed. Preoperative spectral-domain optical coherence tomography was undertaken in all patients. The new parameter, macular hole closing factor (MHCF) was defined as the base diameter - (arm length + IRC height) by adding IRC to the existing parameter. After surgery, patients were classified and analyzed according to the type of hole closure and the damage of photoreceptor. RESULTS: Of the 35 patients, 28 (80.00%) had type 1 closure and seven (20.00%) had type 2 closure. There was a significant difference in postoperative BCVA (P < 0.01), base diameter (P = 0.037), arm length (P = 0.045), and IRC height (P = 0.011) between the two groups. In the type 1 closure, they were further divided into two subgroups according to photoreceptor damage, and it was confirmed that there were significant differences in postoperative BCVA (P = 0.045), hole height (P = 0.048), and IRC height (P = 0.046) in the two subgroups. As for the new parameters, a significant difference between the three groups was confirmed (P < 0.01). CONCLUSION: IRC may help predict hole closure along with the known horizontal parameters. Therefore, the new parameter containing both two factors can help predict not only hole closure but also damage to photoreceptors that affects postoperative visual prognosis.

Cost analysis of depression using the national insurance system in South Korea: a comparison of depression and treatment-resistant depression.

BACKGROUND: The incidence and burden of depressive disorders are increasing in South Korea. There are many differences between pharmaceutically treated depression (PTD) and treatment-resistant depression (TRD), including the economic consequences; however, to our knowledge, the economic burden of depression is understudied in South Korea. Therefore, the objective of the present study was to calculate the different economic costs of PTD and TRD in South Korea, specifically by comparing several aspects of medical care. METHODS: This study comprised patients aged 18 and over who were newly prescribed antidepressants for more than 28 days with a depression code included from January 1, 2012, to December 31, 2012, by the Health Insurance Review and Assessment Service (HIRA). TRD was classified as more than two antidepressant regimen failures in PTD patients. The cost was calculated based on the cost reflected on the receipt registered with HIRA. RESULTS: Of the 834,694 patients with PTD, 34,812 patients (4.17%) were converted to TRD. The cost of medical care for TRD (6,610,487 KRW, 5881 USD) was approximately 5 times higher than the cost of non-TRD (1,273,045 KRW, 1133 USD) and was significantly higher for patients with or without depression and suicide codes. Medical expenses incurred by non-psychiatrists were roughly 1.7 times higher than those incurred by psychiatrists. CONCLUSIONS: TRD patients had significantly higher healthcare costs than PTD patients. Identifying these financial aspects of care for depression can help to establish a more effective policy to reduce the burden on mentally ill patients.

Anti-adipogenic and anti-obesity activities of purpurin in 3T3-L1 preadipocyte cells and in mice fed a high-fat diet.

BACKGROUND: The body responds to overnutrition by converting stem cells to adipocytes. In vitro and in vivo studies have shown polyphenols and other natural compounds to be anti-adipogenic, presumably due in part to their antioxidant properties. Purpurin is a highly antioxidative anthraquinone and previous studies on anthraquinones have reported numerous biological activities in cells and animals. Anthraquinones have also been used to stimulate osteoblast differentiation, an inversely-related process to that of adipocyte differentiation. We propose that due to its high antioxidative properties, purpurin administration might attenuate adipogenesis in cells and in mice. METHODS: Our study will test the effect purpurin has on adipogenesis using both in vitro and in vivo models. The in vitro model consists of tracking with various biomarkers, the differentiation of pre-adipocyte to adipocytes in cell culture. The compound will then be tested in mice fed a high-fat diet. Murine 3T3-L1 preadipocyte cells were stimulated to differentiate in the presence or absence of purpurin. The following cellular parameters were measured: intracellular reactive oxygen species (ROS), membrane potential of the mitochondria, ATP production, activation of AMPK (adenosine 5'-monophosphate-activated protein kinase), insulin-induced lipid accumulation, triglyceride accumulation, and expression of PPARγ (peroxisome proliferator activated receptor-γ) and C/EBPα (CCAAT enhancer binding protein α). In vivo, mice were fed high fat diets supplemented with various levels of purpurin. Data collected from the animals included anthropometric data, glucose tolerance test results, and postmortem plasma glucose, lipid levels, and organ examinations. RESULTS: The administration of purpurin at 50 and 100 µM in 3T3-L1 cells, and at 40 and 80 mg/kg in mice proved to be a sensitive range: the lower concentrations affected several measured parameters, whereas at the higher doses purpurin consistently mitigated biomarkers associated with adipogenesis, and weight gain in mice. Purpurin appears to be an effective antiadipogenic compound. CONCLUSION: The anthraquinone purpurin has potent in vitro anti-adipogenic effects in cells and in vivo anti-obesity effects in mice consuming a high-fat diet. Differentiation of 3T3-L1 cells was dose-dependently inhibited by purpurin, apparently by AMPK activation. Mice on a high-fat diet experienced a dose-dependent reduction in induced weight gain of up to 55%.

In vivo imaging of DNA double-strand break induced telomere mobility during alternative lengthening of telomeres.

Repair of DNA double-strand breaks (DSBs) by homologous recombination (HR) requires mobilization of chromatin for homology searches that allow interaction of the sequence to be repaired and its template DNA. Here we describe a system to rapidly induce DSBs at telomeres and track their movement, as well as a semi-automated workflow for quantitative analysis. We have successfully used this approach to show that DSBs targeted to telomeres in cells utilizing the alternative lengthening of telomeres (ALT) mechanism increase their diffusion and subsequent long-range directional movement to merge with telomeres on other chromosomes. These methods are simple to implement and are compatible with almost any cell line or in vivo microscopy setup. The magnitude of DSB-induced telomere mobility allows the investigator to easily test for factors regulating telomere mobility during ALT.

High Reliability of Ag Reflectors with AgCu Alloy for High Efficiency GaN-Based Light Emitting Diodes.

We propose an Ag reflector layer with an AgCu alloy layer as a thermally reliable reflector for high power flip-chip and vertical light emitting diodes (LEDs). By annealing the deposited Ag and Cu layers, intermixed grains and grain boundaries from the alloyed AgCu layer were formed on the LEDs, and CuO nano dots precipitated at the grain boundaries. A thick AgCu layer was deposited to cover the AgCu alloy layer. The precipitation of the CuO nano dots at the grain boundaries suppressed Ag agglomeration, leading to enhanced light reflectance after the annealing process. Consequently, the alloyed AgCu/Ag reflector produced by annealing at a high temperature of 500 °C demonstrated a higher reflectance of 78% and a lower contact resistance of 7.0 × 10-5 Ω · cm2.

Structure-Antioxidative and Anti-Inflammatory Activity Relationships of Purpurin and Related Anthraquinones in Chemical and Cell Assays.

Anthraquinone (9,10-anthraquinone) and several hydroxy derivatives, including purpurin (1,2,4-trihydroxyanthraquinone), anthrarufin (1,5-dihydroxyanthraquinone), and chrysazin (1,8-dihydroxyanthraquinone), were evaluated for antioxidative and anti-inflammatory activities in chemical assays and mammalian cells (murine macrophage RAW 264.7 cells). Several tests were used to assess their activities: 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical; ABTS radical cation; hydrogen peroxide scavenging; reduction of potassium ferricyanide; chelation of ferrous ions; inhibition of lipid peroxidation; inhibition of nitric oxide generation; scavenging of the intracellular hydroxyl radical; expression of NLRP3 polypeptide for inflammasome assembly; and quantitation of proinflammatory cytokine interleukin 1ß (IL-1ß) for inflammasome activation. The results show that purpurin, from the root of the madder plant (Rubia tinctorum L.), exhibited the highest antioxidative activity in both chemical and cultured cell antioxidant assays. The antioxidative activities of the other three anthraquinones were lower than that of purpurin. In addition, purpurin could down-regulate NLRP3 inflammasome assembly and activation, suggesting that it might protect foods against oxidative damage and prevent in vivo oxidative stress and inflammation. Structure-activity relationships and the significance of the results for food quality and human health are discussed.

Structurally nanocrystalline-electrically single crystalline ZnO-reduced graphene oxide composites.

ZnO, a wide bandgap semiconductor, has attracted much attention due to its multifunctionality, such as transparent conducting oxide, light-emitting diode, photocatalyst, and so on. To improve its performances in the versatile applications, numerous hybrid strategies of ZnO with graphene have been attempted, and various synergistic effects have been achieved in the ZnO-graphene hybrid nanostructures. Here we report extraordinary charge transport behavior in Al-doped ZnO (AZO)-reduced graphene oxide (RGO) nanocomposites. Although the most challenging issue in semiconductor nanocomposites is their low mobilities, the AZO-RGO nanocomposites exhibit single crystal-like Hall mobility despite the large quantity of nanograin boundaries, which hinder the electron transport by the scattering with trapped charges. Because of the significantly weakened grain boundary barrier and the proper band alignment between the AZO and RGO, freely conducting electrons across the nanograin boundaries can be realized in the nanocomposites. This discovery of the structurally nanocrystalline-electrically single crystalline composite demonstrates a new route for enhancing the electrical properties in nanocomposites based on the hybrid strategy.

Distortion-free wide-angle 3D imaging and visualization using off-axially distributed image sensing.

We propose a new off-axially distributed image sensing (ODIS) using a wide-angle lens for reconstructing distortion-free wide-angle slice images computationally. In the proposed system, the wide-angle image sensor captures a wide-angle 3D scene, and thus the collected information of the 3D objects is severely distorted. To correct this distortion, we introduce a new correction process involving a wide-angle lens to the computational reconstruction in ODIS. This enables us to reconstruct distortion-free, wide-angle slice images for visualization of 3D objects. Experimental results are carried out to verify the proposed method. To the best of our knowledge, this is the first time the use of a wide-angle lens in a multiple-perspective 3D imaging system is described.

Optimization of culture conditions of Fusarium solani for the production of neoN-methylsansalvamide.

The aim of this study was to optimize the culture conditions of Fusarium solani KCCM90040 on cereal grain for the production of neoN-methylsansalvamide, a novel low-molecular-weight cyclic pentadepsipeptide exhibiting cytotoxic and multidrug resistance reversal effects. From the analysis of variance results using response surface methodology, temperature, initial moisture content, and growth time were shown to be important parameters for the production of neoN-methylsansalvamide on cereal grain. A model was established in the present study to describe the relationship between environmental conditions and the production of neoN-methylsansalvamide on rice, the selected cereal grain. The optimal culture conditions were determined at 25.79 °C with the initial moisture content of 40.79%, and 16.19 days of growth time. This report will give important information concerning the optimization of environmental conditions using statistic methodology for the production of a new cyclic pentadepsipeptide from fungi.

Effect of Osteoporosis on Clinical and Radiological Outcomes Following One-Level Anterior Cervical Discectomy and Fusion.

STUDY DESIGN: Retrospective study. PURPOSE: This study aimed to evaluate how osteoporosis affected the clinical and radiological outcomes of patients who underwent anterior cervical discectomy and fusion (ACDF) with plating. OVERVIEW OF LITERATURE: The incidence of complications associated with implants is high when ACDF is performed in patients with poor bone quality. METHODS: In total, 101 patients without (T-score ≥1.0, group A) and 25 with (T-score ≤-2.5, group B) osteoporosis who underwent single-level ACDF with plating were followed up for >2 years. The clinical and radiological outcomes were compared between the two groups. The fusion rate and implant-related complications were evaluated. RESULTS: Although clinical outcomes such as visual analog scale scores for the arm (2.0±2.3 vs. 2.4±2.9, p=0.490) and neck pain (1.4±1.9 vs. 1.8±2.2, p=0.343) and neck disability index (7.7±7.1 vs. 9.9±7.5, p=0.225) were slightly higher in group B, no statistically significant difference was noted. Cage subsidence (13.9% vs. 16.0%, p=0.755) and plate migration (7.9% vs. 8.0%, p=1.000) rates did not differ between the two groups. The fusion rate at 1 year postoperatively was higher in group A than in group B (80.3% vs. 68.2%, p=0.139) and slightly increased in both groups (94.6% vs. 86.4%, p=0.178) at the final follow-up. CONCLUSIONS: Osteoporosis did not significantly affect the rate of cage subsidence or plate migration after cervical fusion. After ACDF, increased cage subsidence and implant migration rates had no significant effect on clinical outcomes.