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Chronic repetitive forces on the spinal column promote the development of degenerative spinal disease. Yet the mechanisms linking such macroscale mechanical forces to tissue hypertrophy remain unknown. Here we show that fibrotic regions in human ligamentum flavum naturally exposed to high stress display elevated Rho-associated kinase (ROCK) signalling and an increased density of myofibroblasts expressing smooth muscle actin α. The myofibroblasts were localized in regions of elevated stiffness and microstress, such accumulation was ROCK dependent, and ROCK inhibition partially reduced the stress-driven transcriptional responses. Our findings support the further investigation of ROCK inhibitors for the treatment of degenerative spinal disease.
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http://dx.doi.org/10.1038/s41551-025-01396-7 | DOI Listing |
J Orthop Sci
September 2025
Department of Orthopedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Background: Cervical spine radiography is a common screening tool for cervical spondylosis with radiographic features, including osteophytes, disc height narrowing, vertebral sclerosis, and spondylolisthesis. The Kellgren-Lawrence classification is widely used for evaluating musculoskeletal radiographs, including spinal radiographs; however, evaluating the individual radiographic features of spondylosis is challenging with this classification. This study aimed to develop an elemental grading system for evaluating cervical spine radiographs and the extent of cervical spondylosis.
View Article and Find Full Text PDFGeroscience
September 2025
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Degenerative cervical myelopathy (DCM) is a leading cause of non-traumatic spinal cord disorders in older adults. Gait instability and balance dysfunction are common in DCM, even in the absence of clinically evident lower limb weakness. We hypothesized that subclinical weakness, measured through maximal voluntary isometric contractions (MVICs) of the knee extensors and ankle plantar flexors, is associated with impaired gait and balance in individuals with DCM.
View Article and Find Full Text PDFWorld Neurosurg
September 2025
Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. Electronic address:
Background: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is widely adopted for the treatment of lumbar degenerative disease. Expandable cages are now increasingly used in MIS-TLIF to facilitate disc height restoration in narrow spaces. Despite theoretical advantages, the clinical and radiologic outcomes of expandable cage compared to static cage remain controversial.
View Article and Find Full Text PDFJ Neurosurg Spine
September 2025
1Department of Spine and Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan; and.
Objective: The objective of this study was to introduce and evaluate foraminoplastic inferior pedicle subtraction osteotomy (FiPSO), a novel technique that involves downward resection of the pedicle and vertebral body, aimed at addressing rigid lower lumbar kyphosis.
Methods: The clinical records were reviewed of the patients who underwent corrective surgery from January 2012 through December 2021 for adult spinal deformity using a combination of procedures: pedicle subtraction osteotomy (PSO) at the lumbar level and spinopelvic fixation. Inclusion criteria included patients older than 40 years with sagittal imbalance symptoms and significant radiographic findings: sagittal vertical axis (SVA) > 50 mm, pelvic tilt (PT) > 25°, or pelvic incidence (PI) minus lumbar lordosis (LL) > 10°.
Cureus
August 2025
Interventional Pain Management, Mercy Health-Allen Hospital, Oberlin, USA.
Spinal cord stimulation (SCS) has demonstrated efficacy in treating intractable pain associated with failed back surgery syndrome (FBSS), though its success in patients with severe spinal deformities remains uncertain. This case report presents a 78-year-old female patient with FBSS, advanced lumbar scoliosis, and multiple prior spinal surgeries, who experienced severe, debilitating pain despite extensive conservative and pharmacological treatments. Imaging revealed significant degenerative changes, spinal subluxations, and multilevel stenosis.
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