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Article ; Online: Full endoscopic surgery for calcium pyrophosphate deposition disease (CPPD) in the cervical ligamentum flavum: report of two cervical myelopathy cases.

Choi, Seung Jin / Kang, Dong Wan D / Ham, Chang Hwa / Kim, Joo Han / Kwon, Woo-Keun

2024 Volume 166, Issue 1, Page(s) 185

Abstract: Calcium pyrophosphate deposition disease (CPPD), known as pseudogout, is characterized by the accumulation of calcium pyrophosphate crystals in musculoskeletal structures, primarily joints. While CPPD commonly affects various joints, involvement in the ... ...

Abstract	Calcium pyrophosphate deposition disease (CPPD), known as pseudogout, is characterized by the accumulation of calcium pyrophosphate crystals in musculoskeletal structures, primarily joints. While CPPD commonly affects various joints, involvement in the cervical spine leading to myelopathy is rare. Surgical intervention becomes necessary when conservative measures fail, but reports on full endoscopic surgeries are extremely rare. We present two successful cases where full endoscopic systems were used for CPPD removal in the cervical spine. The surgical technique involved a full endoscopic approach, adapting the previously reported technique for unilateral laminotomy bilateral decompression. Full-endoscopic removal of cervical CPPD inducing myelopathy were successfully removed with good clinical and radiologic outcomes. The scarcity of endoscopic cases for cervical ligamentum flavum CPPD is attributed to the condition's rarity. However, our successful cases advocate for endoscopic surgery as a potential primary treatment option for CPPD-induced cervical myelopathy, especially in elderly patients or those with previous cervical operation histories. This experience encourages the consideration of endoscopic surgery for managing cervical ligamentum flavum CPPD as a viable alternative.
MeSH term(s)	Humans ; Aged ; Chondrocalcinosis/diagnostic imaging ; Chondrocalcinosis/surgery ; Ligamentum Flavum/diagnostic imaging ; Ligamentum Flavum/surgery ; Spinal Cord Diseases/diagnostic imaging ; Spinal Cord Diseases/surgery ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Neck
Language	English
Publishing date	2024-04-19
Publishing country	Austria
Document type	Journal Article
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-024-06080-4
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Article ; Online: Psychosocial Effect of Brace Treatment in Adolescent Idiopathic Scoliosis: A Study Using EQ-5D.

Bae, Byeong Hoon / Ham, Chang Hwa / Patel, Udit / Suh, Yunsun

Clinical spine surgery

2023 Volume 36, Issue 10, Page(s) E488–E492

Abstract: Study design: Retrospective cohort study.: Objective: To evaluate psychosocial effect of brace treatment in adolescent idiopathic scoliosis (AIS) using EuroQoL 5-dimension (EQ-5D) depression and anxiety category.: Background: AIS is a structural ... ...

Abstract	Study design: Retrospective cohort study. Objective: To evaluate psychosocial effect of brace treatment in adolescent idiopathic scoliosis (AIS) using EuroQoL 5-dimension (EQ-5D) depression and anxiety category. Background: AIS is a structural abnormality of the spine often affecting patients during the puberty, a critical period of developing psychosocial problems. Many questionnaires had been adapted to evaluate mental health and health-related quality of life of AIS patients. However, these questionnaires are often time consuming and difficult to obtain. Therefore, a simpler substitute-EQ-5D-was evaluated. Methods: This is a single-center retrospective cohort analysis of adult idiopathic scoliosis patients aged between 8 and 19, visiting outpatient's clinic. Beck's depression inventory, EQ-5D and EuroQoL visual assessment scale, and Objectified Body Consciousness Scale for Youth were compared between brace group and non-brace group of AIS patients. Furthermore, difference between male and female were evaluated within brace group. Results: None of the questionnaire showed significant difference between brace and non-brace group. However, when male and female patients were compared within brace group, female patients were significantly more susceptible to depression and anxiety based on EQ-5D and body consciousness. Furthermore, depression and anxiety according to both BDI and EQ-5D were significantly correlated to health-related quality of life. Conclusion: During brace treatment of female AIS patients, psychosocial status played a significant role in health-related quality of life. EQ-5D is a simple way to monitor the mental health status.
MeSH term(s)	Adult ; Humans ; Male ; Adolescent ; Female ; Child ; Young Adult ; Scoliosis/therapy ; Scoliosis/psychology ; Quality of Life/psychology ; Retrospective Studies ; Spine ; Surveys and Questionnaires ; Kyphosis
Language	English
Publishing date	2023-07-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2849646-2
ISSN	2380-0194 ; 2380-0186
ISSN (online)	2380-0194
ISSN	2380-0186
DOI	10.1097/BSD.0000000000001489
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Article ; Online: Current Knowledge and Future Therapeutic Prospects in Symptomatic Intervertebral Disc Degeneration.

Kim, Joo Han / Ham, Chang Hwa / Kwon, Woo-Keun

Yonsei medical journal

2022 Volume 63, Issue 3, Page(s) 199–210

Abstract: Intervertebral disc (IVD) degeneration is the main source of intractable lower back pain, and symptomatic IVD degeneration could be due to different degeneration mechanisms. In this article, we describe the molecular basis of symptomatic IVD degenerative ...

Abstract	Intervertebral disc (IVD) degeneration is the main source of intractable lower back pain, and symptomatic IVD degeneration could be due to different degeneration mechanisms. In this article, we describe the molecular basis of symptomatic IVD degenerative disc diseases (DDDs), emphasizing the role of degeneration, inflammation, angiogenesis, and extracellular matrix (ECM) regulation during this process. In symptomatic DDD, pro-inflammatory mediators modulate catabolic reactions, resulting in changes in ECM homeostasis and, finally, neural/vascular ingrowth-related chronic intractable discogenic pain. In ECM homeostasis, anabolic protein-regulating genes show reduced expression and changes in ECM production, while matrix metalloproteinase gene expression increases and results in aggressive ECM degradation. The resultant loss of normal IVD viscoelasticity and a concomitant change in ECM composition are key mechanisms in DDDs. During inflammation, a macrophage-related cascade is represented by the secretion of high levels of pro-inflammatory cytokines, which induce inflammation. Aberrant angiogenesis is considered a key initiative pathologic step in symptomatic DDD. In reflection of angiogenesis, vascular endothelial growth factor expression is regulated by hypoxia-inducible factor-1 in the hypoxic conditions of IVDs. Furthermore, IVD cells undergoing degeneration potentially enhance neovascularization by secreting large amounts of angiogenic cytokines, which penetrate the IVD from the outer annulus fibrosus, extending deep into the outer part of the nucleus pulposus. Based on current knowledge, a multi-disciplinary approach is needed in all aspects of spinal research, starting from basic research to clinical applications, as this will provide information regarding treatments for DDDs and discogenic pain.
MeSH term(s)	Annulus Fibrosus/metabolism ; Annulus Fibrosus/pathology ; Extracellular Matrix/metabolism ; Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration/metabolism ; Intervertebral Disc Degeneration/therapy ; Nucleus Pulposus/metabolism ; Nucleus Pulposus/pathology ; Vascular Endothelial Growth Factor A/metabolism
Chemical Substances	Vascular Endothelial Growth Factor A
Language	English
Publishing date	2022-02-20
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	303740-x
ISSN	1976-2437 ; 0513-5796
ISSN (online)	1976-2437
ISSN	0513-5796
DOI	10.3349/ymj.2022.63.3.199
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Article ; Online: A quantitative analysis of surgical smoke-derived particulate matter and formaldehyde exposure during spine surgery: a possible occupational hazard.

Choi, Seung Jin / Seo, Dongmin / Ham, Chang Hwa / Kim, Joo Han / Kwon, Woo-Keun

Journal of neurosurgery. Spine

2023 Volume 40, Issue 3, Page(s) 395–402

Abstract: Objective: Since its introduction, electrocautery has served as a valuable surgical tool, enabling precise tissue cutting and effective hemostasis in spine surgery. While there have been numerous efforts to elucidate the possible hazardous effects of ... ...

Abstract	Objective: Since its introduction, electrocautery has served as a valuable surgical tool, enabling precise tissue cutting and effective hemostasis in spine surgery. While there have been numerous efforts to elucidate the possible hazardous effects of surgical smoke in various surgical fields, there has been very little discussion in the context of spine surgery. The objective of this study was to measure and conduct a quantitative analysis of the particulate matter (PM) of different sizes and of formaldehyde (HCHO) generated by smoke during spine surgeries. Methods: This study included a consecutive series of patients who underwent 1- or 2-level lumbar spinal fusion surgery between June and November 2021. Particle counts were measured using a particle counter, specifically focusing on six different sizes of PM (0.3, 0.5, 1, 2.5, 5, and 10 µm). Additionally, measurements were taken for HCHO in parts per million (ppm). Monopolar cautery was used in the surgical setting. Systematic measurements were conducted at specific time points during the surgical procedures to assess the levels of PM and HCHO. Furthermore, the efficacy of surgical smoke suction was evaluated by comparing the PM levels with and without adjacent placement of suction. Results: This study involved 35 patients, with measurements of both PM and HCHO taken in 27 cases. The remaining 8 cases had measurements only for PM. In this study, statistically significant quantitative changes in various PM sizes were observed when electrocautery was used during spine surgery (12.3 ± 1.7 vs 1975.7 ± 422.8, 3.4 ± 0.5 vs 250.1 ± 45.7, and 1.9 ± 0.2 vs 78.1 ± 13.3, respectively, for 2.5-, 5-, and 10-µm PM; p < 0.05). The level of HCHO was also significantly higher (0.085 ± 0.006 vs 0.131 ± 0.014 ppm, p < 0.05) with electrocautery use. Utilization of adjacent suction of surgical smoke during electrocautery demonstrated a statistically significant reduction in PM levels. Conclusions: The findings of this study highlight the potential surgical smoke-related hazards that spine surgeons may be exposed to in the operating room. Implementing simple interventions, such as utilizing nearby suction, can effectively minimize the amount of toxic surgical smoke and mitigate these risks.
MeSH term(s)	Humans ; Particulate Matter/adverse effects ; Formaldehyde/adverse effects ; Lumbosacral Region ; Spinal Fusion ; Respiratory Hypersensitivity
Chemical Substances	Particulate Matter ; Formaldehyde (1HG84L3525)
Language	English
Publishing date	2023-12-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2158643-3
ISSN	1547-5646 ; 1547-5654
ISSN (online)	1547-5646
ISSN	1547-5654
DOI	10.3171/2023.10.SPINE23806
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Article ; Online: Radiologic risk factors associated with development of myelopathy in patients with ossification of the posterior longitudinal ligament of the cervical spine.

Kwon, Woo-Keun / Ham, Chang Hwa / Moon, Hong Joo / Kim, Joo Han / Park, Youn-Kwan

Clinical neurology and neurosurgery

2023 Volume 227, Page(s) 107668

Abstract: Study design: Retrospective Cohort Study OBJECTIVE: Myelopathy following ossification of the posterior longitudinal ligament (OPLL) is one of the devastating clinical features in these patients, while we still know little about which factors are ... ...

Abstract	Study design: Retrospective Cohort Study OBJECTIVE: Myelopathy following ossification of the posterior longitudinal ligament (OPLL) is one of the devastating clinical features in these patients, while we still know little about which factors are associated with development of myelopathy. We evaluated the difference of radiologic measurements between OPLL patients with or without myelopathy and searched for the clinical significance with emphasis on the impact of dynamic motion. Methods: 305 patients diagnosed of OPLL were enrolled for retrospective review. They were divided into two groups according to the coexistence of radiographic evidence of myelopathy. Demographic data as well as radiologic measures including the presence of disc degeneration (DD), anterior-posterior diameter (APD) of central canal, canal compromise (CC) ratio, global and segmental range of motion (gROM and sROM), OPLL type (morphologic classification) and K-line were collected. Results: APD (odds ratio (OR); 0.411), CC ratio (OR; 1.100) and sROM (OR; 1.371) were significantly associated with the presence of myelopathy in the multivariate analysis. While the statistically significant factors were same in OPLLs with CC larger than 50%, presence of DD (OR; 4.509) and sROM (OR; 1.295) were significantly associated with myelopathy but not the CC itself in OPLLs with CC smaller than 50%. Conclusions: We discovered that the APD, CC ratio and sROM had significant association with development of myelopathy in OPLLs. And the presence of dynamic factors had significant association with myelopathy in OPLLs with smaller CC ratios. This observation and its clinical significance on development of myelopathy might enhance our understanding of OPLL.
MeSH term(s)	Humans ; Longitudinal Ligaments ; Retrospective Studies ; Osteogenesis ; Treatment Outcome ; Spinal Cord Diseases/etiology ; Spinal Cord Diseases/complications ; Ossification of Posterior Longitudinal Ligament/complications ; Ossification of Posterior Longitudinal Ligament/diagnostic imaging ; Risk Factors ; Cervical Vertebrae/diagnostic imaging
Language	English
Publishing date	2023-03-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2023.107668
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Article ; Online: Use of prophylactic perioperative antibiotics for lumbar spinal fusions: A nationwide population-based cohort study.

Ham, Chang Hwa / Kwon, Woo-Keun / Moon, Hong Joo / Kim, Joo Han / Park, Youn-Kwan / Hofstetter, Christoph P

Journal of infection and public health

2023 Volume 16, Issue 3, Page(s) 354–360

Abstract: Background: Perioperative prophylactic antibiotic (PPA) use in spine surgery is known to reduce the rate of surgical site infections. In the past decade, several evidence-based guidelines have been published and surveillance systems to monitor the ... ...

Abstract	Background: Perioperative prophylactic antibiotic (PPA) use in spine surgery is known to reduce the rate of surgical site infections. In the past decade, several evidence-based guidelines have been published and surveillance systems to monitor the proper use of antimicrobials had been adapted by many institutes. Objective: To report the trends of PPA prescription in lumbar fusion surgeries nationwide in the Republic of Korea. Methods: This is a nationwide registry study. Using the population-based data from the Republic of Korea provided by the Korean Health Insurance Review and Assessment Service, data of all lumbar spinal fusion surgeries performed between 2010 and 2018 in adult patients (age ≥19 years) were reviewed. Results: The most frequently used antibiotics were first-generation cephalosporins, which accounted for 38.2 % of total PPA prescriptions and were prescribed in 58.96 % of lumbar fusion surgeries. A gradual increase in prescription trends was observed. The second most frequently used PPAs were second-generation cephalosporins, which showed decrease in use from 2016. The frequency of vancomycin prescriptions gradually increased over the observation period and showed an almost four-fold increase in 2018 compared to 2010. First- and second-generation cephalosporins were prescribed less frequently to patients with renal disease. Conclusion: The pattern of PPA use has changed remarkably over the observation period. Furthermore, specific differences in PPA prescriptions were observed among patients with certain co-morbidities.
MeSH term(s)	Adult ; Humans ; Young Adult ; Spinal Fusion/adverse effects ; Cohort Studies ; Anti-Bacterial Agents/therapeutic use ; Vancomycin ; Cephalosporins/therapeutic use ; Retrospective Studies
Chemical Substances	Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU) ; Cephalosporins
Language	English
Publishing date	2023-01-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2023.01.005
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Article ; Online: Characteristics of Sagittal Spinopelvic Alignment Changes After Symptom Relief After Simple Lumbar Decompression.

Ham, Chang Hwa / Park, Youn-Kwan / Kim, Joo Han / Kwon, Woo-Keun / Kim, Dong Wook / Moon, Hong Joo

Neurosurgery

2022 Volume 91, Issue 2, Page(s) 331–338

Abstract: Background: Sagittal spinopelvic alignment (SSPA) parameters are essential for the diagnosis of adult spinal deformities (ASDs) and their progression. Certain clinical symptoms that occur in patients with lumbar spinal stenosis (LSS) and herniated ... ...

Abstract	Background: Sagittal spinopelvic alignment (SSPA) parameters are essential for the diagnosis of adult spinal deformities (ASDs) and their progression. Certain clinical symptoms that occur in patients with lumbar spinal stenosis (LSS) and herniated nucleus pulposus (HNP) may distort the SSPA and mimic ASD. Objective: To differentiate SSPA in symptomatic patients from asymptomatic patients within 10 minutes in the standing position. Methods: This retrospective cohort study evaluated changes in SSPA after simple lumbar decompression surgery in patients with LSS and HNP. Relative sagittal alignment (RSA), relative pelvic version, relative lumbar lordosis (RLL), Lordosis Distribution Index (LDI), and global alignment and proportion (GAP) values were calculated using the conventional Schwab classification method. First, the preoperative and postoperative SSPA parameters were compared. Second, patients were subgrouped into symptomatic within 10 minutes of standing (SP group) and other symptoms of LSS and HNP as controls. Changes in SSPA parameters after symptom relief after simple lumbar decompression surgery were compared between the two groups. Results: Overall, all SSPA parameters improved after surgery. However, after subgrouping, patients in the control group did not show significant SSPA alterations, except for LDI, whereas patients in the SP group significantly improved in terms of their RSA, RLL, LDI, and GAP values after symptom relief after surgery. Conclusion: Patients with pain on standing within 10 minutes showed significant correction in RSA, RLL, and GAP values after simple lumbar decompression. Therefore, it is important to observe such clinical symptoms to avoid misdiagnosis of ASD.
MeSH term(s)	Adult ; Decompression ; Humans ; Lordosis/diagnostic imaging ; Lordosis/surgery ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery ; Retrospective Studies ; Spinal Stenosis/surgery
Language	English
Publishing date	2022-05-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002013
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Postoperative survival after lumbar instrumented surgery for metastatic spinal tumors: a nationwide population-based cohort analysis.

Lee, Seung Hoon / Kwon, Woo-Keun / Ham, Chang Hwa / Na, Jung Hyun / Kim, Joo Han / Park, Youn-Kwan / Park, Jung Yul / Hur, Junseok W / Moon, Hong Joo

Irish journal of medical science

2023 Volume 193, Issue 1, Page(s) 51–56

Abstract: Background: It is difficult to predict the expected survival after lumbar instrumented surgery for metastases owing to the difference among different cancer origins and the relatively short survival after surgery.: Aims: The aim of this study is to ... ...

Abstract	Background: It is difficult to predict the expected survival after lumbar instrumented surgery for metastases owing to the difference among different cancer origins and the relatively short survival after surgery. Aims: The aim of this study is to analyze the postoperative survival period of lumbar spinal metastasis patients who underwent lumbar instrumented surgery. Methods: Data were collected from the Korean National Health Insurance Review and Assessment Service database. Patients who underwent lumbar spinal surgery with instrumentation between January 2011 and December 2015 for metastatic lumbar diseases were reviewed. The mean postoperative survival period of patients with metastatic lumbar cancer according to each primary cancer type was evaluated. Results: A total of 628 patients were enrolled and categorized according to primary cancer type. The overall median survival rate was 1.11±1.30 years. The three most prevalent primary cancer groups were lung, hepatobiliary, and colorectal cancers, presenting relatively short postoperative survival rates (0.93±1.25, 0.74±0.75 and 0.74±0.88 years, respectively). The best postoperative survival period was observed in breast cancer (2.23±1.83 years), while urinary tract cancer showed the shortest postoperative survival period (0.59±0.69 years). Conclusion: The postoperative survival period of patients with lumbar metastatic spinal tumors according to different primary cancers after instrumented fusion was ˃1 year overall, with differences according to different primary origins. This result may provide information regarding the expected postoperative survival after instrumented surgery for lumbar spinal metastases.
MeSH term(s)	Humans ; Spinal Neoplasms ; Lumbar Vertebrae ; Cohort Studies ; Central Nervous System Neoplasms ; Spinal Fusion ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2023-07-14
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-023-03459-7
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Article: Metallosis: A Complication in the Guided Growing Rod System Used in Treatment of Scoliosis.

Yang, Jae Hyuk / Ham, Chang Hwa / Hwang, Yeok Gu / Suh, Seung Woo

Indian journal of orthopaedics

2017 Volume 51, Issue 6, Page(s) 714–718

Abstract: Soft tissue reaction following metallic debris formation with the use of guided growing rod system has not been previously reported in human. The purpose of this study is to report complications caused by metallosis in a guided growing rod system. A 9- ... ...

Abstract	Soft tissue reaction following metallic debris formation with the use of guided growing rod system has not been previously reported in human. The purpose of this study is to report complications caused by metallosis in a guided growing rod system. A 9-year-old female patient, who underwent treatment for the progressive idiopathic scoliosis (with Cobb's angle of 71°) with the guided growing rod system. Her Cobb's angle was corrected to 13° with the index surgery. During the 5 years postoperative period, she manifested recurrent episodes of skin irritation and progressive worsening of lateral curvature of the spine to an angle of 57°. Furthermore, at her final followup, Risser stage 4 with a gain in height of 26.4 cm was achieved. Considering adequate growth attainment and deterioration in the curvature, revision surgery with fusion was performed. Postoperative Cobb's angle of 23° was achieved with the final correction. During the revisional surgery, signs of implant wear and metallosis were observed at the location of the unconstrained screws. On histological evaluation, chronic inflammation with foreign body granules was seen. However, titanium level in the body was within normal range. She was discharged without any complications. More research on implant wear as a complication in the guided growing rod system is necessary before its widespread use. The occurrence of metallosis with the use of guided growing rod system in growing young children should be considered, when designing the implants.
Language	English
Publishing date	2017-03-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	603194-8
ISSN	0019-5413
ISSN	0019-5413
DOI	10.4103/0019-5413.217692
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Article ; Online: Elucidating the effect of mechanical stretch stress on the mechanism of ligamentum flavum hypertrophy: Development of a novel in vitro multi-torsional stretch loading device.

Kwon, Woo-Keun / Ham, Chang Hwa / Choi, Hyuk / Baek, Seung Min / Lee, Jae Won / Park, Youn-Kwan / Moon, Hong Joo / Park, Woong Bae / Kim, Joo Han

PloS one

2022 Volume 17, Issue 10, Page(s) e0275239

Abstract: Objective: We developed a novel multi-torsional mechanical stretch stress loading device for ligamentum flavum cells and evaluated its influence on the development of ligamentum flavum hypertrophy, a common cause of lumbar spinal canal stenosis.: ... ...

Abstract	Objective: We developed a novel multi-torsional mechanical stretch stress loading device for ligamentum flavum cells and evaluated its influence on the development of ligamentum flavum hypertrophy, a common cause of lumbar spinal canal stenosis. Materials and methods: Stretch strength of the device was optimized by applying 5% and 15% MSS loads for 24, 48, and 72 h. A cytotoxicity assay of human ligamentum flavum cells was performed and the results were compared to control (0% stress). Inflammatory markers (interleukin [IL]-6, IL-8), vascular endothelial growth factor [VEGF], and extracellular matrix (ECM)-regulating cytokines (matrix metalloproteinase [MMP]-1, MMP-3 and MMP-9, and tissue inhibitor of metalloproteinase [TIMP]-1 and TIMP-2) were quantified via enzyme-linked immunosorbent assay. Results: Using our multi-torsional mechanical stretch stress loading device, 5% stress for 24 hour was optimal for ligamentum flavum cells. Under this condition, the IL-6 and IL-8 levels, VEGF level, and MMP-1, MMP-3, and TIMP-2 were significantly increased, compared to the control. Conclusion: Using the novel multi-torsional mechanical stretch stress loading device we confirmed that, mechanical stress enhances the production of inflammatory cytokines and angiogenic factors, and altered the expression of ECM-regulating enzymes, possibly triggering ligamentum flavum hypertrophy.
MeSH term(s)	Humans ; Ligamentum Flavum/metabolism ; Vascular Endothelial Growth Factor A/metabolism ; Tissue Inhibitor of Metalloproteinase-2/metabolism ; Matrix Metalloproteinase 9/metabolism ; Matrix Metalloproteinase 3/metabolism ; Matrix Metalloproteinase 1/metabolism ; Stress, Mechanical ; Interleukin-6/metabolism ; Interleukin-8/metabolism ; Spinal Stenosis/etiology ; Hypertrophy/metabolism ; Tissue Inhibitor of Metalloproteinase-1/metabolism ; Cytokines/metabolism ; Lumbar Vertebrae/metabolism
Chemical Substances	Vascular Endothelial Growth Factor A ; Tissue Inhibitor of Metalloproteinase-2 (127497-59-0) ; Matrix Metalloproteinase 9 (EC 3.4.24.35) ; Matrix Metalloproteinase 3 (EC 3.4.24.17) ; Matrix Metalloproteinase 1 (EC 3.4.24.7) ; Interleukin-6 ; Interleukin-8 ; Tissue Inhibitor of Metalloproteinase-1 ; Cytokines
Language	English
Publishing date	2022-10-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0275239
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