Comparison of adjacent segment degeneration in patients using cervical cage and disc prosthesis in anterior cervical surgery

Aim: To examine the prevalence of adjacent segment degeneration associated with the use of cages and disc prostheses in patients who underwent cervical disc surgery via an anterior cervical approach. Methods: We retrospectively reviewed the medical records of 60 patients who underwent cervical disc surgery via an anterior cervical approach at our clinic between 2018 and 2023. The patients were divided into two groups based on the type of implant used: those with a cervical cage (Group 1) and those with a cervical disc prosthesis (Group 2). Patients' demographic and clinical details, including age, gender, smoking habits, follow-up durations, and any additional comorbid diseases, were recorded. Radiological evaluations focused on degeneration rates in the segments adjacent to where either the cage or disc prosthesis was implanted. Results: In the study comparing two groups, participants' average ages were 48.9 in Group 1 and 48.1 in Group 2 (p=0.720). Group 1 had a higher proportion of smokers (p=0.052) and more discopathy (p=0.196). In terms of disc degenerations, variations existed but were not statistically significant (p=0.259). Utilizing the Pfirrmann grading, Group 1 had more Grade III degeneration (p=0.088) and a significantly higher presence of ossification or osteophytes (p=0.038). Both groups showed high rates of adjacent segment degeneration, yet Group 1 had notably more proximal degeneration (p=0.012). Stenosis and facet hypertrophy differences were not significant (p=0.417, p=0.071). Follow-up duration averaged around 38 months for both groups (p=0.929). Conclusions: No substantial difference in the overall incidence of adjacent segment degeneration between the two procedures. Nevertheless, further large-scale and long-term studies are essential to draw comprehensive conclusions regarding the optimal surgical intervention for cervical disc ailments

Cysteinyl-leukotriene receptor antagonist montelukast decreases blood-brain barrier permeability but does not prevent oedema formation in traumatic brain injury

Introduction: Traumatic brain injury is highly associated with the over-production of reactive oxygen species. The aim of this study was to investigate the putative neuroprotective effect of montelukast, a cysteinyl-leukotriene receptor antagonist, in a rat model of traumatic brain injury (TBI). Methods: Sprague Dawley rats were subjected to TBI with a weight-drop device using 300 g-1 m weight-height impact. The groups were: control (saline), montelukast (10 mg kg -1 per day, ip), trauma and trauma + montelukast. Two days post-trauma, neurological examination scores were measured and animals were decapitated and the brain tissues were taken for the histologic and biochemical [malondialdehyde (MDA)an index for lipid peroxidation, reduced glutathione (GSH), myeloperoxidase (MPO)an index for neutrophil infiltration and Na +/K +-ATPase activity] evaluations. Brain oedema and blood-brain barrier (BBB) permeability were also evaluated. Results: The neurological examination scores mildly increased in trauma groups at 48 hours. Although the scores were decreased in the montelukast treated group, they were still significantly higher than the control. The trauma caused a significant increase in brain water content and Evans blue (EB) extravasation. Montelukast treatment reduced BBB permeability. It also decreased lipid peroxidation and MPO activity. Conclusion: The present study suggests that montelukast may have beneficial effects against TBI-induced oxidative stress of the brain

Effect of COX-2 inhibitor meloxicam against traumatic brain injury-induced biochemical, histopathological changes and blood-brain barrier permeability

Objective: The overproduction of reactive oxygen species and resultant damage to cellular proteins or lipids of cell membranes and DNA by free radicals are the underlying mechanisms of many neuropathologies. Cyclooxygenase-2 (COX-2) inhibitors have been suggested to be neuroprotective by reducing prostanoid and free radical synthesis, or by directing arachidonic acid metabolism through alternate pathways. This study investigated the putative neuroprotective effect of the COX-2 inhibitor, meloxicam, in a rat model of diffuse brain injury