Measurements of low oxygen tension in vitro and response of macrophages to levels applicable to peri- and postoperative treatment of traumatic brain injury

Established clinical guidelines for treatment of severe traumatic brain injury aim at maintaining intracranial and cerebral perfusion pressures. Recently, it has been shown that additional regulation of cerebral oxygen delivery helps to decrease patient mortality and leads to improved 6-month quality-of-life scores. However, eubaric oxygen-guided therapy is still controversial since it is well known that hyperoxia can cause unwanted secondary brain injury. Research studies are warranted to better understand the range of oxygen pressures that positively influence brain cell behavior. We perform such studies using a two-enzyme in vitro system that allows exposing tissue culture cells to various steady-state, or rapidly changing, oxygen pressures. Here, we present a mathematical model of the system and its validation by real-time monitoring of oxygen tensions. We additionally present preliminary evidence that human brain macrophages have a different oxygen tolerance compared to systemic macrophages and propose improvements to our in vitro system to make it applicable for data collection that aim at refining oxygen-guided therapy for patients with traumatic brain injury

Hybrid decompression technique and two-level corpectomy are effective treatments for three-level cervical spondylotic myelopathy

The optimal surgical strategy for multilevel cervical spondylotic myelopathy (CSM) has not been defined, and few comparative researches between hybrid decompression and multilevel corpectomy have been conducted. Here, we reported 28 patients of three-level CSM, of whom 12 underwent hybrid decompression and 16 two-level corpectomy, with each type of procedure chosen according to radiologic characteristics of those patients. Clinical and radiologic parameters of both groups showed various degrees of improvement. However, no statistically significant differences in Japanese Orthopedic Association (JOA) score improvement rate, graft fusion rate, post-operative neck disability index (NDI) or segmental lordosis between the two groups were found. We conclude that both hybrid decompression and two-level corpectomy could obtain satisfying clinical efficacy in the management of three-level CSM for appropriate patients