Qualitative changes in the extracellular matrix have been reported in thickened ligamentum flavum (LF) in lumbar spinal canal stenosis (LSCS); however, no detailed quantitative reports are available to date. Degenerated and undegenerated LF were collected from patients who underwent decompression surgery for LSCS and lumbar disc herniation, respectively. Three cylindrical samples of 2.5 mm diameter were cut from one LF specimen, completely solubilized, and quantified glycosaminoglycan (GAG), collagen (COL), and elastin. The amounts of GAG, COL, and elastin in the LSCS group were significantly higher than those in the control group. Although the GAG was originally present only in trace amounts, GAG proportion, standardized by dry weight, was the highest increase rate. Besides component analysis, histologic analysis showed intraligamentous chondrometaplasia in the caudal portion of the degenerated LF. Increased GAG in LF may be a new therapeutic target in LSCS.

Qualitative and quantitative changes in collagens are linked to various diseases. Monitoring of collagens may provide new insights into the assessment and diagnosis of collagen-related diseases. In this study, we established a method that enables simultaneous quantification of the α chains of types I, III, and V collagens, namely COL1A1, COL3A1, and COL5A1, in a culture medium of LX-2 human hepatic stellate cells using nano-liquid chromatography tandem mass spectrometry (nano-LC/MS/MS). Specifically, simultaneous quantification of multiple collagen α chains could be accomplished by using their specific target peptides. Compared with conventional enzyme-linked immunosorbent assay (ELISA), this method is more sensitive and efficient for simultaneous quantification of various collagens. These data suggested that our newly developed quantification method is valuable and could be used for the diagnosis of collagen-related diseases.

Background: The aim of this randomized controlled study was to compare the effects of ultrasound-guided erector spinal block (ESPB) with those of opioid-based analgesia. Methods: This prospective, randomized, open, blinded-endpoint study evaluated the analgesic effects of ESPB in patients undergoing lumbar surgery. The outcome measures were remifentanil and propofol consumption during operation, fentanyl consumption during 24 hours after anesthesia induction. Results: Data from fifteen patients were analyzed with seven and eight patients in the control and ESPB groups, respectively. There was difference between the groups in remifentanil consumption (median μg/kg lean body mass) 44.1 [37.1, 49.3] and 22.4 [17.3, 26.1]; p = 0.002 in control and ESPB groups during operation. There was no difference between the groups regarding other outcomes including fentanyl consumption for postoperative analgesia. Conclusions: ESPB reduced remifentanil consumption during operation, but did not reduce fentanyl consumption for postoperative analgesia within 24 hours after anesthesia induction in lumbar spine surgery.

Femoral valgus osteotomy (FVO) is used as a surgery for advanced and terminal hip osteoarthritis (OA). The purpose of this study was to clarify the effect of FVO on preventing the progression of OA. The subjects were 10 patients (43.6 ± 4.6 years) who received FVO. The survey items were hip function (JOA score) and the number of patients who underwent total hip arthroplasty (THA). The causative diseases were developmental dysplasia of the hip in 7 patients, epiphyseal dysplasia 2, and pseudoarthrosis after femoral neck fracture 1. The JOA score improved from 45.4 ± 6.7 points to 60.8 ± 27.2 points at the final survey (p = 0.091). The follow-up period was 133.5 ± 32.9 months, and three joints were converted to THA (131 ± 21.7 months after osteotomy). The preoperative stages of the patients who underwent THA were advanced stages. FVO for early and advanced hip OA under the age of 50 allowed relief of symptoms and joint preservation for more than 10 years.