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Journal of Orthopaedic Surgery and... Jan 2024The advantages of anterior cervical decompression and fusion (ACDF) were well published, while research on postoperative results in different subtypes of cervical disk...
Comparison of clinical outcomes between sequestered cervical disk herniation and non-sequestered cervical disk herniation after anterior cervical decompression and fusion: a cohort study.
BACKGROUND
The advantages of anterior cervical decompression and fusion (ACDF) were well published, while research on postoperative results in different subtypes of cervical disk herniation (CDH) still remains blank. This study aimed to explore the surgical outcome between sequestration and other types in CDH.
METHODS
This retrospective cohort study enrolled 108 patients treated with ACDF in our hospital. The participants were divided into two groups according to the existence of a sequestered disk. The Visual analog scale score, the Japanese Orthopedics Association (JOA) score and the Neck disability index score were used to evaluate postoperative outcome.
RESULTS
Significant improvements were observed in both groups at every viewpoint (P < 0.001). The mean JOA was 15.04 ± 1.26 in the sequestered disk group and 14.45 ± 1.43 in the non-sequestered disk group two months after the operation (P = 0.026 < 0.05). The improvement in JOA at two months after ACDF showed a significant difference: 46.58% ± 39.17% in the sequestered disk group and 33.39% ± 28.82% in the non-sequestered disk group (P = 0.047 < 0.05). Thirty-two patients in the sequestered disk group (64%) and 19 patients in the non-sequestered disk group (32.76%) presented with high signal intensity of the spinal cord on preoperative cervical T2-weighted MRI (P < 0.001).
CONCLUSIONS
Patients with sequestered cervical disks seemed to have a higher degree of symptom improvement two months after ACDF. CDH with a sequestered disk appears to be more likely to cause high signal intensity changes in the compressed cervical spine on T2-weighted MRI. We prefer early positive surgery in patients with sequestered cervical disks from the clinical point of view.
Topics: Humans; Cohort Studies; Intervertebral Disc Displacement; Retrospective Studies; Orthopedics; Decompression
PubMed: 38183107
DOI: 10.1186/s13018-023-04515-9 -
Journal of Orthopaedic Case Reports Sep 2022While the body of research investigating anterior cervical disk fusion (ACDF) for symptomatic cervical disk herniations in high-level athletes is large, evidence for...
INTRODUCTION
While the body of research investigating anterior cervical disk fusion (ACDF) for symptomatic cervical disk herniations in high-level athletes is large, evidence for cervical disk replacement (CDR) is sparse. The amount of patients able to return to sport after an ACDF is estimated to be 73.5%, causing surgeons to search for alternatives with better outcomes in this population. This case report describes the successful treatment of a symptomatic collegiate American football player with C6-C7 disk herniation and C5-C6 central canal stenosis.
CASE REPORT
This is a 21-year-old American football safety who underwent a C5-6 and C6-7 cervical disk arthroplasty. Three weeks postoperatively, the patient demonstrated nearly complete resolution of weakness, full resolution of radiculopathy, and normal cervical range of motion in all planes.
CONCLUSION
The CDR may be considered as an alternative to the ACDF in the treatment of high-level contact athletes. Compared to the ACDF, CDR has been shown in prior studies to decrease the long-term risk of adjacent segment degeneration. Future studies comparing ACDF to CDR in the high-level contact sport athlete population are needed. CDR appears to be a promising surgical intervention for symptomatic patients in this population.
PubMed: 36873322
DOI: 10.13107/jocr.2022.v12.i09.3008 -
Biomicrofluidics May 2022Nowadays, centrifugal microfluidic platforms are finding wider acceptance for implementing point-of-care assays due to the simplicity of the controls, the versatility of...
Nowadays, centrifugal microfluidic platforms are finding wider acceptance for implementing point-of-care assays due to the simplicity of the controls, the versatility of the fluidic operations, and the ability to create a self-enclosed system, thus minimizing the risk of contamination for either the sample or surroundings. Despite these advantages, one of the inherent weaknesses of CD microfluidics is that all the sequential fluidic chambers and channels must be positioned radially since the centrifugal force acts from the center of the disk outward. Implementation of schemes where the liquid can be rerouted from the disk periphery to the disk center would significantly increase the utility of CD platforms and increase the rational utilization of the real estate on the disk. The present study outlines a novel utilization of elastic membranes covering fluidic chambers to implement inward pumping whereby the fluid is returned from the disk periphery to the center of the disk. When the disk revolves at an angular velocity of 3600 rpm, liquid enters the chamber covered by the elastic membrane. This membrane is deflected upward by liquid, storing energy like a compressed spring. When the angular velocity of the disk is reduced to 180 rpm and thus the centrifugal force is diminished, the elastic membrane pushes the liquid from the chamber inward, closer to the center of the disk. There are two channels leading from the elastic membrane-covered reservoir-one channel has a higher fluidic resistance and the other (wider) has a lower fluidic resistance. The geometry of these two channels determines the fluidic path inward (toward the center of the disk). Most of the liquid travels through the recirculating channel with lower resistance. We demonstrated an inward pumping efficiency in the range of 78%-89%. Elastic membrane-driven inward pumping was demonstrated for the application of enhanced fluid mixing. Additionally, to demonstrate the utility of the proposed pumping mechanism for multi-step assays on the disk, we implemented and tested a disk design that combines plasma separation and inward pumping.
PubMed: 35607410
DOI: 10.1063/5.0089112 -
Asian Spine Journal Feb 2022Symptomatic disk degeneration is characterized by early pathological changes in the morphological, biochemical, and biomechanical properties of the intervertebral disc...
Preventive and Restorative Responses of Broccoli Sprouts on Biomechanical Structures, Histomorphometric, and Gene Expression Levels of Degenerated Intervertebral Disc in Rabbit Model.
STUDY DESIGN
Symptomatic disk degeneration is characterized by early pathological changes in the morphological, biochemical, and biomechanical properties of the intervertebral disc (IVD). Several methods that can be used to resolve this condition are being researched.
PURPOSE
The present study was designed to examine the preventive and restorative properties of broccoli sprouts extracts in an annular puncture rabbit model of IVD degeneration.
OVERVIEW OF LITERATURE
IVD degeneration is closely associated with low back pain. A degenerated IVD is cytoarchitecturally characterized by a reduction in cell number, morphological changes in the disk tissue, and changes in the extracellular matrix contents. Methods, such as imaging and biochemical characterization, have been used for distinguishing between degenerated disk and non-degenerated disk.
METHODS
Twenty New Zealand white rabbits (weighing approximately 2.0-3.5 kg) were divided into four groups (n=5). Group 1 received 50 mg/kg of normal saline solution orally for 4 weeks; group 2 received 50 mg/kg of normal saline solution immediately after puncture for 4 weeks; group 3 received 300 mg/kg of aqueous extract of broccoli sprouts orally immediately after puncture for 4 weeks; and group 4 received 300 mg/kg of aqueous extract of broccoli sprouts after 4 weeks of puncture for another 4 weeks. After the experiment, the disk height index (DHI), histomorphometry, and gene expression level were measured and analyzed.
RESULTS
The photomicrograph showed that the histological features of the punctured-treated groups (groups 3 and 4) were more similar to those of the non-punctured group than those of the punctured non-treated group. There was a significant difference in the DHI and relative gene expression levels among the non-treated punctured groups compared with those of the non-punctured and punctured-treated groups, respectively.
CONCLUSIONS
This study shows that the aqueous extract of broccoli sprouts exerts preventive and restorative effects in a rabbit model with disk degeneration.
PubMed: 33934586
DOI: 10.31616/asj.2020.0479 -
Journal of Clinical Microbiology Oct 2017Disk diffusion and MIC quality control (QC) ranges were determined for nafithromycin, a new lactone-ketolide, following the completion of a nine-laboratory, Clinical and...
Disk diffusion and MIC quality control (QC) ranges were determined for nafithromycin, a new lactone-ketolide, following the completion of a nine-laboratory, Clinical and Laboratory Standards Institute (CLSI) document M23-defined tier 2 study. Five QC strains consistent with the spectrum of activity of nafithromycin were tested: ATCC 25923 (disk only), ATCC 29213 (broth only), ATCC 29212 (broth only), ATCC 49619 (disk and broth), and ATCC 49247 (disk and broth). Nafithromycin disk diffusion QC ranges were determined to be 25 to 31 mm for ATCC 25923, 25 to 31 mm for ATCC 49619, and 16 to 20 mm for ATCC 49247. Nafithromycin MIC QC ranges were determined to be 0.06 to 0.25 μg/ml for ATCC 29213, 0.016 to 0.12 μg/ml for ATCC 29212, 0.008 to 0.03 μg/ml for ATCC 49619, and 2 to 8 μg/ml for ATCC 49247. All disk diffusion and MIC QC ranges established in this study were approved by the CLSI Subcommittee on Antimicrobial Susceptibility Testing at their June 2015 meeting and were initially reported in the 2017 M100S document. The QC ranges established in this study should be used for determining the activity of nafithromycin in phase 2 and phase 3 human clinical trials and subsequently for testing patient isolates and isolates in phase 4 surveillance studies.
Topics: Anti-Bacterial Agents; Disk Diffusion Antimicrobial Tests; Enterococcus faecalis; Haemophilus influenzae; Humans; Ketolides; Lactones; Staphylococcus aureus; Streptococcus pneumoniae
PubMed: 28747372
DOI: 10.1128/JCM.00972-17 -
AJNR. American Journal of Neuroradiology Mar 2015Intervertebral disk biochemical composition could be accessed in vivo by T1ρ and T2 relaxometry. We found no studies in the literature comparing different segmentation... (Comparative Study)
Comparative Study
BACKGROUND AND PURPOSE
Intervertebral disk biochemical composition could be accessed in vivo by T1ρ and T2 relaxometry. We found no studies in the literature comparing different segmentation methods for data extraction using these techniques. Our aim was to compare different manual segmentation methods used to extract T1ρ and T2 relaxation times of intervertebral disks from MR imaging. Seven different methods of partial-disk segmentation techniques were compared with whole-disk segmentation as the reference standard.
MATERIALS AND METHODS
Sagittal T1ρ and T2 maps were generated by using a 1.5T MR imaging scanner in 57 asymptomatic volunteers 20-40 years of age. Two hundred eighty-five lumbar disks were separated into 2 groups: nondegenerated disk (Pfirrmann I and II) and degenerated disk (Pfirrmann III and IV). In whole-disk segmentation, the disk was segmented in its entirety on all sections. Partial-disk segmentation methods included segmentation of the disk into 6, 5, 4, 3, and 1 sagittal sections. Circular ROIs positioned in the nucleus pulposus and annulus fibrosus were also used to extract T1ρ and T2, and data were compared with whole-disk segmentation
RESULTS
In the nondegenerated group, segmentation of ≥5 sagittal sections showed no statistical difference with whole-disk segmentation. All the remaining partial-disk segmentation methods and circular ROIs showed different results from whole-disk segmentation (P < .001). In the degenerated disk group, all methods were statistically similar to whole-disk segmentation. All partial-segmentation methods, including circular ROIs, showed strong linear correlation with whole-disk segmentation in both the degenerated and nondegenerated disk groups.
CONCLUSIONS
Manual segmentation showed strong reproducibility for T1ρ and T2 and strong linear correlation between partial- and whole-disk segmentation. Absolute T1ρ and T2 values extracted from different segmentation techniques were statistically different in disks with Pfirrmann grades I and II.
Topics: Adult; Female; Humans; Intervertebral Disc; Intervertebral Disc Degeneration; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Reproducibility of Results; Young Adult
PubMed: 25324494
DOI: 10.3174/ajnr.A4125 -
Nature Communications 2013Researchers strive to produce nanoparticles with complexity in composition and structure. Although traditional spherical, cylindrical and membranous, or planar,...
Researchers strive to produce nanoparticles with complexity in composition and structure. Although traditional spherical, cylindrical and membranous, or planar, nanostructures are ubiquitous, scientists seek more complicated geometries for potential functionality. Here we report the simple solution construction of multigeometry nanoparticles, disk-sphere and disk-cylinder, through a straightforward, molecular-level, blending strategy with binary mixtures of block copolymers. The multigeometry nanoparticles contain disk geometry in the core with either spherical patches along the disk periphery in the case of disk-sphere particles or cylindrical edges and handles in the case of the disk-cylinder particles. The portions of different geometry in the same nanoparticles contain different core block chemistry, thus also defining multicompartments in the nanoparticles. Although the block copolymers chosen for the blends are important for the definition of the final hybrid particles, the control of the kinetic pathway of assembly is critical for successful multigeometry particle construction.
PubMed: 23921650
DOI: 10.1038/ncomms3297 -
Current Opinion in Neurology Feb 2021Optic nerve head elevation can be associated with vision loss. This review provides an update regarding key features of optic disc drusen (ODD) compared with papilledema... (Review)
Review
PURPOSE OF REVIEW
Optic nerve head elevation can be associated with vision loss. This review provides an update regarding key features of optic disc drusen (ODD) compared with papilledema from increased intracranial pressure and optic disc edema from other causes.
RECENT FINDINGS
Clinical history and funduscopic examination are not sufficient to correctly diagnose different causes of optic nerve head elevation. Multimodal ophthalmic imaging is noninvasive and should be used as first-line diagnostic testing to distinguish optic disc edema or papilledema from pseudoedema. Advanced ophthalmic imaging, including enhanced depth imaging optical coherence tomography (EDI-OCT) and autofluorescence imaging, can visualize ODD at high resolution and determine whether there is optic disc edema. OCT angiography does not require contrast and can rapidly visualize papillary, peripapillary, and macular microvasculature and identify important vascular biomarker of ischemia and, potentially, visual prognosis.
SUMMARY
Multimodal ophthalmic imaging can help in the diagnosis of ODD and optic disc edema and identify patients at high risk of vision loss and neurological issues in order to ensure appropriate diagnosis and treatment.
Topics: Blindness; Diagnostic Techniques, Ophthalmological; Humans; Intracranial Hypertension; Multimodal Imaging; Ophthalmoscopy; Optic Disk; Optic Disk Drusen; Papilledema; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 33278141
DOI: 10.1097/WCO.0000000000000881 -
Ultrasound (Leeds, England) Feb 2017Although ultrasound systems generally archive to Picture Archiving and Communication Systems (PACS), their archiving workflow typically involves storage to an internal...
BACKGROUND
Although ultrasound systems generally archive to Picture Archiving and Communication Systems (PACS), their archiving workflow typically involves storage to an internal hard disk before data are transferred onwards. Deleting records from the local system will delete entries in the database and from the file allocation table or equivalent but, as with a PC, files can be recovered. Great care is taken with disposal of media from a healthcare organisation to prevent data breaches, but ultrasound systems are routinely returned to lease companies, sold on or donated to third parties without such controls.
METHODS
In this project, five methods of hard disk erasure were tested on nine ultrasound systems being decommissioned: the system's own delete function; full reinstallation of system software; the manufacturer's own disk wiping service; open source disk wiping software for full and just blank space erasure. Attempts were then made to recover data using open source recovery tools.
RESULTS
All methods deleted patient data as viewable from the ultrasound system and from browsing the disk from a PC. However, patient identifiable data (PID) could be recovered following the system's own deletion and the reinstallation methods. No PID could be recovered after using the manufacturer's wiping service or the open source wiping software.
CONCLUSION
The typical method of reinstalling an ultrasound system's software may not prevent PID from being recovered. When transferring ownership, care should be taken that an ultrasound system's hard disk has been wiped to a sufficient level, particularly if the scanner is to be returned with approved parts and in a fully working state.
PubMed: 28228821
DOI: 10.1177/1742271X16688043 -
Advanced Biomedical Research 2014After single disk herniation operation, about 5-20% recurrences may occur. Different etiology may affect the prevalence of recurrence. Disk degeneration according to...
BACKGROUND
After single disk herniation operation, about 5-20% recurrences may occur. Different etiology may affect the prevalence of recurrence. Disk degeneration according to Modic and Los Angles scales could affect recurrence rate. This study wants to show the relationship between disk space degeneration according to these scales on severity, time, and prevalence of disk herniation recurrence.
MATERIALS AND METHODS
Thirty-four patients presented with radicular pain (with or without back pain) and history of lumbar disk surgery was included in this prospective study. Pre- and postoperative T2-weighted sagittal magnetic resonance imaging (MRI) compared for Modic and Los Angeles disk degeneration grading, then, data analysis on SPSS (version 20) software, paired t-test, and others.
RESULTS
The result of study shows for first operation that grade (II) Los Angeles is the most common, but, for second procedure grade (IV) was less common and the mostly decreased (from 14.7 to 9.2%). In addition, Wilcoxon test shows no change of Los Angeles grading for both first and second surgery (P = 0.06). Whereas; based on Modic criteria grading was different from first operation, in other words, grade (I) (41.2%) in first operation was changed to 20.6% in second operation (P = 0.007).
CONCLUSION
Our study showed that the Los Angeles criterion is more practical and useful for prediction of recurrence and in the patients with Los Angles grade III and IV and grade II and III on Modic scale, the chance of recurrence is less than patients with lower grades.
PubMed: 25538906
DOI: 10.4103/2277-9175.145125