Screw placement accuracy for minimally invasive transforaminal lumbar interbody fusion surgery: a study on 3-d neuronavigation-guided surgery.

Purpose The aim of this study was to assess the impact of 3-D navigation for pedicle screw placement accuracy in minimally invasive transverse lumbar interbody fusion (MIS-TLIF). Methods A retrospective review of 52 patients who had MIS-TLIF assisted with 3D navigation is presented. Clinical outcomes were assessed with the Oswestry Disability Index (ODI), Visual Analog Scales (VAS), and MacNab scores.

Increased mortality in patients with severe traumatic brain injury treated without intracranial pressure monitoring.

Object: Evidence-based guidelines recommend intracranial pressure (ICP) monitoring for patients with severe traumatic brain injury (TBI), but there is limited evidence that monitoring and treating intracranial hypertension reduces mortality. This study uses a large, prospectively collected database to examine the effect on 2-week mortality of ICP reduction therapies administered to patients with severe TBI treated either with or without an ICP monitor.

Methods: From a population of 2134 patients with severe TBI (Glasgow Coma Scale [GCS] Score <9), 1446 patients were treated with ICP-lowering therapies.

Porcine T-helper and regulatory T cells exhibit versatile mRNA expression capabilities for cytokines and co-stimulatory molecules.

T-helper (TH) and regulatory T cells (Tregs) are important modulators of immune responses. Aim of this study was to analyse their expression potential for cytokines and other immune-relevant molecules. Therefore, porcine PBMC, CD4(-) cells, CD4(+)CD25(-) resting, CD4(+)CD25(dim) activated TH cells, and CD4(+)CD25(high) Tregs were analysed on their mRNA expression potential ex vivo or after in vitro stimulation with CD3 and IL-2 by RT-qPCR.

Silicate-substituted calcium phosphate ceramic bone graft replacement for spinal fusion procedures.

Study Design: Retrospective study.

Objective: To assess the clinical and radiographical outcomes in spinal fusion procedures using silicate-substituted calcium phosphate (Si-CaP).

Summary Of Background Data: Si-CaP is a newer-generation synthetic ceramic designed to maximize osteoinduction and osteoconduction.

Pedicle screw navigation: a systematic review and meta-analysis of perforation risk for computer-navigated versus freehand insertion.

Object: In this paper the authors' goal was to compare the accuracy of computer-navigated pedicle screw insertion with nonnavigated techniques in the published literature.

Methods: The authors performed a systematic literature review using the National Center for Biotechnology Information Database (PubMed/MEDLINE) using the Medical Subject Headings (MeSH) terms "Neuronavigation," "Therapy, computer assisted," and "Stereotaxic techniques," and the text word "pedicle." Included in the meta-analysis were randomized control trials or patient cohort series, all of which compared computer-navigated spine surgery (CNSS) and nonassisted pedicle screw insertions.

ACR Appropriateness Criteria(®) myelopathy.

Myelopathy is a problem that requires imaging to distinguish among numerous specifically treatable causes. The first priority is to determine mechanical stability after trauma. Next, it is crucial to distinguish intrinsic disease from extrinsic compression-for example, by epidural abscess.

Worldwide survey on the use of navigation in spine surgery.

Objective: Computer-assisted surgery (CAS) can improve the accuracy of screw placement and decrease radiation exposure, yet this is not widely accepted among spine surgeons. The current viewpoint of spine surgeons on navigation in their everyday practice is an important issue that has not been studied. A survey-based study assessed opinions on CAS to describe the current global attitudes of surgeons on the use of navigation in spine surgery.

Factors contributing to ventriculostomy infection.

Objective: Catheter-related infection remains a cause of morbidity in the use of external ventricular drains (EVDs). The aim of this retrospective single-center study was to assess the rate and factors related to ventriculostomy infections in the setting of the published literature.

Methods: Patients that underwent EVD placement in a single-center were retrospectively reviewed.

Numerical solution of a conspicuous consumption model with constant control delay.

We derive optimal pricing strategies for conspicuous consumption products in periods of recession. To that end, we formulate and investigate a two-stage economic optimal control problem that takes uncertainty of the recession period length and delay effects of the pricing strategy into account.This non-standard optimal control problem is difficult to solve analytically, and solutions depend on the variable model parameters.

Minimally invasive lateral approach for symptomatic thoracic disc herniation: initial multicenter clinical experience.

Object: Symptomatic herniated thoracic discs remain a surgical challenge and historically have been associated with significant complications. While neurological outcomes have improved with the abandonment of decompressive laminectomy, the attempt to minimize surgical complications and associated morbidities continues through less invasive approaches. Many of these techniques, such as thoracoscopy, have not been widely adopted due to technical difficulties.

Metaheuristics for the dynamic stochastic dial-a-ride problem with expected return transports.

The problem of transporting patients or elderly people has been widely studied in literature and is usually modeled as a dial-a-ride problem (DARP). In this paper we analyze the corresponding problem arising in the daily operation of the Austrian Red Cross. This nongovernmental organization is the largest organization performing patient transportation in Austria.

The second African Federation of Neurological Surgeons course in the East, Central, and Southern Africa region held in Dar es Salaam, Tanzania, January 2011.

The second International African Federation of Neurological Surgeons course was organized on January 24 to 28, 2011, at the Seacliff Hotel and Muhimbili Orthopaedic Institute in Dar es Salaam, Tanzania. President Jakaya Mrisho Kikwete graced the official opening with high ranking government officials in attendance. The targeted participants were young neurosurgeons in the East, Central, and South African region.

A systematic review of clinical pathways for lower back pain and introduction of the Saskatchewan Spine Pathway.

Study Design: Systematic review of spine care pathways and case study of the Saskatchewan Spine Pathway (SSP).

Objective: (1) What are the differences between clinical pathways and clinical guidelines? (2) Are there examples of clinical pathways in the management of lower back pain (LBP)? Is there evidence that they are successful? (3) What is the SSP, and what are its key features?

Summary Of Background Data: Adherence to evidence-based guidelines for LBP produces superior outcomes and may improve efficiency by reducing unnecessary imaging, ineffective treatments, and inappropriate surgical referrals. A clinical pathway is an attempt to bridge the "translation gap" between guidelines and clinical practice.

Revision strategies for AxiaLIF.

Object: Paracoccygeal transsacral fixation is a novel percutaneous technique for arthrodesis of L5-S1 and L4-5 (Axial Lumbar Interbody Fusion [AxiaLIF]). There are no reports on feasible revision strategies. The goal of this paper is to analyze the surgical details of failed AxiaLIF constructs and to describe revision strategies.

Lumbar juxtafacet cyst resection: the facet sparing contralateral minimally invasive surgical approach.

Study Design: A retrospective review.

Objective: To report our approach and results using a contralateral minimally invasive spinal surgical muscle splitting approach that allows visualization of the cyst without extensive removal of the adjacent facet joint.

Summary Of Background Data: The use of tubular retractors for spinal surgery can potentially minimize tissue injury.

Transient increase of free iron in rat livers following hemorrhagic-traumatic shock and reperfusion is independent of heme oxygenase 1 upregulation.

Hemorrhagic-traumatic shock (HTS) followed by reperfusion induces heme oxygenase (HO) 1. Free iron (Fe2+) may cause oxidative stress, if not adequately sequestered. We aimed to characterize HO-1-mediated effects on Fe2+ levels in liver and transferrin-bound iron (TFBI) in plasma following HTS, including laparotomy, bleeding, and inadequate and adequate reperfusion.

Tissue-engineered intervertebral discs produce new matrix, maintain disc height, and restore biomechanical function to the rodent spine.

Lower back and neck pain are leading physical conditions for which patients see their doctors in the United States. The organ commonly implicated in this condition is the intervertebral disc (IVD), which frequently herniates, ruptures, or tears, often causing pain and limiting spinal mobility. To date, approaches for replacement of diseased IVD have been confined to purely mechanical devices designed to either eliminate or enable flexibility of the diseased motion segment.

Pulsed pressure perturbations, an extra dimension in NMR spectroscopy of proteins.

The introduction of multidimensional NMR spectroscopy was a breakthrough in biological NMR methodology because it allowed the unequivocal correlation of different spin states of the system. The introduction of large pressure perturbations in the corresponding radio frequency (RF) pulse sequences adds an extra structural dimension into these experiments. We have developed a microprocessor-controlled pressure jump unit that is able to introduce fast, strong pressure changes at any point in the pulse sequences.

Bone and cellular immune system of multiparous sows are insensitive to ovariectomy and nutritive calcium shortage.

Research in osteoporosis, which is a complex systemic disease, demands suitable large animal models. In pigs, most research has been done in growing minipigs, which probably are not ideal models for postmenopausal osteoporosis. Therefore, our aim was to analyze the effects of ovariectomy (OVX) and nutritive calcium shortage on multiparous Large White sows.

Exploratory reference intervals on hematology and cellular immune system of multiparous Large White sows.

There is significant lack of basic hematologic and immunological data in adult sows. Therefore, aim of this study was to provide respective reference intervals. 32 clinically healthy multiparous Large White sows aged 33.

Image-based tissue engineering of a total intervertebral disc implant for restoration of function to the rat lumbar spine.

Nonbiological total disc replacement is currently being used for the treatment of intervertebral disc (IVD) disease and injury, but these implants are prone to mechanical wear, tear and possible dislodgement. Recently, tissue-engineered total disc replacement (TE-TDR) has been investigated as a possible alternative to more fully replicate the native IVD properties. However, the performance of TE-TDRs has not been studied in the native disc space.

Biological intervertebral disc replacement: an in vivo model and comparison of two surgical techniques to approach the rat caudal disc.

Study Design: Prospective randomized animal study.

Objective: To determine a surgical technique for reproducible and functional intervertebral disc replacement in an orthotopic animal model.

Methods: The caudal 3/4 intervertebral disc (IVD) of the rat tail was approached by two surgical techniques: blunt dissection, stripping and retracting (Technique 1) or incising and repairing (Technique 2) the dorsal longitudinal tendons.

Posterior approach for thoracolumbar corpectomies with expandable cage placement and circumferential arthrodesis: a multicenter case series of 67 patients.

Object: The purpose of this multicenter trial was to investigate the outcome and durability of a single-stage thoracolumbar corpectomy using expandable cages via a posterior approach.

Methods: The authors conducted a retrospective chart review of 67 consecutive patients who underwent single-stage thoracolumbar corpectomies with circumferential reconstruction for pathological, traumatic, and osteomyelitic pathologies. Circumferential reconstruction was accomplished using expandable cages along with posterior instrumentation and fusion.

[emim][etSO4] as the polar phase in low-temperature-stable microemulsions.

We demonstrate here that microemulsions with an IL as the continuous phase can be formed so that they are stable over a wide temperature range and have intermediary properties between flexible and stiff microemulsions. Three components (1-ethyl-3-methylimidazolium ethylsulfate ([emim][etSO(4)]), limonene, and octylphenol ethoxylate (Triton X 100, abbreviated as TX-100)) were used. This ternary system has been characterized from ambient temperature down to -10 °C by means of conductivity, viscosity, and small-angle X-ray scattering (SAXS) measurements.