Spatial Resolution for X-ray Excited Luminescence Chemical Imaging (XELCI).

Measuring chemical concentrations at the surface of implanted medical devices is important for elucidating the local biochemical environment, especially during implant infection. Although chemical indicator dyes enable chemical measurements in vitro, they are usually ineffective when measuring through tissue because the background obscures the dye signal and scattering dramatically reduces the spatial resolution. X-ray excited luminescent chemical imaging (XELCI) is a recent imaging modality which overcomes these limitations using a focused X-ray beam to excite a small spot of red light on scintillator-coated medical implants with well-defined location (because X-rays are minimally scattered) and low background.

A Rare Case of Acquired Factor VIII Inhibition in an Elderly Female.

Acquired hemophilia A is a rare condition characterized by the development of autoantibodies against coagulation factor VIII. It often initially presents as serious bleeding in the absence of risk factors and carries high morbidity and mortality if not diagnosed early. Due to its rare nature, data is limited, and guidelines are primarily based on expert opinion.

LITE-1 mediates behavioral responses to X-rays in .

Rapid sensory detection of X-ray stimulation has been documented across a wide variety of species, but few studies have explored the underlying molecular mechanisms. Here we report the discovery of an acute behavioral avoidance response in wild type to X-ray stimulation. The endogenous UV-photoreceptor protein LITE-1 was found to mediate the locomotory avoidance response.

Do Inflammatory Cytokines Affect Patient Outcomes After ACDF?

Study Design: Prospective cohort study.

Objective: The aim was to determine the relationship between serum inflammatory mediators, preoperative cervical spine disease severity, and clinical outcomes after anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: Given the role of the inflammatory cascade in spinal degenerative disease, it has been hypothesized that inflammatory markers may serve as a predictor of patient outcomes after surgery.

Prevalence of Fabry Disease in Patients With Cryptogenic Strokes: A Systematic Review.

Fabry disease (FD) is an X-linked disorder involving multiple organs. Stroke is a serious and frequent complication of FD. Cryptogenic stroke is a common presentation of FD, especially in the young population.

Measuring Orthopedic Plate Strain to Track Bone Healing Using a Fluidic Sensor Read via Plain Radiography.

Objective: We describe a fluidic X-ray visualized strain indicator under applied load (X-VISUAL) to quantify orthopedic plate strain and inform rehabilitative care.

Methods: The sensor comprises a polymeric device with a fluidic reservoir filled with a radio-dense fluid (cesium acetate) and an adjoining capillary wherein the liquid level is measured. A stainless-steel lever attaches to the plate and presses upon the acrylic bulb with a displacement proportional to plate bending strain.

Calcium-Alkali Syndrome: Historical Review, Pathophysiology and Post-Modern Update.

Milk-alkali syndrome or calcium-alkali syndrome (CAS) is the triad of hypercalcemia, metabolic alkalosis and renal impairment. It is often related to ingestion of high amounts of calcium carbonate, which was used historically for the treatment of peptic ulcer disease. The incidence of the syndrome decreased dramatically after the introduction of newer peptic ulcer medications such as proton pump inhibitors and histamine blocking agents.

Management of West Nile Encephalitis: An Uncommon Complication of West Nile Virus.

West Nile virus disease (WNVD) is a mosquito-borne disease that affects the meninges and central nervous system, causing West Nile virus (WNV) encephalitis, a debilitating, life-threatening condition, especially in the elderly. While there is a lot of research discussing different aspects of the disease, the treatment is mainly unknown. We conducted a literature review to explore the wide variety of treatment options that consolidate the knowledge about the most recent management of WNV encephalitis.

Babesiosis: Appreciating the Pathophysiology and Diverse Sequela of the Infection.

Babesiosis is a blood-borne disease found mainly in the United States caused by a parasitic piroplasm. While most infections are mild to moderate in immunocompetent hosts, life-threatening complications can occur in those with significant comorbidities like congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD). There is sparse literature discussing the complications of infection or the pathophysiology and management thereof.

Luminescent Spectral Rulers for Noninvasive Displacement Measurement through Tissue.

A luminescent spectral ruler was developed to measure micrometer to millimeter displacements through tissue. The spectral ruler has two components: a luminescent encoder patterned with alternating stripes of two spectrally distinct luminescent materials and an analyzer mask with periodic transparent windows the same width as the encoder stripes. The analyzer mask is placed over the encoder and held so that only one type of luminescent stripe is visible through the window; sliding the analyzer over the encoder modulates the luminescence spectrum acquired through the analyzer windows, enabling detection of small displacements without imaging.

Risk Factors for Pseudarthrosis After Surgical Site Infection of the Spine.

Background: Pseudarthrosis following spinal fusion is a complication that frequently requires revision surgery. Reported rates of pseudarthrosis after surgical site infection (SSI) range from 30% to 85%, but few studies have identified infection as an independent risk factor for its development. The purpose of this study was to determine the incidence of clinically symptomatic pseudarthrosis in patient who developed SSI following lumbar fusion and to identify factors associated with its development.

An implanted pH sensor read using radiography.

A biomedical sensor was developed to measure local pH near orthopedic implants to detect and study implant-associated infection. The sensor is read using plain radiography, a technique which is noninvasive, inexpensive, ubiquitously available in medical facilities, and routinely used in diagnosis and follow-up. The sensor comprises a radiopaque tungsten indicator pin embedded within a chemically responsive hydrogel that exhibits a pH-dependent swelling.

Comparison of Surgical Outcomes of the Posterior and Combined Approaches for Repair of Cervical Fractures in Ankylosing Spondylitis.

Study Design: Retrospective cohort study.

Purpose: To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C).

Overview Of Literature: Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures.

Delayed Bone Infarct in the Ilium Following a Pelvic Crush Injury and Embolization: A Case Report.

Case: We present a case of delayed osteonecrosis of the ilium. After receiving embolization and multiple orthopaedic procedures following a complex pelvic crush injury, the patient subsequently developed posterior pelvic pain and tenderness over the posterior superior iliac spine, along with pain on sacroiliac joint compression. Magnetic resonance imaging of the pelvis demonstrated a bone infarction in the left ilium adjacent to the sacroiliac joint.

Cervical Sagittal Range of Motion as a Predictor of Symptom Severity in Cervical Spondylotic Myelopathy.

Study Design: A retrospective review of radiographic data and functional outcomes.

Objective: The aim of this study was to evaluate whether myelopathy symptom severity upon presentation corresponds to sagittal plane alignment or nonmyelopathy symptoms, such as pain, in patients with cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Cervical sagittal balance is an important parameter in the outcome of surgical reconstruction.

Outcome of a Resident Spine Surgical Skills Training Program.

Study Design: Cadaver training lab.

Objective: To determine if a technical cadaver skills training lab for spinal surgery increases resident confidence, satisfaction in training, and perception of operating room safety.

Summary Of Background Data: Resident training is an important topic in the setting of work hour reform.

Reliability and Clinical Utility of the CARDS Classification for Degenerative Spondylolisthesis.

Study Design: Retrospective cohort study.

Objective: The objective of this study is to determine the reliability and clinical utility of the of the proposed CARDS classification for degenerative spondylolisthesis.

Background: The Clinical and Radiographic Degenerative Spondylolisthesis (CARDS) classification system was recently proposed as an alternative to the Meyerding system for classifying degenerative spondylolisthesis (DS).

Implantable strain sensor to monitor fracture healing with standard radiography.

Current orthopaedic clinical methods do not provide an objective measure of fracture healing or weight bearing for lower extremity fractures. The following report describes a novel approach involving in-situ strain sensors to objectively measure fracture healing. The sensor uses a cantilevered indicator pin that responds to plate bending and an internal scale to demonstrate changes in the pin position on plain film radiographs.

Bone substitutes and expanders in Spine Surgery: A review of their fusion efficacies.

Study Design: A narrative review of literature.

Objective: This manuscript intends to provide a review of clinically relevant bone substitutes and bone expanders for spinal surgery in terms of efficacy and associated clinical outcomes, as reported in contemporary spine literature.

Summary Of Background Data: Ever since the introduction of allograft as a substitute for autologous bone in spinal surgery, a sea of literature has surfaced, evaluating both established and newly emerging fusion alternatives.

Is It Necessary to Extend a Multilevel Posterior Cervical Decompression and Fusion to the Upper Thoracic Spine?

Study Design: A retrospective cohort analysis.

Objective: The aim of this study was to determine if there is a difference in the revision rate in patients who undergo a multilevel posterior cervical fusions ending at C7, T1, or T2-T4.

Summary Of Background Data: Multilevel posterior cervical decompression and fusion is a common procedure for patients with cervical spondylotic myelopathy, but there is little literature available to help guide the surgeon in choosing the caudal level of a multilevel posterior cervical fusion.

The Effect of Dynamic Versus Static Plating Systems on Fusion Rates and Complications in 1-Level and/or 2-Level Anterior Cervical Discectomy and Fusion: A Systematic Review.

Study Design: A systematic review.

Objective: To determine the effect of plate design on fusion rates in patients undergoing a 1- and 2-level anterior cervical discectomy and fusion (ACDF).

Methods: Articles published between January 1, 2002 and January 1, 2015 were systematically reviewed to determine the fusion rate of 1- and 2-level ACDFs using either a fully constrained or semiconstrained locking plate.

C1 fractures: a review of diagnoses, management options, and outcomes.

The atlas is subject to fracture under axial load, often due to traumatic injuries such as shallow dives and automobile accidents. These fractures account for 2-13 % of injuries to the cervical spine [Marcon RM et al. Clinics (Sao Paulo) 68(11):1455-61, 2013].

Performing an Anterior Cervical Discectomy and Fusion.

An anterior cervical discectomy and fusion is one of the most common procedures performed in spine surgery. It allows for a direct decompression of the spinal cord and the neural foramen. When performed properly, the results of this procedure are some of the best in spine surgery.

Level of Evidence Descriptions With Examples.

The level of evidence (LOE) method provides journal readers with a quick appraisal of study quality. The most widely recognized LOE assessment tool is that from the Oxford Centre for Evidence-Based Medicine, and these guidelines are often adapted for other purposes. The assigned LOE typically depends on the design and quality of the study as well as the impact of the results.