Objective: This retrospective monocentric study was conducted to evaluate the clinical and radiological outcomes of the nano-hydroxyapatite/polyamide66 (n-HA/PA66) cage in reconstructing the anterior column of the spine following total spondylectomy (TES).
Methods: A cohort of 24 patients, 20 diagnosed with primary malignant tumors and 4 with metastatic malignancies, was selected based on specific inclusion criteria. All were subjected to TES and anterior column reconstruction with the n-HA/PA66 cage from January 2013 to July 2023 at a single institution. Pre-operative embolization was performed on all patients. Documented factors included operation duration, intraoperative blood loss, length of hospital stay, treatment history, and involved level. Mechanical complications and radiological parameters such as the local kyphotic angle (LKA), anterior vertebral height (AVH), posterior vertebral height (PVH), cage subsidence, and bone fusion time were evaluated. Quality of life and neurological function were gauged using tools like the Visual Analog Scale (VAS), Eastern Cooperative Oncology Group (ECOG) performance score, Karnofsky Performance Score (KPS) scale, and American Spinal Injury Association (ASIA) grading.
Results: All patients were followed up for 12-127 months, with an average period of 39.71 months. An average operation time of approximately 8.57 h and a blood loss volume of about 1,384 ml were recorded. No instances of tumor recurrence or multiple organ metastases were reported, though recurrence was detected in 2 living patients. Solid fusion was achieved in all patients at a mean time of 6.76 ± 0.69 months. Cage breakage or migration was not observed. Subsidence into the adjacent vertebral bodies was identified in 3 patients but was deemed clinically irrelevant. Significant improvements in VAS, ECOG performance score, KPS scale, and ASIA scores were noted from pre- to post-surgery ( < 0.05). A marked enhancement in the AVH was observed from before surgery to immediately after ( < 0.05). LKA, AVH, and PVH values between postoperative and final follow-up showed no significant variance ( > 0.05).
Conclusion: The integration of TES and the n-HA/PA66 cage was found to yield promising clinical and radiological outcomes in anterior column spine reconstruction. The use of this material did not hinder oncological care, including the provision of adjuvant treatments (chemo/radiotherapy), ultimately contributing to the enhanced long-term quality of life for spinal tumor patients.
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http://dx.doi.org/10.3389/fsurg.2023.1278301 | DOI Listing |
Disabil Rehabil
January 2025
Clinic Institute of Medical and Surgical Specialties (ICEMEQ), Hospital Clinic of Barcelona, Barcelona, Spain.
Purpose: Adherence to home rehabilitation following total knee arthroplasty (TKA) is essential to reach optimal functional outcomes, especially in fast-track procedures. The aim of this study is to identify which sociodemographic and health factors significantly affect adherence in this context.
Methods: This is a secondary analysis of a randomized controlled trial with 52 patients.
Surg Innov
January 2025
Morristown Medical Center, Department of Surgery, Morristown, NJ, USA.
Background: In difficult colorectal cases, surgeons may opt for a hand-assisted laparoscopic (HALS) colectomy or attempt a laparoscopic surgery that may require an unplanned conversion to open (LCOS). We aimed to compare the clinical outcomes of these 2 types of surgeries.
Methods: Colectomies for acute diverticulitis with a HALS or LCOS surgery were selected from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) 2022 Targeted Colectomy Database.
Brain
January 2025
Translational Neuroimaging Laboratory, Montreal Neurological Institute, H3A 2B4, Montreal, Canada.
Plasma phosphorylated tau biomarkers open unprecedented opportunities for identifying carriers of Alzheimer's disease pathophysiology in early disease stages using minimally invasive techniques. Plasma p-tau biomarkers are believed to reflect tau phosphorylation and secretion. However, it remains unclear to what extent the magnitude of plasma p-tau abnormalities reflects neuronal network disturbance in the form of cognitive impairment.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
Department of Computer Science and Software Engineering, United Arab Emirates University, Al Ain, United Arab Emirates.
Background: Neuroimaging segmentation is increasingly important for diagnosing and planning treatments for neurological diseases. Manual segmentation is time-consuming, apart from being prone to human error and variability. Transformers are a promising deep learning approach for automated medical image segmentation.
View Article and Find Full Text PDFJMIR Hum Factors
January 2025
Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras Kuala Lumpur, Malaysia.
Background: Evaluating digital health service delivery in primary health care requires a validated questionnaire to comprehensively assess users' ability to implement tasks customized to the program's needs.
Objective: This study aimed to develop, test the reliability of, and validate the Tele-Primary Care Oral Health Clinical Information System (TPC-OHCIS) questionnaire for evaluating the implementation of maternal and child digital health information systems.
Methods: A cross-sectional study was conducted in 2 phases.
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