Anterior Longitudinal Ligament Reconstruction to Reduce Hypermobility of Cervical and Lumbar Disc Arthroplasty

STUDY DESIGN: Retrospective case series PURPOSE: This study aims to present the early clinical and radiological outcomes of anterior longitudinal ligament (ALL) reconstruction following disc arthroplasty. OVERVIEW OF LITERATURE: Although cervical and lumbar disc arthroplasty have entered the clinical setting, there are still concerns regarding the short and long term complications arising from hypermobility of current prosthesis designs. Reconstruction of the ALL is a potential solution to disc arthroplasty hypermobility. METHODS: ALL reconstruction following disc arthroplasty have been performed by the senior author over a 24 month period. Ligament replacements used include allograft and synthetic, ligament advanced reinforcement system (LARS) ligaments. Methods of fixation used include titanium staples, bone anchors and suture fixation. Radiological follow-up pre- and postoperative Oswestry disability index, Neck Disability Index, Patient Satisfaction index scores were recorded on all patients. RESULTS: A total of 18 ALL reconstructions were performed. There have been no cases of early complications, revision surgery for recurrent symptoms or implant failure. Of the 6 patients receiving a minimum of 15 months follow-up, 4 patients received an allograft, 2 patients received the LARS ligament. Favourable, postoperative clinical and radiographic outcomes have been demonstrated. CONCLUSIONS: ALL reconstruction following cervical and lumbar disc arthroplasty is a promising solution to addressing non-physiological kinematics of current disc arthroplasty devices. Randomized, controlled studies with larger study samples and long-term follow-up are required to establish these conclusions.

Study on the viability of Lactobacillus acidophilus in short peptide enteral nutrition liquid / 肠外与肠内营养

Objective: To observe the survivability of Lactobacillus acidophilus in short peptide enteral nutrition liquid.Methods: 5% fermentative medium of Lactobacillus acidophilus was added in 12% short peptide enteral nutrition liquid.The preparations were cultured at 37℃ anaerobic condition.Samples were taken from culture at 0,4,8,12,14,16,20,24 h during fermention.The living bacteria counts,A_600,acidity and pH values were examined respectively.Results: The number of Lactobacillus acidophilus increased at 0 to 16 h.A_600 ascended during the time.Acidity ascended with time.Conclusion: The present study demonstrated that Lactobacillus acidophilus had better survivability in 12% short peptide enteral nutrition liquid,and the terminal time should be controlled during 12~14h.