Impact of sarcopenia on outcomes following lumbar spine surgery for degenerative disease: an updated systematic review and meta-analysis.

PURPOSE: This study aimed to consolidate the evidence regarding the prognostic influence of sarcopenia in degenerative lumbar spine surgeries. METHODS: A literature search of public databases was conducted up to Nov 15, 2023 using combinations of the key words "sarcopenia" and "lumbar spine surgery". Eligible studies were those that focused on adults undergoing decompression or fusion surgery for degenerative lumbar spine diseases, and compared the outcomes between patients with and without preoperative sarcopenia. Primary outcomes were change in ODI and back and leg pain VAS pain scores. Secondary outcomes were changes in Eq. 5D, JOA, SFHS-p scores, and LOS. RESULTS: Ultimately, nine retrospective studies with a total of 993 patients were included. Sarcopenic patients exhibited significantly worse functional improvement as assessed by ODI compared to non-sarcopenic patients (pooled standardized mean difference [pSMD] = 0.53, 95% confidence interval [CI]: 0.17-0.90). Back pain (pSMD = 0.31, 95% CI:0.15-0.47) and leg pain (pSMD = 0.21, 95% CI:0.02 - 0.39) improvement were also less in sarcopenic patients. Non-sarcopenic patients had greater improvements in Eq. 5D (pSMD = 0.25) and SFHS-p (pSMD = 0.39), and shorter LOS (pSMD = 0.62). CONCLUSIONS: As compared to patients without sarcopenia, those with sarcopenia undergoing lumbar spine surgery for degenerative diseases have lower improvements in functional ability, quality of life, physical health, pain relief and extended hospitalization compared to those without sarcopenia.

Navigation-Assisted One-Staged Posterior Spinal Fusion Using Pedicle Screw Instrumentation in Adolescent Idiopathic Scoliosis-A Case Series.

Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a prevalent three-dimensional spinal disorder, with a multifactorial pathogenesis, including genetics and environmental aspects. Treatment options include non-surgical and surgical treatment. Surgical interventions demonstrate positive outcomes in terms of deformity correction, pain relief, and improvements of the cardiac and pulmonary function. Surgical complications, including excessive blood loss and neurologic deficits, are reported in 2.27-12% of cases. Navigation-assisted techniques, such as the O-arm system, have been a recent focus with enhanced precision. This study aims to evaluate the results and complications of one-stage posterior instrumentation fusion in AIS patients assisted by O-arm navigation. Materials and Methods: This retrospective study assesses 55 patients with AIS (12-28 years) who underwent one-stage posterior instrumentation correction supported by O-arm navigation from June 2016 to August 2023. We examined radiological surgical outcomes (initial correction rate, loss of correction rate, last follow-up correction rate) and complications as major outcomes. The characteristics of the patients, intraoperative blood loss, operation time, number of fusion levels, and screw density were documented. Results: Of 73 patients, 55 met the inclusion criteria. The average age was 16.67 years, with a predominance of females (78.2%). The surgical outcomes demonstrated substantial initial correction (58.88%) and sustained positive radiological impact at the last follow-up (56.56%). Perioperative complications, including major and minor, occurred in 18.18% of the cases. Two patients experienced a major complication. Blood loss (509.46 mL) and operation time (402.13 min) were comparable to the literature ranges. Trend analysis indicated improvements in operation time and blood loss over the study period. Conclusions: O-arm navigation-assisted one-stage posterior instrumentation proves reliable for AIS corrective surgery, achieving significant and sustained positive radiological outcomes, lower correction loss, reduced intraoperative blood loss, and absence of implant-related complications. Despite the challenges, our study demonstrates the efficacy and maturation of this surgical approach.

See the Unseen: Red-Emissive Carbon Dots for Visualizing the Nucleolar Structures in Two Model Animals and In Vivo Drug Toxicity.

Nucleolus, which participates in many crucial cellular activities, is an ideal target for evaluating the state of a cell or an organism. Here, bright red-emissive carbon dots (termed CPCDs) with excitation-independent/polarity-dependent fluorescence emission are synthesized by a one-step hydrothermal reaction between congo red and p-phenylenediamine. The CPCDs can achieve wash-free, real-time, long-term, and high-quality nucleolus imaging in live cells, as well as in vivo imaging of two common model animals-zebrafish and Caenorhabditis elegans (C. elegans). Strikingly, CPCDs realize the nucleolus imaging of organs/flowing blood cells in zebrafish at a cellular level for the first time, and the superb nucleolus imaging of C. elegans suggests that the germ cells in the spermatheca probably have no intact nuclei. These previously unachieved imaging results of the cells/tissues/organs may guide the zebrafish-related studies and benefit the research of C. elegans development. More importantly, a novel strategy based on CPCDs for in vivo toxicity evaluation of materials/drugs (e.g., Ag+ ), which can visualize the otherwise unseen injuries in zebrafish, is developed. In conclusion, the CPCDs represent a robust tool for visualizing the structures and dynamic behaviors of live zebrafish and C. elegans, and may find important applications in cell biology and toxicology.

[Arsenic Methylation Efficiency Changes During Paddy Soil Drying and Its Key Influencing Factors Analysis].

The straight head disease of rice is one of the main problems limiting rice production. Arsenic (As) methylation in paddy soils is considered to be highly related to the occurrence of the straight head disease. As a typical field practice, rice fields are usually drained during the late tillering stage and the mid-late grain filling stage. Nevertheless, the key influencing factors on the As methylation efficiency during paddy soil drying remain unclear. In this study, an indoor cultivation experiment was set up to simulate the drying process of paddy soil. Two As-contaminated soils collected from Xingren (XR) in Guizhou province and Nandan (ND) in Guangxi province were used as test soils. Each soil was treated with the addition of rice straw (RS) and without rice straw (CK). With the drying of paddy soil (0, 24, 36, 48, and 60 h), the changes in soil Eh, pH, total organic carbon (TOC), and As chemical species in the porewater were determined. The abundance of the As methylation functional gene (arsM), sulfate-reducing bacteria (harboring dsrA, As methylation-related microorganism), and methanogens (harboring mcrA, As demethylation-related microorganism), as well as the diversity of arsM-harboring microorganisms, were also observed. The results showed that during the process of drying paddy soil, soil Eh changed from -300--200 mV under complete flooding to -150--50 mV after drying; however, the change in soil pH was not obvious. The concentrations of inorganic As (iAs) and dimethylarsenic (DMAs) in porewater significantly increased (P<0.05) with the drying process. Additionally, the concentration of DMAs in the RS treatment was prominently higher than that in CK. Compared with XR soil, the concentration of DMAs in ND soil was higher. As a function of soil drying time, the As methylation efficiency of XR soil (XR-CK and XR-RS) slightly increased but was not significant (P>0.05), whereas the As methylation efficiency of ND soil (ND-CK and ND-RS) increased significantly (P<0.05). After the drying time reached 60 h, the As methylation efficiency of ND-CK and ND-RS increased by 61.8% and 23.2%, respectively, compared with those at the early stage of drying (0 hours). The copy numbers of the arsM and dsrA genes greatly increased with the extension of drying time, whereas an opposite trend was observed for the copy number of the mcrA gene. Furthermore, the addition of straw obviously increased the gene abundance of whole bacteria and arsM-, dsrA-, and mcrA-harboring bacteria. Based on the multi-factor analysis of variance and the redundancy analysis, it was found that the test soil type, straw addition, drying time, and their interaction had a critical influence on the changes in As species, As methylation efficiency, and the gene abundance in soils. TOC, Eh, and the functional genes associated with As methylation were positively linked with the methylated As content in soil porewater but negatively correlated with that of iAs. According to the sequence of the arsM-harboring microbe, it was clearly demonstrated that a community shift of As-methylating microbe occurred with the soil drying. Here, the following conclusions were derived:① the drying process did not lower the As methylation efficiency in paddy soil. On the contrary, in this study, the As methylation efficiency, especially that for ND soil, remarkably improved. The addition of straw notably promoted the As methylation efficiency and the content of DMAs in porewater. ② An increasing tendency was observed for the abundance of microbes related to As methylation, whereas a reverse trend was indicated for microbes related to As demethylation. The community shift of arsM-harboring microbes might be the crucial reason for the improved As methylation efficiency during the soil drying. These observations contribute to a better understanding of the As methylation process during paddy soil drying and will shed light on the future mitigation of rice straight head disease in paddy soils.

Resection with limb salvage in an Asian male adolescent with Ewing's sarcoma: A case report.

BACKGROUND: Ewing's sarcoma is a highly malignant primary bone tumor that commonly affects children. For young patients, multidisciplinary treatment and limb salvage are recommended, and surgical plans considering the growth potential and bone activity after tumor resection are essential. CASE SUMMARY: An 11-year-old Asian boy had a 1-mo history of a right-sided limping gait. Imaging revealed a proximal tumor with bone destruction and physeal involvement over the right femoral neck. He was diagnosed with stage IV (T1N0M1aG3) Ewing's sarcoma with bilateral lung metastases. Neoadjuvant chemotherapy decreased the tumor size and confined it to the metaphyseal region. The patient underwent four stages of surgery: wide tumor excision plus reconstruction with vascular fibular bone graft plus internal fixation; repeat open reduction and internal fixation; femoral lengthening with orthosis after physeal maturity; and orthosis removal and bone elongation (approximately 6 cm). Following surgery, he could walk without discomfort and had almost equal-sized bilateral femoral heads, indicating physis preservation. The surgery was successful, and normal femoral head growth was achieved after complete remission. The patient was able to resume normal activities with equal length of the bilateral lower limbs. CONCLUSION: Tumor treatment and reconstruction following resection are important in skeletally immature patients with Ewing's sarcoma to improve quality of life.

Computed Tomography-Guided Endoscopic Surgery in Lumbar Disc Herniation With High-grade Migration: A Retrospective, Comparative Study.

BACKGROUND: Symptomatic herniated intervertebral discs are debilitating. However, surgical management poses a significant challenge for endoscopic spine surgeons, especially in high-grade migrated lesions. OBJECTIVES: This study aimed to  assess the surgical and clinical outcomes after applying a computed tomography navigated percutaneous endoscopic lumbar discectomy. STUDY DESIGN: The data of patients with high-grade lumbar disc migration who underwent percutaneous endoscopic lumbar discectomy at our spine center were retrospectively collected and analyzed from November 2017 to May 2019. The patients were divided into 2 groups based on different workflows, with group O who underwent percutaneous endoscopic lumbar discectomy with computed-tomography navigation (O-arm), and group C who underwent conventional fluoroscopic guidance (C-arm). SETTING: Twenty-one (n = 21) patients were enrolled with data fully documented. There were 9 patients in group O (n = 9) and 12 patients in group C (n = 12). METHODS: An intraoperative 3-dimensional image was obtained using the O-arm device (O-arm®, Medtronic, Inc., Louisville, CO, United States) after patient positioning in group O, and enable multiplanar visualization during exploring the entry point, trajectory, orientation, and finally discectomy. In group C, conventional imaging scanner intensifier (C-arm) was used during the procedure. RESULTS: The operative time (99.4 ± 40.7 vs 86.9 ± 47.9 minutes, P = .129), blood loss (11.1 ± 15.7 vs 6.7 ± 8.2 mL, P = .602), and hospital stay (2.9 ± 0.3 vs 2.8 ± 0.6 days, P = .552) were similar between the 2 groups. However, group O showed more reduction in the pain and faster functional recovery immediately after the surgery (Visual Analog Score [VAS]: -9 vs -6.7, P =.277; Oswestry Disability Index [ODI]: -53.2% vs -29.1%, P = 0.006) and during the one-year follow-up (VAS: -8.1 vs -7.3, P =.604; ODI: -56.7% vs -40.1%, P = .053) compared with group C. LIMITATIONS: The retrospective nature of the study design, the small population size, and the shorter period of follow-up required further study. CONCLUSIONS: Computed tomography-navigated percutaneous endoscopic surgery is safe and effective for lumbar disc herniation with high-grade migration, and enhance early functional recovery even compared with conventional fluoroscopic guidance.

Lunate dislocation with avulsed triquetral fracture: A case report.

BACKGROUND: Lunate dislocation is an uncommon traumatic wrist injury that require prompt surgical management. Misdiagnosis or delayed treatment often leads to a poor outcome. Open reduction and surgical repair of disrupted ligaments are done in most cases to prevent long-term joint dysfunction. However, this method has certain limitations that include partial functional improvement, which poses a high risk for degenerative arthritis and wrist instability. CASE SUMMARY: A 37-year-old man presented to the Emergency Department of our hospital following a motorcycle accident. Physical examination revealed swelling and tenderness of the right hand and wrist. The patient was initially misdiagnosed with a wrist contusion by an emergency physician, but was eventually diagnosed with lunate dislocation associated with a triquetral avulsed fracture, indicated for open reduction and ligament repair. We performed closed reduction and two Kirschner wire fixations following Tavernier's method. The injured hand was protected with a standard short-arm orthosis for one month. The patient returned to normal daily work without discomfort at five months postoperatively. Encouragingly, there was no lunate necrosis or arthritis in the latest radiologic examinations. CONCLUSION: This case provides evidence that the closed reduction technique for addressing such cases can reduce soft tissue destruction.

Portable molecularly imprinted polymer-based platform for detection of histamine in aqueous solutions.

Histamine, which is a naturally occurring chemical in seafood, is known to cause undesirable inflammatory response when consumed in large amounts. Histamine is produced in unsafe amounts in colored seafood when improperly stored for just a few hours. Food and health regulatory bodies across the world have guidelines limiting the amount of histamine in fresh as well as processed seafood. Conventional histamine detection is performed in testing labs, which is a slow process and results in bottlenecks in the seafood supply-chain system. A system to rapidly detect the seafood histamine levels on site is very desirable for seafood suppliers. Herein, we describe an impedance-based histamine detection sensor built on a flexible substrate that can detect histamine in the range of 100-500 ppm. Moreover, our sensor discriminates histamine in the presence of DL-histidine and other biogenic amines, with the selectivity provided by molecular imprinting technology. As a proof of concept, a smartphone controlled, portable semi-quantitative histamine sensing device was fabricated that gave out reliable testing results for histamine in different test solutions as well as for real seafood. We believe this technology can be extended towards determination of other food contaminants in aqueous solutions.