Efficacy of percutaneous cement-augmented screw fixation plus percutaneous kyphoplasty in the management of unstable osteoporotic vertebral compression fractures.

OBJECTIVE: The present study was performed to compare the efficacy of percutaneous kyphoplasty (PKP) vs. percutaneous cement-augmented screw fixation plus PKP in the management of unstable osteoporotic vertebral compression fractures (OVCF). PATIENTS AND METHODS: A total of 197 patients with unstable OVCF treated in the Department of Spine Surgery, Lianyungang First People's Hospital from September 2019 to September 2021 were recruited and assigned via random number table method 1:1 to receive either PKP (group A, n=106) or PKP plus percutaneous cement-augmented screw fixation (group B, n=91). The outcome measures for the evaluation of different surgical methods included visual analogue scale (VAS), the height of the anterior-posterior border of the injured spine, Cobb angle of the posterior convexity, Oswestry disability index (ODI) scores, and Japanese Orthopaedic Association (JOA) scores. RESULTS: PKP exhibited shorter operative time and length of hospital stay and less intraoperative blood loss vs. PKP plus percutaneous cement-augmented screw fixation (p<0.05). Patients with PKP plus percutaneous cement-augmented screw fixation experienced milder postoperative pain vs. those with PKP alone at 7 days postoperatively, as evidenced by the lower VAS scores (p<0.05). PKP plus percutaneous cement-augmented screw fixation provided more restoration of anterior margin height and posterior convexity Cobb angle vs. PKP alone (p<0.05). Patients with PKP only showed slightly higher Japanese Orthopaedic Association (JOA) scores than those with combined surgery, while the postoperative clinical signs between the two arms were similar (p>0.05). CONCLUSIONS: Single PKP features the benefits of minimal trauma, simple operation, and rapid postoperative recovery in the treatment of OVCF. PKP plus percutaneous cement-augmented screw fixation for severe OVCF provided distinctly better performance than PKP alone in terms of early pain relief, restoration of vertebral body height, correction of posterior convexity deformity, and firm spinal stability.

Efficacy of minimally invasive transforaminal lumbar interbody fusion plus cement-augmented pedicle screw fixation in the treatment of degenerative lumbar spine disease with osteoporosis in the elderly.

OBJECTIVE: The aim of this study was to evaluate the efficacy of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) plus cement-augmented pedicle screw fixation in the treatment of degenerative lumbar spine disease with osteoporosis in the elderly. PATIENTS AND METHODS: From February 2020 to January 2021, 40 elderly patients with degenerative lumbar spine disease with osteoporosis admitted to our hospital were randomly assigned (1:1) to receive either MIS-TLIF plus cement-augmented pedicle screw fixation (group A) or TLIF plus cement augmentation (group B), with 19 cases in group A and 21 cases in group B. Outcome measures included visual analogue scale (VAS), Oswestry Dysfunction Index (ODI) and Japanese Orthopedic Association Scores (JOA), operative duration, intraoperative bleeding, postoperative drainage volume, and the incidence of complications. Frontal and lateral radiographs of the lumbar spine and computed tomography (CT) were performed 3 days after surgery to observe the distribution of bone cement. At 12 months postoperatively, the fusion of the bone graft was evaluated according to the Bridwell intervertebral fusion criteria based on the lumbar frontal and lateral radiographs. RESULTS: All 40 cases completed the surgery successfully and were followed up for 12 months. The two groups did not differ significantly in terms of operative duration (p>0.05). MIS-TLIF plus cement-augmented pedicle screw fixation was associated with significantly less intraoperative bleeding volume (142.25±40.93 mL) and (76.25±17.54 mL) vs. TLIF plus cement augmentation (322.00±93.45 mL, 159.75±54.74 mL) (p<0.05). The difference in the VAS scores, ODI, and JOA scores between the two groups preoperatively and at the final follow-up showed no statistical significance (p>0.05). Patients receiving MIS-TLIF plus cement-augmented pedicle screw fixation had significantly lower VAS scores and ODI and higher JOA scores vs. TLIF plus cement augmentation (p<0.05). The lumbar frontal and lateral radiographs and CT of the two groups 3 days after surgery showed good cement distribution and no cement leakage. At the final follow-up, no complications were seen in group A, and there was one case of intervertebral cement leakage in group B. The intervertebral graft fusion was grade I in both groups. CONCLUSIONS: MIS-TLIF plus cement-augmented pedicle screw fixation shortens the operative time, alleviates postoperative pain, facilitates operative lumbar spine function restoration, and provides favorable intervertebral implant fusion.

Optical transverse spin coupling through a plasmonic nanoparticle for particle-identification and field-mapping.

Electromagnetic fields at near-field exhibit distinctive properties with respect to their free-space counterparts. In particular, an optical transverse spin appearing in a confined electromagnetic field provides the foundation for many intriguing physical effects and applications. We present a transverse spin coupling configuration where plasmonic nanoparticles are employed to couple the transverse spin in a focused beam to that of a surface plasmon polariton. The plasmonic resonance of nanoparticles on a metal film plays a significant role in transverse spin coupling. We demonstrate in experiments that Ag and Au nanoparticles yield distinct imaging patterns when scanned over a focused field, because of their different plasmonic responses to the transverse and longitudinal electric fields. Such resonance-dependent spin-coupling enables the identification of nanoparticles using a focused field, as well as electric field mapping of a specific field component of a focused beam using a plasmonic nanoparticle. These interesting findings regarding the transverse spin coupling with a plasmonic nanoparticle may find valuable applications in near-field and nano-optics.

[Congenital right diaphragmatic eventration manifested with pleural effusion. Report of one case].

A 2,980-gram female infant was born to a 25-year-old mother at the gestational age of 34 weeks with the chief problems of asphyxia and respiratory distress. Prenatal sonogram at 34th week of gestation showed significant pleural effusion, mediastinal shift, polyhydramnios and large for date. Soon after birth, she was put on intubation and ventilator therapy. Physical examination revealed poor chest wall excursion. Breathing sound was markedly decreased over the right lung field. Abdomen was soft and slightly distended with the liver palpable 0.5 cm below the right costal margin and 2 cm below the xyphoid process. Arterial blood gas with patient breathing 100% oxygen revealed severe acidosis and carbon dioxide retention. The first chest film showed right pleural effusion. Chest tap was performed, and 90 cc serosanguineous fluid was aspirated. The white cells of the effusion were 1,971 with lymphocyte predominant. No microorganism or malignant cell was found. Severe respiratory distress and cyanosis persisted inspite of these managements. Follow up chest film at the age of 11 hours revealed the right chest was occupied by intestinal loops. A thoracotomy was performed with the impression of right diaphragmatic hernia. The operation findings included a very redundant membranous portion of diaphragm formed a large sac containing the liver and some bowel loops, the lower lobe of the right lung collapsed and was located high in the posterior chest cavity. Diaphragmatic plication and excision were done with transient improvement of the skin color. The baby's condition deteriorated and expired at the age of 25 hours despite of postoperative vasodilator and ventilator therapies.(ABSTRACT TRUNCATED AT 250 WORDS)