Efficacy and Safety of Establishing an Optimal Path Through Unilateral Pedicle Under the Assistance of Surgical Robot in Percutaneous Kyphoplasty.

BACKGROUND: Despite percutaneous kyphoplasty (PKP) being widely used to treat osteoporotic vertebral compression fractures (OVCFs), the details of puncture are still controversial. With the development of surgical robots in spine surgery, robotic-assisted PKP surgery will become a promising treatment strategy. OBJECTIVES: To evaluate the efficacy and safety of establishing an optimal working path through a unilateral pedicle approach to improve bone cement distribution under the assistance of a surgical robot in percutaneous kyphoplasty. STUDY DESIGN: Experimental and prospective study. METHODS: PKP surgery under the assistance of the TINAVI robot was performed on 78 patients with osteoporotic vertebral compression fractures (OVCFs) from May 2018 to January 2020 in a single spine center. During the operation, the optimal path of the working channel made through unilateral pedicle puncture was designed according to the details of the fractured vertebral body under the guidance of the TINAVI surgical robot. Visual analog scale (VAS) scores of back pain, intraoperative blood loss, surgical time, and complications were recorded and evaluated. Postoperative fluoroscopy and 3D-CT were used to evaluate the distribution of bone cement. RESULTS: We have successfully performed 78 PKP surgeries under the assistance of the TINAVI robot. The mean procedure time was 13.9 ± 2.6 minutes from the beginning of C-arm scan to finish the injection of bone cement, and the intraoperative blood loss was 5.4 ± 2.8 mL. Pain of all cases was relieved immediately and significantly after PKP surgery; the VAS score was 7.5 ± 2.3 before surgery and 1.4 ± 0.8 post-surgery. The mean volume of bone cement was 4.7 ± 1.9 mL, and bone cement leakage occurred at the anterior edge of the fractured vertebral body in 2 patients, with no neurological and vascular injury in any of the cases. Postoperative fluoroscopy and 3D-CT showed that a good bone cement distribution evenly through unilateral pedicle puncture in the fractured vertebral body in all cases except the bone cement leakage in 2 patients. LIMITATIONS: More cases are needed to evaluate the efficacy and stability of robot-assisted PKP surgery. A control group of PKP performed freehand should be included in this study. CONCLUSIONS: Robotic-assisted PKP surgery through the unilateral approach to establishing an optimal working channel is a safe and available procedure for treating OVCFs in terms of better distribution of bone cement, high accuracy, good repeatability, and less surgical trauma.

Altered Behaviors and Impaired Synaptic Function in a Novel Rat Model With a Complete Shank3 Deletion.

Mutations within the Shank3 gene, which encodes a key postsynaptic density (PSD) protein at glutamatergic synapses, contribute to the genetic etiology of defined autism spectrum disorders (ASDs), including Phelan-McDermid syndrome (PMS) and intellectual disabilities (ID). Although there are a series of genetic mouse models to study Shank3 gene in ASDs, there are few rat models with species-specific advantages. In this study, we established and characterized a novel rat model with a deletion spanning exons 11-21 of Shank3, leading to a complete loss of the major SHANK3 isoforms. Synaptic function and plasticity of Shank3-deficient rats were impaired detected by biochemical and electrophysiological analyses. Shank3-depleted rats showed impaired social memory but not impaired social interaction behaviors. In addition, impaired learning and memory, increased anxiety-like behavior, increased mechanical pain threshold and decreased thermal sensation were observed in Shank3-deficient rats. It is worth to note that Shank3-deficient rats had nearly normal levels of the endogenous social neurohormones oxytocin (OXT) and arginine-vasopressin (AVP). This new rat model will help to further investigate the etiology and assess potential therapeutic target and strategy for Shank3-related neurodevelopmental disorders.

Retracted: Bone Mesenchymal Stem Cell-Conditioned Medium Regulates the Differentiation of Neural Stem Cells Via Notch Pathway Activation.

The online-ahead-of print e-pub version of the article entitled, Bone Mesenchymal Stem Cell-Conditioned Medium Regulates the Differentiation of Neural Stem Cells Via Notch Pathway Activation, by Li H-M, Tong Y, Xia X, Huang J, Song P-W, Zhang R-J, Shen C-L, utilizing the DOI number 10.1089/cell.2018.0042 is being officially retracted from Cellular Reprogramming. The original version of the paper was submitted to the journal for peer review on July 29, 2018, with the revised version after peer review submitted on October 21, 2018. The paper was accepted for publication on November 20, 2018 and was subsequently published online ahead of print on December 27, 2018. After the e-publication of the article, the editor received an email from the corresponding author on January 14, 2019 requesting "to withdraw the above-mentioned manuscript for further consideration, due to a technical reason (we have done a further experiment and found this article need add more results)." Though it is unclear why the authors were not able to determine these faults with the paper within the six months the manuscript was in review, revision, and production, the editorial leadership of the Journal has determined that the paper requires a full retraction from the literature as Cellular Reprogramming is committed to upholding the strictest standards and best practices of scientific publishing.