Accuracy of pedicle screw placement in lumbar fusions by plain radiographs and computed tomography.

STUDY DESIGN: Postoperative radiographs and computed tomography scans were used to evaluate 74 pedicle screws in 16 consecutive patients who underwent lumbar spine fusion with pedicle screw fixation. OBJECTIVE: To evaluate pedicle screw placement using plain radiographs versus computed tomographic scans. SUMMARY OF BACKGROUND DATA: Plain radiographs are the primary means of assessing pedicle screw placement. Comparison of plain radiographs and computed tomography has not been done. METHODS: Screws were graded as IN, OUT, or QUESTIONABLE; the direction of misplacement was noted. All evaluations were performed independently by three observers. RESULTS: Fewer screws were clearly within the pedicle on computed tomography when compared with plain radiographs. Computed tomography showed 10 times as many screws violating the medial cortex as did radiographs. Interobserver differences were not statistically significant. Intraobserver differences approached statistical significance when the two tests were compared. No recognized neurologic complications resulted from pedicle screw placement. CONCLUSIONS: Plain radiographs alone may not accurately reveal pedicle screw placement. Plain radiographs and thin section computed tomographic scans should be used to evaluate postoperative neurologic deficits in patients undergoing instrumented lumbar spine fusion with pedicle screws.

Comparisons of nuclear antigens of Epstein-Barr virus (EBV) and EBV-like simian viruses.

Nuclear antigens (NA) of EBV (EBNA), Herpesvirus gorilla, H. papio, H. pongo and H. pan were tested with sera of human, gorilla, chimpanzee, orangutan, gibbon and baboon origins. Both conventional anticomplement immunofluorescence (ACIF) and acid-fixed nuclear binding of antigen followed by ACIF (AFNB) procedures were used. Comparisons of antibody titres by ACIF and AFNB suggested that human sera detected the same antigenic determinants on EBNA by the two procedures but gorilla sera measured different determinants on H. gorilla NA. Asymmetric cross-reactions were found with gorilla, chimpanzee and baboon sera but individual human and orangutan sera were found which had extensive cross-reactivities. Absorption experiments with these broadly reactive sera with H. gorilla NA and comparisons of antibody titres of human sera with EBNA, H. gorilla and H. papio NA suggested the presence of an EBV-specific determinant as well as a broadly reactive determinant on EBNA.

Correlation between Epstein-Barr virus membrane antigen and three large cell surface glycoproteins.

A correlation between Epstein-Barr virus membrane antigen (MA) and three surface glycoproteins has been established on the basis of radio-immunoprecipitation and immunoabsorption experiments. For radio-immunoprecipitation, Epstein-Barr virus-infected cells were radiolabeled either with neuraminidase-galactose oxidase tritiated borohydride, a procedure highly specific for surface glycoproteins, or with a general tritiated amino acid mixture. Intact cells were incubated with MA(-) or MA(+) human sera, washed free of unbound immunoglobulins, and then lysed with Nonidet P-40. The antigen-antibody complexes were bound to protein A-Sepharose and after elution with sodium dodecyl sulfate were analyzed by acrylamide gel electrophoresis in sodium dodecyl sulfate. MA(+) sera specifically precipitated three glycoproteins with molecular weights of 236,000, 212,000, and 141,000 from B95-8 cells induced with 12-O-tetradecanoylphorbal-13-acetate (TPA) and from Raji cells superinfected with P3HR-1 virus. These glycoproteins were not detected on Epstein-Barr virus-negative Ramos cells treated with TPA or on B95-8 cells treated simultaneously with TPA and phosphonoacetic acid. Soybean lectin-Sepharose bound all three glycoproteins, and lectin-Sepharose-bound glycoproteins from TPA-induced P95-8 cells absorbed MA-specific antibody from MA(+) human sera. The data strongly suggest that either all three glycoproteins have MA determinants or they are part of a complex in which one or more of the components constitute the reactive antigen.