Ultrasound-guided caudal cervical articular process arthrocentesis is accurate in live horses with and without arthropathy.

BACKGROUND: Cervical articular process joint (CAPJ) therapy is advocated for horses with neck disorders. Several ultrasound-guided CAPJ techniques have been described in cadaver studies with 72%-89% intra-articular injection accuracy; however, the CAPJ injection accuracy in clinical equine practice has not been extensively reported. OBJECTIVES: To describe a modified cranial approach for ultrasound-guided caudal CAPJ injections, to investigate the accuracy of this CAPJ injection technique in live horses, and to assess the effect of CAPJ injection location, laterality, operator, and radiographic CAPJ enlargement on injection accuracy. STUDY DESIGN: Retrospective case study. METHODS: Medical records of adult horses in which ultrasound-guided caudal (C4-T1) CAPJ injections were performed using a modified cranial approach between November 2006 and December 2020 were reviewed. Radiographic images of caudal cervical vertebrae were assessed by a blinded radiologist and the degree of CAPJ enlargement was graded using a previously described grading system (Rgrade 1-5b). Ultrasound-guided caudal CAPJ injection accuracy was determined by synovial fluid retrieval during an individual CAPJ injection. Statistical analysis was performed using mixed-effects multivariable logistic model to evaluate the association of CAPJ injection accuracy and the CAPJ injection location, Rgrade, laterality (right, left), and operator. RESULTS: The study included 149 horses with 177 hospital admissions. Synovial fluid was obtained from 586/658 (89.1%) caudal CAPJs using modified cranial ultrasound-guided approach for CAPJ injections. C6-C7 CAPJ injections had 7-fold higher likelihood (OR = 6.78, 95% CI: 1.67-27.52; p = 0.007) of synovial fluid retrieval compared with C4-C5 CAPJ injections. Operator, CAPJ injection side (left, right), and degree of radiographic CAPJ enlargement did not have significant effects on the success of synovial fluid retrieval from ultrasound-guided caudal CAPJ injections. MAIN LIMITATIONS: Retrospective study design. CONCLUSIONS: Intra-articular ultrasound-guided caudal CAPJ injections using a modified cranial approach can be performed accurately in live horses with and without CAPJ arthropathy.

A robust triphenylamine-based monolithic polymer network for selective sieving of CO2 and PM from flue gas.

The increasingly urgent issue of climate change is driving the development of carbon dioxide (CO2) capture and separation technologies in flue gas after combustion. The monolithic adsorbent stands out in practical adsorption applications for its simplified powder compaction process while maintaining the inherent balance between energy consumption for regeneration and selectivity for adsorption. However, optimizing the adsorption capacity and selectivity of CO2 separation materials remains a significant challenge. Herein, we synthesized monolithic polymer networks (N-CMPs) with triphenylamine adsorption sites, acid-base environment tolerance, and precise narrow microchannel pore systems for the selective sieving of CO2 and particulate matter (PM) in flue gas. The inherent continuous covalent bonding of N-CMPs, along with their highly delocalized π-π conjugated porous framework, ensures the stability of the monolithic polymer network's adsorption and separation capabilities under wet and acid-base conditions. Specifically, under the conditions of 1 bar at 273 K, the CO2 adsorption capacity of N-CMP-1 is 3.35 mmol/g. Attributed to the highly polar environment generated by triphenylamine and the inherent high micropore/mesopore ratio, N-CMPs exhibit an excellent ideal adsorbed solution theory (IAST) selectivity for CO2/N2 under simulated flue gas conditions (CO2/N2 = 15:85). Dynamic breakthrough experiments further visualize the high separation efficiency of N-CMPs in practical adsorption applications. Moreover, under acid-base conditions, N-CMPs achieve a capture efficiency exceeding 99.76 % for PM0.3, enabling the selective separation of CO2 and PM in flue gas. In fact, the combined capture of hazardous PM and CO2 from the exhaust gases produced by the combustion of fossil fuels will play a pivotal role in mitigating climate change and environmental issues until low-carbon and alternative energy technologies are widely adopted.

Multi-source observations on the effect of atmospheric blocking on air quality in Istanbul: a study case.

Air pollution is affected by the atmospheric dynamics. This study aims to determine that air pollution concentration values in Istanbul increased significantly and reached peak values due to atmospheric blocking between the 30th of December 2022 and the 5th of January 2023. In this study, hourly pollutant data was obtained from 16 air quality monitoring stations (AQMS), the exact reanalysis data was extracted from ERA5 database, and inversion levels and meteorological and synoptic analyses were used to determine the effects of atmospheric blocking on air pollution. Also, cloud base heights and vertical visibility measurements were taken with a ceilometer. Statistical calculations and data visualizations were performed using the R and Grads program. Omega-type blocking, which started in Istanbul on December 30, 2022, had a significant impact on the 1st and 2nd of January 2023, and PM10 and PM2.5 concentration values reached their peak values at 572.8 and 254.20 µg/m3, respectively. In addition, it was found that the average concentration values in the examined period in almost all stations were higher than the averages for January and February. As a result, air quality in Istanbul was determined as "poor" between these calendar dates. It was found that the blocking did not affect the ozone (µg/m3) concentration. It was also found that the concentrations of particulate matter (PM) 10 µm or less in diameter (PM10) and PM 2.5 µm or less in diameter (PM2.5) were increased by the blocking effect in the Istanbul area. Finally, according to the data obtained using the ceilometer, cloud base heights decreased to 30 m and vertical visibility to 10 m.

Integrating experiments with modeling to understand key bacterial taxa dynamics after episodic mixing of a stratified water column.

Hydraulic mixing of stratified reservoirs homogenizes physicochemical gradients and microbial communities. This has potential repercussions for microbial metabolism and water quality, not least in dams and hydraulically controlled waters. A better understanding of how key taxa respond to mixing of such stratified water bodies is needed to understand and predict the impact of hydraulic operations on microbial communities and nutrient dynamics in reservoirs. We studied taxa transitions between cyanobacteria and sulfur-transforming bacteria following mixing of stratified water columns in bioreactors and complemented the experimental approach with a biogeochemical model. Model predictions were consistent with experimental observations, suggesting that stable stratification of DO is restored within 24 h after episodic and complete mixing, at least in the absence of other more continuous disturbances. Subsequently, the concentration of S2- gradually return to pre-mixing states, with higher concentration at the surface and lower in the bottom waters, while the opposite pattern was seen for SO42-. The total abundance of sulfate-reducing bacteria and phototrophic sulfur bacteria increased markedly after 24h of mixing. The model further predicted that the rapid re-oxygenation of the entire water column by aeration will effectively suppress the water stratification and the growth of sulfur-transforming bacteria. Based on these results, we suggest that a reduction of thermocline depth by optimal flow regulation in reservoirs may also depress sulfur transforming bacteria and thereby constrain sulfur transformation processes and pollutant accumulation. The simulation of microbial nutrient transformation processes in vertically stratified waters can provide new insights about effective environmental management measures for reservoirs.

Preparation of cylindrical Chitosan/ß-Cyclodextrin/MIL-68(Al) foam column for solid-phase extraction of sulfonamides in water, urine, and milk.

This study describes the preparation of a cylindrical polymer foam column termed Chitosan/ß-Cyclodextrin/MIL-68(Al) (CS/ß-CD/MIL-68(Al)). An ice template-freeze drying technique was employed to prepare the CS/ß-CD/MIL-68(Al) foam column by embedding MIL-68(Al) in a polymer matrix comprising cross-linked chitosan (CS) and ß-cyclodextrin (ß-CD). The cylindrical CS/ß-CD/MIL-68(Al) foam was subsequently inserted into a syringe to develop a solid phase extraction (SPE) device. Without the requirement for an external force, the sample solution passed easily through the SPE column thanks to the porous structure of the CS/ß-CD/MIL-68(Al) foam column. Moreover, the CS/ß-CD/MIL-68(Al) foam column was thought to be a superior absorbent for SPE since it included the adsorptive benefits of CS, ß-CD, and MIL-68(Al). The SPE was utilized in conjunction with high-performance liquid chromatography to analyze six sulfonamides found in milk, urine, and water. With matrix effects ranging from 80.49 % to 104.9 % with RSD values of 0.4-14.0 %, the method showed high recoveries ranging from 80.6 to 107.4 % for water samples, 93.4-105.2 % for urine, and 87.4-100.9 % for milk. It also demonstrated good linearity in the range of 10-258 ng·mL-1 with the limits of detection ranging from 1.88 to 2.58 ng·mL-1. The cylindrical CS/ß-CD/MIL-68(Al) foam column prepared in this work offered several advantages, including its simple fabrication, excellent water stability, absence of pollutants, biodegradability, and reusability. It is particularly well-suited for SPE. Furthermore, the developed SPE method, employing CS/ß-CD/MIL-68(Al) foam column, is straightforward and precise, and its benefits, including affordability, ease of preparation, lack of specialized equipment, and solvent economy, underline its broad applicability for the pretreatment of aqueous samples.

The effect of UV365/Fenton process on the removal of gaseous ethylbenzene in a bubble column reactor.

As volatile organic compounds (VOCs), gaseous ethylbenzene has adverse effects on human health and ecology. Therefore, an effective degradation process is highly desirable. The Fenton process under UV 365 nm was selected as the first option to remove gaseous ethylbenzene in a bubble column reactor. The main parameters for the batch experiments were systematically studied, including H2O2 concentration, [H2O2]/[Fe2+], pH, UV wavelength, UV intensity, gaseous ethylbenzene concentration, gas flow rate, and process stability towards removal efficiency. The optimum conditions were found to be H2O2 concentration of 100 mmol·L-1, [H2O2]/[Fe2+] of 4, pH of 3.0, UV wavelength of 365 nm, UV power of 5 W, gas flow rate of 900 mL·min-1, and gaseous ethylbenzene concentration of 30 ppm, resulting in a removal efficiency of 76.3%. The study found that the Fenton process, when coupled with UV 365 nm, was highly effective in removing gaseous ethylbenzene. The degradation mechanism of gaseous ethylbenzene was proposed in the UV365/Fenton process based on EPR, radical quenching experiments, iron analysis, carbon balance, and GC-MS analysis. The results indicated that •OH played a crucial role in the process.

Preparation and study of a capillary electrochromatographic column prepared by conjugating ß-CD COFs and gold-poly glycidyl methacrylate nanoparticles.

A new enantioselective open-tubular capillary electrochromatography (OT-CEC) was developed employing ß-cyclodextrin covalent organic frameworks (ß-CD COFs) conjugated gold-poly glycidyl methacrylate nanoparticles (Au-PGMA NPs) as a stationary phase. The resulting coating layer on the inner wall of the fabricated capillary column was characterized by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), energy dispersive spectroscopy (EDS), and electroosmotic flow (EOF) experiments. The performance of the fabricated capillary column was evaluated by CEC using enantiomers of seven model analytes, including two proton pump inhibitors (PPIs, omeprazole and tenatoprazole), three amino acids (AAs, tyrosine, phenylalanine, and tryptophan), and two fluoroquinolones (FQs, gatifloxacin and sparfloxacin). The influences of coating time, buffer concentration, buffer pH, and applied voltage on enantioseparation were investigated to obtain satisfactory enantioselectivity. In the optimum conditions, the enantiomers of seven analytes were fully resolved within 10 min with high resolutions of 3.03 to 5.25. The inter- to intra-day and column-to-column repeatabilities of the fabricated capillary column were lower than 4.26% RSD. Furthermore, molecular docking studies were performed based on the chiral fabricated column and as ligand isomers of analytes using Auto Dock Tools. The binding energies and interactions acquired from docking results of analytes supported the experimental data.

Development and validation of extraction and clean-up procedures for UPLC-MS/MS analysis of aflatoxins in spices.

UPLC-MS/MS analytical conditions for the analysis of aflatoxins in spices were optimized and validated in this study. Liquid-liquid partition-based protocols for the cleaning up of extracts using common organic solvents such as acetonitrile, hexane, and ethyl acetate were developed and validated. The developed liquid-liquid partition methods were compared with immuno-affinity column and QuEChERS clean-up methods for the UPLC-MS/MS analysis of aflatoxins in 8 spices. The reduction of lipophilic components using the partition with hexane is particularly useful in spices like red pepper that have higher levels of fatty acids, carotenoids, sterols, triterpenoids, etc. The subsequent partitioning with ethyl acetate considerably reduced the matrix interference from the polar components and increased the sensitivity. The cleaning up of spice extracts using liquid-liquid partition techniques resulted in limits of quantification (LOQ) of 2-5 µgL-1 in UPLC-MS/MS analysis. Trueness, repeatability, and reproducibility of the methods were in acceptable ranges. The accuracy of the developed methods was further verified by analyzing aflatoxins in naturally incurred samples of spices and comparing the results with those obtained from the immuno-affinity column cleanup-HPLC-FD method.

Purification Process for a Secreted Protein Produced in Insect Cells.

The Baculovirus Expression Vector System (BEVS) is used with cultured insect cells to produce a wide variety of heterologous proteins, which can be secreted into the culture medium during the transient infection process (Smith et al. Mol Cell Biol 12:2156-2165, 1983). When the infection process is complete, centrifugation is often used to separate the desired protein from the spent insect cells. The desired product in the harvested supernatant is contaminated with baculovirus, amino acids, lipids, detergents, oils, lysed cells from the infection process, genomic DNA from the insect cells, and proteases due to the lytic nature of the baculovirus infection process and many other contaminants (Ikonomou et al. Appl Microbiol Biotechnol 62:1-20, 2003). All these contaminants that are present in the centrifuged supernatant with the desired secreted protein make the initial chromatographic capture step critical for effective purification of the desired protein. A purification scheme will be outlined for a slightly acidic secreted protein using cation exchange chromatography (Lundanes et al. Chromatography: basic principles, sample preparations and related methods, 1st edn. Wiley, 2013).

Posterior vertebral column resection: Exploring practical uses in clinical settings.

Background: The purpose of this study was to present our experience in patients who had been treated with posterior vertebral column resection (PVCR) for various spinal deformities. Methods: Thirty-seven patients who performed PVCR between 2015 and 2018 were evaluated retrospectively. The mean follow-up period was 24 months (range: 12-50 months). The demographic data of the patients, mean blood loss, amount of blood replacement, duration of operation, intensive care and hospitalization period, PVCR level, instrumentation level, amount of preoperative curvature, amount of postoperative curvature improvement, preoperative and postoperative neurological status, and complications were examined. Angular measurements were performed on X-ray. Results: The mean age of the patients was 37.5 years (range: 3-80 years). PVCR was applied to patients due to different pathologies (congenital, tumor metastasis, posttraumatic kyphosis, revision scoliosis, and infection). The mean operation time was 445.5 min (260-720) with an average blood loss of 1903 ml (400-7000 ml). It was observed that the average local kyphosis angle decreased from 67.65° to 7.42° in 26 patients who were operated for advanced deformity (P < 0.001). When these values were compared in all 34 patients, the preoperative angle value decreased from 55.1° to 3.5° (P < 0.001) and decreased from 70° to 0° in 13 congenital kyphosis patients. Conclusion: PVCR is an effective method for correcting severe spinal deformities and can be used to correct curvature in different patient groups. Level of Evidence: Level 3.

Continuous-flow separation and preconcentration of microplastics from natural waters using countercurrent chromatography.

Microplastics is known to be ubiquitous in aquatic environment. Quantification of microplastics in natural waters is an important problem of analytical chemistry, the solution of which is needed for the assessment of water quality and potential risks for water inhabitants and consumers. Separation methods play a key role in the correct quantification of microplastics in natural waters. In the present study the applicability of countercurrent chromatography to the continuous-flow separation and preconcentration of microplastics from water samples in rotating coiled column (RCC) using water-oil systems has been demonstrated for the first time. The effect of column rotation speed and mobile phase (water) flow rate on the retention of the stationary (oil) phase in RCC is studied. The retention parameters of 10 vegetable and 2 synthetic oils are determined. Castor, olive, rapeseed, soybean, linseed, sesame, and sunflower oils are found to be applicable to the separation of microplastics from water samples using RCC. Taking as example polyethylene microparticles of different size (40-63, 63-100, and 100-250 µm), the high recovery of microplastics (about 100 %) from aqueous phase into castor and rapeseed oils is shown. The method has been proven to be efficient for the separation of microplastics from simulated fresh and sea natural waters. It may be perspective not only for the quantification of microplastics in natural waters but as well as for the purification of wastewaters containing microplastics.

Understanding the column and batch adsorption mechanism of pesticide 2,4,5-T utilizing alginate-biomass hydrogel capsule: A computational and economic investigation.

Water pollution has remained a pressing concern in recent years, presenting multifaceted challenges in search of effective mitigation strategies. Our study, which targets mitigating pollution caused by 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), a significant aquatic pollutant, is innovative in its approach. We have identified adsorption as a promising, cost-effective method for its removal. Our research strategy involves dynamic adsorption utilizing a peristaltic pump and composite beads containing activated carbon and sodium alginate (CA/Alg), a novel combination that mimics industrial processes. To optimize column adsorption, we examine bead stability under varied pH conditions and optimize parameters such as concentration, adsorption time, and pH through batch adsorption experiments, employing experimental design techniques. Additionally, we optimize column adsorption factors, including bead height, circulation time, and flow rate, crucial for process efficiency, and under these optimum conditions (C2,4,5-T = 80 ppm. pH = 2, t = 27h30min, H = 30 cm and D = 0.5 mL/min) the capacity of adsorption equal to 748.25 mg/g. Characterization techniques like SEM, EDX, BET analysis, XRD, and FTIR provide insights into the morphology, composition, surface area (331 m2/g), pore volume (0.11 cm3/g), crystal structure, and functional groups of the CA-P/Alg adsorbent. Theoretical analysis elucidates the adsorption mechanism and interaction with pollutants. Economic analysis, encompassing CAPEX and OPEX estimation, evaluates the feasibility of implementing this cleanup method at an industrial scale, considering initial investment and ongoing operational costs, indicating potential savings of 64 % compared with the activated carbon normally used on the Moroccan market. This comprehensive and innovative approach addresses water pollution challenges effectively while ensuring economic viability for industry-scale implementation.

Optimization using central composite design for continuous absorption of CO2 gas with green sodium silicate in a packed bed column.

If absolutely nothing is taken to reduce carbon dioxide (CO2) emissions, atmospheric concentrations of carbon dioxide will rise to 550 parts per million by 2050, which will have disastrous effects on the world's climate and food production. An apparatus has been designed and setup to convert CO2 into a useful and vital product which was silica. The effect of different experimental factors on the compositions by weight percent of SiO2 and Na2CO3 were studied including the CO2 gas flow rate (1.037, 1.648 and 2.26 L/min), initial concentration of sodium silicate (Na2SiO3) solution (5, 7.5 and 10 %wt) and the packing size (15.95, 20.175, and 24.4 mm). An optimization process was performed using the Design Expert software program to achieve the optimum experimental conditions at which the maximum weight percent of SiO2 (main product), the minimum weight percent of (Na2CO3) (side product) and the minimum reaction time were determined. From the optimization process, the maximum weight percent of SiO2 (25.63 %), the minimum weight percent of (Na2CO3) (9.62 %) and the minimum reaction time (7.59 min) were achieved at the following optimum experimental conditions of CO2 gas flow rate = 1.648 L/min, packing size = 24.4 mm and initial concentration of sodium silicate solution = 10 %wt.

Environmental profiling of gold nanoparticles by flavonoids fractionalization from carrica papaya leaf extract for photocatalytic debasement of organic contaminants and it's cyto-toxic analysis.

In present investigation, Carica papaya leaf extract has been employed as a bio-reductant agent in order to synthesize ecologically sustainable bio-coupled gold nanoparticles. The formation of gold nanoparticles was confirmed based on colour change of solution and its surface plasmon resonance peak measured using UV-Vis Spectrophotometer (UV-Vis). The Morphology and size of nanoparticles were determined using transmission electron microscope (SEM/TEM), and its crystalline structure by X-ray diffraction studies. Surface area was determined via BET isotherm analysis. The elemental composition of Au nanoparticles was developed using the technique of energy dispersive spectroscopy (EDS). Furthermore, FTIR analysis delineated the presence of functional groups present in the samples of the synthesized AuNPs. Thus, the efficiency of bio coupled Au nanoparticles in photo catalytically decomposing methylene blue was examined under the influence of visible light., the lethal MB colorant had been reduced to 95 % Within 90 min. And also 60% TOC removal was recorded after 5 min of degradation reaction, which increased to 99% after 90 min. Furthermore, cytotoxic experiments on Michigan Cancer Foundations-7 (MCF-7) cell lines showed that Au nanoparticles are effective anticancer agents with an IC50 of 87.2 g/mL on the top of the present work revealed the eco-safety and affordable production of Au nanoparticles from Carica papaya leaf extract, which displayed photocatalytic debasement of organic pollutants and cyto-toxicity effects was investigated.

Development and optimization of high-performance extraction chromatography method for separation of rare earth elements.

The effectiveness of commonly used extractants for chromatographic separation of rare earth elements (REEs) was compared. Columns loaded with similar molar concentrations of tributyl phosphate (TBP), di-(2-ethylhexyl) phosphoric acid (HDEHP), and N-Methyl-N, N, N-tri-octyl-ammonium chloride (Aliquat-336), with mineral acid as eluent were evaluated. Retention factors were determined, and separation efficiency was assessed based on the resolution data of the REEs acquired under the same elution conditions for each column. HDEHP demonstrated the best separation efficiency for the entire REE series (mean Rs = 2.76), followed by TBP (mean Rs = 1.52), while Aliquat-336 exhibited the lowest performance (mean Rs = 1.42). The HDEHP-coated column was then used to optimize the extraction chromatographic separation of the REEs. The primary challenge was to completely elute the heavy REEs (Tb - Lu) while maintaining adequate separation of the light REEs (La - Gd) within a reasonably short time. The stepwise gradient elution procedure improved the resolution between adjacent REEs, allowing the complete separation of the entire REE series within 25 minutes. Better separation efficiency for light REEs was achieved at higher column temperatures and a mobile phase flow rate of 1.5 mL/min in the tested domain of 20-60 °C, and 0.5-2.0 mL/min, respectively, resulting in plate heights (H) ranging from 0.011 to 0.027 mm.

Continuous removal of thorium from aqueous solution using functionalized graphene oxide: study of adsorption kinetics in batch system and fixed bed column.

This article investigated the kinetic studies of thorium adsorption from an aqueous solution with graphene oxide functionalized with aminomethyl phosphonic acid (AMPA) as an adsorbent. First, the AMPA-GO adsorbent was characterized using TEM, XRD, and FTIR methods. Experiments were performed in two batch and continuous modes. In batch mode, adsorption kinetics were studied in different pH (1-4), temperature (298-328 K), initial concentration (50-500 mg L-1), and dosages (0.1-2 g L-1). The results showed that thorium adsorption kinetic follows pseudo-first-order kinetic model and that the adsorption reaction is endothermic. The maximum experimental adsorption capacity of thorium ions was observed 138.84 mg g-1 at a pH of 3, adsorbent dosage of 0.5 g L-1, and a temperature of 328 K. The results showed that AMPA-GO adsorbent can be used seven times with an acceptable change in adsorption capacity. In continuous conditions, the effect of feed flow rate (2-8 mL min-1), initial concentration (50-500 mg L-1), and column bed height (2-8 cm) was investigated. The continuous data was analyzed using the Thomas, Yoon-Nelson, and Bohart-Adams models. The experimental data of the column were well matched with the Thomas, and Yoon-Nelson models. The research results showed that the use of functionalized graphene oxide adsorbents has a great ability to remove thorium from aqueous solutions.

Effect of forced aeration on the biogeochemical cycle of nutrients and metal(loid)s as a remedy for hypoxia in a permanently stratified estuary (Gulf of Trieste, northern Adriatic Sea).

The Timavo River estuary (northern Adriatic Sea) is characterised by strong thermohaline stratification that keeps the deep waters hypoxic. The consequence is an harmful algal bloom at the surface in summer that can be mitigated with a forced aeration system installed at the bottom to improve water oxygenation. The nutrient and metal(loid) cycle was investigated, before and during reoxygenation, using an in situ benthic chamber coupled with sampling and analyses of the water column, sediments and porewater. Dissolved oxygen (DO) decreased along the water column and quickly within the benthic chamber when aeration was not in operation, resulting in hypoxia (2.29 mg L-1) at the bottom and consequent increase in nutrient and metal(loid) concentrations. In contrast, DO levels increased during the activation of the forced aeration system, which proved effective in mitigating oxygen depletion and the efflux of metal(loid)s and nutrients into the overlying water.

Posterior-Only T11 Vertebral Column Resection for Pediatric Congenital Kyphosis Surgical Correction.

Background: Congenital kyphosis is a spinal deformity that arises from the inadequate anterior development or segmentation of the vertebrae in the sagittal plane during the initial embryonic stage. Consequently, this condition triggers atypical spinal growth, leading to the manifestation of deformity. Concurrently, other congenital abnormalities like renal or cardiac defects within the gastrointestinal tract may co-occur with spinal deformities due to their shared formation timeline. In light of the specific characteristics of the deformity, the age range of the patient, deformity sizes, and neurological conditions, surgical intervention emerges as the optimal course of action for such cases. The selection of the appropriate surgical approach is contingent upon the specific characteristics of the anomaly. Case Presentation: This investigation illustrates the utilization of a surgical posterior-only strategy for correcting pediatric congenital kyphoscoliosis through the implementation of a vertebral column resection method along with spine reconstruction employing a mesh cage. The individual in question, a 16-year-old female, exhibited symptoms such as a progressive rib hump, shoulder asymmetry, and back discomfort. Non-invasive interventions like bracing proved ineffective, leading to the progression of the spinal curvature. After the surgical procedure, diagnostic imaging displayed a marked enhancement across all three spatial dimensions. After a postoperative physical assessment, it was noted that the patient experienced significant enhancements in shoulder alignment and rib hump prominence, with no discernible neurological or other adverse effects. Conclusions: Surgical intervention is considered the optimal approach for addressing such congenital anomalies. Typically, timely surgical intervention leads to favorable results and has the potential to halt the advancement of deformity and curvature enlargement.

Accuracy and safety of freehand vs. end-on fluoroscopic guided drill-hole placement in canine cadaveric thoracic, lumbar and sacral vertebrae.

Objective: To develop and evaluate the safety and accuracy of an open, end-on fluoroscopic guided (EOFG) drill hole position technique in canine cadaveric spinal surgery, in comparison to a traditional free-hand (FH) drilling technique. Study design: Cadaveric comparison study. Animals: Canine cadaveric vertebral columns (n = 4). Methods: Computed tomography (CT) scans were performed for in-silico planning. Ideal implant purchase depth and angulations were determined from previously published data. Plans for end-on fluoroscopic guided drill holes included angled reconstructions in thick slab mode to mimic fluoroscopic images. Following surgical preparation of T8 to S2, holes were drilled by one of two experienced surgeons randomized evenly by operated side, surgeon, and technique. C-arm fluoroscopy was utilized for the end-on technique. CT was repeated after the procedures. Safety was determined categorically using a modified Zdichavsky classification and "optimal" placement was compared between techniques. Continuous data for drill-hole accuracy was calculated as angle and depth deviations from the planned trajectories. Data sets were analyzed at both univariable and multivariable levels with logistic regression analysis. Results: Drill hole safety was categorized as optimal (modified Zdichavsky classification 1) in 51/60 (85%) of drill holes using EOFG and 33/60 (55%) using FH (P < 0.001) techniques. There were no "unsafe" holes (modified Zdichavsky classification 3a). Optimal drill hole placement was significantly associated with the EOFG technique and use of the largest cadaver, and was significantly less likely within the thoracic region. Mean angle and depth deviations were significantly lower with the EOFG technique. Angle deviations were significantly lower for EOFG in the lumbar region, whereas bone purchase deviations were significantly lower for EOFG in both the thoracic and lumbar regions. The mean time taken to drill the hole was significantly longer for the EOFG technique. Conclusion: Optimal drill hole placement was significantly more likely with the EOFG technique and improved the accuracy of bone purchase in the thoracic region. Clinical significance: The EOFG technique shows promise for translation into a clinically setting, potentially improving implant purchase and therefore stabilizing construct strength, whilst potentially reducing the likelihood of neurovascular injury and need for surgical revision.