76 research outputs found
Economic comparison of tillage and planting operations in three tillage systems
To study the economy of tillage operations and present suitable systems for land preparation and planting, costs of execution of three different tillage operations in irrigated wheat crop were compared for three successive years. The three systems include: conventional or maximum tillage (Max-till), reduced tillage (Red-till) using multitask machine, and using direct planting machinery to represent the no-tillage case (No-till). Costs were composed of rental cost of tractor, the used implements, multitask machine and direct planting machine. For each case, data were compared and analyzed in randomized block design. The variance of wheat yield in the three tillage systems was significant at the 1% level. Total costs per hectare were 109 and 78 and 46 Dollars for Max-till, Red-till and the No-till case, respectively. Since, the test area under cultivation was part of a 200 hectare farm, crop protection and harvesting operations were carried out alike in the whole farm. Accordingly, operations costs were estimated as 445 Dollars ha-1 tare. Average yields of 7.85, 7.68, 5.2 t ha-1 were obtained, respectively, for Max-till, Red-till and No-till systems. Since, the price per kg of wheat was equal to 0.36 Dollars ha-1, the profits of the harvest was equal to 2,271 Dollars ha-1 for the Max-till, 2,242 Dollars ha-1 for Red-till and 1,384 Dollars ha-1 for the No-till system. In tillage and planting operations, usage of the reduce tillage system is offered as an alternative to the conventional tillage and no-till systems. The Red-till system reduces fuel consumption, operation time, soil compaction due to decrease in the number of tractor trips, which leads to reduced production costs. In addition, less investment in purchasing implements and preparation of the soil, which breaks the soil cohesion, are achieved with the reduced tillage system. Keywords: costs of production, field performance, Max-till, Multitask machine, no-till, red-till, soil compaction
Special article: Update on the magnetically controlled growing rod: tips and pitfalls
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Nutritional improvement following growing rod surgery in children with early onset scoliosis
Purpose We aimed to evaluate the nutritional status of children with early onset scoliosis (EOS) and to determine if treatment with growing rod instrumentation improves weight percentile. Methods: Data was retrospectively collected on 88 EOS patients treated with growing rods at six institutions. Mean age at surgery was 5.8 years, and mean Cobb angle was 75°. All patients were followed for at least 2 years (mean 4 years). Weights were converted to normative percentiles based on the patients’ age and gender. Results: Preoperatively, 47 % (41/88) of patients were 0.05). Children with neuromuscular and syndromic diagnoses do not appear to improve their mean nutritional status after surgery when compared to patients with idiopathic or congenital/structural scoliosis (p = 0.006). Conclusion: Following growing rod treatment, there was significant improvement in nutritional status in approximately 50 % of patients, similar to that reported with VEPTR. Neuromuscular and syndromic patients did not experience nutritional improvement post-operatively. These findings support the theory that growing rods improve the clinical status of EOS patients, as nutritional improvement is one outcome of improved clinical status. The relationship between age at initial surgery and nutritional improvement is intriguing
Painful rib hump: a new clinical sign for detecting intraspinal rib displacement in scoliosis due to neurofibromatosis
BACKGROUND: Spinal cord compression and associate neurological impairment is rare in patients with scoliosis and neurofibromatosis. Common reasons are vertebral subluxation, dislocation, angulation and tumorous lesions around the spinal canal. Only twelve cases of intraspinal rib dislocation have been reported in the literature. The aim of this report is to present a case of rib penetration through neural foramen at the apex of a scoliotic curve in neurofibromatosis and to introduce a new clinical sign for its detection. METHODS: A 13-year-old girl was evaluated for progressive left thoracic kyphoscoliotic curve due to a type I neurofibromatosis. Clinical examination revealed multiple large thoracic and abdominal "cafe-au-lait" spots, neurological impairment of the lower limbs and the presence of a thoracic gibbous that was painful to pressure at the level of the left eighth rib (Painful Rib Hump). CT-scan showed detachment and translocation of the cephalic end of the left eighth rib into the adjacent enlarged neural foramen. The M.R.I. examination of the spine showed neither cord abnormality nor neurogenic tumor. RESULTS: The patient underwent resection of the intraspinal mobile eighth rib head and posterior spinal instrumentation and was neurologically fully recovered six months postoperatively. CONCLUSION: Spine surgeons should be aware of intraspinal rib displacement in scoliotic curves in neurofibromatosis. Painful rib hump is a valuable diagnostic tool for this rare clinical entity
Extension of previous fusions to the Sacro-Pelvis vs. Primary spino-pelvic fusions in the setting of adult deformity: A Comparison of health related quality of life measures and complications [abstract]
Comparative Medicine - OneHealth and Comparative Medicine Poster SessionSummary: Clinical and radiographic evaluation of revision extension of previous long thoracolumbar fusion to the sacro-pelvis compared to primary lumbosacral fusion indicates that although the two patient populations are heterogeneous, clinical outcomes and complication rates of salvage procedures where a prior spinal fusion procedure is extended to the sacropelvis compare favorably to primary sacro-pelvic fusion for adult spinal deformity. Introduction: Patients previously treated with thoracolumbar fusion for spinal deformity may develop degenerative changes below the fusion requiring revision fusion to the sacro-pelvis. Little data exists on the characteristics of patients treated with revision extension to sacro-pelvis compared to primary lumbosacral fusion. We evaluated the differences between patients undergoing revision extension of fusion vs. primary fusion to the sacro-pelvis, minimum 2-year follow-up. Methods: The revision group (REVISION) included multicenter retrospective evaluation of 44 of 54 consecutive patients (1995-2006) that had a previous long fusion ending from L3-5, revised by extension fusion to the sacro-pelvis for symptomatic degeneration. The primary group (PRIMARY) included 20 of 20 consecutive patients prospectively enrolled (2000-2006) at a single center database that received primary long arthrodesis to the sacro-pelvis for adult deformity. Clinical and radiographic evaluation included demographics, coronal and sagittal measures, postoperative SRS-22 scores, and perioperative complications. Results: Mean patient age was 52 years (range 21-81 years). Mean follow up was 43 months (range 23-135 months). PRIMARY had greater median age (59 vs. 49 years; p<0.01) and longer follow up (44 vs. 31 months, p<0.05) than REVISION. PRIMARY had larger preoperative thoracolumbar curve (median TL; 48° vs. 36°; p<0.01) and less sagittal imbalance (median SVA; 0.0. vs. 5.0 cm; p<0.05) than REVISION. Postoperative SVA was similar for PRIMARY and REVISION (median 0.9 vs. 2.6 cm, respectively; p=0.25). REVISION had better postoperative SRS-22 scores (median 3.80 vs. 3.12, p<0.01) and fewer patients with minimum one complication [11 (25%) vs. 11 (55%), p<0.05] than PRIMARY (Table 1)
Conclusion: Significant differences were demonstrated between patients undergoing primary vs. revision extension to the sacro-pelvis. PRIMARY were older, and had larger TL curves, whereas REVISION had greater sagittal imbalance. While PRIMARY had more complications, multiple factors could account for this other than surgery type, including differences in age or number of levels fused. The retrospective nature of the study may have also underrepresented minor complications. Although the groups were heterogeneous, radiographic, SRS-22 and complications analysis indicate clinical outcomes of salvage procedures where a prior spinal fusion procedure is extended to the sacropelvis compare favorably to primary sacro-pelvic fusion for adult spinal deformity
Bony sclerosis and the battered child
A case of child battering in a four monthold infant is presented. In additional to typical physical and radiographic findings isolated sclerosis of the left tibia is described. Diffuse bony sclerosis in battered children has been proposed as evidence for an underlying metaphyseal fragility. Similar sclerosis in an isolated bone in our case suggests that the diffuse bony sclerosis seen in some of these battered children may reflect a more widespread posttraumatic change and not a basic metabolic defect. A radionuclide bone scan was also normal in this patient.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46800/1/256_2004_Article_BF00364627.pd
Clinical utility of ultrasound to prospectively monitor distraction of magnetically controlled growing rods
Reliability and validity of the persian version of the scoliosis research society-22r questionnaire
STUDY DESIGN.: Cross-sectional validation study to investigate psychometric properties of adapted Persian version of the Scoliosis Research Society-22r (SRS-22r) questionnaire. OBJECTIVES.: To translate the SRS-22r into Persian and to evaluate the internal consistency, reliability, and validity of the Persian SRS-22r. SUMMARY OF BACKGROUND DATA.: The SRS-22r has not been translated and validated for Persian-speaking patients with idiopathic scoliosis. This was to provide a validated instrument to measure health-related quality of life in patients with idiopathic scoliosis in Iran. METHODS.: The translation and cultural adaptation of the original questionnaire were carried out in accordance with the published guidelines. About 84 patients with adolescent idiopathic scoliosis were participated in the study. The Short Form Health Survey (SF-36) was used to test convergent validity of the Persian SRS-22r. RESULTS.: Moderate to high correlations were found between the SRS-22r domains and SF-36 subscales. The correlations ranged from 0.54 to 0.67 (function/activity domain), 0.48 to 0.74 (pain domain), 0.45 to 0.55 (self image domain), 0.66 to 0.85 (mental health domain), and 0.35 to 0.55 (satisfaction domain) (P < 0.01). One-way analysis of variance showed that the Persian questionnaire successfully discriminated between patients undergoing observation, brace, and surgical treatments (P < 0.05). Cronbach alpha coefficient for the Persian SRS-22r domains ranged from 0.68 to 0.78. The Persian SRS-22rdomains showed satisfactory test-retest reliability with Intraclass Correlation Coefficient ranged from 0.79 to 0.87 (P < 0.01). CONCLUSION.: The Persian version of the SRS-22r has satisfactory reliability, convergent validity, and discriminant validity to measure health-related quality of life in adolescent patients with scoliosis in Iran. It is simple and easy to use and now can be applied in clinical settings and future outcome studies in Iran. © 2010, Lippincott Williams & Wilkins
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History of Isola-VSP fatigue testing results with correlation to clinical implant failures
The objective was to compare the history of Isola-VSP in vitro fatigue testing results with clinical implant failures from a five-center retrospective survey of 2499 cases to determine if the appropriate types of tests had been performed. To determine the effect of bending iron marks, bends, and connectors on 1/4' rod fatigue, 4-point bend fatigue tests were conducted. To characterize bone anchor-connector-rod assemblies, unilateral construct flexion fatigue tests were conducted. Clinically 111 components failed: 41 screws, 57 rods, nine transverse connectors, two interbody graft/cages, one extended slotted connector, and one at unreported location. The screw, rod, and connector clinical data correlate to the lower to higher relative fatigue strength respectively of original integral nut screws; rods at bending iron marks, connectors and lordotic bends; original slotted connector, current slotted connector, and straight rods with unblemished surface. In vitro and clinical failure locations also correlated. The transverse connector cross member failed near the longitudinal rod in 8/9 instances. This implies a lateral bending profile similar to that produced by the H construct used to test them in reversed lateral bending. Recommendations relative to ASTM standards/guides include: incorporation of an H construct to test transverse connectors in lateral bending, replacement of fixed-fixed end with fixed-free end assembly in F 1798-97, and replacement of constrained
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