Minimum Two-Year Follow-Up of Cases with Recurrent Disc Herniation Treated with Microdiscectomy and Posterior Dynamic Transpedicular Stabilisation

The objective of this article is to evaluate two-year clinical and radiological follow-up results for patients who were treated with microdiscectomy and posterior dynamic transpedicular stabilisation (PDTS) due to recurrent disc herniation. This article is a prospective clinical study. We conducted microdiscectomy and PDTS (using a cosmic dynamic screw-rod system) in 40 cases (23 males, 17 females) with a diagnosis of recurrent disc herniation. Mean age of included patients was 48.92 ± 12.18 years (range: 21-73 years). Patients were clinically and radiologically evaluated for follow-up for at least two years. Patients’ postoperative clinical results and radiological outcomes were evaluated during the 3rd, 12th, and 24th months after surgery. Forty patients who underwent microdiscectomy and PDTS were followed for a mean of 41 months (range: 24-63 months). Both the Oswestry and VAS scores showed significant improvements two years postoperatively in comparison to preoperative scores (p<0.01). There were no significant differences between any of the three measured radiological parameters (α, LL, IVS) after two years of follow-up (p > 0.05). New recurrent disc herniations were not observed during follow-up in any of the patients. We observed complications in two patients. Performing microdiscectomy and PDTS after recurrent disc herniation can decrease the risk of postoperative segmental instability. This approach reduces the frequency of failed back syndrome with low back pain and sciatica

A survey on static and quasi-static finite element models of the human cervical spine

Finite element analyses are an important source of information on the biomechanical behaviour of the cervical spine; as well as an important tool in the design and evaluation of spinal instrumentation. This article presents a comprehensive survey of the finite element models of the cervical spine that have been used to study its pathological/nonpathological biomechanics under static/quasi-static loading conditions. Publications that met the inclusion criteria were analysed to extract parameters relative to model identification (e.g., spine segment, population, utility, limitations), model structure (e.g., loading/boundary conditions, anatomical structures, constitutive representation), simulation structure (e.g., software), verification (e.g., convergence) and validation (e.g., validated procedure/output, assumptions). Besides summarizing different modelling approaches with their associated parameters, this article outlines generalities and issues related to the obtainment of such models. The survey shows that authors often fail to report parameters that are critical for the reproducibility of results and that, even with fully reported parameters, these models are inherently difficult to replicate because they generally are patient-specific with their geometry based on data from in-house specimens/subjects. Overall, while the survey contributes to an understanding of the implications of following different modelling approaches and allows to take advantage of previously developed models, further research is required to improve the accuracy and utility of these models. © 2017, Springer-Verlag France SAS, part of Springer Nature

Plasma membrane aminoglycerolipid flippase function is required for signaling competence in the yeast mating pheromone response pathway

The class 4 P-type ATPases (“flippases”) maintain membrane asymmetry by translocating phosphatidylethanolamine and phosphatidylserine from the outer leaflet to the cytosolic leaflet of the plasma membrane. In Saccharomyces cerevisiae, five related gene products (Dnf1, Dnf2, Dnf3, Drs2, and Neo1) are implicated in flipping of phosphatidylethanolamine, phosphatidylserine, and phosphatidylcholine. In MATa cells responding to α-factor, we found that Dnf1, Dnf2, and Dnf3, as well as the flippase-activating protein kinase Fpk1, localize at the projection (“shmoo”) tip where polarized growth is occurring and where Ste5 (the central scaffold protein of the pheromone-initiated MAPK cascade) is recruited. Although viable, a MATa dnf1∆ dnf2∆ dnf3∆ triple mutant exhibited a marked decrease in its ability to respond to α-factor, which we could attribute to pronounced reduction in Ste5 stability resulting from an elevated rate of its Cln2⋅Cdc28-initiated degradation. Similarly, a MATa dnf1∆ dnf3∆ drs2∆ triple mutant also displayed marked reduction in its ability to respond to α-factor, which we could attribute to inefficient recruitment of Ste5 to the plasma membrane due to severe mislocalization of the cellular phosphatidylinositol 4-phosphate and phosphatidylinositol 4,5-bisphosphate pools. Thus proper remodeling of plasma membrane aminoglycerolipids and phosphoinositides is necessary for efficient recruitment, stability, and function of the pheromone signaling apparatus